Diary of a Mad Scientist

My summer so far:

first of all, I’m sick again. I’m sick of it. I can’t figure out what’s up, except that it seems that every time I get tick bitten, I have some Lyme symptoms about 5 days later. It must have something to do with an immune response to something in tick saliva, or a reaction to some other bacterium or virus, or maybe I was just overdoing it since early May, or… I’ve given up on figuring it out, as it’s just about impossible to do a controlled experiment with my own body to figure this out because changes to my meds, diet, etc, don’t have an immediate effect that’s easy to distinguish from other factors.

I’m taking antibiotics because of the May tick bite and subsequent arthritis/neck pain/tiredness, but also just started some other herbal formulas that tend to knock people out pretty bad. Our end of North Carolina has more ticks this year than ever before- lucky me- and their record numbers have even made the papers. We’re getting covered with them every time anyone walks through the woods. I’ve never regarded my surroundings as being ‘toxic’ before, and it’s really freaky being out on our 80 acres without being able to go for walks in the woods, which I’d spent all winter doing. I’m comparing notes with a couple of other friends with Lyme, and one of them is on the same new herbal stuff as me, and it may be that my new symptoms are a Jarsch-Herxheimer reaction to my antibiotics, some other kind of reaction to the new meds since other people seem to have trouble with them, a reinfection with something (not necessarily Lyme) in May, an autoimmune response, or, or… I don’t know what. It’s driving me a bit nuts. Last week I was doing fine, this weekend’s biodiesel class knocked me out hard, and I’m barely able to function this week. I’m hoping that means that next week will be fine again- who knows.

But, I’m having a blast this summer, since I’ve been mostly well for most of it so far till this week.

Some photos:

interns. I’m running the internship program at the co-op, and I’m having a really good time with it. I’m on-site all the time, I barely see my room anymore, and I’m having an absolute blast.

Now that the first couple of weeks of orientation is over, I’m teaching about 1 1/2 days a week, along with some administrative type crap having to do with the program, and doing some work-days coordination. They’re giving the co-op campus a complete makeover, working on documentation for the equipment at the site so that Piedmont can put more of their technical innovation up on the web, and learning a ton. They have me for a day and a half a week and Bob Armantrout for two hours a week. I go to Bob’s biodiesel business basics class just to heckle him. It’s a blast heckling someone who’s teaching and knows more than me- my damn workshop students do it all the time.

It’s about a month into the program and I think everyone’s got a pretty good idea about biodiesel quality control. I’d looked at my syllabus material this spring and figured out that I have enough material to cover about 10 weeks of lessons pretty intensively, and I’m quite happy this week to see that the interns are just about where I expected them to be. We’ve been playing in the Yellow Garage in the ‘lab’ and with my portable Appleseed equipment- we basically have ‘real’ production at the co-op, where fuel production meets ASTM specs and timelines matter, and then we have my experimental teaching/R&D facility, exactly what I’ve been wanting in California for the past few years.

Next week they get to graduate to the ‘real’ co-op, where making mistakes matters a whole lot more. They have an assignment to get to that level, though- completing a batch in the Appleseed stuff on their own. It was cute watching them spend an hour developing a protocol for what valve they were going to turn when, label everything and name it, etc. Good process to go through.

I love being on-site all the time. I’ve got a hybrid shop/classroom, and it’s staffed with all my small, portable tools, and I’m surprised at how good of an R&D facility it’s become. I’ve been working my butt off on the benefit classes we organized for the last few weeks and haven’t been able to get my head above water since mid-May- there was a four-weekend series that helped fund the internship program. The drawback is the barn/shop/classroom setting is that it’s damn hot here this time of year- we actually overheated a few people in the first two weekend classes (the next one , the Advanced Topics class, should be in air conditioning at least most of the weekend).

System Tricks class designs their theoretical process and equipment:

I decided early on that the internship should include making sure that some basic skills and tool use were covered, whether they’re relevant to biodiesel or not. I got to inflict this on one of the farm interns, too- there are three farm interns living here at the co-op, in addition to the biodiesel ones in my program. Here’s Becca from the farm making herself some printmaking blocks out of a piece of MDF and learning about the different ways to jig a circ saw, and yes, that’s a gigantic load of oil behind her:

These are two of the three biodiesel interns working on the solar cooker project- Susannah, with the red hair, and Joanna, in the red shirt, who are here partially out of an interest in sustainability. This weekend they get to do their first ‘tabling’ session at the Eno River Festival, where the co-op gets to answer stupid questions from random visitors about biodiesel. Today a bunch of us veterans talked to them about what to expect when tabling and gave them some ’sample questions’ to think about (such as ‘I heard that biodiesel takes food away from starving babies, what do you think about that’) .

In the midst of all this, there’s a big re-design of the Piedmont oil handling protocol going on. For the past couple of years, they’ve been settling oil in 275-gallon IBC containers in a poorly functioning passive solar building, which is a really clunky and ineffective way to do things (you can’t heat oil with warm air alone and expect anything significant to settle out of it, which means you have to either throw out 25% of your oil (which they do) or be super-selective about the kinds of oil you can accept (which they also have to do). We’ve finally figured out how to fund a real waste oil burner type of boiler system. One of the interns is starting off his summer by trying to fix up an old waste motor oil furnace we had around, though there’s been an immense amount of thought and meeting time put into ideas for homemade waste oil burners. Of course, I dragged out the Turk again. I’m a huge fan of vaporizing burners rather than atomizing ones, and a couple of weeks ago, one of the locals introduced me to a Sanford former homebrewer who has a really fantastic Turk-burner-based backyard metalcasting furnace. Chuck’s Turk burner does everything that I’d wanted to try next. We had a powerhouse meeting or two over at his place in sanford, geeking out on level control, heat recovery, and more. One of Chuck’s big innovations was basically to add refractory cement to the burn chamber, which I’d thought about last year but never got a chance to try.

