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Welcome to the Healing on Purpose podcast. I’m your host, Dr. Miriam Rahav. The content of this show is meant for informational purposes only and is not intended to diagnose, treat, or cure any illness or health condition. Please discuss all information shared herein with your own personal health authority. I hope you find value in this episode. This podcast is also available on YouTube on the Healing on Purpose channel, should you want to look up any of the graphics, diagrams, or other visuals mentioned in the show. Links to the podcast and its YouTube channel will also be available on my practice website, https://rahavwellness.com. Please join me on my Facebook group, Healing on Purpose podcast with Dr. Miriam Rahav, to continue this conversation. Enjoy the show.
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Hello. Thank you for taking the time, joining me today on the path to healing on purpose. On purpose means with intention and with an awareness of what one is doing. In other words, with consciousness. Thank you for consciously choosing healing. Thank you for taking taking this time for yourself. You deserve it. The subject of our conversation today is a big one, a big one affecting, practically, I would say, every being on this planet right now. The subject is long COVID. It’s a subject of intense research and intense clinical concern because it is a new subject and one that we are all facing in various ways together. It is one that we are facing without a roadmap. In some ways, it’s a level playing field. In some ways, as I’ve described to my intimate community, when I am in the point of care, face-to-face. We find ourselves in a jungle of sorts, and we want to carve out a pathway. There is no clear pathway, and hopefully, we just have a really good machete to carve that pathway out with. And so part of that carving for each of us who is grappling with the clinical entity that we call long COVID is is happening at the point of care.
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And what I want to discuss is my own grappling as a physician at the point of care, seeing people in real-time time, checking labs in real-time, and confronting what we are dealing with, boots on the ground. As a qualifier, I am not a researcher. I am a clinician. I’m seeing people directly. They tell me how they feel. They tell me how they function or don’t function. Together, we try and face those challenges and find inroads. That metaphoric machete of sorts is our lab testing and our various therapeutic tools. Then we have a circle back mechanism where I I get feedback from people. They write in, they call in, we meet again, I see laboratory work. I’m getting the feedback, thankfully, that the thought process that we have and the grappling that we have is making positive effects in people’s lives and that they’re feeling better and functioning better. That is why I am extending sending this conversation to the greater community out there. Remember, we are healing on purpose with intention, with an awareness of what we are doing. I am consciously sharing in the hopes that this will generate hopes and a roadmap for our brothers and sisters out there.
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Without further ado, let me share my screen screen where I have pulled up some images to guide our conversation. Here we go. Let me start here on this image. We are talking about COVID, and we are still learning about what that means. Remember, again, to reiterate, I am at the point of care What I am getting is that people are coming to me and they have a whole cornucopia of concerns. The large over The searching one has to do with energy, the lack thereof, the lack of stamina, the lack of exercise tolerance, actual pains in muscles, the fancy word for that is myalgias. Problems, a whole constellation of neurological problems, from headaches to brain fog to memory loss to to something we call vagal nerve dysfunction or something called POTS, which is describing how the automatic or autonomic nervous system has trouble regulating things that we normally don’t think about, like blood pressure, and we can have sudden changes and sudden feelings of faintness. There’s a fancy word for that called orthostasis. We’re seeing problems with the vascular system. We’re seeing problems in autoimmunity. We’re seeing problems in the gastrointestinal system, loading and IBS-like symptoms.
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Again, a whole cornucopia. But why did I pull up this image of a capillary. The reason I pulled up an image of a capillary is because capillaries are the source of our blood supply to every cell in the body. Here in this cartoon image, I thought it was excellent because it really does a good job of showing… Let me show you another image just as a complement here. Here we can see this vast tree. It’s really just a marvel of nature to contemplate the architecture of our body and see these larger blood vessels branch off to smaller and smaller and smaller blood vessels until we get to what nourishes our cells on a tissue level. Togle back to the capillary here. Now we are at the level of that smallest little blood vessel from that huge vascular tree that we saw in the previous image. Here it turns out that our cells, our blood cells, can actually only travel single file. In this cartoon, it’s a little bit misleading in the sense that you don’t see how tight of a fit these red blood cells actually have within the capillary where they’re marching single file.
