What Tests Do I Need to Find out if I have EBV AUTOIMMUNITY__ _Finally, A GOOD REPORT_ NIDA Meeting _ Special G uests_ Pat & Monty
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00:00:00Welcome and thank you for joining us for DocTalks with Dr. Forrest Tennant and friends.
00:00:05I would like to let you know that in five days from now, DocTalks celebrates our two-year
00:00:12birthday. So happy two-year birthday to DocTalks. I can't believe it's been two years, but it has.
00:00:19And happy, happy birthday. Thanks for being such a good family. Dr. Tennant, it's all yours. Take
00:00:24it away. Good. Thank you very much, Jamie. Yeah, the two years has gone fast and there's been a
00:00:30lot of changes actually in two years. Just before you turned on the mics, you started mentioning
00:00:37about how all of us who not only watch this podcast, but who have the diseases that we target
00:00:44need to support each other and are really a family. Now, I want to emphasize that
00:00:50because you kind of took the words right out of my mouth. The new book on MPCR virus has caused
00:00:57a lot of great interest and has brought home another point that I want to emphasize.
00:01:04There are millions of people with chronic pain. There are lots of diseases out there.
00:01:09But when somebody develops something like adhesive arachnoiditis or true RSD,
00:01:16or some of the autoimmune diseases that we have, and now with Epstein-Barr autoimmunity coming
00:01:23forward, it's very important for everybody watching this to understand that we're a rare
00:01:31group. We are a small group. Now, here is what I'm getting at. We who deal with severe pain,
00:01:41intractable pain, palliative care, end-of-life issues, that's all we talk to. And so,
00:01:50you can kind of get the idea that we're some huge group. We are not. The medical field,
00:01:56the medical profession, the government, the insurance plans, they look at healthcare
00:02:03in the major diseases, okay? Things like diabetes, arthritis, asthma,
00:02:12peptic ulcers, hypertension, cardiac failure, these kind of issues. And there are millions
00:02:21and millions of people with those diseases, and compared to them, we're just a little small group.
00:02:28Now, what does that mean? Well, first off, it means that we have to stick together,
00:02:33okay? That's number one. Number two, it means that you're going to encounter an awfully lot
00:02:40of people in the medical field who don't want to see you. They don't want to talk to you. They're
00:02:46not interested in your disease. They're overwhelmed, you know, taking care of, you know, arthritic
00:02:53knees or hypertension or something. And so, I've got a lot of correspondence here recently in which
00:03:03I think the patient or the individual who had the intractable pain or the disease misjudged
00:03:12how to communicate to the medical profession. And I'm going to ask Mark to weigh in on this a little
00:03:18later in the program. But what I'm getting at, now that we're actually bringing the Epstein-Barr
00:03:25forward, a lot of physicians are getting very interested in that because they feel they've
00:03:28got something they can treat, they can get their hands on. And so, that is a good thing. But the
00:03:34thing I have run into and the question I can't answer for you is just how common is Epstein-Barr
00:03:42autoimmunity? Now, the Epstein-Barr virus is in everyone. I mean, it's a normal parasite,
00:03:51and it lives in the throat membranes where it lives in your lymphocytes.
00:03:56But I do not know how common it is. All I know is that practically everybody watching this show
00:04:04and everybody I deal with has it. Now, if you read the medical literature, as recently as the 2024
00:04:12current diagnosis and therapy, they claim that reactivation of the Epstein-Barr virus is a rare
00:04:19occurrence and only occurs in people with immunocompromised systems. Well, they may be
00:04:25right. But I do know that all our people have Epstein-Barr autoimmunity. So, I want people to
00:04:35realize this. If you go to a pain clinic and you tell the pain doctor, well, I've got adhesive
00:04:42arachnoiditis, or I've got Ehlers-Danlos syndrome, or I've got Marfan syndrome, or I've got Epstein-Barr
00:04:50autoimmunity, they're going to say, see the door? Don't let it hit you on the way out,
00:04:56because they're not interested. They are there to treat you symptomatically. They're not there
00:05:00to treat your disease. And we're going to talk about that in a little while. You've got to
00:05:05remember that when it comes to dealing with pain issues, you have two levels. You have treating
00:05:12your thing symptomatically. Now, you've got to have symptomatic pain treatment to function.
00:05:17And so, that's really step one. And it's very important. And you're going to, we and everybody
00:05:24associated with this program is an advocate and thinks we should have a few changes of not only
00:05:30laws and regulations, but attitudes involving opioids and pain. But that's on one level.
00:05:37On a second level, you want to treat the cause of the pain, the underlying cause of the pain.
00:05:43Now, the pain clinics of the United States are not here to treat the cause of your pain.
00:05:48So, if you go there and tell them that you've got adhesive arachnoiditis, you've got RSD,
00:05:52or you've got Ehlers-Danlos syndrome, they don't want to hear it. They're not trained to treat it.
00:05:58That's not what they were set up to do. And in a little while, I'm going to ask Dr. Ibsen to weigh
00:06:02in on this, as well as myself. You want to say something right now, Mark, real quick on that?
00:06:08But pain clinics in this country were not established to treat your pain, or to treat
00:06:15your pain symptoms, not the cause. Okay, what does that mean? There's no payback for curing anything
00:06:23in the current system. That's very well said, yeah. Well, that's why we're going to talk about
00:06:29curing your problems right now. Okay, we're going to have a lesson now on something that comes up
00:06:35several times a day, particularly since we've sent out our bulletins and our book
00:06:39on the Epstein-Barr autoimmunity. We're going to teach you how to read the test,
00:06:44okay? And we're going to teach you what to tell your doctor, and for you to know a little bit
00:06:50more about Epstein-Barr autoimmunity. It's critical that you do so. Now, to get started,
00:07:00to be evaluated for Epstein-Barr autoimmunity, you have to have three blood tests, okay? Now,
00:07:07there's about eight tests available, but they're not for autoimmunity purposes.
