"My Mighty Quinn" - From Tics, Turbulence, Distraction and Disconnection to Calm, Confident and Connected"

S2 Episode 8: The Misdiagnosed Epidemic: Is it Behaviour… or is your Child’s Brain under Attack? with Dr Nancy O’Hara

• Lucia Silver / Dr. Nancy O'Hara • Season 2 • Episode 8

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Welcome
If you’ve ever been told your child is “just anxious,” needs firmer discipline, or is simply wired differently — this episode could change everything.

Because sometimes, it’s not “just behaviour.” It’s not ADHD. It’s not autism. It’s your child’s immune system attacking their brain.

I sit down with Dr Nancy O’Hara — world-renowned pediatrician and functional medicine expert — to expose the truth about PANS, PANDAS, and Basal Ganglia Encephalitis: immune-driven brain conditions that are more common than most realise, often misunderstood, and frequently misdiagnosed.

This is personal. My son Quinn has PANS. I’ve lived the overnight personality shifts, the fear, the school calls, the tics, sleep terrors, and seizures. If you’ve ever looked at your child and thought, “This isn’t my child anymore,” this conversation will meet you there — and offer grounded hope.

Episode Summary
Dr O’Hara and I unpack what PANS and PANDAS truly are, how they differ from typical mental health conditions, and why so many children are missed. We explore symptoms like sudden OCD, anxiety, tics, regression, sleep and eating changes, and even seizures. Dr O’Hara explains how infections, mould, and toxins can trigger these conditions — and why this isn’t “bad behaviour,” it’s brain inflammation.

We also cover diagnosis, treatment, and the vital role of parental self-care and advocacy. I share my journey with Quinn — the heartbreak, the healing, and the fierce love it takes to fight for answers.

Key Takeaways

  • PANS, PANDAS are underdiagnosed, not rare. They’re immune brain conditions that can cause extreme changes in mood, behaviour, and function.
  • If your child suddenly develops OCD, anxiety, tics, food refusal, bedwetting, rage, or sleep issues — don’t brush it off. 
  • Common triggers include infections, mould, toxins, stress, and family history of autoimmunity.
  • Testing can help, but clinical history matters most.
  • True healing needs a three-pronged approach

Parental stress is inflammatory too. Your nervous system affects theirs — which is why self-care and co-regulation are essential, not optional.

Resources

Resource Links:

[00:00:00] Lucia Silver: So you may have been told that your child is just anxious, needing discipline, or even misdiagnosed with autism or a psychiatric disorder like bipolar OCD or anxiety, or been told that these or the serious tics that your child is presenting with can simply be medicated or masked away. If you've ever looked at your child and thought.

[00:00:22] Lucia Silver: This isn't my child anymore, or watch them change overnight or heard me telling some of the stories about my experiences [00:00:30] with Quinn, then this episode is for you. And what if those symptoms weren't behavioral at all? What if we were to tell you that actually your child's immune system was attacking their brain?

[00:00:43] Lucia Silver: Today we are shining a light on a little known but life altering group of autoimmune brain conditions called pans, pandas, basal ganglia, encephalitis that are often missed, often misunderstood, and misdiagnosed, and tragically mistreated. [00:01:00] I am so thrilled to share with you that my guest today is actually one of the world leading experts in this field, Dr.

[00:01:08] Lucia Silver: Nancy O'Hara. . She is a board certified pediatrician and functional medicine pioneer. Before medicine. Dr. O'Hara worked as a teacher for children with autism and since 1999, she's focused exclusively on integrative biomedical care for children with complex neuro immune and neurodevelopmental [00:01:30] conditions.

[00:01:31] Lucia Silver: She's also the author of The Essential Guidebook, demystifying Pans and Pandas, and a leader in international training for doctors and clinicians needing to understand these conditions. This is a conversation you need to hear. Dr. O'Hara. Welcome and thank you so much for joining us. 

[00:01:51] Dr. Nancy O'Hara: No, thank you so much for doing this, inviting me and getting the word out.

[00:01:56] Dr. Nancy O'Hara: That's what we need. 

[00:01:57] Lucia Silver: Indeed it is. [00:02:00] So let's start by getting some clarity. Dr. O'Hara, for those who've never heard these terms before in simple language, please tell us what are pan's, pandas, and basal ganglia encephalitis? 

[00:02:13] Dr. Nancy O'Hara: Pandas was a term coined by Sue Sweeter in the 1990s, standing for pediatric autoimmune neuropsychiatric disorders associated with stress.

[00:02:23] Dr. Nancy O'Hara: And in 2012 30, clinicians got together to make it less controversial and put it [00:02:30] under the umbrella of pediatric abrupt onset neuropsychiatric syndrome, which included other infectious and metabolic causes. The bottom line is after an infection or some other change like exposure to mold or pesticides or chemicals or anesthesia, there is an abrupt change in that the immune system, rather than attacking that germ.

[00:02:57] Dr. Nancy O'Hara: So rather than attacking the strep in the throat, for [00:03:00] example, instead crosses the blood brain barrier and attacks the basal ganglia, that area of the brain that's responsible for anxiety. OCD ticks. Speech. And so what happens is you see what we call molecular mimicry or a dysregulated immune response, and you get inflammation in this area of the brain that then causes those behaviors.

