Severe Persistent Lyme Disease: Experience/Opinions on the Controversy

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Here is a transcript of the content:

[00:00:00] Hello, everybody. Welcome to the podcast today. I’m going to talk about Lyme disease, Lyme diseases, something of a difficult subject. There are many points of view. a lot of people are, on the internet inquiring about it. it’s a, it’s a subject which, is subject to incredible controversies.

[00:00:21] And my contribution is just going to be to open discussion around, what I’ve learned based on my own struggles. I’ve had quite an experience with Lyme disease and I thought it might be useful to others. Now, let me clarify before I begin that I’m just sharing questions that I think would be good for everybody to research themselves.

[00:00:49] Please don’t listen to me. I don’t have any qualifications as a medical doctor. I’ve done a lot of research and I am a former academic, but this is a subject where you want to get, [00:01:00] technical advice from your physicians, for sure. So please don’t listen to me for. answers, but perhaps I can read you to some really good questions.

[00:01:12]so in summary, I don’t have definitive answers. I only have unresolved questions. this process has helped me an awful lot. And finding relief from my own case, which was fairly severe. It has been helpful in this process of inquiry has been helpful in dealing with the Lyme disease. what I’m going to focus on, I should clarify is the longer term, aspects of Lyme disease, not the short term, in the short term, post go to there.

[00:01:42] Doctor, they’re treated with antibiotics and it’s really quite successful. and, there just aren’t any issues, but that’s not always the case. In fact, there’s this very significant portion of people that continue to have problems. I believe you can [00:02:00] check me on this. But doctor John at Johns Hopkins has said, it’s now up to 2 million people with continuing issues.

[00:02:06] So this podcast is just a discussion that will help. I hope help folks. begin their own inquiry and narrow the questions and help, help them find a path that will be good from their point of view. it’s not medical advice. So it’s about persisting symptoms. It’s not about the case where you might, have an encounter with ticks and Lyme, and it goes away that what I’m going to be talking about is when symptoms persist and, Again, you want to get very high quality medical advice, not less, or this has no substitute and the issues are complicated.

[00:02:41]and it, it becomes quite ideological. folks divided into camps and they’re very, very different perspectives. they’re even different names. Some people talk about, persistent Lyme disease. Other folks talk about, a, a Lyme disease, post Lyme disease syndrome. [00:03:00] the difference here is whether you believe that there might be bacteria still in your bloodstream after antibiotic treatment, or if you believe there is none, but the persisting symptoms have to do with effects on immune system and other things.

[00:03:13]from my point of view, this is, is, ideological and highly unresolved and, requiring. more research for many of the people participating in the controversy. However, you will find that they feel it is resolved and the infectious disease society of America, which consists of highly trained eminent, wide range of, of very highly qualified physicians throughout the United States.

[00:03:42] They have converged on the, Aye. Aye. On the idea that, well, I, bacteria do not generally persist and the best approach is really to avoid further antibiotics, but to consider other methods of treatment or [00:04:00] symptom relief, No. My, my one major reason for this podcast really is because from an outsider, it’s my opinion.

[00:04:09] And this podcast consists really pretty much of my opinions throughout. Please think of it as my opinions and no. No certainties anywhere, but my opinion is the two sides. Aren’t really listening to each other’s each other that, well, there are some doctors that bridge the divide very well, and they are very good listeners, but in general, there’s not a lot of listening.

[00:04:32]so this phenomenon then is going to weed me to my own conclusions. That the best thing for me to do was to vary. Carefully make use of what is known by the, the traditional approach. The IDSA approach take that as far as I can go, but to also consider whether, the other point of view has some value.

[00:04:57] So my approach has been to find both [00:05:00] kinds of doctors to advise, first rewind. Initially on the IDSA approach, which has been beneficial, but I have found benefits from the other approach as well. if you choose your physicians care for, you can find both with stellar credentials. So that’s the kind of a background to what I’m going to be talking about here.

[00:05:22]and the, the next thing I’d like to do is just. A little bit in my amateurish way, summarize the basic problem. The basic problem is that for most bacteriological infections, they can take a sample of blood and they can take it away to a laboratory and culture it and see if they can grow the bacteria, which enables them to identify it.

[00:05:44] So the historical problem with Lyme disease is that they haven’t been able to culture Lyme. There is they take a blood sample. And the technology has not been there, perhaps it’s under development. We always hope for that. The technology has not [00:06:00] been there, to enable the laboratory, to culture the lime and get a definitive answer to the question at this stage, perhaps after it diabetic treatment, do I still have like bacteria in my system or not?

[00:06:15] Now this is not to say that there aren’t tests. there, there is, a widely accepted in a used test, or I should say, combination of two tests that your standard physician has available. it’s not really, too helpful in the first days because it’s it it’s, it’s, it’s a series of logical tests, the books, the antibodies, and those take a while to develop IgG and IgM.

[00:06:43]come forward at different rates, but to get a definitive answer, you kind of have to wait a little while. So that’s a bit of a worry, awesome thing. If you think you, might have a lab infection, but the early tests aren’t, aren’t reliable [00:07:00] for a while. so, so this basic problem that there is no test has led to what some have called the Lyme Wars.

[00:07:07] The Lyme disease Wars were folks who believe that the bacteria can persist are in a major controversy with the majority of infectious disease doctors who believe that the bacteria, the spiral Keats. do not persist or at least they sort of diminished in numbers. The immune system can handle it. So, we find a situation where, after initial treatment with antibiotic and both sides of the controversy we’ll treat with antibiotics, the, the difference comes with the question of how long.

[00:07:49] And what, after what about after the first treatment? I mean, Lyme disease can develop through various stages, which I’m sure you can read about if you consult the internet [00:08:00] and as it progresses, even the doctors who don’t believe in longterm Lyme infection do recognize that if it’s untreated, initially it can advance through your system.

[00:08:11] Come to what you might think of a disseminated nine disease, and they will treat with antibiotics, even intravenous. And that notion of intravenous is, is kind of an important factor to consider because, intravenous antibiotics bring a certain amount of risk and you can understand why the IDSA doctors would not like.

[00:08:36] Folks to be taking longterm intravenous antibiotics, if there’s no real proof or evidence or consensus that the bacteria are still living in one system, they wouldn’t watch it too, because there are dangers of infection, which on occasion can be extremely serious and really major. So, [00:09:00] there’s good thinking behind the fear of antibiotics.

