WE ALL HAVE SOME CHRONIC INFECTIONS; now there is another major breakthrough to prove this.

My Fight program clearly is meant to help us educate our patients that achieving optimal health is a lifetime challenge. With increasing sophistication of lab sciences, we will find many more challenges in every one of my FIGHT categories but with the epidemic of people with chronic fatigue, you now have even more reason to want to learn about Oxidative therapies like OZONE/UVB/SILVER.

However, a unifying approach to enhance our bodies ability to deal with the multifactorial nature of any chronic disease should increase our interest in learning more about Energy medicine. This broad topic includes Homeopathy, Accupunture, Prayer, Microelectric Current therapy, Magnetic Healing, Oxygen, Hyperthermia and much of what is now called Alternative Medicine.

The exerpt below is just one line from the great overview of viral infections and XMRV that is found in Autism and Prostate Cancer and Chronic Fatigue. This area of research is all new this year but we can expect that someone will soon find many more fungi issues or parasites issues. Of course tying impaired health to our toxin load is just beginning to be seriously considered. Do not fail to look for a moment at this article, as when you tell patients they need to deal with the chronic infection component of their current symptom complex, many feel you are off the wall.

Unless they have heard of Candida or Chlamydia, or CMV, or Herpes, or Lyme, they are not attuned to the need to lower their total body burden of pathogens. No one needs to spend the money to chase down which of these infections they have, as no one will test negative for one or more of these infections if adequately tested. So testing for most patients is impractical except to get their attention as to why they must do something about the infection component of my FIGHT program if they are to achieve optimal health.

“XMRV (xenotropic murine leukemia virus-related virus) is strongly associated with chronic fatigue syndrome/ME. The earlier study published in the journal Science was a joint study by the Cleveland Clinic, the National Cancer Institute, and the Whittemore-Peterson Institute of the University of Nevada with Drs. Vincent Lombardi and Judy Mikovits as lead authors. Here the lead author of the NIH/Harvard/FDA study, Dr. Harvey Alter, noted in a press conference that he considered his study a confirmation of the earlier WPI study, even though they had detected different MLV-related viruses (MRVs), rather than only XMRV. There does seem to be a greater variety of MRVs in chronic fatigue syndrome/ME patients than first understood. The WPI’s original study also showed some evidence of additional MRVs.”
Read more: http://www.ageofautism.com/2010/09/my-wife-my-daughter-and-xmrv.html

Sincerely,

Garry F. Gordon MD,DO,MD(H)
President, Gordon Research Institute
www.gordonresearch.com

It is  no too late to come to Phoenix for these two conferences !  You will come away understanding that when you combine my F.I.G.H.T.  Program with the missing link, healing with Physics, using the modalities you can personally experience at my conference, you will experience amazing healing results!

Sincerely,

G.F. Gordon MD DO MD(H.)

____

To anyone interested in Infinite Wellness;

I have found unique synergy combining the biochemistry, like my FIGHT program with the PHYSICS we can no longer ignore. This approach is changing the lives of very ill patients, often almost overnight.

I personally feel younger each day. I am certain that any one of these; PEMF, TESLA based electro muscle stimulation, and correctly designed magnetic pads to sleep on, will improve your life dramatically

You are invited to attend one or more of my 3 workshops being held in Phoenix March 3-7 in conjunction with the great conference offered 3/4/11 by AHIMA. Flyers and registration information are attached. NOTE: Admission is free on 3/6/11 from Noon until 7 PM and only $50 on other dates if you also register for AHIMA conference, $100 if you do not.

Here you will learn that Physics is more important than Biochemistry in determining how you FEEL and how you HEAL! Without a magnetic field there is no life and the experts believe that the earth’s electromagnetic field hasdropped from nearly 30 Gauss at the time of dinosaurs to 0.3 Gauss now. (more)

Register for AHIMA Conference Here

Register for the Energy Workshops Here

Excerpt:

Acupuncture, which is based on the theory that inserting and manipulating fine needles at specific acupuncture points located in a network of meridians will promote the harmonious flow of “Qi,” is one of the most widely practised modalities of alternative medicine. Because needles are inserted up to several centimetres beneath the skin, acupuncture may pose risks to patients. One of the most important complications is transmission of pathogenic micro-organisms, from environment to patient or from one patient to another.

