PAST

Today I have a facility with numbers and finances, but that wasn’t always the case. When I was a boy, I delivered papers for the New Britain Herald. It was an afternoon paper, back when there were such things. In my substack Capital C Characters, I wrote about the “bionic” man who was one of my customers. I had about 60 customers. Depending on the weather — and how many stops I made for socializing— it took me anywhere from a half hour to an hour to bicycle around delivering their papers after school.

On Saturdays I needed to collect payment. Some customers had subscriptions through the office and mailed in their monthly checks. Most of my customers paid on a weekly basis. I had a little flipbook with tiny, dated coupons that I would tear out and give to the customer when the payment was made. I think this was good practice for life because it meant handling money on a regular basis and, by extension, that means dealing with people’s idiosyncratic quirks around money.

Most customers were home and answered the door on Saturday, knowing I would be there to collect. But there were always a few who either weren’t home or didn’t answer, even though I suspected that they were in there somewhere. This gave me an early lesson in persistence.

Weather in my area of Connecticut at that time could still deliver extreme conditions. Winters were marked by bitter cold and plenty of snow. Flash rain storms with thunder and lightning, gale force winds, hundred degree days with high humidity, not to mention the ferocious dogs that wanted a piece of me: it was all part of the mix. There was one day that I just didn’t feel up to delivering papers and so I didn’t. I delivered Tuesday’s paper with Wednesday’s paper. There weren’t a lot of complaints, but the ones that I did get stung. This was my introduction to providing good customer service while managing extreme dissatisfaction.

At least three times a year my family would leave town on a road trip. This was usually to spend Thanksgiving and Easter with both sets of grandparents in Pennsylvania, and sometimes a week at the shore with the Marsland clan. My parents weren’t micro-managing my affairs, and so this meant that it was up to me to find a substitute to meet my obligations, and pay him well enough that he found it worth his time and effort. This was the upside of my not having helicopter parents. I had to figure this stuff out on my own as early as fourth grade.

Zhivago Velasco and Larry Lebatique became my go-to guys to cover my route. They were both classmates, first generation Americans of immigrant Filipino families.  With a memory that astounds me today I was able to easily recall the street names and house numbers for all of my customers and write a list from which Zhivago and Larry could deliver the papers.  If I was lucky and most people paid their weekly bill, I would net about $10 a week, which wasn’t bad for 1976. I think that I paid $15 to Larry and Zhivago. I intuitively understood that they didn’t have the relational capital or emotional investment in this enterprise that I did and accordingly I would have to compensate them with more financial reward.

On the other end of things, I would have to hand over the payments to my handler, the nameless adult who dropped off the bundle of newspapers in our driveway six days a week. Every Sunday evening, I would be sitting at the kitchen table with a pencil and eraser doing long addition, subtraction and multiplication to determine the amount of cash and coins I needed to leave in an envelope taped to the storm door for the handler to collect every Monday morning.  I never got it right. I never left enough. I tried and tried and tried to understand the formula. I’m pretty sure that I called the main office more than once to try and get some insight. The experience which I had around paying my handler, probably planted the seed for me to become a union agitator and organizer many years later. 

What I knew for sure was how hard I worked. And that it felt like I was being cheated. Even worse was that I couldn’t crack the code and challenge my handler, so that his skimming capitalist enterprise could and would exploit my cheap labor. It’s not like I had a mortgage to pay, but I did depend on that money to buy the model planes I liked to build and the candy of which my mother disapproved. I wanted to buy the sugary Fruit Loops and Applejacks cereals that would never make it into our family shopping cart.  I even ventured out into more “exotic” cuisine like yogurt, and the stir fried rice from the local Chinese takeout. I acquired an appreciation of the scent of incense from the New Age store, and bought some Phillies blunt cigars, and Malboro cigarettes.  So, I continued to ply my trade, knowing that I was being exploited, but was getting some reward that definitely improved my quality of life.

RECENT PAST

When the nuclear power plant at Fukushima, Japan melted down in March 2011, I felt despair which landed on top of my feelings at following the prolonged war in Iraq. I determined that the most achievable and sensible way to counteract that despair was to put solar panels and solar thermal tubes on the roof of our house. My wife certainly didn’t stand in my way, but she never had— and still doesn’t have— the same enthusiasm which I did, which was necessary to pull it off.

We needed to replace the roof around the same time.  My wife had been working in construction for 6 to 7 years at that time, co-owner of a small residential building company. Their preferred roofing material was corrugated metal, and some of their customers from the Ithaca community and its environs would install solar panels on their roofs. This meant drilling holes through the corrugated metal which not infrequently led to leaks—and call backs!

At the time, New York State had generous rebates for solar electric, solar thermal, and reflective roofing material. My wife and I are generally inclined to pay more for something that’s built well and will last longer, and we decided that installing a standing seam roof would be the best investment of our money. The racks for the solar panels and tubes could be attached to the seams without compromising the integrity of the roof.  Of course, standing seam metal roofs are only slightly less expensive than slate.

We obtained a home equity loan, borrowed more than $10,000 from our stepmother Betty Ann (who took this out of her retirement in order to bridge the expenses until the NY rebates came in) and signed contracts for a roofer and solar installation.

That was thirteen years ago. Given that the roof hasn’t leaked, gas and electric prices have increased exponentially, and the solar thermal tubes paid for themselves by 2019, I think we made a good choice. My wife might still disagree. Her partner in residential construction was very critical in 2011, quipping that “You’ve got a Cadillac sitting on top of your house.” I’m curious, but only slightly, what he would say today.

What I didn’t know back then, but I know now, is that solar electric panels are no bargain for the global economy and environment. The harm to the environment from mining and processing the raw materials to make them, exploitation of cheap labor, and rebates which ultimately serve bigger corporations that finance installation of PV panels on fertile farmland, taking it out of commission… these are all concerning and give me reason to pause.

But let me tell you, when I see neighbors whose 30 year asphalt shingle roof is being replaced after 10 years, I count myself lucky. It gives me great pleasure every time I come down to the basement on a sunny day and see that the domestic hot water has been preheated to more than 100° by the sun. We resell our excess electricity to our utility company. It’s delightful to see the drop in both the charges for supply and generation of electricity sold to us at retail by NYSEG, now a Spanish conglomerate, but retaining its New York name.

These investments would not still be useful if there were not several passionate men who arrived in our moments of need to help troubleshoot and maintain the electricity, plumbing, and various components of these complex systems from which we benefit.

It is here that I can write about one of the finest human beings I ever had the pleasure of knowing.  Bob Nape and I first met in 2005 when we were both helping to start the Ithaca Free Clinic (IFC). He had serious carpentry skills and together we put up partition walls and drywall to build out the internal exam rooms of the IFC.  The thing is that he didn’t just bring his skills, he brought his warmth, humor, and love of humanity, which made it a joy to be around him.

Bob was a man of long-standing passions. He became keenly interested in solar hot water back in the 70s in Philadelphia. He was also an enthusiastic and probably very good basketball player. He certainly had the height and the speed for it. He was more faithful in living his Catholicism and doing good in the world than the Pope, as exemplified by his perspective and actions from the moment he woke every day. Years after we met through the IFC, Bob started his company Solar Is Hot, through which he helped legacy solar thermal systems dating back to the 1970s, as well as newer ones such as ours, remain functional. I cannot take a hot shower without giving thanks to Bob.

We connected around our mutual challenges with heart disease and arrhythmias, which in my case kept me out of competitive sports, but in Bob’s case never kept him from his basketball games. During the pandemic, he developed complications following acute COVID, had a stroke, and ended up at SUNY Upstate, my previous employer. His loving partner Elizabeth, who also helped start the IFC, attended to him faithfully during his last days, and was at his bedside when he died January 2nd, 2021. I count Bob as one of the many great losses of the COVID era, who I think could still be alive today, but for the war on Ivermectin and all repurposed drugs. An odd twist to our story is that when I signed up for a post office box for the Leading Edge Clinic, it turned out that the one assigned, #6834, had been Bob’s.

Another person who has helped us over the last twenty years of home ownership is David, whose last name I don’t know, but who is the constant presence behind the service counter of an old-fashioned plumbing supply business in Ithaca. I have literally carried in a four foot section of twisty plumbing that I cut out of it’s place under our utility sink, and he helped me identify and assemble the new pieces I would need to replace it. He would guide me with patience and humor every time. And so, for good reason, I trusted him.

In September of 2021 our solar thermal system had a problem, and I didn’t have Bob. There was a puddle of the glycol fluid, which was supposed to be circulating in the system, but was instead pooling beneath the expansion tank. Because I didn’t have a choice, I started reading and watching videos, ordered a new tank, and went to David for advice on a fitting. He gathered what I needed from the warehouse, out of my sight, while I waited at the counter. I paid him and drove home to begin my project.

Eight hours and a lot of cussing later, I was unsuccessful. I had depressurized, disassembled, reattached and re-pressurized the new expansion tank six times, and each time there was a leak around the fittings. My kind, loving, patient wife, was trying to have a productive day in her stained glass studio on the other side of the basement, and it wasn’t going well, because as the hours went on, the number of f-bombs coming out of my mouth was increasing.