I dug out another blower for mine and am just about to move on to the heat exchanger end of things. In the meantime it’s still a fun party trick unit.

Here it is again, the Turk Burner as a ’scientific theory generator’- people can’t stand around this thing without going on and on about what they think it’s doing at various points in it’s burn cycle.

And, last but not least, I’m really proud of the fact that we’re moving ahead on heat problems 6 months before they’re really an issue. That’s major progress around these parts- moving ahead rather than just responding to emergencies.

This year, summer solstice was 8 pm on June 20th. I happen to have spent that exact moment in the best way imaginable- at the end of a long work day, with my new-again boyfriend/co-worker Greg, lazing in the co-op’s front yard hammock in the stifling North Carolina heat, running plans and scenarios for burner and heater options for the co-op. On the longest day of the year, we were trying to imagine what the frozen fingers and short daylight hours and 20F nights were going to be like in December. I’m psyched to have this playground for bouncing these burner ideas off of people.

Through this all, I feel like I’m at Biodiesel Summer Camp. Appropriately, there’s a summer fling. Greg and I were hanging out earlier this winter, but it’s a lot more fun this time around, especially with the Summer Camp focus- I’m teaching him how to weld, he’s supposed to teach me to use a chainsaw, and we’re throwing around ideas for Turk Burner fun and games for the classroom site and a possible future experimental boiler, and some random Weird Science. I get to run home (he’s also my neighbor) and bounce around the room going on and on about the new acid-base idea I just had. He gets to contribute. It rocks.

It’s been quite a few years since I’ve gotten to work on projects with a partner, which was a source of endless frustration in my last relationship. It’s kind of lame being me, and more or less having to “check the biodiesel stuff at the door” when I came home, since my last partner didn’t really care about it. To some extent, ‘checking the biodiesel at the door’ was my own fault- Tom didn’t require it, but there’s a big difference between basic ‘that’s nice, dear’ tolerance of the biodiesel pursuit and complete obsession with it like happens here in Piedmont-land. I know, what I just described, a bored/uninterested partner- happens to most people who are into biodiesel, and most people’s partners aren’t interested- but I kept feeling that for all the time I’ve invested in the Gods of Biodiesel, I shouldn’t have to end up with one of the heathen unbelievers.

My summer feels like a complete immersion program into oil geekery. It’s nice to head in that direction with another nerd.

We’ve been working on a plywood solar box cooker as a way to teach some of the circular saw/table saw safety skills to some of the interns and other co-op folks who haven’t used those tools or gotten a good introduction to them before. I used to teach a 45-minute circular saw mini-workshop, and I’m ecstatic that Tim, who’s one of my co-workers at Piedmont and is also responsible for getting the interns edumacated, also enjoys teaching the ‘basic skills’ intros. We had a nice, late-into-the-night-with-Tim-drinking-beer session whereby Tim, who’s all of 22 years old, has an education degree in ’shop teacher’, and is trying his damnedest to be a grumpy old man, expounded on the things that his woodworker daddy taught him and passed on measure-once-cut-twice wisdom to one of the enthusiastic interns.

I’m building a plywood version of the Heaven’s Flame Cooker, the Appleseed of solar box cookers. Here’s a link to the cardboard version of the same design that I’m using- from Joe Radabaugh’s article in Backwoods Home Mag a long time ago:

http://www.backwoodshome.com/articles/radabaugh30.html

and a photo of a couple of cardboard ones:
http://solarcooking.org/images/hflame1.jpg

Joe is (was?) a barefoot oldtimey Rainbow Gathering hippie who got obsessed with building and testing cardboard box cookers, and I’ve made a bunch of wooden versions of his cooker over the years. It’s pretty similar to the steel version sold through Real Goods and the like, such as the one at http://www.sunoven.com/. He figured out a bunch of easy construction techniques and has a great book about the units,

These units reach 350-375F pretty easily as a baking oven, or can be used to cook crockpot/soup types of dishes (I personally used my past ones to make beans, soups, rice- things that waste fuel in long simmering. I also tend to not waste time trying to boil water in a box cooker (think of how slow it’d be to bring water to a boil in an oven- that’s the same situation here, and probably the most common mistake that people demonstrating solar cookers make, which may make them appear impractical). I tend to first bring the food to a boil on a stovetop, then put it into the cooker to finish up, which makes my solar cooking happen in the same amount of time as on a stovetop.

The difference between what we’re doing and what Joe has in the cardboard box plans, is that we’ll have a door in the back of the oven so that it’s easier to get food in and out (his version involves taking off the top glass for access), and that we’re using plywood for greater durability. I’ve had one or two of these last a couple of years in the rain, unpainted. You occasionally have to deal with warped reflectors but there’s not too much maintenance involved even with the cheap materials. I’m still using cardboard for insulation, which is cheap, effective, and non-toxic. I’ve never built a double-glass one before, but Joe’s book described an experiment where he reached 400F air temperature and nearly burned down his own cooker by rotating it to keep it in constant focus, empty, at high altitude, double-glazed.

The biggest challenges to solar cooking in the US are social- changing your habits to plan around peak daytime cooking times (such as having a small cooker at work where you use it to heat up your lunch), or putting food in the cooker in the morning so that it’ll get heated during peak hours, and also remembering that you’ve got something in the quiet cookstove going outside while you’re home (it’s actually quite easy to forget, since people aren’t used to cooking outside anymore).

