If you read Lightning Bug strictly for clinical content, skip to the P.S.S. at the end, and come back in two weeks, because today and next week, I’m going for the pure pleasure of Marsland family-style storytelling. Next week I’ll write about gambling on a used car, and in the third installment, the misadventures of patients seeking that magic bullet, no matter the cost or outcome.
VERY RECENT PAST
Ominous sky, Ocean City, NJ
Almost every summer since I was developing in my mother‘s womb, the Marsland clan has gathered in Ocean City New, Jersey in one configuration or another. This is largely due to the generosity and hosting of my aunt Sue and uncle Bruce. This last June I headed down to Ocean City in my recently acquired Volvo C30, while my wife stayed behind in Ithaca. Sometimes a girl just needs some alone time.
Trying to crack up Uncle Bruce with my chicken hat from Hoyt’s 5 and 10
My uncle Bruce has been interested in horses and racetrack betting since he was six years old, hanging out at the local race track near where he and my dad grew up in Southeastern Pennsylvania. He’ll usually come down to the shore for the first couple of days, get restless, and head up to Atlantic City for an afternoon and then head back to Delaware. He’ll come back down to the shore later in the week.
My cousin Danny, and second cousin Summer left mid-week so that the remaining Marslands were me, my cousin Lisa, my second cousin Emily and my aunt Sue. While we were lounging on the beach soaking up the sun one afternoon Lisa had the idea that we should all go to Atlantic City that evening. I’ve only ever been to Atlantic City once, when we saw an Elvis impersonator with my aunt Sue and uncle Bruce, so I said “Why not?”
Our general plan was that each of us would allocate twenty bucks for the slot machines and see how things went. I hung back and Emily went first. I was just taking it all in. The lights, the sounds, the characters, the cigarette smoke. Standing in the non-smoking section, I was getting more secondhand smoke than I remember since being a kid in some restaurant with the same absurd idea. All the smokers were seated over here and all the non-smokers were seated over there, as if we weren’t all sharing the same air.
Summer and Emily surfing a wall
Emily is a sassy young woman. I wouldn’t expect any different from the only child of a sassy mother and a spitfire father. She comes by it naturally. With a couple pulls of the lever and a few pushes of buttons, she had already lost five bucks. “This sucks. Why does anyone do this? This is really dumb. I don’t know why we came here. I don’t like this.” Next.
We wandered into a different section of slot machines and Sue took some turns. At least two times on our way over there, one of the security officers stopped us to ask Emily for ID. That’s what you get for looking so young and pretty. Sue didn’t lose quite as badly as Emily, but the net effect was a loss. Next.
We walked around a little bit until we settled into another section of slot machines and Lisa began to play. I stood behind her, fascinated. Although Emily‘s luck wasn’t great, she seemed to be good luck for Lisa, because the numbers kept on climbing. Before long, Lisa had converted $20 into nearly $90 in credit.
Lisa then had her second good idea of the evening, which was that we go to the bar and get some drinks with her winnings. We took “our” receipts to the cashier and then moved on to the bar.
If you enjoy casinos, please don’t take any offense at my impression, but my experience was that it was all a bit of a freak show. The glazed look of people sitting in front of machines who appeared to have been there so long that there were cobwebs growing on them was disturbing. There was no end to the variety of human beings engaged in this activity. Our waitress looked like an anorexic Farrah Fawcett with Botox lips and frosted hair on stilettos. I think her name was Heather. Looking around, I felt like we were the obvious outliers, in our Lands End and L.L. Bean beach garb, but maybe in this bizarre Twilight Zone of the casino, it doesn’t matter—-come one, come all.
I’d never been to a casino per se, I had never played slot machine, and I thought I would go for three of three and order a drink I’ve never had before. So, I ordered a martini. Little did I know how complicated this would be. Having watched endless episodes of M*A*S*H, I thought that all people made martinis with gin and vermouth, and when the waitress-a-la-Farah-Fawcett asked me if I wanted vodka in my martini, I said “No thank you, can I please have a classic martini with gin?” That garnered a pouty puff of Botox lips. The drinks came, including my martini in a classic martini glass with two enormous green olives on a toothpick. I took my first sip as the three ladies scrutinized me to see what my reaction was going to be. Not bad. Different. The olives were delicious.
We had a nice visit and enjoyed our drinks. $90 later, Lisa asked me “Are you going to play the slot machine Scott?” I guess I was. Not knowing casino etiquette, I asked if it would be OK to take our glasses back onto the floor as I was enjoying the look of my martini glass. Yes, I was getting into this.
Now it was my turn. I sat down at the machine next to Lisa and bet “big.“. At least the first five pulls of the lever brought wins and very quickly I was up to $70. Aunt Sue was standing next to me and that was when she said “You should decide now how much you’re willing to lose and when you’re going to stop.” Wise words from experience, not so easy to follow. With about 10 more pulls, I had decreased my earnings by $20 and stopped.
Me, Lisa and Emily at the slots
Against her protest, I gave Lisa my net winnings and happily pocketed my $20 bill back in my wallet as the buzz of my Martini continued to slowly creep over me. An aside; you all know that there are families which fight over paying the bill and then there are families which FIGHT over paying the bill. Thankfully, in the Marsland family, you typically have to be sneaky about paying the bill in order to show your appreciation. I’ve learned to duck out to the bathroom and hand my debit card to the waitress.
Having had a nice time, feeling flush with our winnings, having enjoyed our very expensive alcohol, we called it an evening and headed to the parking garage. When we came to the parking attendant booth, he asked if any of us had a club card. Aunt Sue said yes she had one, but she hadn’t brought it with him. He gave us a $10,000 smile and said “You’re good!” and lifted the gate. We all cheered! When you are a small -time once-in-a-lifetime gambler, saving $10 on parking can feel like five cherries just lined up on your slot machine.
P.S.
Thanks to those of you who answered the reader survey re: a book group. Only subscribers with an email on file received it, as I’m not sure how else to ask you. The results can be seen at this link. It looks like Turtles All the Way Down, Vaccine Science and Myth, Edited by Zoey O’Toole and Mary Hollan will be first up. I’m reading it right now, and will propose a date and time in the next month.
P.S.S.
Give me an extra day and I will go wild! Lightning Bug now has two indexed lists of previous editions and their contents. Both are alphabetized, one by title, and a shorter one by clinical content. I plan to keep updating this periodically.
The ferry leaving Bridgeport, CT for Port Jefferson, NY
In my Substack Road trip I made reference to traveling to Long Island to pick up a 2011 Volvo C30. I did this back in April 2024. The entire day was an adventure, as I set off with $5300 in cash in a money belt strapped inside my shirt, feeling like I was going to conclude a drug deal. My favorite part of the trip was the ferry from Bridgeport, Connecticut to Port Jefferson, New York and back. When I lived in Denmark, I always enjoyed the ferry rides between Jutland and Sjaelland. Some ferries in Denmark have a lavish buffet with their open face sandwiches that are delicious. And then there’s the good Danish beer.
Love at first sight, in a back parking lot
In the four months since I bought the C30, I have had a lot of time for buyer’s regret. I was so focused on my desire to come home with THAT car, that I willfully overlooked numerous flaws, which would have nixed my decision if I was in a more rational state. There are numerous significant impairments (aka dents) to the car’s quarter panels. It has had a couple of brushes up against poles or other cars that it shouldn’t have, and although they aren’t rusting, they are certainly not in mint condition. The windshield had a crack in the bottom right corner, not obvious to casual observation, but a full-stop roadblock to passing NYS inspection. This was later replaced to the tune of $400. The battery needed to be jumped before I even left the seller’s parking lot. Replacing the battery was another $400. (We favor sturdier batteries for the cold New York winters). The air conditioning wasn’t working, although the seller had stated in his Craigslist ad that it ran crisply cool. There was a check engine light on which he vaguely reassured me was because of some recent repairs to the engine and “After driving 50 miles it will turn off.” The right fog light was broken. The back left reflector was cracked. Probably the most significant thing, which is more a matter of aesthetic, but has definitely impacted my enjoyment of the car, is that it smells like dog. It does not have a sweet smell.
