Prelude – by Scott Marsland, FNP-C

Prelude – by Scott Marsland, FNP-C

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Everyone has their story to tell. What prompts me to offer mine is in part what I have learned from my faith and practice as a Quaker. Seeking guidance and solace from God, we share when the spirit rises within us, in the hope that sharing benefits others.

My favorite stories have been those which toggle back and forth between the present, the recent past, and the distant past. Also known as history. May I even approach the shadow of the skill of those hard working writers.

I’ll endeavor to post weekly, for as long as the story takes to tell. It will be personal, but intended to lift us up, together.

Today I am partners in a telemedicine practice which focuses on post acute sequelae of COVID, PASC or long-haul; and injury from the COVID vaccines. Our team has evaluated and treated nearly four thousand people since early 2022, prescribing repurposed drugs to keep people out of the hospital, effectively treating acute COVID, and wrestling with the hydra of PASC and vaccine injury. We know what we are up against, and it is daunting. Yet we have managed to learn a great deal, and get better and better at what we do. There aren’t many practitioners in the world who know what we know. There should be.

In February of 2020, I was working as an RN at SUNY Upstate Medical University in the Emergency Department. Upstate is a Level 1 trauma center. In the middle of a shift, I swiftly fell ill, developing a fever, chills, and general malaise. I think that I was assigned to trauma that day. When I told my co-workers that I was having chills and would have to go, they thought I was joking. I knew that I had an hour and a half drive ahead of me, and things were going South quickly. My life hasn’t been the same since. But then whose life is today what it was in February of 2020?

When I was in third grade, I was in Mr Stevens’ class. He wore cardigans, horn rimmed glasses, and drove a faded black Volkswagen Bug. I was the class clown that year. He and I were not friends. We had a beautiful student teacher who I had a crush on; probably most of the boys did. For reasons that my 3rd grade boy brain couldn’t fathom, she announced one day that we were going to have a vote. She wanted to know if the class wanted to be divided up into boys on one side, and girls on the other, or if we wanted to remain mixed together as we had been for most of the year. Boys voted first. Boys wanting to keep it mixed. I raised my hand. No one else did. Then all the other boys voted to be separated, and all the girls agreed. Ms Student Teacher wasn’t done yet though, and said, “Well Scott, it looks like you are the only want who wants the boys and girls to sit together. That’s not normal. The rest of your classmates voted differently, so we’re going to rearrange the room now.”

I didn’t get it. I didn’t understand why my classmates would want to lose the connections we had, to begin building walls, to be manipulated by a relative newcomer, an adult, because it would make her life easier. I used to think this was a hurtful event in my young life. Well, it was, but life since COVID has changed my perspective a bit. That early experience prepared me to call things as I see them, to not be afraid to diverge from my peers, and, darn it all, to expect the crowd to be easily lead down the garden path.

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Beyond fear – by Scott Marsland, FNP-C

Beyond fear – by Scott Marsland, FNP-C

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History

1973 was a big year for me. I turned four, my family moved to a new home in another state, and I learned about yellow jackets and rats.

There was a woodpile in our backyard. Curious boy that I was, I noticed that insects were flying in and out of it, thin creatures with yellow and black bodies. I could see that there was one opening in particular where they landed, entered, re-emerged and flew off again. I later learned that these were yellow jackets. In a way which would play out over and over again in my life, until I got wise and recognized my own folly, I picked up a stick and poked it in the hole, then ran off. The buzz it stirred up was very exciting. So exciting in fact, that I did it again. It was the third time that went sideways. I didn’t just poke the stick in the hole, I gave it a few good wiggles and wags.

Boy howdy! A storm of angry insects came swarming out of their nest in search of a target. In my screaming, flailing dash between the woodpile and the enclosed porch of our house, I was stung twenty six times. It took my mom and dad a puzzled minute to figure out what all the hooting and hollering was about in our backyard. They rushed me inside and grabbed rolled up newspapers to wack away at the angry ones which had followed us into the breezeway. To this day, I’m not sure if either of them was stung, although I’m sure that I’ll hear from my mother after this post. Later on as I lay dozing in a hospital room with dim lights, it was beyond doubt that my mom and dad were on my side in that moment of crisis. In spite of the fact that I had seriously blundered and brought down a world of hurt upon all of us.

Around the same time, I also learned about rats. We had a beautiful collie named Dutchess. Protective lassie she was, and one day while I was outside playing in the backyard, she cornered a rat on the patio. As I approached, I could see her lunging and biting at a dark furry animal with a long tail. Dutchess wounded the rat, and my dad finished it off with a shovel, but for her troubles, Dutchess suffered a nice bite to the snout. I rode in the backseat with her as we took her to the vet, smearing blood from her nose all over the window. Such excitement!

Dutchess and I , 1971

Since that time, I have never again bothered a yellow jacket that didn’t bother me first. Knock on wood, I haven’t had to tussle with any rats either. But indeed, I learned that the smallest of beings were not to be trifled with, as each has its own dignity and defenses.

Recent past

Shifts worked at SUNY Upstate between the start of the pandemic in March 2020 and my departure in August 2021 have become a blur in my memory. The gestalt is fear of dying while providing care amidst organized chaos. It is hard to think when you are scared. I’m grateful that I was a seasoned Emergency nurse going into the pandemic. Ditto being in my late forties with some living under my belt. Still, I think that we were all scared, and it came out in different ways.

