What is a complex illness...?

"Complex illness", sometimes called "medically unexplained illness", has proven one of the greatest unmet challenges of western orthodox medicine in the past century. We doctors have been very good at diagnosing single-cause and single pathology diseases and prescribing drugs which diminish the symptoms of those diseases, and occasionally cure them. These drugs work quickly and predictably, and result in symptom control very rapidly.

Most of them, however, cannot be sustained as the adverse effects of the drugs become apparent over time. In many of these cases, drug therapy becomes a cause of persistent symptoms and disease, and doctors will often add more drugs to control those symptoms as well. The effect over time is that a person who is sick is unable to navigate their way back to good health until they stop the medications that steal this very capacity from them. They are not in a position to make a judgement on which drugs can be ceased and which ones cannot be. Patients frequently stop drugs that they do need or continue on with medications that have long ago become unnecessary and potentially dangerous.

These complex illnesses are only "medically unexplained" because no one has taken the time to put the entire medical history, family history, medication regimen, and dietary and environmental factors together to make sense of the chronic ongoing symptoms.

This is one of the advantages of having a few hours to devote to each initial consultation. It is also the reason I ask each new patient brings much of their medical history pathology test results as possible. In most cases, the chronology of the illness and the treatments given for the illness expose the causes and contributions to complex illnesses, and provide clear therapeutic options, including the cessation or reduction prescribe medications that may be contributing to ongoing health problems.

This process of ceasing prescribed medications should not be undertaken without professional medical oversight, and all changes to medications need to be with the agreement of all treating doctors. The same is true for ceasing ever-changing complementary medicines, and for defining potentially harmful interactions between drugs and complementary medicines.

My training for this process of reduction of unnecessary or harmful medications began at Lidcombe Hospital in the 1980s. The medical registrar I worked under her passion for safely ceasing unnecessary medications when a person was first admitted to hospital. On average, more than half the medications were found to be unnecessary, and a simple cessation of those drugs resulted in significant clinical improvement, often sufficient to see the person back home within days.

The unravelling of complex illnesses requires a deep understanding of the person's genetic predispositions, their environment and diet, occupational factors, the adverse impact of medications (including vaccines), and identification of stresses such as infection, sleep disturbance, and lifestyle factors that may be perpetuating the illness.

The GEMINI system I have developed to understand and address these areas provides a framework for the consultation and for the therapeutic decision-making that follows. Some patients need less treatment, not more! And for some people, complementary medicines and dietary approaches are sustainable and superior alternatives to potent but unsustainable drug therapies.

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