Brett: Okay. I think it’s first really important to understand about going back to naturopathic philosophy, and really trusting that implicitly that it actually works. And that’s very much around what the clinic does, is that we know implicitly that homeostasis and the body’s capacity to self-regulate is an absolute. So, really, what we want to do is we want to identify roadblocks, and why someone can’t self-regulate. And instead of a diagnosis, we actually look at, well, let’s see if we can use some tools to identify roadblocks, remove the roadblocks that we can see. And then the body will self-regulate independently.

And that’s really how we understand, say, the immune system. We know a lot more about the immune system now, and we can say, “Well, really, instead of looking at the immune system, maybe we need to look at the gut.” Maybe that capacity to achieve that plasticity in the immune system really is determinant of gut function. So, let’s…you know, if we can identify that, you know, there’s some issues around gut function, let’s clean that up. Because we know 70% of our immune regulation has got to come from digestive function, the microbiome. So, we clean that up, and then we re-measure again.

So, then we make sure that we’re always gaining that traction or momentum as far as the immune function is concerned. So, we’re not necessarily looking at the diagnosis or the symptom, but we’re looking at the drivers. And that’s the most important process that we need to do, is just to identify roadblocks, remove any roadblocks. Whatever tools you have, simple as they might be, identify the roadblock, re-measure, and make sure that roadblock is then, I guess, depleted, and the body is in that position to self-regulate. So, that’s how we look at it.

Andrew: Of course, when we’re talking about roadblocks, that’s the detective work of any health practitioner. And they’re not always obvious. For instance, if you see recurrent ear infections in a child. There’s, you know, the usual suspects. You know, we look at dairy, we look at wheat. And we see what effect the avoidance of those foods that can have, possibly with some natural therapies, but certainly, at least at some stage, on their own, and just see, can we re-challenge? How does that person handle maybe a little bit of these foods in their diet?

But when you’re talking about retesting, it’s something that I really like. You’ve obviously got to be a little bit judicious of this, though. Correct?

Brett: Yes, very much so. Yeah. I think we’ve got to be much more, I guess, skilled in our detective capacity. I think that’s where naturopaths are really excelling because, one thing, we have more time with our clients generally to do more investigation, to do more of that detective work. And then it’s just having the skills to use different methodologies to work out how we can test it and how we can retest it. And there are lots of different ways you can do that.

When setting this clinic up 15 years ago, you know, we had a limited amount of tools. We still use those tools today, though. There’s still an important part of this clinic. So, I guess, for naturopaths in general, it’s good to have low-cost, tools that you’ve got within the clinic that you can implement or use readily that the client can see, because I think that’s really important that the client is involved in that process, and they can identify change over time. And, really, have a look at the multitude of testing that we can use. It might not necessarily be mainstream techniques, but certainly, things like general tools in the clinic are really important. As long as you can create a baseline and create…then your treatment creates traction or momentum. It should create that change.

Andrew: Right. Okay. So, let’s go into a few conditions where, I guess, intensity would be an obvious variant. So, if we looked at common immune insults, coughs and colds, the general problems of winter, if I say. Let’s go into some simple stuff and when would you intensify that therapy. Can we start with just coughs and colds?

Brett: Yeah. I guess, first of all, you use those tools that you have to have the capacity to look at what the immune system’s doing. I guess that’s the baseline. So, you’re not necessarily looking for a diagnosis as a naturopath, but you’re looking to create a baseline, of what this person looks like at presentation, so then you have the capacity to measure over time whether the therapy is effective.

So, you could use simple tools. I use bloodwork. We want to take a simple start, and then we look at, well, what kind of complexities are generally in this person? They might come in with a common cold, but when you start that investigation process, underneath the surface, you may see a whole heap of complexity to that. So, then you’re identifying multiple roadblocks.

Other people can come in and there’s nothing underneath the surface. There’s nothing that’s part of that jigsaw puzzle that we really need to investigate more other than the fact that they…it’s winter, it’s cold season, you know, they might have kids at daycare. That’s the classic one at the moment. And they’re going to get re-infected over time.