[00:09:03] But one thing, one thing that, you begin to learn as you work your way into this subject is that, some doctors who believe that the spiral Keats have not died or may not have died, wouldn’t use intravenous antibiotics, they would use oral ones. So there’s a difference there. And sometimes when you hear about the risks of continuing to have Biotics.

[00:09:30] I believe it’s necessary to come to a contrast. The difference in risk between the two, not to say that there aren’t risks with oral antibiotics, there are certain OER, but the question is, is there a major difference in level of risk? So, that’s, that’s the general problem and you’ll find all kinds of things on the internet about this.

[00:09:51]some people who suffer a longterm for mine. I feel very strongly that the doctors haven’t listened a well they’re [00:10:00] there, descriptions of problems were kind of overlooked a little bit, a group put together a film, even on this. I’m not a big fan of the film because it comes across to me like a very heavy handed approach.

[00:10:16] I would say. Really a propaganda film, but it’s so heavy handed. And for myself, I like to keep a balanced mind about things. If I were an IDSA doctor, I think I’d be alarmed at that. At that film. On the other hand, there are many people who have felt actually hurt by the fact that they go to doctors and the doctors.

[00:10:41] Dismiss it dismiss the problem, say it’s psychological, whatever they might say. Although I should mention that this might be this phenomenon of dismissive response. When you go into the doctor, that might be decreasing a lot because, the whole medical community is awakening to [00:11:00] this, issue of persisting symptoms after YME disease.

[00:11:03] And I think, I think people are becoming more, More openminded and even the, the IDSA folks with IDSA approach now have clinics and support for folks who have continuing systems and they try to help with symptoms and whatever. I think, I think there’s actually a controversy within medicine where the Institute of medicine, raised questions about, IDSA, lack of, I wouldn’t say empathy, doctors tend to be overall, fairly empathetic, but lack of responsiveness to the patient perspective.

[00:11:37] Let me put it that way. and I think they took a position and I think generally physicians are, or can be, I don’t know, who’s done a survey. I don’t know the overall. But I, I find that if you go to a number of physicians and I’ve been to quite a few, a lot of them can be quite kind about it. Others are [00:12:00] technicians, there they’re really engineers of the human body and you would expect that they would go with E w w the recommendations they get from the IDSA and others.

[00:12:10] So, That’s an overview of the basic problem. Not to give a little perspective, this I’m just going to go over a little bit about my own experience. way back before wine was really in the headlines before there was much awareness. I moved to an area that, where it turned out ticks and Lyme. What was endemic?

[00:12:27]over time we fell into, this was a neighborhood where so many people get Lyme disease multiple times. It was just almost. Everybody you talk to has experience with it, but way back in 1990, when not much was known about it. And, I work outside a lot, working on a cruising sailboat that I had. I was bitten and I did have the rash and I had certain diagnostic symptoms, which are classic, which would help to diagnose, A classic symptom.

[00:12:59] My right [00:13:00] knee became extremely sore, painful, arthritic, swollen, quite, quite, quite a classic symptom. If you look it up, the knees are susceptible large joints. That knees are very susceptible. I went to the doctor of course, but, who can blame the doctor? He was just completely dismissive said it’s probably a spider, even though I had read up on the time and asked for a test and I believe I’m not sure about this when we did the tests were not as reliable in those days.

[00:13:31] So I’m not one to blame any doctor for anything. They’re all generally doing the best they can. But the point is his symptoms continued. And it wasn’t treated. And for a decade I had symptoms. So if I went into a store, the grocery store, for instance, where they have shelves will go up over my head. I’m not that tall, but if I walk up to the top shelf, I couldn’t look up because my neck would hurt.

[00:14:00] [00:14:00] And I continued with real pain in my right knee. And I had, a fluid bulge in my right knee. I said, I guess you call it synovial fluid. And I even had, I was feeling a two inch diameter of skin a was feeling and I had many other many other symptoms are, I would go into only because my busiest tends to, be associated with migrating symptoms and such a range of them.

[00:14:29] It’s one of the problems. It’s one of the reasons why. The ID, the IDSA and, the medical community generally wants to be careful about people diagnosing when I’m too easily and prescribing all kinds of antibiotics because the symptoms are so varied and complicated. And, it’s kind of hard to pin down without a lot of experience.

[00:14:52] So who would want a lot of people taking antibiotics? If in fact they do not have. [00:15:00] A condition where that would help. Anyway, I even had brain fog in my fogginess. I, I had fell going down to the basement steps. anyway, as this progressed, I, I D I did go to my standard doctors. It’s not like I ignored all of this.

[00:15:17] And, there was a variety of, of responses. I have the most wonderful, compassionate. Dr. Who is both a scientist and a physician just absolutely absolutely magnificent. and, he, he has helped me all through this process, even though he himself is well-educated in the standard IDSA philosophy toward all of this.

[00:15:43] But my approach has been always to go to all the, Referrals that standard doctor would give me and pursue, pursue the theories that one must pursue in case this is not really Lyme disease. So [00:16:00] for one example, I went to a, a rheumatologist and, there I was with a swollen knee and at that point it had gotten into an elbow also, And, he started to go through the possibilities and whatever, and I just mentioned to him, I said, and by the way, there’s very clear clinical evidence that I, I had.

[00:16:20]I, I did have Lyme disease, quite a while back. I thought he should know that. Well, he cut me off immediately. He said, you said you do not have Lyme disease. Now this is understandable. Cause these doctors do seminars. And there, there are very eminent medical minds who are really set in their beliefs that there is no persisting, well I’m infection.

[00:16:45] And they live in fear that doctors will get the wrong impression from all the public outcry. And so a lot of these doctors have seminars where they’re really warned about the ethics of just taking somebody who wanders in thinking they have Lyme [00:17:00] disease. And, and, and going with their theories. So I very, I’m, I’m very supportive of the rheumatologists who cut me off.

[00:17:08] I understand why that is. And actually we remained friends. I quite admire, his, his mind, when my wife and I went to Europe, we shared photographs and things. an important part of all of this is to be understanding of other people and, I think, I think a big problem with much of American culture is people have too much attitude and they, they, they get hot emotions way too easily.

[00:17:34] And I believe in, in the mildness and understanding the people that I deal with. So I did have the experience of being dismissed, but that was just useful information to me because that told me a ha rheumatologist specializing in arthritis doesn’t have solutions. So how valuable. I was glad that I was sent there and I got good information, even if it wasn’t like a solution to the whole problem, but [00:18:00] that was just one stepping stone.