In the 1970s and 1980s most infections associated with acupuncture were sporadic cases involving pyogenic bacteria.1 So far, more than 50 cases have been described globally. In most cases, pyogenic bacteria were transmitted from the patient’s skin flora or the environment because of inadequate skin disinfection before acupuncture. In localised infections, meridian specific and acupuncture point specific lesions were typical. About 70% of patients had musculoskeletal or skin infections, usually in the form of abscesses or septic arthritis, corresponding to the site of insertion of the acupuncture needles.1 2 A minority had infective endocarditis, meningitis, endophthalmitis, cervical spondylitis, retroperitoneal abscess, intra-abdominal abscess, or thoracic empyema.3 4

Linda’s comment: “Your taxes should not be used to fund censorship in a public library, especially the largest medical library on the planet. It is un-American.”  This quote is so very true…how dare they censor information that can and does save lived.  Follow the money.  More and more folks are turning to the Internet today to find answers for their health woes.  They don’t trust doctors with their treatment plans,  Why? Because they are not getting well or have been misdiagnosed.  I wonder how much money Medline receives from the pharmaceutical industry to censor alternative medicine articles?  If they are going to use my tax dollars then they need to put alternative medicine on medline, medscape, etc., etc., etc.

Regards,

Linda or Angel

Excerpt:

Comment by Andrew W. Saul
Editor-In-Chief, Orthomolecular Medicine News Service

(OMNS, January 15, 2010) Did you know that there are “good” medical journals, and that there are “naughty” medical journals?

No kidding. The good journals are easy to access on the Internet through a huge electronic database called Medline ( http://www.ncbi.nlm.nih.gov/pubmed ) This wonderful, free service is brought to you by the US National Library of Medicine and the National Institutes of Health. In other words, by you. By your tax dollars. Generally it is money well spent, until you go searching for megavitamin therapy research papers. Then you will find that you can’t find all of them. That is because of selective indexing.

The National Library of Medicine (NLM) proudly describes itself as “the largest medical library in the world. The goal of the NLM is to collect, organize and make available biomedical literature to advance medical science and improve public health.”

Hmm. Collect. Organize. Make available. Improve public health.

So, after over 40 continuous years of publication, why is the Journal of Orthomolecular Medicine NOT indexed by Medline?

Full article:

http://www.orthomolecular.org/resources/omns/v06n03.shtml

Introduction

Clinical practice guidelines are now ubiquitous throughout the
United States. The National Guidelines Clearing House, under the
category “diseases,” currently lists 2,126 separate guidelines on its
web site. Clinical guidelines are intended to assist physicians in
patient care by clearly communicating the results of the guideline
committees’ evaluation of available therapeutic options. However,
the processes by which individual guidelines are constructed may be
less clear, leading to disagreements between the issuing committee
and the physicians who treat patients-physicians who may well be
as experienced and knowledgeable as the guideline committee.

The 2006 Infectious Diseases Society of America (IDSA)
guidelines for Lyme disease were released in the fall of that year and
were soon the focus of an antitrust suit brought by Connecticut’s
attorney general. A settlement between the two sides was announced
on May 1, 2008; it called for the seating of a new panel and a
comprehensive review of the evidence, including a hearing to allow
for presentation of divergent medical points of view.

This article reviews the 2006 IDSA Lyme guidelines regarding the impact
various recommendations may have on the use of clinical judgment
in the diagnosis and treatment of patients with Lyme disease
Clinical Judgment in the Diagnosis of Lyme Disease

The IDSA in its 2006 Lyme disease guidelines states:
Clinical findings are sufficient for the diagnosis of
erythema migrans, but clinical findings alone are not
sufficient for diagnosis of extracutaneous manifestations of
Lyme disease or for diagnosis of [human granulocyctic
anaplasmosis] HGA or babesiosis.

Diagnostic testing performed in laboratories with excellent quality-control
procedures is required for confirmation of extra cutaneous
Lyme disease, HGA, and babesiosis.

Initially, the statement appears innocuous; laboratory
confirmation of any diagnosis is always reassuring. But here the
guidelines panel goes a step further. By requiring lab confirmation, it
sets up a diagnostic hierarchy in which testing supersedes clinical
judgment, negative results on indirect laboratory assessments of
infection overrule carefully constructed clinical assessments, and
tests are deemed infallible.

Yet, this diagnostic scheme is fallible. Consider the situation in
which 100 patients with undiagnosed Lyme disease seek medical
attention for evaluation of fever, headache, fatigue, and body aches
occurring at the end of June.

Recall that CDC data indicate that erythema migrans (EM) rashes are reported in 68% of patients
meeting the surveillance case definition, and that the guidelines
recommend two-tier serologic testing of patients lacking the
diagnostic rash. In the two-tier scheme, patients are first tested with
an enzyme-linked immunoabsorbant assay (ELISA) or indirect
fluorescent antibody (IFA) test, and those with positive or equivocal
results are then tested withWestern blotting; patients who are negative
on ELISA are not tested further.

Trevejo et al. found the sensitivity of
two-tier testing in early Lyme disease to be 29%-32%; Bacon et al.
found it to be 38%. As Table 1 demonstrates, the laboratory
confirmation requirement is problematic; as many as 22% of early
Lyme disease patients would go untreated.