I had one lifeline which I hadn’t used…Paul Czarnecki, who was mentioned in my Capital C Characters substack. Via phone and text, I explained my predicament, but even Paul couldn’t get me out of this jam. And it was then, after eight hours of blood, sweat, tears and a blue streak of foul language, that I finally understood what went wrong. My dear trusted David had sold me this:

But he didn’t tell me, it was a combination of these two pieces:

As a result, there was not teflon tape or paste between the threads of these two fittings, and under pressure, the connection was leaking. By the time I figured this out, I had put so much torque on the original two pieces that there was not chance of getting them apart, and David’s store was closed. Off to Home Depot I went, purchased the two pieces, came home, wrapped Teflon tape around the joints, reattached the joint and tank, repressurized, held my breath, and turned the circulating pump on again. I swear that on the other side of the wall, my wife was holding her breath too! This time—success— there was no leak!!!!

To this day, that damn fitting sits on my home office desk, to remind me that if we persist and approach challenges with an open mind, questioning our assumptions, we just might sometimes come up with a solution. We just need time to let the little grey cells of our brain work on the problem.

PRESENT

With the author’s permission (my own), I’m going to reiterate part of what I wrote in my subtack Hot Mess Express, in which I discussed the use of Lithium as a trace mineral.

What about Lithium Orotate? Dr Michael Nehls, the neuroscientist from Germany, has been talking a blue streak about Vitamin D and Lithium Orotate to protect our brains from the onslaught of spike. Pierre and I had the pleasure of a private meeting with Dr Nehls nearly two months ago, and he helped us understand that Lithium Orotate was a key tool in the fight to reclaim our brains in general, and the hippocampi in particular. If therapeutics such as Vitamin B6 (as P5P 50), or 5-MTHF, or L-Theanine are useful to rebalance specific neurotransmitters, then Lithium Orotate is a general tonic which helps rebalance all neurotransmitters, because it reestablishes neuronal connections, decreases neuro inflammation, and enables the brain to start making new neurons. The particulars for inidividual patients have proven to be nuanced. I generally start with 130mg, but India Scott FNP-C prefers to start with 20mg of Lithium Orotate and work up to 130mg, stopping if clinical benefit is achieved earlier. Dr Nehls strongly recommended 130mg for symptomatic patients, dropping back to 20-30mg for maintenance when stability has been achieived. It’s important to note that 20-30mg of Lithium Orotate equals 1mg of active Lithium and 130mg of Lithium Orotate equals 5mg of active Lithium.

Because most health professionals — and many laypeople — have preconceptions about Lithium as solely the province of psychiatry and bipolar schizophrenia, it’s important to note that we are talking about Lithium as a trace mineral. Would you be concerned about toxicity from a pinch of Celtic sea salt in your water, or 25mg of Vitamin C? No. Neither should you be concerned about trace amounts of Lithium which are many times less than the doses used in psychiatry. You can get 1mg of active Lithium by drinking a pricey bottle of San Pelligrino mineral water, or eating a lot of seafood, but you’ll also quickly empty your wallet, and in the case of seafood, there are so many toxins in the ocean that you’ll poison yourself with mercury before you reach therapeutic levels of lithium. And it’s cheap, cheap, cheap. Horbaach makes a 130mg capsule of Lithium Orotate which costs $15 a bottle, including shipping, and provides six months worth of the supplement.

The Leading Edge Clinic has several dozen patients in Canada, and together we find ways to get lifesaving supplements and prescription medication to them, in spite of the totalitarian and life-threatening restrictions which the Canadian government continues to impose upon its citizens. Thanks to one of these patients, this week I came to understand that I was somewhat befuddled about the dosing and active Lithium content of the supplements I was recommending. It is my hope to bring light to this topic, as there is ample potential for confusion.

The form of Lithium which Dr Nehls recommends is Lithium Orotate, and that is primarily because of its bioavailabilty and affordability. The trouble begins with how the different supplement manufacturers label their products, and then how the supplement vendors (we use FullScript for a 30% discount for our patients) catalogue the supplements. From my perspective, Horbaach does the best job in their labeling, as the front of the label states “Lithium Orotate 130mg”, and the back states “Lithium 5mg (from Lithium Orotate).” What follows below is correspondence from three other suppliers of essential Lithium as Lithium Orotate: Vital Nutrients, Pure Encapsulations, and Doublewood. First, Vital Nutrients:

Vital Nutrients – Support 
From:support@vitalnutrients.co
To:X
Mon, May 13 at 4:42 p.m.

Good afternoon,

Thank you for contacting Vital Nutrients.

There is 500mg of total lithium orotate and 4% is elemental. So 20mg of elemental lithium and 480mg of orithic acid. (for round number purposes)

This is the highest we do carry. We are unable to do a comparison as other companies may source raw materials from other vendors. It would not be an accurate comparison.

If there is anything else we can do today, please let us know.

Omar
Customer Care Representative II
888.328.9992 | vitalnutrients.co

On Mon, May 13, 2024, at 08:41 PM, X> wrote:
To follow up on my previous question…I think the confusion has arisen from the fact that it doesn’t say Lithium Orotate on the front of your bottle, just Lithium. So I read it as 20mg of pure lithium. If it’s not correct, and 20mg is the amount of lithium orotate, then what is the actual amount of pure/elemental lithium in your supplement? If the opposite is true and 20 mg is the amount of pure lithium, what is the amount of lithium orotate per capsule?

On Mon, May 13, 2024, at 08:29 PM, X> wrote:

Hello, could you please confirm the amount of active/elemental lithium in your supplement Lithium 20mg? My health care provider thinks it’s 1mg of active/elemental lithium, but it looks like the label says it’s 20mg. Is this the highest amount available in North American market? Could you please also compare your Lithium 20 with Horbaach Lithium Orotate 130mg, in terms which supplements contains more active/elemental lithium? I am attaching the link below. Again, my provider thinks Horbaach contains more of active lithium, but I think it’s the opposite. Please advise. This is very important for us to sort out, so thank you in advance! X.

Second, Pure Encapsulations:

And third, Doublewood. I actually found their answer more confusing. But doing a quick calculation clarifies it. 9% or 0.09 x 57mg of Lithium Orotate = 5.13mg of active Lithium.

Here is my translation:

1. Horbaach delivers 5mg of active Lithium from 130mg of Lithium Orotate

2. Vital Nutrients delivers 20mg of active Lithium from 500mg of Lithium Orotate

3. Pure Encapsulations delivers 5mg of active Lithium from an unstated amount of Lithium Orotate

4. Doublewood delivers 5mg of active Lithium from 57mg of Lithium Orotate

5. Pure Encapsulations also has a 1mg Lithium product, which delivers 1mg of active Lithium, ideal for titration in very sensitive patients.

Clinical reports of symptomatic benefit from our patients indicates that the Vital Nutrients product is either not as effective, or too high a dose in some people. Dr Nehls recommends daily dosing with 5mg of active Lithium for symptomatic patients (active brain fog, neurological symptoms), and 1mg for maintenance. However, we can use up to 40mg twice daily without toxicity in severely symptomatic patients, and so people can titrate under medical supervision.

Normal Lithium dosing for adults with Bipolar disorder is 300-600mg of Lithium Carbonate, two to three times daily, with long-term control using up to 1200mg daily. Lithium Carbonate has 18.78% active Lithium, so that typical daily dosing in psychiatric treatment delivers between 113mg to 229mg of active Lithium. It is for this reason that Dr Nehls writes and speaks of Lithium Orotate as a trace mineral, as 5mg of active Lithium is 4.4% the psychiatric dose, and 1mg is 0.8%. At 40mg daily, which is the highest we have gone in any of our patients, we are still at only 35% of the lowest psychiatric dosing.

P.S. I have no financial interest in any of the supplements which I am discussing.

P.S.S. If you enjoy Lightning Bug, an edition such as this takes at least five hours of my time to conceive, write, and edit. I pay an editor to minimize my typos and deliver a better finished product to you. The recommended annual subscription is $50, but the settings should permit you to make a choice for a smaller amount if you want to demonstrate your appreciation, but like most of us, are on a budget. Please consider becoming a paid subscriber, and share Lighting Bug with others who you think would enjoy it. Peace, Scott

 

PROLOGUE

After working in the Emergency Department (ED) for more than fourteen years, I cannot count the number of abdominal pains, chest pains, broken bones, lacerations, heart attacks, strokes, MVCs, stabbings, and gunshots I encountered. I also saw patients in anaphylaxis, which is when an acute allergic reaction leads to swelling of the airway, tongue, lips, and face so that a person’s ability to breathe is compromised. Sometimes a relative rolled them in the door, the patient arching back in a wheelchair as they took their last gasp. But, there actually weren’t that many of them. I can count them, just like the number of cases of priapism (an erect penis that just won’t stop being erect!), or foreign objects mysteriously lodged in a rectum (you can scarcely imagine). I would put the number of anaphylaxis patients over fourteen years at…twenty.

You might then understand that when six of my patients at the Leading Edge Clinic have either approached anaphylaxis or come within a minute of dying from the same, over the short period of six months, well, it got my attention.

What is going on here? To give you an answer, we’ll have to go back in time a few years.

RECENT PAST

 

In my Substack Honest Fight I wrote about my 2019 trip to Sweden and Norway with Ellen David Friedman, a veteran union organizer and international labor leader. While we were there, we spent most of our time with teachers, but had a visit with dockworkers, and also met some nurses and doctors. I had a fascinating one-on-one meeting with Anne Lindgren Berndt, President of Vårdförbundet. Also known as the Swedish Association of Health Professionals, Vårdförbundet is the trade union and professional organization of four registered professions; nurses, midwives, biomedical scientists and radiographers. It represents more than 80 % of the workforce.