Idealistic people from rich countries tend to think of these as something you inflict on people in third world countries to save ‘them’ from poverty and to save the environment from ‘their’ fuelwood practices (see Sunoven website above for a typical example of this, actually), but they don’t tend to get adopted that way for many social reasons either. A typical example is a development group returning to a project site a year later to find the cooker being used for storing valuables to keep them from mice or rain while the family continues to use the three-stone fire their family recipes are adapted to.

We don’t really see them in use in the US very often, and there are so many of them deployed as ‘demonstration units’ at sustainability campuses similar to Piedmont, sitting unused, that it’s almost a cliche of what goes wrong with appropriate technology idealism- it’s an awesome technology, and no one ever seems to want to use it. We once bucked this trend at the Bat Cave, a 6-person house where I lived in Oakland (that also had the full-on greywater, permaculture garden, vermiculture compost ‘deluxe worm condo’, composting toilet, bees, and bike library going in the backyard), and the sucker got used for a couple of years by several people in the house for beans quite regularly (everyone had spent a lot of time in Mexico and made a lot of bean dishes every single week) and occasionally other dishes.

They work best in situations where you have a kitchen door that faces a south-facing yard, or, even better, a deck off of a kitchen door. We might be able to get this to work at the co-op at the Yellow House. They also work well for reheating of lunches- since there’s no microwave, and a number of employees come and go throughout the day, I’m guessing that’ll be the most common use.

I’ve also thought about building a small monitoring panel to see if that furthers acceptance by US users- something like a remote thermometer in the oven that monitors either oven temperature or food temperature, and a control panel with audio timer/alarm and other info in the kitchen, that reminds you that you’ve got food out there and tells you how long it’s been heating.

There’ve been some attempts at building a self-tracking oven such as the one described at this link: http://www.solarcooking.org/plans/Cookerbo.pdf

(usually you have to rotate the cooker once or twice in the afternoon to get full possible BTU’s. However, during most of the year, you can also just set it in the morning, pointed at the spot where the sun will be during peak hours, and your stuff will cook during those hours, but the cooker won’t reach it’s maximum temperature without periodic rotating) .

In a way, what I was doing with the solar cooker is more like what you’d do with a haybox cooker- so if you don’t have a good solar site, you can still cut down on some of your energy use by adopting the ‘haybox’ concept, either as an old-time, bulky haybox, or a more high-tech vacuum-insulated thermos version. I’ve played around with the haybox idea using a Japanese vacuum thermos that had an exceptionally large mouth- this particular one was used for carrying individual tins of lunch foods to work rather than coffee, and worked well for a cooker. The traditional haybox is exactly that- a box that’s insulated with hay, that your pot fits into. I saw one at CCAT in Arcata, CA (http://www.appropedia.org/CCAT)

I feel like the lack of acceptance of solar cookers in the US is due to the principle ‘the perfect is the enemy of the good’- people trying to do the whole thing ‘low-tech’, which isn’t really necessary. You live in a house, you have electricity, if your photovoltaic panels have a control panel so you can monitor what they’re doing, why not design a solar cooker with a simple and cheap control panel to make use easier, or use a bit of electricity or natural gas to make solar cooking more convenient? Similarly, I think I found them easy to use because my objective at the Bat Cave was just to be a cheapskate, rather than be ‘offgrid’- so rather than trying to be completely electricity-free, I found it much more convenient and still energy-saving to use electricity for 3 minutes to bring my bean water to a boil, and then switch to simmering for the same 60 minutes using just the sun, rather than spending 2 hours bringing water to a boil with 300F air and minimal direct heat in the name of purist off-grid-ness. I think that a hybrid approach to sustainability can get you further than the minimalist approach at times.

The following came from deep in the comments section of Lyle’s blog. John Osterhout is a thoughtful engineer from western Washington who makes small-scale biodiesel, and knows farming, and generally does a good job on research. Here’s a good one for the ethanol naysayers:

JohnO Says:
June 23rd, 2008 at 2:29 pm

When I last checked, 45% of US corn was being grown for cattle feed. That obviously takes food out of the mouths of people. Only 19% of corn was grown for people food (not counting HFCS). Roughly an equal % was then being used for Ethanol, but there’s one important point to understand - unlike other uses, a third of the mass used to make ethanol is returned to the cattle food chain as high-value added high protein food. Another third is sold as CO2 (carbonation). The high market price for corn has finally allowed the Gov’t to reduce the subsidy to the lowest level ever! Less acreage is currently used to grow corn than during the American Civil War! (but yields are higher).

Here’re 5 things you can do to free-up corn from fuel to food:
1) don’t eat beef
2) ask the corn farmer to plant sweet corn (for people) instead of field corn (for cows), and pay him a decent amount for the corn.
3) Don’t drink soda pop (to reduce demand for HFCS and CO2)
4) Don’t sell subsidized corn to Mexico - they grew less corn because it was cheaper to buy ours, except for subsistance farmers, who were wiped out by their drought.
5) Don’t drive a gasoline powered car - Ethanol is used to boost the octane of low-grade gasoline.

There, that was easy now, wasn’t it? It wasn’t?, Hmmm, maybe we need to rethink our lifestyles.

There’s plenty of corn, but there’s a shortage of CHEAP corn. The folks who are starving aren’t able to afford to eat, despite a world market that surrounds us all with plenty of food.