Clearly, this is unacceptable; patients would be left untreated at the
stage when therapy is most efficacious. Owing to the potential for false
negative results in these circumstances, Steere et al. suggested that
physicians consider treating patients with “summertime flu”
symptoms.

The need for such a suggestion emphasizes the principal
reason for this challenge-laboratory confirmation requirements
undermine the value and primacy of clinical data and may impede care
as would be the case in this very common clinical scenario.

The same problem with laboratory confirmation holds true for late
neurologic Lyme disease. Starting again with 100 patients who have
undiagnosed Lyme disease and objective, non-EM findings, 43%-56%
would bemis diagnosed because of deficits in laboratory capabilities, as
shown in Table 2

In late Lyme, sensitivity of the testing procedure was
found to be 44% by Ledue et al. , and 57% by Dressler et al.
The low sensitivity of two-tier testing in late neurologic Lyme
disease can be traced back to the original paper by Dressler et al.,
from which the Centers for Disease Control and Prevention (CDC)
took its IgG Western blot criteria.

After identifying the 10 bands on Western blotting that yielded the highest specificity in a retrospective
study, Dressler et al. then tested the criteria in a prospective study. In
that study, the paper reports that 21 of 29 patients with
neuroborreliosis had positive IgG Western blot results, yielding a
sensitivity of 72%.
The ELISA used by Dressler et al. had a sensitivity of 79%. Performing the tests sequentially,
as is done in two tier testing, results in an overall sensitivity of 57% (79% x 72%).
With the two-tier sensitivity for late Lyme disease roughly 50%, a negative
result does not inform physicians, but may easily lead them astray.

Other studies on the two-tier strategy yield different and higher
values for sensitivity. Some studies speak of the “relative
sensitivity” of a test rather than the true sensitivity. The
disagreement between studies investigating the sensitivity of various
testing methodologies for Lyme disease indicates a problem with test reliability, which has been the subject of other papers. If the serologic tests for Lyme disease were equally reliable, sensitivity would be nearly identical across studies of similar, and appropriate, design. (A full
discussion on the limitations of serologic testing is beyond the scope of this paper.)

Other methods available to support or confirm a clinical diagnosis of Lyme disease
in the absence of an EM have low sensitivity (polymerase chain reaction [PCR] of cerebrospinal fluid and blood), may be invasive,or are not clinically available.

With serologic testing being insensitive,clinical data-the history and physical
examination-become even more important.Relying on clinical data to make a diagnosis is
not unique to Lyme disease.

One study on the relative values of history, physical examination,and diagnostic studies found that internists used history alone to establish the correct diagnosis in 76% of test cases.
Another found that in distributing a 100% total relative value between these three types
of data, clinical faculty valued history at 63.3%, physical examination at 19.2%, and
laboratory/imaging data at 17.5%.

Such evidence establishes that the diagnostic hierarchy proposed by the guidelines is inconsistent with the way medicine is practiced. A Lyme disease history begins with the potential for exposure. This history,while a key element, is not always enlightening.

Patients may be unaware of whether they live/work/recreate in a Lyme endemic
area; they may forget about vacations in endemic areas. Questions regarding tick bites may lead to inappropriately ruling out Lyme disease; in one study on erythema migrans, only 14% of the patients recalled being bitten by a tick.

Clinically, and in keeping with its multi systemic nature, Lyme disease has been described as being “symptom rich, exam poor.” Symptoms may be specific or nonspecific, mundane or unusual, acute or chronic; some are prognostic. Some physicians have been
criticized for “seeing Lyme everywhere” in that they recognize scores of symptoms beyond EM rashes, Bell’s palsy, and arthritis as being associated with Lyme disease. Yet, early researchers also noted these symptoms. In a treatment trial on early Lyme disease, Massarotti et al. found that subjects reported the following symptoms: 56% had headache; 42%, stiff neck, with 19% having pain with neck flexion; 14%, dysesthesias; 11%, photophobia; and 4%, facial palsy. Consider these symptoms from Logigian et al.

The wide array of Lyme disease symptoms is consistent with ability to infect multiple organ systems;nervous system involvement creates the potential for varied and atypical symptoms. Common symptoms include: EMrash, fever, fatigue, headache, neck pain, joint or muscle pain, paresthesias, memory impairment, weakness of facial muscles, mood disorders,
neuropathic pain. Acompendium of manifestations by system is given inTable 3.

It is the multisystemic nature of the illness that provides physicians with useful diagnostic information. In fact, with the exception of an isolated EMrash or swollen joint, patients with symptoms restricted to a single system are unlikely to have Lyme disease. Recognizing the
potential for disease is different from “seeing it everywhere.” Failure to recognize Lyme disease may lead to serious harm, as antibiotics are delayed and the infection is unchecked.