00:07:12You have three tests in the panel. You have one that's abbreviated VCA. Just write VCA,
00:07:18because everybody knows what that is now. That stands for viral capsule antibody, or capsid
00:07:24antibody, VCA, okay? Now, you have a second antibody called Epstein-Barr nuclear antigen
00:07:32antibody, and that's abbreviated EBNA, CA, and EBNA, okay? Now, there's a third test,
00:07:45but let's talk about what these two mean. These are antibodies, and they're protective antibodies,
00:07:53meaning that whenever you get it, if you got mononucleosis or you have reactivation of that
00:08:00virus, your body's going to make an antibody, okay? One of them is a VCA, and one of them is
00:08:08an EBNA. In other words, it makes an antibody to two parts of the virus, its capsule and its
00:08:15nucleus, okay? Now, those antibodies are made, and they're going to be in your body forever,
00:08:23okay? They're not going to go down. They're there because the body is trying to give you
00:08:29a protection, and it's an antibody, just like you have an antibody to chickenpox or an antibody to
00:08:36COVID or an antibody to chickenpox or anything else. It's an antibody
00:08:44made to help the body fight the virus, okay? So, those go up, and that's what that means.
00:08:52Okay, now, there's a third test that's extremely critical for anybody with chronic pain.
00:09:01Now, who should be tested by these three things? I'm going to give you my simple formula.
00:09:06Anybody who has chronic pain over 90 days and has got to take medication each day to relieve it
00:09:14should be tested for Epstein-Barr autoimmunity, okay? I know that doesn't set well with a lot of
00:09:22maybe some people because you're talking about a lot of people, but from what our studies show,
00:09:29it's warranted, okay? In other words, what it's starting to show is that the Epstein-Barr virus
00:09:35starts off its whole cycle by first giving you fibromyalgia, and then migraine, and irritable
00:09:41bowel, and carpal tunnel, you know, and small fiber neuropathy, pudendal neuropathy, and then
00:09:49it gives you a slipped disc, and then it gives you, you know, some kind of neuropathy like a
00:09:56sciatica, and then in the end, you might get adhesive arachnoiditis if you don't have something
00:10:03stop in the process along the way. So now we're starting to understand that this Epstein-Barr
00:10:09viral autoimmunity starts in a whole chain of painful events, and so if you, anywhere along
00:10:18that line, you have such pain, you've got to start taking gabapentin every day, or some NSAIDs every
00:10:26day, opioids every day. If you are down to where you're using medicine every day for a pain,
00:10:33my recommendation is you have this three-panel test, okay? Now, I'm going to talk about the
00:10:40third test in a minute. We now have a fairly recent test called the early
00:10:46ebna. The key word is early, okay? Early. Now, I'm also going to digress here for just one minute.
00:10:56I want everybody out here watching this to write these down, take them to your doctor,
00:11:02okay? And you should learn how to interpret the test. They're not hard, and it's just like a
00:11:07diabetic. A diabetic's got to know what their blood sugar is. Somebody with high cholesterol's
00:11:12got to know what their cholesterol means. Somebody with liver disease has got to know
00:11:17what their liver function is. If you've got chronic pain, you need to know what your Epstein-Barr
00:11:23antibodies are, okay? And again, it's new, but it's not hard to learn, okay? You've only got
00:11:31three of them to learn. Now, let's go back and say what these are for and what the treatment is,
00:11:38okay? Because a lot of the treatments you can do on your own, some you may need doctors' help on,
00:11:43okay? Okay. VCA is an antibody, and most of your big labs now, both Quest and LabCorp,
00:11:54they have a cutoff of about 21 or so. Now, we see a lot of people who have severe chronic pain
00:12:03have antibodies so high the lab can't test it. So, it's going to come back above 500 or above 600.
00:12:12In other words, the lab can't even test that high. Now, what does that mean? That means that you are
00:12:19a chronic reactivator. It's like somebody who reactivates their herpes or their shingles.
00:12:27That means that you periodically reactivate the Epstein-Barr virus,
00:12:33and that's how you'll get your antibody levels driven up to 200, 300, 500, 600.
00:12:41In other words, several times normal. That means that during times of stress, you reactivate your
00:12:48virus, then you put the virus to bed later, but then you have it come back, all right?
00:12:53That's what that means. Okay. Now, let's go to eBNA, the Epstein-Barr nuclear antigen,
00:13:02the nucleus antibody. Now, if that's high, that's bad, okay? It means you not only reactivate the
00:13:12virus a lot, but it is that antibody that has a component called an autoantibody,
00:13:20an autoantibody. Now, I've talked this before on what is an autoantibody. If you have chronic pain
00:13:29over 90 days and you've got to take medicine for it, the word autoantibody needs to become
00:13:35as familiar in your vocabulary as does the word breakfast cereal. You've got to know what that
00:13:44means. An autoantibody is a protein or a globulin protein that somehow has decided that your own
00:13:55tissue is an enemy. And so, it starts eating away at it. It attaches to your tissues and it starts
00:14:03eating away like rust. Rust is the right term. It starts rusting your tissues. Now, it likes to rust
00:14:12nice, soft, juicy tissues, those with a lot of collagen in it, things like fascia and cartilage,
00:14:19small nerve fibers, the arachnoid membrane, opioid receptor sites, things like this,
00:14:27likes to get the juicy stuff. Why would you want to take on a bone when you can eat a small nerve?
00:14:33And that's what autoantibodies do. You almost have to think of them as being like Pac-Man.
00:14:38They're alive. They're moved through the bloodstream. They attack nice, soft tissues
00:14:44that give you pain if you can't restore them. So, that's what an autoantibody is, okay?