About three weeks ago I got my life back thanks to my new immune system drugs. I’m crossing my fingers that I’m one of the 50% for whom they seem to work for Lyme issues. I’ve had an insanely busy life since then, started a new (unpaid, but 3/4 or full-time time) job last week that makes me insanely happy, went on a mini-tour in May, went to California, taught some more classes, built some more biodiesel system, went through a bit more of the ongoing divorce hell, went to Chicago and did an insane number of hours of welding on a co-op’s system there, ran back to North Carolina in time to teach my ‘benefit’ classes for the internship program.

One of these days I should change the name of ‘diary of a mad scientist’ to ‘van blog’.

The van had performed stellarly (??) on the long trip. I’d got back to NC the night before the class, happy that I’d gotten across West Virginia without having to break down and rent anything (the thought crossed my mind). I ran my supermarket/drinks/ice sorts of errands that morning in Greensboro and set out on 421 for the final 45 minutes to Pittsboro. The van suddenly lurched and the engine died. I got out to see a puddle of diesel dripping from somewhere. I called Greg, who was on his way to a dump run in that direction anyway, to come get me and the class supplies, and made the requisite calls to a tow yard to rescue the van, and was delving deep into leak-finding when they showed up to remove the beast. Class went off OK despite overheating a few people on the first day in the heat wave and barn setting.

The following week was the beginning of the new version of the internship, which we were doing quite differently than the way it’d been run in the previous semesters here. I threw myself into a 35 hour work week, something I hadn’t had the energy to do in months. It was fun, and crazy, and we had several interns show up, look at the Piedmont Biofuels co-op facility, and freak out. we actually lost three of them to this routine- they turned around and ran home. Oops. This lost us our college connection- we have to have a minimum of 5 people to be sponsored by the college- and Bob and I decided on the spot that we’d rather work unpaid than deal with the pressure of having to find people at the last moment to fill their places.

I called the tow yard to talk van. The first guy I got was the owner, whose thick accent informed me that he thought I’d lost ‘the ignition pump’. It’s a long-running joke in diesel circles that the gasoline mechanic ‘can’t find the spark plugs’, which is basically what this guy was telling me. I thanked him for his diagnosis and told him I’d come get it and fix it myself. It’s almost worth an injection pump, if that’s what’s actually wrong, for the priceless comedy of hearing that I have an ‘ignition’ anything on my diesel.

I didn’t have a breather coming till Thursday morning, and tried to arrange a ride for the van so I didn’t have to spend any time going to get it. I called them back to see what they’d charge me themselves to tow me to Moncure- they’re a tow shop, after all- and there was a good low price quoted. A few hours later they called me back to say that the owner was in the hospital and that things were in disarray and that he’d said I should find another service to tow myself to Moncure.

Hmm, not good. I set that up, and on Thursday we were hitching up my friend Scott’s enormous equipment-hauling trailer when I gave the van tow yard another call to see if they could get the van drug out and ready for our rescue attempt.

And it turned out that the tow company owner had passed away the night before.

So, the van still sits in the tow yard.

So far Van Blog has consisted of:

-van gets hit by old Buddhist lady coming out of church who backs into it’s open door while my mechanic friend worked on it. In the process, the old lady narrowly misses killing my friend, who was hanging out of the van working on the fuse box or something at the time it got hit.

Buddhists try to get it fixed using ’someone we know’, which leads to many fiascoes when it comes back with the door all crumpled - they’d just bent it back- rather than actually repaired. Buddhists get the other side of the van heavily dented while taking it to the ’someone we know’ garage. Buddhists eventually get it right with another shop months later that fixes both sides.

-van goes to Chatham Alignment for minor vacuum pump work that I didn’t feel like doing myself. Chatham Alignment burns down, with van narrowly escaping certain death when some passing heroes decided to save ‘the customer with the out of state plates’ instead of Kevin’s expensive wrecker truck.

-van gets towed for fuel leak. Owner of tow truck dies unexpectedly.

I’m starting to worry a bit about what will happen when I start doing my own work on this thing again.

I took the van for a spin after it came back from the burned garage, and everything was fine- the transmission survived the van’s being dragged by my rescuers (I believed Kevin on that point, of course, but had a nagging worry that something would be expensive as a result of the near-loss).

I’d forgotten how many systems are affected when the vacuum pump acts up- that’s what Kevin had just fixed when the fire happened.

It was raining hard yet again, I spun myself down Highway 1 in the dark, stomping on the accelerator and doing all those other evil things we like to excuse in the name of ‘test drive’. I spun the beast up to 90 mph, committing various crimes against future generations’ climate in the process, listening for new noises and trying to re-connect with the sound of this beast before I set off on a mini-tour across the West Virginia mountains, to Ohio and Chicago. I’ve been driving an 81 Rabbit in California most of the spring and hadn’t driven the van much for much of the winter. The van had just gotten updated registration and I felt freedom kicking me in the brain, watching mentally as this big grin started to spread across my face as the exciting reality of the impending trip crept up.

And I got this ice-cold, stirring endorphin shiver when I heard the whistle of the turbocharger kick in. I hadn’t heard the turbo in months as it’s affected by vacuum leaks and I hadn’t been driving. I hadn’t felt that whole-body shiver since the last time I saw an old flame unexpectedly.

I think I’m in love with this thing.

These are a few of my favorite things:

turbochargers

diesels with nothing noticable coming out of the tailpipe

Crosscountry trips in the van in my pajamas. Yep, it’s my bedroom also, and these are my pajamas. Got a problem with that?

Not having to stop at gas stations on crosscountry drives with extra biodiesel on board

(OK, the picture below, from the first trip I did with the van when I brought it back to Calfornia, is a bit excessive- it’s getting a bit ridiculous when I choose to share my bed with a couple of barrels of fuel- but still, you get the point. PS I don’t know what happened to my eyebrows there.)

