Friday, March 30, 2018

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

My Bio:

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

I think outside the box.  I have a deep appreciation that there are many ways to solve a problem, and my job is to find the method that works best for each individual's needs.  I use medicines, supplements, diets, and other healing modalities, as needed, for tough clinical problems like chronic fatigue syndrome, chronic lyme disease and fibromyalgia.  I get great joy in finding the right diagnosis and solutions for patient problems that have lasted years, or even decades.

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

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

I opened this new medical practice (coming out of an early retirement in 2017) because I can offer an approach that is not duplicated locally, or anywhere in Maine.  I have been blessed with a high rate of recovery in my patients.  I want to offer my services in a way that is respectful, comprehensive, and caring. I am available when needed.  I reserve 1/2 day to meet with new, complex patients and will address all their medical problems.  My fee for this evaluation is $300, or what the patient can afford.  Follow-up visits are generally $75 each and last 30-60 minutes.

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

I hope to see patients with challenging disorders, those who wish to reduce their medications and/or use diet and lifestyle changes to improve health, and those with illnesses occurring after tick bites, fibromyalgia-related, or a consequence of military service or anthrax vaccine.  I will also treat the range of illnesses seen in primary care internal medicine, and I love to work with patients to achieve optimal wellness.  Help choosing the right diet (specific to each individual) can be an important part of my care.

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

* Remember to use tick protection when off the asphalt in coastal Maine.  Maine has the highest per-capita rate of Lyme Disease in the US, and Hancock County had the highest rate of Lyme cases in Maine last year.  Not to mention other tick-borne disease...

Saturday, February 17, 2018

84 Pediatric deaths from flu this season/ it is looking much like the 2014-5 season/ CDC

"What's interesting about this season, however, is that while persons 65 years and older are always most affected in terms of rates of hospitalization, children aged 0-4 years (who are normally the group with the second highest hospitalization rate) are not. Rates of hospitalization in children are either similar to or lower than those of prior seasons...As of early February, CDC reports that there have been 63 pediatric deaths to date. As I noted, this is not out of proportion to what has been seen in prior seasons. "

Click on image to launch interactive tool

Sunday, February 4, 2018

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

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

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

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

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

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

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

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

The WaPo article is here.

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

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

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

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

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

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

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

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

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

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

Click on image to launch interactive tool

Wednesday, January 3, 2018

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

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

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

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

January 2, 2018

Dear Legislators:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Saturday, December 16, 2017

You may have heard we are seeing more early, dangerous flu this year. Not true. Look at CDC's own figures

No need to run and get that flu shot, the one that is reported to be only 10% effective this year. Yes, the same flu shot that will get me 10% off my grocery bill, if I get vaccinated at the supermarket.

When you consider that a shot this year would likely make shots less effective in the next year, there is no reason at all to get it.

While the flu season is starting early this year, comparable to 2014 (see first CDC graph), deaths from flu and pneumonia are considerably lower than at this time of year in 2014, 2015 and 2016 (second CDC graph).  So:  is it really a bad flu season?

national levels of ILI and ARI

INFLUENZA Virus Isolated

Jordan Grumet: I Have to Admit It: I Don't Love Being a Doctor Any More

Here is a short article, by a doctor I don't know, which explains how the medical 'system', which changed during the Obama administration with a bucketload of new demands, has ruined the profession of medicine for doctors, and brought it to its knees for patients.--Meryl

I'll never leave, but the joy is gone, says Jordan Grumet, MD

  • by 
I have a breathtakingly difficult confession to make. A confession that on its face seems rather innocuous but in many ways shakes the foundations of who I always thought I was, and how I identify myself.
I no longer love being a physician.

There -- I said it. I winced even as I strung the words together to write the sentence. You see, to admit this is almost inconceivable. So much of who I was and who I have become is enmeshed in this intricate quilt of a profession. I view most every aspect of my life through this lens.
How could I not? Wanting to be a doctor is the first cognition I can recall from childhood. A childhood marked by a learning disability which brought into contention the idea of being a professional at all. A childhood in which a father's death became a precursor, a foreshadowing of who I was fated to become. I would follow in my father's footsteps. I would finish the work that was prematurely wrenched from his clutches. There was never a question whether I would succeed. The calling was too great, the pull too strong.
To deny my profession is to deny my father's legacy and to deny my own reflection.
Yet, here I stand. It didn't happen all at once. Medical school was difficult and time-consuming, but it didn't happen there. Residency was strenuous and terrifying, but it didn't happen there. My first days as an attending were grueling and sometimes awful, but also energizing.
I suppose the change happened sometime after we started using electronic medical records. It happened with meaningful use. And MACRA. And Medicare audits. And ICD-10. And face-to-face encounters. And attestations. And PQRS. And QAPI. And the ACA. 
What I do today is no longer practicing medicine. Instead it's like dancing the waltz, tango, and salsa simultaneously to a double-timed techno beat. It's sloppy, rushed, unpleasant to look at, and often leaves my partner more confused and anxious than when we started.
I have become ineffective. Not by the weight of ever-expanding medical knowledge or even the complexity of the human body. Instead, my hard drive is being spammed by thousands of outside servers.
But make no mistake, I'll never leave. My love for taking care of people is unwavering.
As for the joy and utter exhilaration of what used to be -- frankly, it's all been legislated out.
Jordan Grumet is an internal medicine physician who blogs at In My Humble Opinion

Tuesday, December 12, 2017

Ex-Spy Chief Admits Role In 'Deep State' Intelligence War On Trump/ Zero Hedge