So, really, what you’re actually just introducing is a support process, allowing the immune system to self-regulate. You know, simple herbals are always the first point of call. If you identify anything more complex, then you start to educate, I guess, the client about the complexity of their systems. And you generally advise them about taking a little bit more care or a little bit more of a dive deeper into their overall immune system.

But generally, if it’s that really surface stuff, it’s pretty easy. Everyone knows those simple herbals, those go-to’s, that acute treatment, getting them back in again. Recheck them, you know. That’s a really good way to develop a relationship with your clients is to get them in, and allow them to see the changes. They can then point it out. They become then the masters of their own health. And that’s really what we’re trying to do, is educate our clients to a point where they have a much better capacity to regulate their own health. And we become a resource or part of that measurement team that they use that process.

Andrew: It’s really interesting what you said about daycare. Just before I move on to the question that I really want to ask about, do you find that you always take some sort of baseline? Like, you were talking about bloodwork previously. Do you always do bloodwork, or do you just sort of…do you wait until there’s a recurrence and you’re going, “There’s possibly something going on here.”

Brett: Yeah. It’s really interesting over the years and particularly when, you know, we’re looking at this point in time when you’ve got things like telehealth being utilised much more, is my testing skills, if I’m not using it, it feels like I’m kind of driving at night without the headlights on, you know. I really find that my testing kit is really…takes the guesswork out of it.

For every single client that I see, what I do is they tell me their story, how they see it and understand it. What the testing does is it allows me to see the relevance of their story and what else we can join up to that story that might be part of what they’re investigating. So, they may know part of the story, but we can see something much deeper, which is always really important. Or we can see those things that they don’t understand themselves. So, these little bits and pieces are really important.

So, for me, after using baseline equipment for so long, it’s my go-to. It makes me feel much more secure. Really, nowadays, it’s about how quick I can get results as well. I’m results-driven. And, really, guesswork takes a lot longer to navigate if I’ve got simple tools. And going back to understanding homeostasis, you know, identifying roadblocks, you don’t necessarily identify the disease, but you may start to just be able to remove some of those roadblocks. So, the body starts to self-regulate. Then you’re measuring the capacity that the body has to self-regulate. That’s where they’re so important. If I don’t have those baselines, I really can’t get a good measurement and effectiveness.

Andrew: And so, to my main question, and that was, for instance, when you’ve got a mother with kids at daycare, you mentioned, and you see the mother with recurrent colds, snotty noses, I mean, heaven forbid, diarrhoea or gut issues. But if you see the mother as the patient and you’re talking about roadblocks, do you ever tweak and go, “Hang on. You’ve got a kid in child care. Bring the child in, and look at their nutritional status, and you might find out, for instance, that they’ve got pica. They’re eating soil and sand and things where that might give you a hint of a nutritional deficiency.” There’s the problem that you’re getting recurrent colds. The mother is the presenter. Do you find that? Do you have to get really into that detective work about…you know, be a super sleuth?

Brett: Yeah. I guess that really is the fun part about what naturopaths do, I think. That’s what I really love is that investigative work. You know, naturopaths really are managers of people’s conditions rather than the holder of the information now, you know. So, the capacity to be that sleuth is really a skill that, I think, is in demand in the community. And that’s where naturopaths can really serve a really specific role. You know, we have specific set of skills, we have a specific amount of time to do this. And it really is about managing people’s health. It’s about coaching them through. It’s not so much about holding information.

So, of course, you’re talking to the kids, you’re investigating what they’re up to. You know, it’s every parent’s nightmare when their child goes to daycare for the first time because you just see it over and over again. So, it’s fairly standard that, yeah, if you get a parent coming in with recurrent colds. I’ve got someone coming in today. And he’s under this pressure at work, but he’s had time off over the last month. He’s got a three-year-old and a one-year-old, and it’s just classic. And so, yeah. You’re looking at…yeah. You’re looking at the kids as well and him. He’s run down. You know, it’s a very standard story.