[00:18:01] I had night sweats going on for a longest time for years. And they were very frequent and, my PCP who’s so supportive and it pursues, every Avenue for me was concerned and, the way he is open-minded and supportive and wonderful. He said, Larry, I think maybe you should see an infectious disease doctor.

[00:18:25] Well, what I’m sure. I don’t know this for a fact, but I’m sure he has had lectures from the eminent, lead scientists who advise the IDSA and many doctors in our Boston area do have to have a continuing education on these topics. But there, there he was opening the perspective, not just say, well, it must be psychological.

[00:18:53] He just keeps investigating the possibilities. Well, I’m kind of an independent thinker [00:19:00] myself. So when he said that, I said, okay, I happen to know from reading about, Other diseases that there are geographical differences. There are medical cultures and geographical differences around the country and how folks look at things.

[00:19:15] And I said, so I I’ve, I’ve seen some doctors in this circle. Let’s just take the doctor’s advice, go to an ID doctor, but we’ll pick one, who might have a slightly different respective. So I did my research and I decided to go. to a highly endemic area where there are water wealthy people, where there was the possibility of thousands of patients and very well experienced.

[00:19:43] Now, there was somebody that really had worked clinically with Lyme disease over a long period. And, I was so fortunate. I I’m going to mention his name here because I admire him so much. I was so fortunate to find a doctor, doctor he’s [00:20:00] retired, no longer practices, but, you can check me. I think I recall he had close to a hundred peer reviewed publications, so he’s, he’s a recognized researcher and scientist, but also a condition, very interested in people and, so I went, I went to see him and, his experience had been

[00:20:21]a little bit against the idea I say, but not really. He was open-minded and he, he would not say, Oh, they’re all wrong. You know, we know what to do here. What’s what dropped antibiotics. He simply said that the tests aren’t that reliable. And in his experience, when people come in, if you look at the clinical patterning and see that it really quite certainly seems to be a lime, phenomenon as it was in my case, that something he had found useful.

[00:20:59] When I remember [00:21:00] this is thousands, I think 10,000 patients useful was to take a safe antibiotic. That he had reason to believe was actually very effective for why I’ve actually more effective than standard dr. Cycling, which is used to use it for a longer period, but not in some wild sort of way, but experimentally, he said, if it doesn’t help just stop.

[00:21:26] And he said, it’s not going to be open-ended. but it can also be able to look diagnostic because. If, when you start taking it, you start to get some worse insists symptoms. That could be the Herxheimer reaction showing that there are secondary effects as bacteria are being killed. So I started down that path and I started taking sex psych, and I recall the tetracycline is, I mean, you can check me on this, but I guess it has often been used for, acne [00:22:00] various things for very long periods.

[00:22:03]I, my expectation was it would take a year to 18 months to really get the full effect, but I started out and sure enough, I had, all the symptoms that I had had off and on at varying degrees. I had a pretty bad symptoms. Within the first three or four weeks, and then they lessened. And then what happened was slowly over a period of months.

[00:22:28] Cause I went 11 months. the symptoms began to decline and, this was in accordance with doctor Dontre’s, expectations. So I continued and, it was not intravenous, so I did not have the infection risk associated with. I need them in my, in my bloodstream, et cetera. And, so I continued on with it.

[00:22:53] I met conservative person, so I did not go the 18 months. I would have wished I had actually gotten a little bit longer, [00:23:00] but I came to the conclusion that quinoa clinical experience here above and beyond the, the studies that attempt to evaluate the effective longterm evaluate, antibiotics.

[00:23:13] Clinical experience was an important source of information. So many Simpsons just disappeared all the night sweats, which had been a big problem. Drenching t-shirts many nights, they just stopped, but most symptoms never came back a few and a lot of. Important symptoms went away like the knee problem. And there was women in my life and, and things.

[00:23:40]however, they didn’t all go away. And I, I wonder sometimes had, might it have been better to continue with, but I did have some, a few continuing symptoms. just to give one example, some doctors, when you come in with Lyme symptoms that persist. we’ll say that they’re subjective and psychological. I [00:24:00] had twitching all the time.

[00:24:01] You know, my wife could look up my arm and see there. It was, there, it was twitching. And, dr. Don says treatment did, did relieve, the, the twitching, however, just little bits after I stopped the antibiotics after maybe six or seven months, just a little bit of that came back. Had indicated to me maybe that we didn’t kill the entire, population, if that in fact what was happening, it’s interesting, why the 11 months could be useful and why the IDSA believes the longterm is not helpful.

[00:24:38] Very, very interesting. the lifecycle of, The, the wives spiral Keat is quite long. And I might talk more about this in a bit, but the, the, it goes into protective forms so that the immune system and antibiotics can not reach it. There are so called [00:25:00] cystic and biofilm forms. That it, that it, forces itself into.

[00:25:06] And, it only comes out of these to reproduce periodically. So if, if, if the period is quite long, if it only does that recently, that you can understand why just a couple of three months of antibiotics might not get very much and 11 might get more and 18 might get more. And by the way, dr. Datto was very open that, There, there are, there’s no guarantee that even taking, even using his experience and approach many, a certain number of cases are refractory.

[00:25:37]his argument was more that he, that he did see benefits in a lot of cases. Not that it was a, a complete solution. Anyway. so I, I gradually increased symptoms, but I was so much better. And my PCP tells me I have a very high tolerance for pain and things. So like I did for like 10 years or something, I, I just ignored [00:26:00] the symptoms.

[00:26:01] As they came back, there was so much less, but they gradually increased. Then within one summer I had a tick bite. And so my PCP prescribed. just out of caution, doxycyclin, and I had a severe reaction. It was just amazing to me, how I had had doxycycline, in the past for, a tick bite. I had a physician who gave me a one dose of it when I had a tick on me for this, for what a while?

[00:26:30] And then I had bitten been bitten one other time and I was in right away and I had a doctor cycling and it didn’t, it didn’t bother me at all, but this time I just couldn’t function. I was really sick. I was laid up for four days. We headed out in the sailboat and we had to dismiss more of the boat and I was just an incapacitated sick person for four days.

[00:26:50]but interestingly, after that, that run of four weeks of doxycycline. My symptoms were relieved even more for awhile. that, [00:27:00] that, that was a reconfirmation for me, that the doxycycline hops now, before I get folks, before I mislead anyone, one thing needs to be said about any antibiotics, which is, you know, just kill, biological organisms in your system.

