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Putting that all together where does that get us? Well I’m going to give you some good news  this afternoon but so at    the news has all been couched in guarded terms. So tot this point we’ve found out that the situation of the patients medically is becoming more complex. We we i narrow down and look at their dentition that’s becoming more complex because of the burden off past treatment. The soft tissues are becoming more difficult and again Gary and Michael will return to tack with you some more about the soft tissue problems in these patients. Then we have the underline changes that are happening and some of the are much linked to the patients’ medical therapy and that’s   why i touched on the topic of bisphostinex with you.

If you then turn that into what doe that means in terms of problems with providing removable partial dentures of these patients and you can generate pretty quickly this sort of list. well there is a smelly area, there’s less muscle  to control , there’s less muscle  for coordination , there’s less healing capacity , the patties  don’t adapt to change so  well .All the things that we are seeing in this  patient group that are making them so ever so much becoming just  little built to trickier to treat as time comes on . I won’t preach to the converted  but i’ sure you’ve all got your answer to mental  algorithms for how you approach patients in elms of their  ad ability to change  and wither  you use a copy technique or whether  you don’t  and where the patient  needs some work up  in term so pre prosthetic surgical or other  procedures as well . Today we need to have some discussion about algorithms because h the patients is becoming more complex. I think most of you would have certainly seen that  trend if you look back  and think about what  you were  doing 5 years ago or  10 years ago and you project that forward  in other 5 or 10 years i think you will see that trend  emerging .

Gary will talk about this more with you tomorrow but as patients age we’ve got more desorption. We’re not going to see so many parliament with beautifully full bridges. In fact we have  deckle  this eon finding these  so called ideal cases for our students to treat  oddity  and make relatively  straight forward  full over full dentures  folds. We actually tend to dose patients who are more complexes who got flabby ridges and very shallow and mobile tissue which all of which makes it difficult to treat. Gary will take you through tomorrow in some of the aeayys you can actually systematically work through examining this patients but it is fair to say as people live longer we are seeing   the cumulative effect of absorption over many, many years and that’s why the move towards implants stabilise prosthesis is becoming so much stronger across the profession at alarm. If you sort of take a  very tradition text book approach and you  drag a classification like those very  long range  from the American Academy of Prosthetics and you start to tick off boxes  of complexity and you start to see patients who got these highly mobile tissues particular in the  mandible and very  , very  shallow silica then you realise what we are actually trying to construct  something on a moving base . It’s like trying to land a fighter aircraft on the deck of an aircraft cart in the middle of a Gail at sea.

It’s actually becoming more difficult to treat such patients and for that reason the move towards implant stabilization with to fixtures or to even go some way toward support, those things are becoming much more common place. In the US , a survey which was  done only a coupled  of weeks ago indicated that one in eight practises was doing  this kind of dentistry  for their patients now as a matter of  routine using  to start to stabilise  these increasingly difficulty lower denture cases. i you think about l projecting that in terms  of workforce if you look at the workforce of  dental;  specialist in Australia  this is one  figures from  work force [Inaudible] involved with us a couple  of years ago , in Australia about  10% of the dentist are specialist which is about  a half  of the proportioned the US  and the prostendotis presents about 12.4% of the specialist . You can see the orthodontist there in large number and you probably all be hereof that if you had children who o required orthodontist. Recently there is certainly no shortage on orthodontist at the moment but when you look at prostidontist that number is actually small when you think about the projected needs of the population. So don’t imagine for a moment that every patient who needs an implant to stabilise a denture is going to end up landing in the lap of specialty care because the number of specialist is actually fairly low in Australia in real terms.

What we do know is that patients do tend to expect more and they certainly have gotten much attuned to aesthetic and cosmetic requirements in denturist. Not  only for removal of prosthesis  but also for  fixed  prosthetics  and merchandise and  orthodontia and every  other thing that you can think of in the  gambit of cosmetic  dens try  today . This has prompted guess a much greater demand for   dentures that are much more realistic and life like looking. So as well as people becoming more complexed they are also becoming become in a little but it more demanding and a bit more discerning.  I think you would have noticed that trend as well in your practise and that’s why it’s every good to see people talking about techniques that can improve the final quality of the procedures that is provided to the patients…

Let’s sort of think about the things that  drive decentralism .So let’s sort of look at the things that drive tooth loss and look at actual head count of actual people with missing teeth and from  that hen  project the need  for  denture into the future. I guess this is the leading up to the big finale part of the presentation which is   really to say is the current workforce really going to meet the demand for the future? Let’s sort of lay down some of the facts and furfures to   support and argument with you.

If you think about what the federal  government expects , the  federal government expects , this is for the national aural health plain that the number of adults  who have lost all their teeth will  be reduced and the target should be down by 2010 , more clearly we’ve gone a  bit past 2010 but that  intention will certainly carry word  into the future. That’s an expectation of the federal government. If you they look at how does the profession as a  whole measure up  against that   and you take the Australia’s  dental generation as  good set of  data  on which to make a  prediction you find that we’re to doing as well  in terms OECD comparisons persons with tooth loss and carries in particular where  we actually doing quite  badly. In terms of children we are doing morbidly well although not as well as we certainly could. We’re actually not doing come basic things very well either.  A couple of weeks ago i have a radio interview on the ABC about this exact problem .Twice daily tooth brushing, the actual ABC interview was bout children but this is the figures for adult Australian. So the proportion who brush twice per day as you can see floats between 40 % and 60 % that’s not very good. When we did the large survey in South East Queensland that number was 95%. So it’s actually dropped. I think that’s alarming because that’s if one of the bench mark indication of people’s interests in preventative dentistry that would have me quit e worried. Some other unpleasant home truths for you. While we kowtow have across moist parts of Australia and now with Queensland finally having got community fluoridation in many parts of it there’s been a belief in the community that somehow dental carries will disappear overnight and that certainly not true for a whole range of reason. We have sub groups in Australia which show 1950s- 1960 very, very high prevalence in sever dental caries and those groups are not going away.

One of our University research cents is actually based in the highest carries community in an all of Australia by post code and there we have thousands of people on GA waiting list for full clearances. It’s just spectacular bad. So Carries has to gone away and it won’t go away but with all the people retaining more teeth we have more risk sides. Particularly for root surface carries and some research that we do did show that for every clinical region that spotted a root surface carries there is a mother legion which will only be found on a berth wing radio graph. So it’s a lot of missed root carries around in Australia as well.

We see a lot of sever carries in young adult and as often the belief in the community only older people need dentures while this young lady over here is only 22 and as you can see she is going to have immediate dentures made and you can see the final results which we archived for her. We see large numbers of these patients they are not going away. The high risk tale of the community are not people who are going to be large of fluoridated  water or attending for lot of dental care. We have some very deep pockets of disease in all parts of the Australian community to day.  we have a lit more teeth retained so  we have a lot  more  root surface  carries and that has implications for denture design because if patients aren’t very festive about how they clan these denture they are  going to be reinserting that plaque biofilm  back against that oopt surface and  continuing on a very long slow process. We know from all ears that root surface carries in austral is airs in increasing in real terms quite a bit and has been doing so for the last decade.

