Monday, October 09, 2006

Welcome Back to CC

As I announced previously, unfortunately Dr. Rick is currently unable to continue with this project. However, the Critical Condition blog is still here for people who want to contribute. I particularly want to encourage health care providers and healers of whatever description -- physicians, nurses, PAs, therapists, psychologists, technologists, you name it -- to contribute here, but I'm also interested in perspectives from patients and outside observers.

This contribution from Dr.Mr. Lewis is in response to a post on Stayin' Alive about medical education, in which I endorsed recommendations to ease up on the basic science in the first two years of medical school, in order to allow more time for learning the basics of clnical practice. Dr. Mr. Lewis adopts a personal, creative approach to healing which I would say is swimming against the current of "evidence based medicine," but it's important to hear the diversity of voices in the field.

Anyone who wishes to post here should send me an e-mail (see the sidebar) and if it fits our very broad criteria, I'll put it up for you. No endorsement by me is implied or necessary -- posts here that are signed by people other than YT are the responsibility of the poster. -- Cervantes.


Quoting Ezekiel Emanuel: "Personally, despite being taught the Krebs cycle (twice during medical school as well as twice in college), I have never used it in my practice or research."

What a terrible shame! The Krebs cycle is so fundamental to... well, to damn near everything, that to ignore it is to ignore a significant portion of the biochemical fundament of healing. I was not taught the Krebs cycle twice. I taught myself the Krebs cycle several times, and have contemplated it for years -- especially in its context as the biochemical mechanism most prominent in mitochondrial function. This is the very basis of cellular health and integrity, EVERY aspect of which depends on the energy compounds generated in the mitochondria (by way of the Krebs cycle). The pertinence of energy to all biological systems and functions can be reflected in mythic terms: "energy is eternal delight" (Blake). That would be apart from eternal adequate cell function, maintenance and repair.

One non-mythic example: a tired, run-down friend of mine was suffering with a high-pressure job and wondering if she was going to be able to cut it. (She is an RN on a trauma unit, by the way, and in this case one of the traumatized was HER.) I suggested a program of what I described, for simplicity's sake, as "mitochondrial nutrients". The basic routine was: a gram or two each of powdered carnitine, ascorbic acid, and potassium bicarb, stirred into water (makes a nice alka-seltzer-like fizzzz) twice daily, combined with a B-50 (B-complex) tablet, and a lipoic acid capsule (100 or 200 mgs). The combination of carnitine and lipoic is known to activate aged or flagging mitochondria (search engine for "bruce ames", "mitochondria", and the compound names); carnitine alone in multi-gram doses often has nice ergogenic/anti-fatigue effects. The potassium is an intracellular essential for all enzyme activity, and I had reason to suspect she was K-depleted. The ascorbic helps correct the generally-universal hypoascorbemia, as well as being a great anti-stress compound (e.g. throwing the switch to send precursors toward DHEA instead of cortisol in the adrenals). It also imparts a pleasant tartness, to counteract the brackish and metallic potassium bicarb. The B-complex was a general measure to ensure full repletion and tissue saturation with the essential coenzymes -- particularly but not exclusively NAD, and others in the coenzyme-hungry mitochondria.

The result was excellent. Her fatigue quickly vanished, and her confidence and general resilience were restored. As she described it (paraphrased): "it is like drinking liquid energy... you can feel it activating all your cells within minutes", or words to that effect. Those were HER words. I had promised nothing of the sort. I told her that the effect, if any, would likely be subtle, developing over several days or weeks, so be patient. As it turned out, happily, she did not have to be patient. (I love it when that happens.) She also noted an improvement in her skin -- less wrinkles, and a fuller, more-hydrated look (less piqued). That's understandable. Potassium depletion and sodium predominance tends to dehydrate, shrink and shrivel things. And taking a big dose of potassium in the evening (best time to replete with potassium) is known in nutritional folklore circles to act as an "overnight face-lift". (Try it. It really does work, often.)