The nonspecific nature of many Lyme disease symptoms leads some to suggest that such symptoms hold no diagnostic value. Lyme disease is like many other illnesses that present with nonspecific and often subtle symptoms-symptoms that may go unrecognized by physicians. Examples include hypothyroidism, ovarian cancer, and acute subendocardial myocardial infarction. What gives the individual symptoms of Lyme disease value is their occurrence in clusters; a single symptom means little but four or five may, for all practical purposes, make the case. Just as abdominal bloating, urinary urgency, and pelvic pain raise “red flags” for gynecologists, the combination of fatigue, paresthesias, arthralgias, and memory
complaints presenting in a single patient commands the attention of physicians aware of these potential Lyme disease symptoms.

Steere et al. noted that patients with early Lyme disease who lacked an EM rash presented with an average of four or more symptoms. Fever, chills, malaise, and myalgia, all nonspecific, were present in 46%-71% of the patients with definite Lyme disease alone.

In this group, it was the clustering of nonspecific symptoms in the appropriate setting that led to the correct diagnosis of Lyme disease. Logigian et al. also noted the nonspecific nature of identi-fying symptoms: “The most common form of chronic central nervous system involvement in our patients was subacute encephalopathy affecting memory, mood, and sleep, sometimes with subtle disturbances in language.  Diagnosis of this condition may be difficult because the typical symptoms are nonspecific ” [emphasis added].

To provide a clinical level of diagnostic sensitivity higher than two tier testing, physicians need to recognize the symptom clusters and aintain a high index of suspicion for Lyme disease

Symptoms not only form the basis of disease identification, they ay also inform on prognosis. Dysesthesias, paresthesias, ultiple EM lesions, increased irritability, persistent fatigue,
headache, stiff neck, and increased severity of the initial illness ere associated by various investigators in the early Lyme disease reatment trials with an increased risk of treatment failure. Symptoms wre also used in the trials as indicators that a strategy was working
or needed to be altered.

indings on physical exam are usually subtle and limited; they ay be variably present. The more common findings include: olitary or multiple EM lesions, manifestations of cranial
neuritis (such as extraocular palsies, ptosis, decreased facial ensation, facial nerve palsy, decreased hearing), swollen and ender joints, diminished sensation, andmotor weakness.

Cognitive deficits are usually not readily apparent on mental status testing, but patients may be disorganized or slow to respond to questions. A lack of physical findings does not necessarily indicate that the symptoms in those cases cannot be corroborated with objective evidence. Halperin et al. studied 14 patients with complaints of distal paresthesias; 10 had completely normal sensory, motor and reflex findings on examination, three had only mild sensory loss, and one had moderate sensory and motor losscoupled with decreased reflexes.

All underwent EMG testing; 13 ofthe 14 had “significant neurophysiologic findings.” Logigian et al. also found that detailed neuropsychometric testing could reveal cognitive deficits that were not apparent on routine mental status testing. Cost and time constraints do not allow for such complete testing in a community setting, but the studies suggests that with sufficiently detailed testing, objective evidence may be discovered and the subjective data supported. The absence of findings does not equal absence of disease.

Even the EMrash has a variable presentation that may cause less informed physicians to miss it. An EM lesion may have one or more of the following characteristics: homogeneously erythematous color,prominent central clearing, target-like appearance, central vesicles or
pustules, partially purpuric, and not scaly, unless topical corticosteroid creams have been applied or the rash is old and fading.

An EM rash must be distinguished from: tick bite hypersensitivity reactions, insect or spider bites, contact dermatitis,bacterial cellulitis, and tinea. An interesting study in compared responses from physicians in endemic and nonendemic areas with regard to what percentage of EM rashes in their practices had central clearing. Physicians from endemic areas thought it only 19%, while those from nonendemic estimated 80%. The authors did not give a reason for the disparity; possibilities include strain variation or physician experience. The variable presentation of the EMrash, coupled with the fact that it does not manifest in 32% of patients, makes it unwise to rely on EM as the only manifestation of Lyme disease that has clinical diagnostic utility.

Physicians use pattern recognition as a common diagnostic heuristic. These cognitive “shortcuts,” when used properly, allow physicians to move quickly to the correct diagnosis. Pattern recognition transforms exposure, individual symptoms, and the course of illness into a unified diagnosis; it is why some physicians specifically see “Lyme disease” when colleagues see only a generalized “positive review of systems.” For physicians unfamiliar
with the pattern of Lyme disease, serologic testing, combined with clinical data, offers the potential for reaching the correct diagnosis. However, serology alone cannot confirm or deny presence of infection. In Lyme disease, there is no testing shortcut

Furthermore, diagnostic criteria are situational. Clinical criteria are constructed to diagnose and treat ill patients. Research criteria are constructed to test a hypothesis in a uniform group of subjects; researchers have no duty to those excluded from the trial.