If we think about the mouths that are being treated today those mouths carry the burden of a lot of treatment. For the people who are adults today who behave heavily filled teeth , they have cuss that are breaking , they have crowns that are  getting recurrent decay , they have roots that re  braking . We know all these things so there is still a lot of the burden of that disease yet to be experessinged in terms of tooth loses today.

Just though it would show you a couple example of patents with heavily restored dentition and over dentures who are going downhill every quickly. This chip over here has got some nicely restored top teeth and pretty woeful perrodnitis conditions and all over denture that is in some pretty significant strife. He’s in his nineties but the s guy his 14 years old and he’s joint an over dentate and his supporting teeth are not doing very well wither. Smoking 9 bongs of marijuana per day probably has something to do with that. I would do suggest to you if you ever seen a patient who has that much marijuana then you will certainly see a dry mouth. This is a perfect example i can actually show you.

We think about dementia. I said that there are a lot of causes of dementia. Alzheimer’s is the biggest one, particularly in the 85 and overs but mostly infect dementia is very common as well. Patients have these little small gaps in memory. Particular in short term in memory and that will cause them to forget   instructions. We will more likely to give them written instructions for example. The epidemic of  obesity many of you would have heard much of this in the press  is linked to reflux  that has drastic consequences  for the  dentition and also strongly linked to  sleepapnia and other issues in terms of  general health such as hypertension .

So these are big things happening at he  community level that affect the sort of patients  that  we are looking after and indeednmyight impact on our  own life. Diabetes because of its very strong two way association with periodontitis is a big factor to think about. We often think all teeth are lost in older patients from periodontitis and that’s not entirely true. The biggest single factor that causes teeth in older patients to be lost is the combination of mouldy factorial tissues around root service caries, periodontitis, what you could also call sometimes prosthetic convenience. In other words the tooth may not be able to be used to support a prosthesis. But you get lots of root carries, you get lots of aggressive periodontitis in patients like that.

If you sort of defocus form the filling narrow view of the dental profession for a moment and think about these big disease they share lots of common risk factors and this nice slide put together by Peter Dettinson just links to gather a whole range of these risk factors so that we can see that stress and diet link very many of these conditions together. So does alcohol and exercise. When we think about the  public health of this  aging community we have all these  little  many epidemics happening  that are interlinks so we will be  coming more used to  dealing with   patients who will care  more  of this burden of  disease as we  have a more aging population .

Just to return to dementia once you get the high levels of dementia you will obviously need a lot of care with activates of daily living and so on. We’ve now got patients who are outside of many of the windows of dental treatment and indeed a lot of the survey data we have in Australia doesn’t capture very well patients that are institutionalised. I recently reviewed a couple of papers for a major Australian journal looking at the dental health for people in different levels of dementia care in Australia. The figures there are much , much , worse ten you would  expect to get if  you  simply did the telephone  survey and aloe t of the data  in Australia airs based on  convenience an  telephone survey .
We  actually tend to under rate some of the e  severity of  oral  health and when you go on income of these facilities as  i know many of you do you see first-hand some  of the conditions that  are there. Some we have a population that is going from go-go , to slow-go , to no-go as the populations is able to live longer it carries more of the burden of life with it. So we need to adjust our mental barometers a little bit looking into the future.

Medications have I big impact on care and they will have an increasing impact on care in the future. Not just prescription medicines but all the over the counter, the natural, the herbal, rhea alternative, all these things can impact on oral health.  I thought i would just give you some simple examples, gingiva enlargement is one group of things and severe oral dryness, or zero stymie is another. Both of them have some important and interesting consequences   and there are some many other once and Gary will show you a nice example of traded dyskinesia tomorrow. So i won’t talk about that one with you. Hers some examples of gingival enlargement driven by the most commonly drug used for hypertension in Australia. A sort of typical nyphetomine class calcium chiding blocker causing some very nice enlargement. You can see here indicated by the arrows creating what looks like asked Uvula in the patient on the body in this large [Inaudible] tissue in the patient in the right. Both of which we removed surgically as you can see here.

Oral  dryness have  big impact and Avery , very common problem is  it would be unusual for me to  see  elderly  patient and now see oral  dryness in the area  of practise that i work in .  It has big impacts for how well lower dentures are lubricated and we’ve still yet to find and absolutely perfect replacement for saliva. It is such a simple yet complexed material.   That we are yet to have a perfect replacement and offer these patients both comfort and all the supporting roles that saliva plays in minting oral health today. It has a big impact on the type of mucosal disease that patients present  with and Michael will come back and talk about the problems of oral  fungal infection with you late ranchos conference but when we see these recurring dfubncal  infection in patients mouth associated with a  denture or not we need to think as  what environment is driving that  and are there things in he patients medical health   or things i n the medication that are  changing the saliva environment and changing the  patients ability  to heal  in the amount good immune  response .  I won’t give you the one hour lectures as much as  is would like  to on the drugs that causes  dry moth but there is a very  long list as you can see here and many of them  start with the word anti  which i guess gives you a little  bit of  a clue.

Of course today  we see patients how are very  frail and very much affected  by connective tissue diseases  , conditions  cut as shivering syndrome and  scleroderma  and not uncommon conditions to encounter and these patients  egret very much  challenged by  incredible  dryness of their oral tissue. That makes it very difficult to think about these patients having a removal of prosthesis whatsoever and it’s very hard for these patients to care for their teeth and for any appliances which we may construct for them. So today we have a whole range of protocol and materials and extra bits   and pieces that we have to use with these patients like some of these products here to try to work again ds or to reverse some of these terrible side effects of dry mouths in these patients.

Many of these patients need treatment to be changed a little bit and  some of these things will be about chair positions , some will be  about the  advice we give a patient , some will be about the timing we give an appointment. There’s a whole range of things we could go through for quite a long time which will all be little things that might help a patient to have a more comfortable experience when they are in the chair. I guess that  I’m flagging  here is that in the long  range planning for continuing education it would seem to me to be a great  area where dental procedures  could  understand besom of the medical  factors coming in their patients  background that would impact  upon care . That i guess sis flagging of this future needs in terms of learning for this professional group.

Certainly when i see h the see patients and i see the harder end of the scale obviously i have to go through the risk assessment and really work out how safe to treat in the chair is and who is not. It could be a radiation patient. This morning followed by a humiliate patient, followed by a dementia patient, followed by phobic. There is no sort of consistent   pattern of patience but they all need something adjusted just a little bit and this complexity of patients will be more a part of our professional land scape. I feel certainly of the rest of our practising lives if not beyond that.

