Underappreciated MCAS strategies with Dr. Kelly McCann

[00:00:00] Jill Brook: Hello, fellow Mast Cell patients and marvelous people who care about Mast Cell patients. I'm Jill Brook, and today we have another amazing episode of Mast Cell Matters with our incredible guest host, Dr. Tania Dempsey, superstar specialist in treating MCAS and related disorders. And in these episodes, she brings along her superstar colleagues to bring us the best discussions on Mast Cell Activation Syndrome. Dr. Dempsey, thank you for hosting, and whom did you bring with you today? Dr. Tania Dempsey: I'm so happy to be here today and I have Dr. Kelly McCann. I'll give you a little bit of a intro to her Dr. McCann began her career in medicine with the intention of providing a comprehensive, holistic approach that encompasses the mind body spirit connection. She's been practicing medicine since 2000 and continues her education to provide cutting edge expertise, tools, and services for healing. She earned her M. D. and simultaneously her Master's in Public Health and [00:01:00] Tropical Medicine at Tulane University. She completed, completed both an internal medicine residency and a pediatrics residency actually in two different locations Banner Samaritan Medical Center and Phoenix Children's Hospital. Dr. McCann is one of only 35 physicians worldwide to have participated in the residential fellowship in the program of integrative medicine at the University of Arizona where she worked with Dr. Andrew Weil. She's certified by the Institute of Functional Medicine and also board certified in integrative medicine by the American Board of Physician Specialties. And she's in private practice I believe in Costa Mesa. And hopefully I didn't miss anything. Dr. Kelly McCann: Now that's plenty. Dr. Tania Dempsey: Dr. McCann, thank you for being here. Jill Brook: Yeah, thank you! Dr. Kelly McCann: Thank you, Dr. Dempsey. I'm very happy to be here. Dr. Tania Dempsey: Great. Well, we love having you and I, I guess we'll just, you know, we'll just dig in and talk a little bit about you know, I'd like to, I'd like to hear from you [00:02:00] how you became interested in mast cells and mast cell activation syndrome. Dr. Kelly McCann: Yes, thank you. You know, I had originally started in integrative medicine and then functional medicine environmental medicine. I did a fellowship with Walter Crinion. And one of my colleagues at the time in that class said, hey, you really need to learn about what this guy, Richie Shoemaker is doing. Dr. Shoemaker, who was teaching practitioners and patients alike about the evils of mold and mycotoxins. And so I learned about that and then realized I needed to know about Lyme disease because people who had mold also had Lyme disease. And then they started coming in really sick and really sensitive, and that led me to Dr. Larry Afrin, who taught many of us about mast cell activation, who's your partner in business. So that was really how it all came about. And [00:03:00] thank goodness, because there are so many people who have mast cell activation, who have weird hypersensitive symptoms, and they don't know what's going on with them, and they really need a lot of help. So, I'm, I'm happy to have learned about this, to have so many tools to help people. Dr. Tania Dempsey: Yeah. No, definitely, and we need more and more people who have, have tools, and I, and one of the things that I love about the work that you're doing is that you're really out there educating, right, because that's part of, part of this is that we need to get the information out there, right, to educate the public and to educate practitioners. So tell us a little bit about some of those educational things that you're, that you're doing. Dr. Kelly McCann: Thank you. I've hosted two, uh, virtual summits, both through Health Means. One was in 2022 and I did that all on my own. I had no idea what I was doing or getting into but it was absolutely fascinating, a labor of love. I interviewed over [00:04:00] 40 40 experts in the field, many of whom you know, and I included you, of course, to really help flesh out the idea and to get this information out into the public venue as much as possible. So, as you know, these online virtual summits are free to the public. Typically, they launch for a week. You can watch the videos as they, they get released. And then last year, Beth O'Hara from Mast Cell 360 and I co-hosted another virtual summit at the end of October. Again, another amazing array of 40 plus practitioners and experts in the field. And we did interview style and sometimes they would do lectures too. Again, help get that information out there. Dr. Tania Dempsey: No, that's great. And I believe, you know, people still talk about these summits and what [00:05:00] they've learned. So that's, that's really powerful. What do you see as an untapped potential for patients to feel better from your experience? Dr. Kelly McCann: You know, I think one of the things that there's so many different things that we can do for mast cell. And I think that yeah, there's so many different things we can do. And I, I really think for mast cell patients, it needs to be a whole, whole being experience, right? We are not going to get somebody from hypersensitive and reacting to everything with lots of mast cell symptoms. And get them better unless we address not just the body symptoms, but also address the mind, the emotions even, you know, going into the realm of spirituality dealing with trauma because our bodies are are an expression of, of our entire being, right? [00:06:00] And whether we're using pharmaceuticals, whether we're using herbs and supplements that's not going to be sufficient to move the needle all the way from where people are starting to where they really want to be in their lives. Dr. Tania Dempsey: And, and how, so how do you work with patients in that regard? Dr. Kelly McCann: I think it becomes, it, we work in layers, right? So we have to help them start to feel better. So I'm often working on symptoms. Some symptom relief is really the first