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But the fact is that they are. What we are seeing here in this image is a depiction of that hollow center of the red blood cell. That is because red blood cells, as they’re created, do we know where they’re created? Anyone, anyone? Can anyone remember? In the bone marrow. Then as they leave the bone marrow and enter their functional life, that nucleus that every cell has that carries genetic information is actually removed from the red blood cell. The red blood cell is the only cell that doesn’t have a nucleus, and therefore, also of note, it has a shorter lifespan. But that leads to this hollow donut-type shape that makes it Squishy. With that Squishiness, it can squeeze single file through a capillary. What it does is it will carry within the red blood cell, oxygen and nutrients, which is why I like this cartoon, to the body’s cells. It just depicted so perfectly here. Then, conveniently, it can then carry carbon dioxide and waste out. The capillary system both furnishes the influx of needed oxygen, and we’re going to speak in a minute about how that drives energy and nutrients, and nourishes every cell in the body.
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And by the same token, and on a continuum, amazingly, magnificently, intricately, our design will also remove carbon dioxide and waste. This is such a key understanding that I want to hold consciously with all of you. Now, imagine. What if there is some small occlusion? I have my cursor here. For those of you listening, you can just listen. But for those of you who may be visual learners, it might be interesting to look up this video It’s going to be in a video format on YouTube and appreciate that this very tightly-fitted, really glove, hand-in-glove type fit of the blood cell in the capillary. If there’s suddenly an expression. You can also see in this particular cartoon that there are these little lines here. This is to really depict that these are cells, that the capillary is made up of individual cells that are tightly adhered together. Anyway, imagine that there is an expression of a spike protein. We have all heard of the spike protein, I am assuming, as one of the mechanisms of action for the virulence, the disease-causing mechanism of COVID-19. Also, famously, we have been giving people the genetic information to manufacture spike proteins.
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This was thought to be something potentially protective against the virus. Either way, imagine the spike protein is now being expressed by one of these cells, many of these cells along the capillary, potentially. Remember, I am a clinician. I’m just putting out information. Thank goodness, we have so many gifted researchers complementing the work of clinicians like me, corroborating, confirming or refuting, as is the nature of our profession. We’re asking questions, and I’m answering those questions clinically. This is not exactly the forum at this time for answering this on a research level. I’m just explaining this so you have a framework or a schema to then follow the conversation herein. What will happen if there is something here expressing itself? But remember, the red blood cell is traveling through the capillary like a hand in a glove, this very precise, exact fit. In this case, The red blood cell will simply not manage to get through. Not manage to get through. I mean, it’s already such a tight fit that it has to squash itself. Remember that hollowed center. Then what happens if red blood cells aren’t getting through the capillary, well, will those oxygen and nutrients be delivered to the cell?
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Good question. And will carbon dioxide and waste be removed from those cells that that capillary is supplying? Great question. My answer is that loss of capillary blood flow will create a deficit of oxygen delivery and nutrient delivery to cells, and a deficit of waste and carbon dioxide removal. This is absolutely an essential key to understanding what follows. Because all of our cells depend on oxygen and nutrients to do what? The answer is to make energy, to make energy. I have pulled up another picture here. Actually, let’s go to yet another picture. Here is this wonderful cartoon of a cell. Here is the whole cell. Remember, the capillary is delivering oxygen and nutrients to the cell, so the cell can do whatever the cell needs do. Within that cell, we have the specific location of energy manufacturer, which is in, here we have it. Here’s your clue. The mitochondria, this little bean-shaped organelle with the squiddling lines. This is the mighty mitochondria. The mighty mitochondria is really the secret to the essence of life, which is tied into exactly our energy, our energy manufacturer. Now, I’m going to show you that other cartoon where we’re going to zoom in on the mitochondria.