In any case, most people are potassium-depleted at the cellular level even if normokalemic (same with magnesium); most people are also slightly acidotic. Correction of this is absolutely essential to anything properly called healing. The potassium depletion, associated with chronic low-level acidosis, started with the advent of the neolithic: : Eur J Nutr. 2001 Oct;40(5):200-13 : Diet, evolution and aging--the pathophysiologic effects of the : post-agricultural inversion of the potassium-to-sodium and : base-to-chloride ratios in the human diet. : Frassetto L, Morris RC Jr, Sellmeyer DE, Todd K, Sebastian A. : PMID: 11842945 [I could give many more citations on this]

And, regarding the primacy of mitochondrial function, a fellow by the name of Richard Fiddian-Green has had many fascinating things to say -- including that mitochondrial malfunction is the likely undergirding (though perhaps not quite "cause" in the conventional sense) of a range of chronic diseases such as CAD, type 2 diabetes, COPD, hypertension, MS, depression, Alzheimer's, Parkinson's, and many more. He is no doubt correct, provided we understand the concept of terrain, or "the patient that has the disease, rather than the disease the patient has". Further, he suggests that many commonly-used drugs are acting as inhibitors of mitochondrial function -- really an alarming charge, if correct. That would mean that the CURING is going on while the HEALING is actively thwarted! Here are a few snippets from Fiddian-Green's writing: ITEM: : http://bmj.bmjjournals.com/cgi/eletters/325/7370/913 :

"An impairment of mitochondrial oxidative phosphorylation : appears to be the primary cause of organ dysfunctions and : failures including psychiatric disorders in the acutely and : possbily even in the chronically ill (2-17). The commonest : causes of impaired mitcohondrial oxidative phosphorylation are : an impairment of oxygen and/or nutrient delivery and the many : inhibitors or uncouplers of oxidative phosphorylation which : may be contained in recreational drugs, medications prescribed : and/or environmental pollutants. The impairment may on : occasions be due to increasing the demand for energy from ATP : hydrolysis beyond the capacity of mitochondria to replenish : their ATP stores." ITEM: :
>
http://bmj.bmjjournals.com/cgi/eletters/325/7366/701#25874 : "Both acute and chronic psychiatric disorders might be the : products of an energy deficit, that is to say an impairment of : the adequacy of mitochondrial oxidative phosphorylation and : accompanying generation of free radicals (2,3). : Antidepressants cause neuronal cell death (4). Fluoxetine : hydrochloride, protriptyline hydrochloride, amoxapine and : doxemine hydrochloride might do so by interfering with : mitochondrial oxidative phosphorylation and hence promoting : the generation of free radicals (5,6,7,8). These potentially : harmful effects are not limited to antidepressants, : haloperidol having similar effects (9)." : [...snip...] : "Drugs and hormones that exert their actions by stimulating : the release of cAMP do so at the expense of ATP from which : cAMP is derived. In circumstances in which the ability of : mitochondrial oxidation to replenish ATP stores is compromised : these drugs and hormones have, therefore, the potential to : compound the severity of the energy deficit present. As an : impairment of oxidative phosphorylation is accompanied by a : fall in tissue pH, enzyme kinetics are changed potentially : changing not only the efficacy of the drugs but also inducing : the expression of rogue genes." I

TEM: : http://www.chestjournal.org/cgi/content/full/116/6/1839 : "[T]he severity of tissue acidosis in anaerobiosis is related to : the degree of impairment of oxidative phosphorylation... Gastric : pHi [intramucosal pH] is a metabolic signal of tissue hypoxia." : [...snip...] : "[C]ontinued accumulation of protons and later net ATP degradation : compromises essential ATP-dependent functions, such as the sodium : pump, and cells swell and die. ATP degradation allows free : radicals to be generated on resuscitation." : [...snip...] : "[M]easures directed toward preventing a fall in gastric pHi5 : and restoring the gastric pHi to normal in a timely manner in : anaerobiosis are associated with improved outcomes and reduced : ICU and hospital stays and costs.6 7 8 9" MORE, see: http://bmj.bmjjournals.com/cgi/eletters/325/7375/1255