At the time I was the union steward in our Emergency Department (ED), and an elected representative to the Executive Board of the Public Employee Federation or PEF. It had been a decade since there was a functioning steward in the ED. Although our team was filled with independent thinkers and sturdy characters, it wasn’t operating as an empowered and organized group vis-a-vis our own rights and safety.

I believe it was Machiavelli who formulated the maxim “Never let a good crisis go to waste”, but I’ll credit modern human resource management with taking this to new heights. As the uncertainty of global viral illness swirled around us, Upstate did one thing it does well, and often. It disappeared several workers faster than an Argentinian dictatorship. One in particular was a dear Nursing Assistant or HCT who was the old grey mare being put out to pasture. Another was an Assistant VP of our sister union, CSEA.

Can I just say that working a twelve hour shift in a busy Level 1 Trauma Center is not an easy feat? And that it is harder when you aren’t sure if you’re going to die after you help intubate that thirty year old who just rolled in with EMS? Even harder when stalwart co-workers disappear and you’re not supposed to talk about it? Even harder when you have a family to support and bills to pay, and who doesn’t? Harder still when you’re the union steward trying to inspire co-workers to stand up for each other?

It was a gift of the universe that in 2018 I met Ellen David Friedman, a force of nature who has been a union organizer for nearly fifty years, and who just happened to have relocated from Vermont to my home town of Ithaca. One of the many things she taught me was to lean into my fear and act, but more importantly, to not act alone. This may be a lesson which many of us need to learn over and over. We look to others, individual leaders, to help us out of the mess we are in, instead of looking to each other. This takes immeasurable patience, and focus, as we hold back our bright ideas. We fight our urge to save people, and listen to each other to determine the steps which we can take as a group. We then shoulder the risk, and the fear, together.

Present

Before we ever met, Dr Pierre Kory introduced me to a concept which helped me survive the beginning of the pandemic in a busy ED. It was the four Ds: density, duration, draft and dimension. This is a risk assessment perspective that will help diminish your fear and empower you to negotiate a Covidian world.

Density: how many people are in the space?

Duration: for how long?

Draft: with what degree and quality of air circulation?

Dimension: in what size space?

These concepts take on greater significance when we expand our concern beyond simply being infected by Covid, and consider the dynamics of shedding.

What is shedding? From a 2015 FDA Guidance document: “The release of viral or bacterial gene therapy products from the patient by any or all of the following routes: feces (feces); secretions (urine, saliva, nasopharyngeal fluids, etc.); or through the skin (pustules, lesions, sores).” The products (i.e. spike protein) are known to be shed via either the synthetic lipid covered nanoparticles or via enclosure within endogenous nanoparticle sized “exosomes” from a vaccinated/boosted person, to another, regardless of their vaccination status. Our impression is that aerosolized particles conveyed via exhalation and inhalation are the primary route of transmission.  Dr Kory’s Substack series on the topic provides insight into the scientific basis of shedding as an observed adverse effect of the mRNA vaccines.

Many of us have been acting on the principles of the four Ds since the start of the pandemic. Grocery shopping early, going to the car lane at the bank, meeting outside with friends. Employing the words, the Ds, and gauging the risk can make it more tangible. It can also form the basis of negotiating our interaction with others.

Sharing a car ride with another person is a very intimate exposure. There may only be two people in the vehicle, but the space is very small. If it the outside temperature is hot, or cold, the ventilation in the car may be set to recirculate the same air. The longer the ride, the more the exposure.

In a recent visit my patient had a relapse in brain fog and cognitive impairment, to such a degree that the part-time work to which he had just returned was proving very difficult. What we identified as the likely cause was secondary shedding. In the last week his mother had spent several hours in a car with her sister-in-law, who had just been boosted. Two people, two hours, recirculating air, small space.

Car rides have been an instigating event for many of my patients over the last two years. Whether it was a daily commute (an hour each way with someone who was several times boosted), or sightseeing with visiting family (hot weather, recirculating AC), or brief rides with a child’s boosted boyfriend sitting behind the patient/driver. It makes sense to have the skinny on who is sharing your ride.

What about being outside? Evaluated through the rubric of the four Ds, this is a very, very low risk scenario. Two people outside is a non-issue. As long as you like. A breeze and movement are your friends. The sky is literally the limit. Introducing a crowd of people shoulder-to-shoulder, under a tarp or overhead structure which inhibits air flow, begins to change the dynamics. But still, this is a lower risk scenario.

How about restaurants? It depends. What time of day? Late lunch hour is going to draw fewer people than noon, or dinner at six. Is it a cozy little bistro where you can smell whether or not your neighbor applied enough deodorant, or an updated restaurant with multiple air exchanges per hour? My wife and I ventured a meal at our favorite restaurant months ago, in which we were at a two-top elbows away from couples on either side. High density, long duration (French, three hours from start to finish), good ventilation, high ceilings and modest size. But there can always be a wild card. We struck up a long conversation with the couple next to us. At the very end we learned that each of them had both shots and every booster available. We were talking and laughing in close proximity for well over an hour. The headaches, body aches, and fatigue to follow that night and the next day were not mysterious.

Airports and airplanes are at two different ends of the four Ds spectrum. Airport lounges and lines can be densely packed, we can wait for hours, but the movement of people, good air circulation and vast dimensions tend to limit the risks. Airplanes are much more confined spaces, in which we sit rubbing elbows, again for hours, with recirculating air.