phase of things. And then also simultaneously trying to understand the triggers. What are the drivers for mast cell for most patients, and oftentimes it is mold. It can also be Lyme and chronic infections. It can be environmental toxicants. It can be EMF. And so we're exploring those things, you know, and, and their patients are coming to me because they have physical discomfort, right? There's things in their physical bodies that they're not [00:07:00] enjoying any more, and they really want to heal that. And then depending upon the level of openness and as we have that therapeutic interaction, we can start to have conversations about, you know, their past, their thoughts and their beliefs about themselves. And so some patients will have a history of a very traumatic childhood that set their nervous systems up to be hypersensitive and constantly in fight or flight. And so, we may then start to work on the autonomic nervous system in terms of the vagus nerve. And it's always a, a interesting path because each person is so unique and what they resonate with is so unique. So, you know, I have like 10 or 12 different vagus nerve stimulation things that I can say, you can try these different ones and which one would really appeal to [00:08:00] you to give them the empowerment to say, okay, this is something that I want to do, that this resonates with me. I teach patients how to muscle test themselves so that they can engage in their, in their supplements and engage in their medications and feel more empowered with the choices that they make. And then after we're calming down the autonomic nervous system and maybe adding in limbic system retraining oftentimes then it's, let's have a conversation about what you're telling yourself. What are the beliefs? What are the thoughts that you have that may be undermining your capacity to heal? What are the emotional things that are getting in the way of your ability to fully heal. And we talk about how the body is the only way through which our, our beings, our soul, our, you [00:09:00] know, higher self, whatever you want to call that, that's our bodies are the only means through which it, ourselves, our true selves can communicate with us, right? And, you know, sometimes people aren't ready to hear this conversation or to have this conversation. So that's why I have to time it in a way that it can be heard and received. But our bodies are so smart and they're doing their best to protect ourselves, right? And so if, if there's a situation that the body feels that it's threatened, it could be a misperception, but it may still be doing the best that it can. And so there's a lot of layers of thoughts and beliefs and emotions that really need to be uncovered. And so I've often referred people to energy healers, to people like Amy B. Sher, who wrote a book called How to Heal Yourself When No One Else Can. And she was a Lyme [00:10:00] patient who who tried all of the things, did stem cell, and didn't, got a little bit better with stem cell, but really needed to do that emotional work to figure out what were the beliefs that she held inside of herself that were really preventing her from healing. And I think that that's the the, one of the most powerful pieces to get somebody from 75%, 80 percent to really not even a hundred percent, but thriving in their lives in a way that they probably never have before. Jill Brook: Well, Dr. McCann it's so interesting and we don't hear very many physicians talk about that. I'm just wondering, can you like give some examples of what you mean, like what are thoughts that might get in the way of healing versus not? And I know you mentioned spirituality earlier, and I don't know if that's tied in, but do you just mind maybe explaining a little bit more the specifics? Dr. Kelly McCann: Sure. So for example, [00:11:00] you know, many times patients are really hard on themselves or they put everybody else first. Right. So it's this, I'm not worthy. I'm not enough. I'm not important enough. My value and my worth comes from taking care of other people. So it's, those are, those are some ideas of thoughts that people can have. I think that not enoughness is, is hugely rampant in the population and, and when patients experience trauma that's the the idea that the world is not safe, and that they have to protect themselves even from people that they love, even from people that are close to them, that sets up a condition in the nervous system where nowhere is safe, nothing is safe and yet, I don't really think [00:12:00] that that's where our being, our soul, whatever you want to talk about in terms of that consciousness, that's not where we're meant to be. And so if our bodies, no, if our souls are trying to communicate with us, the only way that it can do is through the body. Does that make sense to you guys? Jill Brook: It does, it ties into one question I had for both of you that I've been wanting to ask you both for so long, and I don't know if it's totally relevant, but that feeling of impending doom that often times comes with bad MCAS flares or anaphylaxis. That kind of sounds like what you're talking about, this feeling of, oh no, I feel so unsafe. Like, is there anything known about that? And does, does that get better when you work on your beliefs? Dr. Kelly McCann: It does. It does, because it's not true. It's not [00:13:00] true that the world is going to collapse and everything is going to implode. It's not true, right? But we have the perception that that's going to happen. Now, of course you know, I, I start with an assumption. My assumption is that my physical body is not just, is not the only part of me. That there is a aspect of me that is eternal. And, you know, that's, I'm not talking about this in terms of a religious standpoint. It's more of a spirituality standpoint. And that's something that I've always believed from the point, from the time I was a little girl. I mean, I remember I was like four or five years old and Godmother was talking about reincarnation and I just thought that was the coolest idea