Dr. Cook Roundtable Q&A Series: Discussion Around Mold Toxicity & Co-Infections

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The following is a Q hosted by Dr. Host. Weekly calls with doctors. Hey, welcome everybody. Um, great to have you. Um, uh, how are we doing? Any questions?

We, we did have a, um, a couple submitted. Um, This is, uh, actually related to, uh, exosome therapy. Okay. So it's a case where, um, it's a neurodegenerative disorder that is nonspecific per Mayo Clinic workup. It has evidence of both upper and uh, motor neuron lesions, but they stopped short of providing a diagnosis.

His workup for ALS was negative. We currently believe it may be secondary to mold toxicity, and they've done one dose of IV 15 billion, um, mar exosomes and wanted to get a sense of, of how frequently given they, they handled it well, how frequently you'd treat, how much. The further that I go in in. Taking care of people with nerve problems, and that includes peripheral neuropathy.

That includes, uh, and, and that's beginning to include people with upper and lower motor neuron problems. And, and as an example, people with brain lesions, uh, and the full spectrum of neurological problems from neurological Lyme to to ms. Um, uh, I think that there is an overlay and a component of mold that plays into many of those diagnoses.

And I think there's a component of, there's a, um, there's there, uh, there may be a mold component, then there may be a biofilm, uh, a gastrointestinal stealth infection that could be that that's creating a whole bunch of immune dysregulation. That's part of why they're not able to deal with, uh, Things, there may be Lyme, uh, then there may be viral Epstein Bar, C m V.

And so I've, I've seen often in patients like this a constellation of four or five or six things, but particularly mold, Lyme, viral, uh, in, in that spectrum Now, um, My sense is that the most important thing to do, given that, is to try to diagnostically figure everything out from a, from a kind of a classic functional medicine perspective, so that we know what's going on, what, uh, and, and then can develop a treatment plan based around a comprehensive thought process.

Um, what people would like to do is to say, oh, okay, maybe is there something expensive that we can do? Uh, like that would be regenerative. And, and then how frequently would you do that? Um, I would, I'll actively argue against that. And the logic that I'm using to argue against that is that, um, if mold's involved, we need to figure out how much it's involved.

And so the ways that I would try to work that up as I would do a, a mold, urine test, uh, to try to see if they're putting mold out on the urine. And then I would do it the, there's a test called My Micko, and Andrew Campbell is the doctor that, um, uh, this is his lab. And, uh, I think he's one of the top, uh, uh, thought experts in the, in the country.

And, uh, on mold. And so then, uh, he has this antibody test. And so then what we do is we look and we'll, we'll see, oh, okay. They've got very, I just had a, uh, uh, someone that had some neurological symptoms and, uh, their, and so I ordered, uh, a Great Plains, uh, a mold profile on him and his. His gliotoxin and gliotoxins.

A mycotoxin that's a neurotoxin was 200 times the upper limit of their normal. So then that's a valuable data point for me. And then once quarantine ends, I'm gonna get him to come in and I'm gonna do a test and I'm gonna figure out if he has antibodies to mold. So then what that'll do is that'll give me two important data points.

The the, um, Oh, hey, hey, Barb. Tell those guys they should listen. I've got two doctors I'm training today. Um, so then the, the, what I, I get out of the, the antibody test is I've seen a lot of people who are, who are real sick and all their antibodies are all in the red. So that means their immune system considers it to be a problem.

They've got antibodies to the mold, which means they're, they're having a reaction against it. And so then, uh, depending on where that the mold is, that can drive an autoimmune type of reaction against it. And so it could be neurologically or wherever it is. Um, so number one, I would try to do that. Workup number two.

Uh, The next thing that I wanna find out is if they have, um, mold, then what I wanna do is get a workup and figure out where is it, where did it come from, uh, do they have a sense of, of having had some exposure? And so then I have them check their house. And I, in the Bay Area, there's a guy named John Banta, uh, and he is, By far, like miles ahead of anyone else at going to your house and testing.