For a moment, consider also the glucose-insulin-potassium (GIK) solutions used for decades in cardiology. The idea is to drive potassium and glucose into the mitochondria-rich cardiac cells, and give them a boost of energy: the glucose as the calorific energy source, and the potassium as enzyme activator. It was a very good idea, based on understanding of cell physiology basics. Of course it would be much more effective if one were to toss in some magnesium, B-complex, lipoic acid, carnitine, coenzyme Q10, taurine and so on. Whatever. For its time, and even still today, it was and is quite good. In this instance, CURATIVE medicine, perhaps inadvertantly, stumbled upon a HEALING technique. Unfortunately, however, the healing aspect was never grasped. (Winnie Churchill's remark springs to mind: "Many people stumble over the truth, but then pick themselves up and hurry off as though nothing had happened.") For decades, GIK has been bound hand and foot, and restricted to the role of CURE for acute MI, etc. -- in which capacity it performs fairly well. This restriction bespeaks a profound lack of vision. It misses the vast potential of what might be called the "mitochondrial/bioenergetic orientation", or simply an awareness of cell physiology basics followed by application of appropriate nutrient/coenzyme arrays; i.e. HEALING at the biochemical and cellular level. That, combined with a focus on the vertical -- i.e. not waiting until the subject is horizontal, on a gurney, with cardiac arrest. But such was not to be, and in the last analysis (if you'll pardon that trite expression) it really ought not be.

Yes, such ideas could be awkwardly retro-fitted onto cure-based conventional medicine -- calling it "mitochondrial/bioenergetic medicine" or "Krebs-cycle-based medicine". But that would take decades, and would rely on the ridiculous delivery system (a cluster-fuck of impossibly-expensive institutions, bloated salaries, armies of lawyers, and all the rest) that turns a 1.2-cent aspirin tablet into a $10.95 aspirin tablet. Forget it! Let cure-based conventional medicine be cure-based conventional medicine. Meanwhile, practice health and healing, cheaply, yourself and for/with friends. The total cost of treatment for my RN friend was perhaps 15 cents per day, which includes my consulting fee of $00.00. The same kind of consulting (albeit without quite my depth of knowledge of this stuff) could be performed by any reasonably-intelligent person after several hours of study. It is not rocket science, though it CAN be if you insist on digging deep (unnecessary for daily practice). We don't need more doctors and Phds; we need more conscientious and fairly-knowledgeable caring friends. Besides, names such as "Krebs-cycle-based medicine" are too narrow. We're talking about a whole-terrain orientation, not focussed sheerly on mitochondria and Krebs cycles, however important they are.

SO, to return to the good doctor's remark -- "I have never used [the Krebs cycle] in my practice or research" -- all I can say is that he has missed-out on something at the core of healing, and fundamental to it, though he may continue to be very good at curing. And that is appropriate. Let medicine go on curing, curing, curing, but let us never confuse that with healing and health. The "health care" system must be renamed the "disease care" system, for proper perspective. Curing is a good thing and I am not opposed to it. I just want it to be placed in proper perspective. It is good, but very limited in terms of enduring benefits and true quality of life, plus it gets ruinously expensive in short order. And three cheers for the Krebs Cycle! May it long inform the work of healers, and restore the health of billions -- one educated individual at a time. Alan Lewis [aelewis AT provide DOT net]

9 Comments:

Blogger Alan2012 said...

Thanks for posting my rant, Cervantes.

A couple of things. First, I am not a
doctor or any other kind of degreed and
credentialed "professional" -- and a
good thing. If I were, then the chances
of my being able to think clearly and
creatively would be greatly diminished.

