About

 

stasha profI am a neu­rol­o­gist prac­tic­ing in Tyler, Texas. My inten­tion is to use this web­site  to share my obser­va­tions about med­i­cine and neu­rol­ogy with my patients and other physicians.

This site is not to encour­age you to treat your­self with­out a doctor.This site is intended to share my ideas about neu­rol­ogy and the func­tion of the body to help you under­stand neu­ro­logic prob­lems. My inten­tion is that you share these ideas with your doc­tor to help both of you learn and make your treat­ment more suc­cess­ful. Every­thing on this site is based on pub­lished sci­ence but I have taken it a step fur­ther to try to put the whole pic­ture together. They are hypothe­ses or guesses about how our bod­ies work.

I began to think about mak­ing this site when I real­ized that the expla­na­tions I give  my patients about their neu­ro­logic prob­lems are really “best guesses”. Some are my ideas, oth­ers are from books. The expla­na­tions that come from books are also ideas, they’re just  writ­ten down by other neu­rol­o­gists. Doc­tors have cer­tain build­ing blocks of sci­ence that we all agree on: DNA, the struc­ture of the cell, etc. but most of the “expla­na­tions” of  neu­ro­logic ill­ness, from headache to Parkin­son dis­ease, are hypothe­ses. They are ideas that a  neu­rol­o­gist pro­posed that have been gen­er­ally accepted by other neu­rol­o­gists. That does not mean that they are “the truth”. Our bod­ies did not come with a user’s man­ual. We are piec­ing together infor­ma­tion to try to fig­ure out how it works. There is no book to look in to con­firm that our ideas are “right” or “wrong”.  Now that I’ve been in prac­tice for sev­eral years I’ve real­ized that what I tell you today may not be the truth in another 10 years.

Most of the drugs that we have devised to help humans feel bet­ter act on recep­tors on our cells. This implies that our drugs are actu­ally just dupli­cat­ing chem­i­cals that are nor­mally made in healthy humans to act on those receptors.The recep­tors were there way before drug com­pa­nies or doc­tors existed. Lack of a cer­tain chem­i­cal, such as sero­tonin, or insulin, or testos­terone, or dopamine, causes a “dis­ease”. Once the dis­ease is com­mon in the pop­u­la­tion a drug com­pany becomes inter­ested in how to “treat” it, and fig­ures out which chem­i­cal makes the symp­toms bet­ter. Often there is a “genetic weak­ness” or genetic muta­tion act­ing in the per­son who has the dis­ease that means that they don’t make enough of their own chemical.

How­ever, any per­son who has a genet­i­cally inher­ited dis­or­der such as tremor, epilepsy, dia­betes, migraine, who devel­ops that dis­or­der later in life, even at age 15, had that gene muta­tion at birth. Why did they only develop the “defi­ciency” of that chem­i­cal at a later age, why not at birth? In fam­i­lies with a gene for epilepsy why do some peo­ple develop it at 14 and oth­ers at 44? If the genetic muta­tion has been present since birth, but the dis­ease did not cause symp­toms until age 15, it sug­gests that the body was able to “shore up” that genetic weak­ness for fif­teen years. I believe that all of the mil­lions of chem­i­cals we need to make our body run cor­rectly are made while we are in deep sleep. We usu­ally make enough to last only about 16 hours and then we run out. We have to sleep in order to make more. This idea grew out of watch­ing my patients wear sleep apnea masks that allowed them to stay in deep sleep longer. They would notice that at first they woke with no tremor ( or headache, or burn­ing, or dizzi­ness) but it came back as soon as they got up. Then, as they wore the mask more and more nights and had more time spent in deep sleep, their symp­tom would take longer to appear,i.e. in the first month they woke with­out a headache but it came at 10:00 am, the next week the headachce started at noon, and the next week at 3 pm. This implied to me that they made enough of what­ever chem­i­cal it was that “turned off” the head pain sys­tem, but they only made enough to last an hour at first. As time wore on, and they stayed in deep sleep each night long enough to make more chem­i­cal, they could keep the switch in the “off” posi­tion for a longer period of time, until even­tu­ally they could keep it in the “off” posi­tion all day long. Then,  like a nor­mal per­son, it would only “turn on” if they hit their head. The same idea can be applied to epilepsy or ver­tigo. The seizure med­ica­tions that we use are usu­ally sodium chan­nel sta­bi­liz­ers.  Many of the inher­ited seizure dis­or­ders are caused by chan­nel muta­tions. Thus the med­ica­tion I pick may have a close dupli­cate in the patient’s body. They were mak­ing enough of their own “chan­nel sta­bi­lizer” until they stopped sleep­ing nor­mally, then they had a seizure and they needed some of my chem­i­cal, a seizure medication.