During our conversation, Anne shared a story which stuns me to this day. A young couple made a trip to the countryside outside of Stockholm for a picnic with their two young children. After a bee stung their not-yet-one-year-old daughter, her lips began to swell and her breathing turned raspy. They called emergency services and within ten minutes a helicopter with an emergency nurse and physician landed in a nearby clearing. They administered a lifesaving epinephrine injection, and within minutes the girl was breathing more easily. Then they bundled up the girl and flew off to the nearest hospital right? Nope. The pilot, nurse, and doctor hung out for more than thirty minutes, monitoring the little girl, getting a health history, providing a pair of epi-pens, providing education about how and when to use the pens, and ensuring that there would be a followup the next day with her pediatrician. Then they returned to their helicopter and flew away, leaving the young family to enjoy the rest of their picnic. True story.

Sweden is not nirvana, or Ellen and I wouldn’t have been there meeting with union members across several sectors. The neocons strategically, methodically, almost invisibly, have hollowed out the strength and influence of Swedish labor over a period of decades. And still, the story above demonstrates what is possible when a country dedicates more than a fraction of its resources to rational healthcare instead of endless wars.

PAST

Dr Lawrence Afrin is considered by many to be the expert on mast cell activation (MCAS) in the United States, and Dr Gerhard Molderings his equivalent in the United Kingdom. An aside—would you agree that someone with the last name Molderings sounds like he should be in a Harry Potter movie? Anyway, in 2016, Afrin, Molderings et. al. wrote a review of how to treat MCAS. It was titled Pharmacological treatment options for mast cell activation disease. If I could wave a magic wand and bring the medical establishment up-to-date on the post-Covidian world, I would make these twenty three pages of clinical wisdom required reading. But seeing as how this isn’t a Harry Potter movie, and I misplaced my magic wand, I’m going to write you dear readers and try to arm you with some potentially lifesaving information.

The meat of the article lays out a step-wise approach to treating MCAS. Some of these therapies should be familiar by now to most patients with post-acute sequelae of Covid (PASC) and injury from the Covid shots: H1 and H2 anti-histamines, Cromolyn, Ketotifen, etc. What evaded my attention for months, but which rose in prominence with each successive instance of anaphylaxis, was Table 12.

 

As I pay tribute to Dr Afrin, I also feel compelled to share some small insight into the complexity of this man’s mind and expertise. When a hero fails to live up to the expectations in one’s mind, does it make a sound? For me, it sounds kind of like a “whumpf.” It turns out that “whumpf” has been adopted as technical avalanche term, which describes the sound made when a heavier lay of snow collapses under the weight of a person or machine walking over a lighter/weaker layer of snow, sometimes preceding an avalanche. Sounds auspicious to me! So, Dr Afrin has been a hero of mine, shedding light on the topic of MCAS through his prolific writing on the topic. My “whumpf” moment came when a patient told a provider in our practice that a nurse in Dr Afrin’s practice said he believes in the safety and efficacy of the Covid shots, and thinks that Paxlovid is an effective first-line treatment for acute Covid. In case that was hearsay, I checked with another colleague who has been in regular communication with Dr Afrin, and she/he said, “Yup, that’s about right.” If the poignancy of this is lost on you, give it time.

PRESENT

The origin of mast cells helps explain why hyperactivation in MCAS is so problematic. When life on this planet leapt from single to two-celled organisms, mast cells were the second cell to arrive. They were the original bouncers of life, and tasked with protecting the organism. They developed a wide repertoire of tools, which included mediators. We can count the birth, life and death of a platelet or white blood cell in about a week. Red blood cells last up to two months. Mast cells last—get this—two to four years! How would you like to really, really, really piss off your mother-in-law, and then find out she was moving in with you for the next four years? No bueno.

When a person is exposed to the spike protein, whether from infection, shedding, or vaccination, the spike protein hyperactivates the mast cells. In a person who didn’t have mast cell disease before the pandemic, this may not have significant consequences. But in a person who had some degree of mast cell disease before Covid, this can be disastrous. These are people who may have had environmental allergies, food sensitivities, rashes, unexplained headaches, irritable bowel disease, asthma, etc.

So what are mediators? They are substances released by mast cells with characteristics that promote, manage and resolve our immune response, particularly in allergic and inflammatory processes that lead to healing. When they spin out of control, or stay around too long, they cause lots of trouble. E.g. cytokines. Remember all the people who died during the pandemic in the winter of 2021 from cytokine storm? Those cytokines were coming from mast cells. What other mediators are there? Histamines, heparin, proteases, leukotrienes and prostaglandins.

 

Back to Table 12. I’ll skip down to local anesthetics, because I think this point touches the largest number of people. Procaine is what most of us know as Novacaine. It’s the most commonly used local anesthetic in dentistry, because of it’s rapid onset and short duration. In post-Covidian times, in mast cell activated patients, there is a big downside to Novacaine—it can provoke release of mediators from mast cells. If you’re a person without any history of MCAS, perhaps this is no big deal. But what if you are limping along with PASC or vaccine injury?

One of my patients is in his mid-30s, and vaccine injured. He needed to have some involved dental work, and rather than it taking a day or two to recover, it took eight to nine days. A few days after this, he went out to eat with his family and at ate some elk meat. Before the meal was over, he was starting to have trouble breathing, and his throat felt like it was closing. He had an old epi-pen in the glove compartment of his vehicle, and used it. His family drove him to the nearest ED, and he lost consciousness on the way due to diminished breathing and lack of oxygenated blood flow to his brain. He literally came within minutes of losing his life.

Why did this happen? If we go back to the period after he received the Covid shots, one conclusion of the exhaustive testing by system doctors who couldn’t find any abnormal tests, or almost none, was that he had Alpha-gal Syndrome. Ever heard of it? Me neither. It’s a potentially life threatening condition which can occur after a tick bite, and results in a delayed allergic reaction to mammalian meat. Mammals have tits and nurse their young, so we’re talking about the four-leggeds, such as pigs, cows, sheep, but also deer, rabbits, and elk. The likelihood of developing Alpha-gal are pretty slim, or at least they used to be, with estimates as low as 1-2% of the pediatric and adult population. Having never encountered it during thirty years of practice, I’ve now encountered it twice in the last year in our practice.

The patient had experienced some difficulty breathing and throat scratchiness after diagnosis with Alpha-gal, and before eating elk meat, enough to be cautious and have an Epi-pen, but what sent him over the edge? A dental procedure with Procaine, or Novacaine led to a close call.

 

Table 12 doesn’t just point out the dangers, it also points towards the solutions, or alternatives. In the case of Novacaine, there is the alternative of Bupivacaine. This is a local anesthetic which takes longer to numb tissue, up to fifteen minutes, and lasts longer, up to eight hours. That makes it a lot less convenient for dentists and patients, but most dentists will have it on hand. It just requires some advanced planning and communication.

It’s worth noting that Lidocaine is on the naughty list too. If you cut yourself badly and go to the local Urgent Care for some stitches, the chances are that the suturing physician will use Lidocaine to numb up the site first. It may be worth discussing your options.

If we go back up the list of Table 12, we’ll find SSRIs. This is the one instance where there literally is no alternative. Examples are citalopram, escitalopram, fluoxetine, fluvoxamine, and sertraline. And how many people take SSRIs? In the United States, about 13% of the adults or 43 million people. Worldwide, estimates suggests 4-5% of the global population or 300-400 million people. Hey, I’m sorry to put a damper on pharma profits, but I think that we’ve got a problem here. MCAS + SSRIs= mediator release → increased potential for anaphylaxis.

Moving back down the list, we find peripheral acting analgesics such as Aspirin and Ibuprofen. This is where I would caution the reader, and say, “Hey, let’s not go overboard here.” Any decision about whether to use or not use a therapeutic, at what dose, and for how long, is based upon a risk vs benefit decision. We can do this! Heck, most adults drive a car, and that is one non-stop rolling series of risk-benefit decisions. Ibuprofen? Well, if you’re well hydrated, and take it with food, and haven’t just eaten a high-histamine meal with avocado, leftovers, and alcohol (inhibits diamine oxidase or DAO, which breaks down histamine) then you could be fine. But what if you take an SSRI, and you just had dental work with Novacaine, and then you had a high histamine meal. Perhaps Tylenol might be a better choice, or rather least worst choice.

Next up on the list are some opiate analgesics, some of my favorites: morphine and codeine. Meperidine or Demerol is there too, but very rarely used these days.

Trying to quit smoking or fending off the blues with Wellbutrin / Bupropion? I’m sorry to say but that’s on the naughty list too.

How about antibiotics? Not to feel left out, we have some of those too, including Cefuroxime (I think there was a typo leaving the e off the end on the list) and Vancomycin. You’ll generally encounter these in the hospital setting via IV administration. Which is also where you’ll find iodinated contrast medium (think CT contrast) and gadolinium chelate (think MRI contrast). It is into this spiderweb of therapeutics that one of my patients recently landed, with serious adverse consequences.