So I just moved into a new house and so then I literally, uh, called and he didn't come, but he had someone who came, who was super serious and then went through the entire house. Uh, to assess the status of the house. Now, interestingly, what happened is, uh, we had a front loader, uh, uh, or I had a front loader in this house.

And front loaders are notorious for having, uh, mold in them. And in fact, I had had. A front loader in my, the apartment I'd been living in and it had mold in it. And so as part of my strategy of moving to the new house, I literally took everything and got everything cleaned in a mold, uh, friendly thing.

Then went over before I moved, I had John Vanta come in and then had him look and there was mold all over the front loader. And so then before I moved in, I got rid of that, uh, that washer and got a new one and kind of cleaned everything up before I moved in. And so, uh, in the world of mold, in terms of mold remediation, there's a, a huge spectrum of how far you can go.

And what I did is I got rid of that. And then basically he went and the house is mostly stone and. Stone and stucco. So he said Everything else is good. You just had that one thing. So then I proceeded to move in. Um, what I try to do is I have people, if I find people with mold a then we go look at the house.

Uh, we have them try to do some testing at work. So sometimes people I've, and I have had a hundred people who swore up and down to me. That they lived in 4 million houses and that there was no mold. And I'm like 97 out of a hundred that, uh, basically they embarrassed. They said, yeah, you can't even believe it.

Like on the phone you were right. And then sure enough, like in every one of those cases there was mold, you know, in the laundry room or there was mold somewhere. And so then we start our remediation process with that. And I, I can't tell you how many times I have just done that and people do better. Um, Barb came up with a, um, a strategy of using ozone somehow in the.

Washer and dryer, which is kind of an amazing strategy that can be helpful. Um, and then, um, there is, Barb also came up with a strategy of some kind of detergent that you can put it in the laundry that will make your clothes not it, it, it's an anti mold and I have to tell you that. And then, uh, she's gonna come in and tell us what that is.

But that's an absolute home run because. I'd never been sensitive to mold. And then I got mold in the washer and dryer where I was living, and then I started smelling it on my clothes. So I was like, oh my God. So like, I'm a mold doctor and I've got mold. I was like, and so then we went through this cleaning thing and then I eliminated.

And so, uh, then, uh, you wanna check and make sure you don't have mold. Um, uh, In your work and in your house. Uh, Hey Barb. What's the name of the, the stuff that you put in, you found to put in the washer and dryer to make it so that it's not mold? Yes. So that you don't use, you don't use detergent anymore.

Correct. No detergent. Now here's another thing I have been on this one for, I've been telling people that like Tide and all of these laundry detergents are super toxic for years. Chemicals. And so then for all of this time I was using seventh generation and all these things, but I think even those, like a lot of them, them are hypoallergenic as so many people react to them, pure eco laundry.

But if you look here, you can see there's a picture of the, the, the washer, and then up above the washer you can see there's a thing that says pure eco. $347. $347. That's a winner, winner behind door number two. Thank you, Vanna. Uh, so, so then, um, so then, uh, hidden within my answer is we're gonna walk down all of these roads because this is far more important, I think, than something that I think is an amazing bandit.

And the reason I say that is if somebody has mold all over their, uh, laundry room and they've got a leak in their basement, uh, I don't care what you do, that's just a bandaid cuz it's not gonna solve the problem. And so then we have to think about where it came from, what's the, what are the issues, and then how do we strategically wanna manage that?

And then, then, um, That's one. Then when people are in a water damaged building, there's two things that happen. You can either a. If you have a biofilm in your nose and the classic one is called MARCoNS and there's a nasal swab, and then we can send you a link on how, how to order that. And then when people come in, if they have mold, I will have them do a nasal swab to see if they've got marons.

Cuz if they've got this bacteria and it's an antibiotic resistant bacteria that a lot of people can get in their nose, that can have a biofilm and. It's basically kind of like a mucinous, collagenous like thing that is, looks kinda like what you see on ponds come at the edge of a pond. If mold is in the air and you're breathing in in a water damaged building and then you breathe and that that mold comes in and gets in there, now it's living in your biofilm.

