The following is a transcript of a Q&A session conducted online with Dr. Brizman In September, 2001 (courtesy of www.icsuccessonline.com)

(click on question below to go to ANSWER)

Dr. Brizman, you might want to tell us a little bit about what you do first.

Do you find IC to be a pH imbalance?

Do your patients who are treated successfully show no signs of bacteria such as enterococcus?

Do you mostly work on building immune system rather than killing bacteria and candida? How do you treat for bacteria and candida?

Do you use herbal antibacterials or prescription?

Why do some patients get worse around their menstrual cycle?

Can you treat someone long distance, and if so, is there any testing involved to prove candida if one does not have vaginal yeast ? 

Is diet of extreme importance along with your herbal treatment?

Can you explain what happens during the "yeast die-off" and/or how you know it is being killed off?

What type of diet do you enforce?

If we were to travel to see you, do you only do one appt. at that time or more?

Do you prepare the herbals, or where do we get them?

Do you have people stop all their vitamin supplements, etc.?

Is there lodging close by your office? What city are you in?

I'm in Canada, so I probably couldn't get things sent to me?

Do you use homeopathics or just herbals?

How is one billed for the services, and how are the herbs shipped?

Is the acupuncture you are doing standard and could we get the same treatments from a good local acupuncturist? What do you believe is the most common weaknesses of the body in IC patients according to Chinese medicine?

Do you see environmental toxins as a big problem? Like do you ever suggest a person moving?

How long does one usually stay on the herbs and your treatments?

How did you get interested in helping IC patients?

Is there a diet menu that gives you choices for breakfast, lunch and dinner? This "food thing" has me very confused!

What do you think about potassium chloride tests and side effects?

Just wondering if you have any thoughts on how to improve a severely "shrunken" bladder?

If you treat for yeast does our spouse also need to be treated at the same time?

Do you ever see patients who only experience frequency and no pain?

I guess my systemic yeast really helps to cause IC.  Uh oh, that makes me nervous.  What happens to spouses, I thought IC is not contagious?

Is it important to keep the carbohydrates very low? I have lost 10 lbs. in 2 weeks and I'm afraid I will keep losing

If I don't have signs of vaginal yeast, how would I know if my husband and I were passing it?

My IC symptoms are gone but still have "fibro". What could be causing this to linger? What do you believe IC is?

Is IC a mutated strain of bacteria or the body's breakdown in being able to fight bacteria?

Do you see hormones as an important part in someone who is 50?

Do you suggest that all IC patients get some type of hormone testing and, if so, what?

Do you give teas or capsules?

If one were to travel to Los Angeles for a week, how many times would they be seen? I would want it to be worth my time.

How long is the first consult and are you flexible with the time difference?

Do you do any testing for food allergies?

Do you use a combo of acupuncture, diet herbs and sups?

I felt as if I was getting a yeast infection right before my current IC flare up. Would yeast have caused it?

My nutritionist used radio magnetic frequencies, do you too?

While doing an anti-yeast diet, do you suggest anything for flares beyond the usual baking soda or Prelief or flushing with water?

So the acupuncture part of your treatment is not necessarily imperative?

So treating the yeast wouldn't necessarily have warded off the IC attack?

I love the Ditropan XL, for urgency-do you feel some Western meds are OK?

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ANSWERS

Dr. Brizman, you might want to tell us a little bit about what you do first.

I treat interstitial cystitis through the use of acupuncture and Chinese Herbal Medicine.  There is so much to say, perhaps questions would be more beneficial.

Do you find IC to be a pH imbalance?

PH is a consideration.  When the body is out of balance it can’t regulate its PH on its own, and that is an aspect of what we are trying achieve with treatment.  Simply controlling PH through diet is only a band aid.  The body needs to do it itself.  That is a part of what we try to achieve in rebalancing the body.

Do your patients who are treated successfully show no signs of bacteria such as enterococcus?

My patients do come up positive for bacteria, however sometimes those tests are inconclusive so I don't depend on them exclusively. I always treat for some bacteria as well as candida.

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Do you mostly work on building immune system rather than killing bacteria and candida? How do you treat for bacteria and candida?