This patient is in his eighties, and being treated with adjunctive cancer care for renal cell carcinoma which has metastasized to his lungs and bones. One of his arms swelled up to three times the size, and his wife took him to the ED. There was a turf war there, in which the Dermatologist opined that his arm was the biggest hive she had ever seen, and recommended antihistamine treatment (think MCAS). Oncology opined that he had cellulitis, brushed aside Dermatology’s recommendations, and ordered IV antibiotics with a cousin of Cefuroxime; these are antibiotics called Cephalosporins, commonly used to treat skin infections. They also ordered an MRI with contrast. Hours later, the patient was streaking down the hallway, trying to escape, exhibiting what would be called delirium, and powerfully pushing aside his wife in his rush. After being home for several days, she reports that his mind still isn’t the same, his sleep is disrupted, and “it has been rough.” So who was right, Dermatology or Oncology? I would vote Dermatology, and say that Oncology picked two therapeutics interventions, an IV Cephalosporin and an MRI with gadolinium chelate which both ramped up mediator release from his already hyperactive mast cells and created a pro-inflammatory and disruptive environment in his brain which contributed to delirium in this vulnerable, elderly patient.

How could mast cell mediators contribute to delirium? Cytokines such as TNF-alpha and IL-6 can cross the blood brain barrier and promote inflammation. Histamine increases blood brain barrier permeability, allowing inflammatory molecules and other immune cells to enter the brain, ramping up neuroinflammation and disregulating neuronal connections. Histamine can also directly bind to histamine receptors in the brain and impact neurotransmitter release and signaling, particularly with acetylcholine and dopamine, both strongly associated with delirium. Mediators can cause dilation and increased permeability of blood vessels in the brain which affect cerebral blood flow negatively. Mediators like proteases and reactive oxygen species can induce oxidative stress which can damage neurons and lead to cognitive dysfunction and delirium.

The therapeutics on the bottom of Table 12 are ACE inhibitors, such as Lisinopril, and beta blockers, such as Metoprolol. ACE inhibitors relax veins and arteries to lower blood pressure, and are often first-line therapies for hypertension due to concurrent protective impact upon kidney function. Beta blockers block the effect of the hormone and neurotransmitter epinephrine, causing the heart to beat less forcefully and more slowly. We can’t and shouldn’t throw the baby out with the bath water, understanding that patients are often on these medications for good reason, but also expanding our focus, and realizing that use of these medications in a post-Covidian era can prime an individual for a spillover of mast cell mediators, which could in some cases lease to anaphylaxis.

An example in this case is my patient who never had any allergies to seafood, but is on an ACE inhibitor for blood pressure, and takes LDN, Ketotifen, takes Antronex with meals, and as needed H1/H2 antihistamines for her MCAS. She went out to dinner with her husband and was in a restaurant which was sparsely populated, so less risk of shedding. She had a glass of wine (inhibits DAO production to break down histamine) and ordered seafood Alfredo, which had shrimp, scallops and clams. When she began eating her entree, it started to feel like her lips were swelling and her throat was tightening, but it wasn’t obvious to the dining companion observing her. She stopped eating the dish, and this sensation of throat tightness continued for more than twelve hours afterwards. When we discussed this during a followup visit, I suggested that we order her an Epi-pen, and reviewed Table 12 with, explaining that I think she was approaching an anaphylactic reaction.

 

A very important teaching around Epi-pens is that they come in pairs for a reason. Remember that the Swedish helicopter nurse and physician left a pair of epi-pens? Epinephrine is a short-acting medication, and its effects can wear off before a person reaches emergency medical providers. If the patient separated the pens, and put one in a car and one in their home for instance, they may have just one Epi-pen on hand in an emergency. That is what happened with my 30-something patient with Alpha-gal Syndrome, and without a second pen to administer, he nearly died before his family got him to the ED.

My final words of advice are to print out Table 12 and carry it with you. Discuss it with your PCP, dentist, surgeon and anesthesiologist. In a post-Covidian era, our bodies are different, and we need to be smart about how we may respond to drugs and agents which never troubled us before. Be prepared.

P.S. Thank you to Deb for her original artwork, the feature image of this Substack, a tribute to Pierre and I, and our work at the Leading Edge Clinic in treating PASC and injury from the Covid shots.

P.S.S. If you’ve ever heard the Beatles song Revolution 9 (you need to listen to it with a set of ear buds or headphones), you might appreciate why I wanted to call this Substack Table 12. It’s not a zinger of a title, but it should be, because Table 12 is so darned important. I hope that after reading this Substack you’ll agree.

PAST

I had pecked girls on the cheek when I was still in elementary school, but the first time I really kissed a girl, I was in eighth grade. I was attending RHAM Junior High School in rural Amston, CT where we lived on an oil and stone road, between woods and a swamp, . It was Christmas time, and there was a community gathering up the street. The party was in a house built in 1790, and had a stable in back — along with some real live horses. I was trying to disappear into the couch as I nibbled cookies and listened to the adults talking and laughing.

Suddeny this girl was standing in front of me, with a halo of Christmas tree light behind her like my very own angel of mercy. “Can I sit here?” Jesus, Joseph and Mary! “Uh, yeah, sure.” Awkward, so awkward, but somehow we started talking. Before too long, she asked if I had been out to the the stable. Shit, I didn’t even know there was a stable. “Nope.” “Do you want to check it out?” “Yup.”

As I write this forty two years later, it’s the first time it occurs to me that this was a girl who knew what she wanted and had a plan. She had long, shiny chestnut hair, and gold rimmed aviator glasses that made her look kind of like a young Farah Fawcett to me. How could I have never not noticed her before? Granted we didn’t ride the same bus, and we weren’t in the same classes, but we sure had some quick chemistry.

We talked for a long time that evening. I have no recollection what we talked about, but I do remember the novelty of having an extended conversation about a wide range of topics with a girl my age. I can recall the explosions in my brain that came from the kiss which she initiated next to the horse stables, but more than that, I was thunderstruck by what it felt like to be attracted to another human being, and have those feeling reciprocated.

There was something magical about the holiday music drifting from the house, the cold air and smells of the tack and straw, and the quiet sounds of the horses moving and breathing. It turned out that she was a horse girl, so this was her comfort zone. She had been riding horses since she was little, and this helped explain her predilection for plaid shirts and blue jeans. I made a mental note that horsey girls had a lot to offer until proven otherwise.

School was out for Christmas break, and since she lived just up the street, I called the number she had scribbled on a scrap of paper the night before. She picked up on the second ring, and yes, I could come by to hang out. She lived in one of the many saltbox houses that can be found on back country roads in New England. Her parents were both at work, and she had her own bedroom. Geese, I couldn’t hear what she was saying for my heart pounding in my ears. More kissing ensued.

Sadly, it didn’t last beyond the first day back at school. I remember looking up from my open locker to see her walking down the hall with some girlfriends. Our eyes met, and then she looked away, and that was that. Her mom answered the phone the next few times I tried to call. No explanation, no note, no nothing. The rejection stung, but I didn’t languish. I figured that her clique had passed judgement and I didn’t meet the bar. It sure was nice while it lasted….

LESS DISTANT PAST

In 1989 I was studying international business in Copenhagen, Denmark. The net effect of my efforts was to persuade me that I had chosen the wrong path, but I stuck with it in order to finish my degree in business economics rather than add a fifth year of classes and pile of debt to my college experience. It was around this time that I became very interested in farming, and set a long-term goal to acquire some practical knowledge on the subject.

 

If the Fall of 1993, I headed to south central France for an apprenticeship at Le Couteil, the farmstead of La Famille Carlier. The 120 acre farm raised organic meat, which was butchered on site and taken to regional farmers markets in a refrigerated truck unlike anything I’ve seen in the states. The farm house dated back to the 1700s and had been the poker retreat of a French duke.

My first assignment upon arrival was cleaning the leather collars for the draft horses. These horses were in fact double ponies called Haflingers, which hailed from the Swiss mountains. They are beautiful and intelligent creatures who are sturdier than horses and love to work. Fieldwork at Le Couteil, whether it was spreading manure, plowing, or harvesting hay, was done with the team hitched up four abreast or two and two, depending upon the task. There was also an enormous Percheron on the farm which was used more for pleasure riding in a carriage.

 

Cleaning out the cow stalls, bringing hay to the cows in the pasture, and generally working about the farm left me in the leanest, meanest state of physical strength I have been before or since. The biggest meal of the day was lunch, and Brigitte would create the most magnificent dishes from the simple pallette of eggs, farm cheese, leeks, potatoes, butter, onions and the range of meat and poultry grown on the farm. She would also make mouthwatering tarts from the apples kept in cold storage. Almost everything, including the wheat for the flour used to bake our bread, was grown on the farm.

The only dietary objection I had during my tenure with the Carliers was beef tongue, because I simply couldn’t get past the texture. Ultimately, I enjoyed the blood sausage (saucisson noir), but I needed at least a week’s distance from the blood-covered kitchen table and the site of the slaughtered pig’s head bobbing up and down in a huge stock pot on the stove!

 

This period of my life could and will serve as a rich repository of stories for Lightning Bug, as the learning was so deep and extensive. For now, I’ll say that I learned I was not meant to be a farmer, as the physicality of it left me with two shoulders burning and aching to such a degree that I couldn’t lift my arms to wash my face. Perhaps with better pacing I could make it work, but in the meantime, I pivoted to a career in healthcare and have been at it for more than thirty years. Even with the supports in place from the French government, and people willing to pay the equivalent of $10/lb for organic meat in 1994, the Carliers struggled. I could foresee the backbreaking work, debt and uncertainty that farming in the United States was likely to involve. There was a good nursing program at the Community College of Philadelphia which I could pay for as I worked my way through school. The pay wasn’t great, but the job security was appealing, and it would be a skillful way to serve humanity.