ever. Like, okay, we get to come back and talk about a hoarder, I thought, I'm gonna keep all my stuff so that when I'm a little old lady, I'm gonna pick [00:14:00] who my next parents are and I'm gonna give them all my stuff. Oh my god. Uh, yeah. So. So, not everybody starts with that standpoint, with that belief that there is something after death. But if that is, you know, in your consciousness, if that is a possibility, or if you're even open to that idea, what if the life that we have right now is an opportunity for learning and growing and developing, not just as a human being, but as, as as a consciousness and that everything that we're experiencing is enabling us to get to the point where we have the full expression of who we are, right? That's what we're here, that's what I believe we're here to do. And [00:15:00] what if all the things that we're experiencing in MCAS is just, just feedback, just guidance, saying, hey, there are different ways to do this. There are different ways to, to be in this world. And how we're do, how you may be doing it right now is not, not working for you. So how can you dig deeper. How can you uncover what it is that's in your way? Dr. Tania Dempsey: That's a, that's a really interesting perspective but I think there's about, there's a balance, right? Because I, I want to make sure that people listening understand that you're not saying that these symptoms are not real. Dr. Kelly McCann: Oh, no, no, no, no, no, not, not at all. These are a hundred percent real. And they're, they can be devastating. I totally understand that. I see that in my patients. I've experienced it myself. These are very uncomfortable, but think about [00:16:00] how we learn just in school, right? And we learn in life. Some of our biggest teachers, some of our biggest life lessons are when things are uncomfortable, right? We don't learn when it's easy. Not so much. We learn when it's hard. And what if folks with MCAS have signed up for, like, the harder, the harder life curriculum? You know, I mean, we think about having chronic illness as such a terrible thing, but maybe we can reframe it. This isn't terrible. This is your opportunity to embrace the life that you deserve to have, right? And you can dive as deep as you want into your your soul, your being and transform your [00:17:00] entire life. And yeah, it's going to start with cleaning up your diet and cleaning up your home and making sure that you're, you know, physically safe in the world. But then it may also require you to clean up your personal relationships and fully embrace who you are. Say no to, you know, energy vampires and people who do not really love you and care for you the way that you want to be loved and cared for. And do what you want to do. Like, embrace who you really are. Jill Brook: I have to just laugh here because I think I'm hearing my husband's voice saying, so don't think of Mast Cell Activation Syndrome as a disaster, think of it as a disaster tunity and, what I hear you saying is your thoughts and your beliefs are going to affect how you [00:18:00] heal anyways. And so you might as well choose the positive spin because if you want to feel better, that is going to help. Dr. Kelly McCann: Absolutely. Disaster tunity. He needs to trademark that. That's awesome. Yeah. Yeah, I, I mean, I, I get it. It's hard when you feel crummy. It's really hard when you feel crummy, but life is such a beautiful opportunity at any moment and any day to say, you know what? I don't, I don't want to do this anymore. I don't want to live like this anymore. I'm going to make a change. I saw a woman yesterday who I've been seeing for about a year. And when she came in my office her POTS was so severe that she had to lay down. I have like a little half couch and she, she laid down through the entire first appointment because she [00:19:00] couldn't sit upright. And yes, and we still have a long way to go, but yesterday she came in and she's glowing. You know, not only is her POTS under control, but, and actually what ended up happening throughout the course of the years, her husband was like, you know what, I'm done, I'm out. And she was upset, but she also realized that he didn't love her the way that she deserved to be loved. And it was like the most freeing thing for her to get out of that marriage that was no longer serving her, no longer supporting her, and she's just chosen herself again and again, you know, really choosing, choosing herself every time she eats something, every time she takes a supplement, every time she is in a relationship or not in a relationship with somebody. It's really awesome to see that transformation [00:20:00] and to know that that power is inside of you, right? There are wonderful practitioners out there in the world that can help, nutritionists, you know, lots of community of mast cell, for mast cell patients. And, and yet, it's really all about your relationship with yourself and how, how you can empower yourself to make those choices. Dr. Tania Dempsey: It's so, it's so powerful and I, and I think that it's something that we don't talk enough about. So I really, really appreciate you bringing this to our podcast and, and helping us understand that. So let's say a patient is in this state where you know, they're anaphylactic. They are, you know, often anaphylactoid. They are, it's just, it's that feeling of impending doom very often. It's that feeling that they're just never going to get out of it. How, how do they take that next [00:21:00] step? Again, they're working on their triggers, they're working on their mast cell targeted medications, they're doing all that. So how do you guide them to that, to that place? Because sometimes depression, anxiety, other things are so at the, at the surface, you know, that you can't even get to that sort of logical way of thinking. You can't get that deep. So how do you like chip away at it so you can get to that place? Dr. Kelly McCann: You know, I, I think it is multifactorial and I think it is all about timing, right? So, as people start to feel physically a