00:14:51Now, and then you have the early antibody and that means that you have active reactivation. Now,
00:14:59we see really in all the patients that we've tested, whether they've got fibromyalgia,
00:15:05an irritable bowel, or whether they've gone all the way down to arachnoiditis or just down to
00:15:10multiple slipped discs or cervical arachnoiditis or something, the most common pattern we see
00:15:18is somebody who has, frankly, maybe all three positive, okay? Sometimes it's just two of the
00:15:27three. Okay, but now let's cover treatment and what they mean. Now, I know this is a little complex,
00:15:32but that's why we're going to have this session and maybe some more because, in my opinion,
00:15:38everybody with severe chronic pain over 90 days that you've got to take medication for,
00:15:43this has got to be, in my opinion, part of your new treatment, part of your treatment. Okay,
00:15:50if you have a high VCA, high VCA. Now, practically everybody is going to have this. The high VCA
00:15:58means you reactivate the virus periodically. So, what do you do? Now, here's something we
00:16:03have some solid information about. There are some simple measures that appear to stop future
00:16:10reactivations, okay? Now, they're in the textbook and there have been some laboratories that have
00:16:18tested a lot of compounds, a lot of medicinals, to find out what stops the virus from reactivating.
00:16:25Now, the old famous one is vitamin C, okay? And the old mineral zinc comes in there. Selenium
00:16:33seems to be in there. And there are a number of other medicinals. They're in the textbook
00:16:40and I'm going to read them off to you. Resveratrol, luteolin, astrologous, curcumin,
00:16:47andrographis, selenium, zinc, and lysine, okay? Now, I'm going to give you my favorites. Now,
00:16:55there's a lot of doctors have some other favorites and maybe better than my favorite.
00:16:59I don't really know because they seem to work. And so, the one thing that works in this business
00:17:05is to stop the virus from activating in the future. You can't do much about the past,
00:17:11but you can stop the future. And so, my favorite that I like is vitamin C,
00:17:173,000 to 4,000 milligrams a day, you know, 1,000 to 2,000 milligrams in the morning,
00:17:231,000 to 2,000 milligrams at bedtime. And then, the mineral I like the most is selenium.
00:17:30Some people like zinc better or boron. I like selenium with 100 to 200 milligrams a day.
00:17:36And then, I also like, I'm not sure exactly what it does, but the third favorite
00:17:45Epstein-Barr treatment for me is a monolaurin. It's a derivative of coconut oil. And we're not
00:17:52quite sure how it works, whether it inhibits the activation or whether it kills the virus maybe.
00:17:58But monolaurin has become the most popular anti-EBV drug there is, okay? Throughout the
00:18:07United States, it's become the popular drug, okay? Cheap, you get it over the internet.
00:18:13Another one of my favorites is the combination of what they call PEA and luteolin. Trade name
00:18:21is Marika. That's another one of my favorites. But there are some others. There's a lot of
00:18:27innovative people have made one. Here's one called EBH-6. It's really a homeopathic formula.
00:18:35Some people like that. Of course, there's a lot of people like that now. And here's one
00:18:43that we actually, it's made by a mid-level marketing company called
00:18:48Modern America. And it's got selenium, vitamin A, vitamin C. It's a good one.
00:18:54So I don't really care where you get them. Whatever your pocketbook can afford and then
00:18:59find one that you like good. But I will say this. When I heard today, didn't used to,
00:19:07but today when somebody says they've got arachnoiditis or they've got EDS,
00:19:11you know what my first recommendation is? Vitamin C, 2,000 milligrams in the morning
00:19:17and 2,000 milligrams at night. It's cheap, simple, never hurts anybody.
00:19:22And I had never used to be such a believer in vitamin C, but I am now.
00:19:26And so vitamin C and selenium is the first things I tell people to do. Is it the best? I'm not
00:19:31certain it is. Dr. Imstead may have a little different opinion. That's fine. But you, everybody
00:19:38should take these tests. If you've got a high VCA and a high eBNA, take these prohibitive drugs.
00:19:46They prohibit the reactivation in the future. OK, now let me go on to what the eBNA
00:19:54antibody means and what autoantibodies mean. All of you who've watched this program over the past
00:20:01two years have heard a lot of talk about collagen. You've heard a lot of talk about peptides.
00:20:07You've heard a lot of talk about catorolac and about methylprednisolone. We didn't know this.
00:20:14We just thought that we were working on the regrowth or the regeneration of nerves
00:20:21inside the spinal canal. Turns out that's only part of it. Autoimmunity
00:20:28is unfortunate in that we don't know how to get rid of it. In other words, it's like
00:20:34rheumatoid arthritis and lupus. In fact, it may be the same autoantibodies. We can control it.
00:20:42We can't cure it. So if you've ever had these high autoantibodies, you are now burdened,
00:20:50I hate to bring bad news, but you are now burdened with keeping that rust from ruining you
00:20:59and causing you continuous deterioration. OK, our studies are starting to show is that
00:21:08those people who have high Epstein-Barr autoantibodies don't do well unless they're
00:21:16taking catorolac has been dynamite, methylprednisolone, even prednisone on low dosages
00:21:24intermittently. And so also this is where our peptides come in and our collagen substitutes
00:21:31and some hormones, which I may talk briefly about in a few minutes. The bottom line is
00:21:38the thing we've been preaching and teaching here for a couple of years,
00:21:42we've now learned that they have the mission of fighting autoantibodies, not just plain inflammation.
00:21:48And so again, we're going to come back and on this program, BP-157, thiamin, KPV,
00:21:58these are dynamite. And we want people using these peptides. We want people on collagen
00:22:04supplements. And we certainly want people, the people who have done best with adhesive
00:22:10arachnoiditis in our studies of those who have taken periodic dosages of catorolac and methylprednisolone.
