Friday, March 30, 2018

Meryl Nass, M.D.'s Integrative Internal Medicine Practice


My Bio:

I am a board-certified internal medicine doctor.  I was a National Merit Scholar, left high school early to attend MIT, where I graduated with a degree in biology. I attended NJ Medical School and transferred to the University of Mississippi Medical School in 1978, when my then-husband became a professor there.  I returned to New England in 1985, and Maine has been my home since 1997.

I am passionate about improving the lives of my patients.  I treat chronic pain disorders without narcotics. I try to find the least toxic methods of treatment for each individual.  I spend hours with each new, complex patient, until I understand how to explain their symptoms and develop a comprehensive treatment plan.  I use medicines, supplements, diets, and other healing modalities, as needed, for tough clinical problems like chronic fatigue syndrome, chronic lyme disease and fibromyalgia.  I get great joy in finding solutions that work for patient problems that have lasted years, and sometimes decades.

I believe in First, Do No Harm. I have been on the front lines of vaccine controversies, lecturing around the US and testifying to 6 Congressional committees about the problems with anthrax vaccine, and sometimes other vaccines. My goal is to use a minimum of medications and avoid iatrogenic (doctor-caused) harms.

I have consulted for the US Director of National Intelligence, the World Bank and the Cuban Ministry of Health.  I have done path-breaking research to understand Zimbabwe's anthrax epidemic, Cuba's neuropathy epidemic, Gulf War Syndrome, the US anthrax outbreak and the Ebola epidemic.  And while doing this research, I worked full time taking care of patients, and raised two sons.  One is now a professor of computer science and the other a cardiologist.

I opened a new medical practice because there were no local physicians treating chronic, complex disorders like Lyme--despite the large number of affected patients.  (Maine was #1 in the nation per capita for reported Lyme cases in 2016, and in 2017 Hancock County, where I practice, had the highest rate of Lyme in Maine.)

In order to make this practice work, I cannot accept any insurance plans, and patients must pay for my services when services are rendered. While some insurance plans will reimburse patients for the cost of visits, other (including Medicare) do not.

I hope to see patients with challenging disorders, those who wish to reduce their medications and/or use diet and lifestyle changes to improve health, and those with illnesses occurring after tick bites, fibromyalgia-related, or occurring as a consequence of military service or anthrax vaccine.  In my opinion, Lyme and tick-borne diseases should be considered in every patient with an undiagnosed illness.  Tick-borne diseases have taken a large and varied toll on our community. 

I also treat the range of illnesses seen in primary care internal medicine.  Help choosing a better diet (specific to each individual) can be an important part of my care.  Sometimes I offer free classes on food and simplified approaches to cooking, and share books that help patients manage food allergies or intolerances.

The office phone number is (207) 610-5885.  The fax number is 610-5886.
The office address is 210 Main Street, Ellsworth, Maine, 04605.  My cell (for emergencies) is (207) 522-5229.  My email address is merylnass@gmail.com.  I do see patients evenings and weekends, if needed for acute illnesses, and can be reached by email or cell phone any time.  


* Remember to use tick protection when off the asphalt in coastal Maine.  There were 1800 reported Lyme cases last year, but several other tick-borne diseases are also commonly found in our ticks, including Anaplasma (nearly 700 cases in 2017) and Babesia (over 100 cases in Maine last year).

Saturday, February 17, 2018

How effective are Flu Shots? CDC says its an (optimistic) 40%


The CDC website posts information for each of the last 14 flu seasons on the effectiveness of each year's flu vaccine.  Averaged out, the effectiveness of flu vaccines is 40.5%.

Figure. Effectiveness of Seasonal Flu Vaccines from the 2004-2018 Flu Seasons

Seasonal Flu Vaccine Effectiveness Historogram

While that may not sound too bad, it means that 60% or 3 out of every 5 people who get the shot will not get protection.  Yet they are equally at risk of harms from the vaccine as the 2 out of 5 who may benefit.  


Only between 3% and 5% of an unvaccinated population will be come down with a case of flu each year, according to the Cochrane Collaboration.  Therefore, only 40% of 3%--5% (or a total of 1.2%--2.0%) of a 100% vaccinated population will actually be prevented from getting flu by their vaccination.  Stated another way, 98.0-98.8% of those vaccinated get no benefit from their shot each year.


CDC cherry picks the data presented in its chart and graph, choosing only one study per year, or no verifiable study, referring to "unpublished final estimates."  How accurate is CDC's claimed effectiveness?  Well, the most recent, 2017-18 flu shot is said to have been 36% effective in the US.  But in Australia, it was only 10% effective.


In a recent article on flu vaccines in the New England Journal of Medicine, final author Tony Fauci (America's top infectious disease doctor under Obama) cited the 10% effectiveness number to describe last winter's flu shot.  He's not buying CDC's fluff.

