Exclusive: Dr. Larry Sharp on Treating CFS & FM at the Fibromyalgia & Fatigue Centers
December 29, 2004
ImmuneSupport.com Interview with Dr. Larry Sharp, DO
1) Please give a little background on your medical training, and tell us how you first encountered CFS and FM.
Dr. Sharp: My background in medicine began with laboratory science. I completed a BS and then MS in medical technology, which to this day helps me understand the intricacies of modern medicine. I have participated in all aspects, from clinical research to running a medical laboratory. My passion has always been driven by a love for science; to apply scientific principles to medicine is what the medical laboratory represents to me. Upon graduation from medical school in 1984, I intended to pursue pathology. To my surprise, the field of family medicine was what captured my heart. I thoroughly enjoyed working with people and discovered I could utilize all my prior experiences.
After completion of internship and family practice residency, I joined a bustling practice and life could not have been happier. Then on a ski vacation at Lake Tahoe in 1987, my wife and then my son became ill with what I came to know as CFIDS (Chronic Fatigue and Immune Dysfunction Syndrome). So began my personal journey with Fibromyalgia and Chronic Fatigue Syndrome. What had become clear to me after 15 years of practice is that symptom-driven, disease-oriented medicine often fails to deliver effective treatments. There has been a public outcry for compassionate, scientific-oriented complimentary medical care; many practitioners now recognize such illnesses can affect many different body systems, may be misdiagnosed, and may be seriously debilitating.
2) You are currently involved with the Fibromyalgia & Fatigue Centers, Inc. in Ft. Worth, a novel treatment center that is part of a "chain" of treatment centers being opened across the US. Please describe what the center has to offer and how it fills a gap in treatment for the many CFS and FM patients out there seeking help.
Dr. Sharp: Currently, there are Fibromyalgia & Fatigue Centers (FFC) open in Atlanta, Cleveland, Dallas, Denver, Ft. Worth, Houston, Los Angeles and we will be opening centers in Amarillo, Salt Lake City, Detroit, Pittsburgh and Philadelphia in January 2005. FFC is planning to open 20 additional centers in 2005 to bring the total to over 30 centers in two years, but these centers are about as far removed from being a "chain" as you can get. When I hear the word “chain” I think of convenience stores like 7-11 or department stores like JC Penney or restaurants like McDonald’s, where every outlet has pretty much the same products that they sell to millions of customers all over the country. While FFC is the first treatment center in the country specializing in Fibromyalgia and fatigue based conditions to open more than one center and operate with positive patient outcomes, each center treats each patient in a unique way with individualized care and treatment protocols.
There is no “one-size-fits-all” treatment plan for these complicated and complex conditions since every patient presents with different symptoms and different severities. Each physician in each center has a unique background and area of expertise which adds to the rich network of medical experience and expertise we all get to tap into and benefit from. And while the operations of each center are managed in the same way, the treatment we provide is as unique as the patient receiving it. Our algorithm of care has many pathway options so each staff physician can choose which treatment is best for the patient based on what is going on with their body. This individualized approach to treatment is what makes this so unique and also so successful.
There were several things that drew me to become part of this revolutionary way to provide proven treatment to patients all over the country. First, FFC recognized that not all patients were created equal and that specialized care, with time given to the physician to really get to know the patient and all the underlying issues their body was going through, was critical to diagnosing each component of the condition and deciding how to best treat each issue. These patients cannot be treated in 10-15 minutes. At Fibromyalgia & Fatigue Centers each patient spends well over an hour with the doctor during their first two visits.
Next, the FFC protocol has recognized that in-depth testing to discover many underlying etiologies that significantly impact the wellness of the patient are needed to help create a treatment plan that will help get the patient to optimal health and wellness. Most physicians do not do these tests and are missing big pieces of the puzzle when it comes to treating these patients. For example, over 90% of our FM/CFIDS patients have thyroid dysfunction, and yet when they bring past lab tests results in they show TSH levels within the normal range. So their previous doctors have told them their thyroid is fine. When we do more detailed testing, we often discover that the conversion rate or the production rate of specific thyroid hormones is out of whack and that this is a big part of their inability to move forward with more positive outcomes.
Finally, while I have studied these conditions for years and worked with and studied with some of the top names in the field of treatment for FM and CFIDS, I always felt something was missing, that there was one piece I had not yet discovered that was preventing me from getting my patients from feeling good to that next step of feeling great. After hearing Dr. Kent Holtorf, Chief Medical Officer for the FFC, present to a support group meeting I attended in April, I knew that the FFC had discovered many of the pieces necessary to treat these patients and see long term positive outcomes.