So, having said all that, that’s sort of the medical l complexity what’s the side of the coin. I now want to talk about what would call the worries well, so the worried well are patients why are travelling very well medically. They are not so problemised but they are very demanding. I’m sure all the patients of this type don’t live in my wedding room. I’m sure they are fairly thick and fast in your wedding rooms as well where we know we can look objectively at an appliance they are wearing but it doesn’t quite seem to turn all their switches off. Because we know that all   the technical things are only part of a much bigger puzzle and that been very well described in the literature. We need to understand that some patients just want as this fellow said something to replace my missing front choppers, where this other patient wants something that replicates the natural pre-existing dentition almost perfectly in every way. Patients vary enormously and today we can see the expectations of patients growing in the community. If you look at a number of the studies done on patients satisfaction you can see that there is a group of patients who are continually satisfied and some who are more satisfied and a bunch of reasonably happy. Despite all the advances in techniques and technology we see the persistence of patients how are very, very difficult to treat and carry will talk some more about that topic when he goes though the examination go a new patient tomorrow.

Does it impact on oral health? That answer is absolutely. This is one if the first of about   a hundred, not really hundred its bout a hundred and three little graphs I’m going to share with you this afternoon. This is the difficulty in eating seo food in adults in Australia in 2002 from a phone survey. so if you look  at peel which are the purple  buyers and   the people who  have got  a four partial denture you can  see how the likelihood d of avoiding  some foods is  increased by  somewhere about a  third to a half  depending on  which group you’re looking at . So it does make a difference in real terms, in terms of food selection.

If you look at  people who  are aged 55 ears and above above rather than all of the adult  population you can see that having natural teeth only in purple , having a denture with  natural teeth an black  or having no natural  teeth at all in grey gives you  varying  degrees  of  difficulty in terms  of what you can function with . I think we need to realise that it is   really hard to meet the experimentation of complete functional replacement with the technology that we have today.  Those that cause food avoidance in that  same group well the answer is  absolutely yes and as you  would expect the group that have no  tooth  at all , complete  tooth loss, the black  bars show the highs across all the different  age groups .

They are clearly some issues seeing that. The missing part of this puzzle is that data like this fir a phone survey   doesn’t capture those one people how are in high care   dementia. It doesn’t capture in the low socio economic group who don’t have a telephone. It actually under represents the group that will actually have the worst diidessases. What have just shown you on those little graphs is actually the best case scenario. The situation is actually a lot worse than that. You need to remember that telephone surveys miss a lot of people in the population. We also need to remember  that this whole  access issue can patients actually access this care an d can they  afford it and will patients actually stay  on a waiting list for care if the waiting list  is so long they may   as well give up and go and do something else.

Speaker 1: without any further  ado it gives me  great pleasure to again introduce another queens lander, Laurie Walsh or  Professor  , Lawrence  Walsh of the University of Queensland .  Laurie Walsh is a specialist in social needs dentistry. He is professor of dental society at the University of Queensland where he has been the head off the dental school of dentistry since 2004. His research interest are in preventative density, clinical microbiology and advanced dental technologies. Lawrence maintains a part time specialist practise in Bruce man he also serves as a dental advisor to the DVA and the churn of the ADA and infection control committee. It gives me great pleasure jot introduce to you professor Lawrence Walsh [applause]

LW: Thanks very much and good afternoon ladies and gentlemen. Welcome to this afternoon’s session. In honour of the spectacular weather I’m doing something that i normally do which is I’m not wearing a tie. Those who see me lecture before will know what a big change in personality that would probably cause. What I’m going to do this afternoon is take you on bit of a journey on the future? I’m not a futurist, I’m not going to throw crazy ideas at you. I’m going to share with you information and a fair bit of hard data. That data only became available publicly one week ago. So chances are you haven’t seen it but it has a lot of bearing on the profession for dental prosthetics. In fact on the whole of the dental profession industrial so i do   want to share that with you.

I am  happy to give  anyone who wants it a pdf copy of the PowerPoint because  if you want to come back and look at some  of the figures that  i will skip over a little bit  this afternoon then certainly contact me and i will have my  email on the last slide of today . Don’t feel like you have to scribble a lot of things down, I’m happy to provide the presentation to the association who can use it as they see fit.

A little bit of a road map of what i plan to talk to you this afternoon abbot out. I’m going to say a few things on demographics   and reinforce a few things I’m sure  you have already  discovered in my own practise , talk about the complexity of  patient back ground because that is what turns my switches on in the area that i work . Talk about what that means  ion terms of the demand for care and what patients   expect form us today  and some of the  applications that has down  streamed or return  to a little bit later on and talk about in terms  of continuing education for  a group of patients who are presenting to  us more challenging situations .

Hopefully this will be a nice Segway into some of the material that Gary smith will share with you tomorrow. Another string presentation from Queenslander. So that’s where we are going to go this afternoon. So to begin with a bit of stuff on some population trends. No great surprises here. We all know that people are living longer for a whole range of reasons and that has impact on the demand for care in terms of dentures. That’s largely driven by big changes that occurred post the second world award. So you have all heard the term baby burgers, the   people who are born from 1946-1964 who were not so much booming babies as booming bellies i would probably suggest to you.

What is important in that group is there has been i bog change in the gender balance with a lot more females. So just to show you some life expectancy figures here for a moment. We’ve got at birth over here if you look on the screen the- at birth in 1990 the elite expectancy was about 80 years and about 72 for males. People born today are  going to love  longer than that and people who are already 65 you can see on the other side of the slide still have a lot of life lefty and this is up a very big change from expectation that  we might have had  15 or  2oo years ago.

Probably a better way to think abbot population is to look a t these so called pyramid diagrams. I’m just going to show you 4 of these because when you are going to see is very interesting. It changes from the shape of a pyramid into a shape of a coffin. It is really quite remarkable that the numbers actually change into a particular shape. Ina population that has a pyramid distribution, this is the case from the 1960s- 1980s there is lots of young people and there is a very small number of people who are aged of 65. It is a very even distribution so it’s a pyramid distribution.

What you can see in 2000 is that the shape gas changed and there we can see this bulge emerging in the middle and buy 2045 it’s exactly the shape of a coffin. That means that the number of people who are in the age group above 65 are now a very large part of the population and in 2045 I’ll all be one of the people. This is  why the government in terms of  policies done some clever work around self-funded  retirement t and all those  sort of things because then there is an  enormous burden is going to flow  through in terms of all thee financial  situation of these retiree  age people . Of course you see a lot of these females  and that’s in fact the dominant group in my practise  and I’m sure you’ve got them in as well, patients  in their 80s , their 90s and even a number  of  patients over 100.

