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s10e1 Dr Rana MaFee.png

Neurological Diseases

Dr. Mafee is dual board certified in Neurology and Integrative Medicine.  As such, she is passionate about using functional and integrative philosophies to prevent & reverse a host of chronic conditions.  Dr. Mafee is particularly focused on helping patients work through neurodegenerative disorders.   Dr. Mafee joined the Case Integrative Health team in March 2020.

Neurodegenerative disease is an umbrella term for a range of conditions which primarily affect the neurons in the human brain.

Neurons are the building blocks of the nervous system which includes the brain and spinal cord. Neurons normally don’t reproduce or replace themselves, so when they become damaged or die they cannot be replaced by the body. Examples of neurodegenerative diseases include Parkinson’s, Alzheimer’s, and Huntington’s disease.

Neurodegenerative diseases are incurable and debilitating conditions that result in progressive degeneration and / or death of nerve cells. This causes problems with movement (called ataxias), or mental functioning (called dementias).

Dementias are responsible for the greatest burden of neurodegenerative diseases, with Alzheimer’s representing approximately 60-70% of dementia cases. (Credits: JPND)

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S10E1 Neurodegenerative-Disorders


Lita T  00:08

Hello and welcome to another episode of podcast dx, a show that brings you interviews with people just like you, whose lives were forever changed by a medical diagnosis. I'm Lita. Ron is not with us today.


Jean  00:20

And I'm Jean Marie.


Lita T  00:21

Collectively we're the host of podcast dx. On today's show we are speaking with Dr. Rana Mafee. Dr. Mafee is dual board certified in neurology and integrative medicine. She is passionate about using functional and integrative philosophies to help treat and prevent a number of chronic health conditions. Dr. Mafee has a particular interest in treating those individuals diagnosed with neuro-degenerative disorders like mine. Hello, Dr. Mafee, thank you for joining us today.


Dr Mafee  00:58

Thank you for having me.


Jean  01:00

And I think we're gonna end up pronouncing your name 12 different ways throughout this episode, so I apologize.


Lita T  01:04

 Did I say it wrong again.


Jean  01:06

 I think so. It's MFI, Matt. Wait, Maphy, Maphy.


Dr Rana Mafee  01:09



Lita T  01:10

Okay. Okay.


Jean  01:11

 Well, hello, Dr. Mafee, this is Jean Marie. And I'd like to start by asking you what actually led you to a career in medicine.


Dr Rana Mafee  01:21

Um, you know, I was, I had a family with a lot of doctors in it. So I kind of had a lot of, you know, encouragement from that end. And I just, I just had a, you know, it just an inclination, I always felt, you know, inclined to do something more in the sciences, and I was always just more inclined to, you know, things related to healthcare, so I kind of knew from an early age that I wanted to be a doctor.


Lita T  01:50

Sure. That's great. That's great. Oh, I'm sorry, go ahead.


Jean  01:54

Okay. And, Dr. Mafee, what are integrative and functional medicine? Are they kind of the same thing? Or are they two completely different fields?