PRESENT

Long before we ever met, I watched Pierre’s testimony in front of the US Senate Subcommittee which eight million other people watched before You Tube took it down. My wife had called me into the living room with “Hey, you’ve got to see this!” Halfway through I was certain of several things: this guy had guts, he was smart, he was risking it all, and going to the mat for what he believed. Two previous conversations clicked into place like the tumblers on a combination lock to a safe holding the crown jewels. The first conversation had been with my cousin Danny, who follows the latest on solar flares and is a prepper. He had asked me if I ever heard of this drug called ivermectin and whether it could help treat COVID. I had arrogantly responded that I’d never heard of it, and because I worked in a unversity hospital with world renowned medical researchers, it must be a non-entity or we’d be using it. The second conversation was with my dentist, who had done black box research for the Department of Defense in a physiology lab at Temple University before his foray into dentistry. He asked me the same question as my cousin, except this time the source of the question got my attention. Then came Pierre’s fateful senate testimony.

The next day I was in the feed store at Agway with a $100 bill looking for horse paste. I found it and cleared an entire display of it off the shelf. The exchange between the clerk and I was hilarious, mostly non-verbal. She, in her worn flannel and Carharts, who could have easily bench-presseed three of me, her eyes saying “If you’re a horse owner, I’m Barbie.” Me, in my LL Bean fleece, Italian beanie, and Keen shoes, daring her with my eyes “That’s a Ben Franklin on the counter baby, and I mean business.”

My wife and I figured out that the 0.2mg/kg dose was easy-peasy, just dial in the syringe for our weight, give a little push, and a pea-sized dollop of titanium dioxide, propylene glycol, artificial green apple flavor, and ivermectin landed in the spoonful of applesauce. We toasted each other with a clink-clink of our spoons and down the hatch it went. Until the day we could get a human prescription, after paying $400 each for a consult with a telemedicine doc and $120 each for a prescription, it was weekly horse paste and applesauce for us. The worst thing that happened was eventually I developed some wicked heartburn.

I’d had two doses of our special applesauce before my first Pfizer. Yes, I know, I know, the unvaccinated in the crowd are shouting, “Why?!?” I didn’t know yet. I was terrified of dying. I was practically kissing COVID patients and spending two hours at a time sweating my tuckus off in a plastic gown, providing care in a 10ft by 10ft room.

There was one other colleague at work who was on the same page. We both started the horse paste at the same time. I rarely have contact with him now, as he has continued working at SUNY Upstate. It was helpful, though, to know and strategize with another nurse who had made the same calculations and decided that the risk-benefit ratio said to do it.

I used to be ashamed about taking the horse paste and wouldn’t have wanted to share this information. Today, knowing that both my wife and I are vaccine injured from bad batch shots: mine, Pfizers, and hers, Moderna, I am grateful that we did what we did. For my part, if I didn’t have two doses of IVM in my body before the first shot, I think I would be dead. What I understand today, which took a while to comprehend, is that it isn’t me or my wife who bear any shame. It is the physicians who went along with the system and endorsed untested and lethal shots for us who should be ashamed. We were just trying to survive.

Dr Paul Marik gave a brief interview after the recent news of the FDA settlement in the case he and two others brought against the agency for its “Ivermectin is for horses” campaign, and subsequent movement to block physicians from prescribing IVM to prevent and treat COVID. He said “This idea that ivermectin is a dangerous horse-deworming medicine is horse shit. I’m sorry to say that. It is nonsense. Millions of people on this planet have been treated with ivermectin. It is one of the safest medications…After penicillin, this is probably one of the most important medications ever developed by medical science.” Truth be told, Dr Marik, truth be told.

PAST

Those of you who have read my Substack since the beginning, may recall the story about me poking a stick in the yellow jackets nest. There were other more benign, but related events of me probing and testing the world and its inhabitants. In fact, there are many memorable non-events. Did escalators scare you as a child? Heck, did the bathtub drain scare you? I know it scared at least some of us, because Mr Rogers sang a song about it. “You Can Never Go Down the Drain.” Hah!

I wish he’d done a song about the sharp teeth of the escalators, but at least he did produce a sweet episode about up and down which included escalators. In my little kid brain, it seemed absolutely possible that my sneakers could get caught in moving stairs, pulled into them and mashed into bits! Every Christmas my wife and I watch Elf, with Will Ferrel, and I think the scene with him doing that fearful split on the ascending escalators is brilliant.

The escalators in our local Sears Roebuck were particularly captivating— and terrifying— to me as a child. One year around Christmas I saw the big red button at the base of the handle belt, with letters underneath that said STOP. Without much thought and zero premeditation I leaned over and pushed it. Then, those mashing metal teeth stopped. The silence was eerie. I felt this sensation of power over my destiny, that little old me could stop this enormous machine with the push of a button. I looked around and saw no one. Realizing that I maybe should not have done that, I hastily made my getaway. I ran down the now still stairway which released a hollow clunk with each step. I caught up with my mom and we left without further incident— until twelve years later….

SLIGHTLY MORE RECENT PAST

As a teenager, I lived with my Nana and Pop pop in the tiny village of Parkerford, PA, in a little house, with a corn field in our backyard.  My high school was named after the former Supreme Court Justice Owen J Roberts.  We had an active chapter of the Future Farmers of America (FFA), and in the Fall and Spring seasons, when the windows of our classrooms were open, the sweet smell of cow manure being spread on the fields filled the air.  There was also a farm store across the street from our school where many of us headed for snacks before catching the late bus home.  

Trips into the vast city of Philadelphia were therefore a very big deal.  My friend Larami, now an esteemed Interventional Neurologist in the University of Pennsylvania health care system, loved, loved, loved to initate those trips.  We would drive to Paoli and catch the R5 SEPTA Regional Rail line into Center City Philadelphia.  Before Christmas of 1986, Larami, his brother Monk , Chris and I made one such trip.  Larami’s inspirations and infatuations of the moment circumscribed our plans.  So, first we went for the buffet at Salad Alley in the Bourse Building for lunch. Then we headed to The Galleries for some shopping. This was an urban mall with at leat four levels opening onto a vast interior, and it…was…packed.  We entered on the street level and approached the escalator.  Without premeditation, and with an impulsivity that I cannot explain or defend, my eyes landed on the big red STOP button below the escalator railing, right where it had been all those years ago. I leaned over, and pushed it.

Unlike the Sears escalator of my boyhood however, this one was packed with people, who all gave a little forward and backward bobble as the escalator suddenly stopped.I was just ahead of my friends, and when they saw what I had done, they looked at me in surprise, perhaps amusement, and then concern. Within moments I was surrounded by at least six very large security officers. The Gallery didn’t mess around with security. Gang activity and drive by shootings were on the rise, and off-duty police officers could pick up some nice extra pay during Christmas. These security officers were at least twice as tall and three times as wide as me.

Their radios crackled. Ccckkkk “Level one escalator has stopped. Nobody appears to be hurt.” Ccccckkkkkk “We have a white male teen in custody.” Cccckkkkk. Before they even bothered asking me what I had done, they turned to my friends and asked “Is he with you?” They all shook their heads no and slowly backed away. F#@*?rs!! Obviously we were together. Then the guards all turned back to me. I remember looking up and seeing about five hundred people lining the railings of the different levels to see what was gong to happen to this crazy little white boy.

Time passed. I was contemplating what I would tell my Pop pop when I called from the city jail. “You what!?!” More radio crackling. Cccckkkkk “Yes sir. Yes sir. No sir. I don’t think so sir. Roger that sir.” Cccccckkkkk. One of the very big men looked at me and said “We’re going to have to ask you and your friends to leave and not return to the premises.” Really? That’s it? No jail? No report? They escorted me and my disavowing friends to the nearest exit and stood inside the doors to make sure we went on our way.

Well, dear reader, I’d be lying if I said that was the last button I ever pushed. Which brings me to the present moment.

PRESENT

Once a month I meet with wise man who I’ll call my business guru and emotional mentor. His name is Geep, and he likes to tell me instructive stories which I don’t always enjoy. One thing which he has told me more times than I can remember is, “Scott, try not to piss people off by accident.” Well, last week on the FLCCC Webinar, I think I pissed off a lot of women who are keen on using collagen to soften their wrinkles, harden their nails, and keep their hair from falling out. Frankly, I’m lucky to be alive!

It was great fun being on the weekly webinar with Dr Marik. During the webinar, when I shared my observations that collagen appeared to be provoking platelet aggregation and activaton in my patients, it didn’t seem like a big deal. Perhaps what I forgot to say was what all of the Tarot readers my wife watches on You Tube say: “The following is for entertainment purposes only.” When Pierre texts me on Saturday and writes “I known it’s your one day off, but….”, what follows is never good. It seems that I stirred up a shit storm with those observations and the FLCCC was trying to manage it.

To differentiate the players, the FLCCC is a rigorously science-based organization, and Dr Marik is the guardian of that galaxy. If there aren’t studies to back an assertion, or a heck of a lot of clinical observeration, it isn’t going to make it onto the FLCCC protocols. On the other hand, the Leading Edge Clinic is our private telemedicine practice, and as diligent clinicians, if we see signals that a therapy is harming our patients, we won’t wait until a study comes out to warn them. For example, Dr Peter McCullough asserted months ago that shedding wasn’t real, because he couldn’t find any studies which supported the ideas. The rest is history, as we began acting based upon our clinical observations re: shedding almost a year ago, instead of waiting for a study which may never happen to confirm it. Now I can’t count how many interviews Pierre has given on the topic!