If you were in Japan and i asked you how many people were aged of 100 the answer is well over a million people. That amazing isn’t it. Over 100 times 10 000 people who are over 100 years old. So imagine  if you are one of  the no royals  to people who over  100 or the emperor of Japan would  be very busy literally everyday i writing out  1000 of such  letters . It’s just amazing. Now when you look at the age mix of these very old patients that changing quite a bit. Over the next 20 years there will almost be a tripling of that demographic particularly in terms of elderly females. This group is particular of interest clinically because when you go over 85 the chance of having any form of dimension, not just Alzheimer’s dementia   increases quite a bit. That hades implications for what patients will remember and what patients will lose and I’m sure you’ll all encountered this in your practise many times.

Also when these patients get osteoporosis and end up in hospital from hip fracture it has a very high impact in terms of their life expectancy because the chance of not getting out of the hospital is very, very high when you fracture you hop and that introduced a new problem which has only been recognised probably over the last 10 or 15 years and hats the problem off dirges used to pervert osteoporosis induced hip fractures in older women but they have oral complications. SO there is an o bit of an interesting cross over here about that. This group get also a lot of aspiration pneumonia when they go into hospital. It’s one reason why they don’t do so well. So do we in fact have a more compromised older grouped of patients and the answer to that is yes. I was one of those people 25 or so years ago looked at these numbers and thought gee this  would  be a really good area to get into , patients  who have got more complexed medical problems that’s  how i sort of drifted in the area  i now or in today .

We know today that oral health is being recognised as being linked to lots of things and this slide here is being taking from the National Oral Health Plan, the current version that runs out in 2013 which actually links oral disease in the middle to lots of things including food many general health impacts .So when we think about patients who are becoming more frail we are now starting to think both these two way interactions. So let’s just talk about that for a moment. Something that Michael will touch on that for presentation from the University of London what he will give you later this week is some of the important things about oral mural disease. A very common group of conditions that we’ll see in patients who are becoming increasing frailer. We know that oral cancer  ins an increasing  problems in  area that Michael  and a number of the  staff in my old school do a number  of staff in my school do a lot of  work . In dental health month which we are in at the moment it’s a big focus and so we’ve got a group of patients who are very much more likely to show abnormalities of the oral mucosa. Of course the pattern of that is changing and I’m sure Michael will talk to you about that later. I’m sure if you put all of the things of medical astute and the patients to gather what have we seen outlay? Well we’ve seen greater use of multiple medications decrivebed by the word poly pharmacy. As a result of that more mucosal disease and dry mouth. I will talk more about that in a moment.

We’ve  seen the increase in use of drugs to prevent osteoporosis and common drugs used for that and some of the near types of drugs such as polio  or  donosmab have  been  linked to osteoneuoris of the jaws , condition that fight not only  tooth extraction but also trauma form  dentures . So there’s a possibility of this very nasty problem being seen more frequently and we really don’t know enough about that problem today. We’ve got issues around nutritional state of older patient with poorer healing. We’ve got  unrecognised  diabetes where we’ll talk about some more in a moment but for every case of  type 2 diabetes that recognised  in Australia’s we have another patient who will be undiagnosed so we only see half the burden of that in terms of the clinical notifications alone .

Dementia  I will return to in a moment and  if  you think about patients who are  very frail , every dime tally complexed i can tell you now there is not enough special needs specialist  or a number of specialist  around with open appointment books waiting  to treat these patients so  we have a workforce soppy issues on the denial specially side which is another  topic for another day perhaps.

Let’s talk about the emerging epidemics and i will come back to diabetes first of all. So if you think bayou this is a population sense in Australia, it’s been estimated in 1 in 4 of the adults in Australia’s either currently has or will develop some variant of type 2 diabetes. That’s a very high prevalence. That’s has big implications  their ability to periodontitis , it has implication for mucosal disease, dry mouth and for the consequence  of dry mouth such as tooth wear  and  dental caries and particularly for  root surface  caries  . Dry mouth has big implications for the cohesiveness of saliva that may be involved in maxillary dentures or for any of the lubricating functions of saliva.  So the amount of diabetes’s in the population have big implications for oral health and that is going to be ana area to watch.

But what you do have to differentiate between maybe there’s an infection. Maybe it isn’t a healing response. Maybe there’s a urinary tract infection that’s come about, or maybe someone has a lung infection. Certainly, if in doubt, go to the doctor or try to assess, is it something else. Usually those fevers are more noticeable in the afternoon and can run higher if the person has enough vital force, and do need to get antibiotics if you can’t recognize it early on with herbs and all.

But what we don’t want to happen, the reason we say antibiotics if needed, you’ve got somebody already that’s got a weakened immune system with cancer, and then if they have to fight another infection, it takes the body away from dealing with the cancer. So Dr. Gerson and we still feel in certain severe infections, you’ve got to have the antibiotics and get back on board. It all depends on what’s going on.

For those three to five hours, if the person’s really uncomfortable, you can give comfort measures. Tepid sponging, that means lukewarm water, not icy cold, that can bring relief. You squeeze out a washcloth and tap around the body. Increased fluids, keep the body hydrated. Good air flow in the room. You don’t want to blow cold air on them, of course, but just air flow in the room.

Then the pain triad, which is one vitamin C, 500 milligrams; one niacin, 50 milligrams; and one regular strength aspirin. We don’t do that, again, until at least five hours. If that fever’s still high, the person’s getting weak from that fever, then we may bring in the pain triad. So the niacin will help the aspirin actually, help it disperse better. The vitamin C, I’ve heard it may protect a bit from the aspirin, but vitamin C is just such a good antioxidant and healer.

That can be taken once every four hours, if the person doesn’t have, of course, gastritis or stomach problems that would preclude the use of aspirin. I would try to have a little snack, for sure, even when you take the pain triad, to protect the stomach. Anything you want to say on that?

SPEAKER 1: No. I remember the first time I developed a fever after several months on the Gerson therapy. My temperature normally was 96.2, 4, 6, somewhere in there, really low. So when the thermometer registered 104, I was actually excited. It was proof, to me, that I was definitely experiencing healing reaction. I got Charlotte on the phone, talked to me, asked me a few questions, and then said “Well, happy healing.” I took a bath, a tepid bath, and then I got in bed. It lasted till probably the evening the next day, and then it was over. But definitely was quite an experience.

I have had so many different healing reactions and seen and observed different people that, with sprained ankles, old broken bones – my little finger was broken at one time, another toe was broken, and just as Dr. Smith explained, you’ll feel that soreness again. In some cases, the area that’s inflamed will be just as painful as you recall it when you broke it. The accident that I was in and the facial stitches that I had, and then later the impact, was with the head, right at the level where the eyes and the windshield, and that was 50 years ago, more now. But on the Gerson therapy and during a healing reaction, my eye sockets hurt so bad for three days, as if somebody hit me in the head with a baseball bat. I could not focus on anything else.