Second, you write that what I propose
goes against the tide of "evidence
based medicine". Actually, what I
propose has a superb evidentiary basis.
Could not be stronger. It is based on
the very fundaments of cellular health,
rooted in the function of critical
subcellular particles -- mitochondria
-- on which the whole show intimately
depends. The specific agents mentioned,
like carnitine, potassium and
B-vitamins, are thoroughly documented.
There is no ambiguity, no lack of data,
no hazy hypothesis. Most of them are
absolute requirements for adequate cell
function, and have been established as
such by tons of research over several
decades. Some of them (e.g. lipoic in
super-normal amounts) are not
absolutely required, but do have clear
and well-documented beneficial effects
on mitochondrial function. So much for
the "evidence-based" part.

As for "medicine", though, you might
have a point. What I propose is clearly
not conventional (curative) medicine,
and thus one might say (since curative
medicine is as though the only game in
town) that it is not medicine at all.
Fair enough. I have no desire to
practice medicine, defined in that way.
There are plenty of others to do that.
I also have no desire any more to
re-unite curative medicine with
healing. If anything, I think they
should be further segregated. Here is
how I put it to a friend, this morning,
FYI:

Date: Mon, 09 Oct 2006 05:21:07 -0700
From: aelewis AT provide DOT net
To: Georg.....@aol.com
Subject: Re: Mitochondrial Medicine...
[Dreyfus/Dilantin, Changing Medical
Practice]

aelewis wrote:
> In this instance, CURATIVE medicine,
> perhaps inadvertantly, stumbled upon a
> HEALING technique. Unfortunately,
> however, the healing aspect was never
> grasped. (Winnie Churchill's remark
> springs to mind: "Many people stumble
> over the truth, but then pick themselves
> up and hurry off as though nothing had
> happened.") For decades, GIK has been
> bound hand and foot, and restricted to
> the role of CURE for acute MI, etc. --
> in which capacity it performs fairly
> well. This restriction bespeaks a
> profound lack of vision. It misses the
> vast potential of what might be called
> the "mitochondrial/bioenergetic
> orientation", or simply an awareness of
> cell physiology basics followed by
> application of appropriate
> nutrient/coenzyme arrays; i.e. HEALING
> at the biochemical and cellular level.
> That, combined with a focus on the
> vertical -- i.e. not waiting until the
> subject is horizontal, on a gurney, with
> cardiac arrest.
>
> But such was not to be, and in the last
> analysis (if you'll pardon that trite
> expression) it really ought not be. Yes,
> such ideas could be awkwardly
> retro-fitted onto cure-based
> conventional medicine -- calling it
> "mitochondrial/bioenergetic medicine" or
> "Krebs-cycle-based medicine". But that
> would take decades, and would rely on
> the ridiculous delivery system (a
> cluster-fuck of impossibly-expensive
> institutions, bloated salaries, armies
> of lawyers, and all the rest) that turns
> a 1.2-cent aspirin tablet into a $10.95
> aspirin tablet. Forget it! Let
> cure-based conventional medicine be
> cure-based conventional medicine.
> Meanwhile, practice health and healing,
> cheaply, yourself and for/with friends.
>
> The total cost of treatment for my RN
> friend was perhaps 15 cents per day,
> which includes my consulting fee of
> $00.00. The same kind of consulting
> (albeit without quite my depth of
> knowledge of this stuff) could be
> performed by any reasonably-intelligent
> person after several hours of study. It
> is not rocket science, though it CAN be
> if you insist on digging deep
> (unnecessary for daily practice). We
> don't need more doctors and PhDs; we
> need more conscientious and
> fairly-knowledgeable caring friends.
>

George, do you remember, about 20 years ago (!), we discussed the difference between HEALING and CURING? Mainstream medicine is heavy into curing, not healing. Healing is a different ballgame, with much more significance for human health, than curing, though curing has its place, as well.

The only change over those 20 years has been that I now no longer think in terms of changing mainstream medicine toward an emphasis on healing rather than curing. I think medicine should stay roughly as it is, and doctors should occupy themselves being the best curing technicians that they can be. Given the complexity and information-intensity of modern medicine, it is too much to ask doctors to be good at both.