I like to tell people, if you saw like. Kind of that mucinous thing at the edge of a pond that biofilm. And if you walked over and poured a cup of mold onto that and stirred it in, do you think you could get it out? No. That mold now that that's the, now a biofilm that has mold in it and then and, and you're not gonna be able to get that mold out of there.

And so then the conversation then is we send that swab off. Then the next thing that I do is I say, and and, and before I stick that swab in, I say, do you have any sinus symptoms? Do you have anything going on? Do you ever get sinus headaches? Do you ever have any vision things? Do you feel pressure in here or is everything lights out totally perfect?

I would say more than 80% of people who who tell me. Oh yeah, I, uh, I was in a water damaged building. 80% of those people, if they came in with symptoms, will have something going on in here, in, in the, in the face and then, and, and, and in their sinuses. So then we, we do that test. Um, then in addition to asking those questions, I ask people, I.

Do you have any gastrointestinal symptoms? Gas, bloating, and so I'm looking for anything from esophageal all the way to rectal. In terms of symptoms, I'm looking for gas, bloating. I'm looking to see if they've got sibo, small intestinal bacterial overgrowth symptoms. I'm looking to see if they have gas or uh, anything that is, uh, uh, upper small intestine.

Um, I'm trying to get a sense if they've got any abdominal pain, if they could have had parasites. Uh, I asked 'em if they've had any food poisoning and what the trajectory of any symptoms was after that. And then I look to see if they have any colon symptoms, how their stools are, how if there's any constipation or diarrhea and, and what the arc of their gastrointestinal symptoms are.

Um, if. If I'm concerned that they have mold and then they say yes to two or three of, or four of those 15 gastrointestinal questions, I ask them, then I will do a stool test and uh, I'll do a stool test for parasitology. And then depending on what symptoms they give, uh, I will potentially, I may do a sibo.

Breath test and I may, I, I'll do some, a little bit of a gastrointestinal workup. So then the conversation then is if they, often I will find people and they'll say, oh yeah, I've got, I've been having all of this sinus stuff and it happened ever since I moved into this house. Like, I, I, I, I've heard, I've had 50 people tell me that if I've had five.

Um, and then I've also had a lot of people say, oh yeah, you know, I've had this lingering thing for four or five years. I got food poisoning in Mexico, and then i's never been the same. And so then, um, often I will find parasites and then, or, you know, uh, dysbiosis, uh, in their gut. And so then what I will be faced with is somebody with sinus symptoms, gut symptoms, some pathology in their gut, probably, uh, a biofilm in their nose, and so, and an exposure, and then potentially something in their house.

So then now my priority is then working from the house all the way through the body. To try to eliminate the obvious causes. So we're gonna remediate the house to the best of our ability. Um, uh, we will then, um, for the nose, the, the, there's three things that I like to do. Number one, uh, the and, and I, I figured this out.

I, and I feel really good about it, and I feel fantastic about the price. Um, the hypertonic Quinton, Q u y n t o n minerals. And you can get these, um, we can sell 'em to you or you can order 'em at the same price from Quicksilver Scientific. And, uh, what happens is you pop the vial and then you put it into a nebulizer.

And then you nebulize and breathe in and the hypertonic minerals seems to dry out that where that biofilm is and it you're breathing in those minerals. And the minerals kind of start to mineralize the epithelium down into the, into the upper airway. And, uh, we're having real positive results with that.

Number two on the nebulizing front. We have people nebulized glutathione and uh, there's a, a compounding pharmacy that we get, um, preservative free glutathione. And so then that's great cuz I feel great about nebulizing that there's no preservative in it. And they're, we, I'll order, um, 32 CC vials and then what I will do is I will take a two CC vial or two cc vial.

And then I will mix that with two ccs of Isotonic Quinton. And so then I've got four ccs of a glutathione isotonic mineral combination. People respond great to that. Nobody gets irritated. It just works perfectly. And so then what I. And, and so then that works great. And I'm gonna tell you the protocol when I get done with the next part.

So that's step two. And then step three is, um, step three is, uh, there's a, a co, there's a few different sources out there, but Designs for Health is a, a supplement company. And, uh, I like the company JJ Virgin's involvement with it. And she's a friend of mine. And they have a product called Silver Sein, and it's used for nebulizing.