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The list goes on. When I got it back to Ithaca, I took the car to the dynamic duo which we have trusted for more than twenty years. Ana Snyder runs the front of the shop and her father Art Snyder makes it happen under the hood. Art taught at BOCES for a while and any visit to his shop is likely to get you a lecture in physics, chemistry, and mechanical engineering.
Because they are located twenty minutes outside of Ithaca, over the years I have typically brought our car to the shop and waited in their pleasant and cozy porch, or in warmer weather, outside, where one can enjoy their extensive plantings and abundant avian visitors. Art’s classic line after he has looked over your vehicle, ambled out of the shop and up the steps to the porch, is “Well, there’s the good, the bad, and the ugly. Which would you like first?”
After Art inspected the C30, I don’t think there was anything good. He said, “Well Scott, you’ve inherited a few problems.” And smiled. The timing belt needed adjustment. There were carbon deposits inside the cylinders. A section of the exhaust system was rusted and broken. There was an oil leak of uncertain origin. The air conditioning needed diagnosis. The left rear shock had lost all of its fluids, so that both rear shocks needed to be replaced. The total bill was about $2000. My $5300 bargain, if you count the windshield, the battery, and registration, etc. was now an $8000 car. Even after that work was done, the steering wheel still tilted to the right, and would need realignment or at least centering.
Then I had a brief period of trouble free enjoyment. With a new shocks, the car didn’t go KER-THUNK every time I hit one of the many, many Ithacan potholes. The acceleration on this little car is just amazing, owing to a five cylinder transverse engine and a manual six speed clutch. I made some effort to eradicate the foul smell of the car and it faded a little bit. Combined with a little denial, it smelled just fine, especially with the windows down.
I took care of some little issues myself. I replaced the right front fog light. I replaced the back left cracked reflector. I replaced the two rear license plates lights, as it wouldn’t pass inspection without those. I got a new handle for the inside hatch. I even replaced the Volvo logo on the grill, which made it look sharper. Then I took it to the local Volvo shop to get inspected, as Snyder’s recently gave up on the expense and hassle of handling New York State vehicle inspections. It passed!
In June, I drove the C30 from Ithaca to Ocean City, New Jersey and back. One of my goals for that trip was to drive for as long and fast as I could in order to heat up the engine block and catalytic converter to help burn off some of the carbon deposits Art had noted during his post-purchase inspection. The Atlantic City Expressway was especially helpful in this regard. While in Ocean City, I asked my cousin Danny to go for a drive with me. With Danny at the wheel, we headed off the island of Ocean City to some back roads where he could put the car through its paces, and this demonstrated to me that the C30 had even more muscle than I had thought.
Back up cameras were not standard back in 2011 and I had only been in Ocean City two days when I managed to crack the right rear tail light backing into the driveway of the place where we were staying. I felt nauseous because I saw dollar signs and figured that little mistake was gonna cost me at least $300. When I got back to Ithaca, I dropped the car off at the Volvo shop. I had made this appointment weeks ahead because they are so busy. The original plan was for them to center the steering wheel, but while at the shore I had called and asked if they could order the right rear tail light for replacement while they were at it.
Hairy-legged ballerina atop tutu-adorned Volvos in the Ithaca Festival parade
Why didn’t I take the car to Snyder’s? That is a fair question, and the best explanation (excuse?) I have is that the Volvo shop is a ten minute walk from our home and they have decades of experience in maintaining and repairing Volvos. Ithaca is a Volvo town, or anyway it used to be, but now it’s becoming a Subaru town. Maybe a Tesla town next. The annual Ithaca festival has a parade in which a dedicated group of Volvo owners drive their cars with ballerina skirts around them while hairy-legged men in ballerina outfits dance around and on top of the cars. This pre-dated the popularization of trans culture. If you think that sounds bizarre, it is. Not to be outdone, in recent years, Subaru owners formed their own parade contingent and perform the Subaru Samba with synchronized door opening and closing. My colleague Dr Fazio recently told me that Prius owners had a brief period with their own contingent, but we agreed that although Priuses get good mileage, they aren’t nearly as cool.
So, the Volvo place is close, a ten minute walk away, but it is also kind of a pain in the ass to drop the car off on Sunday night and pick it up on Monday after work. Which leads into how I managed to have five visits with them over the period of two months. When I went to pick the car up the first Monday night I saw that the bill was $150. That told me that they hadn’t replaced the tail light. A back-and-forth ensued between me and the owner, in which I asked about the tail light and at first, he said they hadn’t ordered it. Then he double-checked in the back room, returning to say, “Actually, it’s in the back, and we forgot to do it, but it’s late, so we’ll have to reschedule.” At least the steering wheel was centered.
Two weeks later, we dropped the Volvo off again on Sunday night. I left a note with the keys in the dropbox saying that I heard an odd sound coming from the left front of the car. At the short, my cousin Danny had thought there might be something wrong with a wheel bearing. When I went to pick the car up Monday night. The invoice said ninety bucks and I thought “Shit!” They didn’t do the tail light again. Another conversation ensued with the owner, in which he said the sound from the left front of the car was due to part of the inside of the wheel housing rubbing against the wheel when it was turned. He was sorry that they hadn’t done the light, but it was late and they were busy, so we would have to reschedule. I asked him if he would be so kind as to double check that they had the right rear tail light waiting. He went to the back for a minute, and when he returned, he said “It’s a good thing you asked, because it looks like we ordered the left rear tail light. We’ll have to order another one.” I said “Well, if we make another appointment in two weeks do you think that the light will be in?” he said “Absolutely.”
Two weeks later, we dropped the car off on a Sunday night (need I mention that this was quickly getting old?) I left a note with my key adding two requests. One was that the mechanic please turn off the “needs mechanical service” light which automatically comes up at 150,000 miles. The other was that the ABS warning light had come on briefly, indicating that there was a malfunction and then turned off the next day.
When I returned on Monday night, the tail light…had not been replaced. The mechanic turned off the check engine light and evaluated the ABS issue, cleaning the sensors, but somehow didn’t get to the light. I know, I know. Some of you are saying “Don’t go back!” Yes, I had another conversation with the owner. He was apologetic about not replacing the light, but not amazingly so. He said yes, it’s too late. We’ll have to reschedule you again. I took note of the mechanic’s typewritten message on the invoice, which said that the serpentine belt was old and should probably be replaced. Ever the eager learner, I asked the owner to clarify for me the difference between a timing belt and a serpentine belt, because I knew that the timing belt had been replaced at 110,000 miles, and we were now at 149.000 miles. He adeptly explained the difference between the two, which left me with the impression that replacing a serpentine belt was a relatively brief and inexpensive job costing a few hundred dollars.
We brought the car back on a Sunday night two weeks later. I had a lot of visits in the office the next day, and was not able to get downtown to pay the bill before the Volvo shop closed. I asked my beloved wife Kerrie to do so in my stead and she texted me that the bill was $1500. Holy shit! That Monday we picked it up after hours. As soon as I turned the key in the ignition, I knew that something was wrong. There was a new, unpleasant sound coming from the front of the car, which sounded like an exhaust system gone awry. I drove home with a heavy heart, popped the hood in the driveway and could hear the sound and smell the exhaust rising directly from the engine compartment. No Bueno.