Gyms have their own peculiar dynamics. Skip the crowd. Workouts are often an hour from start to finish. A space with an open floor plan and high ceilings quite literally gives you some breathing room. Then there is mat work such as yoga and stretching in smaller spaces, where the density of aerosolized particles accumulates in the lowest inches and feet of the room. It is not uncommon for the exhaled breath from other people exercising to linger in the air for up to 2 1/2 hours, and concentrate near the floor.

Through detailed discussion with one patient, we determined that not only were his post-acute sequelae of Covid (PASC) exacerbations related to days he went to the gym and did mat work, but also his daughter’s increased symptoms (secondary shedding). It’s worth rethinking the timing and format of your routine. For the geeks in the room, this 2022 study on aerosol dispersion in a ventilated room will give you reason to pause.

Here come the Holidays and the attendant travel and convivial gatherings which give so much meaning to our lives. Use the four Ds to help you think about harm reduction. How many people to invite, how long to visit, how to improve the air flow, and how big a space is feasible? If you can’t open windows or turn up the ventilation, consider a HEPA filter in place. We use an Oransi in the waiting area of our clinic space. You may be able to fear less, and think more.

One thing I have come to appreciate through my work in the clinical arena of spikopathy is that I am not alone in fighting the spike protein. Our practice the Leading Edge Clinic is not alone. In learning how to protect against and repair harms of the virus and Covid shots, we continue to build connections with our patients, other practitioners and researchers. We are learning from each other. Stay safe out there, meaning, look out for yourself and each other in practical ways. Remember that you are not alone.

P.S. Any recommendation I make for products such as Oransi HEPA filters are free from financial interest on my part.

P.P.S. I am honored to be speaking at the third FLCCC Educational Conference, ‘Healthcare Revolution: Restoring the Doctor-Patient Relationship’, taking place February 2-4, 2024 in Phoenix, AZ! I’m looking forward to connecting with you there. You can learn more about the conference here: flccc.net/conference (http://flccc.net/conference)

Hashtags:

#HealthcareRevolution #FLCCCConference #F

LCCC2024 #FLCCC #FLCCCAlliance

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Prelude – by Scott Marsland, FNP-C

And forgive us our trespasses

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History

Situated between an older brother and younger sister, I’m the middle child of parents who planned. How else would we be August, September, October babies? I don’t remember being happy, or sad, or resentful when my little sister was born, but I wasn’t exactly welcoming.

When my sister was barely a year old, and I was four, we lived in a suburb of Philadelphia. In our house there was a lovely stone fireplace. One day when our parents were out of sight, I threw an enormous stuffed bear in her way and she tripped, falling forward and smacking her face on the sharp edge of the hearth. Screaming, tears and a gusher of blood commenced. Years later as a trauma nurse, I would still marvel at just how much blood could emerge from the tiniest facial laceration. Our face and scalp are quintessentially vascular tissue.

My dad scooped up my sister, and pulled me along. I don’t remember how we got there, but we arrived in the pediatrician’s office in short order. Can you imagine? A pediatrician who could and would suture? As an inauguration to my little manhood, I was witness to the spectacle of my sister being sewn up. Dad held her firmly as a needle with black thread was passed in and out of her nose through her nostrils, then in and out of her nose on the outside. More tears, blood and screaming. The worst part was that in my four year old mind, it was my fault.

More than a decade ago, after a holiday debacle when we each had too much Chateau Neuf de Pape and a drunken row ensued, something shifted in our adult relationship. By the way, I don’t recommend this as a consistent way to improve communication with your siblings, but in this isolated instance, it was just the ticket. Some dam broke, and we began to have regular meaningful phone conversations. This lasted for years.

Along the trajectory of our years of conversations, I tried to make amends to my sister for perceived transgressions, for which I continued to carry a sense of wrongdoing. She didn’t really bite, either because they didn’t have the same weight for her, or because she would rather just not go there.

The pandemic soured our relationship. I’m presenting my perspective of course, but my sense is that my stance against further COVID vaccinations, and articulation that despite being a lifelong Democrat, I would actually consider voting for Trump irritated her. It probably doesn’t help that a cursory search of the internet would inform her that I’m practice partners with the devil himself, rather than the humble, courageous patriot, fine human and skilled clinician I know him to be. The last time we spoke was when I traveled to Orlando, FL in October 2022 for the inaugural FLCCC Alliance conference on spikopathy. I flew down early to have dinner with her and my mother. She had just been boosted, went out with co-workers for a social hour, and came down with acute COVID. Ahem.

Fifty years later, I’m still trying to forgive myself for tripping up my little sister. I feel kindness and compassion for the little rug rat that I was, and you would think that I’ve paid my debts by now, but, not quite yet.

Recent Past

In my previous post I related the initial flip flop at SUNY Upstate re: whether to mask or not to mask. Upstate next vacillated on when, why, and how to wear surgical masks versus N-95s. Pre-pandemic, we didn’t wear N-95s that much. If you did, it was most often because you had a patient who had active Tuberculosis or a suspicion for the same. If you worked in an urban environment, with immigrants from developing countries, and with prisoners, this would happen more often. You never wore the mask for that long. It was understood that the mask was good for less than thirty minutes. You would gown and mask to go into a negative pressure room. These rooms are designed to have enough ventilation to the outside, so that when the door to the room opens, air can only go into it, not out. There was typically an anteroom before the patient room itself, where you would don and doff your gown, mask and gloves. It was understood that an N-95 was a single use piece of equipment. You would not, under any circumstances, reuse an N-95. Period.

