AFMC Case Study Interview – Julie Spencer – Multi-Autoimmune, Sleep and Stress

Congratulations to SAFM graduate and AFMC-certified practitioner Julie – a Family Nurse Practitioner specializing in women’s health and urology. Since joining SAFM, Julie was able to start an entrepreneurial private practice while also bringing the impact of functional medicine into her regular conventional practice. This is a combination that a number of practitioners at SAFM choose. 

Julie’s case centered on a patient in her fifties, diagnosed with headaches, fibromyalgia, lupus, and Hashimoto’s – a clinical case begging for the insights of Functional Medicine interconnectedness!  

At SAFM, we teach that a particular diagnosis and patient symptoms should not be the only focus of a clinical intervention – these are usually logical and expected manifestations of upstream root causes. Identify the root causes and an effective clinical roadmap will reveal itself. 

This video features Tracy Harrison interviewing Julie on the key considerations in this case. Julie looked at her patient’s history, symptoms and labs through the functional medicine lens and was able to identify several key dynamics that other providers either never asked about or considered irrelevant. And then she used intuition,  great coaching, and some creative toolbox solutions to help her patient achieve rapid relief and incremental lifestyle changes – going at the patient’s pace. If we recommend too much, too fast, and an overwhelmed patient gives up and walks away, then we miss an opportunity to actually have the Impact we crave.  

For this patient, one of the keys was high stress – a lifestyle precipitating many areas of dysfunction from sympathetic nervous system activation, especially affecting the patient’s sleep. There’s no getting around it: if we aren’t sleeping well, then sustainable healing is highly unlikely in any patient case! Cholecystectomy and a history of bowel surgeries set her up for downstream digestive and absorptive dysfunction. And ongoing inflammation was taxing her redox pathways.

So often, functional practitioners want to get too esoteric, too quickly, in their recommendations. But not Julie. She masterfully prioritized rapid relief  in both stress management and sleep as a priority – two dynamics that had never been addressed by any of this patient’s previous medical practitioners. Only once these foundations were in place, did Julie go further to address GI function. Many practitioners know these priorities are important, but they are not confident in how to actually facilitate sustainable lifestyle change. At SAFM, this is a key component of our curriculum (and reinforced with continuous, real-life, complex case practice).

Another huge benefit of Julie’s intervention was helping the patient handle bowel surgery for intussusception. In Julie’s own words: “She went into surgery feeling very well. And she had been very well rested and her stress was better managed. We had been working together for about three months and her outcome after surgery was better than expected. And talking with her, she credited a lot of that to me and what we had done to support her.”

A win for the patient, and an abundance of professional satisfaction for Julie. At SAFM, our mission to optimize clinical outcomes means for both patient and practitioner alike! Thank you, Julie, for your inspiring role model.