But then it passed, and as Charlotte explains, you complete the healing in that area. The scar tissue that was lumpy and bumpy to the right of my nose because it never really healed properly, dissolved. Where for many years I couldn’t even feel the bone on the side of my nose, it was just thickness of tissue. It’s gone. It’s the same way, it’s dissolving tumors, malignant or benign. But the remedies work. It’s amazing.

I was in one home and the gentleman had an injury with his leg involving sciatica nerve. I was new at helping people, but got the book out and I said, “Well, look, it says take an enema and then put a castor oil pack on the area.” So we took an enema, and the whole leg hurt. I said, “Where does it hurt the most?” We just put the castor oil pack on the thigh/knee area. Within 15 minutes after that pack was applied, the pain was gone, and this gentleman was in excruciating pain with that nerve. His leg was just shot out straight and a huge muscle man, not the type that complains of pain – it was gone. I was surprised it worked so fast, but it really – follow the book, follow the instructions.

Okay, pain. The things that I found the most helpful with pain after doing the coffee enema is the castor oil pack or the clay pack. If you can find that that helps reduce the pain to a tolerable level, then you don’t need to take the pain triad. But if you’re losing sleep because you’re in pain, then you need to take the pain triad, because the pain is just as much an irritant to the body, causing trauma, and it’s interfering with your healing. So don’t not take it.

For example, a couple years ago I broke a bone in my elbow, and it required surgery, and the doctor wanted to put a pin in and a plate. Well, I ended up just putting the pin, but for four months, every night, because of the break I couldn’t bend my elbow. It was real stiff and swollen. But every night for four months, I’d wrap it in a castor oil pack – and we’ll show you how to do that – and put the hot water bottle on top of it and sleep with it that way. Each morning, I could actually move my arm closer, till eventually I could start feeding and combing my hair again.

It’s been my experience, first of all, the coffee enema really reduces the pain. But then after that, it’s these packs that we’re going to demonstrate. Sprained ankles. One difficulty that I witnessed with someone here in San Diego, I had heard Charlotte talk about a gentleman that needed to come to the clinic and he really needed oxygen to fly, and they didn’t have really the time to go through the red tape to get it approved on the airplane. So she suggested, she felt comfortable, in his case only, to suggest that he pat hydrogen peroxide on the chest to bring more oxygen in. He made it safely here.

Well, one year when we had so many fires in San Diego, there were several people that were damaged with the smoke inhalation. So I suggested that, hydrogen peroxide, just pat it on your chest, and it worked. They breathed easier; it just got them through a difficult time.
We’re so surprised when these natural approaches really make a difference. It doesn’t come in a bottle and doesn’t have a prescription label on it, and it works, and we’re surprised. That’s what the odd thing about it is.

Lymphasizing. As I mentioned yesterday, the CD, the disc, Samuel West, he’s a promoter of the rebounder. The results of that is that it stimulates your lymphatic system. Highly recommend that. There are other ways to lymphasize. Lymphatic massage therapists. The rebounder is part of the Gerson therapy and recommended. The TENS unit, I’m not that familiar with. Maybe Dr. Smith can address that.

DR. SMITH: It’s a unit – I think it stands for Trans-Electrical Neural Stimulation. It sends in little electrical signals. You would wear it, and it supposedly interrupts the pain pathways. So it can give some symptomatic relief. Another thing, someone that’s not able to stand up and get on a rebounder, they say just if the bed is fairly bouncy, just bounce them on the bed. Not bounce them, but move them. It’s that gravity, anti-gravity that can somehow decrease pressure on pain nerve endings. So it’s worth trying.

And there’s a pain management protocol in your binder. It’s page 224, that covers things we’ve talked about maybe in a little more detail. So refer to that.
Lastly, I want to manage stress reduction techniques. Not only to help get through healing reactions, but for dealing with life and illness and all the challenges that we have. I think for me, the mind-body connection is so important, because we’re not just physical beings; we’re not just mental beings; we’re not just emotional. We’re mental, emotional, physical, and spiritual beings. To address what’s going on in the inner world, there’s so many…

We have a book. I don’t know if it was highlighted, a little booklet that we put together on mind-body resources, and it covers so many from things, from Reiki and massage and guided imagery and hypnosis and touch for help. It’s a wonderful resource. I’ll show that, since I already mentioned it. It’s on order. We have it at the Gerson Institute, and it’s updated regularly when we hear of new tapes and books and self-help resources. It’s very inexpensive.

But it can cover things like just breath work. How many of us don’t even realize and are not breathing? Deep, abdominal breathing. I don’t mean – but breathing down into our belly, not just shallow. Because when we’re stressed, we generally tend to hold our breath. We tend to be a little more contracted. Contraction is less oxygen, less flow of energy, which makes us feel uncomfortable and more tendency to pain. But just if we can start to become more aware, every time we think of it, breathing deep.

When you take a deep breath in, or even a normal breath, if it’s a full breath, what happens? Nature designed us; the diaphragm descends, and it massages the organs, the digestive organs and the liver and the spleen. When you exhale, the diaphragm comes up and it massages the lungs and the hearts, and increases the natural lymphatic flow in our body. The studies just measuring people’s levels of stress response go down. So breath work.

Then there’s particularly techniques that people can do for periods of time, if they want to go into the science of breath work and healing, guided imagery, music. Everyone might be different on what it is that they feel more attracted to, to help them relax, to help them get a different perspective on life when you’re going through a challenging situation; healing touch, Reiki, hypnosis, prayer or meditation. I had to throw in Qigong, which is using the mind and using the universal healing energy. It could be yoga.

I didn’t mention this earlier, and I was going to, but there’s a quite well-known doctor, Dr. Gonzales, who also has an alternative cancer therapy system. He has very high regard for Charlotte; they know each other. Carol had given me an interview with him, in writing, a transcript of an interview. One of the questions at the beginning was, “What is the one thing about all the things you do, or if you had to pick one most important thing for a person for healing?” He said, “It’s your mind and attitude. I wouldn’t have said that a year or so earlier. It would be ‘do this, do the therapy, adhere to it.’” And that’s important, but he says, “I’ve seen it over and over.” Positive and relaxed and centered and having a belief system in something beyond just what we see here, he thinks is one of the biggest factors.

It doesn’t mean that a person goes into denial that they may have a serious illness, but you don’t focus on that. Every day, you meet and respond and try to stay as calm and centered – I’m now going beyond what he said, but I found that very interesting, for someone that’s very, very scientific.

SPEAKER 1: Let me mention, too, Dr. Smith, that these things that she’s going over, the breath work, the breathing techniques, the imagery, the music, even touch, especially helpful when you’re getting through the initial difficulties of getting used to a coffee enema. When you’re really releasing a lot of toxins in the beginning, you can have a lot of cramping and discomfort.