There was an annual ritual around being “fitted” for the correct N-95. It was a big deal. You had to have it done by the deadline or you would be on your manager’s naughty list, maybe even be taken off the schedule until you checked that box. If you grew a beard, shaved a beard, lost some weight, gained some weight, you would definitely need a thorough evaluation. The process took a half hour at Cayuga Medical Center in Ithaca where I worked for fifteen years. Upstate was a little speedier, but the idea was the same. Turn your head this way, turn it that, bend over, grimace, do jumping jacks, repeat this ridiculous paragraph about leprechauns and a pot of gold at the end of rainbow. Some linguist had deduced just the right number of consonants and vowels to test the effectiveness of your mask at preventing aerosolized particles from making their way to your respiratory tract. You get the picture. Tedium ad nauseum.

The whole point of fitting was to have an effectively tight seal of your N-95. Common sense would tell you that taking such a mask on and off multiple times during a shift will compromise this fit. In the blink of an eye, Upstate was telling us that not only could we wear N-95s for an entire twelve hour shift, but even that we could set them aside and they could be cleaned, sanitized, and sterilized. God bless their hearts, National Nurses United put out a fact sheet on this topic by the end of March 2020. But per management, what was drilled into our heads for decades was no longer valid. Upstate started collecting our N-95s at the end of the shift. We were supposed to put our initials and employee number on them, and they would be returned to us after sterilization. The plan was to reuse them two more times.

I complied once, barely. When I received my first sterilized mask back, it had red lipstick on it. For the record, I’ve got no beef with guys who wear lipstick, but I’m not one of them. Frankly, if I was going to wear lipstick, I think I’d be more of a pink frosty kind of guy. Anyway, I don’t wear lipstick. From that point on, sure, I’d put my mask in the bins. After I took a paper hole puncher and gave it a few good plugs, or yanked out the strap. And no, no name or employee ID number, but I wanted them to get the message that not everybody was buying into their scheme. I wasn’t alone.

Present

I’m a Quaker. Quakers try harder to be good people than about anybody within throwing distance. They are by and large, progressive liberals, who are intentionally, determinedly, incessantly boosted. These are my people. The mind bender is that I don’t agree with them at all on this point. Because I have been treating and healing long-haul and vax injured patients for almost two years, and I am vaccine injured myself, I know different.

In fact, the people who I didn’t think were my people, the Trump-voting, evangelical, gun-toting, politically incorrect, not careful and not-trying-so-hard-to-be-good people, are feeling a lot more like…my people. They are the Americans who didn’t jump in line to get the shots, who didn’t trust the government, had some thoughts of their own, and in many ways have paid a huge price for their intransigence over the last nearly four years.

In our Quaker meeting, one manner in which we get to know each other is through Quaker Eights. The idea is to get together with a small group of Quakers at least eight times over the course of a year. Mostly this would be through potlucks, but it could be through any activity we choose.

Given what I know and continue to learn about shedding, I was uncertain whether or not, I could attend an upcoming Quaker Eight potluck without suffering adverse consequences. What I did, and what I would suggest that you do too, is take a leap. I emailed our Quaker Eight group about my predicament. In brief, I told them that I’m vaccine injured, with ongoing health challenges, and concerned about shedding. I explained what shedding was, and asked them to share their booster status.

I understood that this would be completely novel information for them, given their confidence in The Narrative. What I was trying to suss out was whether anyone had been boosted in the last two weeks because that seems to be a particularly potent period of shedding. The responses came back quickly, respectfully, simply stating the time since their last booster. I expected this, but it still felt like a gut punch when I understood that all of them had received the latest booster. None in the last two weeks. Game on. Using prophylaxis which included supplements and Rx meds on FLCCC protocols, drinking green tea, using eye drops and nasal spray, I attended our potluck in the company of boosted Quakers.

Traditional Chinese Medicine (TCM), Green Tea, and EGCG

Within our practice the Leading Edge Clinic is my beloved colleague, Dr. Anthony Fazio. We met in 2005 when we helped start the Ithaca Free Clinic, where he still volunteers. This was the first free clinic in the United States to integrate allopathic Western medicine and complementary or alternative medicine. Boy did we wrestle with those labels!

Anthony is an acupuncturist and traditional Chinese medicine (TCM) herbalist who has been in practice for more than 30 years. Starting with a scientific paper which considered Ayurvedic herbs, and measured their capacity to destroy spike, Anthony developed eye drops, and a nasal spray, which we think provide some protection against shedding. My wife and I were test subjects for early versions of the solutions. He is still making it in micro batches, but approximately 40 of our patients are using it, and reports from the field are positive. We provide the set to our patients at cost, but you can contact Dr. fazio at Peaceful Spirit Acupuncture if you want to order it. Cost is $100 per set including shipping.

I’m distinguishing the TCM anti-spike eye drops and nasal spray from options we have to block the virus alone. For example, diluted povidone iodine, commercially available Xlear, or Enovid, heck, even neti pot rinses with half a teaspoon of salt and half a teaspoon of baking soda are all helpful in preventing us from getting sick from the COVID virus. Enovid shows some effect against both the virus and spike from shedding per my patients’ reports. The TCM combo is not only antiviral, but specifically targeting spike protein conveyed via exosomes in aerosolized particles from another person’s exhalation.