Dr Rana Mafee  02:06

I get that question a lot. So, there, there are some differences. So integrative medicine is, you know, a broad, sort of a way to kind of refer to you know, how to how to intermix different modalities that, that doctors aren't traditionally trained in, in a traditional Western medical school setting. So you know, whether it be incorporating acupuncture, or traditional Chinese herbs, or ayurveda or, you know, intense nutritional therapies, you know, you couldn't call yourself an integrative doctor, if you're kind of blending some, I guess, you could say, east and west, or, you know, other complementary and alternative philosophies with your traditional medical training. Whereas, in with functional medicine, I think of it as you know, having training and using a different sort of like GPS system or roadmap to be able to kind of help optimize health and treat a lot of chronic illnesses, because it's, it's founded and rooted in a lot of like systems biology, sort of medicine, so trying to get at, you know, looking at that one particular individual, what, you know, what are their particular individual needs based on their whole health, so looking at, you know, all the aspects of health, hormonal health, metabolic health, immune health, gastrointestinal health, and so on, trying to kind of look at all the different nodes of health and decide what best suits that individual and in functional medicine, a lot of integrative, integrative modalities are used. So intense nutritional therapies, different herbs and supplements and so forth. So, so it's it's, they are different. A lot of times they are interchangeable, but they are there is a difference between the two. Yeah, so when we talk about neurodegenerative diseases or disorders, it's a you know, a very broad kind of category or a term to refer to any disorder that disrupts causes destruction and tissue death within the neurological axis or neurological system. So whether that be brain related or spinal cord related or nerve or muscle related. There are different types of neurodegenerative diseases. So if we start at At the top with the brain, you know, Alzheimer’s disease, other dementias, Parkinson's disease, those are things that, you know, would be considered neurodegenerative diseases because there's tissue destruction and death in certain, you know, areas of the brain. We talk about, you know, nerve related disease, things like motor neuron disease, or, you know, ALS that might be considered in that category. So that would be a neurodegenerative disease as well. So it's, it's just basically just a broad term that can kind of refer to any kind of disease or disorder that will cause tissue death within the neurological axis.


Lita T  05:45

Okay All right, and how does your approach to treating neurodegenerative disorders vary from a typical mode of care?


Dr Rana Mafee  05:57

Well, you know, our, our system, our traditional medical system is, is very oriented in naming it, blaming it taming it, so naming the disease, kind of figuring out what it's called. And by that time, it's usually progressed pretty far, because a lot of neurodegenerative diseases take several years, sometimes decades to kind of creep up on somebody, before they start to really overtly show symptoms. So naming it, blaming it on you know, you know, on something, and then taming it without usually a medicine or a surgery or a procedure or something like that. So that's the traditional sort of approach. Whereas using, you know, a wider toolbox, you know, if we use a functional medicine approach and integrative medicine approach, we have a lot more things that we can reach for, you know, so things that aren't really considered as heavily in you know, a tradition, traditional Western medical model, so, so really, you know, working with people foundationally in terms of lifestyle, and getting, you know, diet really honed in, because food is medicine, there's no question about that. So using diets, therapeutically, you know, I'm doing some more in depth testing, yeah, oftentimes is what I'll do to kind of investigate what some of the root causes might be, for whatever neuro-degenerative disorder, you know, patients, you know, dealing with, and investigating, you know, all kind of all aspects of health. So, I'm really passionate about, you know, like, fixing people's guts, because there's a huge connection between the gut and the brain and the nervous system. So, oftentimes, I am doing a lot of testing with gut and kind of targeted treatment towards towards gut sorts of things. But then again, you know, based on what the individual needs, or the patient, they may be more, we might need to work more on, you know, metabolic health or, you know, detoxification and, you know, reducing toxic load and so forth. So it all depends on the patient.


Jean  08:27

Dr. Mafee, and I'm sorry, if I mispronounce it yet again, um, I recently read a study from the National Institute of Environmental Health Sciences concerning pollutants, and toxic metals as possibly being the blame it were the cause of neurodegenerative disorders. Is this something that everyone should be aware of as far as risks go? Or is this just something in one more thing in the whole gamut of possibilities for, you know, the result, or Yeah, for causing neurodegenerative disease? Sorry.