Back to collagen. I understand that it could be upsetting to hear me assert that the supplement your functional medicine physician / chiropractor / naturopath / yoga instructor (not kidding here) recommended to you may be exacerbating coaguloptahy in your body. All you were trying to do was not look so damn old. As John Stewart recently said during his second episode of The Daily Show in nine years: “I have sinned against you. I’m sorry. It was never my intention to say out loud what I saw with my eyes and then brain. I can do better.” Instead of Stewart’s ironic statement that “democracy dies in discussion”, I could say “science dies in discussion.”

Forgive me for my habit of risk benefit analysis. Not only are there no studies supporting my position on collagen and clotting, there is even one research paper from 2004 which may contradict it. Of course that paper was written before space aliens zapped us with a bioweapon made in the distant galaxy of Wuhan and deranged our bodies to such a degree that most of our pre-exisitng lab studies, radiologic tools, and diagnostic approaches have been nearly useless. It’s also worth mentioning that the collagen market is estimated at 5.1 billion USD in 2023 and is projected to reach 7.4 Billion USD by 2030, at a compound annual growth rate (CAGR) of 5.3% from 2023 to 2030. This is a minor matter though, because I’m sure that the good people of supplement sales only have our best interests at heart. It also doesn’t really matter that there really isn’t substantial evidence to support the benefit of collagen in attaining beautiful skin, full bodied hair, strong nails. We also need not be troubled by the lack of any standardization or FDA regulation of these collagen products which are ingested in good faith by so many.

Did you know that collagen is a waste product? It’s made from the leftover connective tissue of fish, pigs and cows (unless you’re getting the vegan version). I love waste products as much as the next guy. We have had a worm composter in our basement for years. I love making them smile with a bruised avocado half. Their excrement feeds the beautiful lives of our houseplants and garden. Our cat litter is made from the refuse of lumber mills, pine wood sawdust. It smells great and we can compost it. Even yummy apple cider is a refuse product made from the seconds. The thing is that besides apple cider, I can’t think of another refuse product which I would ingest, let alone pay big money to consume.

According to historian Roxeanne Dunbar Ortiz, at its peak, the Native American population of North American reached 450 million people. They lived on this land for millenia. Uniformly, they used every part of the animals and fish which they hunted and harvested. Tendons and sinews were used to make bowstrings and thread. Cartilage and hooves could be ground into glue. But, they didn’t routinely ingest connective tissue, the basis of animal collagen. Why not? Did they intuitively understand something which escapes us in the present moment?

What follows is a case series of patients in whom I think that collagen played a role in their pathology and in most cases, may have set them up for their original injury, and often exacerbated coagulopathy. You’ll see references to Vitamin K2 as well. I won’t entertain questions about that until I’ve been able to explain my observations and strategy in next weeks’ Substack. I’ve spent a ridiculous amount of time on this project in the last week. Because the number of cases is fifteen and growing, I’m going to divide this up between today and next week. As a disclaimer, the following is for entertainment purposes only, and it is not to be misconstrued as frontline clinical insight or evidence from an expert in the field. ; )

Patient 0

18yo female x2 mRNA Pfizer vaccine injury within two weeks of second shot.  Family unvaccinated. First visit 2/23.  Previously healthy, s/p tonsillectomy, competitive athlete.  Intake reports fatigue, shortness of breath, chest pain, joint pain, dizziness when standing, fast or pounding heart rate (HR), worsened symptoms after activity. Blurred vision when exercising, dizzy, light headed, nauseous, swollen ankles, chest and back pain, heavy weight on chest, sharp pains on left side of chest, trouble breathing, high heart rate and high diastolic blood pressure when exercising. 2/23 live blood analysis showed RBC aggregates, Rouleaux formations, poikilocytes, echinocytes, schisocytes, acanthocytes, and platelet aggregation.  Initiated Aspirin, Eliquis, IVM and NAC Augmentata 3/23.  By 5/23 had seen tremendous improvement in leg movement and strength,adjusting fine motor movements, working with an unvaccinated personal trainer.  4 of 4 microclotting, severe and widespread in study 10/23.  It was surprising that her level was still this high despite five months of anticoagulation therapy.  11/23 visit revealed that several months ago she had tried collagen for 3-4 days.  During that time, leg pain and weakness which was associated with her microclotting became much worse.   Spike ab not available due to location and lack of access to a Lab Corp facility.

Batch ADRs Deaths Disabilities Life Threatening Illnesses

FN7924 No data

FM2952 2

Patient 1

20yo female, x2 mRNA Pfizer vaccine injury.  First seen 2/24.  Previously healthy with no surgical history.  Spouse is not vaccinated, and shedding exposure is primarily from her boosted mother.  Intake reports fatigue, shortness of breath, fast or pounding heart rate, possible enlarged atrium, low blood pressure.  Interview reveals strong signal of MCAS with childhood migraines and many food sensitivities. Also had pediatric GI issues which continue into the present moment.  Developed increased anxiety post-vaccine and started Lamotrigine, currently weaning.  Fainted following a competitive sports event in July 2023.   Started collagen on and off for hair/skin/bones in August 2023.   Started iron supplementation due to fatigue about December  2023.   DC’d oral birth control December 2023.  Had a second fainting episode at work in January of 2024.  Developed chest pain, dyspnea and fatigue.  ED visit showed abnormal ECG, and follow up cardiac echocardiogram was abnormal with possible atrial enlargement, further evaluation pending.  Labs for spike ab, D-dimer, neurotransmitters (urine) pending.

Patient 2

55yo female, post-acute sequelae of COVID (PASC), unvaccinated.  Spouse is vaccinated. First seen 1/24.  Hx TBI, cervical cancer, asthma, hypothyroidism S/p incarcerated inguinal hernia, hysterectomy, oophorectomy, cholecystectomy, appendectomy, tonsillectomy, adenoidectomy, right knee replacement x3 in 18 months. Intake reports fatigue, brain fog, memory problems, shortness of breath, chest pain, joint pain, dizziness when standing, symptoms worsening after activity, distant Hx of PE. Pain in the spleen, increased CRP values, inflammation, severe constipation.  COVID in late 2019, early 2020, and early November 2023.  Strong signal of MCAS,with very narrow range of foods she can eat.  Taking collagen and Vitamin K2.  Guided to DC both.

Spike ab 2345 U/mL

>>D-dimer 0.87 mg/L FEU

PAI-1 4G/4G polymorphism (denotes high risk of developing venous thromboembolism)

ADAMTS13 >100%

ADAMTS13 Ab 3 U/mL

Factor VIII Activity 70%

Serotonin, serum 76 ng/mL

Patient 3

68 year old male with PASC, unvaccinated.  Initial symptoms in 2/23 were sinus congestion, impact on right ear hearing, new diagnosis of asthma, and wet end-expiratory breath sounds.  Raynaud’s began before COVID and receiving monoclonal antibodies in the Winter of 2020.  Post-COVID, developed an arrtyhmia and worsening GERD.  Has had allergies his whole life.  Most recently, feeling well overall, but has intermittent muscular trouble with focal pain in one leg and bilateral leg fatigue after exertion.

Spike ab level: 3564 U/mL in 2/23, down to 157 U/mL 5/23, up to 2172 U/mL 12/20/23 following travel and shedding exposure. Microclotting score 3 of 4 moderate in 8/23, drop to only 2.75 of 4 in 1/24.  Question arose re: why there was such a small drop in microclotting after five months with use of Aspirin, IVM, Serrapeptase, Nattokinase, Flavay, Baobab, NAC Augmentata.  Scrutiny of medication reconciliationg (med rec) revealed that he was taking collagen protein peptides as a powder along with Vitamin K2 in an MVI.  The collagen had been recommended by a functional medicine physician for muscle soreness several years ago.  Collagen and Vitamin K2 DC’d.

Patient 4

54 y.o. female x2 mRNA Pfizer with vaccine injury.  First seen for acute COVID in 9/22.  Seen in follow up 10/22 for persistent enlarged, painful lymph nodes, then 11/22 for vaccine injury.  Had been on a proton pump inhibitor (PPI) when she was originally infected with COVID and vaccinated, which likely contributed to her injury.  She stopped this in early 11/22.  Lymph nodes in bilateral axillae continued to be painful, and she noted outbreak of Herpes Simplex Virus (HSV) lesions on her lips.  Reporting persistent heel pain, GERD.  In 12/22, had extended menses of twenty days, which stopped 4-5 days after initiation of high dose IVM.  We then dropped the dose due to emerging photosensitivity.  Nattokinase was started.  Lost weight, followed a lower histamine diet, had COVID again around Memorial Day 2023.  Menses began to be prolonged again, following acute COVID and extensive travel for work.  Was experiencing increased fatigue.  Started sipping Baobab in 7/23 as one of our twenty pilot study participants.  Spike ab level has consistently been >25,000 U/mL since first testing in 7/23, and with repeat testing in  9/23 and 1/24.  Microclotting score was 3 out of 4, moderate 8/23.