But believe it or not, breathing deep and exhaling – Dr. Gerson says to breathe deep while you’re doing your coffee enema. How many remember to do that, or even massaging your stomach or in the back? I found that it can almost instantly stop the cramping, just a small rubbing motion. But the relaxing, because when you cramp, you tense up; you’re just going to make things worse. So all these things she’s talking about, put them into practice as you’re doing your enema, and you’ll see them work.

DR. SMITH: Be kind to yourself. I like the term having compassion for yourself. There’s nothing that anyone has done wrong. We don’t know, ultimately. We can come up with all these reasons, yes, that have contributed to illness; but ultimately, are we in charge? Are we in control? It’s how we respond. Just smiling inwardly, sending love no matter what, and being compassionate to whatever is going on is tremendously healing.

The end of the year is when most flexible spending, health savings, and insurance benefits expire and we’d like to give everyone a friendly reminder that it’s a good time to come in for a dental visit.

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the podcast: http://drvinograd.com/holistic-dentist/podcast-episode-4-leaving-fear-of-the-dentist-in-the-past/

SPEAKER 1: Hemorrhoids can last days or weeks or even months. The one thing I think you should know about the hemorrhoids is that it can very well be the body’s response to releasing toxins and the pressure, like Dr. Smith said earlier. A lot of times you can bleed profusely, and still not have to stop the enemas. The enemas are really the remedy for the hemorrhoids. But if there’s continual bleeding, you do have to be careful of losing too much blood. There are other things you can do to ease the discomfort; aloe vera juice.

If there’s itching involved with the hemorrhoids, I’ve found just a little bit of that potassium compound solution that’s mixed with water, just a dab on some cotton in the area will stop the itching. There are other things listed here for you: flax seed oil with a few drops of Lugo’s sitz bath, and Dr. Smith will give you more information about the sitz bath.

Just keep in mind, as always, it’s best if you have someone supervising what you’re doing. Ideally, if you can go to the clinic, then that gives you the opportunity to have the doctor’s assistance to help you get through these times so you’re not the one judging “Should I stop the enemas, shouldn’t I? Am I bleeding too much, am I not?”

I had that opportunity to deal with a hemorrhoid, and the bleeding lasted for about a day and a half and scared me, and yet I did not stop the enemas, and then it passed, and I was okay. But I was at the clinic at the same time. So if you do not go to the clinic, you don’t have a practitioner helping you with the Gerson therapy, then by all means, call the Institute. There’s other services that we have, such as the coaching that I mentioned earlier, and perhaps we can give you some guidance. If we can’t, then we’re going to tell you to go to a doctor, someone who can help you right on the spot.

DR. SMITH: Just to mention, it’s actually page 227 in your binder, but sitz baths are a remedy, a naturopathic remedy for many things. Of course, you’ve got to have a water source without chlorine or fluoride, so you might have to fill jugs of water up, but it involves two tubs sitting in a big tub, or the bathtub and another tub.

Essentially, you’re sitting your butt perhaps up to here in fairly warm water for perhaps three minutes, and then you get out and you plunge your butt into the cold water for one minute. Always less cold. And you go back and forth and repeat that three times. You’re pumping the circulation. Warm, cold, warm, cold. So we’re pumping the circulation, which can really help with hemorrhoids, for that tone of the vessels.

It’s also helpful for other conditions that women have, pelvic congestion, and not only blood flow, but lymphatic flow and energy flow is impacted. So it’s recommended in the naturopathic field for other conditions. But it takes some time, and again, you’ve got to have clean water. I just wanted you to have that information because it’s a really good remedy.

Cold sores, fever, blisters, canker sores, as I mentioned earlier, are classic. Almost everyone on the therapy gets to some degree, and those that have had chemotherapy, it can be really severe. Their mouth is so sore, and their tongue.

Some of the things that you can do, there is an herbal preparation at most health food stores called Herpilyn. That’s probably going to be more for just on the inside or around the outside. If they’re in the sides of the mouth, that might be a little harder. Swishing aloe vera juice around in the mouth regularly can be really helpful. Rinsing the mouth with a liquid acidophilus can be helpful.

And something I’m going to put in on the next slide that I knew, but was reading and it reminded me, slippery elm is a wonderful herb, and I would suggest – you can get it organically in most health food stores or herb shops in a powder. Slippery elm powder. You put maybe a half a teaspoon in a little pure water. It doesn’t mix totally. Then just swish that around, hold it in your mouth as long as you can. Slippery elm is just very healing and soothing to the tissues. And then swallow it, because it’s good for the whole GI tract.

Maybe sometimes drinking with a straw. They work with it; it will go away. It might come back, but eventually it will go away. It’s just the toxins are coming out through the mucosa here, causing inflammation.

SPEKAER 1: I’ve seen patients at the clinic that had had chemotherapy prior, and a lot of times that’s one of the symptoms with cold sores, and it’s very painful. But they’ll take the aloe vera plant, and just the gel from the inside of the plant, a little small piece, and just put it right on top of that open wound in the mouth, and they can’t be without it. One patient had me cutting little pieces all day long, and then she would just keep that aloe gel on top of it, and she said it took the pain away.

DR. SMITH: Skin rashes, again as I mentioned, it’s toxins coming out. One of the avenues is the skin. Some people are more susceptible to skin rashes than others, as their channel of detoxification. Oatmeal baths, that’s a classic in the natural literature. It may not be that practical, again, if the bathwater isn’t pure, but putting oatmeal and sitting in a bath. Or a poultice. Carol has found that doesn’t work so well, but that is in the literature and has been tried, making a poultice water and oatmeal and putting it on the skin. You could always try it.

SPEAKER 1: It worked for me when I had trouble with my arms. It worked for me like the first day, and then it seemed as if the second and third day it was too drying, and then it ended up causing itching. What I found is that sometimes the aloe worked better, sometimes the oatmeal. It was a pack, a poultice, with the oatmeal.

The other thing to keep in mind is depending on why you have the skin rash, if it’s severe and it’s coming from inside the body, and you’re putting clay or something on it to pull it out, it could make the symptoms worse before you completely get it out of your system. Then for me when it did get severe, the enema reduced the swelling and itching. But that’s from the inside. That’s pulling the toxins out that way.

But minor itching, minor problems, the clay, the oatmeal packs, even the potassium compound solution, again, liquid –

DR. SMITH: Same one that you put in your juice.

SPEAKER 1: Same one. It stops minor itching. Temporarily; it’s not a permanent fix, because you’re detoxing.

DR. SMITH: But never suppress it.

QUESTION: How about those people who have [inaudible 00:38:52] or eczema? I have breakouts [inaudible 00:38:56] treatment. It was really clear.