Surveillance criteria are much the same, the goal being selection of a homogeneous patient subset that can be observed over time and treatment. The difference between these situations is an important consideration. This distinction is highlighted by these comments from CDC epidemiologist Dr. PaulMead

Aclinical diagnosis is made for the purpose of treating an individual patient and should consider the many details associated with that patient’s illness. Surveillance case definitions are created for the purpose of standardization, not patient care; they exist so that health officials can reasonably compare the number and distribution of “cases” over space and time. Whereas physicians appropriately err on the side of over-diagnosis, thereby assuring they don’t miss a case, surveillance case definitions appropriately err on the side of specificity, thereby assuring that they do not inadvertently capture illnesses due to other conditions.

Recognition of the differing goals allows knowledgeable physicians the discretion to diagnose Lyme disease in patients lacking the five of 10 bands required for admittance into the surveillance group. Failure to acknowledge the distinction results in many patients with Lyme disease remaining undiagnosed and untreated.

Mandatory laboratory confirmation of clinical diagnoses, as advanced in the 2006 IDSA guidelines, reverses the roles of clinical and laboratory data in the diagnostic process and hierarchy. Substituting laboratory tests for physician judgment is not clinically
sound, particularly when laboratory tests lack sensitivity. This recommendation is a change from the 2000 IDSA guidelines on Lyme disease, but the 2006 panel did not discuss the reasons for this change nor cite any references from the literature to support it. Guideline developers have identified the need for reconciliation between new and former versions of the same disease guidelines; the IDSA, itself, endorsed the reconciliation process, yet it did not
occur in this instance.

Clinical Judgment in Management of Patients with Lyme Disease

Clinical judgment is required to appropriately manage patient care. Patient management is an evolutionary process, not a static state; ongoing assessment allows for refinement of the original diagnosis or the search for new one. Lyme disease is no exception to this rule; yet the 2006 IDSA guidelines reduce clinical management to a one-size-fits-all approach quickly chosen from a table. Clinical judgment is especially important when the clinical picture is unclear and laboratory data unhelpful. After careful investigation of other potential diagnoses, physicians may need to perform an empiric treatment trial as a diagnostic modality.The use of such trials extends well beyond Lyme disease. For example, patients with nonspecific
epigastric pain may be offered “GI cocktails” as a means to both diagnose and treat the condition

Clinical decision-making in Lyme disease requires ongoing information; the longitudinal treatment trials on Lyme disease demonstrated the value of this data. Historical and physical
examination data were gathered at defined points; on some occasions the information was used to alter the treatment protocol (investigators withdrew or re-treated some subjects). Followup visits in many of the studies on Lyme disease demonstrated apositive correlation between reported symptomatic changes and subsequent physical findings or test results. Long-term follow-up extending beyond the active treatment phase provides researchers, as
well as physicians in clinical practice, the ability to discern the difference between placebo and treatment effects

Clinical judgment in Lyme disease requires physicians to weigh risk-benefit concerns with individual patients. Treatment risks for the patient include potential adverse effects from antibiotic therapy (including risks associated with medication administration), costs,associated with therapy, and lifestyle changes to accommodate treatment

Patient benefits include improved health with attendant improvement in quality of life and lower medical costs following recovery. Antibiotic therapy, including long-term oral antibiotics, is
generally safe and well tolerated. A meta-analysis on the risks associated with intravenous (IV) access of various types found that peripheral intravenous catheters cause 0.5 bloodstream infections per 1,000 intravascular device (IVD) days while surgically implanted long-term central venous devices-cuffed and tunneled catheters-cause 1.6 infections per 1,000 IVD-days

Data from Lyme disease treatment trials can inform on the risk of IV antibiotic therapy in this patient population. Table 4 reports the complication rates in the treatment groups of Lyme disease studies which used IV ceftriaxone for a minimum of 30 days. Significant adverse events included medication-related events (severe allergic reactions, gall bladder toxicity, Clostridium difficile enterocolitis, renal failure) and catheter-related events (skin infiltration, infection, and thrombosis).

Adverse events in the Fallon study are considerably higher than in the others; reasons are unknown, and the small sample size makes it difficult to draw conclusions. There were three cases of ceftriaxone allergy in the 23 patients; this 13% allergic rate is higher than expected. Thrombi developed in two patients, but the paper does not provide details of the site of the peripherally inserted central catheter (PICC) or its specific type. Additional studies are needed to delineate the risk of IV antibiotic therapy extending beyond 30 days in better detail, and to determine whether there would be opportunities to minimize those factors contributing to the total risk

There are also risks to the patient associated with failure to treat a continuing infection. These include declining health, decreased productivity, a potential for increased costs as more health-related services are required, and costs related to palliative medications (including their potential adverse effects).