But when you start including the family, then you start, I guess, this social engagement. You’re not only treating or involved in individuals but you’re involved with whole families. And I guess, that’s the next stage as far as the work that we do is that we work within that community structure as well. You know, you’re educating people around. It’s not just your health, it’s your family’s health, which is part of that holistic process and the services that naturopaths can provide really effectively.

Andrew: I love what you do. I love how you think not just about patient treatment, but you think community. I’m just so enthused with what you guys do. Let’s move on. So, more serious concerns. So, when you’re dealing with chronic fatigue, for instance, a multitude of aetiologies, I guess the big hurdle that every practitioner faces, it’s such a frustrating condition, and the biggest thing is trying to get them back to previous. Can you get people back to previous, particularly when in my experience, the people that I’ve tried to help with chronic fatigue refuse to learn the meaning of pace?

Brett: Yeah.

Andrew: They will not pace themselves.

Brett: Yeah. That’s a big one, huh? Yeah. Yeah. Chronic fatigue, I kind of…when I think about it, it’s almost like a state of bankruptcy, is the way I always look at it. When I talk to clients, it’s all about how much money you’ve got in the account. And something like, just because you got $10 in your bank account, doesn’t mean you spend 15, you know. And that’s, I guess, what you’re talking about. It’s always that problem as far as how do you build that reservoir first before you can launch someone.

And I guess that’s what we look at with chronic disease you’ve really got to build that foundation first. If you don’t build the foundation work, you try and launch anyone, then they’re just burning up, you know, fuel without any real capacity to get results. And I think, you know… We tend to charge after the disease. And I think, when we built this clinic, you know, we were getting people ready to go overseas to large clinics in Germany or America or South America. We’d be getting people ready. And there’d be this variation of results when they came back.

And so, we started to look at, well, why the variation, you know? They’re having the same treatment. There’s a similar condition. Why are people coming back with variations as far as results? And what we realised is, that individuals are going with their own set of resources. And what happens if their resource-poor and they go for these really complex treatments, they tend not to get as good a result.

And again, it goes back to homeostasis. There are too many roadblocks for their body to be able to self-regulate. To be really to be able to benefit from that therapy, you need the body free to, I guess…and plasticity, I think, is really important. And adaptation. They need the capacity to adapt. But if they’re poorly resourced, then you’re going to run into trouble. So, I guess, with something like chronic fatigue, we look at how well-resourced they are.

You know, we get complex diseases, but we get people in here that are really healthy. So, that means that we can then push and create this push and recovery process much more effectively. And we can pace them with a lot more confidence. If we had someone that comes in who’s really poorly resourced, nutritionally deficient, then really, we shouldn’t really go after the disease until we see that platform develop first. And again, that’s where our baseline tests are effective, that we identify the deficiencies, we build them up, we re-measure, make sure that when they become well-resourced, then we launch them. And then you start to see the results.

So, I guess, you know, with some chronic fatigue, I guess, you’ve got the metabolic side and you got the immune side, two different aspects. Really, you have to get those two well-resourced. They could… And classically, they come in with everything else. They come in with nutritional deficiencies, poor gut function, you know, chronic sinusitis. You know, you’re seeing all these other conditions. You start chasing chronic fatigue. And, really, they don’t…they’re not resourced well enough. So, build those resources first, identify what those deficiencies are, build it, get them robust, get them some money in their bank account first, and then you can launch. And then you start…you tend to get much more effective and beneficial results.

Andrew: I think you said a very telling thing there about money and their bank account. There’s a twofold thing. One is the analogy that you talk about with health, money in their bank account the other thing. And I’ve seen this is people going overseas, spending scores of thousands of dollars, where you could get more than that, better treatment than that in Australia for a fraction of the cost. It is insane to me how these people go overseas. I don’t know why.

Forgive me. I saw this in a heartbreaking issue with a woman with cancer, you know, who, despite my protestation to refuse chemo, and she went overseas where indeed the diagnosis that they gave her had a different connotation in Australia. They said remission over there, which in Australia, the equivalent is stasis, not remission. So, of course, she stopped all therapy. It was a drastic, horrible outcome.

