Delaying Duchenne Muscular Dystrophy

Q: Can natural and holistic therapies assist people with significant genetic disorders?
A: Absolutely!
Working closely with Naturopath Christine Barnes, our young patient has avoided being wheelchair bound and is joining his peers by participating in the school athletics carnival.

Transcript

0:02

Hi Christine, how are you doing? Hi Daniel. Very well, thank you. I am so grateful you came on today. Thank you very much. You're very welcome. I'm particularly grateful because many years ago I went to a conference and they were talking about using specific nutrients and nutrition and diets in people with down syndrome. And I was completely blown out. I've got to say what you could do by changing someone's diet using some specific nutrients. There was a professor that had come out from Germany to talk about his results and they were talking about changing bone structure. If you got the child young enough, they were able to change some degree facial expression, so didn't quite look like a person with down syndrome. And facial features started look like people that didn't have down syndrome. So I was absolutely astonished and that was why I'm so excited to talk to you today, because I know that you do a lot of work with people diagnosed with specific genetic diseases. I really believe there is so much that can be done so good. It'd be really bad if you didn't agree with me. Yes, true, true. But yeah, it is an interesting. I actually haven't had a Down syndrome case, but I would love it. And I invite anybody listening that would like to explore that with me. I have a bit of an unusual attitude to my clinical practise where if I haven't done a case that's specific, I just say to the patient, I'll give it a good bash, we'll work together on it. And really that's what keeps me interested in what I do. To me, it's a puzzle to unravel and explore. And there's so much research now on nutrition and herbal medicine and the practical application in some of these cases. Yeah, and I guess once you've got a really good understanding of your field, nutrition, herbal medicine, etcetera, and you have a really good understanding of the human body, genetics, anatomy, physiology, all that stuff. I suppose most conditions you can think about with the same philosophies and how you're going to treat and with some nuances, of course there are some specific nutrients that can't be used or you've got to be cautious or extra cautious with some medications and, you know, contraindications and that sort of thing. But when you know, you know. Exactly. And this is the wonderful part about human health, is that especially with these genetic expressions. But we're all an expression of our genes. Yeah, me sitting here is an expression of my genes. And I have my unique detoxification issues. And, you know, certain things that are expressed don't express, etcetera. So I've always used nutrition and herbal medicine to optimise my health. Why wouldn't I use it for somebody with serious or sometimes sinister type presentations? And it's very interesting. You mentioned down syndrome. When I was a student, I did work on a case. And for a while, just as a student, not actually treating, of course, because I wasn't qualified at that time. But I did find it very interesting. And even at that time, all those years back, there was still quite a bit of information about nutrient depletion, mitochondrial issues, all those sorts of things. And I suppose some of that laid the seeds for the work I do these days. Good. I'm glad you are. And I hope by the end of this conversation we have today that other people in other parts of Australia or the world can pick up the flame and keep running. Yes. And I do find that the new practitioners coming through, I'm often sharing some of these experiences with them. And even they're like, oh, we didn't know it could be that good. And then new enthusiastic people that are in there, you know, if you think about us and the human experience, we're basically just a bunch of minerals and mortar and pumps and all these things when it comes down to it. So, you know, with some of these conditions, it's about optimising. Of course, we can't say that we can or anything, but we certainly can get people functioning to the point where you wouldn't know they had some of these issues. What differentiates us is also we all have some sort of a spirit and an emotional ties into the condition. And that can be the patient themselves, if they're a young person or influenced by a parent or guardian or sibling or whatever. So I guess holistic approaches talk about all of those aspects that the physical, the physiological, and the spiritual, emotional side of things at the same time, which. Can either help facilitate optimization or it can be an obstacle as well. So. But yes, you're quite right, that nature nurture situation is very much part of that picture. I grew up with a very melted family from, you know, I had people that were married in, and they came with kids and all sorts of things. And one part of the family actually had a child. I think she was about five when she joined our family, who was what we called unfinished and which is a, which is interesting because it's a french term, unfinished. But she had a level of retardation. But we embraced her and we took her, we taught her to water ski, we taught her a bit of guitar to this day. And now she's. How old is she? She's in her early fifties. And to this day she is just addicted to music. And that's her pleasurable thing, her hobby, all that sort of thing. But again, that's part of what's made me who