The IDSA guidelines raise concerns about the impact longer treatment regimens may have on society. While these concerns should not sway treating physicians who are entrusted with the care of individual patients, the concerns merit some comments. The guidelines authors focus attention on treatment risks to society, citing additional costs and the potential for increased bacterial resistance in the community. However, the authors ignored potential benefits to society from such treatment regimens. These benefits include improved health in the community, increased production from previously ill patients, and potential for success in this patient population to inform treatment decisions in other groups. Additionally, there are societal risks from not treating; these include ever increasing expenses for a chronically ill subpopulation and lost productivity from ill workers

In the individual patient, the decision to treat or to prolong treatment may depend on the length of time between onset of illness and diagnosis; severity of the patient’s presenting symptoms;
presence of neurological symptoms;whether the course of the illness is progressive; whether the illness significantly affects the patient’s quality of life or functional abilities; presence of untreated co-infections; the patient’s immune system status; whether diagnostic tests, symptoms or treatment response suggest ongoing infection; the patient’s response to treatment; which medications the patient can tolerate; the specifics of prior treatment regarding antibiotic type, dose, and duration; whether the patient relapses when treatment is
withdrawn; the risks/benefits of the treatment approach under consideration; and availability of any alternative treatment approaches and their attendant risks balanced against the risks
associated with failing to treat. These highly individualized decisions are best made by the treating physician and the patient

The controversy over antibiotic treatment duration for patients with Lyme disease exists because there is no test of cure, and individual patient responses to specific therapeutic approaches have been highly variable. Lyme disease, in many patients, is marked by
periods when the illness is relatively quiescent. Lacking a test of cure, physicians who do not rely on arbitrary cut-off points are faced with a difficult decision when attempting to determine an appropriate stopping point. Mixed results from the treatment trials add to the uncertainty

The variable response to treatment has been well documented; the causes remain unclear, as scientific evidence in this area is still evolving. Early hypotheses of autoimmune processes have not been substantiated; persistent infection, however, has been demonstrated in case reports and animal studies. Patients with Lyme disease are a heterogeneous group. Genetic variation may play a role in pathogenesis and treatment response. Just as HLA status may be related to treatment response in Lyme arthritis, the response in patients with other types
of Lyme disease pathology may be based on some yet to be discovered genetic subtype

Variation in infecting strains of B. Burgdorferi certainly is a factor. More than 100 strains of Bb have been identified. Certain strains are more virulent and pathogenic than others; instances of antibiotic susceptibility varying between strains is well documented. Coinfections and comorbidities also contribute to the heterogeneity of treatment response seen in Lyme
disease.  Ixodes scapularis is able to carry multiple known bacterial, viral, and parasitic pathogens, and evidence for additional tick-borne pathogens continues to emerge. Different combinations of pathogens require different treatment regimens; failure to identify and treat the specific pathogens causing an illness may partially explain variations in treatment responses

As explained by Kravitz et al., “[h]eterogeneity of treatment effects reflects patient diversity to risk of disease, responsiveness to treatment, vulnerability to adverse effects, and utility for different outcomes.” Kravitz et al. discuss the application of generalized, or averaged, results from treatment trials to the care of an individual patient, and pitfalls inherent in applying them too strictly, noting that “misapplying averages can cause harm, by either giving patients
treatments which do not help or denying patients treatments that would help them.” The individual patient is not a numeric average but, rather, falls somewhere on the continuum of the bell curve and,hence, requires individualized care.

Clinical guidelines should not supplant the judgment of treating physicians. Quality patient care requires the physician to consider management decisions in light of the details unique to each patient. When guideline recommendations are substituted for carefully derived, individualized decisions, there is a potential for harm. The American Academy of Pediatrics policy statement on guideline development recognizes this principle. The document outlines how evidentiary strength and risk-benefit analyses are integrated to yield a specific recommendation level. For example, strongly positive recommendations require benefits to clearly exceed risks, and supporting evidence must be of excellent quality

In this scheme, strong recommendations are not made based on low-quality evidence or expert opinion. Options identify treatment alternatives. Options recognize patient preferences and respect the clinician’s decision-making process. The U.S. Preventive Services Task Force also recognizes scenarios in which the certainty of the evidence is low. In those situations, no recommendation is made, regardless of the perceived net magnitude of benefit or harm.
Additionally, the Task Force advocates shared decision-making between individual patients and their physicians, instead of population-based recommendations, when issues under consideration are highly sensitive to patient utilities.