And I've used it and I have had no problems with it. And so it's a pro, it's a product that's very easy to use. And so then, uh, you can take four ccs of that. You get a bottle that's like a big bottle for 30 bucks. So it's super cheap. There's like, 200 doses in there. And, and the, the, the cost of the Quinton is, is dollars and then the, the, the cost of, uh, the, the glutathione is in the, um, kind of five to $10 a day type of ball, ballpark.

Um, and so then, um,

Yeah, so, so then what happens is, is I will order whatever people want, and so then I have some people who will do the glutathione every day, so, And then they'll, uh, do the hypertonic minerals every day. So they'll do, they'll do it twice a day. What I usually will have people do is I'll, I'll see what they wanna do.

What I found is of all things that I talk about, Having chronic sinus stuff and mold stuff is such that, um, what I've noticed is that, uh, people are super motivated and as soon as they start to do this stuff and feel better, they'll be like, oh, I'm totally down with that. And so, uh, I have a whole bunch of people on a three day rotation where they'll do one day of.

Hypertonic, one day of glutathione and one day of silver, and then just repeat that. And so they'll do a little nebulizing treatment every day. Um, I have a whole bunch of people who will do a little bit more than that, and so they'll, they'll do glutathione every other day. Uh, and, and I have, um, interestingly, I have.

Several people who emailed in, who were mailed that protocol for, um, for mold and I, I started them on it and then they ended up getting covid. And they were like, that was the only thing that saved us. So, and thank you. So I've gotten several really nice emails of people who sounded like they got pneumonia and they were able to do these protocols and they said that every time they did it, their breathing got better.

And then I'm, I know of, uh, another doctor in Canada that had, uh, that's a friend of ours that, uh, had a similar um, Similar, similar situation. So, um, So that's the, the protocol, and that's a nebulizing protocol. There are some other protocols where you can actually qui it up, uh, some colloidal silver, and you can, and then there's a, uh, protocol where you can do an, uh, there's, uh, two different, uh, Com antibiotic combinations of antibiotic sprays that you can do.

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since I found my combination of silver glutathione and hypertonic minerals. We've been having so much popularity with that that I, I have not been doing the antibiotic sprays, which is kind of great because there's tons of antibiotic resistance. So at this moment I'm kind of quite happy with that. And then what we're gonna do is we're just gonna continue and I'm gonna start to track some data and see how effective we are at eliminating the marks and then at eliminating the symptoms.

But I think this is a great, um, Conversation. So then in terms of the gut, uh, I may have found kind of an amazing new thing that I'm quite excited that I'm currently testing. Um, somebody, we have two doctors here today and they said, how much do you test? And I says, well, I'm testing two or three things on myself every day, which is, um, kind of fun.

But I think I may have had kind of a, a. A breakthrough on a couple things I'll tell you about, but, um, for the gut, first of all, I try to figure out what's going on. If there's a parasite, we figure out if there's a protozoan or a metazoan Percy, and then I figure out, um, if there's yeast. We, we, I have a parasitologist that looks at the stool and kind of does a full analysis of that.

And then we do some of the other typical microbiome and, uh, genetic testing in the stool. And then, If we find a lot going on, I will put them on some biofilm investors. We'll have them take herbal antimicrobials. Um, uh, we're, I'm giving them, uh, oral glutathione or trying to, uh, heal their, get that way. Uh, we're, we have.

Pre and probiotic strategies, and we're rotating different ones around there. Um, but overall, we're building a strategy to build resilience and health in the gut and eliminate a biofilm. Sometimes we're doing a ozone water, sometimes we're doing rectal ozone. And so we're doing a, a very comprehensive and thoughtful strategy towards eliminating Antibi film in the gut.

So now, We fix the house, we fix the nose, we fix the gut. And to me, you can rapidly work on all of those things, but you're doing a disservice to someone if you try to go after a neurocognitive and you, you don't address all of those things because you're leaving. You're leaving money on the table, kind of from a gambling analogy in the sense that if you don't do that, then you may not be fixing the cause, and then you're just throwing money away because you're not actually eliminating.