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Here on this zoom in focus, it’s showing us how the mitochondria will take various forms of fuel, such as glucose, that it converts into another famous molecule that many of us may have never heard of called pyrovate. Notice, by the way, that in this cartoon, we’re showing how that conversion takes place outside of the mitochondria. What will really drive the utilization, the ability for our body to make, turn glucose and then pyrovate into fuel is we’ll follow the pathway of this mitochondria all the way through. We’ll notice here at the end, I’m circling it with my cursor, is O₂. O₂ stands for what? For oxygen. O2 is how oxygen, two molecules of oxygen together, live in our environment. Remember the capillary? What does it deliver into the cell and into the mitochondria in order to enable the mitochondria to work and make energy? That’s right. It’s oxygen. My experience, clinically, is that long COVID on a cellular level, on a cellular level, from the capillary to the cell to the mitochondria, is in fact a low oxygen state. That has so many, so many implications. Because every cell, remember I mentioned long COVID being a cornucopia of symptoms?
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Well, every Every cell depends on oxygen and energy to do whatever that cell needs to do. You’re going to have a whole cornucopia of symptoms that are informed by that underlying process of a low oxygen state. Let’s discuss further. If the mitochondria are not able to get energy in, and also the cells are not able to excrete waste. They are going to start dysfunctioning. Now, what if there were already vulnerabilities that the individual affected by COVID was experiencing? What if that person already had, let’s say, problems with blood flow? Let’s say that person in question has a condition that also affects mitochondrial health, which will be a subject of another conversation on healing on purpose, having to do with diabetes and how That is also a mitochondrially vulnerable state. Let’s say that person is going through cancer. Let’s say that person has hypertension. Let’s say that person has maybe a low-grade infection that they were not aware of, that maybe they had a little bit of yeast overgrowth in the gut, maybe a little bacterial overgrowth in the gut. These will be subjects for other conversations on our podcast, Healing on Purpose. But for the sake of our conversation today, Please understand that all infection does not like oxygen.
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What is long COVID? Long COVID potentially potentially, is a state of low oxygen delivery to cells. You can then imagine that if you already had a little touch of IBS, or maybe you had IBS that was treated, that you could experience a resurgence. You can imagine that, let’s say, you had limes or a bout of limes in the past, or maybe you were dealing with chronic your limes symptoms are getting flared. If you had some issues with brain fog or exercise tolerance, whatever your vulnerability may have already been. Lowering your ability to deliver oxygen to tissue will exacerbate your pre-existing vulnerability and/or induce a new one. What do we do if this is what we suspect? Well, we can start looking at some specific biomarkers in blood that tell us a little bit about how well the blood is flowing. We have a helpful marker that we can do on laboratory work called fibrinogen. Fibrinogen is protein that can tell us how much of a tendency towards the blood being clotty in a state of tissue injury, which I want to propose the inability to get oxygen to tissue or take waste out of tissue, can absolutely lead to tissue injury, and therefore, may be a tendency for higher fibrinogen.
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There’s another marker that we can find that points to a clottiness, and that is D-dimer. As we started following our brain wave about what the clinical entity at the point of care of long COVID might be, we started looking for these biomarkers in our laboratory work. And lo and behold, we discovered these to be high, positive, frequently, and absolutely higher and more positive. When people actually happen to do bloodwork that later in hindsight we discovered, they were actually in a active COVID-infected state. That was a gift to learn. It gave us that clinical clue that I mentioned, that road roadmap about what are we looking at. It also gave us a window to step into, well, how do we help the body oxygenate better? One thing that we can do is support a very special molecule called nitric oxide. It is a molecule that’s made within the body that leads to blood vessels to open up the other fancy word for that is dilate or phasodilation, and that leads to better oxygen delivery to tissue. We can also look at substances Oh, sorry, back to the nitric oxide. Exercise can also induce nitric oxide. Also, there are foods that don’t deliver nitric oxide directly, but can support nitric oxide production in the by delivering the building blocks for nitric oxide.
