Saving Your Child from PANDAS

Today's Valuable Resources/Link:

https://www.drohara.com/

Summary

In this episode, I introduce you to Dr. Nancy O’Hara

She is a board-certified pediatrician who specializes in treating PANS, PANDAS and BGE and other neurodevelopmental disorders. She is a leading trainer and mentor of clinicians in the US and globally, educating medical professionals to recognize, diagnose and treat PANS, PANDAS and BGE.

Dr. O’Hara graduated with highest honors from Bryn Mawr College, as part of the Alpha Omega Alpha Honor Society from the University of Pennsylvania School of Medicine. She earned her Master’s degree in Public Health from the University of Pittsburgh, and completed her residency, chief residency and general pediatric fellowship at the University of Pittsburgh.

Before she began her medical career, Dr. O’Hara taught children with autism. From 1993 to 1998 Dr O’Hara was a practicing general pediatrician and partner in a group practice. In 1999, she began her consultative, integrative practice for children with special needs, dedicating her practice to treating children with neurodevelopmental disorders, ADHD, PANS/PANDAS and BGE, OCD, Lyme, and Autism Spectrum Disorder.

Today she speaks about:

Introduction and Background (0:00)

Understanding PANS and PANDAS (6:14)

Symptoms and Diagnosis of PANS and PANDAS (6:32)

Risk Factors and Genetic Predispositions (11:21)

Treatment Approaches for PANS and PANDAS (18:55)

Challenges in Diagnosis and Medical Education (27:14)

Conclusion and Final Thoughts (28:22)

Join me for this episode of Mommy Heal Thyself to learn more about ways to identify and address neurological issues that may be affecting your child.

Transcript
(Note, this was transcribed using a transcription software and may not reflect the exact words used in the podcast)

Intro  0:00 

Welcome to Mommy Heal Thyself.  We featured guests that provide you with the tools, resources and strategies you need to say no to a life of pain and suffering all forms of preventable disease, toxic drugs and unnecessary surgeries. We hope to inspire you to boldly reclaim your ability to heal, and to serve ones to love.

Dr Michelle  0:08  

Welcome. Welcome everyone to another episode of mommy heal thyself today I have with me, Dr Nancy O'Hara, which is the blah blah, let's start us again. Okay, and let me make sure I'm pronouncing your name properly. O'Hara, perfect. Okay, alrighty. Welcome everyone to another episode of mommy heal thyself. Today. I have with me the wonderful Dr Nancy O'Hara, who is a board certified pediatrician specializing in treating pans pandas and BGE and other neurodevelopmental disorders. She's a leading trainer and mentor of clinicians in the United States and globally, educating medical professionals to recognize, diagnose and treat pans, pandas and BGE. Now, Dr O'Hara graduated with highest honors from Brian Mauer college as a part of the alpha omega alpha honor society from the University of Pennsylvania School of Medicine. She's earned her master's degree in Public Health from the University of Pittsburgh and completed her residency, Chief residency and general pediatric fellowship at the University of Pittsburgh before she started her medical career, Dr O'Hara taught children with autism from 1993 to 1998 Dr O'Hara was a practicing general pediatrician and a partner in a practice group practice in 1999 she began her consultative, integrative practice for children with special needs, dedicating her practice and treating children with neurodevelopmental disorders such as ADHD, pans, pandas, Bg, E, OCD, Lyme, Autism Spectrum Disorder, whoo, that is a whole heap of stuff. Doctor O'Hara, Lord have mercy. I just barely made it through. Well.

Dr  OHara  2:02  

Thank you. Truth is of just another mom trying to help moms get their kids better. So that's a short version.

Dr Michelle  2:10  

Fantastic. And as I was sharing you with you before we started, I have to betray my ignorance. When I heard about pandas, I just think little furry, cute, black and white, little things from Australia or wherever they're supposed to be. And then I realized Michelle is probably a little bit more serious than that, because she's dedicated her life to this. So I guess we can start with first telling us a little bit about what is pans pandas, and how did you get caught up in this? How did you even discover that this was a thing?