What's the actual thing now for a mold program? Uh, once I fix the gut and fix what's going on, then we we're, then we're putting people on binders. Uh, and, and, um, so we've got a couple of different binders. I like the quick silver binders. Uh, we're gonna have, uh, our own, uh, uh, bio reset zeolite, which is an amazing.

Uh, binder, which, which helps a little bit for the cellular detox. Um, and we got delayed in all of this stuff where our supplement line just because of the pandemic, but that's gonna be out soon. Um, and so then we're trying to bind onto mold because if there's mold in the gut and you have. Binders, they're gonna bind onto that and pull it out.

Uh, we give a product called SBI Protect that has immunoglobulins that may be able to bind onto that. And we've, I've noticed a lot of symptom relief. We've also noticed symptom relief with colostrum and then, um, And then finally, if people have fairly profound, uh, mold intoxication after a few months of that, And I've, I've got them on binders.

We're healing the gut, we're healing the nose, and we're starting to pull stuff out. Then I will often put them on sporanox and we'll, sometimes we'll do that up to a couple months. Sometimes we'll do a month on, a month off, but we'll often do two or three months of, of and a systemic antifungal. And that can be quite helpful.

Now, um, uh,

Uh, and so then that's that. Now, then next thing after that, what I would say is I, my sense is that ozone is quite helpful for helping people detox mold clinically. Uh, I have can't tell you how many people that I've seen that had. Uh, very high levels of mold and, and chronic brain fog and a lot of, uh, lot of neurological symptoms.

And we start to, to do ozone and a lot of times I see people start to feel a lot better. And so then, um, in that, uh, case, what I do is I like to start low. And particularly with mold, it is critical to start low with your detox. And the reason for this, this is, uh, amazing. Uh, mold can have such an immune dysregulating effect and can cause so much of a, a backlog in your detox pathways that once you turn it on, um, uh, sometimes it can be too much.

And interestingly, I have, um, Consulted on a handful of people who were super toxic with mold, super, super, super toxic, who had someone give them exosomes and then they got dramatically worse. And I think it's because exosomes are also a helpful detox thing, but it was the wrong timing because it's the thing that was supposed to be last was done first because it's the easiest.

Of all of the things to do. And so, um, what I would, I like to do ozone and I would typically start with major auto hemotherapy or, or one pass and then double that to two passes and then double that, increase that to three to four. And I'm slowly working my way up to treating them, uh, building, uh, confidence.

Uh, in us that we're able to do things, get them moving in the right direction, and they're, they're not getting worse. Um, and, uh, uh, So we'll do that. N a d can be very helpful for people with mold. And so then often, generally, almost always, when we do an IV ozone, I'll give them n a d. When I give them n a d I always give them trimethylglycine.

And then the other thing, uh, is, is that I will, um, go very, very, very low. With n a d, particularly when it's new people, and then particularly when it's with mold. And so as a, as a way to think about n a D, you have somebody who, uh, if you have somebody that came in and they came in on the addiction side and they were drinking a bottle of vodka a day, They probably don't have that much mold because anybody that has is sick with mold, can't, can't drink two shots of vodka, much less a bottle.

And so that person that drinks a bottle of vodka today could do a thousand milligrams of N A D for 10 days, and it would be the best thing that ever happened to them in their life. And. Uh, a super toxic mold person might have a fairly significant detox reaction with 500 milligrams of N A D. So I'll start with 50 or a hundred milligrams of N A D and then slowly work my way up.

So then we're building confidence and safety around that. Uh, I'll generally give them vitamin C when we do that, but I'll give them low doses of vitamin C maybe. Two or five grams closer to two and, um, support them, uh, that way. I'll do some oral things like cetin and things like that, that are, uh, probably helpful.

Um, and then I'll get them going with that and get them going and I'll, I'll, I'll have them do two or three or four or five. Therapies like that, uh, before I try to go down the road of doing something, uh, regenerative. Now, at this moment, the, the, I would say that the f d A and the regulatory agencies are a little bit on the war path on, uh, regenerative medicine.