[00:03:27] Dr. Nancy O'Hara: So it's not a [00:03:30] rare diagnosis, but it is one that is way underdiagnosed, misunderstood. And then therefore undertreated or mistreated. But it really is out there and it really is real. 

[00:03:46] Lucia Silver: And with the severity of everything that you have just listed, how many children do you believe at present are affected?

[00:03:53] Lucia Silver: Are we looking at an epidemic here? How wide scale is it wide? 

[00:03:57] Dr. Nancy O'Hara: I do think it's much more wide scale than the [00:04:00] numbers reveal. Right now in the literature it says one in 200. I think those of us who are on the front lines say that it's at least one in a hundred, but I think even in those numbers, we are way under diagnosing and missing a mold as a trigger or in the background of kids that have strep as their trigger or viruses as their trigger or mycoplasma.

[00:04:25] Dr. Nancy O'Hara: Is the trigger also in the background these days, maybe COVID. [00:04:30] Which we know reactivates a lot of other dormant viral infections like mono and tick-borne disease, tick-borne diseases like Borrelia, which we call Lyme disease, but Bartonella, which is classic for causing rage and aggression. And Babesia also classic for causing night sweats unrelenting headaches and really dysautonomia dysregulation of the day-to-day [00:05:00] automatic nervous system.

[00:05:02] Dr. Nancy O'Hara: So I think because those parts, the mold, the COVID the chick borne diseases are so underdiagnosed, it's even more than that one in a hundred. And certainly in my practice it's practically one in one, but I know I have a skewed view, 

[00:05:17] Lucia Silver: but one in hundred sounds huge for anything to be unrecognized or unknown.

[00:05:21] Lucia Silver: If we started from that premise. So what are the exact symptoms that you see? Because it's a clinical diagnosis, there are markers in the bloods, there are all sorts of [00:05:30] things that can show up and we'll touch on that in a moment. But because many of these do differ. Yeah. In their presentation from mental health conditions like OCD, anxiety or A DHD, how are you identifying pans and pandas?

[00:05:44] Lucia Silver: Yeah. 

[00:05:45] Dr. Nancy O'Hara: The most important thing in the true diagnosis is that it is an abrupt onset of these changes in behavior, however. In children with mold or tick-borne disease or even COVID, it [00:06:00] may be more gradual, may be more subacute. Also, if the first diagnosis is missed and they're treated with an antibiotic for an ear infection, for example, at age two or three, and it's thought that the behavioral changes were part of the terrible twos or whatever, the second and third, maybe more gradually.

[00:06:22] Dr. Nancy O'Hara: Started and therefore again missed, but it's an onset of OCD a dramatic [00:06:30] change in OCD if your child already had it or a dramatic or abrupt onset. An OCD is not just about hoarding or checking or flipping lights on and off, or opening and shutting doors. It's also about intrusive thoughts. Thinking things that you've never thought before from a religious perspective, a sexual perspective a horrific homicidal or suicidal perspective, or anything in that range.

[00:06:57] Dr. Nancy O'Hara: And that may present just as [00:07:00] anxiety. The child may be having different thoughts, but they don't wanna tell you that they don't even understand it and they're just showing as anxiety. The other thing that may happen in at least 20% of the children, but in our practice, it's over 35% is a restrictive eating disorder.

[00:07:18] Dr. Nancy O'Hara: Fear of contamination of foods, fear of choking, only wanting to eat a certain texture or color or style of food, and then two of seven other [00:07:30] symptoms. One is the anxiety I mentioned, particularly separation anxiety, 11-year-old that won't go to school or go to sleep at night without mom. Baby talk regression behaviorally where they're now at age 13, watching Thomas the tank engine videos or something like that.

[00:07:48] Dr. Nancy O'Hara: Or speaking in a babyfied voice, motor abnormalities, and that's where the ticks come in, but also handwriting deterioration. If you see changes [00:08:00] behaviorally and your child's handwriting deteriorates, that's pathognomonic for this disease. Absolutely. And then other somatic symptoms like an abrupt onset of bedwetting or urinary changes like frequency or urgency or odd sensations and sleep changes.

[00:08:19] Dr. Nancy O'Hara: Particularly what we call rem disinhibition, where they never get into that deep sleep. Instead they have very restless sleep. They're all over the bed, the sheets are on the [00:08:30] floor and all of those. Can be part of this diagnosis, and we have to rule out other things. We have to rule out the, medication overdose the toxin overload of other sorts the tumor, the stroke.

[00:08:45] Dr. Nancy O'Hara: But again, if you have a dramatic change in any of these behaviors, I really almost beg parents to go to their practitioners, show them the research, and there is so much. And so [00:09:00] many platforms like this one that are trying to get the word out and find a practitioner who will listen. And look for this diagnosis 

[00:09:10] Lucia Silver: and especially Dr. O'Hara with the sort of comorbidity. It's one thing to have a child suddenly presenting with a little bit of OCD that you could align to anxiety or maybe a little bit of bullying at school or a little bit of this. But when you get, and I will list this for the purpose of our listeners, Quinn had.

[00:09:27] Lucia Silver: And we didn't touch on this, we could come back to this. He, [00:09:30] it, it ended up with some mild seizures. Yeah. But prior to that, he had huge anxiety, didn't wanna go to school. He had a mild tick existing beforehand, but his ticks, he never had verbal ticks, so he suddenly had. Making lots of noises, drumming on the desk.