From 2021-2023, there were multiple studies demonstrating that EGCG or epigallocatechin gallate in green tea helps block spike entry into cells. Aside from therapies listed in FLCCC Alliance protocols to inhibit spike, such as nasal rinses, NAC, quercetin, etc. green tea is my go to, along with the TCM eye drops and nasal spray to prevent shedding.

The Epoch Times had an excellent article about the differences among green teas and their EGCG content. A simple rule is that Japanese Sencha and Matcha have the highest content. My favorite source is Rishi Tea out of Milwaukee, WI, one of the largest importers of organic loose green tea in the United States. Of course, you can buy EGCG as a capsule or in a combination anti-spike formula, but as with all things herbal, when you isolate a single component, you are certain to lose many additional compounds. These compounds synergistically improve the effect of the target molecule, and limit any potential side effects. Besides, green tea is yummy.

The potluck went well. I didn’t note any increase in my vax injury symptoms afterwards, and future labs will tell whether I’m holding steady in the face of shedding during social exposure. As we head into the holidays, whether you have PASC, vax injury, no concerns or this is all new to you, thinking about and negotiating shedding will serve your health and well being. I’ll plan to discuss this further in upcoming posts.

P.S. I don’t have a financial interest in products or brands recommended such as Rishi Tea, Xlear, Enovid, etc.

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Prelude – by Scott Marsland, FNP-C

Stop making sense – by Scott Marsland, FNP-C

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Recent past

In early March of 2020, when news of a pandemic was filtering into our lives, I was working as an RN at SUNY Upstate Medical University in the Adult Emergency Department (ED). Some of my colleagues began to wear surgical masks after the WHO announcement of the COVID-19 pandemic on March 11th, 2020. That first day stands out in my memory. Our manager was a woman of immense character and intestinal fortitude. We had worked together more than a decade prior to when she hired me on at Upstate. I always had and have tremendous respect for her. She also took her marching orders from above seriously, and executed them diligently. That day, that first day when things really changed, she was rounding on staff and chewing them out for wearing masks. The message was simple. “Don’t wear masks, you’ll scare the patients.” Some of those interactions were intense. You don’t work in a Level 1 trauma center if you’re a pushover, and ours was a particularly seasoned and independently thinking team.

I also remember the next day. Clearly. My beloved manager and friend made the rounds again. This time, she was brow-beating staff…for NOT wearing masks. The switch had flipped. Right there they lost me.

Do you know the Paul Simon song Obvious Child from his album The Rhythm of the Saints?

Well I’m accustomed to a smooth ride
Or maybe I’m a dog who’s lost it’s bite
I don’t expect to be treated like a fool no more
I don’t expect to sleep through the night
Some people say a lie’s a lie’s a lie
But I say why
Why deny the obvious child?
Why deny the obvious child?

History

As a boy, I spent a week most summers at a Lutheran summer camp called Camp Calumet on Ossippee Lake in Freedom, NH. It was run by a wholesome group of boys and girls, but there must have been some adults in the mix. The food as I remember it was yummy. But spending the day running around outside in nature builds up an appetite. There was always “bug juice” to wash it down anyway. I learned to sail, and still do on Cayuga Lake in our home town of Ithaca, NY. I first heard Rocky Raccoon by the Beatles at a campfire. I kissed a few girls on the cheek at a dance. One summer, I came home with lice.

My scalp itched like crazy. There were little golden critters on the towel after my mom washed my hair with a special shampoo and combed them out. Honestly, it was all just another childhood experience. Much less of a big deal, because school was out and there wasn’t the stigma attached to it. Yet. Later that day I walked down the street to play Legos with a neighborhood friend. His mother knew I had just come back from camp and asked me if it was fun. Guileless, I proudly said “I got lice!”

Do you know those moments when you’re watching someone’s face as you’re interacting them and their expression changes? At the time, you think, “Hmmm, something just happened, but I’m not sure what.” Growing up in the household I did, I was especially sensitive to this, even if I didn’t know what it meant. Then hours, or days, or weeks, or even years later, you get another piece of information, and the lightbulb goes off. Aha! That’s why they looked that way. More about this in later posts.

I heard my friend’s mother on the phone, sounding upset, so my ears perked up. Next thing I knew, she said “Scott. (period, definitive, commandment) Your mother (not mom, formal, uh-oh) wants you to come home right now.” So much for Legos. I still had little clue until I got to the end of our driveway and saw my mom’s face, standing there with hands on her hips. There is a good reason that they say dynamite comes in small packages. This package was fixing to blow. Years later, I have to wonder what my mom was thinking when she let me wander out to play with our neighbor. Maybe she was just tired. That makes sense, sort of.

That day I learned that not everyone was as excited about contagious pestilence as I was. I also learned…as if I didn’t know already? I learned that adults don’t always know what they’re doing. Which, as I grew up, began to extend to authorities and institutions. Best to be doing some thinking of your own.

Present

For more than a year, our practice has been using spike antibody dilution as a proxy for determining spike levels in patients. In May of 2023 I presented about this at the FLCCC Alliance conference on spikopathy in Fort Worth, TX. You can access the excellent lectures for free from national and international experts on spikopathy at the FLCCC website. If you find value in what you learn, please consider making a donation to the FLCCC.