What about herd immunity from the flu shot?  Well, when 6 out of 10 recipients (or maybe 9 out of 10) are not protected, there is no herd immunity.  No way to achieve it.  Influenza will spread through the population, year after year, no matter how many vaccinations are given.


What about all those nurses and doctors and paraprofessionals who have to get a flu shot or wear a mask continuously during the six months of flu season?  Well, 60% of flu shot recipients (or more, depending whether you believe the data from Australia or from the CDC) will get no protection.  


As for the professionals wearing masks, which expert among us honestly thinks the mask protects patients, when the masked professional is not sick?  None. Obviously, the mask is intended as a badge of shame for the unfortunate employee who dared refuse their vaccination.  Will the mask protect patients when the medical professional is sick?  The sorry answer is that no one actually knows--but why are they at work if they may transmit a disease?


There are no data that support healthcare professionals wearing masks all winter if they are not vaccinated.  Furthermore, CDC notes that only ill healthcare workers should be masked:

If symptoms such as cough and sneezing are still present, HCP [health care personnel] should wear a face mask during patient care activities.
In CDC's Interim Guidance for the Use of Masks to Control Seasonal Influenza Virus Transmission, updated in 2018, there is no mention of masking of healthy healthcare workers as a means of flu prevention.  Masking of unvaccinated employees is simply a punitive measure imposed by a healthcare establishment that long ago lost its way.

And what about the vaccinated worker who does not wear a mask, but is likelier-than-not to be without vaccine-induced protection?  Does she come to work sick, thinking she is protected from flu?  Will she avoid wearing a mask when she needs one, so she is not confused with those employees who are being shamed?

Come to find out, years back the vaccine-strain viruses mutated, further reducing effectiveness. And current manufacturing practices are the cause.

"It's been apparent over the last 10 years that egg adaptations have affected the efficacy of flu vaccines," according to Rice University Professor Michael Deem.
and
Due to the mutation, most people receiving the egg-grown vaccine did not have immunity against H3N2 viruses that circulated last year, leaving the vaccine with only about 30 percent effectiveness.
This problem has been known about since at least 2014, but so far nothing has been done about it.  No matter;  fuggetaboudit; and in the phrase TV doctor Nancy Snyderman made famous, "Get your damn shot!"   In case you haven't noticed, mandating flu shots isn't about science.  It's about control.



Sunday, February 4, 2018

Doctor who linked thimerosal to autism wins damages from Maryland Medical Board for harrassing and humiliating him/WaPo

State medical boards license doctors.  They also enforce standards of practice.  For example, medical boards took away the licenses of over 50 doctors who treated chronic Lyme disease, and investigated many more.  Frustrated Lyme patients, unable to find doctors to treat them, went to their state legislatures to fight back.  As a result, every state legislature in New England has passed legislation directing their medical boards to give doctors the right to diagnose and treat Lyme disease, outside of the restrictive guidelines issued by the CDC.  It sounds crazy, but it's true.  Here is the Maine law.

There are many reports of state medical boards taking action against doctors for other heretical beliefs, such as that vaccines may cause autism. 

Dr. Mark Geier has published many research papers linking vaccines to adverse outcomes.  His review of the evidence linking thimerosal to adverse neurological outcomes in small children was especially strong.  He has testified in many vaccine injury cases, and advised government agencies internationally on vaccine issues.  He also treated vaccine-injured children.

No doubt his advocacy rubbed many (in government and industry) the wrong way.  The Maryland Board of Physicians went after him, pulled his medical license, and made spiteful (and illegal) personal attacks on him and his family.  Board members and staff then destroyed evidence and failed to produce documents when Dr. Geier fought back and brought suit against them.

Medical boards have acted in egregious ways before, no doubt believing that their acts were protected because they were behaving as an arm of state government.  Dr. Geier's case demonstrates that they cannot necessarily act with impunity.

In a most interesting turn of events, each member of the Maryland board who participated in the illegal harrassment of Dr. Geier has been personally directed to pay punitive damages, based on his/her net worth (from $10,000 to $200,000) to Dr. Geier and his family.  Yes: out of their own pockets.  Explaining the unusual award, the judge wrote that "It is necessary in this case, unfortunately, to deter such conduct in the future." 

I imagine other medical boards will take note, and this may deter them from capricious harrassment in future.

The WaPo article is here.

Can it be? Study finds that college students who had been vaccinated against flu were more likely to excrete flu virus / Proceedings National Academy of Sciences

It is only one study.  But it was carefully done, used interesting methods, and it tried to explore issues that have rarely been studied.  Researchers from the University of Maryland studied students who had new symptoms of influenza to see if infectious flu virus spread during coughs, sneezing, or regular breathing.  They looked at nasal swabs as well as exhaled air during normal breathing. 

They found that sneezing is rare during flu and is not important in spread of flu.  They found that cough is not necessary to spread flu:  simply breathing excretes plenty of influenza virus.