I work both on building the immune system, killing bacteria and candida, balancing hormones and any other thing required on a case by case basis. Upon initial consultation the patient provides an extensive history and I monitor closely once they begin treatment

Do you use herbal antibacterials or prescription?

I use antibacterial herbs and not prescriptions. Treating for bacteria and candida is accomplished with the use of broad spectrum antibacterials and antifungals in conjunction with other herbs needed to balance out each individuals body. Yes I treat long distance.

Why do some patients get worse around their menstrual cycle?

Because hormones effect everything in our body and the fluctuations are going to accentuate anything that is wrong in our bodies. Also, around our period we have a lot of blood building up getting ready for our period putting more pressure in our pelvic area.

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Can you treat someone long distance, and if so, is there any testing involved to prove candida if one does not have vaginal yeast ? 

Yes many of my patients are long distance. I used to use testing every time but I don't anymore. I go by symptoms because I found that many times the test results were mistaken. I found that with these types of diseases tests are often inconclusive so it is better to go by symptomology.

Is diet of extreme importance along with your herbal treatment?

Diet is a critical part of herbal treatment in order to give the body the space it needs to heal.

Can you explain what happens during the "yeast die-off" and/or how you know it is being killed off?

If you have yeast you will early in treatment develop some of various symptoms such as cold or flu symptoms, nausea, headache, fatigue, achiness, etc. It happens very differently for each individual so the symptoms need to be followed carefully. It is important to do the process through someone who understands it. Die off does not happen the same in all people.

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What type of diet do you enforce?

I use the anti candida diet and remove certain foods that irritate the tissues of the bladder.

If we were to travel to see you, do you only do one appointment at that time or more?

The number of appointments depends on how long they can visit. I try to make the most use of the time that they have to spend here with me.

Do you prepare the herbals, or where do we get them?

Currently I prepare the herbals myself. I am currently working on starting a formal research project and trying to refine and complete and prove my methods before making the information public. Also herbs can be dangerous if misused so I don't promote self care.

Do you have people stop all their vitamin supplements, etc.?

Supplements, almost always. There have been exceptions, medications. I usually tell people to stay on them until they can get their doctors to wean them off.

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Is there lodging close by your office? What city are you in?

We are in Los Angeles. There is plenty of lodging.

I'm in Canada, so I probably couldn't get things sent to me?

I have five patients in Canada I send herbs to, so it is no problem

Do you use homeopathics or just herbals?

Only herbals

How is one billed for the services, and how are the herbs shipped.?

In the beginning we c.o.d. until we develop a relationship and then we just send the bill with delivery.

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Is the acupuncture you are doing standard and could we get the same treatments from a good local acupuncturist? What do you believe is the most common weaknesses of the body in IC patients according to Chinese medicine?

I advise against getting acupuncture by another practitioner when under my care because I try to isolate all variables and acupuncture has the capacity to interfere with treatment if not done in conjunction with my treatment methods.

Weaknesses vary from patient to patient. There is not one answer to that question. My approach to each patient is very individual. The variations of this disease are numerous, as individual as we all are.

Do you see environmental toxins as a big problem? Like do you ever suggest a person moving?

I think that each of use should be able to combat toxins in our environment efficiently and if it is not it is an indication that our immune systems are weak and overloaded. One should not have to move their location.

How long does one usually stay on the herbs and your treatments?

Treatment is generally at least one year. In severe cases possibly more. It takes a lot of time to undo what has taken so much time to evolve. Generally by the time someone has developed IC their bodies have been ill for quite some time. Treatment requires a lot of time. But you start to feel better as you go. You don't have to wait a year to see any results.

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How did you get interested in helping IC patients?

I have always had an interest in urological and gastroenterological diseases because there are so few answers for those patients and I enjoy accompanying those patients on their journey back to health

Is there a diet menu that gives you choices for breakfast, lunch and dinner? This "food thing" has me very confused!

The diet is a very broad spectrum list of do's and don'ts.

What do you think about potassium chloride tests and side effects?

That falls under a different protocol that is unnecessary and unrelated to my treatment methods. It may be important to someone else’s treatment methods but not mine. I have no criticism of other treatment methods but mine are exclusive to Chinese Medicine.

