BRAIN BODY MEDICAL

What is Functional Medicine and Root Cause Evaluation?

Root cause evaluation looks at the etiology of dysfunctions- the base or the roots of a tree. We think brain imbalances are manifestations of foundational disturbances in the body. Functional medicine practitioners focus on restoring imbalances by looking at the fundamental physiologic imbalances and strengthening the foundational lifestyle factors: sleep, exercise, nutrition, stress levels, relationships, and genetics. The fundamental imbalances are like the trunk of the tree and the lifestyle factors are the roots and soil. The Functional Medicine Tree represents the core aspects of the Functional Medicine paradigm and highlights the difference between conventional medicine and Functional medicine.

Does Brain Body Medical accept insurance?

Unfortunately, when doctors participate with insurance carriers, they enter into a contract that allows the insurance companies to dictate what services will be supplied, thus limiting the quality of care that we believe you deserve. Insurance-based medicine does not allow us to practice the in-depth, expert model of functional and root cause evaluations. Therefore, we out-of-network with all insurance plans. Payment for services is required before your visits. We are happy to provide you with a super bill, which you may submit to your insurance company to request reimbursement if you have out-of-network coverage. We do not correspond directly with insurance companies; time spent interacting with insurance companies will be billed to you. We cannot accept patients with Medicare due to Medicare billing rules. Some insurance carriers may cover Functional laboratory testing as out-of-network benefits. You are responsible for contacting your insurance company regarding your level of coverage.

Can Dr. Madhava be my primary care physician?

We require all our patients to have a primary care doctor for routine medical care and emergencies. Dr. Madhava is an addiction medicine and functional medicine specialist.

What can I expect on my first visit?

The first visit is our opportunity to get to know one another and discuss your expectations and goals. We will have shared decision making on testing and treatment options. During a first visit, we typically:

1. Review questionnaires
2. Discuss goals and expectations
3. Discuss plans to taper, detox or discontinue the substance you are on
4. Trialing with neurotransmitter precursors based on your questionnaire responses
5. Determine potential medication/supplements/psychological supports needed
6. Recommend testing, possibly including but not limited to:
   1. Comprehensive blood testing
   2. H air Tissue Mineral Analysis
   3. Stool testing
   4. Hormone testing
   5. Neurotransmitter test
   6. Complete nutritional evaluation with blood and urine testing
7. Referral to a health coach or educator
8. Enroll you in our practice- a minimum commitment of 6 months is required
9. Assignment to a level of service for symptom management depending on all of the above

Do you do telehealth visits?

In light of the current COVID-19 pandemic, we are currently conducting most of our visits via telemedicine.

How do I know if I am a good fit for your services?

We feel that patients who get the most from our highly personalized services are those who are 'ready, willing, and commited' to recovery:

• Ready to stop or decrease drug and/or alcohol use
  
• Willing to do the testing and follow through with our protocols, including taking nutrient supplementation in addition to making the lifestyle changes needed to correct underlying imbalances
  
• Commited to following through with the other components of optimal health: psycho-social-spiritual aspects of healing and recovery

What is the best way to schedule an appointment?

Schedule a 15 minute phone appointment here to see if our services are right for you. If we decide that our services are right for you, you will be asked to complete a new patient application followed by intake questionnaires on our patient portal. After these are complete, you will be able to schedule an appointment with Dr. Madhava via our patient portal.

How quickly can I get an first appointment?

We encourage patients to book appointments at least 1 week in advance, though we occasionally may be able to schedule you sooner. You will need to fill out a series of intake questionnaires before we can schedule your first visit via our patient portal.

How do you treat amphetamine or cocaine use disorders?

We use neurotransmitter precursor therapy as the foundations of treatment. There are no FDA approved medications for treatment of amphetamine use disorders. Sudden withdrawal of cocaine and amphetamine results in a sharp decrease of dopamine levels. Our goal is to replenish depleted dopamine levels with neurotransmitter precursor therapies such as L-Tyrosine, N-acetyl cysteine, and other amino acid and herbal remedies as we address the underlying brain and body imbalances with testing and targeted treatments.

How many labs would you recommend that I do?

Typically we will start with the following tests: 1. Comprehensive blood test, which may be covered by your health insurance plan 2. Hair Tissue Mineral Analysis (not available to residents of New York) 3. Gastro-intestinal (gut) test 4. Adrenal hormonal test 5. Neurotransmitter test (may not available to residents of New York) 6. Nutrient and key biomarkers evalution looking deficiencies and imbalances We may need to pursue additional testing, if the results and your continued symptoms suggest that we would need to dig deeper. Depending on the type of test, the samples required are blood, hair, saliva, urine or stool. Many of the tests are completed by the patient through test kits that are self-administered in the comfort of your own home. Test kits can be delivered to your home during the COVID-19 pandemic.