[00:27:19] They’re also, anti-inflammatory. So one of the things to keep in mind is if you ever have antibiotics and it makes you feel better, that’s not proof that bacteria were being killed. It might be just that the inflammation was lowered and you had an information problem. so my point about all of this is you need to be suspicious and have a, you need to do critical inquiry about all of this, all of the time.

[00:27:46] You must always develop as many questions as you think you find solutions and keep investigating. Cause nothing is completely clear. Anyway, so we have a situation where I [00:28:00] took the doxycycline, and I got sick that kind of confirmed the Herxheimer theory, but, as I say, those were my.

[00:28:10] Suppositions nothing is that queer through this whole process. there can be some internal certainty, but nothing in the way of scientific certainty. but as, as, as I continued on with these symptoms, which gradually increased over time after once, cause they did start to increase again after the doxycycline very gradually, I noticed they were kind of on a three week cycle and you know, you’d have to ask yourself.

[00:28:36] Exactly why there would be like a three week cycle or something like that. you know, I’m not sure that the, the sacred genic theory of all of this conforms to such rigorous simplicity. why, why is that? There are a lot of deep questions to ask yourself. When you go into a doctor who has been schooled in the IDSA approach, he or she will tell you. [00:29:00]

[00:29:00]Well, we’re not too worried about our thinking on why, because it’s a, it’s a spiral. Keat much like syphilis and we know from syphilis, it can be killed effectively with the treatment of, of antibiotic. there’s a, it’s a good pair of there. My. Discovery about that was first of all, that’s a good starting point for thinking, but then you research further and you find that the, the amount of genetic material shared between, between, syphilis and Lyme is not total.

[00:29:39] There’s something over 30% of genetic difference. So there’s, there’s a lot of evolutionary. Have been evolutionary developments and these bacteria that might produce effects in the human body. By the way, when I say 30% difference, that’s you have to think about that carefully because [00:30:00] the nature of all genetics is that we all, if you go back to the simplest earliest life form, the most permanent thing.

[00:30:07] Well, we all share such a massive amount of DNA. When I say 30%, first of all, look that up for yourself to check the, the actual figure. But, in case I’m not quite right, right on there, but if you go back and look into that statistic, it means if you look at the, at the genetic difference, Among bacteria.

[00:30:31] If you look at all bacteria and say, well, where do bacteria vary? Don’t compare it, you know, to, a parrot or don’t compare it to a, a gray seal just among bacteria, among those bacteria. There’s quite a big difference between Lyme and, syphilis. So anyway, in my mind, the cycle. Does it seem to be conformant with the idea of why bacteria flare, if one [00:31:00] accepts, I guess there’s fairly good observational evidence now that the lime retreats into little cysts, cysts, micro colonies, biofilm areas where they can protect themselves against, the immune system and antibiotics.

[00:31:17]anyway, That’s my early experience with, with, with the lime, kind of gradually increased after me antibiotics and, then progressing forward in time. Cause remember this whole thing is over, I guess 1990, they were talking about like a 30 year period here. w moving forward. after that last treatment with dr.

[00:31:41] Cyclin, it gradually increased to gradually increased until eventually the pain in my leg and hip and, you know, the lower leg, in the hunches, it became really pretty bad. So sometimes it was actually hard to do our daily walk [00:32:00] and the original doctor had retired. I actually, at this point felt I needed some kind of treatment because, you know, I need to keep exercising for my health and I’m at this juncture I’m going to actually recommend, even though I’m not recommending anything in this, in this video, I’m going to mention something I do recommend, and that is always find yourself the best doctors with regard to their training.

[00:32:28] And also with regard to their. Outlook to where their patients. And, I was very fortunate to find a new doctor who’s, degree was from the medical school, which is ranked best in the country and had six years in an Ivy league teaching hospital. And, she, took an, led me through some. Further, investigations that has been quite beneficial.

[00:32:58]as an aside, I’d mentioned here [00:33:00] that, I guess I would have one recommendation and that is when you’re facing something that’s possibly debilitating. What’s very important. I think it’s always good to have two advisors and I found it quite useful to have. And adviser in the traditional camp and then an advisor who is in the more, in the camp of having more general thinking and open to more possibilities, not really aggressively anti IDSA, but just very, very open minded.

[00:33:32] And, by having these two types of doctors advise you, I, I find you can make, huh. A lot of progress in your own thinking. And then, and then figuring out what to do. unfortunately in the next round of treatment, I ran into a bit of a difficult situation because it’s very hard to interpret because, I actually had without jumping to any conclusions as to why [00:34:00] I actually had a.

[00:34:02]sepsis, which is a cytokine storm and was in the hospital, very serious symptoms. but who knows what caused that? Because the timing was just terrible. Three things had happened. First of all, I cleaned out big Moss nests, at our camp. And, it’s well known that there’s something called Hanta virus, which can cause.

[00:34:27] Symptoms much like I had now in our part of the country, Hanta virus is quite rare, although it is documented and this was quickly put to bed by another IDSA doc, another infectious disease doctor that I consulted who said it can’t be because I didn’t have any flooding of the lungs. Well, I did my own research there and found out that the, There has been a U S government medical alert that there was this sub variety of not the virus, which [00:35:00] did not have, there was, did not have any, flooding of the lungs, which we had used as a diagnostic criteria.

[00:35:08] And so that means that that whole diagnosis was in question. However, I had the antibody testing and it was found to be marginal, but it didn’t persist. So. That was all kind of left up in the air in the hospital. They saw signs of a possible atypical lung infection, but they were very suspicious because it didn’t look quite right and they doubted at all on.

[00:35:30]so, it’s possible that that my sepsis was due to lung infection, but, but at the same time, I had started a prescription with an antifungal nasal. Because I have a pops in my nose and it turns out that that biofilm Buster, which I guess can, has the potential unevaluated theoretical of, of disturbing, biofilm, colonies of lime.

[00:35:59] And who [00:36:00] knows if a lot of lime might’ve been released or somehow there was some other effect, but also I tried some antibiotics for my life and it’s possible that I had a Herxheimer reaction of a very severe nature, but typically Herxheimer reactions with whatever Wes said the year. And so that theory.

[00:36:24] It can be questioned. However, when you look into it deeply, there are cases where people get very severe Herxheimer reaction after antibiotic treatment for a while. So this whole area is a, is just a puzzle. What caused that, but it did make me very, very cautious about taking any more antibiotics to treat.