I explain to patients that using the spike ab is like using a mirror to look for the monster behind you. Actually, I say the vampire behind you, but aren’t they supposed to be invisible? We have this level on more than 500 patients, with more than 2000 data points. In early October things started to go sideways. Both vaccinated and unvaccinated patients, whose levels were below 1,000 u/mL began to retest at levels >25,000 u/mL. They hadn’t been sick. They didn’t get boosters. We have never seen this before. In a world of statistical analysis, this was a standard deviation of more than 20 from the mean. What changed? In consideration of the timing, these levels started to shoot up after the rollout of the COVID boosters in mid-September, and the patient tests were from the beginning of October onward.

My working hypothesis is that the latest round of COVID boosters, despite drastically reduced uptake by the general public, have potentiated the shedding of lipid covered nanoparticles, spike protein, and spike antibody. For a robust discussion of shedding, please see this Substack series by my practice partner Dr Pierre Kory, or this webinar from the FLCCC.

As we emerge from Thanksgiving, the patient messages are rolling in about downturns in their condition. Many of us traveled and spent time together with our extended families and friends, some of whom were recently boosted. The case studies of shedding are piling up on my virtual desk. What are we to do? The immediate answer is to educate ourselves about shedding, the science behind it, the steps we can take to neutralize spike using tools such as those provided by the FLCCC in its protocols. The longer answer is that we need to grapple with the present danger to our health, and the thoughts/feelings/hesitation that prevent us from having difficult conversations with the people we know and love.

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Soy un perdedor – by Scott Marsland, FNP-C

Soy un perdedor – by Scott Marsland, FNP-C

PAST

The West Hartford, CT of my boyhood had a well-developed soccer league. In Connecticut public schools, soccer had more sway than football. For three years I played right wing for a team called the Darts. Our uniforms consisted of green and white jerseys, with white shorts.

 

I’m bottom right, just before Tank

Our head coach was a chain smoking man who I only knew as Coach Miller. I also saw him at our house playing bridge with my parents and other adults. Our team had a few assistant coaches, including a tall, bespectacled, red-headed high school kid who would carpool with us to practice and games. There was a fullback named Tank who also sang in the church choir with me. That’s Tank bottom right in the photo, with me next to him. Timmy was the star center striker who was as fleet of foot as he was handsome.

I loved to play, but I was not very good. In fact, the best I could expect was to play one of four quarters in any given game—for three years. I never made a goal. If I assisted a goal it was by accident. If our team won any games, I don’t remember them. I was a lackluster player on a losing team. At the time, I simply accepted my experience. Kind of like a dog that’s missing one of its legs that doesn’t lay around feeling sorry for itself, and gets on with the business of life. It helped me get scrappy and it sure helped prepare me for life.

I would say my experience of being a loser on a losing team was a net positive. There were winning moments in the course of losing a game. I could take great pleasure in watching Tank bring the center of an opposing team to an abrupt stop with a slide and kick that sent the ball across the field into their goalie’s hands. I recall lots of fresh air, and being present in my body through discomfort and exhilarating exertion. There are many pleasant sensory memories: the smell of torn up field grass and dirt, the feeling of sunshine and cool New England air on our sweaty bodies, the taste of orange slices that we sucked on between plays, and the Gatorade that we drank from old coolers.

I also remembered the smell of mud which coated me from head to toe after I lost a bet with one of my teammates, and didn’t pay him in a timely manner. He was the captain of our team, and holds the ball in the photo above. He sent me flying face first into a deep and wide puddle. The bet was that I could score a goal on him during practice. I didn’t score the goal, and I couldn’t pay him right away. The result was one of the strongest memories of my childhood in which my mom refused to let my mud-covered self get into the car after practice and get muck all over her seats. She left without me, and I ended up running the distance between the practice fields and home, which was probably 3 to 4 miles. My dad came out to look for me in his car, and encountered me just a few blocks away from home. I don’t think I’ve ever run that far before or since in my life. I survived, but the experience cured me of any desire to make a wager with money on the line. (I did make an exception to this recently when I instigated a practice bet on Pierre’s microclot score).

I don’t think the parents were yet the “helicopter” type and mostly let the coaches do their job. Players didn’t get trophies simply for participating. I found it healthy to interact with other boys from different schools and I made a few friends.

I know that some of you will object to this assertion, but my experience has been that in life, most of us are losers. It’s not a radical statement. Anyone who watched the latest Super Bowl could sense the disappointment and pain of the losing team.

The patients for whom I have the least patience are the ones who continually ask “Why me? “ My first thought is, “Oh, you weren’t a loser like me.” My second thought is, “Why not you?” 5 billion people on this planet have been poisoned by the shots and the rest are being slowly poisoned by shedding. Come on team, let’s get it together, we’re all losers at some point. We can’t all be winners, and even winners can’t win every time.

Everybody loves a winner, but I think that having losing experiences as a child can prepare you mentally and emotionally for the world in which we live. Losers can still have a good life, and we do!

RECENT PAST

2014 was a big year for me. I graduated as a Family Nurse Practitioner from SUNY Upstate, started my first job as an FNP-C, and became the co-conspirator to lead a unionization drive in our local community hospital. There was a lot to lose, as we have lived in this town of Ithaca for twenty four years, and consider it our forever home. I’d worked at Cayuga Medical Center for fifteen years and had the respect and friendship of many. But, on the occasions when I made a med error in a busy Emergency Department, my own root cause analysis was that I had worked ten or more hours without a break. I reached my breaking point. I’d had enough and wanted to change our working conditions.

