From the Publisher.
Kenneth Stoller, MD, was informed on May 8th that the City of San Francisco was investigating him for writing medical exemptions for vaccinations. Stoller is a noted anti-vaxxer who has been prominently praised by parents on Google for providing such exemptions. The City Attorney subpoenaed his patient records to determine if Stoller falsely wrote exemptions not justified on a medical basis. One source stated that Stoller used data from patient 23andme genetic reports to justify medical exemption.
Stoller's attorney, Richard Jaffe, is highly critical of the authorities' motivation for the investigation, purportedly that unvaccinated individuals represent a "public nuisance" by substantially increasing the incidence of preventable infectious disease such as measles. Jaffe states:
The use of the state public nuisance laws as a basis/pretext of investigating a physician's medical decisions is unprecedented and represents intrusion into the physician/patient relationship. We believe City Attorney's action is part of the campaign to pass SB276 to eliminate a physician's ability to write medical exemptions under SB 277, and to attack physicians who are following SB 277 in their vaccine exemption decision making.
Physicians, particularly alternative medicine practitioners, naturopathic doctors, and chiropractors are being asked to write vaccine medical exemptions, although it is unclear whether chiropractic letters are legally acceptable. Previous history of severe adverse reactions post-vaccination is clearly appropriate for exemption. Suppression of the immune system and weakness during and following cancer chemotherapy are also reasons to skip immunization. An allergy to eggs also is justification. However, once these criteria are examined and ruled out, is there a basis for medical exemptions? If Stoller wrote an exemption without "proven" medical criteria, simply because he and his patient's parent(s) wished to avoid vaccination, did he improperly and illegally provide it?
Might this be a harbinger for further physician investigations in California and elsewhere? Maybe. However, it is clear that society and conventional medicine are not happy with the recent mushrooming measles outbreak. Despite legitimate concerns with loss of freedom of choice in medical decision making, the concept of herd immunization by vaccination remains absolutely proven and indisputable by the medical authorities. That being the case, doesn't writing vaccine exemptions amount to hoisting oneself upon one's own anti-vaxxer petard?
For those who would like to support Dr. Stoller, please visit GoGetFunding.com and search "Legal Defense Fund for Dr. Kenneth Stoller." GoFundMe dropped Dr. Stoller's defense fund from its website.
Yes, It's a Yeast Infection, But a Deadly One, Resistant to Antifungal Drugs
If I had to designate time periods for the clinic work I have done, one of them would be when I focused on the diagnosis and treatment of the "yeast syndrome." Before that it would have been "hypoglycemia," and after that it would have been "chronic fatigue syndrome," and more recently, "Lyme disease." The work on the yeast syndrome was a strange business in that conventional medicine has always considered a yeast infection caused by Candida albicans to be just a localized infection immediately treatable with an antifungal medication, such as nystatin. However, a number of integrative and functional medicine physicians and researchers have thought that the infection was not so localized; and the yeast in its various forms, as well as the mycotoxins it generated, was quite harmful to many individuals, especially those whose immune system if not compromised was to some degree impaired. C. Orian Truss, MD, observed early in the 1980s that a certain component of psychiatric patients suffering from depression and related disorders were infected with a yeast infection and that the use of nystatin reversed their depression and psychiatric symptoms. (The story is detailed in his books, The Missing Diagnosis and its sequel.) William Crook, MD, dedicated his career, after reading Truss's work, to the treatment of yeast, which he wrote about in The Yeast Connection. My use of the term, the yeast syndrome, derives from the book of the same title written by John Trowbridge, MD, and Morton Walker, DPM.
The thinking of all of these physicians was predicated on the systemic nature of a yeast infection capable of rendering a wide constellation of physical and mental symptoms. Treatment largely consisted of a restrictive diet of meat, eggs, vegetables, and yogurt (MEVY). Anti-fungal medications included nystatin with limited effectiveness on the surface of the tissue it was applied to or within the confines of the digestive tract, as well as those that were absorbed systemically such as ketoconazole and fluconazole. Naturopathic treatment employed plant-based anti-microbials such as olive leaf extract and fatty acids such as caprylic acid derived from castor bean or coconut oil. For many patients, diagnosis and treatment of the yeast syndrome facilitated a dramatic recovery unattainable with the "usual" treatment offered in primary and specialty medical care. Trowbridge, the only physician of the aforementioned group who is still practicing, continues to recommend immediately ruling out yeast syndrome as a primary diagnostic strategy in all patients suffering with chronic physical and mental symptoms. From his perspective, digestive distress, depression, chronic fatigue, recurrent rash, and chronic muscular pain are symptoms of yeast syndrome until proven otherwise; furthermore, an untreated yeast diagnosis could be complicating the treatment of many more serious diseases, including autoimmune illness and Lyme disease.