This is important because fine aerosols generated simply by breathing remain suspended in air for relatively long periods.  Current thinking is that infectious particles larger than 5 microns fall to the ground quickly, but particles smaller than 5 microns may remain in air longer, travel further, and be infectious at larger distances from an infected person.  So staying 3 feet or 6 feet away from a person with flu will not be sufficiently protective.  Typical infection control for flu in healthcare facilities usually involves contact and droplet precautions, for spread over short distances only.

However, this study suggests this may be inadequate, if airborne transmission is a major contributor to spread.  Prevention of airborne (fine aerosol) transmission requires special air handling and the use of negative pressure rooms.  Visitors to the rooms of flu patients will be at risk.

Twenty-two of the University of Maryland subjects with influenza had received flu vaccinations during both the current season and the previous season.  Surprisingly, this group had significantly greater shedding of viral RNA in fine aerosols, compared to subjects who had not been vaccinated in the current or prior season.  This raised the question whether vaccination might actually increase the spread of influenza.  Hopefully other research groups will pay attention to this finding and help confirm or disprove it.

Is this year's flu a major killer or an annoyance?/ CDC

Probably the best data on the severity of yearly influenza epidemics comes from deaths in children, because there is mandatory reporting of each death as related to influenza.  Flu-related deaths in adults are reported as due to flu (very few), pneumonia (more) or underlying chronic medical illnesses that contributed to death during or after a bout of flu.  So what CDC does is estimate adult deaths, instead of counting them.

This is a bad flu season in terms of the number of people affected, since few of us had prior immunity to this year's influenza A H3N2 strain.  But at this point in time (and I think this flu epidemic is starting to die out) it looks like the number of pediatric deaths is about average.

UPDATE:  As of February 5, CDC reports there have been 53 pediatric deaths associated with influenza in the entire US this flu season.  This is about average.  The US has about 74 million children.

https://www.cdc.gov/flu/weekly/index.htm

Click on image to launch interactive tool

Wednesday, January 3, 2018

Meningococcal vaccine is a scam--but you may forfeit an education if you refuse

On January 3, 2018 the Maine Legislature's joint committee on health discussed adding the Meningococcal ACWY vaccine to the list required to attend school.  France just added 8 vaccines to its required list last week.  Around the world, a push to get more and more vaccines into schoolchildren, using the threat to withhold schooling, has gained momentum.

Yet some vaccines have nothing to recommend them for schoolchildren.  Such as the  meningococcal (Menactra/Menveo) vaccines.  I summarized the facts for our legislators below.

Be mindful of the following, please, as it is never taught in health class:  meningococcal disease can be effectively treated with antibiotics, if caught early.  When a child has fever, headache, and a rash or stiff neck they should see a doctor IMMEDIATELY for treatment.


January 2, 2018


Dear Legislators:

You finally have an easy decision to make.  There is not a single good reason to add meningococcal vaccine to the schedule required for schoolchildren in Maine.

Only 3 factors need to be considered: 
  • 1.   How much benefit?
  • 2.    How much harm?
  • 3.    How much does it cost?

1.  The potential benefit eludes us. CDC says there were between zero and one cases of meningococcal meningitis in Maine last year. 


Zero to one cases.  In the entire US, only 185 people had a form of meningitis (C, W or Y) that could potentially be prevented by this vaccine last year.

You have been told that the purpose of vaccination is to protect adolescents and young adults, who are at higher risk of this disease.

Really?  CDC tells us that in children and young adults aged 11 through 23, there were only 21 cases in 2016, in the entire US, that might have been prevented by vaccination.


You may think that vaccination is needed for herd immunity.  But that isn't actually true. You may be surprised to learn that about 1/3 of people carry meningococcus in their nose at any one time, and the majority continue to carry it--even after they are vaccinated.  So, herd immunity cannot be achieved for this disease using vaccines.


2.  What are the harms?  The label says that in clinical trials, 1.0-1.3% of adults and adolescents had a serious adverse event. Regarding milder adverse events, over 25% of recipients reported headaches and fatigue. A rare but very serious side effect, Guillain-Barre syndrome, may occur.  The Menactra vaccine package insert estimates that between zero and five people, per million vaccinated, may get Guillain Barre syndrome as a result.
  

So while less than one in a million Americans will get a meningococcal C, W or Y infection in a year, an additional 0 to 5 people per million vaccinated will develop Guillain Barre syndrome (within six weeks of their vaccination).

This is a remarkable statistic.  The risk-benefit equation for this vaccine is so bad, it should never have been licensed in the first place. 

But it was.  And now you are being asked to expand its use.

3.  What is the cost?  CDC says the federal government pays $89 dollars per dose, and the private sector $113.


The cost to vaccinate 183,000 schoolchildren in Maine with 2 doses, at $100/dose, is $40 million dollars, which someone has to pay.

The vaccine proposal is an expensive boondoggle.  The only beneficiaries of this bill are the pharmaceutical industry and its handmaidens.  Please don't fall for this scam.


Meryl Nass, M.D.
MIT graduate
Currently practicing Internal Medicine in Ellsworth, Maine