I am and just helping that person get to whatever their optimal status is. And of course that, I'm sure colours how I treat people as well. Well, I guess the obvious question from me is she finished now? But then I realised, before I asked that question, I thought, actually none of us are ever finished. So we just keep going. Yep, just keep making the most of ourselves and optimising everything as much as possible. So the point of this podcast is to punctuate our success as holistic practitioners by talking about a case, just to bring an example to what we do. And today we'll be talking about a client of yours with Duchenne muscular dystrophy, or DMD. And it's a really interesting case. A young boy came to see you when he was about four years old. Would you mind just introducing us to the case please? Yes, sure. It's actually a really interesting case and continues to be. I still am ongoing supporting this young man who's now twelve years old, and it's quite rare. Duchenne's is the rarer form of muscular dystrophy and thankfully I was invited to support him by his mother. His mother has a master's degree in nursing and she knew conceptually that he needed some help and that that would help him, but she didn't realise to what degree we could help. But it's one in, I think it's one in 3600 that are affected or commonly diagnosed. The common age for diagnosis is around that five or six years of age, but not always. What's been interesting with this case is the mother networked with a lot of people that were in these groups, these parent child groups, with Duchenne's in particular. And so along our journey together over these few years, she's been able to observe the other children that were only treated within the medical model, or not at all, and how they have not advanced as per her child. And it's a. That's what's kept her on track, the parent on track, because even though sometimes she goes, it scares me some of the things you're suggesting, I don't understand it, but let's keep doing it, because his specialist keeps saying, whatever you're doing, keep doing it. And she said, now I don't even bother telling the specialist. Right. She had a point of reference comparing her child to the other children in her groups. Well, that's really interesting. It is. It's been very interesting and very sad at the same time. So that's the frustrating part of doing the work that we do. I just go, he's one in, I don't know, 50 that she's in contact with, and the only one that's still not using a wheelchair. He's in the athletics team at school. He's no problems at all. We know we're monitoring his heart very closely. He's on some medication that I need to navigate around, so I need to make sure whatever I'm prescribing, we're not interacting in a negative way with his medication, but he's on absolutely minimal medication. And along the way, we've discovered a few other things that have been influencing his status, and we've been able to deal with those aspects as well. One thing that's very interesting is a lot of these Duchenne's muscular dystrophy cases have the. There's a high percentage of being in the autism spectrum to some degree, and commonly, they have gut issues and a lot of things that us naturopaths are used to treating. What I discovered with this young man is that he has fructose malabsorption, and that was creating his add. So, you know, we've been able to help him along that pathway. So, as you know, Daniel, when we're treating someone, we're treating the person. We're not just treating the disorder, the disease, or even just the symptoms. And I like to have a look at the foundation first. Are we having bowel movements every day? Are they healthy looking bowel movements? What's our diet like? When a naturopath, particularly, or a holistic practitioner, has success with a chronic, often deemed incurable or untreatable condition? Often the medical system says, oh, we must have got the diagnosis wrong. It mustn't have been Duchenne's or whatever condition that we're talking about. Yeah. So how was the diagnosis confirmed that it was actually Duchenne's that we're talking about? Well, this child did actually have genetic testing by the specialist. And, of course, the early signs and symptoms are weakness in muscles. And, you know, they started looking at that then the mother went straight. I mean, she's from a medical background, so she went down that pathway, and that's a good thing. I'm very pro working alongside a medical practitioner because I think it helps me to be able to develop the treatment protocol if I have a definitive diagnosis. And I just sort of taking a sidestep for a moment. I hope it's not too confusing, but I did treat around the same period that I got this case, two young women, one was diagnosed with muscular disorder, which was miss. Yeah, so she had that diagnosis. I had similar, very similar. In fact, we all thought it was miss as well. Young woman around the same age. But it was mould. Yeah, but they both went down the medical pathway to rule in or rule out what the diagnosis was. So even though in those cases there was crossover with what the treatment was, the end treatment that I developed was quite different because the underlying driver was quite different. Yeah, yeah, no, I get that. If that differential diagnosis is just so critically important overall, when you're looking at a young child like, can we just give him a name? Well, let's give him a name. DMDH. DM. Okay, so when DM came to see you and you sit back and you look at someone like DM, what's the first thing that comes to mind for you? What, what do you think