The Goldilocks Principle - aiming for the sweet middle spot of treatment

August 29, 2020

 

 

Ventilator use is not an innocuous therapy,  ventilator injuries are not rare, and too aggressive use of ventilators may cause more damage than benefit.

 

This supports my general belief to employ cautious slight under-treatment for GDD- waiting to see if the patient can recover the rest of the way on their own.

 

I have previously written that the individual sufferer has to determine what the best interval of chelation is for them based on their experience. If they are on weekly chelation and seem to go into FLARE and stay in a state of Flare, it tells us the frequency of chelation is too great. If the interval is out to 5-6 weeks (maybe because of COVID travel interruption) then the interval may be too great and they are suffering from le Chatelier natural re-equilibration, if their symptoms get worser at week 3-4... Those are the extremes and it can be more subtle than that. 3-4 weeks is generally a good compromise of treatment interval.

 

If one is out 4 weeks since last chelation and symptoms are getting worse, the interval is too great; and at the same time it indicates that your system is not ready for a prolonged pause in treatment, since it was not recovering the rest of the way on its own. Spontaneous continued recovery is a subtle and lengthy process, but is not preceded by significant worsening. Following a reasonable course of chelation, 10-20 chelation sessions, if the individual has not shown substantial improvement, then progressively increased immune suppression will be necessary. A strategy that I currently employ to ramp up the immune suppression starts with low dose cellcept. Currently, I am cautious with increasing immune suppression in the face of worsening COVID pandemic. Interestingly, immune suppression has been shown to be helpful for COVID - but presently it seems when the patient is already infected, with the strategy of using dexamethasone. Likely some form of targeted immune suppression maybe is critical with viruses (remember the story about bats and they are somehow immune suppressed to viruses, and that form of immune suppression means that they do not react and become sick, despite the virus presence). The future strategy is targeted immune suppression, which would be ideal for GDD.

 

The best strategy is the Goldilocks Principle: aiming for slight under-treatment. Ventilator injuries from too early aggressive use for COVID infection- this is essentially true for all diseases: thoughtful less is generally more.

 

Richard Semelka, MD

 

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