As I saw the same trend in the tremor or dizzy or “burn­ing in the feet” patient I began to think of these symp­toms in a dif­fer­ent way. Per­haps they were symp­toms that were caused by a part of the ner­vous sys­tem “turn­ing on” inap­pro­pri­ately. Per­haps patients with burn­ing in the feet have nerves that are “on” when they wake in the morn­ing, instead of “off”. Per­haps it’s because of a lack of main­te­nance dur­ing the night, or not enough of the proper chem­i­cal is made at night to keep them in the “off” state until the patient acci­dently steps in the fire.

This implies that there are many neu­ro­logic dis­eases that can be treated or improved by allow­ing the patient to stay in deep sleep longer. It seems to work in my prac­tice, for headache, dizzi­ness, atten­tion deficit, tics, epilepsy, ver­tigo, parkin­sons, cere­bel­lar ataxia, and depression.

The above are just ideas, they may or may not turn out to be “true”. But it seems to me that there are many “expla­na­tions” in neu­rol­ogy, par­tic­u­larly about headache and sleep, that are com­monly accepted but don’t really turn out to be “true”. The only absolute truth in med­i­cine is your obser­va­tions about your body. We doc­tors then “inter­pret” your obser­va­tions to try to tell you “why”.  But if my expla­na­tion doesn’t fit your expe­ri­ence with your own body it may not really be the “truth”. All of the ideas on this site are open to inter­pre­ta­tion by you and your doc­tor. Take what seems to make sense and fits with your expe­ri­ence and leave what doesn’t. Don’t be afraid to have your own ideas. We doc­tors have much to learn from our patients. The inter­net has brought you as the patient the oppor­tu­nity to be an equal par­tic­i­pant in your own care.

About Dr. Wal­ter Stumpf:walter

The ideas expressed on this site are built upon the exten­sive sci­en­tific work of Dr. Wal­ter Stumpf who, sadly, passed away at the end of 2012. He was an amaz­ing sci­en­tist who sin­gle hand­edly clar­i­fied one of the most impor­tant aspects of our endocrine sys­tem. Despite wide­spread resis­tance to his ideas and repeated rejec­tions of his sub­mis­sions by var­i­ous sci­en­tific jour­nals he con­tin­ued to believe in the valid­ity of his con­cept of “soltriol”. His many jour­nal arti­cles describe Vit­a­min D’s actions, and its inte­gra­tion into the other parts of our endocrine sys­tem mak­ing up a triad of gonadal, adrenal and der­mal steroids. It is a brave thing indeed, to face absolute resis­tance and severe crit­i­cism by one’s col­leagues for 30 years of pro­fes­sional life and still hang on to one’s beliefs. It was my plea­sure to meet Wal­ter and to get to know him before his death. Together we added the idea that soltriol is piv­otal to nor­mal sleep. I think of him daily as I teach my patients about the impor­tant role vit­a­min D plays in our biol­ogy. Lack of atten­tion to Walter’s work over the last 25 years has pro­duced epi­demics of pain, suf­fer­ing and death through­out the devel­oped coun­tries of the world that might have been pre­vented had his ideas been accepted ear­lier. It is my pas­sion­ate hope that, when the rest of the sci­en­tific com­mu­nity finally catches on, Wal­ter will receive a posthu­mous Nobel Prize for his work. I also believe that the name of this hor­mone should be changed to the term that he coined for it; “soltriol”. Partly out of respect for Wal­ter but also because it is a term that more appro­pri­ately expresses our bio­log­i­cal con­nec­tion to the sun.

Stasha Gom­i­nak, M.D.

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