Knowing I could help my patients gain even more significant improvements by being part of what the FFC has to offer, I was anxious to join this esteemed group of medical professionals and do whatever I could to help improve the wellness of patients all over the country.
3) I understand there is a more or less standard treatment program used at the Fibro & Fatigue Centers. Does your personal approach differ or deviate in any way? How do you go about creating a treatment program for a patient when they come to you for the first time -- how do you assess their symptoms and proceed to treat them?
Dr. Sharp: It would be great if there was a standard treatment program that could be used on all FM/CFIDS patients, but unfortunately due to the nature of these diseases, there is not. As I mentioned, the algorithm we use has many pathways to follow with mul
tiple treatment options available at each phase. So while there seems to be a “standard treatment program” there are really just pathways the FFC physicians use as a guideline for treatment options.
Each treatment is unique to each patient because there are multiple options available and the physician can select which option may be best for that specific patient. What is standard about what we do and how we do it, are the tests we need to make sure we are not missing any of the basic conditions that impact the ability of the patient to improve.
What I have been doing personally for the past five years in my own practice has been very similar to what the FFC has developed. But again as I said earlier, I always felt there was more that needed to be considered. When there is something one of the FFC physicians may have discovered or been using with patients that has had positive outcomes in the past, the FFC is wonderful about exploring it as a treatment option to include in the algorithm. And as research develops and new treatment options are proven to be successful, these options will be added to the algorithm as well. Like all good medical practices, you have to keep current and keep an open mind when it comes to new treatments that can enhance patients’ outcomes.
The first visit is the beginning of the learning experience for the physician. We get to spend time with the patient and really get to know them and their history with their condition. They bring with them a completed 24-page medical history questionnaire. It asks detailed questions about their general health as well as issues specific to their past treatment and symptoms for FM and CFIDS. We sit with the patient and review it line by line, and then go over any recent lab reports the patient may have brought with them as well.
We do a simple physical examination which includes the standard heel drop and tender points testing. The majority of the time is however spent in conversation with the patient so the doctor can begin to understand what medications they are and have been on, and what treatments they may have had in the past and what the results were from those treatments. Again, this is all knowledge that will help us design their treatment protocol. If there are lab tests we need that have not been done recently, we write up the lab request and with a phlebotomy lab on the premises, the patient has their blood work completed, and in some instances the medical history will show that some sort of treatment can be ordered immediately. So it is not uncommon for a patient to get supplements or even a treatment (e.g., injection therapy, IV drip) before they leave the office. Often we will implement the first two steps in our six step approach to care by:
• stabilizing the patient by addressing their pain and sleep disturbances; and
• promoting energy by enhancing their mitochondrial function.
Our goal is to help make the patient feel a lot better emotionally and at least a little better physically when they leave their first appointment. Then we continue to build on that wellness path throughout the course of their treatment with us.
About two to three weeks later, once lab results are in, the patient returns for their next appointment and then we can move into the next steps of our program:
• balancing hormones by evaluating hypothalamus and pituitary function;
• enhancing immunity and treating underlying viral infections; and
• addressing unique etiologies such as neurotoxins and coagulation defects.
The final step:
• providing each patient with an individual maintenance program
comes after we get them close to their optimal wellness and we can adjust their treatments so they are able to function with an absence of symptoms with the minimally necessary medications and supplements.
4) What kind of home and self care do you encourage CFS and FM patients to undertake?
Dr. Sharp: We know that the patient needs to work with us to help control the condition that is controlling them. This means they need to work at home to help achieve and maintain their wellness.
Our patient handbook, provides them with details on how they can help reduce their stresses, exercise for improved health, employ alternative therapies that can help enhance their improvements and make alterations to their lifestyle that will help them on their road to improved health. Medication and supplements alone will help make them feel better than they have been feeling, but our goal is to get them to feel as good as they possibly can. Better isn’t good enough and we need them to help us take them to that next step to feeling their best.
5) Further on the topic of self care, do you recommend any dietary interventions or nutritional approaches to manage some of the symptoms of CFS and FM?