[00:09:46] Lucia Silver: He was running away at school. That was the level of his anxiety. His eating, thankfully, was not an issue. His sleeping became terrible. Night sweats and all sorts. So there you go. Why would you [00:10:00] suddenly have that under any condition and for a school to suddenly say. When a child has been a well behaving sweet little child Lucia, Quinn's being very aggressive and talking back, he's quite unlike himself.

[00:10:14] Lucia Silver: Yeah. So there you have, there's a case study. It's me, I'm saying it, it's my little boy. It's very real. And some of the parents that have reached out to me subsequently say things like no. There isn't any OCD and I'll be like okay, is there any repetitive [00:10:30] patterns? And one mom said to me, my daughter walks round in circles.

[00:10:34] Lucia Silver: That's a form of OCD or a repetitive motor behavior. It's anything perseverant, continuous invasive, that's the basal ganglia that it, that has the direct pathway to shut down movements. It's gone through the roof, Dr. O'Hara it's not controlling the show anymore.

[00:10:50] Dr. Nancy O'Hara: And all of those are signs of inflammation. Inflammation is a good thing. You bust your knee, you get a cold, your body is [00:11:00] supposed to increase those particles or molecules within the body that are to fight that infection, that injury, et cetera. And that's like a smoldering campfire.

[00:11:12] Dr. Nancy O'Hara: But what we're talking about is a raging wildfire. So in Quinn's case, for example, those ticks were a little bit of that smoldering fire or thinking about frayed electrical wires, sparking. And then after the inflammation really takes off, it's a big [00:11:30] wildfire and you get an actual seizure.

[00:11:32] Dr. Nancy O'Hara: Absolutely. And certainly seizures can be part of this more rare than other. Types of way of showing this inflammation. But they're all about that inflammation in the brain, and that's what I think many clinicians are missing as far as diagnosing it, assessing it, and therefore then not treating it appropriately.

[00:11:55] Lucia Silver: Absolutely. And as you say, the smoldering is quite important because certain early signs might have [00:12:00] been missed and it might have actually happened in Quinn's case, and we're gonna come onto this next triggers. In Quinn's case, we had all of this going on and we were able to identify thanks to a doctor at the time.

[00:12:12] Lucia Silver: Not in the uk, in the States, you said, I think this is Pans. Has there been anything He's been around that's unusual, like mold and I was, again, our UK listeners will be mold What? In the states you're again a lot more educated than we are, but it's. It's [00:12:30] about understanding the triggers, isn't it?

[00:12:31] Lucia Silver: Dr. O'Hara, it isn't always an infection. It isn't always a strep or an Epstein bar or mycoplasma pneumonia, which we can find in the bloods. There can be other contributing factors that the sort of, the straw that breaks the camel's back. And because mold is so highly once in the environment, so highly invasive and gets into the nose and the lungs and the blood-brain barrier and everywhere, it is quite a contributing factor, isn't it?

[00:12:56] Dr. Nancy O'Hara: In many children it is and it's also that [00:13:00] usually it is not just one trigger, it's a combination of the toxic load and it's part of that toxic load, whether it be mold or chemicals or in our environment or in our food, that sort of increase the total load. And further break down the blood-brain barrier.

[00:13:18] Dr. Nancy O'Hara: But I often have parents say, wait, my child had strep and then he had mycoplasma, and then he had viruses, and then he had mold. And he's gotta be so sick. Yes, except this is not an [00:13:30] infectious disease. It's an immune disease. It's the immune system attacking self. That's why it's autoimmune.

[00:13:39] Dr. Nancy O'Hara: And so if it's an immune system disease, any trigger that comes across that child's path, any virus, any mold, any tickborne disease, et cetera, can trigger the cascading effects of the brain inflammation. 

[00:13:54] Lucia Silver: So it's like a misdirected autoimmune response. Correct. And in this case, why [00:14:00] do some children. Have that one child in a room with mold, one child that gets a strep infection and they're fine and another child is suffering.

[00:14:08] Lucia Silver: Do we understand that? 

[00:14:10] Dr. Nancy O'Hara: We don't fully understand it, but we know that there's a genetic susceptibility, and as my mentor always said, genetics loads, the gun environment pulls the trigger. So those children that are genetically susceptible with certain HLAB alleles like we see with other inflammatory conditions [00:14:30] and th 17 differences and several others, like Manus binding lectin protein differences within their genomics and tumor necrosis factor alpha differences within their genomics.

[00:14:44] Dr. Nancy O'Hara: There are multiple ones. There isn't any one genetic snip. It says this child is more susceptible. But certainly we know that 64% of children that present with this diagnosis have autoimmune [00:15:00] disease in their family history. So without any tests. If you have grandparents with inflammatory bowel disease or rheumatic fever, if you have a dad.

[00:15:09] Dr. Nancy O'Hara: Juvenile arthritis, and now psoriatic arthritis. A mom with Hashimoto's thyroiditis, another child with autism, which in my opinion is an autoimmune disease. There are multiple different autoimmune diseases, and if you have that, it's not like you have to go and dig deeper into the genetics to find these snips, these [00:15:30] single nucleotide polymorphisms I'm talking about.