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Then we have a category of supports through nutrition and supplementation that actually support blood flow. Namely, and this might be a new term for many of you, a category of substances called proteolytic, proteolytic enzymes. Proteo from protein, lytic from cutting, and enzymes. Names of these enzymes include natokinase, serrapeptidase, and lumbrokinase. These are substances natokinase comes from actually fermented soy. It’s a popular food in Japan, actually. Serrapeptidase is actually the protein that silk worms can excrete to help them get themselves out of their own cocoons. Isn’t that fascinating? Lumbrokinase is an enzyme that earthworms make to break up soil so that they can move through it. And fascinatingly, as a side note, Chinese doctors, thousands of years ago, when they had cardiac patients, knew to administer to their patients ground up earthworms to support their cardiovascular function. Isn’t that just incredible? We can take that ancient wisdom and apply it strategically. In fact, we can stack these tools potentially together, and we can substantiate the need to stack these tools together by checking bloodwork, by instituting the strategic supplementation, and then seeing how biomarkers change and how functional status changes. I hope you’re getting the picture here.
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It’s straightforward, it’s logical, it’s corroborated, and it’s followed through. Ad infinitum in a feedback loop. What other things might we need to do to support people through long COVID and hopefully get people feeling and functioning better? Well, you may have heard of bio oxidative therapies. What do I mean by this? I mean delivering oxygen to people. Remember what I mentioned is that there is a lack of oxygen delivery to tissue. So how might we antidote that? Well, maybe some hyperbaric oxygen treatment. Maybe that can support the body’s reoxygenation. This is a Therapeutic strategy we use quite a bit in our clinic, which is if you have a hypothesis, for example, my symptoms have to do with lack of oxygen delivery. Why don’t we get you some oxygen oxygen delivery. To what degree are your symptoms improved? To what degree are they reversed? That is a therapy that then becomes diagnostic if you If you have lack of oxygen delivery, that’s a hypothesis. Then we give you oxygen delivery, that’s a therapeutic. If the giving of the oxygen delivery reduces symptoms, that is a confirmation that we are on the right track. That is the work that clinicians at the point of care can and should be doing.
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Together, when we do that work and create these pathways, whacking through the jungle with a machete, we can create a roadmap for hope and healing on purpose. There is much, much more to be said on this topic. That would be more bioindividual, depending on the person and their underlying vulnerabilities pre-existing COVID, depending on the person and the amount of injury, the duration of injury, compounded with their pre-existing vulnerabilities, we may also need to address those pre-existing and underlying vulnerabilities that may have been exacerbated as part of the long COVID process. Therefore, in addition to this general information that I have shared, there is a need to look at each and every one of you grappling with this entity we are calling long COVID. To address you bio-individually. What I mean to address in this conversation is just a working understanding of what we might be dealing with and how That initial problem may be propagated, literally as we discussed, to every cell in the body and/or to any given system in the body, depending on you and your vulnerabilities, such that we might need to work on that individually. But that this clarity, this consciousness that we want to grow together in terms of a hopefulness that a road map exists, I believe, exists now.
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We are finding that people are responding to this strategy, informed by this thought process now. That means that there’s room and there’s hope for you as well to heal on purpose and avail yourself of this thought process to your own benefit. Thank you for listening and joining with me today for this conversation. I hope it sparks greater interest, curiosity, and hope in you. Remember, these conversations are general and that this conversation is intended for educational purposes only and not for diagnosis of treatment of you. You really do need to build upon hope Hopefully this foundation with your own personal health authority. To your health and to your life, thank you for joining me today on the path to healing on Purpose.
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Thanks for listening to the Healing on Purpose podcast today. I hope you found this information helpful, and I encourage you to share this episode with others who may also benefit from the information shared. Please consider rating and reviewing my podcast on Apple Podcasts so more people can find this information. I also invite you to join the Healing on Purpose podcast Facebook group to continue this conversation. I’ll see you there.