about? Well, first off, I'm looking at if the disorder is about the mitochondria, which is that little battery we've got in the muscles, and that's then affecting muscles. So physical muscles, heart muscles, so organs as well. I'm looking at how to support that. So I go and look at all the research associated with that and go, okay. And then I go, is there any research that's associated with nutrition or herbal medicine, treatment with that particular disorder? And then I look at the mode of action. What is the action that that's creating? How else can I create that action to support that? Young Mandev? The role of natural medicine in all of this is potentially to find the gaps in his diet, nutrition, or to look at the blood chemistry or our understanding of chemistry and try to enhance where it needs to be enhanced and down regulate where it needs to be down regulated by the use of various nutrients and herbs. Is that fair? Good question. Yes. And even with that, as I started to say before that, we're looking at the foundation, no matter what the diagnosis is, are we well hydrated? How many handfuls of vegetables are we consuming a day on average? All those different aspects. So we worked on the general diet with mum, and of course with a case like this, especially at this age, they're fussy eaters, they don't like this. So you've got to manage around all of those unique likes and dislikes, et cetera. So we did that, and what I did discover with his blood test results was that the liver enzymes were not particularly, they weren't outside of the reference range, but they were close. Yeah. So what I call high normal. So not bad enough for a medical doctor to go, oh, that's something else going on. Do you think that was part of the condition or because of whatever medication he was on at the same time? No, because early in the PC was actually wasn't on a lot of medication. It sort of was developed over the coming years. So I looked at that closer and went, there's something else going on now. You can have an umbrella of things going on. We already knew that he had an autism diagnosis, we already knew he was hyper. So I went, let's test him for fructose malabsorption. So many of my hyper cases have a positive for fructose malabsorption. So he was positive, high positive. So then we adjusted the diet in relation to that. So we looked at low fructose to glucose ratio diet. We introduced enzymes to help process those naturally occurring sugars, plus some first aid. Remembering is at this stage, he's probably about five years old and he's, no matter what the diet is at home, they go to school or grandma gives them things that they shouldn't have. So we put in place some first aid for that to minimise any negative aspect of that, and that then creates a problem within the gut. So we discovered he had severe candida. So we started on a pathway of treating that and rebalancing his gut from there. And we also explored heavy metal testing and he was very high in heavy metals, which was also part of the liver enzymes being high. And so you can see how with each step that we were checking on, on the foundation, we go, no matter what the diagnosis was, we want his body to be able to function at the best and him absorb this great food that his mother was preparing for him, especially for him. And so we dealt with all of those aspects. Which heavy metals was he particularly high in? He was high in aluminium and mercury, a bit of lead as well. Mercury potentially from seafood he was eating, or fish. No, no, I believe that he had and still has some detoxification issues. Right, okay, that again, this genetic predisposition, not detoxing certain things. Yes. Possibly born with some imbalances in his gut microbiome. So that puts another obstacle on it. And of course, a lot of these heavy metals are in the food chain. In pesticides and herbicides that get sprayed on things. They're naturally drawing up some of these nutrients, naturally occurring heavy metals detoxing the soil, but it goes into the food. But why does that child have a problem building up the heavy metals and the next child doesn't? It's because of his unique genetic predisposition. Yeah, I guess also potentially the environment they're in because some parts of every country has some pockets that are richer or lower in particular nutrients or heavy metals or, you know, whatever the food they're exposed to from an early age. Yes, you're quite right. And Australia's very deplete in selenium, just naturally. And selenium is the antagonist for heavy metals. So it's not always about genetic issue, it's about the environment. And it's not always about the toxic environment. It's about the deficits in the food chain that aren't there to protect us. I remember talking to some farmers who said they always knew where their sheep or cattle died on a big property, because that would be where a patch of rich grass would grow over time. And the nutrient that was going back into that soil was selenium, which made me think about how deplete all the selenium was in the crop around that Beastie. Exactly. And that can vary from toxic levels because you can have too much selenium to totally zero. And this is where some of the functional testing that we do now as naturopaths, I love working in this time because when I started, we didn't have access to all this functional testing. And it's wonderful. So we can design the diet and the treatment protocol based on fact. Just going back to the beginning for 1 second, what made his mother think very early on that her child, or DM, was very. Was different to other children? What were telltale signs