Dr  OHara  2:49  

Yeah, so pandas is an acronym. It stands for pediatric autoimmune neuropsychiatric disorder associated with strep. So it's when a child gets a strep infection and then they devolve into anxiety, OCD ticks, some type of neuropsychiatric symptom abruptly and then pans was because a lot of doctors thought it was the black and white bears. They didn't take it seriously either Sue sweeto and coined the phrase in the 1990s when I first started in practice. And I think if she were a guy, sorry, guys, or if she had more of an ego, she would have named it the sweeto disease, and it wouldn't have been so controversial and misunderstood. So in 2012 they all got together of about 30 clinicians, researchers, and broadened the term to be pants, which stood for pediatric abrupt onset neuropsychiatric syndrome, and took in a lot of other causes, like viruses and mycoplasma, which is another bacteria, and Lyme disease and mold and lots of different things. But that only made it more controversial. So I started, as you said, in that lovely introduction, which is in my bio. You know, I was a card carrying pediatrician, doing all the usual stuff. Both of my parents were doctors. Before I went to medical school, I taught kids with autism, so I had a lot of autism in my practice, but I was going through infertility, and nothing in western medicine was helping me. And one of my patients with parents of a child with autism came to me and said, You've got to meet this guy, Sid Baker. He's brilliant. He changed my life. And I said, Well, how did he change your life? And he said, he changed my child. Well, that's stupid. How does diet help autism and but because I went through infertility, I went to Sid as a patient, and that changed my life. And six months later, I was pregnant, and I left my general pediatric practice and started my own functional medicine practice for integrating the care of our children with autism. Fast forward nine years to the early 90s. Well, no, my son was born in the 90s to the early 2000s and he devolved into seizure like ticks. He would be sitting there doing his homework, and then looked like he's having a seizure about a few weeks after he had strep throat, got bit by a Lyme positive tick and had a viral infection at the same time, and only because I was doing all this work with kids with autism, I had sort of heard of this thing, reached out to one of my colleagues, and they said, Oh yeah, that's pandas. And then I dove in headfirst through the kitchen sink at him. Got him better within a month, and then started really focusing on Pam's pandas as my focus of practice. And now about 90% of the children in my practice have that disorder. And you mentioned BGE, and let me just explain it a little bit more, because what happens is, let's say you take 200 kids that have strep throat, 199 of them, you treat them appropriately, they'll get better. It was strep throat, no big deal, but about one in 200 it's about one in two in my practice, but let's say in the general population, about one in 200 kids. The immune system, rather than attacking the strep in the throat, instead attacks the basal ganglia, that's the BG in BGE, that's the part of the brain that is in in charge of motor development and anxiety and OCD and stuff like that. So the antibodies are these parts of the immune system, rather than attacking the strep and the throat, instead attack the brain and attack the basal ganglia and cause inflammation, which is what the encephalitis is, the E and the BGE as as and then they get the symptoms. So it's what we call it medicine, molecular mimicry. It's, it's like, instead of attacking the right place, you're attacking another part of the body, we saw it historically like any of our grandparents that may have had rheumatic fever after getting a strep infection, same sort of thing. And why I call it demystifying, pans pandas and a guide to basal ganglia and cephalitis or BGE, is because these other names so many physicians and other practitioners just find them too kitschy. Just, you know, Sue sweeto Actually, back to you going about the black and white bears. She was presenting at the American Academy of Pediatrics decades ago, and she was supposed to present about all the research about pandas for 15 minutes, and then this other guy was supposed to present give a rebuttal. You know what he did for his 15 minutes? He showed pictures of the animal. And this isn't a national pediatric you know. So, so why I call it basal ganglia encephalitis is, that's what it really is. Yeah, so what happens is you get an infection. Doesn't have to be just strep. It could be a tick bite, it could be a virus, it could be covid, it could be you get in a moldy, water damaged building. It could be a pesticide exposure, it could be anesthesia. So anything that has happened within a few weeks, usually two, but all the way up to three months. But most of the kids are four to six weeks later, they developed an abrupt onset of OCD. Now, what's OCD? That's that's a repetitive it's not just the hand washing. It can be repetitive thinking like intrusive thoughts. It can be repeating something over and over again. It can be reporting behaviors or excessive cleaning behaviors. It could be a restrictive eating disorder. Well, all of a sudden they think all their food is contaminated or or they're afraid of choking, or whatever it is. And then together with that, there's one or two of seven other so it could be an abrupt onset of anxiety, a nine year old that all of a sudden won't leave mom's side, or behavioral regression, 11 year old that starts talking like a baby, or only wants to watch Thomas the Tank Engine videos, or, heaven forbid, Barney or, you know, abrupt onset of ADD, all of a sudden, they can't process things. One of the things that's like pathognomonic for this, is handwriting degree. So they were writing just fine, and then all of a sudden, you look at their handwriting, I mean, I have so many pictures of this, and it totally changes. They're either writing over and over again, or they can't stay within the lines if they were coloring, whatever it is. Or they could have urinary symptoms, so that they have one of those behavioral symptoms together with an abrupt onset of bedway where they were previously dry at night, or urinary frequency or urgency or sleep disturbances. The biggest one is what we call REM disinhibition. And doctors use a lot of big words, but I try to explain them. But REM is inhibition. Disinhibition just means you're a restless sleeper. You all of a sudden, you know, the sheets are all over the place. You start at one end of the bed, you end up at the other. You can't get to sleep at all, or you've got these intrusive thoughts all night long. So you just have to have two of those. And again, if it's the handwriting deterioration or the urinary or sleep issues, plus OCD or anxiety or chicks, that's this disease, and there's so much you can do about it. So does that make sense?

