PAST
In 1976 my dad bought a meter maid scooter at the West Hartford, CT town auction. It was a 1969 Vespa with a 150cc engine. The Vespa was made in Italy, and derives its name from the shape of its body which resembles a wasp. The West Hartford Police had spray-painted over the POLICE lettering on the sides and it was a pretty metallic blue. I suspect this was one of those impulse buys which Dad didn’t clear with Mom, kind of like the Model A Ford he stored in some farmer’s barn until my mom saw a receipt for the monthly rent and extracted a new Singer sewing machine in the ensuing disagreement. He would have been about thirty-five years old, with three kids, a wife, steady job and about on time to feel a little restless.
I can reach back to that time and find the elusive feeling that all was right in the world, even if for a brief moment. Rides on the back of the Vespa, holding onto my dad, are some of the sweetest moments of my childhood. It would have been warm and sunny. He felt strong, and smelled good, like soap and aftershave – and dad. For a guy that had never ridden a motorcycle before, he was smooth with his shifting and handling in the curves of the road.
My dad died after New Years in 2000 from metastatic renal cancer. The Vespa we rode together in my childhood came to reside with us in Ithaca, NY. It had 10,000 miles on it, a tempermental clutch, a flywheel ready to seize at any moment, and many more dents and dings at the hands of my stepbrother and his pals. It afforded me many more moments of joy and laughter, as there was a scooter culture in Ithaca with an annual rally, and contingent in the parade during the annual Ithaca Festival. She was even dressed up with a grass skirt for the Hawaiian theme one year.
The day finally came when I passed the Vespa on to someone who would appreciate her, could fix her mechanical woes, and ensure more years of riding. Working in the ED has its hazards, and as time went by I cared for more patients injured, maimed and killed in motorcycle crashes. I lost my enthusiasm and gumption to ride. What I held onto were the moments riding with my dad. What makes me connect this to a Substack on healing the gastrointestinal tract is that it was a time when I felt calm, loved, and settled in my gut. The mind-body brain-gut axis isn’t just an idea. It’s an existential state.
RECENT PAST
My classmates at SUNY Upstate in the MS-FNP program chose very reasonable topics for their Master’s research: antibiotic resistance in the ICU, throughput in the Emergency Department (ED), diabetic education in the outpatient clinic. I don’t set out to be the weirdo, it just happens. My focus was juicing, as in fruits and vegetables, as a transitional tool for better health. When we presented our research my classmates were committing death by Power Point, i.e. reading every word on the slide that you can read faster than them. I lugged in my Breville juicer, two grocery sacks of produce, and made the audience some juice to remember!
There are a lot of studies about juice. It turns out that the NIH has funded many of these due to an interest in the power of phytonutrients. Some of my favorites included sour cherry juice in marathon runners as an alternative to Ibuprofen or NSAIDS, or use of fresh orange juice to reduce incidence of stroke. The standout studies for me were a trio on raw cabbage juice to heal peptic ulcers.
In the world of evidence based medicine, new is sexy, and old is not. There are however some very well done studies if you are willing to go back in time. There was also a change in attitude about the rights of test subjects in the 1970s.
Between 2010, when I began my studies at SUNY Upstate, and 2021, when I left employment in the ED, I had to complete biannual training related to the ethics of experimenting on human subjects, the origins of Instituational Review Boards (IRB), and my role in regulatory compliance. There was a lengthy online program through Collaborative Institutional Training Initiative (CITI). If the intention of these trainings was to ensure that the entire clinical staff of our research institutions understood the history of unethical research practices and stood up for the right to informed consent, the pandemic proved it was an epoch fail. Upstate was no better than any place else, pushing patients to receive Remdesivir, providing unequal treatment to the unvaccinated, and mandating the Covid shots for all of its employees. Some day in this Substack I will write about how the first Covid shot which I received, which countless Upstate staff and volunteers also received, was Pfizer batch EK9231. It was a bad batch which injured, disabled and killed more people than any other Pfizer vaccine batch in recorded history.