00:22:16When I say periodic, maybe once a week, maybe twice a month. But they're doing it. And we now
00:22:22know that one of the things that they're doing is controlling the autoimmunity of the Epstein-Barr
00:22:29virus. So anyway, that's where that stands. Now let's go on to the one that physicians
00:22:36are going to have to get involved with. And that is people who have elevated early
00:22:45eBNA. That means the virus is active. Okay? It's active as you sit there. It means it's producing
00:22:54more autoantibiotics, more pain, more disability, getting you closer to being bedbound, closer to
00:23:02the grave. It's not good. Okay? But you want to know about it, and I'll tell you why. That's the
00:23:10one thing we can reverse. Now the studies are early, but if you have an activated Epstein-Barr
00:23:19virus, you're going to need your doctor's help. The doctor's going to need to put you on antivirals.
00:23:26Ivermectin is dynamite. That's got a good place. Ivermectin is on it. And so the two things that
00:23:35that we are recommending there, if you do have activated virus, this is where I'm certainly
00:23:43recommending therapeutic trials of, you know, acyclovir, valocyclovir, that's Valtrex,
00:23:50famcyclovir, that's famvir. The doctors know about these, and they've used them because they've used
00:23:57it for herpes zoster or shingles or for recurrent herpes genitalia or of the lips. And so all the
00:24:04doctors know about antiviral therapy, and they're pretty good at it. And they may have one antiviral,
00:24:10they prefer that over another. Some of the infectious disease specialists are really
00:24:15loading up on these antivirals, given two or three of them. They're really going after it.
00:24:19Is that the way to do it? I don't know. I'm not going to say it isn't. Maybe it is. So right now
00:24:24we're in this stage to where everybody knows we got to do something, and we know that antivirals,
00:24:31we know the corticosteroids, and we know that ivermectin, these things are all having some
00:24:37place with it. The goal of treatment is to reverse the activated virus to inactive.
00:24:45And we do have cases now in which people are converting from active early eBNA to negative,
00:24:53okay? And so that's where we're at today. I know this sounds a little complicated,
00:25:00but just write on a piece of paper those three antibodies and a few notes on what you do with
00:25:06each one, and it'll come to you naturally on what we should do. Now those are the three,
00:25:11if your doctor wants to order the blood test, those are the three you want. If you want to
00:25:15order something else, that's fine too, but these are the ones you need, okay? Because you're looking
00:25:20for autoimmunity. You're not testing for infectious mononucleosis or post-transplant infectious
00:25:29mononucleosis. You're looking for Epstein-Barr autoimmunity because that's what's giving us
00:25:35the intractable pain. They're invading the people who have ankylosing spondylitis or
00:25:41EDS. These are the bane of the people who have these kind of genetic problems
00:25:48and who understretch, catch, activate the Epstein-Barr virus. So again,
00:25:54we know that the people that Mark and I deal with all the time have this. I don't know how many
00:26:02people out there in the real world do, but among our people, it's very big. Now I'm only going to
00:26:09take five minutes here quickly to introduce you to the next subject, but it ties together and we
00:26:16haven't talked a whole lot about it, but I'm going to introduce you to something that we've mentioned
00:26:23on this program, but not a lot, and that is hormonal therapies for severe chronic pain and
00:26:29intractable pain, okay? Now when you mention hormonal therapies, doctors, patients, the media,
00:26:42everybody sort of says, oh my god, they jolt backwards and they say, oh my god, I have
00:26:47hormones. I can't take hormones. I don't like hormones. I don't know what this is all about,
00:26:51and it's kind of a natural reaction because it has a lot of pejorative thoughts to it.
00:26:59The first thing I want you to know about hormones is that it's a new field in medicine,
00:27:06okay? It's a new field in medicine. Do you know that the word hormone never appeared in a medical
00:27:13dictionary until 1906? Hippocrates never used the term hormone, okay? Dr. Edison never used the
00:27:23word hormone, and he invented Edison's disease. In other words, the word hormone and the specialty
00:27:30of endocrinology is less than 100 years old. Now in medical terms, that's nothing, okay?
00:27:37And so, it's new and it's very controversial, very poorly understood,
00:27:43very poorly understood. I just want to walk you through a few things about it, and then we're
00:27:50going to have to cover it because, again, if you have severe intractable pain, you're going to have
00:27:57to use some hormonal therapies, and you probably do now, and you don't realize that's what you're
00:28:01doing, okay? Probably don't know. Okay, there's about four basic reasons on why hormones are used,
00:28:12okay? Four of them. The first one is replacement, okay? Now, replacement really brought hormones
00:28:21into sort of existence back 100 years ago, and the first thing that doctors noticed was people
00:28:27had big goiters, and then they went into dry skin and low blood pressure and slow
00:28:32mentation, gained weight, and they found out that it was thyroid. And then the second thing they
00:28:38found out was that you started losing weight, and you started getting infections and skin problems,
00:28:45and that was called diabetes. That was a lack of insulin, okay? And so, the first
00:28:54uses of hormones therapeutically were thyroid and insulin. Now, the third one that came along
00:29:02was cortisone, and Dr. Addison might surprise you. He didn't actually invent the word cortisone.
00:29:10He just said your adrenal glands were shot, okay? He never mentioned the word hormone. He never
00:29:17mentioned the word cortisol or anything else. He just knew that your adrenal glands went south,
00:29:25so that's what he did. Anyway, in the 1920s and 1930s, Addison's disease got recognized as a
00:29:32clinical entity by doctors, and there were a couple of famous ones who managed to take
00:29:40extracts out of the adrenal glands, and they even made a pellet to implant them under your skin.
00:29:45John F. Kennedy was one of those people, incidentally, where they actually implanted his
00:29:50tablets under the skin. Then, as time went on in the 1940s, they found out that
00:29:59cortisone and pregnenolone from the adrenal gland cut down inflammation, and pregnenolone
00:30:06was the treatment for rheumatoid arthritis up until 1950 when prednisone was discovered,
00:30:12and so we've had an autoimmune and an inflammatory process.