he was not. Hitting his developmental markers compared to a lot of kids. And when you think about muscles, it's like, wasn't crawling. Yeah. Was very late to those sorts of things. Once he actually started crawling, he went like crazy because he was so overstimulated. So. And his growth. His growth was slow. He's much shorter. And Duchenne's muscular dystrophy kids are much shorter. And so. And, you know, eye contact was a bit of an issue. She wasn't too sure what was going on. But again, she had a medical, or has a medical background, so she was more aware, possibly, than the next person. But I think with a case like this, any mother would be onto it and going, I don't know what's wrong, but something's going on. And it did take a while. When she first approached me, she said that muscular dystrophy had been mentioned, but they also were a bit unsure whether it was just more of an autistic situation. And really she started becoming quite motivated and if you like, helped the medical community do what was required. Because you can get a lot of gaslighting in cases like this. Yeah, sure. And because he didn't present as severe as some, possibly, but his case actually has been quite severe. It's just that we've been able to hold back the tide and say he's now twelve. Most of his cohort are in wheelchairs or dead. That's what's scary and frightening, but it's also what motivates this parent to, you know, we have periods where he's doing really well, we've got him on a base protocol and she won't see me for three, four, six months. And then she's like, oh, I've noticed he's a bit weak getting in and out of the car. That was the most recent reconnection. I hadn't seen him for about six months and she said, look, we need to get back on track. We've dropped off some of the supplementation and the diet's gone a bit out the door. She said, we need to get back on track. And so we're back in there working away and staying on track, because my goal, if the patient, and in this case the parent allows, is to have everything rebalanced. So he's optimised the beautiful naturopathic word homeostasis. He came in to see you, you made some assessments as to and some additional testing as to where you thought the need was. What was the first thing you did? Did you give him some supplements, adjust his diet, exercise programmes? The first thing I did was test his hair for tissue minerals. I looked at the diet as far as the obvious, cutting back on the high sugar content, getting bone broth in there, getting healthy fats in there for the brain development. And that took quite a bit of coaching because he was not exactly the easiest child to get on with. Look, I find most of my young patients around that age, they know their mind, they don't want that, whatever that is. But, you know, she understood good parenting and that persistent side of things and and also identifying, for instance, he loves sausage rolls. So we just what I call pimped out the sausage rolls. So we created things around what his likes and dislikes were. So we did a hair tissue mineral test, and that really was an eye opener. I could see the autism spectrum pattern there of the peaks of and troughs. He had virtually no calcium in his tissue. And when you go, okay, we've got a structural muscle issue here. And in particular, our concern is always about the heart. There's the walking around and grabbing and things like that. But the heart, you know, you can, you can't function without your heart. So we over accentuated easy to digest, high calcium foods and started working that way. And, of course, supplementation, we could see his toxicity. So I put in place some herbs and nutrients to support the liver function. And, yeah, we started working along those ways, and then on top of those, as I say, that foundation, we then applied things that were specific what the research showed us that actually helped and gave good results. And you mentioned selenium, so that was very good for ligaments. Yeah. And also an antagonist for the heavy metals and a good antioxidant, lipoic acid for heavy metals, antioxidant functionality, phosphatidylcholine. And please, anybody listening to this, I'm not prescribing or suggesting you go and get these nutrients. This was, we have lots of disclaimers at the end of this podcast. And so, you know, and coenzyme or q ten or ubiquinol, the actual ubiquinol form. And I, what I was interested in was the level of dosing required to hold back how his presentation could move forward, that negative expression of it. And ubiquinol, even at five years old, I had him on adult, what's commonly called adult dosing, but monitored very closely. We introduced it slowly, and also, I'm monitoring his levels ongoing. So even on high dosing, it didn't come up as toxic in his pathology. No. Well, look, I get that completely, because when people have significant chronic health issues, often dosing needs to be much higher to start with, to get something into the body and then cut back over time. Exactly. So you saw him, you made some adjustments to his diet, and I, and I'm aware that with Duchenne's, you know, there is a risk of putting on weight quite easily, which, you know, has a deleterious effect going down the track as well. So when he came back, were things as expected, or did you have to do a lot more tweaking? Oh, no, it's an ongoing process. You know, it's, it's not something that we can just go here, take all these things and some magic will happen. And my style of treatment is very much introduced. Things at the lowest dose possible build up to what the research shows. Monitor quite closely, observe