[00:15:33] Dr. Nancy O'Hara: You just weigh up your child's percentage chance. Of at some point receiving this diagnosis. 

[00:15:41] Lucia Silver: So moving on from that point, Dr. O'Hara, we have a as parents listening, seeing signs in their children, what do you suggest is the first thing that they do as regards getting testing? Because it is a clinical thing, but I'm thinking as a mom here listening now, this is what my kid's doing.

[00:15:59] Lucia Silver: I'm gonna go to [00:16:00] my doctor and my gp, I can tell you right now in the uk is not gonna know what this is. So what are they gonna do? The tests are not necessarily, as you've said, when you do these tests for the auto inflammation markers, they may not always show, and yet a child may be clinically and symptomatically presenting with pans or pandas.

[00:16:20] Lucia Silver: So testing isn't necessarily gonna be the nail on the head with this one. So what do you suggest they do? Do. 

[00:16:27] Dr. Nancy O'Hara: So not to try to sell my book, but [00:16:30] you can take the book, you can take articles that are in the book to your pediatrician and there are other great books like that by Scott Antoine that is got 1200 references, whereas mine has about 500.

[00:16:43] Dr. Nancy O'Hara: Lots of good information out there, but ask them to do conventional lab testing. It may or may not be positive and still be this diagnosis, but at least it's a starting point. And on some of the first pages of my book, I have the whole list in [00:17:00] case I forget any today. But. One of the things is to check immune system markers.

[00:17:06] Dr. Nancy O'Hara: The most frequently positive test is an ANA, an alpha nucleic antibody, which is a marker of autoimmune disease. Usually collagen vascular diseases like lupus or ms or scleroderma, but in 56% of the children in the literature, 60% in our practice, that test is positive. [00:17:30] The other inflammatory markers are like high sensitivity, C reactive protein, CRP.

[00:17:36] Dr. Nancy O'Hara: Erythrocyte sedimentation rate, ESR, even a basic complete blood count. CB. C may show an elevation of platelets, which is an inflammatory marker, an acute phase reactive. It may show an elevation of neutrophils, the types of cells that fight bacterial infection, or lymphocytes that fight viral [00:18:00] infection, or eosinophils that are often elevated with allergies or sometimes parasitic infections.

[00:18:06] Dr. Nancy O'Hara: Those are very basic things your pediatrician or other practitioner can get. I also recommend looking for different diseases. If your child had a strep infection six, eight weeks ago and then abrupt onset of change, or even if your child's sibling or best friend had the strep infection, your child never had any symptoms.

[00:18:27] Dr. Nancy O'Hara: That's very common in these children too. [00:18:30] Ask for strep titers, which is an A SO and an anti DNAB. The other one I always get is Mycoplasma IgM and IgG. Often grandpa had a pneumonia that, that they called walking pneumonia or an aunt had a bronchitis or something like that. The child again, often doesn't have the signs of the infection, but then the immune system reaction to being exposed [00:19:00] to it causes the behavioral reaction.

[00:19:02] Dr. Nancy O'Hara: So that may be elevated and there are multiple others that I get that are foundational because as one of my mentors always said, you have to build the foundation of a house. Before you can build the walls. So you wanna also think about checking vitamin D levels, vitamin A levels, zinc levels, magnesium levels, because those are the foundation.

[00:19:25] Dr. Nancy O'Hara: And if those are deficient, then the child may not, even [00:19:30] when treating the disease, may not be as well as they should. You have to build that foundation and check for it. 85% of the children in my practice are vitamin D deficient. 60% are zinc deficient and 40% are vitamin A deficient. So it's not a small number.

[00:19:47] Dr. Nancy O'Hara: Wow. And then unfortunately, many of the tests for mold and tick-borne disease are actually specialty labs. So it's going to be much harder to get your practitioner to even [00:20:00] look at those. And then the article that we wrote last summer on cerebral folate deficiency. The folate antibodies, which is again present in about, in our study, 63.4% of children on this with the pans span as diagnosis.

[00:20:17] Dr. Nancy O'Hara: That is also a specialty test. Get the baseline stuff, get those, and then use the history, my child was bit by a tick, or my child has these symptoms and those go along with [00:20:30] Babesia or a Bartonella or these symptoms and that goes along with mold and we just had water damage in the house.

[00:20:35] Dr. Nancy O'Hara: Then find a practitioner. And there are many that will do telehealth wherever they are in the world, mentoring consults, or even practitioners within the UK who can help you make that right diagnosis. 

[00:20:49] Lucia Silver: Yes. And indeed. And once you're slightly in the door, as you say, you've done a little bit of detective work, you're and within, I must say it has to be within the functional medical world as far as the UK is concerned in terms of [00:21:00] doctors that are willing to look and able to look and trained, to look trained, to look at the root causes. We were able to establish that there was a mold and therefore we. Then felt, I then felt I could afford to invest sensibly in that test for a Mica Mycotoxin test.

[00:21:16] Lucia Silver: It wasn't just throwing spaghetti at the wall. That really made sense. And sure enough, we discovered that there were those mycotoxins in his blood. So I think a lot of the time there's nervousness around testing because there's no one guiding that process. But actually. [00:21:30] I think bit by bit, if you take it slowly, some of those paid for tests are worth it, but you just need to make sure you're with a functional medical expert who knows what they're doing and isn't giving you 25 tests.