00:30:17Going on into the 50s and 60s, hormones became famous because they modified the menstrual cycle,
00:30:23and that allowed birth control as well as some other gynecologic problems, and so a lot of
00:30:28people, when you mention the word hormones, they think in terms of only estrogen or progesterone
00:30:34or something to do with the menstrual cycle, and that's one use, no question about it.
00:30:40And then, however, the new kid on the block that I want to introduce you to, and then we're going
00:30:46to move into our guest, and that is the use of hormones for tissue restoration. Okay, tissue
00:30:56restoration. The most famous part of that is the only people that have been doing that has been in
00:31:04the military, sports, and then I and a few other people have been using it to try to restore
00:31:11tissues in severe intractable pain. Okay, now, and one thing about it, endocrinology
00:31:19doesn't do this. Endocrinology is the study of the disease of the glands, but functional medicine
00:31:25doctors, some doctors who are interested in pain and others, are starting to use, and we're going
00:31:32to talk a lot about it, the use of some hormones to restore tissues, and in my opinion, I'm going
00:31:40to cover it a lot. In my study of people who are deteriorating with adhesive arachnoiditis,
00:31:46their hormones are almost in arrears, okay, and they're going to have to be tested.
00:31:53And one last thing before we move on. The thing that has brought hormones to the forefront
00:31:59have been tests. It might surprise you to know that getting hormone blood tests up until about
00:32:0610 years ago was very difficult. In other words, we knew you could, there was estrogen, we knew
00:32:12there was testosterone, we knew there was pregnenolone, but now they have panels for these,
00:32:18just like a panel for the Epstein-Barr virus. So, laboratory technologies come forward here in the
00:32:24last, since in this century, to make the use of hormones have some new uses, and we're going to
00:32:31be talking about those, because in my opinion, they are essential in the treatment of intractable pain.
00:32:37So, I'm going to shut off there. We have some fascinating guests tonight who have been with us
00:32:40before. I understand, Jamie, that you have Pat Irwin back with us. Yes, sir. We've got Pat and Monty.
00:32:49And Monty's here too. Yes, we're so happy to have you both with us, and if you could.
00:32:56Can you hear me now, Jamie? Yes, we sure can. Welcome, Pat. Great to see you.
00:33:02Thank you so much. And do I have my partner on? Is Monty there? I'm here, Pat. Hi, Monty.
00:33:12Oh, it's wonderful to be here this evening. I am so grateful for this opportunity every time.
00:33:18And Dr. Tennant, before I go into my piece, I want to say, these are brilliant lectures that
00:33:25you provide us. It is outstanding, the quality of the material that you give us and how pertinent
00:33:33it is to all of the situations that we find ourselves in. Just very briefly, my son has ME
00:33:42CFS, which is chronic fatigue syndrome, like long COVID, and his Epstein-Barr virus is through the
00:33:50roof. And I have been relaying the information you've been giving us to him, and he just wants
00:33:57to relay his gratitude to you. He has one of the diseases in the chain, the chain of torment,
00:34:06I call it. Just one thing, this wasn't what I wanted to talk to you about, but maybe it is.
00:34:13One of the things that's happened in the United States, good or bad, it's just a fact, and that is
00:34:21universities have given up doing clinical research. And during COVID, the last vestige got
00:34:30wiped out. The universities use their physicians to bring in the money. They've got to support
00:34:36those places. And so all the research is given to basic science, okay? And they're doing a great
00:34:43job. I mean, I read some great papers every day. I read a bunch of new papers on autoimmunity done
00:34:49by your basic scientists this morning. But what that's made is that those of us who are physicians,
00:34:55who are research trained, have had to go outside the university, set up our own foundations,
00:35:00our own money. I'm not the only one. I've got a handful of other doctors, and I've got one I may
00:35:07bring on to our own foundation and try to raise some money to do some research. So anyway,
00:35:12that's another subject. However, one of our buddies, Chris Ogden, and I are talking about
00:35:17we need to start some kind of a seminar or some public things to start disseminating some of this.
00:35:24But so anyway, my old universities, they don't do much clinical research anymore. So we had to go
00:35:32into another way to do it. But we'll get it done one way or another. So anyway. Anyway, Pat and
00:35:38Marty, I guess first off, you guys have been so active and so helpful in opening up avenues of
00:35:49communication, if you will, with some of the very right people, particularly in California.
00:35:55Could you and Marty give us just a little idea about what you've been doing? And then I've got
00:36:00some special things I'd like to ask you, and I know Mark well. So give us a report is what I'm
00:36:05saying. Absolutely. Just briefly before we jump into the California boards, the pharmacy board
00:36:13and the medical board, I do want to let people know there was some really good news yesterday,
00:36:20some wonderful happening. Dr. Laughurn spoke to the National Institute for Drug Abuse specifically
00:36:33to the lead physician in chief there. And he was able to convey to her all of the situation that
00:36:42we're facing with chronic pain patients, essentially being discriminated and shortages
00:36:48and all of the trauma that we're facing. She was very attentive. The mission of that group
00:36:56is very limited. Of course, they primarily do look at addiction medicine, but they were very open to
00:37:04taking our message and giving it to other groups, including the National Institute for Neurological
00:37:10Disorders, which would be fantastic because their primary look right now, she said, is at pain
00:37:20and how pain interacts with other diseases. So we're very hopeful. I know we just hear bad
00:37:26news after bad news, but this was for us a really big breakthrough. And it sounds like more good
00:37:33things will happen from that. So that Dr. Volkow is first class. I'm aware of who she is. Yeah,
00:37:38that's great to know. Yeah, that is good news. Yeah. Yes. She personally, she was hoping to
00:37:45attend. She got pulled away, which we completely understand. It was her chief of staff who was
00:37:50there. And I think Hoban, Hobine, Monty can jump in with the name. I think it was Hoban. But anyway,
00:37:57her chief of staff was there and very, very receptive. And with that, we will switch over
00:38:04to what's happening in California. And what I'd like to say is what Monty and I will talk about
00:38:11with California is really apropos to any of the work that you could do with your state pharmacy
00:38:17boards or medical boards. It's a slow process. We didn't do this quickly by sending one letter
00:38:26or one phone call. It's really been months and months of slowly listening in. What we've been
00:38:32doing is listening in to both the medical board and pharmacy board. And whenever we have an
00:38:38opportunity, boy, Monty and I are there being able to give public comment, much to our pleasure. Yes,
00:38:47Monty got a positive response. And the response was that the medical board, they wanted to set
00:38:54up a meeting with him. And he invited, yay, and he invited Red and Kristen and myself to sit in.