Dr Michelle  11:08  

Yeah, so now I'm curious as to what is the thought in terms of why it is that for that one child out of 200 the immune system goes berserk and starts attacking the basal ganglia. What are some of the things that may trigger that or make someone more susceptible to that occurring? Great

Dr  OHara  11:28  

question. So I always use the term genetics. Loads the gun. Environment pulls the trigger. So first these kids are genetically susceptible. We know they have problems with their T cells, and we also know they may have what's called some HLA A B alleles, similar to other kids with other inflammatory conditions like lupus or vasculitis or things like that. So the things to look for in the history are one a history of other autoimmune disease in the child or in the first degree relative. So mom has thyroiditis, Dad has inflammatory bowel disease, diabetes, grandma or sibling has rheumatic fever, any type of autoimmune disease that is found in about 65% of these kids. The genetics you wouldn't know, but you could also have a frequent infection. So a kid that's always getting upper respiratory infections, sinus infections, and then all of a sudden get an infection and devolve into that. What these repeated upper respiratory infections have done is broken down that blood brain barrier. So those are the risk factors, but truly, any child that comes in with an abrupt onset of those symptoms, this should be considered and treated. So now

Dr Michelle  13:05  

you were talking about the quote, unquote, genetic predispositions, but can you tell us a little bit more about the epigenetics? Because, as you said, genetics is not really what's driving this at this point in time, or else we would have seen these children for generations and generations going backwards. And what I always say is that our children are like the yellow canaries in the coal mine. They are the ones that are indicating to us that there's something that we need to be paying attention to. And instead of vilifying the genetics of the child, let's look at what's going on that that child is signaling us about. So what are the triggers that are genetic or environmental that could lead to flipping that switch on? Yeah,

Dr  OHara  13:54  

great question. And you know, I grew up in weathers Virginia, where we did send the Canaries into the coal mines. And when the mines were too toxic, the Canaries die, exactly miners in and that's what it is. You know, we live in such a toxic world these days. And so those toxins in the mom as well as then into the child, are what are predisposing our kids to be sicker and so in combination of less breastfeeding, more C sections, living in more urban areas, not playing in the dirt, you know, we're so worried about Germs these days, but we're not getting our kids outside playing in the dirt, getting the good germs that they need in their bodies, not eating an organic whole food. Processed foods are really increasing our autoimmune diseases and using more antibiotics, antibacterial soaps, all of those sort of things. So all of those are influencing our mom's health, but also our baby's health and making them more Canary.

Dr Michelle  15:15  

Yeah, so I was curious. I know you shared a little bit about your history in terms of having difficulty in having a baby at first. And what I when I work with moms who are in that position, what I what I share with them, is that Mother Nature is very wise, and so if things aren't ideal, so to speak, then she's like, Nah, not right now. And so I was curious if, when you're looking at these children who are manifesting pans, pandas, BGE, do you find that a lot of the mothers were women who had difficulty conceiving, or may have had difficulty during pregnancy, or things of that nature.

Dr  OHara  16:03  

So that has been looked at a lot. When we're in the autism world, we're only starting to get that information in the pan's pandas world, we don't have quite the numbers, but in my personal anecdotal experience, absolutely there, there's definitely an increased incidence of infertility, particularly and the use of assisted technology, there's an increased risk with multiple ultrasounds, And there's increased risk, as I said, with C sections and lack of breastfeeding. So absolutely, those are factors. Well, tell us, tell us a little bit about medical that helped me get pregnant. It was craniosacral therapy, yeah, fixing my diet, fixing my dysbiosis,

Dr Michelle  16:56  

exactly anyway. But tell us a little bit more about the ultrasound component. Because, you know, as women, we're told ultrasounds are completely safe and you should have no problem getting these ultrasounds done. And so I would love for you to tell us a little bit more about how the ultrasound could affect a developing child in the womb.