little bit better, and you're talking about somebody who I might not have this conversation with yet, right? It may not be the right time. I had a, another young woman, I've been working with her for probably three years now, [00:22:00] and and she had oxalate issues and she was miserable and her hormones were all messed up and, you know, so we're chipping away at the physical stuff and, and it probably wasn't for a good year, year and a half maybe before I even said, okay, you're ready. I'm going to broach the subject with you. Right. So it really is also about the practitioner and having a, a confidence and an understanding of when these concepts may be able to be introduced, you know, and, and for this patient, she was doing Gupta, she tried Annie Hopper, you know, she was trying these things. And what she told me later was she couldn't find joy. You know, one of the things that Annie Hopper and, and Gupta program is like, okay, find that memory of joy, and she was like, [00:23:00] it ain't there, right? I can't, I can't access that, right? And and so that may not be the right time. But sometimes it's a, it's, it's more an opportunity to say, what if we reframe how you're thinking about this, right? And maybe that's where I start the conversation. The disaster tunity. Maybe, maybe there's a reframe. Cause I think we get really stuck, this is the way it is, and I've got this pathway. You know, and even while I'm doing the, what I would call the physical world stuff, like, you come to see me cause I'm an MD, and I'm doing all this physical stuff. I'm still empowering them, right? I've taught them how to muscle test. Because honestly, as much as I respect Larry, the idea of taking two weeks to go through every H1 blocker [00:24:00] on the planet just seems a little exhausting. Right? I want people to feel better faster. And if I can teach them how to muscle test, not only do they at least have some buy in that these, you know, five or six things are going to be helpful to them, and it's not perfect all the time, but you know, there's, there's something to it. Now I've empowered them. They have a tool. They can use that tool. Does this feel, this, this food feel good for me? Does, you know, this supplement, is this going to be helpful for me? Jill Brook: Can you say a little bit more about muscle testing? What's that? Dr. Kelly McCann: Okay. I've got my woo woo hat on now. if I didn't have it on before, I definitely do now. Again, um, our bodies are really smart. We're connected, you know, it's like mind, body, spirit. We're not separate. So, if our, if our beings, our intuition knows what's good for us and we can ask our bodies in a way [00:25:00] that it can communicate to us, why not? Right? Chiropractors have been doing this for a long time. But I don't want you to have to come to me to push your arm down and say, oh yeah, that food, that thing is going to be good for you. Right? I want you to be able to do it for yourself. So usually I will teach people a variety of different ways but for those, I'll explain a little bit more detail for those who are like, what is she talking about? And you can play around with this with your friends at home. So grab a buddy and then have one person stick their arm out straight. You want to keep your arm straight and you want to resist. And then the other person is going to take their hand and try and push down your arm around your wrist. And, you know, do it without saying anything. And so try and resist. And that is when you're strong or the answer is yes, right? We're going to ask yes or no questions. And then, then I want you to say my [00:26:00] name is whatever your name is and have the, have your partner try and push your arm down. You should be strong unless of course you don't like your name, but you really should be strong because your being knows your name. And then say, you know, my name is George or Harry or whatever it's not, and see what happens to your strength. When we tell lies, when we are not being truthful, when something is not accurate or good for us, we go weak. So, if something is true, accurate, in alignment, healthy, whatever did you guys ever look at Omoto's work? He was the one who did the, the Language of Water, I forget what the exact name. He had those pictures of water crystals, and so he would write words on the water crystals, like love, and then freeze [00:27:00] the water, and would show pictures of the, the crystals that were in those containers, and love, beauty, truth, they were all beautiful symmetric, gorgeous crystals. When he would write things like hate or put a swastika on the water, it would be ugly, deformed, just amorphous. Very clear that it was not synchronous, right? The idea is the same with the body. We're how much percentage water? A large percentage of water. And so it makes sense that when things are authentic, true, in alignment, we're going to have more strength, more capacity more symmetry. When things are out of alignment, we're not going to [00:28:00] be that. So that's the general concept of muscle testing. Does that make sense? Dr. Tania Dempsey: Yeah, and thank you for explaining that. I, I do use some muscle testing in my practice. You know, I'm certainly not trained, you know, fully, but I, but I've sort of taught myself, and I do think it can be helpful, and I respect patients who, who use this technique. What I have found, and this may sound a little bit woo woo also, but I'm just going to put it out there. What I have found is that it's not as helpful in, in MCAS specifically. Okay, that's going to sound kind of crazy, but we can muscle test herbs, you know, let's say we're going to treat Lyme disease, we can muscle test, you know, I have some patients that really love that because they're so connected energetically, so that when they, they muscle test, they know, they feel it and it makes sense to them. There are patients who don't believe it, and I don't think that it's not going to be right, and we don't do [00:29:00] it. But, but, what I have found is that I have patients who have come