00:39:03We were able to have an hour-long conversation with Dr. Thorpe, who's a medical physician on
00:39:13the board, and then an executive director. An entire hour. It was wonderful. So, Monty, would
00:39:22you like to go into a little bit of detail maybe about the highlights of what we talked about?
00:39:27It's an interesting story. It's one I really, you know, one of the pleasant things of all the stuff
00:39:32we work on. But one person you didn't mention, and I'm going to, is Kristen Ogden. Our involvement,
00:39:41my involvement with the board started with watching and listening to Kristen Ogden speak
00:39:48to the medical board as they were updating their opioid prescribing guidelines. So, I got involved
00:39:52in that process and participated quite a bit. Monty, can you speak up a little? I routinely provided
00:40:02written and spoken comments. And we've had a friend on the board for the whole time.
00:40:07His name is Dr. Thorpe, the gentleman that Pat just mentioned. But we've been beating them up
00:40:16collectively, politely, respectfully beating up the board about the fact that they haven't
00:40:22rolled out their 2023 opioid prescribing guidelines aggressively like they were going to do.
00:40:28Webinars, going to other professional boards, doctors actually doing possibly some CME training
00:40:35on their guidelines. And the other thing that has gotten the interest of Dr. Thorpe is the impact
00:40:43on pharmacy shelves of the AG's opioid settlement with the three major distributors.
00:40:51He's been interested in that. He spoke to the board about that. I piggybacked on his comments
00:40:56to the board. Long process. And we've developed a relationship. And I spoke to the board
00:41:04at their last meeting about the, you know, virtually about their,
00:41:08the impact of the injunction on the supply chain to the pharmacy shelves and to the fact that they
00:41:16really need to get with the program and get their guidelines aggressively rolled out. And while that
00:41:23meeting was still going on afterwards, I got an email from the lady that coordinated it saying
00:41:29that both Dr. Thorpe and the executive director of the board, Mr. Reggie Varjish, wanted to have
00:41:34a meeting with me. And Pat told you about the meeting we had. It was great. It was an hour long.
00:41:42Red Laughurn participated in it. Kristen Ogden did, Pat and I. And I wanted really Red Laughurn
00:41:51to meet Dr. Thorpe. He's been a major supporter of pain patients in California. And I think we
00:42:00may have something going there. I followed up with an email back to those folks, to the two
00:42:05gentlemen, and got a reply from Dr. Thorpe with his personal email and his cell phone number,
00:42:13which I am not going to broadcast. But I think we're making some real progress there.
00:42:19And so I'll shut up now and turn it back over to you, Pat.
00:42:22Great. Great. So if any of you, I'm going to volunteer for, oh, go ahead.
00:42:29Can I make one last thought? The thing is, I'm trying to encourage people across the country
00:42:35to follow the process that Kristen Ogden, myself, and Pat have done with the Board of Pharmacy
00:42:42and the Medical Board of California. I don't think cold calling and writing them letters or emails
00:42:48is going to cut it. You have to establish a relationship. And the way to do that is by
00:42:54participating in their meetings respectfully. That's what I think is the key to our success.
00:43:00And I'm super excited about it. Absolutely. And if any of you are interested, I mean,
00:43:10not all boards are going to be this welcoming. Believe me, I understand if you try to call the
00:43:16board in Maine, they would probably hang the phone up on you. But it's worth a try. And if you,
00:43:25you know, I'm going to offer myself. Monty can say what he wants. But if you need help,
00:43:30if you have questions, please let me know. And I know we would be happy to
00:43:36give you some suggestions if you're trying to get a hold of your medical board or your pharmacy.
00:43:41Do you have a question, Dr. Tenet? Yeah, you just gave me an opening on a question that I
00:43:50really want to ask. We have people who really should be, frankly, complaining to their medical
00:43:57boards. You know, they're being mistreated. In some cases, the mistreatment has resulted in deaths. We
00:44:05had this week, I unfortunately am aware of a doctor who took somebody off benzodiazepines,
00:44:11cut him in half one day and another third another. And of course, they led to suicide.
00:44:18How do we, is there a way that you guys, could we train people how to
00:44:26complain to a medical board? You know, one of my frustrations throughout all of this has been,
00:44:33and Mark, I'd like for you to weigh in on this. People who are mistreated, it is time that those
00:44:40people themselves not only complain to their medical boards, but the person paying their bill,
00:44:45that insurance company. 75% of physicians in this country now work as an employee for either a
00:44:52hospital or a health plan. And these people are getting by by telling doctors not to treat them,
00:45:00ignore them. And we've got to have, and you guys have been, and if I say so myself,
00:45:08you guys are educated, you're experienced, you're knowledgeable, you're worldly.