Dr Rana Mafee  09:02

So certainly, that there's there's actually a lot of mounting evidence that that toxins in general, are seeming to be a contributor to neurodegenerative, neurodegenerative diseases. So, in the beginning, when I started, kind of, you know, learning this, this approach and the style it was, I was really impressed with the data on you know, like Parkinson's disease, and the effects of things like pesticides and insecticides and heavy metals, because there is some some good evidence showing that there are links, not to say that it is the cause of Parkinson's disease. It's a very complex illness with you know, I'm sure multiple etiological factors, but there is good evidence to show that things like insecticides, pesticides, you know, and heavy metal are partially to blame. So, you know, and over the years evidence has been also mounting similarly, to implicate, you know, similar toxins in Alzheimers disease in ALS. So, you know, I think a common tie of most neurodegenerative diseases is that the, the, the cells in the nervous system aspects of the cells, I should say the the little energy factories in the cells, the furnaces of the cells are called the mitochondria, so they become dysfunctional. So those are really, really critical to help keep those cells very vital and alive and, and thriving. And when the mitochondria become, you know, broken and dysfunctional, the cells start to die. And oftentimes, the common link here is something called oxidative stress. So there's like, like a rusting on the cells, there's like this oxidative stress that causes these mitochondria to kind of become less efficient, and ultimately to cause cell death. And so a lot of these toxins in our environment are showing to be, you know, mitochondrial pollutants to tox.. to be toxins to our mitochondria. There are also other, you know, reasons for why toxins in general, cause Ill, Ill effects so they can have direct effects on our immune system, they can dysregulate our hormones, they can disrupt dysregulated our metabolism. So a lot of reasons why toxins in general, you know, are to blame.


Jean  11:52

Okay, that makes a lot of sense.


Lita T  11:54

Wow, that's incredible.


Jean  11:58

And I'm curious what type of testing can be done to determine if a person has, like, you know, you had said that it can take a long time to determine that someone has a neurodegenerative disease? But is there a specific testing that can be done to determine if someone has a neurodegenerative disease?


Dr Rana Mafee  12:12

ummmm not, I wish there, I could say yes, you know, oftentimes, these, like, the symptoms that come on are insidious, so very slow. So like, let's take Alzheimers, you know, as an example, so. So there may be some slight, very subtle signs and symptoms of memory issues, cognitive issues that creep up, you know, 10, maybe even 20 years before the onset of the diagnosis, there's no real test for you know, am I going to get Alzheimer's disease, you know, there are some genetic markers that might make you more prone to develop something like Alzheimer's disease, something like Parkinson's disease, there are some very rare genetic, you know, predispositions for that. But oftentimes, it's something that comes on without a family history. And it's, you know, if there's no direct test for it, but you know, I would say, if, if you are concerned about it, and you, let's say you are have some kind of occupation where you're maybe at higher risk, you know, like, like, you're a farmer, and you work with a lot of pesticides. Yeah, it might be, you know, to your benefit, or worse, you know, kind of meeting with a doctor who's, who practices the way that I do, and, you know, even though you're not showing any signs or symptoms, just to make sure that, you know, everything looks good, you know, like nothing, there are no warning signs of illness, and that, you know, all sorts of the aspects of your health are kind of kept in check.


Jean  14:03

Okay, and I guess also, you'd be establishing a baseline at that point.


Dr Rana Mafee  14:08



Jean  14:08



Dr Rana Mafee  14:09



Lita T  14:10

Well, Doctor, what are some elements of wellness that most people overlook that might help us you know, avoid


Dr Rana Mafee  14:18

so I would say, you know, with our, I would say the two things that are kind of on the top of my brain with that question number one would be diet because, you know, we, we, in our Western society, we are, you know, eating a what we call a SAD diet, the standard American diet. Not everybody but a lot of people without you know, fast food on every corner and you know, just it not being stressed as much. When you go to see just your primary care doctor, you know, it's just not really taught and ingrained in medical school that doctors should really be Like heavily counseling their patients on healthy diets, and I personally even think that, you know, like, diets that are recommended, you know, that are like, like for the food, like the Food and Drug Administration, you know, like, I don't think that the standard diets that are recommended as healthy or even the best guidelines. So, you know, like having a really paying attention to diet, having a really anti inflammatory diet, which, you know, the most data shows that the Mediterranean style diets are, there's a lot of good strong evidence that those are very, very good diets in general. But diets In my opinion, needs to be very personalized. So depending on you know, the person and their needs, there's there's a lot of ways to make nuanced changes to the diet, diet recommendation. So diet, I think it gets overlooked, for sure. But also, stress, stress is a big big factor, I think that gets kind of overlooked in terms of wellness, and people don't take as good care of themselves don't know when to set limits, don't know what to say no, get too overwhelmed, get overworked, don't sleep enough. So, you know, I think self care and just, you know, not being too stressed, I think is something that gets overlooked.