[00:21:40] Lucia Silver: We went straight to a neural zoomer, and I know that, not in all cases, but it was very helpful for us because we did identify, straight away within that, that there was autoimmunity in the brain and it just closed the circuit for us and began. Focusing our treatment pathways.

[00:21:58] Dr. Nancy O'Hara: I will say though, and [00:22:00] I totally understand that, but when you have this abrupt onset of behaviors or even a subacute onset, don't go spending a lot of money to look for the brain inflammation because whether it's positive or not.

[00:22:14] Dr. Nancy O'Hara: Remember, most of this inflammation is microglial. Meaning microscopic, so it may not be picked up by the test, and a negative test may be doing more harm to the way you're thinking than a positive test. So I'd rather you [00:22:30] spend the money on the appropriate treatment than on all the specialty tests except for a few.

[00:22:37] Dr. Nancy O'Hara: Some of the ones I've mentioned, and the other thing I just wanted to mention is, although I am an MD and I can prescribe, my practice was full of dieticians, naturopaths chiropractors who could not prescribe but could still treat this disease very well. So there are lots of other practitioners besides MDs and DOs that, that can do [00:23:00] this work quite well.

[00:23:00] Dr. Nancy O'Hara: So just wanted, 

[00:23:02] Lucia Silver: that's very encouraging to know, and I know that your approach is a three-prong approach, and I want us to come onto this now because it's, it can feel all doom and gloom. I've had parents say, my kid's in a wheelchair, the condition is extremely complex and can be extremely severe.

[00:23:18] Lucia Silver: But I have read many case studies under your dear care as well as some of your colleagues of children who are absolutely recovering. So let's focus our attention on. The protocols and [00:23:30] interventions to consider. We won't be able to dive into them all on this podcast, but I do recommend both Dr. O'Hara's book and also the module that Dr. O'Hara and I have covered in the whole Child Healing roadmap as well. But please, Dr. O'Hara, talk to us about your three-prong attack.

[00:23:45] Dr. Nancy O'Hara: So the three pronged attack is always treating the underlying trigger, which may be antimicrobials, antibiotics, if it's mold, putting an antibiotic on is gonna make them worse.

[00:23:56] Dr. Nancy O'Hara: Immune modulatory approach, anti-inflammatories, [00:24:00] and that's not just IVIG, ibuprofen and steroids. There are many and treating the symptoms. So unfortunately in conventional medicine, at least here in the US, often doctors especially are just treating the symptoms, putting on an SSRI or an anti-seizure medications or what a medication for bipolar disease or whatever.

[00:24:23] Dr. Nancy O'Hara: But also often our functional medicine colleagues are just treating the trigger and not treating the symptoms. [00:24:30] We have to do all three. So I always start with treating the symptoms of greatest impact to the family. That may be that nobody's sleeping, I wanna treat sleep. That may be that the child is ticking horribly.

[00:24:43] Dr. Nancy O'Hara: I wanna treat that. So I look at what the biggest trigger is, and I'm treating it. Herbally, botanically and nutraceutical, not talking about medications there. And then I look at the immune system. The immune system has to be treated, and [00:25:00] as I said, not just ibuprofen though. Ibuprofen at 10 milligrams per kilogram can be also diagnostic.

[00:25:07] Dr. Nancy O'Hara: If you give your child ibuprofen and the severity, frequency, or intensity of the ticks, the anxiety, whatever symptom they're having, decreases gets better. Then that's a sign. This is an inflammatory condition, but I use things like turmeric aloe, essential fatty acids, phospholipids [00:25:30] specialized pro resolving mediators helmet therapy, platelet therapy.

[00:25:34] Dr. Nancy O'Hara: There are so many different ways to treat. The immune system and then I treat the trigger, and as I said, if it's mold, you wanna treat with an antifungal and a detoxifier, not with an antibiotic. Although if it's mold and strep, or mold and yeast and mycoplasma, I may well be using herbals and not an antibiotic that may treat the [00:26:00] strep or the mycoplasma, but will make the mold worse.

[00:26:03] Dr. Nancy O'Hara: I will use a rotation of herbal. Antimicrobials that may treat all of those together. So it's that three-pronged approach. And the other piece of it, I have to say, is also lifestyle. A, as much as it may be hard eating a diet that's an anti-inflammatory diet. A modified diet, a diet that's full of oils and proteins and anti-inflammatory foods.[00:26:30]

[00:26:30] Dr. Nancy O'Hara: It's not one that's full of sugars and candies and carbs. Getting outside more, the best form of biohacking is being outside, being playing in the dirt, getting exercise, getting vitamin D exposure even on, on days like this here in Connecticut where it's rainy and disgusting. But and also breathing.

[00:26:53] Dr. Nancy O'Hara: So much of the time when we're under stress as parents and as children, we hold our breath, we hold our body [00:27:00] tight, and as parents, we need to model for our children. That taking deep breaths, that being present with our feet on the ground, that this will get better, and moving forward.

[00:27:13] Dr. Nancy O'Hara: All of those things are so important in treating these children. 

[00:27:18] Lucia Silver: So it is complex and there are lots of sequencings in the picture as you say. What happens if you've got this, and this? And certainly in Quinn's case, he had mycoplasma, he had strep, he had Epstein bar, and there was the mold. [00:27:30] So you know, where do you start?