in, I had a patient yesterday who had some muscle testing done by another practitioner who told her that her Xyzal was bad for her, her, something else was bad. It was all the medications and then gave her more supplements to take on top of it, but she was in a state of a flare. She was in a flare. The patient didn't understand, actually, that it was a flare. She thought she really was reacting, because she saw it as the health of this practitioner, who then was trying to help, trying to help, but what, what, what I see, and this is not the first time I've seen this, she'll do, they'll do this muscle testing, they'll say, okay, you know, the Xyzal's bad for you. The thing is that mast cells are very fickle, and they sometimes, like one thing, they don't like one thing, right, they change very quickly. And so what I have found is that muscle testing does not work really well in the realm of medications for mast cell. Because I can test her, and the Xyzal [00:30:00] could be very strong, and then somebody else can test her tomorrow, and I'll be very weak. So I actually am a little bit, like, concerned about using muscle testing for mast cell drugs, in particular, because I've just found them to be the most inconsistent of anything that I've ever tested. So just, that's just like a little anecdotal thing, and so I'm also a little bit worried about patients who, let's say, are doing well. So, so the whole point is that the Xyzal was not the problem with this patient. It was a mold exposure combined with the stress of the mold remediation, and that was the problem, right? The Xyzal was probably controlling her to some degree, but not enough. She maybe needed more mast cell targeted therapy. The other practitioner, not understanding it fully, just said, okay, you're taking, you know, drugs are bad, so the drugs, you know, you're reacting to. Dr. Kelly McCann: Right? Dr. Tania Dempsey: Again, she meant well, but I just think that it just, you know, then patients start to become very scared of the, those things and, you know, they can't take it because one time they [00:31:00] tested badly, but the testing can change. You could be sensitive to something one day, not sensitive to the other, the other day, right? So I'm just a little bit cautious when we're talking about drugs for MCAS because I want to make sure that we're not like stopping and starting Claritin, stopping and starting Xyzal just because like one day it didn't test as well, and because something else was going on that day, right? So that's the one thing that I just, I want to bring up. I'm just curious what your experience is, you know? Dr. Kelly McCann: I completely agree Dr. Dempsey, and I'm glad that you brought that up. You know, one of the, so there are two caveats to what I'm saying. One, my goal for patients is to learn how to do this themselves and to learn how to read the language of their own bodies. And if they're not there yet, then we're not, they're not there yet, right? And we're going to practice. I don't want you to be reliant on anybody else to do the muscle testing. So although my description was about [00:32:00] how we do it, how other people can do it for you, that's not my goal. And I completely agree with you in terms of we have to be really careful and really thoughtful about changing things up because you're right, there are a ton of very well meaning practitioners out there and they're doing their best and they might not have the full scope of the whole picture. And I think that's really important. Especially when patients go to practitioners who want to load them up on a ton of supplements. You know, um, the goal is not more supplements. The goal is the right, the right medications and combinations of supplements for you at the moment that we're dealing with it. And when I'm teaching patients muscle testing, it really does depend if I think that they're ready for that. Not everybody's ready for that. And that's okay. [00:33:00] It's a tool that some people can utilize and, and some people can't because that's not, they don't believe it, or it's not, you know, it's against their religion or whatever that may be. It's it has to be very thoughtfully applied. The other thing that I I also do, when I'm teaching people how to muscle test, is make sure that you are grounded and that you get yes as an answer and an appropriate no as an answer before you start asking the questions. Right? So, I'll teach people what's called the Sway Test and I'm self taught. You know, no, I didn't take a class in this. I've just practiced with patients and practiced on myself and it's not complicated, but there's that level of connection that you have to have. So before I have patients start, we have to make sure that, you know, they sway [00:34:00] forward with yes and backward with no. And if they're, if they're not, then we can't proceed with the muscle testing. And I do think that that's something that gets missed for some people. So thank you for you know, bringing that bringing that issue to the forefront because I agree again. It's really about timing. Dr. Tania Dempsey: Yeah, it's about timing, but also, I want, I, you know, I, I probably sit somewhere between you and Dr. Afrin, right? So, okay, so maybe two weeks sounds like a long time. Usually you can tell a little sooner than that. You really can't get a sense, but the, the reality is that the body does change and so Claritin could be great today. You know, next year maybe it's gonna be a different drug or, you know, sometimes that happens. Sometimes there is just one drug that's good. Again, I think that the muscle testing has a role, you know, and I, and I love, I love that, that piece of it. But again, in the [00:35:00] mast cell world, it just doesn't seem to be as applicable as in Lyme world, or when I treat other conditions. And so that's just like a little bit of a warning, like, again, because what, what I don't want to happen, and I, and I've seen this, excuse me, where patients are, let's say today they tested positive for Claritin, so they take Claritin. Tomorrow, they