Further, medicine WILL stay as it is, no matter what. It is practically impossible to change it, and I don't think it desirable to try, very much. I mean, outside of a scant few thousand individual docs who are capable of independent thought. THEY can be changed, but the broad structure of the medical system, and bulk of the practitioners, cannot be changed -- at least not at any perceptible rate.

A compelling example is the experience of Jack Dreyfus, the famous investment management guru, and an extremely wealthy man. I won't go into all the details right now, but the short version is that he spent 70 million dollars of his personal fortune, and devoted over 30 years of his life, on an attempt to make one SMALL change in mainstream medicine; to wit, to induce physicians to consider, and make use of, the broad therapeutic applications of the old "anti-seizure" drug dilantin (diphenylhydantoin). Dilantin is a wonderfully useful drug in a wide variety of conditions, as Dreyfus and his team of medical advisors documented thoroughly (thousands of references to the medical literature). It is so useful, and its effects so profoundly beneficial at fundamental levels (normalizing effects on core cellular and biochemical processes), that I am tempted to classify it a HEALING agent, along with the nutrients.

Anyway, they spent decades trying to communicate this message to doctors, including multiple free mailings of beautiful books (with all the documentation, attractively and usefully presented) to every physician in the U.S., multiple personal meetings with U.S. Presidents, FDA heads, etc., etc. The result? Practically nil. Dreyfus just this year released a book on his experiences, titled "Written in Frustration". The title says it all.

This is an amazing story that should give all of us pause. If Dreyfus could not do it -- with 70 MILLION dollars, a team of crack medical advisors, massive bought publicity, connections to people at the very highest levels, etc., etc., plus his own passionate and near full-time effort, all over 30+ years -- then who the hell could?

My conclusion is that it is simply impossible, and ought not be attempted. Change can and will occur, but it will take generations. Watchful waiting for change is like watching the trees grow. Of course, by "change" I am talking about truly significant change -- paradigm change, if you will. I am also talking about significant change within some reasonable period; say, 5 years, or a decade.

There will of course be many trivial changes, every year. For example, scores of new me-too drugs, offering no advantage over existing products, will be released, and will find their way into clinical practice. But a paradigm-busting attempt to get an old, off-patent drug like dilantin into routine use for the scores of different conditions in which it is useful will fail. Or, perhaps, will not fail, but will succeed -- over an additional half-century or so (making, in that case, a total of 80 years). It is just like watching the trees grow.

There are many other examples, but that's a particularly striking one.

I am reminded of that quote from Max Planck:

"A new scientific truth does not triumph by convincing its opponents and making them see the light, but rather because its opponents eventually die, and a new generation grows up that is familiar with it" -- Max Planck, Scientific Autobiography and Other Papers pp. 33-34. New York: translated by F. Gaynor, 1949. http://www.redflagsweekly.com/features/rasnick.html

Right. A new generation. Or maybe two or even three generations. Whole generations must literally, physically die before things can change.

In the case of the dilantin episode, we're not talking about scientists as such (medical doctors are rarely scientists, or even very scientific), or even necessarily with "new scientific truths" (the facts about dilantin go back in the literature many decades), but with a general resistance to unfamiliar ideas on the part of "experts", "professionals" and the like, who have deep emotional investments in certain ideas and ways of doing things, as well as very heavy investments in maintaining professional status and appearances (never admitting to have been wrong, etc.). It goes back to the formal schooling, which somehow imparts -- along with the actual knowledge -- a commitment to seldom or never questioning that knowledge, and defending (often with missionary zeal) one's profession and degreed status as a representative of that knowledge. New ideas are perceived as threats, and are at minimum ignored, or if they are considered "dangerous" enough, become the subjects of denunciation or suppression.

Meanwhile, most ordinary folk, without such investments, can do better, right from the getgo. MOST ordinary folk, most of the time. There is also an element of conservatism (skepticism about the new) that seems to be a part of the human constitution, or "human nature".