My partner in organizing was a spitfire ICU nurse named Ann Marshall. I love you Ann! We came from very different angles. I was a lifelong Democrat. She was a lifelong Republican. I’ve been a health nut for years and she was a closeted smoker. Wine was my thing, beer was hers. I was a vegan and she was a devoted carnivore. What we had in common was courage and integrity, with a bit of piss and vinegar for good measure.

 

Ann and I holding copies of Nursing Against the Odds, by Suzanne Gordon. We crashed the annual employee dinner dressed as the American Revolutionaries that we were/are.

Ann’s family had owned and run a steel mill in Connecticut. Because her family treated their employees well, providing safe working conditions and good compensation, they never faced a union drive. She was not a unionist by any stretch.

The maternal side of my family were Slovak immigrants who emerged from the coal mines of central Pennsylvania by opening an illegal saloon behind a storefront facade during prohibition. I joke that I come by my criminal tendencies naturally (E.g prescribing IVM during a pandemic). The saloon had a long oak bar that was broken up with axes by Federal agents. My Baba and Grandpop (first generation Irish, Duffy clan) opened a restaurant supply business outside of Philadelphia. No unions there.

It makes sense to me that the spark of a union began in the ED and the ICU, where you have the most independent thinkers and rabel rousers. The greatest opposition we had was from within the Maternal Child Health department, the OB/GYN nurses who had the best staffing, resources and working conditions.

 

Being new to unions, we didn’t think too long or hard about which union we chose to organize under, SEIU 1099. We, the organizing nurses, ended up running a guerilla campaign, raising our own funds and making some decisions which ended up angering the union leadership, while simultaneously drawing fire from the hospital management. For example, without the union’s permission, we paid for a billboard on one of the main roads into Ithaca, and ads on four Ithaca City buses.

The union leaders were furious that we had placed these ads without their permission, and that the billboard had the SEIU1099 logo on it. The hospital tried unsuccesfully to get the billboard taken down by threatening the ad company within two hours of placement. The hospital also tried to force the ads off the buses by marshalling their influence on the board of directors for TCAT, our city bus service. In a show of union strength and solidarity, the drivers and maintenance workers of United Auto Workers (UAW) Local 2300 told them to buzz off to the moon. If the board wanted to push the issue, there would be no buses running. In fact, we could only afford to pay for a month of ads but they stayed on the buses for more than four months. Thank you UAW!

The crucible of the union drive was stressful on all of us involved, as well as our families. Individual nurses such as Alicia and Erin took great risks to venture onto other units to try and get signatures for union cards. I hawked my dad’s college ring at the pawnshop to help pay for those ads. Nurses like Chicken Nugget (previously mentioned in Capital C Characters) overcame their fears and concerns for job security to continue meeting and organizing together. We truly believed that we were fighting for the safety of our patients as much as our dignity as workers.

Management for Cayuga Medical Center was ruthless and criminal—literally. The NLRB ultimately found them guilty of more than twenty violations of federal labor law. But in the end, they beat us. They had more money, time and lawyers, and kept appealing, and losing the NLRB decision, up through 2019. I was one of the first nurses to go in 2016, as the part-time schedule had fewer hours for me, and Ann wasn’t far behind me. Ultimately, out of a nursing staff of nearly 350, I think that more than 150 of us left. It’s fair to say that we were among the best and the brightest, and the most independent thinkers. It was not more than six months later that a patient died in the waiting room of Cayuga Medical Center from a treatable arrhythmia. The hospital pinned it on a travel nurse, but those of us who had been organizing knew better. It was precisely the outcome we were struggling to prevent.

PRESENT

This month marks the two year anniversary of our telemedicine practice, the Leading Edge Clinic. What started as the Dr Pierre Kory Advanced COVID-19 Care Center has evolved into a very experienced team which is nurse-driven, patient-focused and provides compassionate care for complex conditions. Having cut my teeth in the business world and written ad copy for a small business, I realize that those words may sound like pap. The truth is that they are based upon what we actually do, who we really are, and what keeps us showing up for our patients.

Why nurse driven? In most healthcare settings, nurses barely reach the potential of their scope of practice. In our practice, the nurses have accumulated a great deal of expertise in the treatment of post-acute sequelae of COVID (PASC), and COVID vaccine injury. In order to meet the intense needs of our complex patients, the nursing team spends an exceptional amount of time with them. It never feels like enough, it stretches our budget, and yet it far exceeds the quality and duration of what most people have experienced in a lifetime of interactions with our broken healthcare system. We are also a nurse-driven team, because as the managing partner of this practice, I am a nurse first and foremost, and I am proud of the history of nurses focusing on the whole person, and promoting health, in a way that I have always found distinctive from the medical school disease-focused model which moulds the physician. Growing from the RN role into the FNP role, I have relished and embraced the many opportunities for patient education. It is what RNs and Nurse Practioners do best! Finally, we are a nurse driven practice because the single physician in our midst is a humble and decent human being, a man whose head hasn’t swelled with his renown, and who recognizes and depends upon the skillful and intelligent nursing team which drives our care.