I called the owner of the Volvo shop first thing Monday. If you haven’t figured out by now from reading my Substack, I have a long fuse, but when you get to the end of it, I have one hell of a temper. I’ll call it a Marsland family trait, no matter your gender. To my credit, I kept my language clean and my tone civil. I explained my disappointment that I had dropped off the car for a limited specific job and got the car back with a new problem that the mechanic should have heard while driving the car out of the garage and investigated further. The owner didn’t disagree with me, and this time, rather than making me one wait two more weeks, he agreed to have the car come back in in the next day or so.
When I talked to the owner in our next conversation, he said “Yes, you were right. There is a problem with the exhaust system. The gaskets for the manifold need to be replaced and that is about a $600 job. But, that has nothing to do with replacing the timing belt and would have happened anyway. “ I didn’t argue.
My memory finally caught up with the current situation and I recalled that there had been a sticker on the engine block when I bought the C30 indicating that the timing belt had been replaced at 110,000 miles. The Volvo mechanic had conspicuously removed it. I took the car in for replacement of a serpentine belt, and they replaced that and the timing belt. They charged me an extra $1000 for their effort, and gave me back a car with a new problem. That evening was when I noticed the fluid leaking under the car. Oh no. The next day when I was driving home from an errand, the steering got funky and I barely made it around a corner using all my strengths to turn the wheel. I pulled into the driveway and said “That’s it! Time to go to Snyders.”
I had AAA tow the car to Snyder’s repair shop. I didn’t expect rocket-fast service, because I was abruptly dropping my tale of woe upon them. The next week I got an email from Anna and the report was far worse than I could’ve imagined. All the fluid had leaked out of the boot for the steering system and the rack and pinion would need to be replaced. $2300. The exhaust system was damaged where the flex pipe exited the engine block and would need to be replaced, including the expensive catalytic converter, which would cost $5300. The water pump needed replacement, which at minimum would be a $700 job, but there might be other issues while repairing that. The caveat was that the total cost was uncertain. My $5300 bargain now needed an infusion of $8300 at minimum to be roadworthy. My first response to Anna was to ask, “Have you ever donated a car to a charitable organization?”
I’ll tell you that I’m a performance-improvement-oriented person. I think that is one of the things that makes me a good clinician at the Leading Edge Clinic. I’m observant, and although I can make mistakes like any other human being, I tend to learn more quickly from them and correct course. I’ve had several weeks to reflect upon my decision-making and path with the C30. I know that there were many signals from the beginning that this car would be trouble and that I should leave it alone.
I got to speak with Ana and Art in person last week. It helps to have known each other for 20 years. They were both very kind. They are both faithful Christians and very gentle people who are slow to blame, but in our conversation they were both crystal clear that the damage to the exhaust system was directly related to the timing belt replacement, which didn’t need to happen.
Anna said “You can just chalk this up to a midlife crisis.” I’ll tell you that, at least up until this moment, I didn’t think that I was having a mid-life crisis, I thought I was having an I bought a junky used car that I shouldn’t have and now it’s broken crisis, but hey, Anna was calling it as she saw it. I replied, “A very expensive midlife crisis.” Anna replied, “They always are Scott, they always are.”
Art’s therapeutic commentary related to his love of flying. When you are standing inside the shop getting your invoice and paying your bill, aside from one of the many cats walking around, you will see a photo of a younger Art Snyder shaking hands with another man in front of a single turboprop plane with the caption that he had just received his complex flying license. I also know that Art belongs to the East Hill Flying Club here in Ithaca, because we had once attended a pancake breakfast fundraiser at his invitation. Art said “Sandy [his wife] says that flying is a very expensive hobby, but it’s a lot cheaper than seeing a Psychiatrist.“ Thanks Anna and Art. Between the two of them, I left our conversation with the decision that one way or another, I would be driving a C30, and that was okay.
Waiting for the ferry back to Bridgeport, CT
P.S. After an Art’s diagnosis of the C30, the Volvo shop agreed to repair the exhaust system without charge. It’s not going to the junkyard just yet.
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Dr Pierre Kory opened our telemedicine practice, the Advanced COVID-19 Care Center, in February of 2022. We became partners in June of 2022, followed by renaming our practice the Leading Edge Clinic. In the years since than time, we have learned a lot about how to prevent COVID, treat acute COVID, and care for patients with post acute sequelae of COVID (PASC) and injury from the COVID shots. I really don’t want to call them vaccines because, in truth, they are experimental, genetic therapy products at best, and bioweapons at worst.
As someone injured by the COVID shots, I’m very sympathetic to patients who become frustrated with the slow pace and not-so-linear path of recovery. At times, they turn in desperation to novel therapies, clinicians and practices which make promises of effective treatment – and frequently charge a hefty sum for their services. Part three of my series on Winning for losing is where I was headed all along. I wanted to make you laugh and smile with stories of small time gambling in part one, and shared my car follies in part two, because when we delve into the misadventures of my patients, it can get pretty dark.
The Leading Edge Clinic is a cash-payment telemedicine practice, and our fee structure can be shocking to anyone who has only ever paid co-pays for shitty conventional healthcare. Our prices reflect the true cost of delivering quality care, in which you spend a lengthy period of time in a visit with an expert clinician. Our course of care utilizes live, highly trained and knowledgeable Registered Nurses to deliver patient education and perform regular clinical follow ups, rather than Medical Assistants or computer bots. Thanks to Pierre’s relationship with the FLCCC Alliance, we have a very modest pro-bono fund which we can utilize to supplement care for existing patients, and once in a great while, a new patient.
In this context, I don’t blame a patient when they decide to bet it all on the roulette wheel of treatment. It’s just that, most of the time, it doesn’t turn out very well. One thing I have learned in our care of PASC and vaccine injury, is that ongoing trials of treatment, over time, is what has the greatest long-term benefit. There is no magic cure, in part, because we are living in a world contaminated with spike, and like a lobster trying to crawl out of the tank, as soon as you reach the top, another lobster may pull you right back into the morass. Recovering from PASC and injury by COVID shots is certainly not for the faint of heart.
A few weeks ago, during my ritual visit to the Ithaca Farmers Market, I stopped at the stand for Christi Sobel and bought four boxes of cards featuring her original artwork. Why would I do that? Because in the last two months, three patients have died, and when they do, I want to send a personal note to the survivors. Caring for PASC and the vaccine injured, and more recently, cancer patients, is not for the faint of heart either.
I’ll preface the stories below with the assertion that most of the practitioners who these patients went to are “the good guys.” My writing isn’t meant to pick on any of them, but rather to illustrate how much time, effort and money can be expended without clinical improvement for individual patients. This is the strongest argument I can make for the wisdom of limited, successive trials of therapy, with steady, modest gains, as the most successful path forward. All patients’ names are changed to protect their identity, but their stories are true.
Life’s a casino I’m telling you And everybody’s playing Boys and girls women children Me and you The dice are loaded And everything’s fixed Even a hobo would tell you this
MILLY
Milly had been a writer before vaccine injury, and made a decent living at it. She was very proud of her sharp mind and financial independence. The shots changed all that, and there wasn’t a single visit with me in which she didn’t shed some tears or offer a few choice words for the rat-bastards who did this to her. If only she could get her hands on them. In my estimation, we were making steady progress, but, as happens sometimes, the incremental improvements only made her hungrier to be completely recovered. The day came when her package of visits was completed, and rather than sign up for another four months of care, she pivoted to a different solution. It was a clinic which promised redemption, for the small price of $20,000. She dipped into her life savings, and put herself at their mercy. They drew blood, tested urine, performed a wide range of studies which I had never before (or since) encountered, made pronouncements about her diagnosis, delivered an arsenal of proprietary pills and potions, and…she got worse. Just like with the slot machines in Atlantic City and a used car dealer on Long Island, there was no guarantee of success, satisfaction, or your money back.