the patient, you know, make sure that there's nothing that we weren't aware that could be happening. Because human health is complex. So I find frequent monitoring is very helpful and in particular, this style of case. And so, you know, regular, frequent appointments to the point where, as I say, he was functioning really well on all levels, his cognition was improving. Later we got him involved with some people that helped him and many others in the autism spectrum doing, as you mentioned, exercises and hand eye coordination and cognitive therapy and things like this. He was put on steroids for a while, so again, that was something I had to navigate around. Why was that? The heart. So they were concerned about the heart. They were working on prevention. I can sort of see what their thought process was. But then they took him off that, so that was okay. And yes, his weight had already started going up, but when he first presented and we did some pathology, he was quite hyperglycemic. So we made his, apart from managing sugar and protein and carbohydrate and all of that, we ensured that he was eating frequently as well. And then the steroids made the weight come on even more. But we just helped manage with that, minimised any negative effects of the steroids. Eventually, steroids weren't needed with all of those medications that the medical community has to, in their own system, prescribe. Otherwise they're deemed as not caring for that person. Sometimes my role is minimising the negative effect, working around it, so there's no interaction with anything I'm doing. But sometimes we can actually optimise things. So if we've got a pharmaceutical that is put in place, sometimes we can actually put something else in place to help that pharmaceutical work better. And this is the beauty of some of the wonderful research that's available to us as clinicians these days and continue on with that. So, and, you know, because he is so functional in a musculoskeletal wise, as I say, he, he's winning athletic competitions. I mean, his mother, where most of my patients, I get them to report in what, what symptoms are, what you're taking, what your diet looks like. The mother sends me video of him doing diving competitions or hurdles. He's doing hurdles. Wow. Amazing things like that. So she sends me these videos and a lot of the work that I've done over the years in spectrum disorders, whether they're vaccine, damage spectrum or pre vaccine, sometimes video tells a thousand words. It's really quite incredible. And I did work with a mum a while back. Geez, that would be probably eight years ago now, six or eight years ago. And she first noticed that he wasn't making eye contact and was a distant at this water park for little ones and she actually thought maybe he got an infection from the water park. She was so worried but because she had this baseline video where she had him a month prior engaged and eye contact, all those sorts of things. Then in the same spot she took a video of him totally shut down, not present, not functioning well. When we did make improvements she took him back there and did the video again just as a comparison. So all these series of videos which were both delightful and clinically very relevant. Yes. When you're treating serious genetic conditions what are the major obstacles that you come up with as a practitioner from. From the medical system or family or patient compliance, interactions, all that sort of thing. Where do you find your majority? Obstacles. Major obstacle is commonly in the home. Either both, if it's children, either both parents or one of the parents have a lack of belief and understanding of the sort of work us naturopaths do. And I totally get it because I think in some ways we're like a secret society. People just don't realise the sort of work that we do to the level that we do and the results that we can get. And often the general public only hear about you know, some crazy person that's done something and you know that's colours the whole industry. So often there is either a lack of disbelief and therefore then a lack of compliance. Right. So that can be a very real obstacle. But I like to, just like you and I are talking, I like to talk to the parents, answer any questions or concerns. Concerns or fears. The mother of our DM, our muscular dystrophy boy, she expressed some concerns about some of the dosing and we went through it, we talked about the research. I thought her concerns were relevant and worthwhile and we just agreed that we'd monitor very closely. Other obstacles can be if the patient or the parent of the patient takes on board any negativity from the medical community. When somebody is told there is no cure it gets into our subconscious and therefore then that can express in a lack of belief that we can make any improvement. We can't say medically we can cure people but we want them to be as functional and as well as possible. So that taking on board what the medical community says as an absolute and then that creating an obstacle with compliance. Enough appointments, things like that. Yeah. Throughout his treatment with you over the years of treatment, is there any evidence of continuing atrophy of muscles or heart or lung tissue or anything? It isn't as optimal as I'd like, but it's not a case of atrophy at this point. Okay. But when I compare where he's at and his functionality and his test results, I go, well, that seems to be on par with where we're at with his treatment, when I look at functional testing. So from my perspective, it's like we just keep focused and getting those parameters, those