[00:36:48]My symptoms, even though I was having trouble walking, just to summarize the outcome of all of that was, that again in [00:37:00] consultation with a very open-minded doctor, and this turned out to be pressured to what a, what a prediction. There, there are certain herbal medications which are used so widely in traditional cultures and have been tested.

[00:37:16] So they are known to be relatively more safe. And one of these was felt to be active against Lyme and also the possibility of persisting Baebies Yosis. And I tried that in very, very tiny doses and then a little bit more, and that really improved my symptoms a lot. I got so I could, you know, mostly walk most days and manageable pain other days.

[00:37:39] So that’s another dimension to all of this where you might want to not saying to rush off to an alternative doctor, but try to seek advice from all sources and watch the. Literature carefully. I may talk a little bit about recent tests done at Johns Hopkins university, where it’s found that [00:38:00] doxycycline is not so able to kill all the lime that doxycycline forces lime into, protective, cystic forms.

[00:38:09] But also that live is more susceptible to. An alternative cocktail of antibiotics is not generally used. And finally, in this context, the point I’m trying to make is it’s been tested against some traditional herbal medicines and they were found to be more effective than doxycycline. So it’s not, I don’t view it even though you should probably very suspicious of what I’m saying here.

[00:38:36] I personally don’t view it as scientifically. In supportive or scandalous that one of these might’ve might’ve helped me. I was seeking a moderate approach than antibiotics and felt so grateful that I, that I found something. so that’s, that’s quite, quite interesting. I’ve got to pause at this point for a moment.

[00:38:58]okay. I’m back [00:39:00] to continue. talking about Lyme disease. I’ve said a number of times that I’m not making any recommendations, except that everybody investigate for themselves. I did, I did recommend a moment ago that in doing that, it’s good to have more than one doctor advise you. That’s always helpful when there’s a controversy in anything.

[00:39:21]second opinion philosophy is well accepted in medicine. You might want an ongoing second opinion, for Lyme disease, for sure. But let me, let me make another recommendation before I proceed. and this is, something I found very useful for myself. It’s not a medical recommendation. It’s a recommendation about how to get advice.

[00:39:43] One of the things that I found as I looked into all of these questions was that, there appeared before me many questionable sources of information. And I tried to [00:40:00] look at credentials and I wasn’t too impressed in many cases, but again, and again, maybe up to seven or eight times, I was really struck when I came across a doctor who seemed to have good, very good credentials.

[00:40:16] Yeah. And had somewhat open-minded and alternative, philosophy. Toward continuing Lyme symptoms. And I discovered that these folks were doctors who had had lie persisting symptoms, persisting lives in symptoms, in their own family. So that can be very, very useful. I think when you’re working for a doctor and somebody to advise you.

[00:40:47] You find a doctor, just think a doctor with all this training with him, you know, high IQ and dedication, and they spend all this time sacrificing much of their youth. How do you enlist them [00:41:00] really as, as your best support system? Well, just think if they’ve had Lyme in their family, a child, a relative, a sibling, a spouse.

[00:41:13] If, if that. Experience affects a physician the way it does. Most of those of us who have had continuing web symptoms, what would you expect? You would expect a lot of careful thinking and research. So I would recommend always looking for doctors who themselves have had some experience with the lime. Just to consider it may, it might be you find other sources which are better, but that will help.

[00:41:44] And, generally those physicians who have been close to the problem, won’t have this response, that many other physicians do, that there could be a lot of subjective symptoms, that maybe. Should be dismissed, might be [00:42:00] depression might be psychological phenomena. cause they’ve been so close to it with people that they knew.

[00:42:05] Well, I mean, you can see why doctors think it might be subjective symptoms because this is an area of medicine that isn’t really well understood yet. And, a lot of the symptoms associated with Lyme do show up as subjective symptoms. The doctors are quite right and having an open mind toward that. So it’s a natural.

[00:42:25]area of, investigation where there should be so much of a supposition. I’m not sure, but, I certainly am understanding why doctors, take that approach. okay. So I’ve talked a little bit about my situation approach, my philosophy and strategy. Y my, my philosophy is to try to be objective, like everything.

[00:42:46]there are known facts and then. Around those facts. There are mysteries, there are unknowns, there are scientific advances that will refine those facts. So the philosophy is to push both to [00:43:00] advantage people that have quite definite conclusions about what science has told us and those who are trying to push the science further.

[00:43:10] Those are the two avenues that should be compared and contrasted. And that you can see why I recommend finding a physician whose family member has continued in the line because they’ll have, they’ll have a dog in the fight in both sides. I’d warn you against many sites on the web trying to profit and take advantage.

[00:43:29]there seem to be many treatments without medical basis, and, It’s important to push past just whatever shows up on your screen and work for credential doctors who have treated, treated many patients. As I say, you start to thousands of patients. It really helped in my own experience. the Lyme story is very, very complicated, and I personally think that, we all need the guidance of both IDSA type and.

[00:43:58] Oh, I have doctors. [00:44:00] yeah, there are also, doctors who are on purpose, keeping themselves above the fray and, keeping an open mind from both perspectives and that’s can be really, an advantage, but I myself have great fear of just rushing in with the rushing in. Into the alternative view that, Oh, it’s nine and we just have to treat it with a lot of heavy antibiotics, very suspect of that in case it might be something else.

[00:44:33] So I just think of the advantage. If you have two types of doctors, you have one doctor that checks out all the possibilities, given your symptoms, what could it be? What could it be? Check them out, check them out. And only when you come down to the case where nobody can find anything. And then you’re in a position to better evaluate what the other camp might be saying that this can be persistent, or have infection.

[00:44:58]and, good [00:45:00] doctors with prestigious credentials can, can really, can really help with this. The, the possibility of, getting misdirected here. Is really fairly major. So, I think extreme caution is necessary, in whatever you, whatever you do. And, we should talk a little bit about, why you should even question the IDSA approach at all.

[00:45:28] Given the fact that they, that there’s such so many. I think there were thousands of doctors in that camp and there’s so much research conducted. I mean, we have to get on here at some point to ask ourselves, well, why would one question all that research? I don’t actually think you should question it clinically.

[00:45:48] I don’t think you should just jump over to the other camp myself. I think it’s best to try to be very objective and very analytical, as I say, critical inquiry is the [00:46:00] thing that counts here. accidental things may happen in your life. I’ve recently come across an established scientist with the very highest credentials. I mean, public publishing in the very most prejudice, strategic prestigious, international publications, and finding that he had. To some extent, the same experience is the same doctor in the same good result.