00:45:14And the average person that I deal with are just ordinary people. I've never dealt with
00:45:20a government agency. And to think in contacting UnitedHealth and writing their CEO, it's just
00:45:27nothing they would even think of. Do you suppose we could have some kind of a training program for
00:45:33this? I will say yes. I think there are certain things that you can lay out in your complaint
00:45:42that will help it to be more understood. It is really intimidating. I mean, and the other thing
00:45:47is patients, when they complain, they're hurting and they don't feel good. And it's very difficult
00:45:53for them to come up with it. So, you know, there may be, let me noodle on it. And there may be a
00:46:00way I can come up with a template of kind of things that you would want to present. Now,
00:46:05it will be different state to state, very different. We are very fortunate in California,
00:46:11the medical board in 2023 has the guidelines that they put out, which are really relatively
00:46:19patient. And so what you would do is if you have guidelines in your state, you can refer
00:46:28to them in your complaint. For instance, we're fortunate enough in the California board
00:46:34that says in guidelines, it says that did force tapers are discouraged. You should be able to
00:46:41pause the tapers and go through all of the things that's really would be
00:46:48protective to patients. Now, the board can't tell an entire hospital system,
00:46:53like they can't tell Kaiser, you know, stop forced tapering patients, but they can address,
00:47:00like you're alluding to Dr. Tinn, an individual patient that's had problems. Let's say they've
00:47:06forced tapered and it has severe outcome from them. They absolutely should use the guidelines
00:47:13from their state, write their board and put in their claim. I would very much encourage that.
00:47:20And if it's pharmacy related, let's say Dr. Ibsen has more cases than I care to even think about.
00:47:27If the pharmacist has refused them to fill a fill-ups prescription, they can also write to
00:47:35the board of pharmacy, which would be a similar process, but a different board. Each board has
00:47:42a website. So somebody just asked where in California the board is. It is in Sacramento,
00:47:51but you reach these boards essentially virtually on their website. So Monty and I did not go in
00:47:58person. That's all you find their website. First of all, you go to their website, find out,
00:48:04you know, when their meetings they'll have, when their meetings are, who's on the board.
00:48:09And then if there are guidelines for your state, they'll have the guidelines there. Then you can
00:48:15read through the guidelines and use those to help protect you as you write up your complaint.
00:48:22Oh, absolutely. Monty, do you have thoughts on that on using the guidelines as your basis for
00:48:29your complaint? Most states, in my opinion, to my knowledge are not as, even though they're not
00:48:38over the top, pain patient friendly. California is one of the better states. That's true. So I fear
00:48:45that the guidelines are going to hurt more than help in many states in the country. I'd hate to
00:48:52be a wet blanket, but I do, I do think, you know, the process, and I want to reiterate this,
00:48:57Kristen Ogden has made a couple of comments in the chat. She's nailed it right on. The way to
00:49:03get to these folks is to participate in their meetings. And just keep showing up. Exactly.
00:49:12And it's, that's a separate issue a little bit than if you have something happen with a doctor
00:49:18at a doctor's office and you're filing a complaint with the medical board. In California, that's a
00:49:23pretty straightforward process. You know, it's all automated. It's, I think they call it the breeze
00:49:28system or something, but those kinds of things are relatively simple. Pat has done, I know for a fact,
00:49:36Pat has nurtured some folks here in California through that process. I have never had to file a
00:49:43complaint with the board. My interaction with the board has been more on a proactive basis,
00:49:48trying to get them to implement some change in their policies that will help the patients in
00:49:54California. One of the things I didn't mention earlier, the board of pharmacy is going to
00:50:00actually have a presentation by a couple of the distributors on the 16th of this month on the
00:50:07impact of the nationwide opioid settlement on them. That's going to be at the board of pharmacy.
00:50:14I happen to know through the back door, one of the guys from the medical board's going to
00:50:19view that just like I'm going to do it virtually from my office here in Southern California.
00:50:26So Monty, Dr. Ibsen just, just underlined your statement. He writes boards have doctors
00:50:34intimidated and, and absolutely. I need to be careful that there are boards that are equally
00:50:41corrupt and have, have the Kool-Aid. So you've just got to, you've got to try your own board and
00:50:50see what they're like. If you know, you can get one that's anti-pain patient and then it's very
00:50:56difficult, but don't, don't give up. Don't give up. Litigate. Thank you. You can try it.
00:51:05Mark, are you out there? Yeah, I'm here. Go ahead. What do you have to ask these fine folks
00:51:13or add to what they're saying? Well, I must, I must tell you that at least three times a day,
00:51:19I encounter a pain refugee or a patient who's seeking help and I advocate with them and
00:51:24it's all pro bono stuff. And I recommend to anybody who's been cut off from their medicines
00:51:29or forced tapered, or they can't get something from their pharmacy that they file complaints.
00:51:34It is ad nauseum, these recommendations. I don't know how many people have actually done it,
00:51:40but it is so bloody simple to file a complaint against a physician who's
00:51:46given you bad information or, or cut you off unfairly, et cetera. And, and, and patient
00:51:55complaints have much more influence over boards than doctors complaining. Doctors just want to
00:52:01be invisible. It's basically don't put the ring on your finger or Sauron will see you.
00:52:08It's so the doctors must it's sort of like remaining invisible at all costs. So doctors
00:52:17do not want to be known by their medical boards because once they have you in their sights,
00:52:24you become their next target and they don't give up. They don't stop targeting you. Even if you
00:52:30beat them with a stick. So, so in fact, if you beat them, then they hate you. This is my personal
00:52:36experience, but, but so, so we need patients to be active with the medical boards and there's
00:52:43no statute of limitation on unprofessional activity. If you've been treated poorly by
00:52:48a doctor or a pharmacist that doesn't age out in seven years or three years or anything like that,
00:52:55you can go back and you can say, I was treated poorly by this physician at this time.
00:53:00And I'm letting you know now because I'm no longer intimidated by that doctor, something like that.
00:53:05So, so I think patient complaints are a great way, but, but I got to tell you that the advocates
00:53:10that are in this room together develop deserve the Nobel peace prize for sitting through
00:53:18endless meetings with people pontificating about and completely ignorantly doing it.
00:53:26And that you have the patience to endure and create relationships.