nutritional levels at an optimal. Get rid of all of the heavy metals, get his microbiome beautiful. That's what I'm seeking to do. And of course keep the fructose managed quite well. And so it's not to the point where we're concerned about his functionality, but he's having regular testing and assessment by his medical team and I'm very keen to have that information. The mum is great. She sends me all of the test copies of all the test results. His specialist, his DMD specialist just says, I don't understand what you're doing, but keep on doing it and that's really helpful. And mum was very keen for us almost to prove to the medical community that the work we were doing was working. We don't always get that opportunity because sometimes the medical community's not listening and not interested. They're just going, we've done, they've done their job and that's all they care about and that's fine. And sometimes I have to explain that to patients, that that's what the medical system is, that's how it's designed. So we're not looking to prove them wrong or prove that we're better, we're just looking for best patient outcomes. Everyone's on their journey. Yes, exactly. What are the other than selenium? Are there any other key nutrients that you thought were very important and relevant to this case? Yes, early in the case, getting him enough vegetables, which sounds very dull and boring, but he was not consuming as many children don't eating enough food that was nutrient dense and didn't have enough wide variety of fibre. So that's an ongoing struggle with most of my patients. But detoxification supporting his liver was really the key. But of course that fibre and its impact on the microbiome, the gut is part of that decomposition toxification process. That's why I mentioned that straight up front, but silly. Marin St. Mary's thistle, very famous. We did have some elevated ferritin in his liver test results, so I was quite confident in giving him reasonably high doses of silymarin. And it's a great antioxidant. Please, anybody listening to this? If you've got low iron, silymarin is not necessarily the right herb for your, for your liver. It's also amazing for blood sugar. Absolutely, yeah. For this patient, could have been quite good. Yeah. And foster tidyl choline phosphatidylserine, because he was very hyper. And of course, we had mercury, so I always put that in place when we've got mercury, vitamin e, very good for the heart. And again, he had adult doses of it, so, but really worked for him on a lot of levels for the fructose, which really, I was so pleased we got that diagnosis. We put in place a product name. It's called quatrains, and it's a range of enzymes that break down sugars. So it handles gluten. Lactose helps process sugars, and in particular, xylos isomerase for the fructose. So we didn't just target the fructose, we looked at all sugar because he had that hyperglycemic picture. And of course, the weight issue, cetera. Ubiquinol, definitely. That was, you know, a non neglect. Is that mainly for the mitochondria? Mitochondria. But if you look at the mitochondria function in all organs, and Leah Hickman, who's famous for fertility, famous naturopath and researcher, she's doing research at the moment on ubiquinol and finding dosing as per weight is very important as far as fertility is concerned. So, yeah, I listened to a talk she did the other day on that topic. Actually, it just affects everything. And when I hear that research starting to be coming through, it helps me go, yeah, that makes sense why we went down that pathway. I mean, I guess you would also normally think about magnesium. When you think about muscles, you often think about magnesium. Did that come into the equation? Absolutely. So both his calcium, magnesium in the tissue were very low. His magnesium was higher than the calcium, but we dosed him with both. And the dosing for the calcium was quite high, because when we understand the muscle function and its need for calcium, we don't want it toxic level, we want it goldilocks level. Perfect. His was so deplete. I just didn't understand how his heart was even working. And especially when we're looking at the tissue test results being heart being tissue, and that duciennes muscular dystrophy is all about tissue and muscle. So we worked with that. So we worked with it on the diet and supplemental as well. So, yes, a very large protocol. I mean, for a case like this. Were you keeping an eye on his blood creatinine levels and how are they going throughout the period? Beautiful, because we also prescribe that. So as a measure, creatinine. I always thought of creatinine as a measure of muscle breakdown, and therefore, you know, it might be one way of seeing how the transition is going. Exactly. And we found him at one point starting. And it was. And usually it was when we get test results where there was more muscle breakdown. And most patients, when they haven't seen me for a while, they go and get some test results as just the same with this case. And we found that when he was off his protocol, his optimal protocol, things started going backwards. Now, it may not have been physically that we could see in symptoms, but we could see in the biochemistry. So luckily for him, his mum was onto it. And even if they. I hadn't seen them for a few months and just the human nature of swallowing pills and powders and being on a special diet, we all get a bit fatigued with that. So she got either a symptom that was, you know, she noticed, or a test result where things were not as good as we wanted. She was back on track and she got, well, we need to