Lita T  16:29

That two very important factors. And, you know, Doctor, office visits nowadays, are so quick, you know, you're in and out, you don't really have a lot of face time with your doctor. So, you know, maybe there could be an augmented segment of medicine. Maybe the nursing staff could be the supportive role for those type of things, you know, like, maybe


Jean  16:59

we're integrating new, you know, having a nutritionist,


Lita T  17:02



Jean  17:02

 you know, other things as well. Yeah, it's it, if you think about the human body is so complex,


Lita T  17:08



Jean  17:09

 And yeah, you guys have a lot, a lot to deal with.


Lita T  17:13

But that's one of the reasons that we did this podcast is because we realized that your face time with your doctor is very limited nowadays.


Jean  17:22

And anything we can do to make that, as that time as valuable. And as as beneficial as you can is great,


Lita T  17:32

right? We try to give people advice on you know, or suggestions and how to plan their visit with the doctor so that they can get the most bang for the buck. And and people probably don't want to hear


Jean  17:48

that they have to do a lot of work


Lita T  17:49

 you have to do the work themselves.


Jean  17:51

Yeah at least like documenting symptoms and things of that nature. But I have a I have an unusual question because you're using functional and integrative medic medicine. In addition to being board certified neurologist, does that affect how your office handles billing and insurance?


Dr Rana Mafee  18:10

it so we do offer we do kind of work on a cash based model. So we it's a fee for service model. However, we provide super bills to patients so they can submit their their insurance for reimbursement. The reality is that, you know, our current medical our current health care system, and insurance model doesn't support as you kind of alluded to the type of care that's needed to really deal with complex chronic illness, if you want to kind of address the whole person. So it takes a lot of time our our visits are lengthy and we spend a lot of face time with patients. I can't remember the last time I will only had a 15 minute encounter with a patient. So for that reason, I think most doctors that practice functional medicine are are kind of leaning towards this sort of practice model.


Lita T  19:16



Jean  19:16

 yeah. Because insurance agent companies want you to spend so much time and it's you know,


Lita T  19:21

and yeah, restrictive. yes


Jean  19:24

And they and I mean, the saying health is wealth. Nowadays you really have to invest in yourself and your own health. And I think definitely, you know, finding a physician such as yourself who is going to take time to actually get to know you and is just it's fantastic.


Dr Rana Mafee  19:41

Yeah, definitely.


Lita T  19:44

Oh, personally, on a personal note, what helps you find a good work life balance.


Dr Rana Mafee  19:50

Oh, well, I'm not working full time and burning myself out. So I work part time because I have a family. I have three kids So it would, I would not practice what I preach at all, if I were, you know, working myself into the ground. So working part time, spending time with family as much as possible, you know, you know, having some time out for myself for self care. You know, those those things I think are what keep me in balance. And in check.


Lita T  20:25

I bet every doctor that's listening to this thinking, wow, this sounds great. Let me let me jump over there.


Jean  20:33

Well and we have noticed that a number of people that we interview, we want to know, like, do they have more hours in the day? Because it seems like everyone just is accomplishing so much and taking on so much. And


Lita T  20:45

but it's got to


Jean  20:45

 that you have to balance?


Lita T  20:46

 Yes. Right? And what is the best advice that you've received? As far as treating someone with a chronic neurodegenerative disorder?


Dr Rana Mafee  20:59

Hmm. Well, these are very complex, chronic illnesses. And, you know, oftentimes, patients are told they're untreatable for the most part, you know, you can abate symptoms with medicines and, you know, procedures and so forth. So just showing a lot of compassion, you know, and spending as much time as needed with patients to kind of answer our questions and, and be available, I would say is, you know, that's probably what I'd say,


Lita T  21:34

well, that's great. And that's something that you in your, in your chosen practice can do when there's a lot of doctors can't


Jean  21:42

Right, and I think with a neuro degenerative disease, especially, you really do need more time,


Lita T  21:46



Jean  21:47

To take everything in.