Dr  OHara  17:18  

We're we're still getting the bulk of that research, but there are a couple of good studies that show that the sonar effects on a newly forming fetus are changing the connections that are being made, so not as much of a risk in the third trimester, that sort of thing. But the ones that are wanting to do an ultrasound very early, especially first trimester, you know, or let's find out the sex of the baby in the couple weeks. Or, you know, by whatever, that's where I really say take pause. And whenever I do any type of a test, I always say, What am I going to do differently with the results of this test? Is it worth, you know, is it going to change my management enough? And, you know, I just think we're overdoing it, and it's part of the the toxic load. Yeah, in this age of screen time and veg and and lack of ozone layers and all the stuff, this is one more piece in the bucket that for a very young fetus that is only a group of cells. It is a factor. Can be a factor that's

Dr Michelle  18:40  

just amazing because, you know, it really gives us pause to look at other traditions which have an understanding of the import of sound and colors and light and scents, how it affects the physical, mental and emotional, spiritual development of a person in general. And as you said, our children, especially that young in their developmental journey, are extremely sensitive and susceptible. Wow. So now I'm curious, because, you know, I'm the kind of person where I'm like, Okay, now what do I do with all of this information, you know. So if we have a mom who's looking at your checklist and saying, I got like, two or three on those on that checklist, what can she do? Where can she go? And from what you're saying, it seems like the first thing is we're going to have to educate our medical providers, because most of them are clueless about this and and then what are some things that you have found have been consistent, you know, in terms of things that we can all implement, even if we are not able to get to the high level interventions of a practitioner who knows what's going on,

Dr  OHara  20:03  

right? So with everybody, it should be a three pronged approach, okay? So one is treating the symptoms. Okay? So that you know, if the biggest symptom is the kids not sleeping, then you need to add something simple to help them sleep. It could be melatonin, melatonin increases or serotonin, which can also help us calm down. That's something you can easily get. It may be an herb called Valeria, which is also really good for sleep, and I can list more of those. But let me first say the three pronged approach, because the second is treating the immune system. Remember, this isn't about the germ that causes it. It's about the dysregulation of the immune system. So the first thing I would do as a mom, if I'm thinking about this, is I would give my child ibuprofen. I would give them 10 milligrams per kilogram of ibuprofen, not Tylenol. You know, ibuprofen, like Advil Motrin, and see if the flare of behaviors gets better with the ibuprofen that there's several research articles on that that show that, that shows that it's inflammation that's causing that behavior. Then if you find the ibuprofen works, there's a lot of great natural anti inflammatories, like turmeric, golden milk tea is a great anti inflammatory. Aloe, suck it right out of the plant. That's a great anti inflammatory. You know, CBD can be a very good anti inflammatory, not with THC, but just the CBD that you can get from a local health food store. So those are some of the ones that I use. Then the third is treating the trigger. Now, recruiter isn't always stress. It could be another germ. It could be a virus. It could be mold, you know, if you just so, you have to know what the trigger was. Your child just had a viral infection, for instance. And then this started think about the things that you use naturally to help viruses, vitamin A, vitamin D, you know, Vitamin D is deficient in 95% of these kids. So adding some vitamin D can be very helpful. The zinc, you know, zinc is in a lot of our natural cold products. Zinc can be very helpful. And then you can consider, if you feel comfortable using other herbs to treat the microbes, if, if your doctor won't treat with anything else, one piece of information many of these children, even when it's strep, perfectly fine. Remember, the immune system is not attacking the throat, it's attacking the brain. So in so make sure, if you go and you're you know, your child's been exposed to strep, that you ask the doctor to do a throat culture, even if the throat looks good, nine times out of 10, that throat culture is still positive. Wow. And then the last thing in treating the symptoms is all those things that we think about in in you know, Wim, Hof, hot, cold stuff, and all the bagel theory stuff. It's all about using good techniques to help our children relax, to decrease that bagel over stimulation so our cells taking a deep breath, helping our children to breathe, doing a good bath, like with Epsom salts and baking soda, and maybe if they're taking showers, ending with a cold shower, because that cold resets the bagel, getting good Sleep, as I mentioned, eating well, eating good, anti inflammatory diet, which is no processed foods, more good proteins. You know, all the non barcode foods, you know, the stuff that drill food, the foods, the vegetables, the the proteins, etc, and and then thinking about other natural ways to help decrease that, but it's really about just decreasing our vagal overstimulation when we talk about treating the symptoms.