Historically, I usually find out that I’ll be joining Pierre in some sort of discussion at the last minute. It’s usually a text that says “you and I are going to appear on _____ at _____ (time).” It’s probably just as well that that’s how it goes because it leaves me little time to object or decline. That’s how it went at the FLCCC conference when I ended up on stage with Dr. Marik and Pierre doing case reviews. If you’ve watched their repartee, it’s kind of like being the odd man out in an Abbott and Costello routine. My apologies to the younger people who are reading. Abbott and Costello were two famous comedians from the black-and-white movie era.

What struck me most as we were listening to those three case reviews was that ivermectin was not front and center on a daily basis in any of them. This is something that I don’t quite understand. The FLCCC Alliance has made a Herculean effort to educate providers and patients alike about the central role of ivermectin in preventing Covid, treating acute Covid, as well as treating long-haul and vaccine injury. Yet these patients were not receiving it. Pierre even wrote a book on the subject.

In part it is for this reason that I thought it worth your time, and my time to make the case for daily use of ivermectin from this point forward. Starting with the basics. Ivermectin is one of the safest medication‘s known to humankind. In the context of Covid we understand that it neutralizes spike protein, decreases inflammation, modulates immune response, and stabilizes mast cells. Even if you don’t have PASC or vaccine injury, but you believe shedding is real, those are all good reasons to keep on taking ivermectin on a daily basis.

But wait, there’s more! Ivermectin is showing itself to be invaluable in preventing and treating cancer. It made it onto the list of repurposed therapeutics that Dr. Marik and the FLCCC Alliance listed in his monograph on cancer treatment. It will play a central role in the protocols used by the five practices participating in the FLCCC Alliance cancer study, one of those practices being ours. However, the single most important reason why I advocate that my patients continue to take ivermectin on a daily basis, is the role that it plays in relation to micro clotting.

We all have our heroes from this pandemic. Although it makes me shudder, I realize that for some people that hero is Dr. Fauci. One of my heroes is a man whose name you may not have heard of, but who has profoundly influenced my clinical practice. He is Dr David Scheim, a semiretired officer of the United States Public Health Service Commissioned Corps. In February 2022 he published a theoretical paper about the role of ivermectin in relation to red blood cells and platelets. He posited that because of its effect on CD 147 receptors on the surface of red blood cells (RBCs) and platelets, ivermectin prevented the spike protein from triggering platelet activation and aggregation, and red blood cell (RBC) aggregation, or a agglutination. He also put forward some calculations about the number of molecules of ivermectin in proportion to RBCs could be expected when doses of 0.2 mg per kilogram were delivered. “For a dose of IVM administered with food in the standard, non-aggressive range of 200–350 µg/kg, the peak plasma level (at +4 h) of IVM plus active metabolites would be approximately 412 nM, which amounts to 52,000 molecules of IVM and active metabolites per RBC in human blood.” The numbers were very reassuring. (My editor told me to translate the above in lay terms. Essentially, with low doses of IVM, there is an enormous amount of IVM in proportion to the cells in our body which can form abnormal and harmful microclots.)

That relatively brief paper, that clinical hypothesis, and those numbers, gave me the confidence to continue swinging away with ivermectin over the last two years with thousands of patients. When I encountered colleagues who hold up treating the Microbiome as the be-all-end-all of clinical care, I can listen to what they say, but hold on to what I think is a more important truth. The microbiome can be healed over time, but coagulopathy can kill you now.

In the Winter of 2022 Dr Scheim et. al. published another paper titled SARS-CoV-2 Spike Protein Induces Hemagglutination: Implications for COVID-19 Morbidities and Therapeutics and for Vaccine Adverse Effects. Then in the Fall of 2023 Dr. Scheim et. al. published a « piece de résistance » regarding ivermectin and the role that it plays in relation to endothelial cells, red blood cells, and platelets. Dr. Marik kindly shared it with the understated subject line “cool paper. “ One of the most important assertions of this paper is a statement of fact, that individual endothelial cells have 38,000 glycan receptors and only 175 ACE2 receptors. Additionally, platelets and red blood cells have zero ACE2 receptors, but are covered with glycan receptors. Given the profound impact of the spike protein, following injection, entry into the bloodstream, systemic endothelial injury, and provocation of clotting, the dearth of ACE2 receptors in that initial pass has enormous significance. In both the popular press, and the circles of practitioners treating PASC and vax injury, the conversation has been dominated by the narrative that the ACE2 receptor is the penultimate target of the spike protein. What if we expand our understanding to include glycan receptors?

Dr. Scheim et. al. elucidate in great detail how profoundly ivermectin protects endothelial cells, RBCs, and platelets from the harm of spike protein, additionally contributing to the resolution of injury and coagulopathy. By both expanding the narrative beyond ACE2, and explaining the profound clinical action of ivermectin on the blood vessels, and in the bloodstream, Dr. Scheim et. al. help propel ivermectin into the Covid Hall of Fame for years to come. Retrospectively, their research vindicates the brave practitioners who dared to prescribe ivermectin to their patients in the face of blistering criticism and specious slander.

Having been a loser for so long, I’m accustomed to ongoing struggle. I think that we have lost the war of this pandemic, and are fighting skirmishes to save the lives of as many people as we can. Ivermectin has been and continues to be a reliable and versatile tool in our fight. After two years working together, I can say that whatever the future may hold, whatever the final outcome of this historic battle for humanity, the good people of The Leading Edge Clinic have formed a winning team.

P.S. Thanks to Beck for his song Loser, and Randy Travis for his song Better Class of Losers for their musical inspiraiton while writing this Substack.

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