[00:46:25] So, you know, anecdotal happenstance can, can reinforce your view, but there’s perhaps danger or just listening to any one person you run across. For me, that was after the fact confirming, some of my, some of my beliefs in my own mind, rather than guiding me. of course there, there are many books online you can, can consult those.

[00:46:48]one of the most extensive is there’s a book by dr. Horowitz who’s covered. It was treated many, many patients for myself. he fi and this I think is a compliment. He finds so much [00:47:00] complexity from his practice in what he calls multi-system theory. There was no involvement, not just the vibe, but many other factors, so much complexity that it’s hard to find any solutions to somebody who is actually suffering.

[00:47:15]you would actually need him to guide you through the whole process, but it’s interesting what he found, what he found was as he treated patient after patient. I guess he found it. Doesn’t always just come down to the NY, but many, many other things that he wanted to test for all of these. And, in some ways it’s discouraging because it confirms the IDSA picture that it might not be, Y might be something else.

[00:47:38] But on the other hand, he often did end up treating Lyme and he often found, in, he also offered, found other dimensions. to human health, which, were very, very important to consider and treat. So that book, I guess that, that, that just helps one to understand how much complexity there [00:48:00] is. I don’t really know what to recommend in terms of, specific steps for specific individuals.

[00:48:06] Cause we’re all different. I would say that that book is good to read. If you want it one to understand the full complexity of. And, I think he was on a national committee. I think that he is somewhat respected in the, in the general medical world though. Probably probably a strict idea say protect practitioners would, would have when I brought up very much about, his whole approach.

[00:48:33]remember that the. The battle is between folks who feel that spiral Keats may still live in your system. And what one might think of as, huh. The persistent and then I’m deniers folks who feel strongly that don’t no, it’s not bacteria that can continue to live on. It’s interesting in this regard that, In my investigations of COVID-19 I’ve I’ve come to admire Michael Foster home [00:49:00] just tremendously.

[00:49:02] For me, it’s just the best mind in the U S and, he, he, he has just such a careful mind, such a trained mind. He himself mentions how many courses he did in statistics. It just it’s, it’s just. He’s at the pinnacle of American civilization as are many of the doctors that I’ve consulted with. I’ve never Osterholm himself as an epidemiologist, not a doctor.

[00:49:28] I’ve never, I don’t know him at all. I, I just read his things, but it’s interesting that, in an aside, he, in his epidemiological work, he just generally accepts the IDSA, conclusions about why and Warrens everybody against. Any other view. so this raises a really interesting question, which is at the heart of this whole podcast.

[00:49:55] I’m trying to put together here. And that is why [00:50:00] should one at all, have questions about the research that the IDSA refers to. I mean, these are smart people. They have available to them. Statistical consultants, epidemiologists, microbiologists, the whole works. and if, if you go out into the treatment world, you might very soon be told that there are four or five high quality studies showing that, longer-term antibiotics does not help.

[00:50:35] So isn’t that just in an open and shut case. High quality studies respected by the best minds in American, infectious disease science, well, knowing my own shortcomings. And I remind you of them here, remind you not to follow, me so much in my thinking, but just to take. [00:51:00] My own journey as an example of how you might begin your own.

[00:51:04] And perhaps my recommendation that you try to develop questions to accompany any solutions you hear about that might be very good advice, but what is the argument that IDSA might not really have the final answer? They have moved science ahead. There’s no doubt about it. Well, what is a high quality study?

[00:51:29] Well, it needs to be randomized and double blind. Randomized means that you take two groups of people and use a random number generator or whatever to assign people into one group or the other. And so you get a good, a good sampling. you get two good samples that are arbitrarily and completely randomly selected.

[00:51:55] And then you give one of these groups, the [00:52:00] treatment, like longer term antibiotics and the other group, you don’t give the treatment. You give them a placebo, you trick them, make them think they’re getting a treatment, but they aren’t. And it’s double blind, which means the patient doesn’t know if they had a treatment.

[00:52:17] There was, they might’ve had. Pills to take, which had antibiotics in them, or didn’t have any antibiotics in them or injections or whatever, but it’s double-blind which means the people conducting the study and giving those treatments. They don’t know either. Nobody knows which treatment or lack of treatment either group gets.

[00:52:36] So it’s double blind. Okay. So you run this study and then you simply measure you measure in some way. Has there been a benefit of the treatment? Well, certainly the idea is he folks might’ve expected that there wouldn’t be any benefit to longterm antibiotics because in the case of the syphilis aspire, [00:53:00] Keat, the antibiotics tend to work.

[00:53:03]as I understand it, And they can even explain to themselves why folks have felt that longterm antibiotics helps because it reduces inflammation. So a lot of symptoms can be reduced by the longterm antibiotics. Long term antibiotics are suspicious. That’s the reason for these studies. Okay. Of course there are a lot of other facts that they don’t invert to like the swell river reproduction cycle of Borrelia.

[00:53:29] That’s that’s their lives spiral. Keat. Or, the fact that the genetics are differentiating it, doesn’t, advert to the periodic periodic nature of flares. It doesn’t advert to the Hercs reactions when you’re taking antibiotics. it doesn’t advert. What does, I guess it doesn’t give full credence to the fact that there have been studies, Finding life spiral Keats, a very famous study by a, a researcher, [00:54:00] with, a population of chimps, took, chimps that they infected with Lyme disease.

[00:54:07]Then they treated the chimps with. Dr. Cyclin or any antibiotics as much as you would a human. So now supposedly all the wine is cleared. Then they’ve now recall that there’s no way to culture and know if they still have lime in their body. So they took him, they put fresh, healthy ticks on the chimps.

[00:54:27] These are ticks with no Lyme disease and let them stay there a while. And then they took them off and they were able to work for, Lyme disease on these, In these texts and they did find some, so many reasons why the question should be raised. It’s also been discovered that assisting in biofilm forms of, of Lyme, which are less accessible to immune system and antibiotics.

[00:54:52]let alone, perhaps for me the most major question, why we might. Ask [00:55:00] for more studies than this than the four or five high quality studies so far is I don’t believe they were based on the clinical experience, you know, in my world. And my scientific world, one looks at the folk were to develop the hypothesis then goes to test it.

[00:55:18] So if you go out and you ask around among people that have treated, treated thousands of white patients and find that, you know, oral, Antibiotic of a fairway old and traditional tape really helps if it goes on long enough. Well, that tells you that the longterm effects of the longterm benefits of, antibiotics, wouldn’t just be a couple of three months.