Camping at a campground during a class weekend instead of being in a hotel. That’s where I am right now, teaching class at a community college diesel program in a small Ohio town by the West Virginia line. Aah, it’s warm enough again to be doing this more sanely than the airport-and-hotel method. Oh, bliss.

I got bit by another tick a couple of weeks ago, and I’m seriously fighting off something or another, probably as a result. I’m back to having exhaustion, sleep problems, brainfog, air hunger, and this absolutely excruciating Lyme-type neck pain that is supposedly a form of meningitis caused by the disease. For me, the neck pain came with my initial Lyme infection, and it still sometimes flares up when I have a relapse or when something mercury-poisoning-related happens, so I’m not sure that it’s a sign that my latest bite is specifically a Lyme reinfection (which I don’t really think is likely based on my other symptoms) or just an infection with something else. My immune system has been absolutely TRASHED all winter- so even if the tick only had staph or something rather than Lyme and it’s common coinfections, I’m sure my system is just stresssed fighting it, and the standard ‘relapse’ symptoms are what I’m feeling. The standard medical cliche is that “ticks are sewers"- they carry a bazillion pathogens from mammal to mammal, and this one was an adult, meaning it had had a few life cycles and previous blood meals in which to pick up various nasty things before getting me.

Right before this happened my doctor suggested putting me on low dose naltrexone, an experimental therapy for immune function sometimes used for AIDS and cancer patients, so I’m hoping to start improving things this summer as I’m sick of fighting off colds and flu and other issues every three weeks. LDN is kind of exciting stuff- I didn’t know there was anything that western medicine really had for generalized immune function- and LDN works by regulating brain hormones that regulate the immune system. I had just spent the winter reading a large number of books about the biochemistry of the brain, so it was quite interesting to learn that there’s actually a practical application of that theory that seems to work some of the time (incidentally, I’ve heard on the internet that it doesn’t help all Lyme patients, but my particular issues seemed to be specifically immune system problems, not active infection)

I found the tick on my hip, just like when I got Lyme the first time, and now have a local skin infection around the bite and swollen lymph nodes just on that side (the doc put me back on antibiotics by the way). I’m starting to think about getting a tick tattooed on my hip- I’ve never wanted to commemorate anything before via tattoos, but this damn disease has been such a defining crisis in my life that I think it’s going to make it onto my skin.

re-posting this because it got buried in my Lyme posts the last few days:

Biodiesel Essentials class in Marietta, OH May 17-18, 10-5 each day
With Maria ‘Mark’ Alovert, author, Biodiesel Homebrew Guide and co-founder of www.biodieselcommunity.org

at Washington State Community College Auto/Diesel Truck Systems department, room 121.
$120, no one turned away for lack of funds

Biodiesel fuel, which runs in any diesel engine and some heating equipment, can be made in your backyard or garage for under $1 a gallon with common ingredients, using very inexpensive equipment. Relatively little chemistry knowledge is needed to produce quality fuel that will run in any diesel engine, and thousands of people around the country have discovered homebrewing fuel to be an addictive hobby. Come learn what it takes to produce your own clean-burning biodiesel fuel, and to build the equipment to do so.

These classes are hands-on and fast-paced - you’ll be making test batches of fuel, titrating and testing oil, and assessing quality of the finished product throughout the two day class. There will be a full-scale home biodiesel reactor and system at the class site, and we will make a batch of fuel in it to demonstrate the process, and will discuss equipment design for larger systems. This class is a good preparation for the Chicago-area advanced ‘farm-scale biodiesel production’ class happening at the end of May (see www.girlmark.com/tour for details).

To register for the class, please go to www.girlmark.com/tour and register online, or simply show up on the morning of the first day.

The class is held at Washington State Community College in Marietta, OH:

here’s a map of campus, you’ll be looking for Auto/Diesel Truck Systems department, room 121:
http://www.wscc.edu/Main/maps.asp

Biodiesel Essentials is a two-day class for either beginners or those who want a refresher on quality control. I also teach a series that includes more advanced topics, for more of those workshops please see www.girlmark.com/tour.

Some topics covered in the Biodiesel Essentials class:

biodiesel/SVO/solvent thinning options and history, biodiesel chemistry, testing oil (titration and water testing), (hands-on), making test batches (hands-on), an overview of equipment, a tour of the full Appleseed-type processor and some more sophisticated wash systems than usually seen in homebrewing, long discussion of quality control factors, quality testing (hands-on), mistwashing and other water washing options, breaking emulsion (hands-on), two-stage base biodiesel (hands-on), waste water and glycerine disposal, glycerine burners for process heat, water reuse and uses for glycerine, common pitfalls, hands-on experience recovering from failed batches, safety

contact: classinformation@girlmark.com

There have been a couple of good articles (and many bad ones) recently about the IDSA/Connecticut Attorney General Blumenthal settlement regarding Lyme treatment guidelines.
Below are two good ones, and some of the comments from the publications:

Medical groups differ on courses of treatment
By Robert Miller Staff Writer

http://www.newstimes.com/ci_9231161
05/12/2008

In the battle over how best to treat Lyme disease, a new settlement between Attorney General Richard Blumenthal and a major medical group might seem to offer at least a little hope of expanded treatment for those with the tick-borne disease.

That, however, would involve a change in the lines of debate over the disease, and it’s not clear there will be any yielding.

The settlement, reached this month between Blumenthal and the Infectious Diseases Society of America, provides for a review of the IDSA’s guidelines for treating Lyme disease – guidelines that a second group of doctors, the International Lyme and Associated Diseases Society, say are strict and inflexible to the point of harming some patients.