Batch ADRs Deaths Disabilities Life Threatening Illnesses

EW0177 1458 6 12 18

Fasting glucose decreased from 99 to 96 over the first month of sipping Baobab.  Menses stabilized.  Began anticoagulation with Aspirin, Eliquis and Plavix in 9/23, along with IVM, NAC Augmentata, Nattokinase.  In 10/23 saw decreased dyspnea with exertion, but injured left shoulder while lifting a heavy object. At this time she stopped taking collagen, and began taking colostrum to help heal her gut. I was not yet suspecting the role of collagen in provoking coagulopathy.  Use of the Arc Microtech helped minimize bruising and bleeding concerns on anticoagulation.  Despite stress of family health issues, job changes, and her own health challenges, she was doing well during this period.  Flavay was started in 11/23, and we fine-tuned treatment for MCAS by adding Antronex, a natural antihistamine from Standard Process.  She had an acute viral illness around Thanksgiving following exposure to many family members who were acutely ill.  We initiated peptide BPC-157 for gut healing and ProTandim for emerging cognitive concerns.  Chronic connective tissue concerns began to yield, with less shoulder and heel pain, improved appetite, resolution of skin issues.  She had backed off the Baobab use for two months.  Menses became elongated again, and she was having sleep disturbances.

Patient 5

49 yo female, PASC, unvaccinated.  Husband not vaccinated.  Hx migraines, MTHFR gene mutation, S/p ACL reconstruction.  Previous COVID-19 infection by testing or presumptive by symptoms, January 2022 and December 2022.  Onset ~ four weeks after initial COVID infection.  Intake reports brain fog, memory problems, anxiety and depression. Mother, sister’s husband and all of their close friends have been vaccinated. Was around them after sick first time. Unvaccinated daughter and son attend schools around many vaccinated students.  Husband works around many vaccinated individuals.  Shedding is an active dynamic and ongoing consideration in her care.  2/23 labs showed spike ab 844 U/mL and slight elevation of D-Dimer at 0.51 mg/L FEU, a late sign of microclotting.  3/23 labs reflected reactivation of EBV with early antigen level of 10.4 U/mL.  8/23 microclotting study showed stage/grade 4 of 4, widespread and significant.  Patient and her husband asserted that there was a mistake in the labs and this was another patient’s blood. When she went to the lab for another draw, the phlebotomist couldn’t draw her blood, because it kept clotting.  They then agreed this was in fact her blood, and wished to initiate treatment.  Started triple anticoagulation with Aspirin, Eliquis and Plavix as well as IVM, LDN, NAC Augmentata, Nattokinase.  Repeat microclotting study 11/23 showed reduction to 2.5 of 4, mild.  Patient felt 95% recovered.  In 12/23 and 1/24 visits, patient was exhibiting some relapse of symptoms secondary to shedding, but still doing well overall. In 1/24 visit she remarked, “Two weeks ago I was feeling really good.  I haven’t felt that good since 2022.”  Then her menses came, and she experienced a return of severe migraine.  At the end of the visit, in response to questioning from this provider, she reported that she had started taking collagen a few weeks ago.  Collagen DC’d after this visit. End of 2/24 patient reports that she is feeling much better, and was able to go for a one mile walk.

Patient 6

39 yo female, x2 mRNA Pfizer vaccine injury.   Increased fatigue over 2021 following vaccination.  Previous COVID-19 infection by testing or presumptive by symptoms, December 2021.    Husband vaccinated, works in health care.  Hx chronic fatigue syndrome, headaches, migraines. S/p no surgeries declared.  Intake reports fatigue, brain fog, memory problems, dizziness when standing, chest pain, tachycardia, headaches, depression or anxiety, worsened symptoms after activity, new onset daily headaches/ migraines, nausea.  One night she didn’t take her Aspirin, and the next day she had a severe headache.  “This is like dementia. I would open the fridge ten times and not knowing what I was looking for.”  During discussion late 2023, patient reported that she would use collagen supplementation in a liquid form regularly in the years before she became sick with COVID.   2/23, spike ab was 9814 U/mL.  8/23 study showed 4 of 4 microclotting, severe and widespread.  

Batch ADRs Deaths Disabilities Life Threatening Illnesses
EL0140    1243           52                    20                  24
EJ686             8

Patient 7

61yo female, PASC, unvaccinated.   First seen 4/22.  Hx of hypertension (HTN), s/p tubal ligation and foot surgery.  Three previous COVID-19 infections by testing or presumptive by symptoms, 11/2020 around Thanksgiving, and again 1/21, 7/22.  Onset 3/21, with lost of taste and smell, hypertension, fatigue, brain fog and memory problems, with worse symptoms after exertion. Stress from a busy work week also exacerbates symptoms.  Eating a low histmaine diet.  Completed BioAnalytics cytokine panel with Dr Patterson, started on Maraviroc for one month and most of symptoms resolved, although CCL4 remained elevated.  Excercise with HR > 100 provokes post-exertional malaise, and allergy symptoms with increased phlegm production and watering eyes for several days afterwards, at worst with vertigo, nausea and vomiting.  Low dose Dexamethasone was helfpul, as well as short-term, low dose Fluvoxamine.  HR improved and tapered off a beta blocker.  High dose IVM didn’t resolve loss of taste and smell; we then tried Vascepa, again without benefit.  Spike ab was 2497 U/mL.  During 2/23 visit, secondary to shedding from spouse traveling to a trade show, going to the gym, and being around vax/boosted people, saw increase in sympotm burden.  Experiencing eye twitching, vertigo, heat on back of her neck, returning fatigue, and increasing BP.  Initiated Arc Microtech after 7/23 visit.  At 11/23 visit, vertigo resolved, drop of spike ab to 940 U/mL continuing with low intensity exercise, modulating MCAS with antihistamines, and eating lower histamine diet.  Aspirin and Flavay initiated for presumed microclotting.  In successive visit Antronex and Ketotifen for MCAS initiated, and Oxytocin for taste/smell.  Completed microclotting study 1/24, which showed 2.5 of 4, mild.  During that visit, in response to my questions, she reported that she had been taking collagen 1 Tablespoon daily for years.  Collagen DC’d.  Within about two weeks of stopping the collagen, and initiating low-dose Nicotine patch, her taste and smell, which had remained elusively absent for more than two years, began to return, albeit inconsistently.  

P.S.. Thank you to Dr Ronald Epner for your generous financial support as the first reader to become a Founder. And thank you to each of the individuals who has chosen to support this work by becoming paid subscribers.

P.S.S. If you know someone in Wyoming or West Virginia who would enjoy reading Lightning Bug, please share. Those are the only two states from which I don’t have subscribers. I’m offering a free lifetime subscription to the first person from each of those states to become a reader.

P.S.S.S. I tried to send out a brief survey re: collagen and it didn’t work out of the box, so I deleted it. I’ll try again after learning more about this tool.

History

I had at least four fathers. My biological father, my stepfather, my paternal grandfather, and the father of my best friend in high school. Only the last of these is still alive. One thing which each of them had in common was a facility with explanations about the world around us and how things work. Instead of facility, I thought to use the word alacrity, but my Pop pop could be grumpy when I asked him the meaning or spelling of a word. “There’s a very big dictionary on the book shelf at the end of the hall Scotty.” Yes, I knew that. It was the one that each of my siblings, cousins and myself would take turns sitting on at the dining room table during holidays growing up. “But you’re right here Pop pop, and you explain it so well.” That would usually get a look up from his Travis McGee novel and over the rims of his glasses, then an answer. Yes!

Because my dad had the first shift in this province of fathers, his patient explanations overshadow all others. Why is the sky blue? What makes wind? Are cats smarter than dogs? Why do dogs eat cat poop? (seriously, that made me doubt that dogs are smarter than cats) Do girls ever fart? Do all fish have teeth? (the movie Piranha had come out) How does Santa get down the Chimney? If God created the world, who created God? How does a lightbulb work? Why do you use a radar detector? That’s just for starters. Clearly he had his work cut out for him.

I marveled that he knew so much about so many things. As an adult, I remember my dad and think that it would be fair to say he was a Renaissance man. He played tennis and volleyball, and took up martial arts before his death. He built a passive solar house, restored a Model A Ford coupe with a rumble seat, had a beautiful garden, and was a decent cook by his third marriage. He was a successful salesman, an introvert who taught himself to be socially engaging, and was well-respected by his colleagues. He knew things, things that mattered. He had the answers to my questions, and on the rare occasion that he didn’t, he didn’t fake it.

Recent Past

One of my favorite novelists is Barbara Kingsolver. The last book I read by her was Demon Copperhead which is a story of life and love in the southern Appalachian Mountains of Virginia. A line early in the novel has stuck with me as I have struggled to master this novel medical realm of Covid. “If you care, you’ll learn one thing from another. Anybody knows a sheepdog from a beagle, or a Whopper from a Big Mac.”

In the emergency setting, knowing one thing from another can make a big difference in the how the day goes for the patient in your care. Was that Morphine (MS04) or Mag Sulfate (MgS04) which caused you to stop breathing? Before I hang your blood, are you Bill Jones (DOB 6/24/59) or Bill Jones (DOB 6/23/59)? Did that telemetry monitor just show you brushing your teeth, or did you enter a potentially fatal dysrhythmia of ventricular fibrillation? You know, things that matter.

