experienced or functional dr?

[elee1222]

Hi,
I would like to start the AB protocol for inflammatory arthritis. I have an appt with an experienced doctor from the list I requested, but not for another month. Would it be better to have my functional dr (who doesn’t have much experience with AB) start me now and have the other dr. take over, or wait to start with the experienced one? I am eager to get started, but I weigh less than 100 lbs, and it seems that dosing might need to be adjusted.

Thanks, Elizabeth

[Maz]

@elee1222 wrote:

I would like to start the AB protocol for inflammatory arthritis. I have an appt with an experienced doctor from the list I requested, but not for another month. Would it be better to have my functional dr (who doesn’t have much experience with AB) start me now and have the other dr. take over, or wait to start with the experienced one? I am eager to get started, but I weigh less than 100 lbs, and it seems that dosing might need to be adjusted.

Hi Elizabeth,

Is the “experienced doctor,” Dr. F. in CA? If so, I understand his preference is for folks new to AP to have labs for mycoplasma run prior to their initial visit and they may send a new patient packet to have these labs run in advance so the results are available upon that first visit (call to check). If PCR myco testing is being run, there needs to be a clear month of no abx ahead of the test. So, this may figure into your equation with regards to starting AP before such a visit, as abx can abrogate the test results.

If you check out the Historical Protocol on the main site, the starting doses that Brown used are outlined there….also at the end of the Brown documentary at the top of this forum (doxy = mino in terms of mg). There is also info in the Henry Scammell book on dosings he used, titrating to patient tolerance, and starting low and slow. E.g. Brown often started patients on 100mg on MWF minocycline or doxycycline, which is equivalent to less than 1/4 used for teens per week with cystic acne, so it’s quite a small dose. Brown’s goal was to prevent excessive herxing from too much die-off, which can ramp up inflammation in the early months, because RAers tend to have extremely hypersensitive tissues that are reactive to bacterial endotoxins (toxins released from dying bugs). All this is explained here on the main site:

https://www.roadback.org/index.cfm?fuseaction=studies.display&display_id=184

Hope this helps in some way?

[elee1222]

It’s Dr. B in PA. Do you know if he requires testing ahead of time?

[Maz]

@elee1222 wrote:

It’s Dr. B in PA. Do you know if he requires testing ahead of time?

Sorry, no, I don’t know. Maybe others who see Dr. B. can elaborate for you when they see this, but would suggest calling ahead to ask if you can have labs drawn prior to initial consult for any myco or other testing needed. He may or may not do this, but worth noting that it can help with getting IVs covered by insurance, as they can then be coded for infection (IV clindamycin is not a standard of care covered by insurance for rheumatic diseases). Each doc works differently and there are many patients who start oral AP with a local doc and then move on to an experienced doc later, if needed, so it shouldn’t stop anyone from getting started with the treatment. It’s just worth being aware in advance that baseline testing prior to starting abx can provide more accurate readings and this can be especially helpful in terms of getting IV therapy covered, if needed. An experienced doc may not determine that IVs are needed for someone with early, mild disease, so early testing for this purpose may be a moot point, anyway. 😉

[Joanne NJ]

I just went to Dr. B in PA on October 9th for the first time and he did not require any labs prior to my visit. He is very into the exact practice of AP with Dr. Brown’s protocol, and mentioned the IV’s, but we did not go that route. I did AP back in 2010 and brought my labs from that time period (remission for me), and he wanted me to do exactly what I had done beore since it worked. Hope this helps-Joanne

[Maz]

@Joanne NJ wrote:

I just went to Dr. B in PA on October 9th for the first time and he did not require any labs prior to my visit. He is very into the exact practice of AP with Dr. Brown’s protocol, and mentioned the IV’s, but we did not go that route. I did AP back in 2010 and brought my labs from that time period (remission for me), and he wanted me to do exactly what I had done beore since it worked. Hope this helps-Joanne

That’s great info, Joanne! Wondering how or if Dr. B. helps patients pay for IVs as Dr. S. will do, coding them for infection. If you or anyone has any experience of Dr. B. in this respect, it might also help Elizabeth. Thanks!

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