[00:27:31] Lucia Silver: And again, this is where. Sometimes it can get a little bit tricky financially, but be guided by these books. If you can't afford to get to a private practitioner. Look at Nancy's book. There are resources there where you can follow things systematically, but there's a job to do, isn't there? Dr. O'Hara, in removing the trigger, of course, if you're in a moldy environment, you have to move out of that environment.

[00:27:53] Lucia Silver: But where do you go in terms of training? The immune system to behave [00:28:00] differently, is that one and the same as reducing the inflammation, or is there a way that you are cultivating it to respond differently? 

[00:28:07] Dr. Nancy O'Hara: So I think treating the immune system is of utmost importance. And if you're using herbals, those are immune modulating as well as antimicrobial.

[00:28:17] Dr. Nancy O'Hara: So again, one of the reasons I'm very high on herbal interventions for tickborne disease, for mold, for any of particularly the long-term treatment of these children. [00:28:30]And then also calming down the immune system with diet, as I mentioned, the anti-inflammatory diet, calming down the immune system by being outside off of our screens, even though we're both on screens now as we must be.

[00:28:44] Dr. Nancy O'Hara: And using those immune modulatory interventions that I mentioned, like the turmeric, like the aloe, like the specialized pro resolving mediators or phospholipids, those sort of things. So yes. That is [00:29:00] vital and can be helpful for our kids no matter what their diagnosis. They really have to be done.

[00:29:07] Lucia Silver: And I wanna talk about one last piece within the inflammatory story. Sure. Because a lot of our mamas, particularly living close to their little ones that have gone through this, like me have, there's even PTSD I've even had a doctor say to me, Lucia, you what you've been through with Quinn was extraordinary.

[00:29:26] Lucia Silver: You wouldn't wish it on anybody speaking as a, as a mother, it [00:29:30] is without doubt one of the worst things I have ever been through in my life. And I'm so grateful to be in this position with Quinn now with him healing and no apparent signs really right now. A little bit of a tick, but very low ebb in comparison to where we were.

[00:29:46] Lucia Silver: But as a parent with our little ones, they're prefrontal cortex responsible for regulation. I don't think it's until we're 26 that our prefrontal cortex is actually fully developed. So all [00:30:00] children need their parents, their mirror neurons and their co-regulating to help them calm down.

[00:30:05] Lucia Silver: That's just a fact of life for any child at any time. But with these children, particularly when there is so much unsafety in their world, it is more important than anything that we can hold that safe space. However, you are also completely dysregulated when this is going absolutely on. So we're in a very peculiar I felt like I was in an altered [00:30:30] reality where I could looking down on myself, thinking I'm not myself either, quite frankly, but I'm trying to bring my little guy back into the safety of this world, knowing full well that my stress.

[00:30:41] Lucia Silver: Was inflammatory would be worse for him, and then school was worse. And the whole situation, it's a very tangible form of inflammation. Stress is what I'm ultimately sharing with our mothers listening and would you agree, Dr. O'Hara? Absolutely. 

[00:30:56] Dr. Nancy O'Hara: Stress is also a trigger. And the PTSD is [00:31:00] real. I've shared this many times before, I came to this disease naturally also through my own son and after he had recovered and was doing well and in college and all of that, he, we were together and he said to me.

[00:31:15] Dr. Nancy O'Hara: Mom I'm not right, something's off. I don't feel good. And I was up for four nights straight. Is it the mold? Is it the Bartonella? Is it the lime? Is it the strep? What is it that came back? What am I missing? Just beside myself with worry [00:31:30] and anxiety? And after four days, he finally said, mom, it's about a girl.

[00:31:34] Dr. Nancy O'Hara: And it was in that moment that I realized that I still had tremendous PTSD from all those years. And it may come back again and again. And it certainly does, and COVID brought it back again and et cetera. And we have to recognize that. And even if it's before we put our feet on the floor in the morning, just taking one moment to breathe.

[00:31:58] Dr. Nancy O'Hara: To, for me it was finding [00:32:00] something to be grateful for in that moment. It was something to, to whether you meditate or pray or whatever, and taking that deep cleansing breath, and then it's going attacking the day with also remembering in each moment to take that breath. To be resilient in yourself as much as possible.

[00:32:24] Dr. Nancy O'Hara: And then at the end of the day, saying, I did the best I could. Tomorrow's another day, [00:32:30] I'll try again tomorrow. And being grateful for the one step forward as, as well as the two steps back, because all of. Teaches us something and helps us to hopefully get closer to the ultimate healing. But yes, stress in moms, in dads because also, remember that it, often you are on an island as a mom, hopefully you have the agreement and the support from your spouse but.

[00:32:56] Dr. Nancy O'Hara: Unfortunately, often that doesn't happen. Sometimes [00:33:00] you don't even have it from your own family, and you certainly often don't have it from the school system or the medical community. But there are groups. There are wonderful groups like your Brain Health Movement, like aspire.care here in the United States, like med maps.org, that can provide that community, that can provide you with that.