Dr. Sharp: Frequently, FM and CFIDS patients have food allergies or sensitivities that cause them to react in a less than favorable way and significantly impact their improvement. We instruct them to be in tune with their bodies and how they respond to foods they eat. Carbohydrates seem to impact a significant number of our patients and their sense of well being, so again we ask them to consider how they feel after they eat and record that in their patient journal so we can see if there is a pattern that we can detect and hopefully modify. Again, it is a question of the patient getting to know their body and what triggers wellness and what triggers symptom flare ups and then working with us to develop a plan to modify those behaviors and reactions.
6) Are there any recent research studies you are following that you think hold promise for CFS and FM patients?
Dr. Sharp: As a member of AACFS, an international professional organization for clinicians and researchers to study CFIDS, I am able to follow current research in the field. I also follow the current literature on Fibromyalgia, and there are many research projects going on that are quite hopeful. I have submitted for publication a study based on the Marshall Protocol.
The Marshall Protocol was developed by Trevor Marshall, Ph.D., in 2002 to treat certain diseases that involve Th1 immune system dysfunction. Dr. Marshall’s hypothesis is that Sarcoidosis, Lyme disease, Chronic Fatigue Syndrome, Fibromyalgia, Lupus and Rheumatoid Arthritis are caused by intracellular bacteria and a dysfunctional immune system. His theories of Th1/Th2 imbalance of the immune system sounded like what I had learned about CFIDS. I have a patient who has made a remarkable recovery from Sarcoidosis with this protocol, and now many CFIDS and Lyme patients are becoming aware of this important discovery. When I met Dr. Marshall in Wisconsin last month at the AACFS, he remarked how researchers like himself are often 20 years ahead of traditional practitioners, which is very frustrating.
Other areas of interest I am following include hypercoagulation issues, neurotoxins, emerging infectious agents and using nutraceuticals to balance these issues. I am most impressed with the work of Jeffrey Bland, Ph.D., and his theories of how nutrition is related to gene expression, which in turn causes or reverses illness. I am convinced that the area Dr. Bland calls “Nutragenomics” holds great promise for all mankind in dealing with chronic illnesses. I truly believe if we can stop polluting the world and poisoning ourselves, we may be on the verge of eradication of many illnesses.
7) What is the single most important piece of advice you give to CFS and FM patients?
Dr. Sharp: NEVER GIVE UP HOPE! I know that is easier said than done, but there is hope and there is help available for you to regain control of your life. Our outcomes are showing that we can help patients regain a quality of life they thought was long gone. Research is moving forward and as these conditions gain more national attention, more research will be funded to develop even more treatment options for patients.
8) Anything else you'd like to address? Parting words of advice or encouragement?
Dr. Sharp: First, keep reading and educating yourself and your health care provider on the options available that have proven medical outcomes. Often physicians, who do not specialize in this highly specialized area of medicine but are working hard to help their patients with FM/CFIDS, welcome information regarding these treatment options since they don’t have time to stay on top of the latest options that are helping other patients. The Internet has a wealth of information on it and resources for patients and health care professionals alike.
Next, know you are not alone. We recently conducted an Internet survey of FM/CFIDS patients and we asked a lot of questions about lifestyle issues and how they were impacted by these conditions. The response was overwhelming (over 1350 responses in 10 days) and the quality of life issues they deal with seem to be universal. One of the most common statements and questions posed in the free writing sections of the survey was “Please tell me I am not the only one feeling like this.” Right now it is estimated that here are over 12 million Americans suffering from these debilitating conditions and their stories of pain, exhaustion and loss of quality in their lives are similar. So while each patient has a unique presentation of these conditions, each experiences similar struggles.
And finally, keep searching for health care providers who “get it”. If you are being treated by a physician who does not recognize that this is a very real condition – find a new health care provider. You are not sick because you are depressed, you are depressed because you are sick. These are very real conditions which can and will rob you of your life if you don’t get them under control. And, if you are being treated by a provider and are not seeing a significant improvement over 6-12 months, look to other treatment options or if your practitioner is not open to trying other treatments find a new provider. It is important that you take control of your health care choices and the path you follow as you work to overcome these overpowering diseases.
Readers can get more information about FFC and our approach to care and treatment by visiting www.fibroandfatigue.com or by calling toll free 1-866-443-4276. A complete list of current FFC centers is available on the website including direct to center phone numbers.
The Fibromyalgia & Fatigue Center of Ft. Worth is located at 4521 S. Hulen Street, Suite 200, Ft. Worth TX and the direct number is 817-924-1010.
This interview is an exclusive and is copyright ProHealth, Inc. All rights reserved.
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