didn't test for Claritin, and they start doing it every day, and trying to figure out what they're supposed to take every day. Maybe there's, there's, there's that's good for some things. I do think, like, if the body doesn't need all the vitamins today, maybe you don't take all your vitamins today, maybe, right? I'm not sure I, I buy that totally, but if they're, because their body told them, they thought it told them that today they don't need Claritin and then tomorrow they're in a flare, but they don't realize it's because they didn't take the Claritin yesterday because their body told them. But did their body really tell them that? Or is it a, is it an accurate sort of assessment? And, and, and could it just be that it wasn't like right at that moment but they really should have taken Claritin like an hour later? It just [00:36:00] gets so complicated and I just want to make sure that patients are not playing around with their drugs and especially when things are working. Dr. Kelly McCann: Absolutely. Yeah. That's, I use it really to help guide my choices and I'm not saying muscle test every day to make sure what what you need and what you don't need. Particularly if things are working for you. And especially if you, if you're in a flare, then we need to evaluate what's driving the flare. Far, far more important to look for a, a new exposure, a new root cause than, oh, all of a sudden you're supplements don't work for you. Yes. Jill Brook: You know, what's interesting that's going through my head is getting back to what you were talking about, the study with the water and the love versus hate, and it seems to actually have some effect somehow through energy. I think that this could be valuable for somebody like me who knows I should not spend time on Twitter getting angry at the world, but I do it. And, [00:37:00] and I wonder if, you know, doing the muscle testing with something like that could help me see that, oh yeah, that's bad for you that, you know, you were doing fine until you got all that Twitter negativity and that's what threw you off. And you know, we, I think a lot of us mast cell patients do have days where we felt like we did everything right and we still were itchy all night or something like that. But we're thinking about what we did with our food and our medicine and our, you know, things like that. And we don't think about the fact that, oh yeah, I got, I got really angry at the world cause I stayed on Twitter too long. Or, you know, some of those other thoughts and things. And it's kind of a good reminder that it, it all matters. And these subtle things maybe make a difference. And anyway, that's, that's, that's what went through my head, is I'm gonna use that, and I'm gonna, I'm gonna use it as one more tool to help me break some bad habits that I know are bad anyways but it might be good to see it. Dr. Kelly McCann: And then, you know, also kind [00:38:00] of do a little self inquiry. What is it about going on Twitter that, that I keep finding myself doing? So, so there's something that is drawing you there. And what is that? What is that about? How is that serving you? Is that really serving you? What, you know, like, using that as an opportunity, not just to ask if Twitter is bad for you, good for you, but, but like, what is it about that, that I'm attracted to? And is that really something that I want to put my energy towards? Because then you're rooting out the deeper the, the deeper incentive to, to go do that because you could just shift it, right? Okay. Well, I'm not going to, you know, I'm not going to watch Twitter because I know Twitter's bad for me, but I'm going to do this X, Y, and Z instead for the same underlying reason,[00:39:00] right, which still may not have the positive benefits that you're wanting. You know, it's like when we have January 1 and we got all our New Year's resolutions and we want to do these things, but we're not really looking at, well, when I fall off the wagon and I'm not doing those good things for me, what is that about? What is in me that is driving me to not make those healthy choices? And how can I understand my true motivations? Not my motivations up here, like, I want to be healthy. Or I want to, you know, go for a walk, or I want to, you know, have this goal. And then when we have what I call competing intentions how are we sabotaging those things? And what is it that's underlying that, those choices? Jill Brook: Smart yeah, for sure. Dr. Tania Dempsey: Excellent. Excellent. Yeah, no, this is, well, this went in a direction I didn't expect and I, and I'm... Dr. Kelly McCann: Sorry.[00:40:00] Dr. Tania Dempsey: No, no, I love it. I love it. Thank you. No, it's a, it's a, it's definitely important things to talk about. So are there, are there areas in, within MCAS triggers, things that you are thinking about more and more beyond the stuff that we just talked about? Dr. Kelly McCann: Always, always, always think mold. One. Right? It's ubiquitous. I do think that environmental toxicants get a little bit forgotten. We are inundated by toxic exposures on a regular basis. And you know, some of the first likely presentations of mast cell activation that were written about before we called it that was multiple chemical sensitivity. We've known about multiple chemical sensitivity for decades, and those patients were sickened by environmental toxicants. Plastics, pesticides, heavy metals. [00:41:00] And so do think about those things, both patients and practitioners. And the other thing that I've been playing around with a lot in my my practice is looking at hypercoagulability and clotting, which is profound. I've been looking at genetics in patients, not just mast cell patients, because I have a broad array of complex chronic patients. Anyone who has a family history of cardiovascular disease or cerebrovascular disease or cancer, which is basically everybody, because everybody dies from something, so most patients have family histories of those things. I'm looking at those genetics and not everybody has Factor V Leiden, but