Dr Michelle  24:33  

So now what can be done to help with the misdirection of the immune system where the immune system is has lost its way, so to speak, and is starting to attack self. Is there something that can be done to help to get it to

Unknown Speaker  24:53  

stop thinking that self is the

Dr  OHara  24:58  

great, great question and and it's about first decreasing the inflammation, that autoimmune reaction, yeah. And, you know, most western medicine doctors, not functional medicine doctors will say, all you got is ibuprofen, steroids and IVIG. That's it. That's all you can do for this disease. That I only 20, and I have the worst kids because, you know, I have a long waiting list, and, you know, I've become an expert in this and all of that. So only 20% of the kids that come to me go on to IVIG, and I can count on one hand the number of kids I use steroids in. So there is a lot you can do now. One of them that I find fascinating, that I use a lot of Dr Baker taught me, is Helman therapy, which is actually giving a helmet, which is a grain beetle, worm egg, to the child to reset that immune juice, immune tolerance. That's a lot of what I do in my practice, but that's what I meant by going out and playing in that journey. Yeah, yeah, yeah. That more immune system to the kids, but it's really about decreasing that inflammation with the turmeric, that's my favorite, and or aloe, or one of those anti inflammatories to decrease it. It's about figuring out what triggered this autoimmune reaction, what set it off, and then trying to treat that, and then treating the vagal system to try to relax everything back down. And usually those things work.

Dr Michelle  26:40  

So would part of it be getting the testing done to discern what type of pathogen, whether it be viral or bacterial, was part of the triggering mechanism?

Dr  OHara  26:54  

Yes, and you can do that all through a conventional I don't, I don't like to use a lot of specialty lab tests. One thing, 30% of these kids also have an immunodeficiency so not only is their immune system dysregulated, they just can't mount the appropriate immune response. And everything you're measuring in the blood requires you to have an immune system. So the thing that's

Dr Michelle  27:22  

most a lot of false negatives, exactly.

Dr  OHara  27:25  

So don't, don't let a doctor say, well, those strep markers are normal, so it can't be this, or there's nothing in the blood work, so it can't be this. If your child has an abrupt onset of these symptoms, it's this and and you can treat them, and if your doctor won't do it, you know, not trying to sell my book, but you can get the book and and take to your doctor, there's 500 references in there, and say it's real, you know. And we just actually published an article on a part of this too, so that you can take the research article too. But anyway, if I got off track thinking about that, but, but anyway, if, if the blood work is formal, don't rule this out. But the blood work that I get is, I get strep markers, yeah, they're called Aso, an anti DNA ASB. I get a mycoplasma test, yeah, I get viral tests, like for covid and for viruses that are going around at that time, rhinovirus, virus or whatever. But I also ask to the parents to look at EBV, mono, yeah. Also does it and herpes, especially if they have cold sores, herpes. So you measure those, but you also measure the immune marker, yeah, the anti nuclear antibody, the sed rate, and the what's called a CRP, a C reactive protein, those are much more likely to be positive, yeah. And then I also tell parents to ask the doctor to measure a vitamin and a vitamin A level, the zinc level, because if those are low, that's very foundational, and just rechecking those can make a difference Absolutely. But all regular lab no money out of your pocket,

Dr Michelle  29:11  

yeah. So now you've mentioned your book. What is the title of your book that we can use as a resource?

Dr  OHara  29:18  

It's It's right behind me somewhere here, but it's demystifying pans, pandas, okay, and it's available on Amazon. And I, just a couple weeks ago, taped my audiobook, awesome. And the audiobook will be available probably next month on Amazon, also in any of the you know, audible Spotify, whatever. And I added five new chapters to that, on more on lime and lime co infect, more on mold, more on covid. Because I wrote this before covid was well, it was my covid baby, but we didn't know as much as we know now. And what I started, which is, is another part of the thing that a lot of these kids are deficient in, and that's folate, the B vitamin, yeah, and so I have a whole new chapter on that in the

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