DR. SMITH: All I can say is symptomatically, reduce the symptoms the safe ways, but you’re just going to have to go through it.

QUESTION: Don’t suppress?

DR. SMITH: Don’t suppress, and the main way you can suppress is putting on a steroid, which is the first thing a dermatologist will give you. That just drives it in further. It’s symptomatic and it’s not good.

SPEAKER 1: She’s talking about eczema, in case you didn’t hear that question clearly.

DR. SMITH: Or any rash. They just usually pull it out and put the topical steroid on, because it decreases inflammation. But we’re not dealing – I think we have time. I get really fired up about this, particularly little children, little children that come in and they have their eczema and their rashes and probably they’re on wheat and dairy and all these other things anyway, and their poor little guts are inflamed and all. Of course, they just pile on the cortisone.

Well, what happens, and we know this in our homeopathy background particularly, is things are trying to come out; they’re expressing the best way they can; the body’s intelligent, this is what it’s trying – and we suppress it and drive it back in, and what we usually see with young children is later they develop asthma. It goes to a deeper level and comes out another way.

Someone that ends up seeing a homeopathic doctor and saying, “Hey, I’m not going this route anymore,” when that asthma, when it’s treated naturally, starts to subside, that skin rash will come back. Temporarily, because the body is going back, like an onion, and healing. So that has to come back out. That layer that was suppressed needs to come back out, and then heal.

Don’t suppress it. If it’s extremely uncomfortable, do the simple things we’re talking about to get you out of discomfort. But it’s just going to take time for it to actually heal and go away.

We were talking about detox reactions and toxic reactions; now the true healing inflammation, which I spoke on the first day, is when the system has, again, detoxified enough and nourished enough that it’s coming back to life, and it has strength and energy, and the immune system can kick in. What the immune system does with all its different immune modulators and all, will recognize a tumor or another area of the body that never healed right to begin with, and it will go there and it creates its inflammation, but it’s a healing inflammation that breaks down, kills tumor cells, breaks down scar tissue that didn’t heal right in the first place, and it involves inflammation.

This is how one usually can distinguish. Oftentimes they’ll get a little fever; they’ll feel redness and pain and swelling, either at scar tissue where there was surgery, or where there still is a tumor or some other problem in the body. They broke their arm or sprained their ankle years ago, it might start hurting. “Why is that hurting? That healed.” It’s a good sign. That means the body’s retracing and going back and finishing the healing that it didn’t do right, particularly with surgeries and scar tissues.

Here’s some more information. Oftentimes, the person feels really good before they go into this healing inflammation. Why? You’ve got the vital force. You’ve got the energy now. I even notice myself, I’m noticing this pattern that sometimes, once in a while I’ll get a flu, that I feel really good beforehand, and then I wonder “Wow, why did I get this flu?” I think the body sees it coming and it’s mounting its response and things are being revved up. High energy, could be. Maybe not, but one could have a little more energy.

A healing reaction, it’s hard to tell you exactly, and they’re changing a bit than I think they did years and years ago, when people weren’t as toxic as we are today and it didn’t take as long to get to a healing reaction, and the system didn’t have to be detoxified. The systems aren’t as weak as they used to be, and they might’ve happened sooner and stronger than sometimes we see today. It all depends on the person.

But they can last from three days to ten days, give or take. Again, accompanied usually be a fever, low energy, malaise, as well as if there is a specific area of the body, whether it’s a tumor or an old injury or whatever, that itself will become very inflamed.

The fever is the body’s response – when we have a fever, that creates immune modulators that fight infections. We have a fever, the white blood cells come on board. That’s why we have a fever, because it brings the healing response of the body. We don’t want to suppress a fever, unless it’s too high for too long, or there’s somebody that’s very weak or susceptible for seizures or whatever. If it’s running 101, 102 – here we say 104 – try to let it stay for at least five hours, if you can. Because this is a healing response. There’s a lot going on inside the body. If it is a healing fever, it generally comes on in the evening, generally, and it breaks in the morning, and it’s only a couple of days, maybe longer.

We’re going to move on to healing reactions. I thought it was tagged here, give me a second.

SPEAKER 1: While they’re finding that, let me bring you a couple bits of information that came up after yesterday’s class. I was shown in the handbook where it talks about cooking potatoes, and it says cook on a slow temperature for about two to two and a half hours. There are three or four vegetables that are an exception to that slow, low-heat cooking. The potato is one of them; beet would be another one; the artichoke; and corn. Remember, corn is only allowed once a week. But the baked potato really needs to be cooked at 350 or 375 for about an hour and 15 minutes. If you read that in there, please don’t try and bake your potato on low for two and a half hours. You’ll never be able to eat it.

Let’s see if there was something else. No, just a reminder that any of your questions, because we do have the panel discussion later today, try and just write them down and save them for that time. It’ll give us each a chance to give you some input, instead of limiting it.

DR. SMITH: There will be a little time after this presentation, probably, for questions regarding this. Then in that panel, it opens it up again to everything.

QUESTION: Could you be a little more specific about the corn? I understand the baked potato, but what did you say about the corn?

SPEAKER 1: The corn is one vegetable that’s only allowed once a week. But it also should be boiled, as the artichoke and the beet.

DR. SMITH: Okay, healing reactions.

SPEAKER 1: We’re going to encourage you to read the chapters 15 and 16 on Healing Reactions, page 181 through 194. Remember yesterday I said that that is one of the reasons for failure sometimes with a patient, if they don’t understand what’s happening to their body and they start developing these toxic reactions or healing reactions, and then instead of helping that to happen, they’ll suppress the symptoms. So it’s helpful to read that chapter.

The other thing I wanted to mention is that don’t be afraid of the healing reactions. They’re actually the body’s response to what you’re doing, and it proves that your body’s responding to it. It’s essential. The patients at the clinic sit around the dinner table together to eat together, and they’ll be sharing their information. A lot of times a patient will not be experiencing healing reaction right away, or not sure, and feel left out or neglected because they’re not in pain or discomfort or nauseated or high fever.

So it’s a different way of looking at what’s happening to your body, but it’s essential to understand it. It just proves that the body is promoting detoxification. It’s dumping these toxins back into your system, in the blood system, in the digestive system, you’re going to react to it. It can create different symptoms, and we’ll talk about that.

DR. SMITH: Yes, it’s both the looked forward to and the dreaded at the same time, because they can be uncomfortable, but you know that the immune system is starting to kick in. Something’s happening.

Now, technically there are three different kinds of reactions, and I’m going to talk about them just so you understand a little better what’s happening and why we do certain things for each one. But then you don’t have to, each time, “Which one am I?” They can all actually happen at the same time too.

But there are toxic reactions and detox reactions that are a little different than the actual immune system response healing reaction that I was referring to on the first day as the third objective of the therapy.

