MIDWAY — When Jim Roach of the Midway Center for Integrative Medicine talks about the mercury fillings in your mouth heating up and steaming after you eat a hot lunch, you feel as if you've stepped into Tales From the Crypt.
You inhale the vapors, he explained, and this is bad for you, but you also swallow some of them, which is not as damaging.
And that's just an aside in Roach's running conversation about all the things that you have done, probably inadvertently, when getting fillings or when thinking rice really is gluten-free, that might have damaged your health and triggered some of the conditions you can't explain.
Roach, 59, a physician long known as an anti-smoking crusader in a tobacco state, decided when he turned 50 "to figure out how long and how well I could live."
He began to research various therapies and found that "each one has a piece of the truth."
That includes not just diet and exercise, but also spirituality, he said: "If you meditate or pray or do spiritual reading, you don't overreact to those situations."
Roach's free-ranging conversation about all aspects of a patient's life helps him in his career as a sort of disease detective. "I see issues that others can't figure out," he said.
That includes chronic fatigue syndrome, fibromyalgia, attention deficit disorder hyperactivity syndrome, panic attacks and cancer complications. An average patient with, say, chronic fatigue syndrome might have 25 to 40 health issues, Roach said.
His job is to sort out which issues can be fixed, and how.
"Maybe we're specializing too much," Roach said. "You need a general in charge of everything who can look at the whole body."
Roach has so much information that he wants to share, and when he makes one point — say, using more of the spice turmeric — it carries over into how important it is to know the difference between folic acid and folate and what pomegranate does to your hormone levels.
The answers: Turmeric fights infections and reduces inflammation. Folate is synthetic, while folic acid occurs naturally in food. Pomegranate juice increases testosterone levels.
But then Roach is already off on the benefits of zinc and selenium and fish oil. Roach has plenty of ideas, and he is not slow in expressing them.
Saying that Roach is a different kind of doctor is really not fair to him. He is a doctor who likes to talk about health — your health, his health, the trends of the healthy and unhealthy worldwide.
He bristles at the label "alternative" health care because the tools, the tests and treatments he uses are often more precise and detailed than those found in some specialty clinics. And he spends ample time on each patient. Although a staff member deals with "digestive counseling," much of the discussion about a patient's history is done with Roach himself.
He prefers the word integrative to describe what he does — a style of medicine that melds high technology with extensive one-on-one counseling and testing.
"There are answers," Roach said. "You just have to look for them. It takes time. But why don't you at least look and see?"
He understands how other doctors conduct their practices, and why — insurance companies can be cruel masters for reimbursement, and many doctors begin their days running for appointments for which they are already late.
At the Midway Center for Integrative Medicine, insurance is accepted, but Roach feels that he's off the schedule treadmill.
Spending time, expertise
Al Smith, a journalist and the former longtime host of KET's Comment on Kentucky, had radiation treatment for prostate cancer that left him technically cured but inexplicably fatigued. He made an appointment with Roach.
"I hadn't been around a doctor who spent three or four hours with a patient for years, if ever," Smith said. "He's very passionate about his patients. He's very caring, and he concentrates on this holistic approach to medicine and nutrition."
Smith went on a regimen of Roach-recommended nutrient-packed smoothies and felt better. But then, he pointed out, his urologist told him he would feel better in about a year anyway. What made him feel the best about dealing with Roach was being proactive about his health, and dealing with a professional who spent a great deal of time with him, in addition to the nutrients and exercise.
But Smith got a harsh lesson on what happens when you put aside a wellness plan. He went full-bore on finishing a book, dropped off his exercise regimen and eventually felt the effects, suffering a small stroke in October, from which he has recovered. He plans to re-adopt some of Roach's nutrition and exercise recommendations.
Listening to patients
Nurse practitioner Dee Dee Carman spent 30 years as an emergency room nurse in Lexington, rarely seeing the same patient twice. Now she delights in being in a setting where she can see changes in her patients from visit to visit.
"When people come in they'll say, 'Nobody ever listened to me before, and they didn't give me any positive ideas on what I can do,'" Carman said.
When a patient comes to talk about chronic fatigue or fibromyalgia, Roach wants them to think hard about their health and how they can assume responsibility for it rather than simply taking a pill. He'll provide the tests, yes, but patients provide meticulous information on what they eat, (sometimes even keeping a food diary), what they read, how they relax (Buddha's Brain: The Practical Neuroscience of Happiness, Love, and Wisdom is a tome often recommended by Roach) and even how their food is digested when they eat.
If you want to get ambitious about nutrition, ask Roach what's in the viscous green concoction in the Ball jar that sits on his desk. It might include spinach, parsley, celery, cucumber, romaine, watercress and apple with lemon and lime and ginger.
Blueberries sweeten things up a bit in the smoothie, but it is a sippable, rather than chuggable, nutrition source, Roach said.
Moving patients from processed fatty food to the big green smoothie takes time. That's why Roach sees patients multiple times to assess progress. He is careful never to dismiss their concerns because, he said, you never know what detail will yield the essential bit of information that solves the puzzle.
"The two most important things are nutrition and spirituality," Roach said. "For healing to occur, you have to get these two things right."
He says he merely shares his knowledge with patients. What they do with that knowledge is a choice.
"I don't tell them to do this or do that," Roach said. "I say, 'This is my understanding. This is what the research suggests.'"