Quite a different scenario is now unfolding on the world stage, and it has health authorities worried much more than the current myriad cases of measles and episodic bouts of Ebola. Meet another yeast, one that has emerged as one infectious disease expert has characterized it from the black lagoon, Candida auris. An April 6 report in the New York Times, "A mysterious infection, spanning the globe in a climate of secrecy" by Matt Richtel and Andrew Jacobs, well summarizes the fear that a "harmless" fungus has caused mental paralysis of hospital administrators and CDC researchers. Like C. albicans this organism is extremely capable of establishing itself wherever it settles and will not lend itself to early demise with simple bleaching or being gassed with ozone. And once it has infected an immune-compromised individual, despite heroic use of all the antifungals, death occurs within 90 days in more than half the cases. A decade ago there was one identified case--a woman in Japan who had a curious ear infection yielding the name C. auris, from the Latin term for ear. Over the past ten years, the organism has infected individuals around the world creating nightmares for hospitals treating these patients. Following the demise of an infected patient in a Brooklyn hospital, maintenance staff needed to nearly nuke the facility to eliminate the organism, using poisonous chemicals, as well as cutting out floor and ceiling tiles. Testing revealed its presence not just on clothing and blankets but on all the medical equipment. Needless to say, hospital staff are not thrilled about working with these patients, worrying that they will acquire the infection themselves or pass it on to their loved ones by bringing it into their households. Most outrageously, hospital administrators attempt to hush any scuttlebutt and refuse to divulge any information to the press and local authorities about a patient being treated for C. auris. Imagine coming into a hospital for non-emergency surgery and being exposed to it!
Why has C. auris emerged "from the black lagoon" appearing in hospitals worldwide? Just like our love for feeding antibiotics to chickens, pigs, and livestock, farmers are generously spraying antifungals on food crops to avoid plant disease. And just like bacteria that are becoming resistant to antibiotics, fungi are evolving that are resistant to azole antifungal drugs. For hospitals, finding a solution to controlling C. auris could not come soon enough. In the interim, keep track of the infectious disease incident reports of your local hospital, especially if you reside in New York City, Newark, or Chicago as well as London, Valencia, Delhi, Islamabad, Johannesburg, Tokyo, Amsterdam, and Caracas. Medical tourists travelling abroad for less expensive cosmetic surgery may want to reconsider that decision.
Integrative MDs may want to rethink whether azole drugs are the best choice for treating yeast syndrome patients.
Ritchie Shoemaker, MD, on Moldy Buildings and Damaged Brains
Ritchie Shoemaker, MD, has made a career of helping sick people with brain fog by identifying the initiating factor as a water-damaged building with mold. As a physician who strongly believes in scientific method and evidence-based medicine, including peer-review double-blinded studies, he has sought credible diagnostics and therapeutics that explain why individuals with a laundry list of symptoms are never properly diagnosed by conventional medicine. The problem is that inflammagens, the toxins or microorganisms that cause inflammation, beget more and more inflammation in an endless loop of exacerbation and misery. Much of the problem begins in the water-damaged building, a structure that is not always the wreck remaining from a hurricane or flood, but the ordinary school, home, or office building that sustains continuous water leaking day-by-day, year-by-year. From Shoemaker's viewpoint, attempting to reverse chronic inflammatory disease without attending to the reversal of the water damage and leaking is a certain recipe for failure. Of course, for many sick individuals, remediation of a domicile or workplace is not within one's means, and landlords and employers frequently shirk off any responsibility to fix the "leak" and mold.
Shoemaker, together with mycologist David Lark and genetic-testing CEO James Ryan, PhD, has put together a five-part article on water-damaged buildings, chronic inflammatory response syndrome, and repairing the body and damaged brain. The first part, in this issue, will provide an overview of what Shoemaker et al. use to approach the problem diagnostically. Shoemaker emphasizes that the approach is substantiated and that the doctor and patient should be able to understand chronic inflammation, confirm that the illness is caused by microbes and toxins in the water damaged building(s), employ protocols to diagnose and treat the condition, and document physiologic markers to quantify the extent of disease and monitor progress in treatment. Shoemaker even dares to broach the "cure" word.
Why Hidden Infection Must Be Part of Our Diagnostic Hunt by Jason Bachewich, ND
When a patient presents with peculiar pain, strange dermatitis, a bizarre change in thinking or mood, unexplained autonomic symptoms such as hypotension, tachycardia, flushing, or hot/cold flashes what diagnostics can we do? If it's localized, we could do x-rays or scans; but when they come out normal, what's next? Sure, we can do chemistries, blood count, sed rate, C-reactive protein, and other routine tests, but what do we do when these are all normal? Assuredly, let's not reach for the prescription pad and prescribe a tranquilizer or antidepressant. Perhaps we should consider investigating for microbes--Lyme, not just Borrelia, but co-infections, viruses, Mycoplasma, parasites, mold and more.