Guideline committees are not in a position to perform riskbenefit analyses for specific patients. Patient-specific riskbenefit analyses are the essence of clinical judgment. Such
judgments are the domain of individual treating physicians; guideline committees may inform judgments through their evaluation of therapeutic options, but they may not substitute their
judgments for those of the treating physicians. A recent editorial by Shaneyfelt and Centor said as much: “Guidelines are not patient-specific enough to be useful and rarely allow for
individualization of care. Most guidelines have a one-size-fits-all mentality and do not build flexibility or contextualization into the recommendations.” While the 2006 IDSA guidelines contain the typical legal disclaimer that “they are not intended to supplant physician judgment with respect to particular patients or special clinical situations,” formulaic disclaimers cannot overcome the failure of the guidelines to provide treatment options and to recognize the role of clinical judgment in individualized care. These shortcomings cannot be addressed in boilerplate disclaimers; they can only be addressed in the substance of the guidelines.

Available laboratory tests for Lyme disease have poor sensitivity. Treatment trials cited in the guidelines for early Lyme disease were dissimilar, making it hard to compare outcomes;
those for late neurologic Lyme disease involved only 96 patients whose treatment responses can be analyzed. Both the early and late treatment trials yielded poor outcome rates for complete recovery. The prophylaxis recommendation is based on a single study performed under conditions unlikely to be reproduced in community practices, and the list of “not recommended” therapeutic modalities is apparently based on panel opinion. Given the limits
of guidelines in general, and the specific shortcomings of the 2006 IDSA guidelines on Lyme disease, patients and their physicians should be free to act without interference; many may justifiably decide to decide for themselves which strategy to embrace

http://www.jpands.org/vol14no3/maloney.pdf

Elizabeth L. Maloney, M.D. Journal of American Physicians and Surgeons Volume 14 Number 3 Fall 2009

I Love Being Hated by Quackbusters…

Opinion by Consumer Advocate Tim Bolen

Thursday, November 12th, 2009

New Orleans area doctor James Carter MD, PhD, author of the famous book “Racketeering in Medicine,” the blatant 1994 expose of the plot to destroy innovation in US health care, called me up one day, several years back, and asked me if I was coming to a certain health convention where he was going to be.

He had me worried for a minute, for I thought that he might be angry at me for I had recently removed him as the “most hated person in quackbuster land,” and inserted myself into that position.  After all, there is honor, in certain important circles, in being on Stephen Barrett’s website.  The thinking is that the more space you get on Barrett’s sleazy pages the more good you must be doing for humanity.  Barrett was giving me lots of space – more than anyone had ever gotten.  I was worried that Jim Carter might be upset with me for pushing him into second position.

But he wasn’t.  He wanted me to come and speak to a large group of cutting-edge doctors and he wanted to introduce me personally.  Barrett has no idea, to this day, how much of an honor he had bestowed on me.  I spent a weekend with a group of people who lead the nation, if not the world, in innovative health care thinking.  It was, to say the least, stimulating.

Jim Carter, with his immense book, had taken the high road in his expose, even suffering through a lawsuit over the book, from Barrett – which Jim won.  I, on the other hand, took the low road, and called bullyboy Barrett out into the street, so to speak, where I proceeded to slap him around, bloody him up, in front of his own audience.  I took Barrett’s very own tactics and played them right back at him – and rubbed his nose in it.

Barrett, of course, being the arrogant wanna-be tyrant he actually is, couldn’t take it and sued me – or, I should say “sort of sued me,” for, as we all know it has been NINE YEARS since Barrett announced on his sleazy website that he was suing me – and of course, the Court has since thrown out the case (after eight-and-a-half years) of no activity.

There is no question that Barrett, and his band of loser malcontents, hold me, Tim Bolen, out as Public Enemy Number One.

Ahhhh, that feels good…  The only thing I could think of that would be better than that would be a personally signed Christmas Card from the Pope thanking me for my good works on the side of “Good” in the war against “Evil” – something my Mom would, definitely, put on the refrigerator.

So – What’s next?

Is there more coming?  Oh yeah.

Stay tuned…

Tim Bolen – Consumer Advocate

Angel Huggzzz
Linda

Suzanne Somers’s Cancer Book “Knockout” Soars to Number One on New York Times Best Seller List…

Opinion by Consumer Advocate Tim Bolen  www.bolenreport.com

Thursday, November 12th, 2009

It just had to happen sooner or later – the truth about the US Cancer Industry not working at all, just had to come out – to the American public, in a very big way.

If you haven’t picked up, and read, Suzanne Somers’s newest book, you don’t have anything better to do today, after you finish reading my newest newsletter, of course, than running down to the store and picking up a copy.  In fact, if you have a list of people in mind you care about, then pick up more than one, and give those people a copy.  The book is about the real world, and, frankly, I think Suzanne did a better job, much more, than she intended.

There is a Foreword to the book by Julian Whitaker MD.  Those of you who know Julian will not be surprised that he tells it like it is, clearly and succinctly.