She felt depleted, distraught, and humiliated. We didn’t hear from her for several months, as she gathered the gumption to return to us and relate what had happened, asking if we would take her back, while gathering up the pieces of her remaining health and trying again to rebuild some semblance of a functioning life. We did start again, and as we keep on learning, we were actually able to help her regain lost ground. There was, however, a new tension to each visit, because now Milly was $20,000 poorer, so that the cost of each visit, test, supplement or prescription, became a constant source of contention and complaint.
SUE
Sue is in her early twenties, and comes from a very modest working family in a Southern state. She has long standing mental health issues which have compelled her to continue living at home with her parents when she would have rather been living on her own. Upon the recommendation of her family’s long-time PCP, she received two mRNA COVID shots; the second one despite adverse reactions and an Emergency Department (ED) visit within hours of the first. Her health deteriorated rapidly, and she suffered a wide range of symptoms, from debilitating headaches, skyrocketing anxiety, chest pain, dyspnea, dizziness, palpitations, POTS (rapid heart rate with position changes and minimal exertion), severe bilateral leg pain, and neuropathy. She spent days in bed or on the couch due to soul-crushing fatigue.
Her family dipped into their life savings and paid for Sue to travel with her parents to Los Angeles, CA, home to one of two clinics run by AMA Regenerative Medicine & Skincare Inc., founded in 1999 by Dr. Alice Pien and Dr. Asher Milgrom. Pierre knows Dr Milgrom to be a talented physician and fine human being; he presented at the first FLCCC Conference in October 2022. AMA focuses on use of five central therapies, which include IV ozone therapy, EBOO/F, and IV therapies, which effectively target mitochondrial health. AMA reports that together with stem cells and hyperbaric oxygen, their treatment has resulted in a speedy and complete recovery for approximately 70% of their patients. Unfortunately, after spending about three weeks in California receiving treatment from AMA, Sue was worse, and headed home with her parents. The center continued to call them for weeks, encouraging Sue to return for more treatment, but her parents had used up what money they had; there would not be another visit.
Months after this disappointing – and discouraging – trip, Sue and her mother had their first visit with me. It was challenging, because her symptom burden was so severe, and her anxiety so high, that the outline of pathology and treatment which I explained overwhelmed Sue. As I recall, she didn’t start any of the medications which I ordered, and didn’t show up for her second or third visits. At least six months passed, and we heard from Sue’s mother, signing her up again. At that time, Sue said she was now ready to try the interventions which we had initially discussed. Between Sue’s first visit with me, and her second visit six months later, I had begun to learn about Iliac Venous Compression (IVC) or May Thurner Syndrome in patients with PASC or those injured by the COVID shots. With my new understanding, Sue’s presentation was more clearly that of a person suffering from IVC, and we initiated plans to have an MR Venogram to evaluate this. The MRV was positive, meaning it showed severe left iliac venous compression, and we set up an initial telemedicine consult with Dr Brooke Spencer, our collaborating Interventional Radiologist in Colorado. Sue traveled to Colorado, had a stent placed, and returned home, showing excellent improvements over the next weeks. She is still a patient today, and we are steadily addressing the lingering, although significantly decreased symptoms of leg pain, headaches, and cognitive impairment. She has initiated treatment with Sulodexide, which is showing great promise for repairing injured endothelium, while also dramatically lowering microclotting, with less bleeding risk than Eliquis or Plavix.
FRANK
Frank is one of the most injured patients I have ever met. He has also spent more money and tried more therapies than any of my patients. Conservatively, by last count, he had spent more than $200,000 on trying to get better. Among the list of physicians he dropped big money with are Dr Bruce Patterson’s team where he paid $1500 per month for Maraviroc, before Patterson dropped the price (as he owns the patent for Maraviroc) to $500 per month. The Maraviroc helped him breathe, but as he reported, “It shrank my stomach to the size of a walnut!” He did countless cytokine panels (Patterson’s proprietary lab), with levels that went up and down with the wind.
Next he traveled to Panama for stem cell therapy, which he later repeated in the Midwest. Since May 2023, we have offered mesenchymal stem cells and exosomes (MSC-Exosomes) to patients. We replicate the stage two clinical trials of Vitti Labs, which use MSC-Exosomes to treat post-COVID pulmonary fibrosis, administering infusions on days one, three and five. But we also administer nebulizations and nasal administration of exosomes. This is about $40,000 worth of therapy for a third of the cost, because unlike most other practices, we aren’t marking it up 400%. I tried several times to persuade Frank to come see us for treatment rather than the physician he chose in California, but ultimately, he made a Hail Mary pass to Hollywood.
In Hollywood, he paid $42,000 to have fat cells sucked out of his body, have the stem cells harvested, and then injected back into him. He was in quite a bit of pain after this treatment, and ultimately, it didn’t help. Amidst his many expensive forays into promising treatments, he would pop in and out of visits with me, checking up on the latest developments we were exploring. I can’t say that I did much better than any other practitioner for Frank, although these days I wish he was still in touch, and that he could try Sulodexide (SDX). The anti-fibrotic properties of SDX offer some promise of reducing the pulmonary fibrosis which continued to plague him.
JENNIFER
Jennifer is a woman in her mid 30s who lives in the Midwest and has always been a clean-eating, physically active, outdoors-oriented person. The vaccines brought all that to an abrupt stop with persistent chest pain and shortness of breath. She has pursued treatment with many different practitioners, and went so far as to travel to Cyprus to have aphoresis treatment with Dr. Marcus Klotz. The out-of-pocket cost for that treatment alone is more than $10,000, not including the airfare and the cost of food and lodging while in Cyprus. Unfortunately, not only did the treatment not help her get better, but long-term, she thinks it led to her clinical deterioration.
Dr Klotz is in the ZeroSpike forum which I participate in with about forty other practitioners worldwide. When he was extolling the virtues of his treatment in the group, I challenged him, because Pierre and I have had consistently negative experiences with aphoresis. Patients either get worse right away, or they have neutral effect, or they have some short-lived benefit before getting worse again. I can’t say that no one ever benefits from it, but when you have negative feedback like this right in front of you, with patients under your care, it makes a stronger impression than a stranger’s testimonial.
After I raised questions, Marcus, to his credit, qualified his statements to say (I’m paraphrasing here) “Well, there are more than forty methods and machines used to perform aphoresis. Most of them don’t work very well and some make patients worse. We are using The Big Green Monster, a machine which is no longer produced, very technically challenging to learn how to use and maintain, and we only have them in our clinics in Germany and Cyprus.”
Okay, that sounded more consistent with our clinical experience. During one of her most recent visits, Jennifer filled me in on some of the details around her experience in Cyprus. “I have a bone to pick with Marcus. When I was in Cyprus, I asked him for data about the treatments that they were giving, and what the mechanisms of action were. He tapped his head and said, ‘It’s all up here.’” She went on to note that she herself was a scientist, and told Marcus point-blank,“That is not how science works Marcus. You need to keep track of data and be able to present the factual evidence of your clinical successes, and failures, mechanisms of action, and the rationale for treatment.”
INSPIRATION
Sister Calista Roy
When I was in nursing school in the early 1990s, one of our assignments was to identify a nursing philosophy which we found compelling, and write about it. At the time, because I was working full-time and going to school full-time, it felt like a poor use of my time, and not immediately relevant to my practice. Over the last thirty years, I have slowly come to appreciate the value of this exercise. The nursing philosopher I chose to study was Sister Calista Roy, who taught at Boston College and developed the adaptation model of nursing.