I think what has happened to the "professionals" is that that latent human conservatism has been exponentiated by the whole formal schooling/credentialing/professionalization process, so that what WAS a perfectly normal, mild tendency becomes extreme. Appropriate conservatism morphs into a wierd reactionary stubbornness or willful blindness.

That conservatism is to some extent built-in would be good were it not for the fact that the world has been turned into a chaotic and unsustainable mess by ultra-radical influences (e.g. industrial modernity, economic liberalism), such that now it is necessary to embrace new, liberal or even radical ideas in order to reverse the damage of the prior radicalism!

The "new ideas" that I would like to see embraced are actually not new at all, at their core. They are either old ideas, or new twists on old ideas, or else new ideas that somehow point "backward" -- back to the nobly traditional and evolutionarily and environmentally sound. LSD, for example, is a "new idea" in the sense that it is a brand-new compound, but it points backward to a primordial/traditional world of shamanic healing and entheogenic plant work. LSD is a product of industrial modernity that has the potential to be profoundly subversive of industrial modernity, in its effects -- and that, of course, is very very good. The products and practices of industrial modernity are good insofar as they point to, facilitate or encourage the correction of the gross imbalances created by industrial modernity and its cognates (finance capitalism, etc.).

For another example, take the bicycle -- an industrial product, but one with a unique potential to displace and depose the very worst artifact of industrial modernity. I speak, of course, of the automobile, and of petro-fueled transportation generally. The idea of replacing automobiles with bicycles is a radical one, coming from where we are today, and yet it is a "radicalism" that would act mightily to UNDO the extreme, radical tyranny of the automobile. It is a radical idea only in relation to the egregious extreme of the current situation, and its accomplishment would be profoundly effectively conservative.

Educational efforts should proceed along this line, linking the "new" with what is in truth quite old, and actively invoking the memes and associations of tradition, conservatism, and biological/cultural ancestry.

But now, I will return to my initial theme -- the near-impossibility of inducing an entrenched, stubborn and far-too-rich medical/academic/industrial complex to undertake significant change or paradigm change, and the matter of healing versus curing.

What Dreyfus tried to do, in effect, was to introduce the concept of healing, of a sort, with this quasi-healing agent dilantin. Healing agents, almost always of natural origin, have characteristics that are much like dilantin: they tend to be NORMALIZERS (rather than stimulating or depressing in a lop-sided way); they tend to ameliorate LOTS of things, not just one thing; they are mild and relatively free (sometimes totally free) from adverse effects; and so on. Dilantin is a synthetic compound which does not, as far as we know, occur in nature. And yet from all we know about it, it is as though a natural healing agent. We might call it an honorary healing agent -- one of synthetic chemistry's very best offerings, right up there with LSD and a few other compounds.

But the medico crowd did not, and perhaps (permanently) CAN not, get it. The qualities just mentioned did not compute. This simply is not "the way things are supposed to be" within the curing paradigm; it does not fit. Whereas, within the healing paradigm, it fits naturally. Within this paradigm, one expects to find just the qualities that dilantin has. Such things are natural and defining characteristics of healing agents.

Finally, again, it is just as well that the medics cannot grok this. They are busy with their curing -- and so, perhaps, it should be. Curing is a difficult business requiring much attention and study if one is to be good at it. Let them focus their attention on that, and be good at it. Frankly, if I need a doctor, I would not give a fig about their awareness of healing; I can handle that part myself! I would want him or her to be a good technician -- nay, a great technician, great at CURING. CURE me, doc, and I'll do the healing on my own. But of course not everyone has my background and knowledge.

What is needed here is not an attempt to alternative-ize or holistic-ize medicine (a doomed initiative, anyway), but to develop a collateral quasi-medical HEALTH CARE (healing) system, leaving the existing DISEASE CARE (curing) system pretty much as-is. We need legions of something akin to Mao's "barefoot doctors". In our world these would be "tennis-shoe doctors", the tennis shoes having been manufactured in China. Such "doctors" would be something like the personal trainers of the athletic world, but devoted to spreading fundamental health and healing knowledge to variable groups of friends, family and neighbors.