But the whole thing about bank accounts with regards to getting enough reserves for people to be able to embark on that slow incline, that crawl back to their previous health before the insult, what’s your timeline? How hard do you have to go with things like far-infrared saunas, with other testing and therapeutic machines that you guys have? How do you gauge? How do you strategise it?

Brett: Yeah. Well, I guess, again, you’re building the resources first. So, often, they may have done a lot of work before they come in. You know, if we want to get traction or momentum, it might be using IV therapy might be the capacity. And that may just be hydration. A lot of people come in, and they just don’t identify simple things like hydration. Eating regularly, you know, hypoglycemia is a really big factor as far as that traction or momentum, that capacity to produce energy. So, simple things can often be really beneficial for that work-up.

What tends to happen is you see it as a practitioner, all of a sudden, the lights come back on. And I was just talking with a client the other day, and I said, “I didn’t even know that you were English because your voice was so slight and so low when you came in. I didn’t even hear it.” And then all of a sudden, she’s coming back, and she’s getting that vitality back. And then all of a sudden, she’s throwing her voice out. You know, really simple things like that.

That’s where that detective work comes in as well. You start to notice these slight changes. You start to notice this spark. You start to notice light bulb moments where they start to cognitively understand their situation much more, I guess, effectively or efficiently. They sense that they have this energy to actually start to move forward. And so, as a practitioner, you’re looking for those moments.

Then what we can do is we can start the process. And when we start using our equipment, we’re actually measuring right through that process as well. And so, we can see whether that person is actually responding effectively to the equipment. So, we’ve kind of got a minimum standard with each piece of equipment. So, people aren’t reaching that. Then we understand that their body still doesn’t have those resources to push forward. These take a lot of energy to actually get through this process. People might be in here for three or four hours in a day. And that might be five to six days a week. So, it’s really important that they’re really well-resourced to be able to get the results.

But what we can see over time is, we can see whether that’s effective or not. If we’re finding that, we create that little push, and they’re so exhausted from that small push, then we know that they’re not ready to go forward. So, then we pull back, and we start to look at more support, you know, more strategies as far as what resources that person’s missing and why they’re not in a position to get that traction or momentum, and that adaptation effect, which is really what we’re trying to have an effect on.

Andrew: Do you make assessments before patients are ready to move to the next stage? Do you sort of check-in and say…not just nutritionally, but do you, say, do bloodwork, for instance, to say, “Listen. You’re not ready for the far-infrared sauna yet. You’re not ready for this type of…” Do you do that?

Brett: Yeah, we do. And we can even put them into our equipment, and we can see…we’re measuring what their metabolics are doing all the time. So, if we’re using a small amount of heat, say, we’re using 46-degree heat, and their internal body temperature is 36.1 degrees, and over that half an hour, there’s just no change in the body. You know, there’s no heart rate increase. The internal temperature doesn’t increase. Then we really know that the body doesn’t have those resources to really become robust and raise that internal temperature. You know, we want that sort of mild fever mechanism to actually come into play.

And what can happen is, you know, you might have those low temperatures for half an hour. They come out of it, and they’re exhausted. Well, we know that, really, they’re not in a position to benefit from that. So, it may be that they’re using hyperbaric, more Nutritionals, more diet, and sunlight. Really simple things are the best practices before. So, we’re measuring right through. And after doing this for so many years, you start to understand someone’s capacity to respond.

We might have someone with exactly the same diagnosis. And they’ll come in, and we’ll have them at 50 degrees inside, you know, this chamber. And they’ll actually then, you know, getting internal temperatures of 39 degrees, and their pulse rate will be 140 beats per minute. And you can see this robustness of the body. And they’ll get out, and they’ll feel good, and they’ll feel like they’ve achieved something. And you can tell very specific differences between people and their capacity for adaptation. Because, really, what we’re actually inducing is the body’s capacity to adapt. That’s really what homeostasis and the capacity to bring someone back into health is about. It’s their capacity to change and adapt in a positive direction. And that’s what we’re always measuring and trying to achieve.