But the IDSA’s guidelines will remain unchanged until that review ends. And while the review process will include the participation of an ombudsman, the guarantee that opposing voices will get their say, and hearings that will be broadcast on the Internet, they may not yield a single change, said Dr. Eugene Shapiro, a pediatrician, epidemiologist and professor of investigative medicine with the Yale School of Medicine in New Haven.

Asked last week if the IDSA guidelines could remained unchanged after the review, Shapiro said flatly, “Yes.”

“If the scientific data recommends a change, we’ll be happy to change,” Shapiro said. “But we have 25 years of research on Lyme disease. We feel very comfortable the guidelines will stand up to any scientific scrutiny.”

Doctors who are opposed to the IDSA guidelines said they believe there’s at least a chance their position – that infection from the Lyme disease bacteria Borrellia burgdorferi can create a chronic illness that needs long-term treatment with antibiotics – will gain some credence with the review panel.

“I hope it will lead to an improvement to patient care,” said Dr. Steven Phillips of Wilton, who has been one of the doctors opposing the strict guidelines in favor of those in which doctors can tailor treatment to individual patients.

Phillips is a past president of the International Lyme and Associated Diseases Society, which believes there is ample scientific evidence to treat people for chronic Lyme disease.

“We’ve looked at the same evidence as IDSA and come up with significantly different conclusions,” said Dr. Daniel Cameron of Mount Kisco, N.Y., the current president of the group.

This isn’t a merely a spat between two opposing medical groups.

In a press release, Blumenthal’s office pointed out that insurance companies now use the IDSA guidelines to restrict care for patients and refuse to pay for long-term antibiotic care.

“It’s a good way to have people denied insurance,” said Maggie Shaw of Newtown, a member of that town’s Lyme Disease Task Force. “It also puts the fear factor in doctors.

“Here are two standards of care, but only one gets recognized,” Shaw said. “It’s because of the stranglehold the IDSA has on this.”

The settlement between Blumenthal and the IDSA came after Blumenthal sued the group – which represents about 8,000 infectious disease specialists in the United States – in 2006 for antitrust violations.

Blumenthal said his investigation discovered many examples of conflicts of interest among the doctors who wrote the IDSA guidelines. He also said they refused to “accept or meaningfully consider” any evidence concerning chronic Lyme disease in writing the 2006 guidelines and blocked the appointments of scientists and physicians who differed with the IDSA view that all Lyme disease can be treated with two to four weeks of antibiotics and that chronic Lyme disease does not exist.

“Our focus has not been on medicine but the process,” Blumenthal said. “There may have been violation of the law and it’s my job to enforce the law.”

Dr. Sam Donta, a Massachusetts-based infectious disease specialist, was on the panel that drew up the IDSA guidelines. Donta said he refused to sign off on the guidelines when the group refused to acknowledge that chronic Lyme disease is a problem.

–The issue should not be whether there’s chronic Lyme disease, but why we’re seeing these patients,” he said

The review process established in the settlement, Blumenthal said, will be “fair, open and free of conflict.” Donta said Friday he hopes to serve on the panel.

But in its own press release on the settlement, the IDSA emphatically denies there was any “significant” conflict of interest on the part of any of the doctors who wrote the 2006 guidelines, or that they excluded conflicting points of view while writing them.

In fact, Shapiro said, having stricter guidelines means doctors who follow the IDSA protocols see patients fewer times and prescribe only short-term regimens of generic antibiotics.

Shapiro said the IDSA agreed to the settlement simply to end any attempt by Blumenthal to take the case to court.

“The alternative was spending a lot of money in an expensive lawsuit,” he said.

Shapiro said all the scientific evidence on long-term treatment of Lyme disease, including five double-blind studies in which some patients got antibiotics and others a placebo, show that long-term antibiotics did not cure the symptoms that people include in the diagnoses of Lyme disease.

“It’s not that data isn’t there. It is,” he said, pointing out that 95 percent of all Lyme cases are successfully treated with only two or three weeks of standard antibiotics.

But Cameron said the double-blind studies, all with a small number of patients, only show that Lyme disease is complicated.

“The evidence is quite mixed,” he said.

And the trials often look at the effect of just one type of antibiotic on patients, Donta said.

“If one doesn’t work, do you say all antibiotics don’t work?,” he asked. “If one cancer drug stops working, do you not try and find another? There’s insufficient information in the guidelines for physicians to make a decision.”

Phillips of Wilton said many peer-reviewed articles published in medical and scientific journals make the case that chronic Lyme disease does exist.

What they hope the new review of the IDSA guidelines do, they said, is take all this into account and give doctors a chance to treat each case individually, rather than with a one-size-fits-all approach.

“Let the doctors have some flexibility,” Cameron said.

Contact Robert Miller at bmiller@newstimes.com

Some good comments from newstimes.com site:

first of all, my own comments:

For an example of a very flawed double-blind study often cited by the IDSA guidelines authors to back up their allegation that long-term antibiotics don’t help chronic lyme patients, see this analysis (by a firm that specializes in analyzing medical studies for hidden bias for use in court cases):
http://www.verimresearch.com/Verim%20Research…

In brief: the often-cited Klempner study took a very small number of patients who had already had treatment failures with antibiotics (meaning they were difficult cases for whom antibiotics don’t work well), then treated them for only 30 days with an IV antibiotic and for only two months with oral doxycycline, and then did a subjective symptom survey of the patients and other subjects who received placebo instead of antibiotics.

The study’s authors then proclaimed that because the survey results didn’t differ between the treated patients and those who received placebo, this proves that long-term antibiotics don’t do anything for Lyme.