And so I think it's gonna be an intriguing moment to see. What happens with that and where that goes? I think the patient population that has more to benefit and more to gain from regenerative medicine than anyone else other than peripheral nerve problems and musculoskeletal problems is probably the neurocognitive and the neurodegenerative problems.

Now given, given that.

If you bring up the spectrum of an infectious etiology, then what I would say is I still think ozones gonna be the best modality. Um, if. But then, uh, if you, someone was to do, uh, if you look at what Doug Spiel talks about, uh, he has treated a lot of people where he gave them exosomes and, uh, would give them 15 billion exosomes.

Uh, and he would do that once a quarter. And so I, there are a whole bunch of practitioners that I know that have done that, and I have done algorithms like that. And I think that that's, uh, a reasonable and, and, uh, and as is probably a safe thing to do. Um, I think it's, it's crucial to try to figure out what you're doing and diagnostically really dive into that.

Um, the, um, Jan actually is working with a device, uh, called the Ponds device, which, uh, is interesting and, and I think that there's an entire huge arc. Of devices that, uh, that benefit us neurologically and, and, and, and at the peripheral neuro level that, and I think we're, we're looking at, uh, uh, treating some patients with, with this technology and doing some collaborative work with you guys.

And I'm enormously interested and excited about that. Um, uh, and so then that's. Maybe. And so then my, that's, that's kind of my answer this, and, and, and my answer is couched into the fact that this is a regular, this is a, a nuanced regulatory moment where I don't wanna say an answer. Um, but w we know that there's many people that have done treatments for this on a.

Uh, every month, every two months to every three months basis. And I think that's reasonable, but I think it's, it's most important to, um, to really figure out what's going on and then lay everything out on the table and make a coherent plan. Any questions about that?

Okay. That was a great answer. I'm sure Dr. Am will be pleasantly surprised at how thorough you were in responding. Okay. There, uh, there was a question regarding, uh, updating on the irb. Research project so that we're, um, we we're submitting four different IRBs and um, I think one was submitted this morning and then the, the other four are gonna be submitted in the next, uh, four or five days.

We're just kind of going over everything, uh, and having calls into the night and stuff like that. But, um, and so then I'm. I'm hear, I, I know some people are hearing in as soon as a couple weeks. Um, I think we've flattened. You know, I think we've done a good job in California. I think we've done a good job in the west coast of creating, uh, creating a good job of, of stabilizing this.

And so then what I think we're gonna have the staggered rollout where people are, um, Gonna engage in life and stuff like that, but we're gonna have masks on 'em. There's gonna be a, a level of social distancing in all of our normal lives over the next, over the next 12 months or longer. And so then we is just gonna remain how that plays out.

And then hopefully we're able to go to a hotspot and test people and do something and hopefully learn, learn, learn a lot and help some people. Um, and so I've got, so we're moving as, as hard as we possibly can on that front. Um, so that's good. Dr. Cook, have you, um, I got a text question. Have you identified a test?

Um, Or have access to tests that you like at this point. So, uh, I'm gonna do a podcast, um, I think tomorrow, um, with, um, Um, a friend of mine who's a, uh, a top, uh, expert, Dr. Messier, who's a friend of Jan's who's a top expert. Uh, and, um, she's gonna lay out all of her thoughts on testing. And so that's gonna be on the podcast.

And, um, and we have. We have tried and been largely unsuccessful in, in, in getting testing, but I'm gonna, we're gonna record and then put that up and that's gonna be, I think, enlightening for all of us. Okay, great. Um, I had a question submitted. You've talked a lot about IV lysine. Um, is there a, a source at this time for that or, oh, yeah.

I go to, um, Archway. Archway Apothecary. Hold on one second. Is, uh, a compounding pharmacy

and you can order it. Um, you can order, you can order that from them. Okay. And then Keith, do you wanna ask, Keith, you still here? Do you wanna ask your question or do you want Yeah, I'll just unmute if that's okay. Hey. Hi. How you dick? How you guys doing? Um, I was wondering, um, what do you have on your crash cart for IV treatments?