Andrew: Just a point, I guess, of safety with regards to thermotherapy. You know, you’re looking for an improvement of stress adaptation, and ability to raise blood pressure and pulse, and things like that. But there are also the characteristics of that pulse. So, for instance, if it’s a bounding pulse, you know, you might have a concern about blood pressure or if it’s a thready pulse or… I’ve got the wrong word. An infrequent pulse. Come on. Ectopic atrial fib is what I’m looking at.

Brett: Yeah. AF.

Andrew: Yeah. AF. Thank you. So, the characteristics of the pulse and the blood pressure. So, I guess this goes back to a big lesson that I learned early on in my nursing. And it was when I was feeling rather overwhelmed. And I’ll always remember this nurse, Sister Getys, who, I’ve got to say, many people didn’t like because she could be very blunt. But because I was like a child and kept on asking questions, “Why? Why? Why?” For some reason, she liked me. And I confided in her that I was feeling overwhelmed. And she said, “Look. You can learn that stuff with experience and over time. Right now, I want you to observe your patients.” And it’s exactly what you just said.

You were talking about twinkle in their eye, the character of their voice, the physical reactions to a stressor, these sorts of things. But with the more nuanced things as well. The twinkle, the character of their voice, the confidence, the spark. Forgive me, but you impress me, man, because it’s these little things that we so often forget when we’re caught up in being a professional.

So, the question, I guess, from here is, when do you raise a red flag to go, “Whoa.” Like, it’s not just they’re not ready. There’s an issue here. What do you look for? Thready pulse, for instance.

Brett: Yeah. You know, you see, people can degrade quite quickly from these processes. So, you might induce a small amount of heat, but their response is completely outside of what would be expected. So, you know, absolute exhaustion. We can look at oxygen saturation becomes really poor. Pulse rate drops. These are all indicative of someone’s capacity to adapt. They don’t have the resources. You know, their palate changes. They come out of the heat, and they’re white. And it really gives some fairly quick indications.

Also, when you’re talking to them. So, you’re never allowing them to go through those processes in isolation. So, there’s a constant dialogue that’s happening. Through that dialogue, you’re checking in, you’re making sure they’re okay. And so, it’s the relationship. It’s the nuances. It’s knowing the person when they first come in. That’s really something that I’ve strived to do, is to keep a memory of the person when I first met them compared to when I see them again over time. And that reference point gives me an indication of, really, about what’s happening with that person regardless of what they’re telling me.

And this is the fun part of it, that investigative quality is that they may…you know, classic, “Yeah, I’m fine. No, couldn’t be better.” And you’re just looking at someone that’s. Yeah. And you know. You’re like, “Okay, then. That face is great for everyone else. But when you walk in this door, it just doesn’t cut it.” And that, for a lot of people, they can relax and they can say, “No, actually, life’s pretty crummy at the moment.” Because stress response another big part of what we do. With chronic diseases, it’s probably the stress response that the hypothalamus’ capacity around regulation is probably the determining factor around the chronic disease. So, stress is a massive part.

We need an environment when people come in that they can somehow relax, feel comfortable, feel comfortable with the environment and the people. So, they’re not on this constant roundabout. It’s only got worse with Dr Google because there are just so many rabbit holes now for people to jump down into. There’s that constant stress response. So, we really got to get that stress response reduced as quickly as we can as a determinant factor or as someone’s capacity. I always talk about it that basically as long as you’re in fight or flight, you’re never in recovery. The body will sacrifice everything for the concept of survival.

Andrew: A salient point. A salient lesson. But I’ve got to say, I admire the way that you guys have a very open, welcoming clinic. I mean, it’s gorgeous, which… Forgive me. And it’s not just the clinic. It’s your demeanour and the way that you guys talk about and with your patients. That would break down barriers. That would enable them to feel comfortable with vulnerability. So, despite their physical complaint that they’re seeing you about, there’s that emotional component that you can look after them with.