The history which we were supposed to study and learn from starts with The Tuskegee Study of Untreated Syphilis in the Negro Male. It was conducted between 1932 and 1972 by the United States Public Health Service (PHS) and the Centers for Disease Control and Prevention (CDC) on a group of nearly 400 African American men with syphilis. Its participants were not informed of the nature of the experiment, nor were they treated, and as a result, up to 100 of them died. The study’s gross ethical violations hit the press in 1972, which led to the 1979 Belmont Report and the establishment of the Office for Human Research Protections (OHRP) and federal laws and regulations requiring IRBs for the protection of human subjects in studies.
Back to the human labs rats. In 1949, 1952, and 1956 there were three separate studies which evaluated the effectiveness of raw cabbage juice in healing peptic ulcer disease. The 1956 double blind experimental study was conducted on prisoners at San Quentin in California, after obtaining permission from Dr Morton Willcutts, the medical director. The authors commented that “The advantages of using the prison facilities for investigation of this type cannot be overemphasized.” Ahh, the good old days.
Unlike the men of the Tuskegee Experiment, the prisoners of San Quentin who received the experimental treament got better, really quickly in fact. Most had complete healing of the ulcer craters within three weeks. Prisoners who had failed treatment with placebo were later rotated through treatment with cabbage juice and also had complete healing.
Ironically, at the time I was immersed in my study of more than 200 research articles on juicing, I was experiencing a severe bought of esophagitis. My Cardiologist had increased my daily potassium supplementation over time as he chased a serum level above 4.0 mEq/L, reaching a dose of 40mEq twice a day. I hadn’t made the connection that the potassium was injuring me, but my PCP did, and we stopped the potassium. The question was how to heal my esophagus? An NP colleague in the ED suggested a proton-pump inhibitor (PPI) such as Omeprazole, but I already had reason to be wary of them. See below. I settled on two weeks of Zantac, an H2 or acid blocker. Then I bought some cabbage and got down to juicing.
Raw cabbage juice could be described as cruel and unusual punishment, but if you are motivated to heal without drugs that could injure or kill you, it’s a fabulous option. My advice would be the same as Canadian country singer Corb Lund, just substitute cabbage juice for whiskey:
Drink it like you mean it, like the serious people do
If you’re down and broken hearted and you’ve got good reason to
Drink it like you mean it to the bottom of the glass
With resolve and strong intention, drink it right down to the last
Speedy isn’t fast enough to describe my recovery. It took two days flat to be healed. That made quite an impression upon me, and I’ve been more than happy to share this experience and recommend the cabbage juice adventure with many patients since that time.
Here are a couple of pointers. When using fresh vegetable or fruit juice as a transition to a healthier diet, or a tool for healing, only make enough juice for immediate consumption. The phytonutrients break down quickly. Try to use only enough fruit or sweet vegetables like carrots to make the juice palatable to you, as the sugars are calorie laden and can promote inflammation. With cabbage juice in particular, buy a large head as it will be sweeter than a small head. Organic produce can have more than three times the nutrient content of conventional produce and doesn’t have the herbicides and pesticides which could be counterproductive to healing. A quarter of a large cabbage head is usually enough to make about a cup of cabbage juice. It is best to drink it by itself on an empty stomach. If you have to cut it with another veggie or fruit, you can.
PRESENT
Proton-pump inhibitors or PPIs such as Omeprazole (Prilosec), Nexium, Prevacid and Protonix are used to treat gastroinestinal disorders such as heartburn, acid reflux, gastritis, peptic ulcer disease and Barrett’s esophagus. They are among the most commonly prescribed drugs in the world. The US market is currently valued at $2.3 billion and forecast to grow to $4.9 billion within the decade. About 15 million Americans use them annually,
Before the pandemic, I understood that PPIs were problematic. The National Health Service (NHS) of the UK had found that PPIs were the source of increased antibiotic resistant gastrointestinal (GI) infections. This lead to a decrease in their use in the UK. (An aside, which is a rabbit hole I couldn’t bear to go down, is that the NHS withdrew previous guidance re: limiting use of PPIs to prevent harm. Under whose influence?) It was also known that PPIs cause iron deficient anemia, and inhibit absorption of B-12 and calcium, so can contribute to neuropathic symptoms, osteopenia and osteoporosis. More recent evidence suggests contributions to neurodegenerative diseases and dementia. These drugs were never meant to be long-term therapies, but that is exactly what they have become for many patients in the United States.