there's one called Plasminogen Activator Inhibitor that is very, very common. I would say 80 90% of my patients have at least heterozygous, if not [00:42:00] homozygous. And oftentimes my more complex chronically ill patients have PAI one homozygous gene mutations, myself included. Jill Brook: Can you say that again, plasminogen what? Dr. Kelly McCann: Plasminogen Activator Inhibitor one or PAI one, we call it PAI one. You test through it through LabCorp Request. Yeah. I was originally taught by Ruth Criss, who's a nurse practitioner, and and she would say you check for the PAI one activity, and if the activity was high, then you check for the genetics. But I've actually found the PAI one activity is elevated in people who have metabolic dysfunction. But the PAI one gene is practically ubiquitous. It is so common, and for, for example, for myself, I have cardiovascular disease and cerebrovascular disease on both sides. And I think that this PAI one [00:43:00] gene is, is very closely linked to that because it's a gene on the fibrinolytic side of the coagulation cascade. And, you know, this is just my clinical observations but there's not a lot of, there's not a lot of literature on PAI one. And my suspicion is that because we don't break down the clots as well, if there is atherosclerosis or clot formation, it's not being broken down adequately enough and then ends up as a heart attack or stroke for patients. But it also exacerbates biofilms. So if you have Lyme disease or Bartonella or Babesia or you have biofilm colonization in the bladder with interstitial cystitis and you have a hypercoagulability gene or predisposition, fibrin gets [00:44:00] deposited in the biofilms, and that makes the biofilm more resilient and resistant to the immune system, even to antimicrobials, and so it's really important for all patients who have chronic infections to be evaluated for hypercoagulability because it will change the biofilm busters that you're able to use. Dr. Tania Dempsey: So the genetics, so PAI one, so what you're saying is that if you, if you have this genetic mutation, the mutation causes the gene, it causes that enzyme or the, or that it's an enzyme, essentially. Dr. Kelly McCann: An enzyme. Yeah, it doesn't work as effectively. Dr. Tania Dempsey: It doesn't work. So, you said that they, that there would be higher levels in the blood of P, P, PAI 1? Dr. Kelly McCann: Not necessarily. So that's where the, that's where what I was taught and what I'm discovering is not the same thing. Dr. Tania Dempsey: [00:45:00] Okay. Dr. Kelly McCann: If the PAI 1 activity is high, oftentimes, so, I have had several patients who are, you know, metabolically challenged, like they have metabolic syndrome, high triglycerides, higher blood sugars fatty liver, and they have elevated PAI 1 activity. But the PAI one genes are normal, so their genes are 5G, 5G, which is the normal genes. I've had that a couple times. Whereas I have a ton of patients with PAI, PAI one 4G, 4G, which is the abnormal gene variant. And they have absolutely normal PAI one activity, but there is still that risk, and they may have elevated levels of fibrinogen activity, for example, or they might have elevated levels of prothrombin fragment 1 plus [00:46:00] 2. And then, you know, depending upon if they do or don't, I'll put them on nattokinase or lumbrokinase. Dr. Tania Dempsey: So, that's, that's how you're, how you're addressing PAI 1. Dr. Kelly McCann: Mm hmm. Yes. Dr. Tania Dempsey: And, um, and how do you think that translates to, so let's say in the mast cell patient, you said that it's not always, obviously you're not always treating only MCAS, but do you see any correlation between their their MCAS symptoms and dealing with the PAI 1? Dr. Kelly McCann: This one I have to tease out a little bit more. I've been putting flags in my chart and have to really look at it. Many of the patients who seem to be more complex, complex and complicated who have either a longer history or a more complicated history, tend to be the 4G four Gs. Not across the board, but it just, it's, that's a gestalt that I have about the patients. So it does seem that they're more [00:47:00] complicated. Jill Brook: Could I ask both of you a question about using nattokinase because it's interesting that it seems like some of the supplements are around 2, 000 units, but then you see the ones that are like 100, 000, and it just seems like they're so much higher. Is there danger in overdoing it, or are the higher dose ones more effective in your mind, or any thoughts on that? Dr. Kelly McCann: I haven't really looked that closely at it, honestly. I haven't seen it to be problematic at all. Nattokinase is very well tolerated, not associated with bleeding. They're not supposed to have any issues with them unless there's elevated fibrin. But you know, because we're potentially breaking up biofilm, some mast cell patients do have some issues and so we do have to go slow with some patients. But I've never really seen an issue with it. I don't know. What do you think, Dr. [00:48:00] Dempsey? Dr. Tania Dempsey: Yeah, no, I, no, I agree. I mean, I think, I mean, generally, like for nattokinase you know, you treat it. Typically, you'll see one capsule or two capsules of something like 20, 000 units. Some patients need, I have patients who take 20, 000 units three times a day you know, I have patients who can only take, you know, they, they open the capsule, they, they dump out half and they start, you know, really slow. So, so there's, it really just depends on the patient, the state of their coagulation pathways and their coagulopathies, or however you want to say that, and and the state of their biofilms, because that's really ultimately where, you know, where the problem is. So it sounds like you're, you're, you're interested in biofilms, as am I. I think this is like the, the real, like, next stage in, in understanding complex chronic diseases, because I think the biofilms are where it's at. Dr. Kelly McCann: [00:49:00] Absolutely. Yes. I've been using a company called MicroGen