Lita T  21:50

Yep. Yeah, I'm definitely leaning.


Jean  21:52

You're scheduling an appointment as soon as we get off the phone?


Lita T  21:56

Yeah. How have your family and friend supported you while you were in medical school, your residency, and then your career?


Dr Rana Mafee  22:04

I'm very fortunate, I have a very supportive family, you know, I started my family and my residency. So my, you know, I had loving parents loving in laws that helped, you know, I, you know, in the beginning, when I was just doing traditional medicine, and you know, I had a hospital job, and I was on call often, and it was long hours. So I did have a lot of support in that way. You know, not everybody's as fortunate. But, you know, I, like I said, it just worked out that way.


Lita T  22:37

That's great.


Jean  22:38

Yeah And what tips or advice do you have for new medical students and those just finishing up with a residencies?


Dr Rana Mafee  22:47

Oh, boy. Well, I think my experience is not the same as the experience of current residents and medical students, because they've shown


Jean  22:57



Dr Rana Mafee  22:58

 policies on hours and I mean, I, the hours that I worked were insane. So if I were to go back and talk to my previous self, I would say, you know, just take care of yourself. Make sure you sleep enough, you know, sleep is so important. Eat well. Don't Don't, don't eat crap, you know, like, healthy diet, enough sleep, and you know, do things to just take care of yourself, whether it's going on a meditative walk, or, you know, like, taking time out to just breathe, you know, just take care of yourself.


Jean  23:33

That's Yeah, that's great advice for everyone. Definitely,


Lita T  23:35

definitely. And Dr. What would you say the biggest challenge has been so far in your career?


Dr Rana Mafee  23:44

Oh, probably striking that work life balance for sure. I had a I had a couple of years where I took off I just didn't work at all because, you know, I went from working full time and having two kids and getting burned out, you know, so I just I needed a break for myself, I just needed to turn it off. You know, as I turned it off for a while, and then I figured it out. I figured out how to go back and kind of keep a balance. So keep finding that work life balance was it was a journey, you know, it took even taking time off for a few years.


Lita T  24:21

Oh, okay. Yeah. And I didn't I didn't put this in the script, but I'm just curious what led you to neuro-degenerative diseases?


Dr Rana Mafee  24:31

Well, I wouldn't say that I went into neurology just to kind of deal with neurodegenerative diseases. I I had a an interest in neurological issues in general. So like, that's what led me to do that residency. But you know, in my training with, you know, integrative medicine and functional medicine, I just started to realize more and more like how instrumental this sort of approach is specifically for neurodegenerative diseases.


Lita T  25:04

Okay, all right, good. Well, now we're going to do our tips hints and tricks, lightning round segment of the show.


Jean  25:12

Yeah, kinda like a game show.


Lita T  25:14

Sort of. Yeah. So 10 question lightning round. Dr. Are you ready?


Dr Rana Mafee  25:19



Lita T  25:20

Okay. Why is the brain important to you?


Dr Rana Mafee  25:25

Oh, the brain is important to me because it's your thinking organ. You know, it's like that what makes us human is what sets us apart from other animals and primates. And it just it's important. You know, that's what makes us human..


Jean  25:41

Yes Yes. Good answer. 10 points.


Lita T  25:44

Okay. And what might what makes life easier during COVID?


Dr Rana Mafee  25:50

Spending time with family and friends safely? As much as possible?


Jean  25:59

Oh, wonderful advice. A wonderful, wonderful answer.


Lita T  26:02

And what is your go to? online resource for medical information?


Dr Rana Mafee  26:10

Oh, PubMed? Probably


Jean  26:12



Lita T  26:12

Yeah. Yeah. Good answer. And do you have any tricks for dealing with stress?


Dr Rana Mafee  26:18

Yeah, one thing I do, which bugs my husband, but I set an alarm on my phone twice a day. Just to remind myself to take a few minutes out to just breathe. Take some deep breaths.


Lita T  26:33

Okay, that's a good answer. And what do you always bring with you when you go to a doctor's office?