Like what do you keep in the office and like, you know, what do you keep nearby? And just in case somebody has some sort of anaphylactic reaction and, um, do you ever have any issues and, you know, what do you administer? How much and. That's a great question. Uh, so I've got epinephrine, atropine, um, uh, I, I have, uh, glycopyrrolate and um, uh, we've got a defibrillator.

Um, and then I've got monitors. I've got monitors on rolling wheels that can come in and real quickly, Get somebody's oxygen saturation. We've got dextro in there in case somebody gets, is, uh, hypoglycemic. Um, the, um, when someone goes down, there's, uh, couple things to think about. You wanna think about what happened, why did it happen?

And then what, how am I gonna manage that? So the one common thing that can happen is, is that you get a vasovagal. If you get a vasovagal, someone can become extremely bradycardic with a vasovagal i e, like a heart rate of 30, 30 or 40 or 20. Okay. Now what happens with that is, is that that means their blood pressure is gonna go to 60 over 30.

So then some of us can tolerate that, but then a bunch of people can't tolerate that. And so some people will go ischemic right away if their blood pressure goes to 60 over 30. And so I was, I was talking to my guys that are here today, cuz what happened in anesthesia is I used to. I, I would have an arterial line in, or I would have like a blood pressure mo monitor on, and then for some reason someone would get like, go, uh, vasovagal and then I would watch their heart rate and you would see a heart rate go down to like 30, and then you would see their blood pressure go down and off and they're on a rhythm strip.

And so then a lot of times with the, when you start, you start to see ect, Pete. And so then you'll see, you'll, you'll see the QRS comp complex widen, and then you'll start to see PVCs. And then, so then once that happens, you have, uh, minute or, or two or three, but you don't have like seven minutes to bring them back.

So, Our, our chairs can lie down, and so I immediately get them to lie down and then lift their feet up in the air, um, to, to bring blood back to the heart. And 95% of the time, that's all you need to do. Um, the, the Roben all is amazing at just increasing the heart rate. However, it takes like a minute and 30 seconds to work.

Now if you push Roben all in that, it's an agonizing amount of time. For Robbin all to, to increase the heart rate. So you're just sitting there waiting and, but then once it kicks in, it's good. Now ephedrine is good and ephedrine comes in fast and it's easy to dilute. So I also have ephedrine in there.

And so ephedrine, there's a 50 milligram vial. And so if you take a fif, if you take a 50 milligram vial and draw it up, and then real quickly pull in four ccs of saline, that's five milligrams or that's 10 milligrams per milliliter. Because five milliliters is 50 milligrams. And so if I was really worried about somebody, I might push 10 milligrams.

If I was really, really worried, I might push 20 milligrams of of ephedrine. But if you give somebody 2020 milligrams of Ephedrine iv, their heart rate is gonna go from 30 to 120. Now, they could also get ischemic at 120. So you have to be kind of aware of. Who you're dealing with and what's happening. And so generally, if I saw someone vasovagal or somebody was bradycardic, I would just give them 10 milligrams of ephedrine and push that in.

If I thought that I didn't have a minute, then I would give up epinephrine. Now, the issue with epinephrine is epinephrine works immediately. Som epinephrine works immediately and that's amazing. The problem with epinephrine is epinephrine's really potent and it requires a double dilution. So what I do is I have epinephrine and I haven't, since I've been in private practice, I've, I have not had to use epinephrine, but I used epinephrine like.

Every week when I was at the surgery center, it's like a little tiny bit, and so then what I do is I have 100 CC bags, and then I will draw the epinephrine, which is one milligram, which means it's 1000 micrograms. So I take one milligram and I put it in a hundred cc bag. That a hundred cc bag is now 10 micrograms per cc.

So 10 micrograms times a hundred is a thousand micrograms or one milligram. Now if you're in a hurry, this is the best resuscitation thing that there is because if someone is a, has a heart rate of 30, and you give them 10 micrograms of epinephrine, which would be one cc, their heart rate's gonna go to 90 95.

