Bambini June 2017 Newsletter 
What Is Photobiomodulation??
Photobiomodulation (PBM) describes the use of red or near-infrared light to heal, regenerate, and protect tissue that is either injured or inflamed.

 The brain suffers from many disorders that can be put into three groupings: traumatic events (e.g. stroke, traumatic brain injury), degenerative diseases (e.g. Alzheimer's,  Parkinson's), and psychiatric disorders (e.g. depression, anxiety, PTSD). Autism, PANDAS, and ADHD might be included here as well.

There is some evidence that all these seemingly diverse conditions can be beneficially affected by applying light to the head. There is even the possibility that PBM could be used for cognitive enhancement in normal healthy people!

For instance, Naeser et al studied 11 patients that were anywhere from 1 to 8 years out from a traumatic brain injury. The patients were treated with a cap that contained 11 LED lights three times a week for six weeks. Each session lasted about 10 minutes and delivered about 2500 joules. Testing after the 18th treatment showed significant improvements in executive function and verbal memory as well as reduction in PTSD symptoms.

PBM improves mitochondrial function -- increasing oxygen consumption, production of ATP, and cellular energy stores. Nitric oxide is released which leads to increased regional blood flow.

Can you walk into CVS or Walmart and pick up a photobiomodulation device? Well, not yet. But various products are starting to appear online such as the Quantlet,  Vielight and Joovv. Inexpensive infrared security LEDs are being suggested by some biohackers as a way to bring this technology into the home at minimal cost.

There are two basic ways to deliver this light: LEDs which are familiar to us, affordable, and very safe. As you might imagine, because the light emitted is not coherent, they can't penetrate very far into tissue.

The other light source is low level or "cold" laser.  These are referred to as therapeutic as opposed to surgical lasers. Therapeutic lasers have been broadly categorized as to either "Class 3" or "Class 4" based on power output.

For the last three months, Bambini has been selectively treating a small group of patients with a powerful class 4 unit called the K-laser. To date, we have treated inflamed tonsils, sinuses, lymph nodes, joints, tendons, and muscles.

One little girl with complex regional pain syndrome (also called reflex sympathetic dystrophy) in her right ankle, which typically takes about two months to respond to standard care, was symptom-free three days after a single treatment! Over the coming months, we hope to offer class-4 K-laser therapy to larger numbers of patients.
Herbs for Lyme: Pinella & Houttuynia
Japanese Knotweed 
The recent report that stevia has remarkable efficacy in the test-tube against Borrelia burgdorferi has further stimulated interest in the use of herbs to treat tick-borne pathogens.  Today, we'll touch on a couple of these.

Pinella is the brand-name of a (44-proof) tincture made from Pimpinella anisum (anise) stems.  It is a component of the Cowden protocol and, based on rodent studies that showed anti-convulsant and neuro-protective effects , has been used to help brain fog in patients that have been clobbered by Lyme.  
 
Efficacy of Pinella in Lyme or brain fog is based solely on anecdotes.  There are no published clinical studies.  Bummer.  On the positive side, it is very safe (no one has ever overdosed on biscotti!) and quite affordable ($20 in the Bambini apothecary).

Houttuynia is another Nutramedix product prepared from the chamelion plant (aka fish mint, fish leaf, or bishop's weed).  Leaves are heart-shaped, and the plant can be quite invasive. 

Houttunyia extracts have been shown to have strong anti-inflammatory effects.  Components of the oil have both anti-viral and anti-bacterial effects; they also appear to have potential in cancer, allergy, and diabetes.

Clinically, it is said to be helpful for Bartonella.  Again, however, there is no published research.  As an edible herb, however, it is very safe and used as a garnish -- if you don't mind the fishy taste!  $26 at Bambini -- lower than most online prices. 
Detox Options for Lead Exposure
Twenty years ago, when the CDC started reporting on this matter, about 7% of children in the US had blood lead levels over 10 mcg/dl. In recent years, that figure has dropped to about .5%. Good news! Closer to home, not surprisingly, lead exposure is primarily of concern in the 12601 area code. Bambini's experience has been in line with these numbers.
 
The recent public health fiasco in Flint, Michigan has unfortunately brought lead toxicity back into the spotlight. Over the last couple years, we have heard reports that water fountains in a number of area schools, for instance, have been shut off due to higher than acceptable lead content.

What options are there for families that live in urban areas where there are many home built before 1970 or where there has been questions raised about lead in drinking water?
 
As prescription drug options such as DMSA and EDTA are limited by their own potential toxicity, the CDC focuses on avoiding exposure and monitoring levels.

Parents concerned about low grade ongoing exposure may be interested to know that garlic has been shown to work even better than penicillamine, one of the drug options for high leads. Michael Greger MD has a brief video on this and related studies.
 
Other options that parents could consider include:
Blinkhealth vs GoodRx
Early last year, another Rx cost-comparison website went live:  BlinkHealth.  One of our staffers heard good things about it.  So we decided to put it to the test.

First, we checked prices for ProAir HFA, an asthma inhaler comparable to Ventolin or Proventil.  The best price listed on BlinkHealth was $130.51 at Walmart.  With their $5 off first time use coupon, that would bring it down to $125.51.

How did GoodRx, the old standby, do?  With their discount coupon, which you can print out on the spot, you could walk into almost any pharmacy -- CVS, Walgreen, Rite Aid, etc -- and pay just $50.75.  Big difference!!

Maybe that was a fluke.  What about acne medicines.  They drive us crazy because very, very few are covered.  So we looked up Differin Gel .1%.  Again, on Blink the best price we could find for a 45g tube was $148.  Ouch -- going to have to live with some pimples!

A search for Differin on GoodRx, on the other hand, led us to a generic equivalent called adapalene.  (Did you know that 90% of the prescription drugs sold in US are generic?)  Moreover, GoodRx advised us that adapalene is now available without a prescription (we didn't even know that), and you could pick up a tube at Walmart for $57.  That 's about $90 less than what BlinkHealth gave as best price!

Moreover, to use GoodRx, you simply type in the drug name, hit search, and the prices pop up.  With BlinkHealth, you have to register and even agree to SMS messages on your cell phone -- not good.  To delete your Blink account, it takes several email exchanges.

We also like the GoodRx app -- which, like the website, is free and user-friendly.  This contest wasn't even close!
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