00:53:33I really admire you. I'm going to remain in the rebel category because I'm already
00:53:40painted, but, but, but, but I, I think that, you know, the, the more of us that can actually
00:53:46create, create relationships with the boards and, and ask nicely then, and if it works,
00:53:55then great. And, and it, and if it doesn't I think publicity is going to be the next thing.
00:54:01It's going to be basically you know, we have to let everybody know that the board of,
00:54:06like my attitude would be, where's the board of California in terms of, in terms of promoting
00:54:14their guidelines and, and, and, and if they haven't done it, then we'll do it and proceed,
00:54:21proceed it in that way. And that may, that may not create the greatest, greatest relationships,
00:54:25but frankly, our relationships are adversarial with most of these people. And, and I agree that,
00:54:33that being professional and being appropriate in a meeting and not cursing and swearing and putting
00:54:39them down is, is probably a good idea. That's why I haven't been attending. But I think that
00:54:46at some point they're going to need some public shaming. Yeah. Let me, I just, an experience I had
00:54:57just in the last few days was with a prominent, I hate to, Marty and Pat, I want you to hear this,
00:55:06with a physician here in California, he's very well known, been president of his county medical
00:55:11association, on the board of one of the best hospitals, published a lot of papers,
00:55:17somebody I consult with quite often. And I asked him, I said, you know, what have you ever,
00:55:27he has the same philosophy we do. And I said, have you ever complained to the medical board
00:55:32as you're concerned about some of the doctors who are cutting people off drugs and causing all this
00:55:37havoc? And I think he summarized it very well. He said, Forrest, let me tell you,
00:55:44he says, you know this as well as I know, if I'm for it, the board's going to be against it.
00:55:50And so the word adversarial relationship, the reason why a lot of us can't get involved with
00:55:55you lay folks, is if we're involved with you, you're going to go nowhere. They hate us. You
00:56:01know, 30, 40 years ago, physicians were thought, and we're the most respected people in society.
00:56:08Today, we have been denigrated, we've been pejorativized, we've been investigated,
00:56:15condemned, we are at the bottom of the public's totem pole. And so if you folks who are non
00:56:22physicians don't advocate for doctors, that's why I'm so glad you're doing this. We can't help you.
00:56:27If we raise our hand, we'll hurt your efforts. They hate doctors. I don't know where this came
00:56:33from. But you got to remember that people on medical boards are political appointees.
00:56:40They're appointed by partisan political people. And so whatever view those partisan political
00:56:47people have is what your medical board is going to reflect. And so doctors today, you're right,
00:56:52they're hiding out. They're not about to raise their hand, write a letter, complain, just leave
00:56:57me alone. I don't want to be known. Now the public might find this hard to believe. But
00:57:04the doctors fundamentally as a group, there's exceptions, obviously. But I think as a group,
00:57:11what you're going to find among practicing physicians is that they feel they're the enemy
00:57:15of the medical boards, and that they are there to be horsewhipped and denigrated and cast about
00:57:23by any variety of means. So that's why you've got what, a third of the doctors are
00:57:29going to try to retire now and are bailing out of medicine. I mean, they're not going to stay
00:57:33with it. I think it's terrible for the country. When you start having a very negative opinion
00:57:39of your doctors, remember, we're all going to face one. Okay, you're not going to get around them.
00:57:46Okay, because they're here. And it is tragic that we cannot help you get pain medicines that we
00:57:53need. Okay. So with that, with sad note, all I can do is say thanks to Kristen, Marty, Pat,
00:58:03and all the rest of you who are trying to help out. Because if you don't do it for the doctors,
00:58:07at this point, we're helpless. Okay. Before you go, Dr. Tennant, you said earlier
00:58:16about how we don't know how many patients in chronic pain or how extensive the Epstein-Barr
00:58:26reactivation phenomenon is. I'm suspecting, and I think you do too, that it's bigger than we think,
00:58:33and that we're dealing with an iceberg kind of phenomenon here. And so what I want to say to the
00:58:40people who, you mentioned this great quote about we are uncertain about autoimmunity and its effect
00:58:51on things. And my response to that is we don't know yet. I think this may revolutionize the
00:58:59practice of medicine, and particularly what I think it may revolutionize is that every patient
00:59:04that we see that confuses us, that we want to blame the patient because they're not getting
00:59:08better, they got Epstein-Barr virus reactivation. Well, I'll close it out. You're absolutely right.
00:59:16And I went over a lot of records just this week. And they not only may have the Epstein-Barr virus,
00:59:22they may have titers that are way, way above normal on two or three others at the same time.
00:59:27In fact, it looks a little ominous to me. So let's close out with a word of thanks to Maudie
00:59:35and Pat. Please help us. We need you. And secondly, that word iceberg, I'm going to stick with you.
00:59:42Yeah, thanks so much. Thank you. Well, we'll carry on next week, and let's keep moving.
00:59:49Thanks so much, everybody. God bless us, everyone.
00:59:53Yes. Thank you.
01:00:00Thank you, everyone. God bless everyone.
01:00:06God save the pain warriors.
01:00:13Thanks, Monty.
01:00:16According to my doctor, 80% of the world's population has the Epstein-Barr virus and
01:00:22don't even know they have it. 80% of the world's population.
01:00:28Usually by two years old.
01:00:30How do you get tested?
01:00:32It's the early EBNA.
01:00:36It's the EBV nuclear antigen.
01:00:40And the VCA.
01:00:41And the EBV, VCA.
01:00:45Yeah, EBNA, early EBNA, and VCA. Is that right?
01:00:50Yeah, well, the fact is we've all just got to buy the book.
01:00:53Yep, that's it.
01:00:54Page 82.
01:00:58What'd you say?
01:01:00Page 82.
01:01:01Page 82, yes, that's awesome.
01:01:02Oh my God, we're going to quote it like scripture now.
01:01:06Let's quote it.
01:01:07That'd be great.
01:01:11Thank you all for joining us tonight.
01:01:15I love you all.
01:01:17Back at you.