I have a decent understanding of how drugs work, at what doses, through what mechanisms of action, and with what side effects. It helped to spend nearly a decade on the Pharmacy and Therapeutics Committee at Cayuga Medical Center in Ithaca. But I still relied heavily upon the expertise of my pharmacy colleagues while working in the Emergency Department (ED). When I started work in the trauma center at Upstate, this reliance grew, both because there were expert clinical pharmacists stationed in the ED itself, and because they actively participated in bedside care. During care of a trauma patient, it was Rob or Greg who was right behind me at the bedside, mixing drugs, passing syringes, reminding the team when the next dose of Epinephrine was due. They mixed the drips which made intubation work, hearts keep beating, blood pressure supply vital organs.

In this complex environment, I outsourced some of my learning. When the Covid vaccines were being rolled out, it was our pharmacist Greg to whom I turned. He had spent twelve hours watching expert testimony about the vaccines. I remember in the med room he assured me that the technology was at least a decade old, that they were safe, and he had done his homework in order to answer questions from colleagues like me. That was enough for me, because this was the guy who had my back when the chips were down, every damn time.

Present

I don’t outsource many of my questions anymore. Since I received two bad batch shots in January of 2021, I do my homework. In fact, I’ve read more studies in the last three years than the previous thirty. At this point, my study and clinical practice have propelled me into the position of trying to teach you.

The longer we are in practice at the Leading Edge Clinic, the more I encounter patients who still have almost both feet still in the land of conventional medicine. They still trust their PCP, their Cardiologist, their Gastroenterologist. The people who advised them to get the shots. They have been through the ringer, and haven’t been getting any answers. They are talking to me because their friend, family, neighbor, co-worker referred them. All they know is that they were told I might be able to help them.

This is a weak position from which to question the guidance of the trusted medical professionals in their lives. One way in which I approach this is by offering a framework. I suggest that when they next speak with their practitioner, they ask them this: “Sir/madam, can you please help me understand what is spikopathy, the pathologies it causes in long-haul and vaccine injury, and what you know about how to evaluate and treat those injuries?” I suggest that when that doctor/NP/PA gives them a blank stare, they remember it. You figure that into your calculations about whether their evaluation, testing, diagnosis and treatment is based upon reality.

The same practitioners may also tell you “We just don’t know much about long-haul and vaccine injury, and it will be years before we understand it and can effectively treat it.” My response is that today, not tomorrow or years from now, there is a graduate level course in long-haul and vaccine injury available at no cost. It is the eighty-two (and growing) part series by Dr Syed Mobeen, known as Dr Been. It is the Long Story Short series from the FLCCC Alliance. Any layperson or practitioner who watches and learns from that series will acquire knowledge that currently evades 99.9% of the practitioners in the United States, if not the world.

Along those lines, a patient recently told me that we need to share a list of medications that people experiencing spikopathy shouldn’t take. She was right. This is a start. In upcoming Substacks I will cover proton-pump inhibitors (PPIs), statins, and polyethylene glycol (PEG). In this Substack I’ll start with aluminum-containing over-the-counter and prescription medications. Examples are Maalox, Mylanta, Pepto-Bismol, Carafate or Sucralfate.

What are these products supposed to do? Aluminum hydroxide (Maalox, Mylanta) is a basic inorganic salt that acts by neutralizing hydrochloric acid in gastric secretions. Aluminum hydroxide is slowly solubilized in the stomach and reacts with hydrochloric acid to form aluminum chloride and water. It also inhibits the action of pepsin by increasing the pH and via adsorption. Bismuth subsalicylate (Pepto-Bismol) consists of trivalent bismuth and salicylate suspended in a mixture of magnesium aluminium silicate clay. The medicine forms a protective coating over the lower part of your esophagus, and partly coats your stomach. This helps protect them from stomach acid. It also has weak antacid properties that may help reduce too much stomach acid.

Sucralfate/Carafate works by forming a barrier or coating over a gastric ulcer. This protects the ulcer from the acid of the stomach, allowing it to heal. More technically, it dissociates in the acid environment of the stomach to its anionic form, which binds to the ulcer base. This creates a protective barrier to pepsin and bile and inhibits the diffusion of gastric acid. Sucralfate also stimulates the gastric secretion of bicarbonate and prostaglandins.

Why use aluminum in these antacids? One word, flocculation. If your house is connected to a municipal sewage system, when you flush the toilet the waste flows to your local sewage treatment plant. It is common practice in the United States to add aluminum powder to the raw sewage in order to make the solid waste settle out of the solution, so that it can be collected and removed. How does that work? Aluminum is what chemists call a cation. It has a +3 charge. The organic waste from your poo has a negative charge. Aluminum binds to the organic waste and this joint venture becomes sludgy. Ergo, flocculation. What happens when you ingest medications which have aluminum? Flocculation, in your blood. Sludging, in…your…blood.

It is not rare that during my first visit with a patient who has post-acute sequelae of Covid (PASC) or vaccine injury they will have one of these medications on their list. Or, as we progress through the visit, it comes out that they take one of these medications, Carafate being the worst. That is the moment when I try to explain to them that we have a bit of work to do just to get to the starting line of healing.

When I assert to you that 100% of the population has microclotting, regardless of vaccination status, the import of what I shared about aluminum gathers weight. For now, I’ll direct your questions about microclotting to Dr Jordan Vaughn’s presentation on Microclotting at the FLCCC Alliance in May 2023. We have lost the controls in this dystopian medical experiment, and we have all been contaminated by spike. On a scale of 0-4, the best we have seen when testing blood for our patients is a 1.5. This was only one patient, and after months of anticoagulation therapy. Dr Vaughn, who I consider the United States national expert on microclotting, after testing thousands of patients, would assert that the best score we see in the general population is microclotting at a level of 1 out of 4.

Some of you are old enough to remember the white stick which your dad or grandad had in the medicine cabinet and would use to stop bleeding from a cut suffered while shaving. I’m old enough that I still have one of these. Safety razors have mostly made this a thing of the past, but that white stick was a styptic pencil. Anhydrous aluminium sulfate is the main ingredient and acts as a vasoconstrictor in order to disable blood flow. The stick is applied directly to the bleeding site and it stings. The high ionic strength promotes flocculation of the blood, and the astringent chemical causes local vasoconstriction. It has 56% aluminum.

If you doubt that the little bit of aluminum in these medications is enough to cause trouble, I’ll give you a couple of examples. One of my unvaccinated patients is a band teacher who was relatively stable. Then he went on a trip to Disney with his students. He took along his travel kit, in which he had a travel deodorant with aluminum, and travel hair gel, with aluminum. During the trip he drank soda out of aluminum cans. After the trip his health deteriorated dramatically. When we had the next visit, he reported symptoms reflective of microclotting: severe headache, vision changes, arm and leg muscle pain, joint pain, GI upset. Shedding was contributing to these changes. When he returned to his non-aluminum deodorant at home, and stopped using his aluminum containing hair gel, he saw improvement in his symptoms.

Another patient is a radiologist who had symptoms reflective of microclotting, with cognitive issues, headache, myalgia and joint pain. With the simple intervention of eliminating his habit of drinking seltzer out of aluminum cans, he achieved a remarkable reduction of his symptoms. Just avoiding this tiny amount of aluminum had enough impact that this trained medical professional could clearly identify the benefit.

Sucralfate/Carafate contains 21% aluminum by weight. A typical regimen of 1 g 4 times/day contains 828 mg of elemental aluminum. I used to love Carafate, and would introduce patients to it by saying it was an old-fashioned drug which was very effective at helping heal peptic ulcer disease or esophagitis. Ironically, the underlying autoimmune dysregulation, antibody response, mast-cell activation, and microclotting from spikopathy can easily lead to heartburn and gastrointestinal dysregulation. Along comes a general practitioner or gastroenterologist and they prescribe Carafate. The result is a catastrophic escalation of microclotting, as each dose of aluminum provokes more and more and more flocculation or sludging in the patient’s blood.

What are your alternatives to these aluminum containing drugs? First and foremost, knowledge. Dr Sherry Rogers recently updated her classic No More Heartburn: The Safe, Effective Way to Prevent and Heal Chronic Gastrointestinal Disorders. Buy it, read it, and act upon it. Take time to chew your food, drink less liquids with your meals, drink less alcohol, eat fewer processed foods, and limit caffeine intake. Try using oral liquid aloe vera, apple cider vinegar, and slippery elm bark to heal your inflamed gut. Eat a healthier diet, and cultivate a more robust microbiome, preferably with cultured foods and liquids rather than proprietary pills and potions promising probiotic nirvana. For the unfortunate with bleeding ulcers, get a juicer, and drink raw cabbage juice. There were two excellent studies from the late 1940s and 1950s which demonstrated this intervention to be a safe and quick way to completely heal ulcer craters. See references here and here.

One thing from another. If you care, you’ll learn.

P.S. This last week I appeared on the Shaun Newman Podcast episode #554. The content of his show has taken a giant turn from focusing on sports to discussing current events in Alberta and Canada. We had a fun and informative visit together. After this podcast was released on Friday December 22, 2023, bad actors hacked Shaun’s website and diverted web traffic to a bogus site in Indonesia. They stole his domain and registered it under GoDaddy. We understand from expert cyber security consultants that the cost of such a job for a talented hacker would be $20-40,000. Somebody, some organization, or some government (Canada?) doesn’t want Shaun broadcasting. My translation is that in the content of our discussion, we are over the target. Don’t let Them win. Please give a listen, and share with others.