Originally, Roy wrote that health and illness are on a continuum with many different states or degrees possible. More recently, she states that health is the process of being and becoming an integrated and whole person. Roy’s goal for nursing is “the promotion of adaptation in each of the four modes, thereby contributing to the person’s health, quality of life and dying with dignity”. These four modes are physiological, self-concept, role function and interdependence.
I think the most important insight of her philosophy is this: health is not merely the absence of disease or infirmity, but reflects the individual’s ability to adapt to various environmental stimuli. Health exists on a continuum and is constantly changing based on the person’s ability to respond and adapt to changes in their environment. A healthy person is one who can successfully adapt to physical, emotional, and social challenges, achieving a level of balance and well-being across different dimensions of life.
This is not just a matter of semantics. As more and more of us struggle with chronic health challenges, it is a very practical matter to reframe our definition of health to include adaptability and support a positive sense of self. Last week I spoke with two patients, both far along in their recovery, which has been noteworthy to family and friends. Yet those patients think they have made no progress. Until they have reached 100% recovery, they think that they are unwell. A shift in perspective will serve them better.
OUR PATIENTS
I will be the first (maybe the second, because the patients will say this first), to say that not every patient story of treatment with us represents a resounding clinical success. None of us was taught in school how to treat injury from a bio-weapon! What I can also say is that every one of the twenty people who work in our practice cares deeply, has suffered financial losses, has endured persecution for acting on their/our convictions, and is mission-driven. This is not just a job for us. It is a calling.
When patients discontinue care with our clinic, we don’t hold it against them or take it personally. As Pierre has said to our team many times “If I was vaccine injured, I would also be doing everything I could to recover.” We don’t blow ozone up people’s asses, we don’t have an HBOT facility, and we don’t do aphoresis. We do continue to learn from our own research, and from our patients themselves. We have provided stem cell and exosome therapy to a limited number of patients, more than half of whom have benefited from it. We continue to add services for our patients. Aly Burt, RN is skillfully providing the Safe and Sound Protocol to help stabilize the vagus nerve in patients with dysautonomia and adrenal fatigue. We continue to advance our treatment of patients with safer anticoagulation which actually heals the endothelium and more effectively breaks down the fibrotic changes directly and indirectly provoked by the spike protein. Dr Sid Lawler is our Medical Director of Adjunctive Cancer Care, who brings her twenty years of clinical experience as a hospitalist. She is leading our participation in a five year study using repurposed supplements and prescription medications, in conjunction with a keto diet.
Our scheduling, nursing and medical team includes people who have PASC or have been vaccine injured themselves, and whom we have recruited to join our team. Our experience has been that from the front end to the back of the house, people who have gone through what you are going through are often in the best position to be empathetic and provide insightful and informed care. As someone who is injured by the Covid shots, I would say the same about myself. At the end of the day, we are all looking for a path to winning from losing.
A Burning Soul, glasswork by KG
P.S. I’m more than halfway through Turtles All The Way Down: Vaccine Science and Myth by Anonymous (Author), Zoey O’Toole (Editor), Mary Holland J.D. (Editor, Foreword). I hope that you have your copy and are reading too, so that you can join me in a live book discussion in the near future.
My mother’s mother was our Baba. Baba was a first-generation American from a Slovak family in Central Pennsylvania. Luckily for me, I spent a lot of time with her growing up, including summer visits to her home in Wyndmoor, PA, where she lived with my Grandpop until his death in 1985. When I was adopted by my paternal grandparents in 1984, I relocated to Parkerford, PA, which put me within an hour’s distance of Baba, and once I had my driver’s license, I could—and did— go visit her.
Baba and I, high school graduation week 1987
The inside of the garage at Baba and Grandpop’s was clean and spare. Along with their two cars, there were two golf bags, his and hers. I think there was a lone snow shovel. But tucked in the back corner there was a huge, black, shiny hunk of Pennsylvania Anthracite coal. I always wondered about this, but never asked. As an adult, it makes perfect sense. Baba wanted to remember from whence she came.
As the second youngest daughter, with three siblings, Baba was the first in her family to leave Coaldale, PA, go to the big city of Philadelphia, and achieve a higher education. She went to secretarial school at the Peirce School of Business, and she boarded in a building nearby at the corner of 14th and Pine Street. Somehow, between her studies, she made it all the way out to Pottstown, PA to Sunnybrook Ballroom for dancing.
Sunnybrook is a stone’s throw from Parkerford. In it’s day it was an elegant place, which began as a swimming club in 1926 with a circular pool that had a lively summertime crowd. During The Great Depression, a ballroom was constructed which became one of country’s great dance floors during the Big Band era of the 1930s-1940s. Both my maternal and paternal grandparents met at Sunnybrook and danced the night away. My junior and senior proms were held at Sunnybrook. For years we would take Nana and my aunts to Sunnybrook for a delicious Mother’s Day brunch. The Eggs Benedict were unbeatable! My Nana and Pop pop’s 50th wedding anniversary was celebrated at—you guessed it—Sunnybrook.
Baba had what I would describe as presence, which I’m guessing went back to her childhood: she was a beautiful, smart, and capable. She was ambitious in the highly motivated manner emblematic of many first-generation American immigrants. She and my Grandpop built a successful restaurant supply business, and were original bondholders for the “new” clubhouse of Whitemarsh Valley Country Club, which was incorporated in 1908. Her name was on every…damn…trophy in the vast display case of the WVCC lobby. I admired her tremendously, and always enjoyed her company. But it could sometimes, actually often, be excruciating to be in Baba’s presence in a restaurant. She expected to be waited on, and was very vocal if the service was less than exemplary. Every time I gather up the cutlery and plates for our waiter or waitress, I think of my Baba and the time she slapped my hand away in WVCC. “You DO NOT clear the table. That is the job of the servers!” Oooh boy. Yet in the next breath she would whisper to me in a conspiring tone, “These haughty Philadelphia blue bloods have no idea that I’m a saloon keeper’s daughter.”
Competitive doesn’t quite capture Baba’s ethos. Yes, she was a fantastic golfer. In her 70s, when she would take me to a little nine hole, par three course called Woody’s (I’m a terrible golfer and WVCC wouldn’t have tolerated the number of divots I produced), we would invariably get matched up with two strong young men as a foursome. She always let them go first, then me. Yes, their swing was strong, and the ball would travel far, as long as they didn’t shank it into the treeline. But Baba, her swing was elegant and her aim was true. I loved, loved, loved to watch their expressions, when my little old lady grandmother in her green pants and bug-eyed sunglasses hit that first ball. Huzzah!!
I could write dozens of stories about my Baba and our adventures, but for today’s purposes, I wanted to wrap up this section with a reference to her skin care routine. It fascinated me. Baba looked…shiny. In her bathrooms she would have enormous jars of Vaseline. As best as I could tell, she would liberally apply this to her entire face on a daily basis. Her bedtime ritual was a gentle wash with Dove soap and warm water, and then a coating of Pond’s facial cream. With her quilted smoker’s jacket, white cream-covered face, and long, thin, brown More cigarettes, she reminded me of a Hollywood actress backstage in her dressing room. Indeed, in my life, she was a star.
RECENT PAST
Between leaving my first primary care job as an FNP-C, becoming embroiled in a two year unionization campaign, and landing at SUNY Upstate, I spent some time exploring aesthetic medicine. My friend and dentist of twenty four years happened to have a fancy-pants laser machine gathering dust in his office. His staff at the time, and his wife/business partner, had been keen on starting an spa as a side hustle, but their enthusiasm quickly petered out. During one of our conversations which took up a good part of a dental visit, he pitched me an offer.