get back on track, come and help us. And so we'd revisit everything. I guess that. I guess it's also a tough balancing act because we're talking about significant doses of a number of nutrients, basically for a lifetime. And so you will get fatigue with patients stepping back occasionally and then re entering the ring whenever you need to. Might be a way forward. It makes sense. Look, sometimes I find that when patients go off the rails and they're not in my calendar and I'm going, oh, don't think I've seen that patient for a couple of months. What's happened to them? Sometimes they come back and they go, oh, you know, it was a disaster. This is what went on. But it can help them come back and be more compliant, because sometimes we don't realise how well we're doing on a treatment until we stop it. Very much the situation, a case like this. Yes, I would suggest, you know, the reason that he's not in a wheelchair and he's even still alive, I quite confidently say it's because of the mum and me and him being agreeable to have the food and swallow the supplements and things like that. But now his cognition is at a point where he understands and he's even said to his mum, oh, I haven't seen Christine for a while and, you know, I haven't been taking as many pills. I like not taking pills, but I've not won the race that I wanted. So he's even starting to make the connections cognitively and, yeah, it's just human nature. And that's the challenge with the work that we do. I don't find the research challenging or coming up with a treatment protocol. I mean, I'm not saying I don't get challenging cases, but I'm a bit geeky. So I quite. That's fun to me. And we had a case that we talked about, the teabox case. When that presented to me, it sounds a bit macabre, but I got the call about that case and I went, oh, that sounds exciting. That's how much of a weirdo I. Most people going, oh, my God, that's frightening. And I go, oh, that's something for me to get my hands into. But the human nature aspect of we become. We get sick of taking tablets, we get a bit overwhelmed. It's private medicine. So we go, oh, this is costing so much, blah, blah, blah. I usually ask my patients just to tell me when they're struggling. And, like, in this case, it's a big protocol and it's, yeah, it's going to be a marathon, but it's keeping this young boy alive and living his best life. So we do it and we just accept when the family falls off the rails and does that, what's the normal. Lifespan for somebody with Duchenne's? Do you know? Many, as I said, many of his cohort are either passed away, but there are cases that live well into their twenties. The difficulty is with working with cases like this. Sometimes we get labelled with how long we'll live for, but often those statistics are not based on an integrative treatment. So I like to remind my patients that, like, when we're looking at those statistics, even with cancer, I do a lot of work with cancer. So in those statistics, when they go, oh, I probably only got five years left anyway, and I go, well, those statistics are just based. If you're using pharmaceuticals, but with your permission, we're going to do all of these other things. What if that five years was ten years? We. We don't know. We can't promise anything. But that's generally what I find. And the other big aspect to it is actually the quality of life, not just the length of life. And, you know, ten years of quality is everything. Well, look, absolutely fascinating. So where are things at right now with DM? Well, DM's doing really well. He's actually wanting to talking about representing his state in athletics. I mean. Oh, my goodness. Yeah, this is crazy. And I'm going, oh, that might be a bit much for, you know, I'm just like, tell me what you need, I'll support him through it. Yeah. Oh, that's good to have. Aspiration. Yeah. And he's doing really, really well. The whole family's doing well. He has a younger brother who doesn't have any of these health issues. And, you know, the whole family's doing really, really well. And to give you an example, because I do my appointments via telehealth, just like we're talking today, mum was running late because she was on the way to drop them both off athletics carnival. So we did our appointment in the car. She's like, yeah, here's all your athletics gear. Right, off you go. I'm going to do this appointment and I'll meet you out. But they're going to athletics like, three times a week. What? Duchenne's muscular dystrophy. Really? Yeah, yeah. It's just amazing. And what a beautiful story. Well, great work and thank you. It's just great. I mean, to know what possible for people that are being written off, to be honest. We've got this nasty genetic disorder. Not much we can do. It all needs a bit of a rethink, and there are plenty of opportunity out there. So I'm super duper grateful that you came on and shared your wisdom and experience and what a fascinating case. You're very welcome. I just hope somebody hears us having a chat and takes some level of inspiration. Even just doing one thing might improve their health and their wellness levels. And the question I always ask everybody, how do people get in touch with you? Oh, online, I'm fully online, so I don't have any borders on who I can speak to. So it's christinebarns.com dot au. My clinic is called the bodyguard. So thebodyguard.com dot au go to either of those websites booking an intro chat where we have a short chat just to see if we like each other, if we want to work together, and then we go forward from there. Okay, wonderful. Christine, you're a gem. Take care see you.