In China, only the wealthy minority could afford PPIs, and the rest of the population had to settle for H2 blockers like Famotidine or Pepcid. In 2020, there was a Chinese study which spoke to this dynamic. I read it in January of 2022, just as we were launching our telemedicine practice. It concluded that use of PPIs within the previous 30 days was associated with a 90% increased risk of severe clinical outcomes of COVID-19.
With this information in mind, I was alert to the presence of PPIs on the med lists of new patients we were treating for acute Covid, as well as those presenting with post-acute sequelae of Covid (PASC) or vaccine injury. At the time I would tell them that although we didn’t yet know why, use of PPIs was associated with worse outcomes in Covid, and we should try to wean them off that medication. The simplest thing I could say was that millions of years of evolution had lead to every mammal on earth having an acidic stomach, and it was probably unwise to fiddle with this process.
Most patients were willing and able to discontinue their PPIs. One of the Registered Nurses in our practice, Kara Gabrielson, became adept at crafting weaning schedules for patients, so that they could slowly titrate their dose and transition to H2 blockers, then non-prescription approaches. We knew that sudden cessation of PPIs was a terrible idea, because our bodies stop making as much acid when we are on these medications. When we stop them abruptly, there is usually a burst of acid production which can leave a patient in agony from terrible acid reflux and heartburn.
In July of 2022, I was on the floor of our living room doing stretches one morning. It had become my routine to listen to the Wednesday FLCCC Webinar broadcast on Saturdays. During one of these episodes with Dr Paul Marik and Dr Mobeen Syed I learned why PPIs lead to more severe clinical outcomes in Covid. Dr Marik dropped the truth bomb, and I sat straight up, yelling out. My wife thought I’d been hurt and came running in to see what was wrong. I reassured her that I was fine, but just found out that PPIs don’t just decrease the acid in our stomachs, but also in our cells.
A fundamental process by which our bodies take out the garbage and combat pathogens is via the lysozomes in our cells. These are little pockets of acid, which are gathered together, and fused with little sacks that contain deformed proteins or pathogens. If there aren’t enough lysozomes, or they aren’t acidic enough, they can’t do their job. It would be like chewing a piece of meat, but not quite enough, swallowing, and then choking on it.
After this revelation I doubled down on guiding patients to get off PPIs. The pattern became clearer. There was a small number of patients who could not or would not discontinue their PPIs, and they were not progressing in their recovery. They could get to a certain point, but would then plateau, or backslide. The worse case scenario was that they were on both a statin and a PPI, and their PCP, Gastroenterologist, Cardiologist, and other system practitioners were lobbying hard for them to continue these medications. Often they aren’t ready to dedicate the time and energy to learning new behaviors such as chewing longer, avoiding alcohol, and eating at least four hours before bedtime. I’m sympathetic, as I love wine and know enough about it to find a good glass or bottle on a menu in a restaurant, but at this point, it mostly isn’t worth the adverse effects. I’m also sympathetic, because I know how ferociously the system docs defend the use of these harmful medications.
What are your alternatives to PPIs? As mentioned in my Substack on aluminum containing drugs, first and foremost, knowledge. Dr Sherry Rogers recently updated her classic No More Heartburn: The Safe, Effective Way to Prevent and Heal Chronic Gastrointestinal Disorders. Buy it, read it, and act upon it. Take time to chew your food, drink less liquids with your meals, drink less alcohol, eat fewer processed foods, and limit caffeine intake. Try using oral liquid aloe vera, apple cider vinegar, and slippery elm bark to heal your inflamed gut. Eat a healthier diet, and cultivate a more robust microbiome, preferably with cultured foods and liquids rather than proprietary pills and potions promising probiotic nirvana.
Aligning our mind and body along the brain-gut axis is essential to recovery in PASC and vaccine injury. Each day that I work with our team at The Leading Edge Clinic, I’m sensitive to how we are pushing against the limits of a broken healthcare system which peddles harmful medications to patients who are suffering. What buoys my spirit is when patients realize their body’s inherent capacity to heal. Every day we expand our knowledge and capacity to counter spikopathy, reject harmful chemicals and poisons, and harness safer resources to regain function and hope in our lives.