Where can I purchase nutrients and supplements?

Dr. Madhava recommends supplements from high quality and reputable manufacturers that can only be purchased with a practitioner’s recommendation. You may visit our shop here. If you want to do your own research on different supplements, we welcome you to do so but we do not provide any other recommendations nor advise on other specific blends or brands. If you purchase other supplements from other manufacturers, please research carefully. Not all ingredients are equal, and there is not a guaranteed quality when you purchase supplements elsewhere.

What are the fees for consultations?

Our fees depend on the level of service each patient requires. Please see our fees page here for more information.

What types of payment does Brain Body Medical accept?

Methods of payment are with credit cards.

How much time do I have to cancel or change a scheduled consultation?

If for any reason you cannot make your appointment, please let us know more than 24 hours before your appointment so that we can reschedule accordingly. You will be charged 100% of any visit not cancelled within 24 hours.

What conditions does Dr. Madhava treat?

Dr. Madhava specializes in treating patients with dependencies to the following substances:

• Alcohol
• Amphetamines
• Benzodiazepines
• Cocaine
• Cigarettes
• Food
• Marijuana
• Opioids
• Sugar

How do you treat alcohol use disorders?

Our goal is to address the underlying brain and body imbalances as outlined previously to optimize brain function and reduce cravings and risk of relapse. Sucessful addiction treatment requires the identification and treatment of the multiple underlying disorders.

• We use neuronutrient precursor therapy, supplements and a pro-recovery diet as the foundations of treatment
  
• If outpatient medically supervised withdrawal is warranted, we follow the American Society of Addiction Medicine (ASAM) guidelines
  
• We can follow the treatment recommendations of The Sinclair Method (TSM) for those who prefer this method. More information about our use of the Sinclair Method can be found here

What is Hair Tissue Mineral Analysis (HTMA)?

HTMA is an analytic test that measures the mineral and toxic-metal levels in hair. It is a valuable screening tool and testing can identify nutritional imbalances not revealed by other testing methods. Please read our page on HTMA here for more information.

How do you treat opioid use disorders?

Our goal is to address the underlying brain and body imbalances as outlined previously to optimize brain function and reduce cravings and risk of relapse. Successful addiction treatment requires the identification and treatment of the multiple underlying disorders.

• We use neurotransmitter precursor and a pro-recovery diet as the foundation for initial treatment as we address the underlying brain and body imbalances by testing and targeted treatment. Sucessful addiction treatment requires the identification and treatment of the multiple underlying disorders.
• We can use medications for symptom relief, if needed
• We can use buprenorphine for detoxificiation and maintenance, if preferred

Can I email Dr. Madhava with any questions/concerns?

Dr. Madhava is happy to answer brief questions via the patient portal when you may have brief questions about your protocol, requiring yes or no types of answers. If you have complex questions which requires further back and forth communication, she will recommend scheduling a follow-up appointment via the patient portal.

What should I do if I am struggling sticking to my protocol?

We completely understand that following new protocols often requires major life changes. We have health coaches and educators to help you stay on track with recovery. Our advice is to take one day at a time. Often keeping a health journal allows one to stay on track and also shows the progress we've made for when we need a little inspiration.

When are follow-up appointments?

The frequency of follow-up appointments depends on the treatment protocol and level-of service. For some patients, daily follow-ups may be required. For others it can be a few times a week, weekly, or biweekly. Lab testing results usually come back to us between 2 week and 4 weeks after submission of the test. Therefore a lab follow-up visit will be within 2-6 weeks after labs are submitted. These lab review appointments will take about 60-90 minutes.

How do you treat benzodiazepine use disorders?

Our goal is to address the underlying brain and body imbalances as outlined previously to optimize brain function and reduce cravings and risk of relapse. Successful addiction treatment requires the identification and treatment of the multiple underlying disorders.

• We will use neuronutrient precursors and a pro-recovery diet as the foundation for treatment
• We think a slow taper with a long-acting benzodiazepine is the best treatment option, as quick tapers often lead to severe symptoms and relapse
• We can follow the treatment recommendations in Ashton manual for those who prefer this method

Can the brain recover after using substances?

Yes, changes to brain chemistry and function caused by long-term substance use can be reversed with treatment and abstinence. Because it takes a long time (several months to over a year) for the brain to heal, we ask for our patients to commit to long-term treatment plans that work towards lasting recovery.