A toxic reaction is where, after all the food and the juice and the potassium and the thyroid and the system is now receiving what it needs and it has energy and it starts to release its toxins into the bloodstream, if those toxins are being released faster than they are being eliminated from the body, you can have symptoms. A lot of them are actually nervous system symptoms, which could be headaches or nervous irritability.

Even depression. It’s not uncommon that some people know when they’re going to have either a healing reaction or even a detox reaction because they feel depressed, and they’re not usually someone that is depressed. Then, sure enough, in another day, here comes the reaction.

It could be unclear thinking. For some people, there’s a lot being released, and maybe they had some drugs in their system before, they can get hallucinations even. Memories from the past.

Also can be foul odors. The body starts to small. You can start to crave foods, and usually not the healthy foods. Probably foods that were not the ones that you should’ve eaten at the time, that you did, that you’re remembering them or something is happening where it’s coming up into the nervous system. Joint and muscle pain. This is just some of them.

What do you think, if this should happen, would be the first thing to think about for a remedy? An extra coffee enema, which you are allowed to do, particularly when you’re drinking all your juices. We also mentioned, I think it came up a little bit ago, some people, because you’ve got 12 hours or whatever at night, sleeping, and toxins are being released during the night. If there are a lot, some people wake up and feel really bad. They get up – if they’re doing all their juices, they can do this – they get up and they take an extra coffee enema, and they are relieved, and they go right back to sleep.

The primary remedy is the coffee enema. If for some reason it’s not possible to do this, you’re going to need to temporarily reduce the number of juices. The question came up of being able to only do one or two juices a day on certain days when one’s working, but trying to do 10 juices. If you don’t have any symptoms, if you don’t have any detox symptoms, maybe.

But usually people get to learn when they feel toxic. You can just feel it. You may taste it in your mouth, you may feel headache-y, you just know, “I’m feeling toxic.” If that doesn’t happen, okay. But it might be more wise to at least go down to six or eight juices when one isn’t able to take the full amount of enemas to keep that flowing. You can play with it, learn how your body responds.

Detox reactions – it’s a matter of semantics – is really where these toxins that are being released, they’re now flowing through the GI tract, and they are irritating the GI tract, all the way from the mouth to the anus. That’s where typically these symptoms are found. Some of them are also from the sweat. These toxins are trying to be pushed out. So in the skin, there might be rashes, because our skin is a large organ of elimination. The sweat might smell foul. It’s just another way the body’s getting things out.

A woman’s menses could have a different character and odor to it, because that’s a way that every month, some blood gets out of the system. And the body, I think, is intelligent enough to know, “I can send some toxic stuff out with this.”

The whole GI tract could feel irritated, very nauseous, feel sore, because the toxins are irritating. It can cause feelings of nauseousness all the way to vomiting. Dark stools. Usually rule out, of course, if it’s that tarry black, that there’s not blood coming from higher in the digestive tract. But just dark stools usually are a sign toxins are being released. Hemorrhoids are often that irritation right at that area, and some back pressure that can go along with that. Diarrhea. The GI tract, the colon’s being irritated by these toxins, so its reaction is peristalsis, let’s get this stuff out. Diarrhea we’ll talk about. We don’t necessarily want to stop it, unless it’s really severe.

And I mentioned, the skin rashes, cold sores, very common. Canker sores in the mouth, in the tongue, are one of the first symptoms that many people get. Particularly people that have been on chemo. The chemo starts coming out, and we’ll talk about some things to do for that. Just another type of detox reaction. Toxic, detox. Uncomfortable, but you know toxins are being released, and they’re on the move, and it’s a good sign, and we try to give you ways to help moderate that so you can get through that and not have to stop the therapy.

The first one we’ll come back to on the detox reactions is nausea and vomiting.

SPEAKER 1: The best thing, really, the first thing you want to try if you have experience with nausea, is the gruel. The recipe, I mentioned yesterday, is on page 189 in Charlotte’s book, Healing the Gerson Way. It’s really just a mixture of five parts water, one part oatmeal; simmer it for a few minutes and then strain it. We saw the demo on the video. That helps tremendously. A little bit in each juice, you can put some in the peppermint tea, and drink it. The peppermint tea is also another way to help reduce that nausea.

It’s amazing how fast the gruel works. A lot of times when you have a condition or maybe the patient’s had chemotherapy, I think it’s best to just go ahead and start drinking that gruel and peppermint tea as you start the Gerson therapy instead of waiting for that nausea to happen.

Several times I’ve seen patients have an aversion to the green juice. It is usually the first thing that they dislike about the Gerson therapy during a healing reaction. In rare occasions, you can take the green drink as an implant to get through that time, and there’s instructions for that in Charlotte’s book. But you also may need to adjust the diet and have just soft cooked foods for a day or two; applesauce, mashed potatoes, but some soup in with that, oatmeal.

You will pass through it. As long as you’re doing the full protocol that fits your need, you’ll pass through it. I think it lingers longer when you’re not optimizing your potential for what you can do to detox.

DR. SMITH: I just want to add that the gruel being so helpful. At the clinic, Dr. Malindis [sp] calls it better than Maalox. It just is emollient and soothing. It’s that very thin oatmeal and gruel, because it’s kind of just gruelly.

SPEAKER 1: And it tastes good, too, it really does.

DR. SMITH: And it’s giving some extra calories for those people that just aren’t eating as much as they should. If you put some gruel in their juices, they’re getting some extra calories, a little extra protein at the same time.

Diarrhea, which can happen when those extra toxins are irritating the lining of the colon. If it’s not severe, when it’s just starting, we don’t want to plug it up, because this is a way toxins are being released. But we want to moderate it. One really good remedy is a quarter of a teaspoon of clay. We don’t have the canister, but you’re going to hear about clay in a little bit, when we demonstrate clay packs. But montmorillonite clay or bentonite clay has these absorptive properties; when you ingest it, it doesn’t get absorbed into the body, but it pulls toxins, many times its weight in toxins, as it’s moving through.

We add a little clay and potassium gluconate – it’s a supplement that most of the companies sell, the Gerson companies – with some peppermint tea. Just keep sipping that. That can help the diarrhea, because it will just help pull the toxins out that are irritating quicker.

If it’s severe diarrhea or it’s just constantly, which doesn’t happen that often, but just running and running, a person doesn’t want to get dehydrated. So they may need to stop the coffee enemas until they get it under control. Make sure you’re drinking the juices and the carrot juice and staying hydrated. Sometimes just a little chamomile [inaudible 00:29:48] or some chamomile tea goes in and just comes out.

Once that diarrhea is starting to slow, slow, slow, then we start the enemas. Maybe even with chamomile tea then, and then slowly – if we had to stop them because of a severe condition of diarrhea – start in slowly. And that’s a picture potassium gluconate. This is a key company one that you can have on hand.