[00:55:43] It would be much longer than that. they’re also in vitro studies showing the doxycycline doesn’t eliminate. well, I mean, it encourages them to make protective SIS. it also shows that the in vitro [00:56:00] studies also show that, different sets of antibiotics might be more effective than doxycyclin, which is traditional, in secretary accident and others.

[00:56:09]and did some relatively safe herbals can be more effective than doxycyclin. There’s also a study by a Brown statistician that found that the I’m not sure what the more recent was with the early limes so-called high quality studies were under powered. that’s a situation where, the number of subjects and interplays with the nature of the procedures.

[00:56:35] And effects how certain, when must be about the, the conclusions. so to summarize all of this, one can ask this question. So we have double blind studies, but should there be triple blind? This is a main point I want to make. This is the question I have of both sides of the, of the Lyme Wars. Should there be triple blind studies?

[00:57:01] [00:57:00] And that would be one where the design itself is blind to assumptions that might predispose the output. Perhaps the design of these studies set things up to get an, a negative conclusion. I would argue that if you have a physician with eminent qualifications, who’s treated 10,000 cases and is finding that longterm means.

[00:57:30] Many months, 12 months to 18 months. And he does see benefits. It seems to me that should be the null hypothesis in any high quality study that would be triple blind. You go out there to the person who’s really challenging your theories and has evidence. Has actual evidence, clinical evidence, not, not, not actual studies, but clinical evidence.

[00:57:57] If you really want to put the question to bed, [00:58:00] you have to say, well, perhaps dr. Dante is the real thought leader in all of this, but he can be wrong. Let’s find out. So that would be a way. To end the line Wars. In my opinion, if people designed to study that went a long time, using antibiotics are known to be more effective than doxycycline and do it managing risk, not, I was never given intravenous antibiotics, just the same antibiotic that young people with, with acne, took, and it was monitored the whole time.

[00:58:43]anyway, you may agree listeners here may agree with this or not. I’m open to the possibility that might be completely wrong. I keep having these experiences though, that lead me to make this, this podcast. I think I mentioned already meeting, scientists. I [00:59:00] admire so much and finding that he had been to exactly down the, exactly the same path, but also just recently I saw that perhaps.

[00:59:09] The most credential and worded a Y researcher in the country had a, a webpage associated with clinical treatment in, in some lab, associated and, talked about the, the great relief that came to this patient without using longterm antibiotics. And how encouraging that would be to folks with this problem.

[00:59:36] I mean, it’s dr. John writes that there’s 2 million of it and, it really made me doubt myself. And then I came across the same patient with a webpage two years later, having to give up his, his primary occupation, his primary employment because of, increasing Lyme symptoms. So. You know, the idea is right.

[00:59:59] You can’t, [01:00:00] you can’t jump to conclusions. You get everybody in trouble. and, it’s probably very, it’s very, it’s very, highly advisable not to ignore what the IDs is telling us and do everything you can to avoid getting into, getting into trouble. After all I had. I had sepsis. I have no idea what caused that, but, you can, you can harm yourself by not listening to doctors.

[01:00:27] So I recommend you listen to IDSA, certainly, but should you listen to other doctors as well? And should there be questions in, are there ways, I have been a scientist myself and I think I see a way of resolving all of this and that is a triple blind study. Okay. I like to move on a little bit and talk about another person that I admire admire so much.

[01:00:50] And that’s dr. John at Johns Hopkins university, a major new results of the last few years from a ma prestige science [01:01:00] center. I’ve already mentioned this above. I’m just going to run through. The high points again, you might want to look at the research evaluated. You investigate here, whether I’ve read anything wrong.

[01:01:11] If I’m drawing conclusions that are inappropriate, but in vitro, that means in a Petri dish, it turns out nine does not, is not as susceptible to DOCSIS. So on as one might hope, but two, there are cocktails of antibiotics that do seem to be more effective, effective. and almost, I shouldn’t say comical cause suffering is involved here, but I did find it somewhere.

[01:01:36] I’m using that in this lab at Johns Hopkins. Apparently they use doxycyclin to create, assistant biofilm sustained or biofilm forms resistant to antibiotics so that they can go and test how various treatments affect those. self protecting forums, not just the [01:02:00] open living, circulating, spiral Keats and the bloodstream, but one’s hidden away protecting themselves.

[01:02:09]so that’s quite ironic infused doxycyclin to create those, given the doxycycline as a standard of treatment for Lyme disease. In this lab, they also found that essential oils can be effective. Although there are warnings everywhere, not for patients not to jump to any conclusions, essential oils can have bad effects.

[01:02:28]there are all kinds of questions about doses and things. These are not treatments at all, but just interesting questions. And then similarly it’s they showed that in vitro. Once again, all this is in vitro that several of the safest herbals. Safest being in quotes because there’s much, you must consider there in consult consultation with your doctor.

[01:02:50] Everything has side effects. Okay. You have to be very careful, but several of the safest herbals seem to be more effective than de DOCSIS cycling. [01:03:00] so is there hope there that some of these herbals that are. In so-called toxicity tests, which is sort of chemicals. Shouldn’t take that to me that it’s not harmful that you need to research that on your own, but they’re used massively in other cultures.

[01:03:14]So, that’s pretty much the narrative that I’ve, I I’ve had on my mind. And I thought it would be useful to share. I might summarize a little bit right now. the summary being that, we’re all going on the claim that there’ve been high quality randomized, double blind trials, showing that longterm antibiotics are not effective, which I think should be taken very seriously, but there are reasons why you might raise the question, whether the studies might be done somewhat differently.

[01:03:51]so, so called triple blind approach that I’ve suggested, when might find that longterm antibiotics or according [01:04:00] to dr. Johns in vitro, that alternative cocktail of antibiotics might have more hope than the IDSA boys. certainly it’s good for anybody designing a study to consult clinical experience.

[01:04:15]and dr. Dante has experienced it over 12 or 18 months. a well known, antibiotic is used for other purposes for long periods of time. That’s in the same family as dr. Cyclin, seemed to show benefits for not all, but certain subset of his patients. of course, the IDSA, you always come back to the fact that they’re on solid ground in their warnings, because there are many doctors that have used intravenous, antibiotics over extended periods.

[01:04:50] And the idea is he points out, the dangers of antibiotics of any kind, but in particular, the. The intravenous ones. of course [01:05:00] dr. Uses just oral, even oral has some issues even if different or less, but, I’m not presenting any final solutions here. I’m just trying to raise questions. So I wouldn’t go into it all.