Just wondering if you have any thoughts on how to improve a severely "shrunken" bladder?

I have no way of verifying that my treatment methods increase the size of a shrunken bladder. It is my feeling that because those I have treated with shrunken bladders have increased capacity and improved symptoms, I would assume that the bladder has increased in size, but I have no way of verifying that because when patients feel better they don't go back in for, especially invasive tests.

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If you treat for yeast does our spouse also need to be treated at the same time?

In some cases if the spouse is symptomatic and a perceived part of the problem yes, I treat them.

Do you ever see patients who only experience frequency and no pain?

Absolutely, many!

I guess my systemic yeast really helps to cause IC.  Uh oh, that makes me nervous.  What happens to spouses, I thought IC is not contagious?

IC is not contagious but if a husband has yeast he can continue to make the IC patient worse. It is not the IC that is contagious, It is the yeast that they are passing back and forth that can make the IC patient worse. Candida absolutely can be a part of causing and exacerbating IC but it is not the only thing.

Is it important to keep the carbohydrates very low? I have lost 10 lbs. in 2 weeks and I'm afraid I will keep losing.

I monitor each person’s diet depending on symptoms. If you are losing weight too rapidly we increase carbohydrate intake.

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If I don't have signs of vaginal yeast, how would I know if my husband and I were passing it?

You would not. That is why I need to talk to each person and find out what is going on.

My IC symptoms are gone but still have "fibro". What could be causing this to linger? What do you believe IC is?

When IC is related to fibro, the fibro is almost a deeper aspect of the IC so it is related, and treatment needs to be continued. Whatever you did to improve yourself needs to be continued. Perhaps you did not give it enough time.

Is IC a mutated strain of bacteria or the body's breakdown in being able to fight bacteria?

As far as a mutated strain, I believe more importantly that it is a combination of bacteria, yeast and various imbalances in the body which need to be addressed all simultaneously.

Do you see hormones as an important part in someone who is 50?

I see hormones as an important part of many patients, not necessarily having to do with age. Treating with HRT is not generally the solution in my opinion.

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Do you suggest that all IC patients get some type of hormone testing and, if so, what?

I don't do hormone testing on all of my patients. Only on a case-by-case basis. If I am to test I use saliva testing only. I never use blood.

Do you give teas or capsules?

Extract teas that are mixed with water and/or capsules, depending on the case.

If one were to travel to Los Angeles for a week, how many times would they be seen? I would want it to be worth my time.

It is not always necessary to come here. That is also determined on a case-by-case basis. There are many patients who I treat long distance who I have never seen.

How long is the first consult and are you flexible with the time difference for subsequent consults?

The first consult is usually an hour (more if necessary), and yes, we are always flexible with time differences.

Do you do any testing for food allergies?

No, I do not do testing for food allergies because, in my experience, food allergies abate with overall treatment.

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Do you use a combo of acupuncture, diet herbs and sups?

I use herbs, diet and supplements. For those who are local I also use acupuncture.

Sorry if you addressed this earlier, I just got on. I felt as if I was getting a yeast infection right before my current IC flare up. Would yeast have caused it?

In some people yeast can be the final trigger of something that was waiting to happen.

My nutritionist used radio magnetic frequencies, do you too?

No I don't use radio magnetic frequencies.

While doing an anti-yeast diet, do you suggest anything for flares beyond the usual baking soda or Prelief or flushing with water?

If under my care I try to avoid supplementing with Prelief or baking soda unless absolutely necessary. These just mask symptoms and, if it is not excruciating, it is better to try to ride through it. I work with each individual person to get them through what is necessary to ride out the discomfort while in the treatment process.

So the acupuncture part of your treatment is not necessarily imperative?

That is correct.

So treating the yeast wouldn't necessarily have warded off the IC attack?

Treating the yeast may ward it off but if your body was ill something else like bacteria for example could have pushed it over the edge instead.

I love the Ditropan XL, for urgency-do you feel some Western meds are OK?

I never ask anyone to get off their Western medication until they feel it is time and it is appropriate, and it is done under their prescribing doctor's care.

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