In reality, the study didn’t really treat it’s patients with anything remotely resembling ‘long-term antibiotics’, and picked an oral antibiotic that frequently fails to show results in those patients who experience antibiotic treatment failures. There were many other flaws- the Verim Research analysis summarizes some of them on page 6 and 7 of the PDF, which are a good introduction to the entire issue of Lyme treatment controversy.

Chronic Lyme patients who are lucky enough to have access to a lyme-literate doctor are often treated with 6 months to many years of antibiotics. For those for whom simple treatment doesn’t work (and for some people it’s specifically doxycycline or amoxycillin that don’t work), doctors may progress to using combinations of antibiotics, or longer treatment with IV. Doxycycline is a first step for many patients but when it doesn’t work more expensive antibiotics, and combinations of antibiotics, are usually prescribed by knowledgeable doctors such as members of International Lyme and Associated Diseases Society (www.ilads.org ).

The Klempner study was designed with many built-in conditions that seem designed to predispose it’s small sample size of subjects to treatment failure, and the IDSA guidelines authors seemed to base their guidelines literature review on similar studies, hand-picked to prove their extreme position.

When the 2006 guidelines were announced, the ILADS president produced a statement that there were something like 1800 good studies on Lyme treatment in existence, but that the IDSA guidelines authors had hand-picked the worst 400 to prove their point.

*****************
Phillis Mervine from CALDA commenting on the article:

Your article quotes Dr. Eugene Shapiro as saying that having stricter guidelines means doctors who follow the IDSA protocols see patients fewer times. That’s because IDSA’s treatment protocol has a 50% failure rate. No intelligent patient with any resources would continue such a self-defeating course when alternatives are available.

What IDSA says, in effect, is that persistent infection can’t be proven to cause symptoms. In early March, the American Society of Microbiology published research that proved that one month of treatment with the IV drug ceftriaxone did not **** all the Lyme spirochetes in infected mice. This is the most recent research to prove persistence of infection.

A few weeks later, IDSA President Donald Poretz sent a letter to members of Congress, saying, “[T]here are no convincing published scientific data that support the existence of chronic Lyme disease.” We wonder what type of evidence the IDSA would accept, if any.

According to previous IDSA statements, equally meaningless are positive Lyme antibody tests plus symptoms; positive Lyme bacteria DNA plus symptoms; post-treatment symptoms; positive brain SPECT scans plus symptoms; tick bite in a known endemic area followed by symptoms.

In case anyone has missed the message, there is no justification for extended antibiotic treatment in the IDSA belief system. Although numerous studies have shown benefit of longer and/or more aggressive treatments, IDSA’s position is that ‘enough is enough’ They oppose treating for longer than two weeks, even when people improve on treatment and relapse when treatment is stopped. Where would people with cancer be today if we treated them like that?

CALDA and other patient advocacy groups tell people to look for a doctor who belongs to the International Lyme and Associated Diseases Society (www.ilads.org ), whose guidelines allow clinical discretion and are flexible. We also refer patients to their local online support group, which in Connecticut may be found at http://health.groups.yahoo.com/group/connecti…

Phyllis Mervine
California Lyme Disease Association
www.lymedisease.org

*************************
and another good comment:
Thank you, Mr. Miller, for your fair and balanced reporting of this issue. And thank you, News-Times, for showing the integrity to support Mr. Miller’s journalistic efforts. Not all of the newspapers in CT have been fair in reporting the results of AG Blumenthal’s investigation, and I am proud of the News-Times for having done so.
As a psychotherapist who sees children and adults suffering from the effects of chronic, persistent, Lyme disease and coinfections, I have seen the damage that is done to the patients and their families by untreated or undertreated Lyme. I have also seen them recover, and be able to resume work and school, when treated efficaciously, comprehensively, by their courageous doctors, who do not give up on them, or put them on paliative care, when they fail to get better in 30 days of abx. I have seen them resume full lives, after months or years of anti-microbial treatment, by doctors who understand chronic Lyme.
By denying the magnitude of the Attorney General’s findings (http://www.ct.gov/ag/cwp/view.asp… ), the IDSA is announcing that they are not accepting responsibility for the corruption in the process found by the Attorney General. By not acknowledging the points made by the AG, they are failing the patients once again, and sustaining the suspicion held by many that they, in fact, do have something to hide.
The attorney general emphasized that his findings were about the PROCESS of developing the guidelines, and this PROCESS was seriously flawed. I urge the readers to check out the text of the AG’s press release on the website. It will clearly show who, in fact, can be believed.
Sandy Berenbaum, LCSW, BCD
Southbury, CT and Brewster, NY

**********************************************

Here’s another good article(from a Maryland newspaper) that just came out:

http://www.stardem.com/articles/2008/05/11/news/32096.txt

Society to review Lyme disease guidelines
By STEVE NERY News Editor
Published: Sunday, May 11, 2008 5:24 PM CDT
The Infectious Diseases Society of America has agreed to reassess its controversial Lyme disease diagnostic and treatment guidelines after an antitrust investigation uncovered serious flaws with them, Connecticut Attorney General Richard Blumenthal announced May 1.

The IDSA guidelines were under fire from Lyme disease patient advocacy groups, including vocal groups in Maryland, for restricting long-term care and denying the existence of chronic Lyme disease. Blumenthal’s move also could affect Congressional bills, now stuck in committees, that aim to develop better testing and treatment for the tick-borne ailment.

“My office uncovered undisclosed financial interests held by several of the most powerful IDSA panelists,” Blumenthal said in a statement. “The IDSA’s guidelines improperly ignored or minimized consideration of alternative medical opinion and evidence regarding chronic Lyme disease, potentially raising relevant questions about whether the recommendations reflected all relevant science.”
According to the IDSA guidelines, patients should receive antibiotics for no more than four weeks.