Never would I have imagined that I would be interested in aesthetic medicine. Yet the work was interesting, and turned out to be quite rewarding. Richard, my friend/dentist, first used the laser on me so that I would understand what it felt like. It wasn’t terribly unpleasant. My face felt sunburned for a day. I don’t hold it against him, but my labial folds have been uneven ever since. Geesh! We reviewed the protocols, I read a stack of research papers, and then I started seeking volunteers from among the many female nurses and friends in my life. In fact, the more wrinkles, the more welcome you were.
The most satisfying work I did was with a woman who had been attacked with a knife by an abusive boyfriend. She had a divot and scar in the side of her face that makeup would never hide. I wasn’t able to eliminate it, but by the time we were done, it was much less pronounced. A close friend who told me that premature wrinkles were a curse upon the woman of her family felt that I had given her back three years of youth (I thought five). Another woman who detested the striae (stretch marks) on her abdomen from carrying four children was also thrilled with the results. Aside from treating joint pain, I am empathetic with why women (and some men) would be eager to use collagen if they thought it will help them look younger. During my foray into aesthetic laser work, essentially I got to make some women happy, and see the lift in their smile and self-estimation. Not a bad way to make a living.
PRESENT
There are three main points I want to cover in this second part of my collagen case series: how our bodies have changed, a potential mechanism of action for collagen to promote pathology, and some limited observations about Vitamin K2.
Before I go there, I’ll mention that my colleague Dr JP Saleeby wrote a brief Substack on the topic of collagen a few weeks ago. I value the perspective of such a learned practitioner. Knowledgeable criticism from his clinical experience should only shed light on the topic. JP uses modified anticoagulation, avoiding Plavix, and infrequently measures micro clotting as we do, because of the logistical challenges of completing it. The synopsis is that we shouldn’t throw the baby out with the bone broth.
I also note that a Registered Nurse writing for The Epoch Times wrote an electronic article, now printed in the most recent paper edition, which extols the virtues of collagen and enthusiastically encourages its use. I share these references with you so that you will understand that while my perspective is based in what I see with my own eyes and brain in front of me, it is a minority view.
The bodies which we inhabit today have been transformed from those we inhabited pre-pandemic. In areas of the world with vaccination levels between 70-90%, we can expect that everyone has microclotting, from direct injection of spike promoting molecules, or receipt of spike into our bodies from shedding. Spike has traveled to every part of our bodies. It is the most toxic pathogen known to modern medicine, and has a very lengthy list of potential pathologies which it promotes. See pages 9-10 of the FLCCC I-RECOVER Protocol for a list. When you speak to any physician, it is fair to ask her/him, “What is your understanding of spike protein, the pathologies it engenders, and how to treat them?” If you are rewarded with a deer-in-the-headlights look, at least you know that the expert in front of you has an expiration date: November 2019. Any claim to expertise in the realm of medicine which preceded that date, stops at the doorway to spikopathy. Clinicians who aren’t curious or motivated to learn about the spike protein which has poisoned more than five billion people are less capable of accurately evaluating, testing, diagnosing and treating you. In fact, they could be dangerous to your health.
I don’t know if collagen was harming or helping us before November 2019. One reader shared her experience with how it healed her Doberman. Another pointed out that she wasn’t using it simply for reasons of vanity (skin/hair/nails), but to help aching joints function better. The question however is not whether collagen used to help or harm us, but rather this: given what we know about how the spike protein has altered our bodies, is it possible that collagen is deepening that harm? My clinical observations tell me that the answer is yes.
The next question is, how might collagen be harming us? As you read in the first part of my case series from last week, and now in the second part this week, you will see that I’m focused on the amyloid fibrin microclotting which is measured in our patients at the Leading Edge Clinic. In particular, when the microclotting score of a patient, and then another, didn’t drop after months of anticoagulation therapy, I wanted to learn why. The common thread was collagen.
This week however, in a visit with a patient who has had a tortuous postoperative course following major surgery, another possible explanation began to emerge, which is the impact of collagen on mast cells. Aside from microclotting, a second way in which our bodies have changed is that our mast cells have been dysregulated. The Epoch Times had an excellent article on the subject recently. My appreciation for the profound impact of mast cell activation syndrome (MCAS) on the clinical trajectory of patients with post-acute sequelae of COVID (PASC) and vaccine injury has only grown over time. Dr Lawrence Afrin is the eminent expert on the subject, and I recommend his accessible book Never Bet Against Occam: Mast Cell Activation Disease. Even more accessible is the website of my beloved colleague, Dr Tina Peers in the UK. Her recommendations of NAC Augmentata and Arc Microtech microcurrent technology have made a profound impact upon our patient care.
It turns out that collagen impacts MCAS. This isn’t a scientific reference, but it’s a good place to start digging. From the website of an Australian collagen vendor, Nutraviva:
How Does This Impact People With Sensitivities To Histamine?
Unfortunately for people sensitive to histamines, bovinecollagen powder supplements, gelatin, and bone broths can present a challenge. Histamines can be present in certain species of fish so choosing Marine Collagen as an alternative may not always be the best option either. The appropriateness of a collagen supplement is also very individualised and dependent on the individual’s level of tolerance, so one product may be more suitable than another.
If you have a dietary histamine sensitivity or Mast Cell Activation Syndrome (severe, clinically diagnosed histamine intolerance) then a collagen protein powder or bone broth may not be appropriate due to their sourcing and long processing/cooking times and the bioaccumulation of histamine from a range of foods sources within a time frame, which may increase levels of histamine overall.
A few words of explanation are in order. Among the hundreds of cytokines released by mast cells, there is the cytokine IL-6. This is a cytokine which we are targeting with low-dose Naltrexone (LDN) when treating PASC and vax injury. Among it’s many roles, IL-6 elevation is provocative of …abnormal clotting. And cancer. Mast cells which have become hyperactivated are releasing IL-6 throughout the body. People with hyperactivated mast cells who ingest collagen, according to some Aussies who make the stuff anyway, are going to have trouble. They will release more Il-6. And, the patients will experience more coagulopathy. Which comes first, MCAS or clotting? If someone has both, I’m not sure how much that matters.
Now on to Vitamin K2. (Ooof, I can hear the experts howling to the rafters already). As with collagen, there have been signals of trouble from my patients. When you spend an hour with a patient (as opposed to a ten minute McSick Care visit), there is time to listen and ask questions. I like the rule of three. By the time the third patient says, “You know doc, when I started that K2, I just felt like my blood was sludgy”, she/he has my full attention and intent curiosity.
In the fourteen years I spent in the Emergency Department setting, I administered IV Vitamin K2 less than twenty times. It’s what we do for a patient who is on Warfarin/Coumadin and has a gastrointestinal bleed. K2 is an antidote, by way of blocking one pathway in what we call the clotting cascade. The dose is 10mg in an IV bag over at least thirty minutes.
Our patients are uniformly taking 100-200mcg of Vitamin K2 because they are also taking high dose Vitamin D3, and they have been instructed to do so. The understanding is that K2 helps prevent deposition of calcium deposits along the walls of our blood vessels as a result of how Vitamin D3 at high doses modulates calcium metabolism and absorption. Fair enough. But wait, what might be different in our bodies since November 2019? I know this doesn’t make sense, because the ratio is obscenely out of balance. But, could 100 mcg of Vitamin K2, which is 1/1000th of the dose given to reverse a GI bleed, possibly increase clotting in a PASC or vax injured patient? I think so.