There's a chance it might go to 110, but probably not. If you gave them a milligram of epinephrine, their heart rate is gonna go straight to 200. So then they, they, they could die. Like they, you could, you could drive someone all the way into a cardiac arrest by giving them a milligram of epinephrine, uh, often.

Uh, people will put epinephrine. You can put epinephrine down an endotracheal tube and you can get some absorption. You can inject it. Im, and, um, uh, but, but the, the reason they call it a double dilution is you would normally draw it up. And throw out nine ccs and then draw it up again. But what I found is it's much safer and quicker to have a hundred cc bag, put it in there, and now you have a bag and you're just gonna give one cc at a time of that solution.

And so then, um, and so then those are, those are gonna cover all your major bases, um, of, of. Of problems. I'm just speaking, I haven't thought about this in months, but I'll, I'll look at my, I'll look at our, our crash cart and if, if there's anything to add, I'll, I can go through that. So, no, no. Benadryl. Oh yeah, no, we have Benadryl and we also have Decadron.

Okay. And, and so then those are both super useful because Benadryls are real easy to just open up and give 50 milligrams as a push. Um, I'll give, if I think there's an allergic reaction, I'll, I'll, I'll give. Decadron. Um, remember if, if I'm worried, I'll give Decadron as a push. I, I have no problem giving Deron as a push if I think that there's an a bad allergic reaction.

Um, if you give 10 milligrams of Decadron as a push, what happens is, is that, um, people, uh, will get a. Profound, 10 out of 10 itching in their genital area, and they will say, I feel like my genital area is literally on fire. It's burning. If you put the Decadron in a 100 cc bag, or you just kind of infuse it slowly, they won't have that problem.

So it's useful just to know that as a data point. Um, uh, And then we, I have ranitidine and, and, uh, stuff like that, um, uh, in there too for symptom management, but

thank you. Yeah. Oh yeah. Hold on a second. Hey, Jan. Unmute. Unmute yourself and tell us about the, um,

the, uh, surface plasma reactivity. Yeah. Yeah, so the, um, this is a lab director. His name is Dr. Hansman. He's originally from Sweden and he came to Canada, Tobolt Canada's First Health Canada approved, uh, genetic sequencer for, for, for humans. And I be, he's been doing mostly brain stuff and about a month ago we were chatting and he was pivoting to using surface plasma reactivity.

Which is a new kind of antibody testing and I've been sending people to him in the last two weeks. They're just validating. So people were PCR positive nasopharyngeal swab, and he can now, um, check the levels of antibodies as well as the antibody affinity. And a lot of labs I heard, uh, Helen speak last night for ifm.

And a lot of the, the lab testing that's out now in the us uh, they basically checking for regular coronavirus. Yeah, obviously when I check for coronavirus too, uh, the SARS COV two. So they've already checked, uh, the four, uh, regular coronaviruses that's been out like the regular cold viruses and they are checking four epitopes of the, no, the novel CO cov two.

They should be ready for primetime in about two weeks. They, they're looking for a, a, a US distributor. Um, they're talking to a lab corp distribu in Canada called, uh, Dynacare. So we hopefully do to launch that in about two weeks. Yeah, that's a problem because if you're the, and I have had 25 people that I have spoken to that were like, oh yeah, I had a fever of 103 degrees.

And I lost my sense of smell and I got, I cold and I got a pneumonia and then I got tested. But I'm negative. I'm Were those the lateral flow test or were they like Quest? It was both an it. Those were antibodies. The bunch of those were antibody tests, which were probably looking at a different virus. But then some of some of those were also swabs.

Yeah. A lot of it's false, false negative and false positive, which is even worse. Mm-hmm. Yeah. So then we'll, uh, we'll interview, uh, Helen, um, Sier and we'll see what she has to say cuz she's, she's my guru on testing. Yeah. Yeah. She interviewed Dr. Reman on Tuesday, so she should be able to give you a good answer.

Okay.

All right guys. Well that was, uh, a little mold update. Um, I hope that was helpful for everybody. That's great. That brings us to the hour, full hour. Thank you. Okay, you perfect. Stay safe. Okay. Stay safe. Have a great day. Take care.

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