DX. Do you use them? Dr. Tania Dempsey: No. Dr. Kelly McCann: Okay. So MicroGen DX has what's called next generation sequencing, and they have a woman's kit, which is a bladder and a vaginal swab. They have a men's kit where you do semen and urine. They have a sinus kit. They have a bunch of other kits, but those are the primary kits that I use. And for patients who have urinary incontinence, interstitial cystitis even just urinary frequency they will often have a biofilm and, and colonization in the bladder that may not show up in a, a culture. And culture technology is at least 40 years old, if not older. So we're using that as our gold standard for bladder infections, really. So, next generation sequencing. They also do PCR. They do take insurance, which is great. And I've been finding [00:50:00] a ton of biofilms. And the thing that's really fascinating is in even some of my patients with mast cell and mold and, you know, if they have urinary symptoms, sinus symptoms, we'll find, we'll do a couple days of biofilm busting ahead of time sometimes even longer if I'm highly suspicious that they have a hypercoagulability, because remember that fibrin incorporates into the biofilm. And then we'll do the testing, and then we'll do the treatments and the test results come back with the bacteria name, the percentage of the bacteria that they found in the specimen. They'll look for bacteria, they'll also look for fungus, and then they'll tell you the sensitivities of those organisms. And so you know exactly how to target your therapies to treat the organisms. I've had a number of mold patients who have had fungus in their sinuses, fungus in the [00:51:00] bladder and then being able to treat it. It's been pretty profound at helping some of these patients get better. I had one nurse who was on disability because she was so profoundly ill with joint pain and fatigue and, you know, kind of all of the symptoms that many of our mast cell patients have, and finding that she had biofilm colonization in her bladder and treating her with a couple of rounds of antibiotics, she was like 80 percent better. It was amazing, across the board, not just the urinary symptoms, all of her symptoms got better. And I really felt like it was, it was that source of, inflammation and infection that the body had been trying to deal with that it couldn't deal with because of the biofilms. And finally we were able to clear it out with appropriate antimicrobials and it was just, she [00:52:00] took off. It was great. Dr. Tania Dempsey: Wow. Well, that sounds like an amazing lab. I'm going to look into it. Dr. Kelly McCann: Yes, please. Dr. Tania Dempsey: Obviously, I do a lot of, you know, sort of infectious disease stuff and and so that's, you know, that's interesting that I, I've not come across it. I may have heard of it. I feel like you know, it's come up, but I've not really dug, dug into it. So, is this a test that can measure, like Lyme disease too and things like that? Dr. Kelly McCann: No, I haven't ever seen, I haven't ever seen those kinds of organisms in there. But it is really fascinating. You know, I'll do a husband and wife and so some of the vaginal bacteria will be in the prostate and vice versa. So I really think this idea that our bladders are sterile is completely false. Dr. Tania Dempsey: Oh yeah. Dr. Kelly McCann: And we're all, we all have some level of colonization and, you know, it just makes me think about, remember the poor little late [00:53:00] old people who would get delirium when they would get a urinary tract infection when they were older and in the hospital or in a nursing home? I think that's all because they have biofilms that nobody has dealt with over the years. I mean, it happened to my mom, because my mom has PAI 1 genes, right? So, fortunately, I've got her on a biofilm buster regularly now, and she hasn't had a UTI in like six months. Dr. Tania Dempsey: Yeah, that's, that's, that's powerful. Alright, that's that's, I know where, I know the rabbit hole I'm going down tonight. Thank you so much, Dr. McCann. I'm so happy to have you here. Dr. Kelly McCann: You're welcome. My pleasure. We went all over the place. Jill Brook: No, this is fantastic. You two are amazing because you have been down so many rabbit holes and it seems like there's so many important ones Dr. Tania Dempsey: Yeah, I mean, I say rabbit hole, it sort of makes it sound like it's not, you know, credible or whatever, but [00:54:00] yeah, no, rabbit hole is like, that's... Dr. Kelly McCann: It's a good thing. Dr. Tania Dempsey: It's my favorite place to go because then I will immerse myself in it and look how many more patients we can help, you know. Dr. Kelly McCann: Absolutely. Jill Brook: One thing I appreciate about both of you, is I know that you take lifelong learning so seriously, and I know that you're both always spending so much time to learn about the latest, greatest stuff, because, I guess, I guess, who knew? Human bodies are complicated, there's always more to learn, right? Dr. Kelly McCann: Always more to learn. Jill Brook: Dr. McCann, where can people go to find you online? Dr. Kelly McCann: Thank you, Jill. I have brick and mortar practice in Costa Mesa, California, Southern California. The website there is TheSpringCenter. com. I do have state licenses in other states, so if you are not located in California, you can contact the office and see if I happen to have a state license in the state where you reside, and I do have quite a few of those, [00:55:00] so, you never know. And you can also find me on drkellymccann. com. I have a webinar series that I host a couple times a month with guests, and it's pretty awesome, so we'd love to see you and connect with you there. Jill Brook: Excellent. Thank you so, so much. And hey listeners, that's all for today, but we'll be back again next week with a normal episode of the POTScast, and we'll be back again soon with more Mast Cell Matters with Dr. Dempsey. In the meantime, thank you for joining us. May your health be good to you, and please join us again soon.