[00:33:21] Dr. Nancy O'Hara: You can do this. To help decrease the stress part of it for you so that you can keep helping your child. [00:33:30]

[00:33:30] Lucia Silver: And that's why we need to get the awareness there because the one battle you don't need to be having is with your medical and educational community being shamed because of, I was very lucky that my school, 

[00:33:40] Lucia Silver: Had some common sense. This was a child who for seven years was one way and then wasn't. Nobody was gonna say it was bad parenting. But you do see that accusation a lot. Absolutely. And it's overwhelming to be dealing with it at home. And then the minute you step out of your front door I was gonna ask you, what advice do you have for parents at home but there it [00:34:00] is.

[00:34:00] Lucia Silver: It's really take a breath and I think the education and understanding of the biology of the condition helped me a lot because there are times when you don't like your child very much. There are things that they may say where they're you. You said in one interview I heard you say so sweetly sometimes they can be quite mean.

[00:34:17] Lucia Silver: And I thought yeah, exactly. It it's that the self-care piece is huge within this. 

[00:34:23] Dr. Nancy O'Hara: Yeah. And just remember that their brains have changed. Especially in this disease, [00:34:30] their brains are different. This is not them. Several of the children rename this behavior. I have one kid that named it cheeky.

[00:34:37] Dr. Nancy O'Hara: I have another that named it Meanie. And it's really understanding. This is not my child when they're behaving or acting that way. This is the inflammation taking over their brain. So sometimes that helps too. Does you don't, it does have a bad child and you are not a bad parent. This is a physiologic biologic.

[00:34:59] Dr. Nancy O'Hara: [00:35:00] Inflammatory condition. 

[00:35:01] Lucia Silver: And when children come into feeling a little bit more regulated and we'll talk about it, the flare in a moment, the nature of it, it is heartbreaking. 'cause Quinn will say, mommy, I dunno how you can love me when I speak like that. It's not me. I don't know where it comes from. And that is heartbreaking, but it's also an immediate reminder.

[00:35:19] Lucia Silver: You are not dealing with. Necessarily a purely psychiatric condition. You're dealing with something that can present psychiatrically, nor are you dealing with someone who's got a rubbish attitude and [00:35:30] doesn't respect their parent, and nor are you necessarily dealing with the other host of stuff that's been thrown at you as a possible diagnosis.

[00:35:37] Lucia Silver: So right there is, in those moments where they're out of that space, you have to remind them that you understand how they feel. And one thing I say over and over again to Quinn, and I say this to parents in, in my parent coaching, there is nothing you could ever do.

[00:35:53] Lucia Silver: It's gonna make me cry. There is nothing you could ever do that will stop me loving you. 

[00:35:57] Dr. Nancy O'Hara: Yeah. Exactly. [00:36:00] Yeah. And one practitioner once helped me in just a slightly shorter version of that to say to your kid, I get it. Even when you don't, those three words can help them to feel heard, can help them to feel loved and starting at it's not, I get it, but it's not, I get it and it's just, I get it.

[00:36:24] Lucia Silver: Yeah, 

[00:36:25] Dr. Nancy O'Hara: I get it. Yeah. And then taking a breath. 

[00:36:27] Lucia Silver: Yeah. Because a lot of it doesn't make sense, Dr. [00:36:30] O'Hara, that a child will push you away. Quinn will tell me, get out of my room, and at the same breath will go, but please stay with me. But please don't leave me in the dark. Yeah, absolutely. So we're gonna talk a little bit now just about the institution and how we, with the support that parents need to ask from a child's school.

[00:36:48] Lucia Silver: Some parents are following me at the moment with this process. They followed my process with conventional medicine and seen how some antibiotics were thrown at the problem, and then that was the end of it. We're now. [00:37:00] Got a little fly on the wall watching me present to the educational psychologists who are well Quinn's absolutely fine.

[00:37:09] Lucia Silver: He's got no pro. He seems absolutely fine, Lucia, what? And I'm like, yeah. But when it happened, he couldn't write he wasn't able to write and he couldn't follow in lessons and he was so disruptive. He had to be moved out of class and yeah, but he's fine now. Yes, he might be fine now, but this is an episodic condition, which God willing.

[00:37:28] Lucia Silver: I might have cracked it. We [00:37:30] might be really lucky, but we also might not. And this might revisit, and I need you to know that Quinn is going to need support. He's gonna need teaching support if you take him out of the classroom. If he's quiet enough to manage in the classroom, he might need some support in the classroom.

[00:37:45] Lucia Silver: Yes. What do you say to that, Nancy? What should parents be speaking to their schools and saying is needed to help their kids get through and access the curriculum? 

[00:37:53] Dr. Nancy O'Hara: And you're absolutely right. It is episodic. It ebbs and flows on a day-to-day basis on a week to [00:38:00] week basis. Or if you're lucky enough, you go months without an episode, but it can come back.

[00:38:05] Dr. Nancy O'Hara: Part of the PTSD. So number one, I talk about having accommodations in place. Having a list of things that if the child starts to get off or if even there's a large strep outbreak in the classroom or viral outbreak, what should be done? And aspire.care just shared these accommodations that I wrote about.

[00:38:29] Dr. Nancy O'Hara: They're [00:38:30] in my membership, but they just shared it on social media. So there, it depends on each child what you need. You may need fluid access to the bathroom. You may need the ability to be able to go to the nurse's office. You may need just longer time on tests. You may need adapted physical education at times.