Dr Rana Mafee  26:42

Probably just a list of questions. Just make sure that I remember to ask everything I wanted to ask.


Jean  26:49

Yeah, that's Yeah, cuz it when you're there, yeah, you can get overwhelmed or get off. But


Lita T  26:54

Yeah, yeah, we always we always advise people that we're interviewing that if you don't write it down. Once you're in there, you may forget what you wanted to go in there for. As matter of fact, I was just, at a doctor, and I forgot to ask him, I didn't write it down.


Jean  27:09

So now it's now it's on her calendar.


Lita T  27:11

Yeah Okay. What do you do? or excuse me, what do you use as a distraction during long waits? If you're like, you have to wait for a long time.


Dr Rana Mafee  27:23

It's a bad answer, but my phone.


Lita T  27:26

I think everybody does nowadays. Right? It is it is where it's


Jean  27:30

CPU. Yeah. Right. Yeah, definitely.


Lita T  27:33

And what is your fast and easy, nutritious, nutritious snack


Jean  27:38

go to snack?


Lita T  27:39



Dr Rana Mafee  27:40

I'm probably a handful of nuts like almonds or walnuts. Or sometimes I'll make a little trail mix with, you know, pumpkin seeds, maybe almonds or walnuts, raisins, and maybe a little dark chocolate.


Lita T  27:55

I call that Garp.


Jean  27:56



Dr Rana Mafee  27:57



Lita T  27:57

that I call that Garp. garp. I used to make that for my kids. Whenever we did a long road trip. I would I would mix it do like a trail mix type thing. Okay. Give us three of your favorite recreational pursuits.


Dr Rana Mafee  28:15

Well, I love yoga. I've been doing yoga for about 10 or 11 years. Through COVID. I started doing a little more Pilates, black mat Pilates, so that what else? I like to ride a stationary bike. So I like cycling. And I'm recently getting into pickleball.


Lita T  28:41

Oh, I've heard of pickleball. I haven't haven't seen it, but I've heard of it.


Jean  28:47

What extra little pickle like little tiny cucumbers flying in the air


Lita T  28:51

. Yeah. What animal best reflects your personality?


Dr Rana Mafee  28:58

I don't know something gentle and friendly. Maybe a dolphin? I don't know.


Lita T  29:04

Okay, I like that. I like that. And what do you do to treat yourself?


Dr Rana Mafee  29:10

Oh, I love getting a pedicure. Okay, once in a blue moon, I'll get a massage for myself. You know, and just spending time with friends.


Jean  29:22

That's wonderful. And yeah, we did a wonderful job with our little game show there. And I have a question. How can we learn more about you and your practice?


Dr Rana Mafee  29:33

So I'm going to our website so www dot case, ca s e integrative We're also on Facebook and on Instagram as well, as Case Integrative Health. That's probably the best way to learn more.


Jean  29:55



Lita T  29:56



Jean  29:56

sounds great.


Lita T  29:57

I am definitely going I didn't realize that You did, because we interviewed a colleague of yours


Jean  30:04

regarding, yeah, regarding Lyme disease,


Lita T  30:07

Right but now that I know that you do this particular aspect of health, I'm going to be a patient because I have been. Yeah, I've been dealing with some memory problems for quite a number of years and they can't wrap their head around it and I'd like somebody to try to help me. Well, I think that wraps up this episode. Thank you very much for taking the time to talk with us today. Doctor,


Dr Rana Mafee  30:31

thank you was a pleasure.


Lita T  30:34

 And a special thank you to the PR agent, Alexandra Moresco. She's set us up with a couple of interviews from your staff. If any of our listeners or have any questions or comments related to today's show, they can contact us at podcast on Facebook, Twitter, Pinterest or Instagram and we have a website, podcast dx com.


Jean  30:59

And if you have a moment to spare, please give us a review wherever you get your podcast. As always, please keep in mind that this podcast is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding medical condition or treatment before undertaking a new healthcare regime, and never disregard professional medical advice or delay in seeking it because of something you've heard on this podcast


Lita T  31:21

Till next week.

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