Dr. Jason Bachewich, a naturopathic physician who practices in Winnipeg, Manitoba, Canada, thinks that we have been ignoring infectious disease etiology in our workups. The infections may not be obvious, but that does not mean that they are stealth or completely hidden. In this issue Bachewich discusses his experience treating a patient with severe, chronic testicular pain that ultimately proved to be a strange form of herpes zoster, an "internal" form of shingles. Another patient suffering with bowel pain was eventually diagnosed with Yersinia infection. He argues that even when there is a confirmed diagnosis with a name, like multiple sclerosis or certain cancers, we need to rule out a microbial etiology. Whatever the condition might be, if an underlying infection is diagnosed and treated, the likelihood of success will be much higher.
Mast Cell Activation Syndrome: A Diagnosis Whose Time Has Come by Patel, Farshchian, and Forsgren
Beyond mitigating mold that one has been exposed to from residing or working in a water-damaged building, as well as treating a hidden infection, one must also address the disruption of the immune system caused by acute and chronic inflammation. From the vantage point of Raj Patel, MD, Thalia Farshchian, ND, and Scott Forsgren, FDN-P, that dysfunctional state could manifest as the mast cell activation syndrome (MCAS). Mast cells are white blood cells in the skin, mucosal, and connective tissue, as well as the blood brain barrier. They resemble basophils with substantial nuclear granular material that release histamine, heparin, and other enzymes upon activation. In normal circumstances vasodilation by histamine, anti-coagulation by heparin, and enzymatic degradation by proteinases enable immune defense against allergens and pathogens such as parasites, as well as provide support for many other functions, including wound healing. In abnormal circumstances the release of these substances can act pathologically on the body resulting in flushing, heat flashes, pallor, hypotension, hives, itching, pain, headaches, diarrhea, brain fog, and much more. Uncontrolled mast cell activity has been designated as MCAS since 2010; its behavior is much like mastocytosis except there is not an unusually high number of mast cells, just excessively activated mast cells.
Patel, Farshchian, and Forsgren discuss the triggers that incite the mast cells into such a state of frenzy. Beyond the microbes, mold, and parasites, are the thousands of chemicals and heavy metals that insult our system daily. Ignored by high tech is the effect of EMF on mast cells. But the one that has most immediate impact for MCAS sufferers is the role that diet has on perpetuating the excitability of mast cells--everyday foods, "good" foods, organic or otherwise, are pivotal in causing mast cells to degranulate. Foods such as shellfish, mushrooms, tomatoes, spinach, potatoes, citrus, berries, grapes, yogurt, cheese, pita bread, beans, tofu, walnuts, flax seeds, honey, vinegar, and alcohol all contain "high" amounts of histamine. The first and most important step in addressing MCAS is eating a low-histamine diet. It is not easy but relief can be secured in less than a week by consuming less histamine.
The authors detail lab testing, medication, and herbal supports for MCAS in this issue. Unravelling and avoiding the myriad of triggers is the key to successful symptom control and reduction in inflammation.
Connie Strasheim on Becoming Happy, Healthy, and Free after Lyme Disease
Unfortunately, not every symptom can be addressed by diet, removing EMF, countering microbes, and abating water damage--some issues can only be healed emotionally, mentally, and spiritually. As a Lyme disease patient, survivor, advocate, and best-selling author, Connie Strasheim is familiar with the challenges faced in being diagnosed with the condition. What goes largely undiscussed is the depression, anxiety, PTSD as well as the deeper psychospiritual issues that medical professionals prefer to ignore. It's easy to hand out a prescription for Prozac or Xanax; but not only are these drugs only minimally effective, they pose major problems when one would like to discontinue their use.
Strasheim had to deal with the latter problem--it's a battle, a brutal one at that, tapering off these drugs, especially withdrawing from the benzodiazepines and related "insomnia" medications. She touts the benefits patients experience employing amino acid therapy to build up precursors for the neurotransmitters. Hormone balancing and augmenting reduced hormone levels is critical for beating depression. Following a dietary program to reduce inflammation and using anti-inflammatories are key to improving anxiety and related mood disorders. Ultimately each patient also needs to dig deep and face the issues that have blocked one's living and spirituality, a path Strasheim discusses in this issue that is vital for successful healing.
Dancing with the Stars--Maksim Chmerkovskiy
Our cover story this issue is part 2 of Karina Gordon's interview, "Dance: A Healing Art," featuring Dancing with the Stars' Maksim Chmerkovskiy. Working with non-professionals is a constant stress and strain on the body and subjects even the best dancer to injury. In fact, Maksim did sustain a medial calf tear that he rehabilitated with orthopedist Dr. William Seeds using platelet-rich plasma and stem cell therapy. Of course, Chmerkovskiy credits much of his healing to a well-disciplined diet, the use of optimized supplementation, and peptides. He also employs contrast hydrotherapy, massage, stretching, adequate sleep, and maintaining fitness.
Maksim thinks that we all can do more on maintaining a disciplined diet that is key to preventing injury no matter what activities we engage in. Of course, he is an advocate of encouraging each of us to take up dance, perhaps the best means to rehabilitate our weakened muscles and regain our range of motion.
Jonathan Collin, MD