[01:05:13]an important thing to note is that of the five high quality studies. They’re mostly under four months and it’s often pointed out by lab investigators that there were benefits shown in some of these studies, even in those short time periods, just that they weren’t overwhelming enough to, revolutionize the theory of live treatment.

[01:05:39] But I, it certainly suggested that perhaps if they had gone on longer, they would have seen more, and it’s interesting too, that the effects that they did see with longer term rates Fitex tended to be toward the end of the trials. Like it was just beginning to kick in. And if you’ve lived that life has a swell reproductive cycle and the cysts in the, in the biofilm [01:06:00] forms, it all makes a certain kind of sense of.

[01:06:06] And after all in the end, I would like a battery of advanced statisticians to investigate the Brown, the conclusions of the Brown statistician, who felt that the, the many of the studies were under powered. I once was in a, a yogurt shop and hit up a conversation with an eminent statistician from Harvard.

[01:06:27] And I mentioned to him, I was interested in this question of under power and his answer was he hasn’t seen a statistical study yet that wasn’t under powered now, not to take that too far, but the point is there’s always more to wear. anyway, the idea of say, has a general philosophy. They’re not completely closed minded. They’ve they do, they have adverted to the possibility that there’s a few, that there’s a small amount of, wide bacteria after standard treatment, but are just, I think the belief has been that [01:07:00] that’s fairly inconsequential and, the belief is just that the persistence in monkeys, And then in there studies have mentioned above is not significant.

[01:07:12]and the conclusion that they’ve come to is that, Oh, these these symptoms are very real. They’re, they’re extremely, They’re there. They’re palpable there. They’re very real. And the patients they’re there. They’re not dismissive anymore. They’re very supportive. But if you want, must be the immune system, they’re believing it must be the immune system immune system effects.

[01:07:34] And also if there are dead spiral Keats, that’s a kind of a toxin which might be causing negative effects in one’s system. from my point of view, I’ve gone to the immunologists and asked them with kids. What do you have in terms of actual results, your actual studies, and they’re there? They’re saying that they’ve been saying to me that they don’t have a treatment, they don’t really have any useful results [01:08:00] yet.

[01:08:00] So I’m wondering whether in every discipline, when things are hard to understand, just to maintain ones, Not to be overwhelmed by the amount of detail and confusing facts. There’s always a waste backs phenomenon. I’m wondering if people are just, if there really isn’t immune system response, I suspect others might be able to convince me that there really is if there’s immune system response or if in fact the, folks are just saying, well, it must be that.

[01:08:31] Cause we don’t believe in the of bacteria. anyway, the insensitivity criticized by the Institute of medicine, I think is probably less of an issue, although I wish you walk. If you hit physicians who are, are insensitive, I would just encourage you to pursue all of the avenues you have open to you.

[01:08:52]even these doctors who would say it’s just a post now I’m syndrome, it’s not live bacteria. And who’s saying, so [01:09:00] therefore there’s no actual treatments. They will have palliatives things to make you feel better available that can help their whole clinics dedicated to that. and, so the, the real, the real question comes down to the one that I think has unresolved. But is resolvable. It really can be sorted out. Is it an immune response is, is persistent in our persistent Lyme symptoms and auto immune effect. I’ve already said one of the listed, one of the mines I admire most in all of American culture, believes that, or is there ongoing bacterial infection?

[01:09:36]Studies can be designed simply by respecting the other side of the argument to put this to bed. and I want to be open minded, you know, the analogy to, so syphilis may hold a lot of weight since both are spiral Keats, but they do differ dramatically in genetic content. And also if you, if you [01:10:00] believe that essentially it’s an auto immune response.

[01:10:03]It’s unclear how the immune system is infected we’re wearing from COVID that we really don’t understand as much as we need to about the immune system. So maybe, maybe there will be progress in the future. actually my own experience was that there wasn’t really any solution for the syndrome. I pursued both lines of thinking and came to a, I came to a conclusion that.

[01:10:29]the best, the best manner of approach was to take both sides seriously. keep researching it. It would be my final advice. Keep researching with an open mind, really take every answer and present questions to it. So, for example, there’s a very recent study showing that in Y the very small nerve fibers are affected, this was never known before, and new things will be discovered all the time.

[01:10:59][01:11:00] I’m going to pause again here for a moment.

[01:11:01]okay. Continuing on once again. Pardon me for the interruption. please. Excuse the amateurish nature. Of this broadcast, my little studio here has to be run by one person. I quite often sit with a significant amount of pain, so I apologize for my fighting intonations. And if I don’t bring the points alive, as much as I would like to, Let me just verify quickly then summarize the high points.

[01:11:26] The conclusion. This is a, that this is not advice, Roy of any kind, certainly not medical advice. the points I’m, I’ve been trying to emphasize the Lyme disease in its continuing manifestation is complicated. Many factors and having advice from more than one source is very useful in city logical.

[01:11:51] There really, it really is a difference of opinion about, about Lyme disease. So, to fully educate yourself, we [01:12:00] couldn’t have advisors who were open to both points of view and in particular advisors, who’ve. Have had Lyme disease in their own family tend, tend to be folks who have looked into this very carefully.

[01:12:13]it’s important to realize that much has unresolved. I mean, that’s, that’s a reason why I would never tell anybody what to do here. I’m just saying to ask questions. When things aren’t resolved, you know, not just a fear, but a knowledge that you will tell people to do something and it will be wrong.

[01:12:29] So please don’t believe me. my main point is the two sides aren’t really listening in the most constructive way to develop the null hypothesis in a way that most useful. And if they did, I believe they could put questions to bed. So in your own, in your own investigation, I think the best you can do right now is find both kinds of doctors to advise, look for good credentials, look for, folks who have had Lyme disease in their family.

[01:13:01] [01:13:00] And, yeah. Get more than one point of view on the, on the whole thing. So, good luck in your own. Situation and, apologies for my own shortcomings. I’m aware of that. organizationally in terms of content and coverage much could be improved here. And I fully recognize the fact that I’m like everybody involved in this.

[01:13:24] There will be areas where I will find where it will be found that I am wrong. Like everybody else. science is a process of refinement. And, as you move forward, you would always, revise what you might’ve said before. So I’m in my mid seventies. I doubt there’ll be a revision to this, but, please know that there, there would be, if this whole topic were revisited some number of years from now.

[01:13:52]Okay. Thank you for listening.