Just one last question for you, Brett. And that is regard to these patients that don’t do well or that cannot gain, or regain homeostasis. And there are those. What happens with regards to referral for, let’s say, pharmaceutical medication in some instances. If somebody’s really severely depressed or let’s say, somebody cannot regain a physical mobility that you’d hoped for. And so, it may require surgery. And certainly, there’s those people that come in with regards to cancer. And they may need a very stern talking to about looking at not just partnering with chemo, but some people refuse chemo. And sometimes, you just can’t work without these medicines.

Brett: Yeah.

Andrew: How do you navigate those conversations?

Brett: I always start off with, I guess, that…you know, we’ve got all this kind of therapies that we can use. And what naturopaths really fit into well is, we’re not the last resource. We’re kind of, like, at the beginning. And when I first started talking about this clinic, I said…I wrote at the top, “We’ll know when we’re succeeding when we see people at the beginning and not at the end.” When we started this 10 years ago, people had…you’re choosing natural therapies because they have no other options. And that was the worst-case scenario for us.

And so, really, we’re the people that work at the beginning. We’re the people that do the groundwork. We’re the people that do that really good foundational work. And so, I believe that all the other therapies in this timeline, it’s when you actually activate those or participate in those different therapies as far as time-wise is concerned.

Of course, it doesn’t matter what therapy you use. If the foundation is good, then the capacity to adapt and recover at any kind of therapy then has a massive improvement. There are such better outcomes with people getting that foundational practice right. And that’s really where we sit.

So, over half of our clients are using a conventional protocol as far as their health is concerned. And we fit into that as far as playing a very specific role. So, really, we’re not saying, “Well, it’s either this or them.” We’re saying, “Well, what’s our role in this process for you? And how can we just help you in your capacity to get through this and recover?”

So, really, it is always that foundational process. And naturopathy has a place within medicine. It has an awesome place within medicine. But it’s not the only answer. It’s the capacity then for people to use the other therapies. And because of the work that we’ve been involved with, with that client, they only get much better results. So, what we see, for instance, is people who should be presenting as quite sick are actually presenting as quite healthy.

And so, one oncologist said to a client, when they’d gone through the therapies and they said, “Well, you know, we’ve gone through the mastectomy. What now?” And she said, “Well, really, I only see…I really don’t see healthy people. I really see sick people.” And so, she had no place for a person that recovered well, got through the surgeries, got through the treatment, and was generally healthy. And that’s our ideal.

Andrew: Mm-hmm. It’s such a wonderful thing you say because, let’s take pain, for instance. I have podcasted with a man who I have the utmost respect for, Greg Mapp, a pharmacist, very much retired now. But he used to pick up the pieces of the opioid-dependent people. And he used to consult very intensively to try and get people off opioids, and try and get them off onto more natural — certainly, there’s toxic equivalent — whilst still managing their pain. Let’s say it’s pain. Whereas what you’re talking about is seeing people at the beginning, helping them to regain mobility, and lessen pain, so they don’t have to use so heavy an opioid regimen. And so, they might have to use some, but it’s not such a dependent. And so, their risk of opioid dependence is vastly reduced. And so, the healthcare system is going to thank them later on down the track. It’s a monetary benefit for the healthcare system. It’s brilliant what you’re doing. I’m so impressed.

Brett: Thank you. Thank you. Yeah, pain’s a big one. It’s the hardest one. It really is.

Andrew: Yeah, it is the hardest one. So, look. There are so many rabbit holes we could go down today, Brett. But thank you so much for taking us through the intensity and sort of how you might strategise intensity with various patients. Indeed, your detective work and your care for patients being attuned to not just their symptoms, but their nuances of how they’re looking and how they’re interacting with you. Well done. And I look forward to podcasting with you again at some stage. Thanks a lot.

Brett: Great. Looking forward to it. Thanks, Andrew. Have a good day.

Andrew: And, of course, everyone, thank you for joining us today. Remember that all the other podcasts and the show notes for this podcast can be found on the Designs for Health website. So, thank you very much for joining us today. I’m Andrew Whitfield-Cook. And this is “Wellness by Designs.”