Money would almost certainly pollute and degrade the enterprise. As soon as paychecks enter into it, then one becomes reluctant to do anything (and eventually even to THINK anything) that in any way challenges the source of the check.

Part of the purpose is of course to forestall the need for the ruinously-expensive products and services of the medical/industrial (disease-care) behemoth. The ideal price for services is zero, though small sums for necessary materials (nutritional, herbal, hormonal, etc.) will be required. Best that this initiative be based on the free efforts of those genuinely interested in health and healing (of which there are many, and plenty enough). Compensation should not and would not be an issue, if a universal minimum wage system were adopted. Health and healing would be one area of natural "specialty" by a subset of an economically free people.

Alan

8:21 AM  
Blogger Cervantes said...

Well, evidence based medicine means that interventions have been tested in randomized controlled trials. It's precisely not about making deductions about what is likely to work based on understanding of biology, or even the kind of empirical evidence you have collected by just trying it and observing your friend.

10:55 AM  
Blogger scalpel said...

Exactly. While this hypothesis is quite interesting to me personally (as someone with a BS in Biochemistry and an MD), if the only outcome measurement is an anecdotal report of decreased fatigue and "restoration of confidence and general resilience" then I would be reluctant to recommend it to anyone with any confidence.

If you believe in it, then arrange for a double-blinded, placebo controlled study with measurable outcomes. Then we'll find out the truth. I would wager that 200 mg of caffeine 4 times daily would have even better results. :)

12:29 PM  
Blogger Alan2012 said...

"evidence based medicine means that interventions have been tested in randomized controlled trials"

Indeed. That's the common and
rather stifling definition. If
only RCTs really were all they
are claimed to be.

4:56 PM  
Blogger Alan2012 said...

Scalpel, you absolutely should
NOT EVER recommend such a
schedule to anyone. Stick to your
guns, and your caffeine tablets.
Or better yet, methamphetamine
caps.

4:59 PM  
Blogger scalpel said...

modafenil > caffeine > amphetamines > unproven vitamin/mineral mixture.

Until proven otherwise, that is.

5:31 PM  
Blogger AEDhub99 said...

I recently published an article on AEDs – here is a quote from it, in case you are interested:

Statistics give us more and more pieces of information that are bound to worry us, to make us react and change something if we can. More and more people and in earlier and earlier stages of their life die of a heart disease. Statistics, only in the US, are extremely alarming:
- Every 30 seconds someone dies because of a heart disease;
- More than 2.500 Americans die daily because of heart diseases;
- Every 20 seconds there is a person dying from a heart attack;
- Each year 6 million people are hospitalized because of a heart disease;
- The number 1 killer is a heart disease.
Although AEDs are not a universal panacea for all heart diseases, nothing else can compete to its major feature, that of actually re-starting the heart after it has been stopped by a sudden cardiac arrest. Under these circumstances is it necessary to ask you why anyone in this world, any family, in any home would hope for having such a device in their first aid locker?

If you feel this helps, please drop by my website for additional information, such as Public Access Defibrillation PAD or additional resources on AED manufacturers such as Philips defibrillators, Zoll AEDs or Cardiac Science AEDs.

Regards,

Michael

8:44 AM  
Anonymous Five said...

It is interesting that you mention the Krebs cycle aka Citric Acid cycle. Apparently mine is out of round. Citric acid, as I understand it is related to glutamate. Many people have problems with this, beginning with MSG and then develop other chemical problems, such as DHEA immediatly becoming Melatonin.
Doctors are clueless on this. They say, "Oh, you have "food allergies", and offer no help at all.
When I eat anything containing citric acid I develop a 2 day headache/brain fog/body misery, the same as if I had taken MSG.

So what do you have to offer in the way of correcting the Krebs cycle?
rhudson1968@tampabay.rr.com

6:10 AM  
Anonymous maggie.danhakl@healthline.com said...

Hi,

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3:10 AM  

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