[00:38:49] Dr. Nancy O'Hara: You may need, assisted technology. So they can hear the instructions rather than just see them or vice versa. So there are multiple [00:39:00] accommodations. The second thing is we have what I call an acute viral protocol. That foundational stuff that, especially because many of the triggers are virally related, but even if they're strep or mycoplasma or whatever.

[00:39:15] Dr. Nancy O'Hara: Adding the vitamin A, the vitamin D, the zinc, or doubling those at the onset of an infection, may help to prevent or minimize the flare. Ibuprofen, as I mentioned before, may [00:39:30] help to do that. Turmeric May Fever, few May, BBA Pinella May. So there are many things that we can do to minimize the symptoms of the flare, but also to have in place the understanding, especially with the school.

[00:39:46] Dr. Nancy O'Hara: But also family members, friends, et cetera, that this can come and go. And when we start to see it, this is what we need to do. And it's very individualized in each child [00:40:00] based on how they present. 

[00:40:03] Lucia Silver: Thank you. That's very helpful. Dr. O'Hara, just in, in summing up, if you could. Put together what it would look like moving forwards with dealing with this condition.

[00:40:15] Lucia Silver: If you had the full support and edu they were educated the schools and establishments in the medical community, how would you see this looking now? How would this happen if a child presented? What would the trajectory be? 'cause we've had a laugh. A [00:40:30] laugh at my journey.

[00:40:30] Dr. Nancy O'Hara: I could be out of business, which would be great.

[00:40:32] Dr. Nancy O'Hara: At my advanced age. I would be very happy with that. As well as get rid of the tissue box in my office, which I often say is the best instrument because so many people have been so misunderstood and misdiagnosed. I think what it would look like is that when we have an abrupt change, that everybody would be able.

[00:40:52] Dr. Nancy O'Hara: Meaning all the school psychologists, teachers, school nurses, school doctors, as well as the primary care could say, you know what, [00:41:00] this could be pans, pandas, basal ganglia, encephalitis, and let's immediately put on an antimicrobial and anti-inflammatory, and not just an SSRI or medication, but something else to help this child.

[00:41:18] Dr. Nancy O'Hara: And then let's figure it out together. Let's sit there and what changed? What were the triggers? And there are checklists. There are checklists of [00:41:30] behaviors. There are checklists of what are the things we should be thinking about. But in, in my ideal world, that would be. On the front page of every governing bodies, in our country, the a P, the American Academy of Pediatrics, the CDC, all of those bodies, that would be part of what they would say when there's a change like this.

[00:41:57] Dr. Nancy O'Hara: What's changing is that if you Google [00:42:00] abrupt change in behavior, pans and pandas now come up. It didn't. Yeah, it does. chatgpt has, that's a change just in the last couple of years. So we are moving there. The A P has at least recognized this disease, but we need a lot more of that. We need people to understand that it is treatable, that these kids can get better and that we can't.

[00:42:26] Dr. Nancy O'Hara: Allow them to still feel so bad about [00:42:30] themselves, so bad about their symptoms. We need to keep fighting to, to get each and every one of them treated and healthy. 

[00:42:38] Lucia Silver: And that may I say, is true for the work that I'm doing within the movement as a whole. And I know that you are not disconnected to other related chronic illnesses.

[00:42:47] Lucia Silver: Where I know we sit in the same place on how we view autism and A DHD. The whole neurodevelopmental story for me is one of. Absolute possibility to be healing. It is not simply genetic. There is so [00:43:00] much genomics and epigenetics and the shaping that we are absolutely able to take agency of and direct our children to healing pathways.

[00:43:09] Lucia Silver: So thank you for being the extraordinary pioneer you are. Thank you for not only sharing your expertise, but your deep compassion for the children and families living with these conditions. What you've given us today isn't just empowering knowledge, it's hope. It's direction and it's the first step toward healing.

[00:43:29] Dr. Nancy O'Hara: [00:43:30] Absolutely. And it's not false hope. It is real hope. Born out of 30 years of working with these children and as my mentor always said, have we done enough for this child? And in until the child is fully better, we haven't done enough.

[00:43:47] Lucia Silver: So to our listeners, if anything in today's episode felt like a light bulb moment for you, please know you are not alone.

[00:43:56] Lucia Silver: You are not imagining it and you are certainly not [00:44:00] powerless. You now have some information and understanding and the first steps to take agency and control of your child's health and wellbeing. We're gonna link to Dr. O'Hara's fantastic book, demystifying pans and pandas, and to her other helpful resources in the show notes, and you'll also be able to enjoy a whole deep dive teaching module with Dr.

[00:44:19] Lucia Silver: O'Hara within our complete whole child healing. Roadmap course, and the link to that is also in the show notes, and we'll produce a free guide from today too, [00:44:30] highlighting the top tips for diagnosis, testing, and treatment of Pans Pandas from Dr. O'Hara. And if you haven't already, make sure to subscribe for more interviews without standing trailblazing, doctors and experts, and more explanations, revelations, and transformations.

[00:44:47] Lucia Silver: Until next time. Keep asking questions, keep trusting your intuition and keep walking this healing journey with us. 

[00:44:56] Dr. Nancy O'Hara: Thank you so much.

[00:44:58] Lucia Silver: Thank you.