Then Suzanne tells her story about how, about a year ago today, she had a health problem coming home on an airplane, checked into an Emergency Room unable to breathe properly, and was given about a gazillion dollars worth of what hospitals seriously label as cutting-edge testing.  She was then diagnosed by six separate doctors there with full-body cancer.  They recommended, of course, full-body chemotherapy and told her to get her affairs in order immediately.

This all came as a big surprise to Suzanne, of course, who prides herself on taking care of her health.  After the initial shock wore off common sense kicked in, as in “wait a minute here, Cancer does not come on this quick.”  There is something wrong with this situation.

Fortunately, Suzanne had health care “secret weapons” available.  Unlike most Americans she had telephone access to some of the best cutting-edge practitioners the world has to offer. She knows the same doctors I know – and she grabbed her cell phone and called a few.  They told her what to really do – for she had been tested about a month before and was, at that time, in the peak of health.

So, where then, did this “full-body cancer” come from?  Suzanne demanded a biopsy.  Of course, as you probably already suspect, the biopsy came back with no signs of cancer…  and the authoritative six doctors were tripping over themselves trying to pretend that this didn’t happen.  Their cell phone calls were probably to their Malpractice Insurance Carriers.

Then, if you think things could not get any worse, four more doctors show up, this time so-called experts in infectious diseases, and declared that “since there was no cancer, then Suzanne must have either tuberculosis, leprosy, or coccidiomycosis (valley fever)” and they declared that she must isolated from the hospital community.  They moved her to the isolation ward and put an armed police officer in front of her door so she couldn’t escape, and her family couldn’t see her.  And, of course, they told her that it would be two to six weeks before the laboratory results came back defining what was actually happening.

Now, let me explain something to you about Suzanne Somers, so you will understand the explosion that’s about to come the hospital’s way – quickly.  Suzanne is an Irish girl, descended from a long line of Celtic men and women who have developed a strong sense of right and wrong, and an even stronger sense of what it takes to right a wrong.  The Celts, as you may know, both men and women, used to strip naked, paint themselves blue, and ride their war chariots into the enemies battle lines with gusto.

With that said, I want you to take a look at the picture of Suzanne on the cover of her new book. She’s Blue.

When Suzanne demanded to be able to go home the infectious disease doctors told her she would have to agree to take all of the medications for each of the diseases they suspected she might have.  They mentioned that the leprosy medication makes you sweat blood.  Suzanne signed the papers and took the prescriptions home – but took none of them.

She called her own experts first – who told her not to take them.

Finally, Suzanne got the results back from the tests and found that she had a severe case of Valley Fever, something extremely common in the Pacific Southwest.  It is caused by a common fungus found in the dirt in California and Arizona.  And, it is easy to treat, and it is not usually life threatening.

So, why didn’t the hospital find this first, or at least look for it?  Good questions.  Unfortunately most of know the answer.  What happened to Suzanne is fairly common.  How? The test for this fungus is cheap, and does not require the use of fancy machinery and massive billing for test services, so it would simply never be used first.  In hospitals health care decisions are made using Sutton’s Law.

What’s Sutton’s Law?  In the 1920’s a bank robber named Willy Sutton was finally captured.  When asked “Willy, why do you rob banks?”  Willy answered “because that’s where the money is…”

It is the same situation with health care decisions.  Hospitals, and their doctors make decisions based on the profit on the test, or the treatment – not on what works, or is most practical.  Which, in case you were wondering, is why hospitals and Oncologists recommend chemotherapy for Cancer when they are clearly aware that it only has a 2.1% success rate over five years.  It is VERY profitable, and Oncologists will recommend it until the very end – when either the patient finally dies, or the health insurance maximum runs out.  Whichever comes first.

What’s Happening…

This book is tearing up the Cancer Industry.  Right from the start the industry brought out their best Spokes-bozos.  The guy from the American Cancer Society (“The Limousine Charity” – 71% of the contributions made to them goes to Administrative costs) was an absolute hoot, walking right into one trap after another on national television.  Clearly the industry was not  then, and is not now, prepared to fend off the attack Suzanne threw at them.  We haven’t seen this guy since.

And, of course, now the book is at the top of the New York Times Best Seller List.

Points to Consider…

The book is for the layman.  It is divided up into readable segments that make sense, and lead to the next important points.  She talks about “What Got Us here, The Doctors Who Are Curing Cancer, Preventing Cancer Before it Starts,” and offers resources.

For those of us living in the world of trying to protect, and promote, innovation in health care in general, and cancer specifically, it is a valuable resource.

Of course an old guy like me has to admit that I bought the book for the picture on the cover.  I know that Suzanne Somers is 63.  But there, on that cover, she makes 63 the new 33.  And she is wearing Celtic Blue…  You can see the cover, and the book’s beginning, by clicking here.

Stay tuned…

Tim Bolen – Consumer Advocate

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