I’m a sailor, so I’ll put it to you in sailing terms. Sailing into a north wind, the boat will be upright, the mast straight, the sail luffing. Sailing 28 degrees northwest or northeast of a north wind, the sails will fill and the boat will lean (heel) to the side. Pre-pandemic, if you gave Vitamin K to someone who was bleeding, it would be like steering your boat back towards the north wind, and your ship would right itself. Currently, with all of us microclotting, it’s as if we are moving fast and heeling hard, with one edge of our boat dipping into the water. Then you turn away from the wind just a smidgen more, say 30 degrees, 100mcg of Vitamin K2, and in rough weather, the water may start splashing over the sides.
If a patient is taking Nattokinase, at least 6,000 fu daily, I have little concern about them accumulating calcifications along their blood vessels. The reason the Japanese live to be eighty, don’t have dementia, are still physically active, is because the slimy, stinky, fermented soy they eat—Natto–has Nattokinase, which gently prevents and removes such plaques. To keep the ship sailing without taking on water, I will guide patients who are on Nattokinase to stop their Vitamin K2. I also caution them to avoid super green powders, which have concentrated Vitamin K1, as there have been signals of similar concerns with this. Basically, get your Vitamin K from your food. Do I have the same level of concern about Vitamin K2 and supergreen powders as collagen? No. But if you were my patient, we would discuss the risks versus benefits and come up with the answer which is right for your individual case. This is the art of medicine.
What follows are six more case studies in which I think collagen is an active dynamic. They are necessarily works in progress and incomplete. I will follow up with a third Substack in the future as we recheck labs and observe for clinical responses with discontinuation of collagen.
Patient 8
61 yo male, x2 mRNA + booster, last shot 7/22, onset of symptoms 8/22, vaccine injured. First visit 9/22. Hx IBS, eczema, psoriasis, bilateral mediatsinal lymphadenopathy. No surgeries declared. Reported facial flushing, sudden sense of heat, numbness/tingling of nose, mouth, fullness in ears — like underwater, insomnia, occasional dizziness with standing, myalgias, groin discomfort, chest discomfort, depression/anxierty, mild brain fog, rash on chest, post exertional malaise. Strong signal of MCAS. Initiated IVM and has used on/off, with LDN on/off , Nattokinase, Neprinol, NAC Augmentata, Turmeric, Garlic. Labs 2/23 show reactivated EBV, spike ab 24,330 U/mL. 8/23 testing showed 4 of 4 microclotting. PAI-1 5G/5G polymorphism, which should have placed him in the lowest risk category for venous thromboembolism. Started Aspirin 8/23, Plavix 11/23. Long-term workup for iliac venous compression started. By 11/23, spike ab down to 11,671 U/mL. During 1/24 visit, in response to quesitons from this provider, patient reported that he stopped collagen-protein peptides 20gm per day in November of 2022(after vaccine injury), because of concerns upon reading more medical literature on the topic.
Patient 9
67 yo male, x2 mRNA shots. First visit 5/22, with unknown previous COVID at that time. Hx squamous cell carcinoma, congenital slight curve of spine, arthritis of lumbar vertebrae, s/p excision of squamous cell carcinoma. Intake reported brain fog, two incidents with brief loss of vision in left eye, tinnitus, sleep disruption, failed root canal. Bi-weekly use of IVM at time of first encounter, increased to daily, later with Nattokinase, then NAC Augmentata, 2/23 spike ab was >25,000 U/mL At 6/23 visit reported an incident while traveling: developed sudden onset of dyspnea, lethargy, and malaise. Concern for iliac venous compression began around this event. Spike ab down to 23,156 by 7/23. 7/23 added Aspirin daily, and microclotting study result was 3 of 4. Began anticoagulation with Plavix and Eliquis. Using the Arc Microtech 3-6 hours daily and a grounding mat. Last visit was 1/24. At that time patient felt that he was getting worse, waking with muscle aches in his arms and legs, some increased varicosities, and ongoing dyspnea. In response to questions re: collagen use, patient shared that he had been adding collagen to his bullet coffee daily for months. Collagen DC’d. At 2/24 measurement, microclots were only down to 2.5 of 4, despite nearly seven months of therapy.
Patient 10
65 yo male, x1 J&J shot, and five previous COVID infections (four after the shot). First visit 10/23. Intake reports fatigue, brain fog, memory problems, shortness of breath, fast or pounding heart rate, anxiety and depression, symptoms worsening after activity. Reports reduced capacity during exercise, tachycardia and palpitations during higher intensity exercise, poor recovery following exercise. Strong signal of MCAS, early concern for iliac venous compression based upon history. 10/23 measure of spike ab was 9108 U/mL. IVM, LDN, NAC Augmentata initiated. 1/24 study of microclotting was 3.25 of 4. Discussion at second visit, end of January 2024 revealed that patient had been supplementing with collagen for an extended period of time, although it hadn’t been on his list. Collagen DC’d. Plavix low dose, Aspirin, Antronex initiated.
Batch ADRs Deaths Disabilities Life Threatening Illnesses
203A21a 1645 18 21 23
Patient 11
80 yo male, x2 mRNA Pfizer, last shot 2/21, onset of symptoms 2/21. Hx neuropathy, muscle weakness and atrophy, Sjogren’s syndrome, joint pain, tinnitus, S/p gall bladder removal via open surgery, catheter ablation for A-Flutter, detached retina surgery following cataract surgery the previous year. Intake reports weight loss (30 lbs), muscle loss, weakness, neuropathy, nerve sensitivity, symmetrical sensorimotor axonal polyneuropathy by EMG and blood work, fatigue, brain fog, joint pain, worsened after activity. D-dimer prior to our first visit 10/22 was elevated at 321ng/mL (normal <= 230ng/mL) Eliquis had been recommended by PCP, but patient was reluctant. Using soft-shell HBOT. Many, many trials of therapy over time, with consistent use of Aspirin, LDN and IVM. Later adding EPA, NAC Augmentata, and Nattonkinase. Late September 2023 study showed 3.5 of 4 microclotting. Patient initiated low dose Eliquis and Plavix shortly thereafter. At end of November 2023, patient reported that he had been using Dr Gundry’s Phyto Collagen Complex and had DC’d it in the last week.
Patient 12
75 yo male, PASC. Acute COVID infections April and November 2022. Onset of symptoms January 2023. First vist 10/23. Hx transient ischemic attack (TIA), HTN, depression, anxiety S/p bowel obstruction surgery, with extensive adhesions noted in August 2023. Intake reports fatigue, brain fog, memory problems,dizziness when standing, anxiety and depression, symptoms worsening after activity. Anti-depressants stopped working and he developed insomnia. Started on Aspirin prior to our first visit. Early concern for iliac venous compression, validated in review of previous CT abdomen/pelvis and during consultation with coordinating IR specialist. Patient unable to travel very far and so stent placement is not easily achieved at this time. Already on IVM and LDN; started NIR, Flavay and Arc Microtech. Moderate signal of MCAS. Mid-November 2023, spike ab was 70 U/mL, reported during visit that he ran out of his collagen supplement two days prior. Collagen DC’d. Microclot study 2/24 revealed 2.5 of 4. 12/23 lab showed very low serum serotonin level of 34 ng/mL (range 23-230ng/mL).
