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 easier 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.)

• 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. Avoid other display problems by selecting for your update notes a font found on the MPSS - Arial, Comic sans, Courier New, Georgia, Impact, Tahoma, Times New Roman, Trebuchet or Verdana

• 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.

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.

Please try to keep your signature line up to date so that other members of our support community can best understand your situation and experience before responding to your posts.

Composing a detailed progress update may seem too overwhelming at the start, but breaking it into smaller bits of information can make the task easier. Then, once the basic format is created, each new update can be an edited copy of the last posted update, meaning less effort going forward. (Some find it helpful to print the following instructions and work from a paper copy.)

Start each progress update with a single number rating your overall symptom level for this time period on a scale of 0-10.

This gives yourself and other readers a quick idea of what you have been experiencing (to help assess the tolerability of your symptoms). This overall number may be slightly different from your “highest” level ratings given in the symptom details listed down further into your update.

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 level: 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

MP start: Jul'09
Benicar/olmesartan breaks: Feb'10, Sep'10 (2 months)

Since early adopters were using antibiotics, this antibiotic history is of interest, even though antibiotics are no longer considered a key component for recovering immune function. For those that have used antibiotics taken at older protocol dosing, they may also add this history, including months on each. (abbreviations: M = minocycline; B = bactrim; C = clindamycin; D = demeclocycline)

Antibiotic history: M Aug-Oct'09, M+B Nov'09-Jan'10, M+C May-Jul'10, M Aug-Oct'10

Current Benicar/olmesartan dose & schedule, flagging any changes, and listing number of days at current dose/schedule as appropriate.

Benicar/olmesartan dosing:
Benicar/olmesartan 40mg every 6 hours (since Jul'09), trialed 20mg every 3 hours during recent acute bladder infection symptoms

List one medication/supplement usage per line (give purpose for item in parentheses following). For those weaning from steroids, 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.

Palliative or other medication dosing:
Minocycline 50mg every 12 hours (last 3 days for acute infection)
Benedryl at bedtime last night (to help get to sleep after outing to movie)
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% NoIRsSpecial sunglasses worn by Marshall Protocol patients to block light., 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, kept tolerable by extra care when changing positions

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 a bladder infection. 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 keep up frequent minocycline for a week and watch for signs of infection clearing or not.

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 has tried minocycline for a bladder infection? If the symptoms return, are there other antibiotics that are compatible with the protocol I can ask my doctor 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 level: 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

Benicar/olmesartan dosing:
Benicar/olmesartan 40mg every 6 hours (since Jul'09), trialed 20mg every 3 hours during recent acute bladder infection symptoms

Palliative or other medication dosing:
Minocycline 50mg every 12 hours (last 3 days for acute infection)
Benedryl at bedtime last night (to help get to sleep after outing to movie)
Homeopathic dry eye drops at bedtime every evening last week (to soothe 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, kept tolerable by extra care when changing positions

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

Plan:
Will keep up frequent minocycline for a week and watch for signs of infection clearing or not.

New test results:
3 Hour Glucose Tolerance Test (2 weeks ago)
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.

If you have an unanswered question that requires a timely response, you may send an email to our Admin Staff with a request for a reply in your progress thread.

If you decide to take a break or stop the protocol, please post this in your progress thread so that we can include your current status in our study data. In particular what medications you were taking at the time you began to wean or stop the MP and the date that you ended your treatment.

As participant in a long term study, your continued status, whether on or off the protocol is an important part of study data.
Updates at least every 12 months are the most helpful. Your post-protocol updates will be very much appreciated, however, we do ask that you refrain from advocating or promoting any non-MP treatments in your posts on the forums. Think very far ahead and consider leaving information with that trusted person, the executor of your will, on how to post here to advise the Research team of your certified cause of death.

When you are no longer on the MP or are simply taking a break for a while, you are always welcome to post any questions you have regarding the Marshall Protocol and how it may apply to your current health situation.