Posting your progress updates

Post updates describing your progress regularly. Those who do this generally have the best success on the Marshall Protocol. When in doubt, post your questions in your progress thread so that others can provide you with support.

• It is one way to give back to the community that is supporting your recovery. Your updates will give newer members a glimpse of your experiences that may very well help them along on their own journey to recovery.

• Updates provide members of our support community with information that may help them to identify when your situation may need additional support.

• Updates provide a record that can be referred back to when looking for historical patterns and trends when addressing the current issues you are experiencing.

• Historically, members that post regular updates have had the best success with managing the protocol.

In addition to logging in just to post progress to your own thread, there is a demonstrated value in regularly connecting in with our larger support community.

• One helpful way to make tracking your progress go smoother is to keep a more detailed daily journal that you can refer to when composing your weekly progress updates.

• Clarity will be improved by avoiding abbreviations and unexplained notations.

• Accuracy is very desirable.

• Some brevity is good.

• Important details tend to get lost if they are not highlighted in some way. Try to keep any longer narrative for the comments section. For long posts, adding a summary at the end may help readers catch the key points of your update.

• It is recommended that you compose your progress updates in a file on your own computer and save a copy of your update for your records. (Just in case a technical glitch drops it from the site.)

The frequency of your posts should track with your current status. For example, new members just getting started, and those who are not managing their symptoms very well, often find that posting every few days can allow better support from our community.

For those who have reached that near recovery point, another excellent way to give back to this community is to take the time to provide support to those who are just getting started on their MP journey.

Starting each progress update with a single number rating your overall symptom tolerability for the past time period on a scale of 1-10 gives yourself and other readers a quick idea of what you have been experiencing.

To help select a number, the following scale is provided: 1-3 = symptoms have been negligible, 4-6 = symptoms are tolerable, 7-9 = symptoms are intolerable, 10 = on the way to the hospital.

Overall symptom tolerability: 6/10

Include the following (if available):

• Pre-MP result of 1,25D testing in pg/mL with date. Please convert units if necessary (See 1,25D units of measurement).
• Any results of 25D testing in ng/mL with date; e.g. “12 ng/mL Dec'07”. Please convert units if necessary (See 25D units of measurement).

PreMP D-metabolites: 1,25D=50 pg/mL, 25D=20 ng/mL Jul'09
25-D testing history: 17 ng/mL Oct'09, 14 ng/mL Jan'10, 10 ng/mL Apr'10, 6 ng/mL Jul'10

Include the following as appropriate:

• MP start month and year.
• List months when not on full doses of Benicar/olmesartan and total months on full break
• List any antibiotics taken and indicate months on each

You may use the following abbreviations:

• O = olmesartan/Benicar
• M = minocycline
• B = bactrim
• C = clindamycin
• D = demeclocycline

MP start: Jul'09
Benicar/olmesartan breaks: Feb'10, Sep'10 (2 months)
Antibiotic history: M Aug-Oct'09, M+B Nov'09-Jan'10, M+C May-Jul'10, M Aug-Oct'10

For each of your MP medications, include doses & schedules for each, flagging any changes, and listing number of days at current dose/schedule as appropriate.

MP medications:
Benicar/olmesartan 40mg every 6 hours (since Jul'09)
Minocycline 50mg every 48 hours (decreased from 100mg 7 days ago)

List one medication/supplement usage per line (give purpose for item in parentheses following). For those weaning from steriods, please list total daily dose plus time of day and how much taken at each dose and please indicate number of days at current dose/schedule.

Non-MP and/or palliative medication use:
Benedryl at bedtime last night (to help get to sleep)
Homeopathic dry eye drops at bedtime every evening last week (to soothe irritation)

List normal daily exposure, your response, and any unusual events during period. Sometimes this provides hints as to the cause of increased symptoms.

Light exposure:
Sunlight, 20 min.s during drive to/from work; covered, 2% NoIRs, leather gloves, some face exposure
Indirect sunlight, 1 hour while sitting in shade 2 days ago, 10% NoIRs, covered, 6% zinc sunscreen
Watched movie in theater last night; forgot NoIRs (had hard time getting to sleep after)

List each symptom on a single line with severity first, then the symptom description. Note if they were constant or intermittent. List only those that are significant and recent. Indicate if they are tolerable or intolerable.

Rating them at their highest for the week shows how you are doing since symptoms should be tolerable at all times.

Symptoms: (severity on a scale of 1-10)
4 - Rash and itching on shins, constant, tolerable
6 - Joint pain in fingers, intermittent, tolerable
6 - Post-exertional fatigue, constant, tolerable
8 - Orthostatic intolerance, intermittent, tolerable

Often it is helpful to provide some brief comments about any observations you have made about Your symptoms, mood, or external situations affecting your sense of well-being.

Comments:
Increased level of stress this past week due to family situation. However, mood stayed good, which is an improvement.