Patient 13
60 yo female, PASC unvaccinated. Hx HTN, hypothyroid S/p partial thyroidectomy with benign nodule. Onset January 2022 after acute COVID. Intake reports severe fatigue, tachycardia, anxiety and depression, symptoms worsening after activity, insomnia, only able to sleep 2-3 hours at a time. She suffers from a burning sensation throughout her body – extreme heat – mixed with itching of skin. Had Epstein Barr Virus (EBV) reactivation reflected in labs. Strong signal of MCAS. Started on Aspirin, Nattokinase, IVM, NAC Augmentata, and Arc Microtech. 8/23 spike ab was
22 U/mL. 9/23 visit had some days of feeling better, then overexerted and was back in bed for 3-4 weeks. Burning was less intense. Conintued to have palpitations. Presentation consistent with iliac venous compression, but difficulty getting correct study and doesn’t want to use Gadolinium contrast. In 11/23 started Ketotifen. 12/23 microclot study showed 3 of 4. Visit following this report revealed patient was taking collagen daily. Collagen DC’d. Late 1/24 visit, started Eliquis and began having night sweats. Went up on Flavay, started Antronex, titrating up on Ketotifen. 2/23 visit feeling stronger, walking more, finding benefit from NAD Platinum from QuickSilver. Off Eliquis, feeling clearer when she wakes up. Tolerating Plavix ¼ tab daily. Mental clarity from 5-HTP. Plan to trial Cromolyn nebulizers, and try Inositol for reactivated EBV.
Mr Gali was my fifth and sixth grade teacher at Webster Hill Elementary School in West Hartford, CT. He was a short and stocky man with a stern face and menacing, thick eyebrows. He had a passive-aggressive way of massaging the shoulders of us misbehaving boys, which both taunted our nascent homophobia and established him as the Alpha male in the room. As with most people – especially those that loom large in our past – he was complicated.
He had a friend who we called Mrs Barker. She was an elegant woman with red hair that she wore in an old-fashioned beehive doo. At my young age, it was hard to say how young or old she was, but from this vantage point I would guess her late 50s. She wore neatly tailored pantsuits, or a blouse and slacks, and always had light scent of a flowery perfume.
Mrs Barker and her husband had lived in Japan for some time, and on some of the occasions that she would join our class, she brought treasures from her travels, including the most beuatiful silk kimonos and caligraphic scrolls. Her stories stirred our imaginations with news of a peaceful people, who ate fish and rice for breakfast, while sitting on bamboo mats, lived in homes with moving rice paper walls, and who use terms such as Chan and San. Until we grew older and could venture out ourselves, this was an engaging way to expand our understanding and awareness of the world beyond our immediate experience.
I was aware of birds as a boy, because there were many trees around our home and in the mature neighborhoods of West Hartford, CT. But I had never touched a bird, or seen one up close, until Mrs Barker. What would have been weird or creepy from another person, came off as eccentric from her, i.e. when a bird would fly into a window of her home and break its neck, and she would wrap it up in a plastic bag and put it in her freezer. (I always imagined them right next to her half gallon of mint chocolate chip ice cream). She would then bring them to our classroom, so that we could feel what light as a feather really was, and admire their bright colors and delicate features in detail.
Our class once made field trip to Mrs Barker’s house. It was a quite a spread, almost a museum. There were more kimonos on the walls, as well as numerous vases and sculpture from her time in Japan. She encouraged us to touch and smell, which was so different from don’t-touch field trips to the Hartford Atheneum. She was always happy to entertain our many questions. I didn’t even get in trouble, because my mind was present, and I was able to pay attention in this classroom of life.
RECENT PAST
One of the reasons we moved to Ithaca, NY nearly twenty five years ago was Cornell University. No, we didn’t attend as students or work there as minions or Ivy League demi-gods/goddeses. But we knew that the presence of such an old and esteemed institution of higher learning conferred many opportunities and resources to the surrounding community.
Cornell was part of my childhood. My great grandfather had attended the state side of the school (as compared to the private side) and studied agriculture, twice! It was a source of friction with my great grandmother’s newspaper tycoon parents that Walter Stanley Marsland, Sr was happy as a clam to grow cash crops in New York and Florida, trucking his family back and forth according to the season. His son, my great uncle David, studied at Cornell as an undergraduate in chemistry. As a result, my Nana and Pop pop had a thing for Ithaca. They came to Ithaca for their honeymoon in 1937, and later they would visit Uncle David while he was in school.
One of my Pop pop’s quirks was that he enjoyed picnics all year round, when more delicate souls wouldn’t even consider spreading out a blanket and nibbling on fried chicken and fresh pie. Several times during my childhood, I rode along for four hours with Nana and Pop pop from Parkerford, PA to Ithaca for a picnic. I remember the suspension bridge, the gorges, and the vast Cornell campus. I remember being cold, and quietly wondering that nobody else seemed to be doing what we were doing. I remember my Pop pop and Nana laughing, and looking at each other with a surprising tenderness and twinkle in their eyes. Perhaps remembering their honeymoon? Then we drove another four hours home.
– SAPSUCKER WOODPECKER -2021
True to our expectations, one of the resources Cornell has provided to Ithaca is the Lab of Ornithology. I don’t think I ever even heard the word ornithology before we came to Ithaca, and it took many years of living here before we ventured into this realm. The birders among you are likely familiar with the Lab of O as a tremendous resource of pictures, sounds, and knowledge of all things birdy. There is a physical building that is a seriously expensive pile of stonework and architectural extravagance. Then there is the land and the paths around the water features, with blinds for watching the birds in any season. On Saturday mornings, if you can get your sleepy head out of bed and show up by 7:30am, you don’t even need to bring binoculars (provided) to join a group for a walk and bird watching.
Sapsucker Woodpecker & Scott at the Lab of O
I’ll just say birders are weirdos. And, I’m finally old enough that I’m glad to be counted as a weirdo among weirdos. Birds are simply amazing. There are so many different kinds, doing so many different things, in so many different ways, and regularly performing feats of aeronautical maneuver, navigation and long distance travel that it renders me silent. I marvel at the miracle of it all.
PRESENT
My commute is a seven minute walk up a steep hill to the clinical space I share with my colleague of twenty years, a traditional Chinese medicine (TCM) herbalist and acupuncturist. Over the last week, I have heard the sounds of the birds returning to Ithaca, or passing through on their migration further north. The Sapsucker greets the morning with its raspy chatter and a harsh, squealing weep. The Robins emit their string of clear whistles. The Black Birds lift my eyes and heart from my weary trudge with their shrill rising squee and concluding metallic click.
The deer which eat our perennials and frolic in the field outside my office window will soon be mating, and hiding their fawns in surprising places. The ground hog woke up much earlier than I can enjoy noting, and can be seen nibbling at the base of the bird feeder every morning. Soon the family of skunks, or their most recent progeny, which has lived under our mud room for nearly a decade will show themselves. I will have to be more cautious when I arrive home or take out the compost, so that I don’t get sprayed!
– GROWING TOGETHER -2021
Sprouts, buds, tendrils and shoots are appearing all around us as reminders that we have made it throught another Winter. I look forward to seeing what plantings survived, what volunteers landed in the soil from the excrement of a passing bird or a resourceful squirrel. There will also be the encroaching invasive species which will test our perserverance again this year.
My beloved steadily conceives and brings forth creative expression into the world. She manifests this in glass and metal which require infinite variations of light to fully appreciate. Her labor is Olympic, Athenian even, as she moves against the currents of a collapsing society, a devaluation of art, and loss of hope. While I’m trying to help make life bearable for hundreds of patients, she ensures that life is worth living, because there is spark, spirit and beauty.
– BLUEBIRD -2015
P.S. It turns out that there was in fact a subscriber from Wyoming already, who was the recipient of a lifetime subscription to Lightning Bug. The 50th state from which I am still wishing, and desiring, oh, so ardently, a reader, is the wildly beautiful and rugged West Virginia. Please announce yourself monsieur/mademoiselle/madame.
P.S.S. This week marks the occasion of reaching 1000 subscribers to Lightning Bug! There are so many Substacks, and posts and papers and, and, and to read, and yet some of you spend some of your time each week reading Lightning Bug. Thank you!