Identify if you plan to keep things about the same or if you are considering any changes.

Plan:
Will stay at lower dose of minocycline until family stress lets up.

List one test result per line and be sure to include the lab range. It is helpful to make some type of identifying mark on out range labs.

If posting all test results seems too overwhelming, is ok to only list the names of tests with “within-normal-limits” results.

New test results:
3 Hour Glucose Tolerance Test
Glucose, fasting = 88, (<95 mg/dL)
Glucose, 1H post 100G GLUCOSE PO = 125, (<180 mg/dL)
Glucose, 2H post 100G GLUCOSE PO = 102, (<155 mg/dL)
Glucose, 3H post 100G GLUCOSE PO = 81, (<140 mg/dL)
(all results normal)

If you have any questions, include them at the end so they will be easier to find.

Non-urgent question format example:

Questions:
Just wondering if anyone else has had the same experience as I wrote about?

If you feel you have an urgent question, you might want to post it in bold, uppercase lettering. In addition, in a crisis situation you may send private messages to 2 or 3 members of the support team, asking for a timely response.

Urgent question format example:

Questions:

SHOULD I BE WORRIED ABOUT MY NEW AND SEVERE ABDOMINAL PAIN?

This is an example of an entire progress update in our suggested format that you can use as a template for your own posts.

Posting date: 20.Oct.2010
Overall symptom tolerability: 6/10

PreMP D-metabolites: 1,25D=50 pg/mL, 25D=20 ng/mL Jul'09
25-D testing history: 17 ng/mL Oct'09, 14 ng/mL Jan'10, 10 ng/mL Apr'10, 6 ng/mL Jul'10

MP start: Jul'09
Benicar/olmesartan breaks: Feb'10, Sep'10 (2 months)
Antibiotic history: M Aug-Oct'09, M+B Nov'09-Jan'10, M+C May-Jul'10, M Aug-Oct'10

MP medications:
Benicar/olmesartan 40mg every 6 hours (since Jul'09)
Minocycline 50mg every 48 hours (decreased from 100mg 7 days ago)

Non-MP and/or palliative medication use:
Benedryl at bedtime last night (to help get to sleep)
Homeopathic dry eye drops at bedtime every evening last week (to sooth irritation)

Light exposure:
Sunlight, 20 min.s during drive to/from work; covered, 2% NoIRs, leather gloves, some face exposure
Indirect sunlight, 1 hour while sitting in shade 2 days ago, 10% NoIRs, covered, 6% zinc sunscreen
Watched movie in theater last night; forgot NoIRs (had hard time getting to sleep after)

Symptoms: (severity on a scale of 1-10)
4 - Rash and itching on shins, constant, tolerable
6 - Joint pain in fingers, intermittent, tolerable
6 - Post-exertional fatigue, constant, tolerable
8 - Orthostatic intolerance, intermittent, tolerable

Comments:
Increased level of stress this past week due to family situation. However, mood stayed good, which is an improvement.

Plan:
Will stay at lower dose of minocycline until family stress lets up.

New test results:
3 Hour Glucose Tolerance Test
Glucose, fasting = 88, (<95 mg/dL)
Glucose, 1H post 100G GLUCOSE PO = 125, (<180 mg/dL)
Glucose, 2H post 100G GLUCOSE PO = 102, (<155 mg/dL)
Glucose, 3H post 100G GLUCOSE PO = 81, (<140 mg/dL)
(all results normal)

Questions:
None, thank you.

• Type up your progress update in a simple text editor on your computer first. It is best not to use an application like “Word” because it will embed hidden characters that may not display correctly.

• Click the green {My Account} button (found at the top right of each page).

• You should see your progress thread listed in the {Watched Topics} tab.

• Click on the link to your your progress thread.

• Click on any green {Reply} button (these are found to the right of each post in the thread).

• Paste a copy of the text of your progress update from your computer's text editor into the text box on the reply page.

• Click {Send} on the bottom of the page. (Please do not hit send twice, it will simply create double entries.)

You will want to check to see that the post is displayed correctly.

• If you find the post needs a correction, click on the green {Edit} button along the top right of the post.

If you have not already created a progress thread, you will need to create one using the following steps.

• If you are not already logged in, log in to the site.

• Add a New Topic by clicking here: Getting Started Forum.

• In the subject line type your given name (and username) in the format shown in the example here:

Subject: Jim's updates (jjtop)

• In the description line type any diagnosis you may have in the format shown in the example here:

Description: Sarcoidosis (lung, neuro), hypertension

• In the body of your first post, you can share a little about how you found the MP and your experience to date on the protocol.

• When your post is ready, click on green {Send} button (to the bottom right). (Please do not hit send twice, it will simply create double entries.)

You will want to check to see that the post is displayed correctly.

• If you find the post needs a correction, click on the green {Edit} button along the top right of the post.