“United Healthcare, Health Net, Blue Cross of California, Kaiser Foundation Health Plan and other insurers have used the guidelines as justification to deny reimbursement for long-term antibiotic treatment,” according to Blumenthal’s release.

Blumenthal’s investigation resulted in several findings, including:

The IDSA failed to conduct a conflict of interest review for any of the panelists on the 2006 panel. Several of them had conflicts of interest, involving relationships with drug companies, diagnostic tests, patents and consulting arrangements with insurance companies.

• The chairman, who had a bias against the existence of chronic Lyme, was allowed to handpick the other members of the panel.

• In 2000, the group removed a panelist who dissented from the position of the others on chronic Lyme disease to achieve consensus.

• The panel blocked the appointments of others by saying was it was already fully staffed, even though more members were later added.

• The IDSA portrayed the American Academy of Neurology’s guidelines as corroborating its own even though it knew both groups shared several authors.

The new panel, which will consist of eight to 12 members, will reassess the 2006 guidelines individually to determine if they are justified, according to Blumenthal’s release. The panelists will all be screened for conflicts of interest and cannot have served on the last panel. At least 75 percent of the members will have to vote in favor of recommendation from 2006 for it to be affirmed.

“We congratulate Attorney General Blumenthal for exposing the IDSA’s conflicts of interest and helping reduce the suffering of Lyme patients everywhere,” said Pat Smith, president of the national Lyme Disease Association.

Lucy Barnes, director of the Lyme Disease Education and Support Groups of Maryland, said it’s terrible that so many people have suffered as a result of the IDSA’s restrictive guidelines. She pointed to the International Lyme and Associated Diseases Society’s guidelines, available online at www.ilads.org, as a better alternative.

Barnes and other members of Lyme disease support groups hope the move will prompt the U.S. Congress to give hearings to bills designed to develop better testing and treatment of the disease. Both introduced in early 2007, Senate Bill 1708 now awaits a hearing by the Senate Committee on Health, Education, Labor and Pensions, while House Bill 741 awaits a hearing from the House Subcommittee on Health.

All of Maryland’s Congressional members, including U.S. Rep. Wayne T. Gilchrest, R-Md.-1st, Sen. Barbara Mikulski, D-Md., and Sen. Ben Cardin, D-Md., signed onto the bills. Local Lyme disease groups have been urging Mikulski, a member of the health committee, to help get SB1708 a hearing. Melissa Schwartz, a spokesman for Mikulski, said only Sen. Edward Kennedy, D-Ma., the chairman of the committee, can get the bill a hearing.

The only member from Maryland on the House committee, U.S. Rep. Albert Wynn, D-Md.-4th, removed himself from all his committee assignments weeks ago as he’s resigning from Congress effective in June.

The legislation would provide $20 million annually for five years to help develop better diagnostic testing and treatment, as well as $250,000 annually to fund a tick-borne diseases advisory committee. The committee, to be made up of members of the scientific committee, volunteer organizations, health-care providers, patient representatives and health department representatives, would also work to develop better reporting and enhance prevention efforts.

If not acted upon, the legislation will die at the end of the year, as a similar measure did in 2006. Volunteer groups are planning on showing up at the office of U.S. Rep. Frank Pallone, D-N.J.-6th, from 11 a.m. to 2 p.m. this Wednesday. For more information, visit www.LymeRights.org.

IDSA President Donald Poretz wrote the committee members in March opposing passage of the bills and questioning the existence of chronic Lyme disease.

“The premise for prolonged antibiotic therapy for Lyme disease is the notion that some spirochetes can persist despite conventional treatment courses, thereby giving rise to the vague symptoms ascribed to chronic Lyme disease. Not only is this assertion microbiologically implausible, there are no convincing published scientific data that support the existence of chronic Lyme disease,” Poretz wrote.

Poretz’s letter was dated March 21, meaning it was written after a University of California at Davis Center for Comparative Medicine study concluded that the maximum treatment recommended by the IDSA did not kill all Borrelia burgdorferi spirochetes, the tiny organisms responsible for Lyme disease, in mice in lab tests.

Instead of a federal advisory committee, Poretz proposed the Institute of Medicine of the National Academies conduct a review of Lyme disease diagnosis, treatment and prevention methods, adequacy of current treatment guidelines, treatment options for “post-Lyme disease disorder,” effectiveness of current prevention methods and controversies associated with chronic Lyme disease.

Barnes also wrote the committee members, fearing that if the bills are not passed, “we are going to lose more chronically ill patients to a treatable but very serious infectious disease.”

“The IDSA is so distressed by the possibility that researchers outside their tight-knit group will be allowed to sit at a table and present scientific evidence and recommendations that could prove them wrong, they are willing to fight bills and forfeit the much-needed $100,000,000 in research funding they would provide over five years, just to keep from being exposed,” Barnes wrote.

Barnes cited several passages from the Food and Drug Administration, National Institutes of Health and the Centers for Disease Control which refer to the chronic Lyme disease that the IDSA denies exists.

“No patient wants to have antibiotic treatment without good reason and good science backing the protocols; and no doctor wants to prescribe treatment if it is not needed, as the IDSA would have you believe,” Barnes wrote. “That deduction is as absurd and preposterous as a person wanting to have chemotherapy if they didn’t need it.”

Barnes also pointed out that the IDSA recommends against using several antibiotics that produce an anti-inflammatory effect except for Doxycycline, the cheapest of them all.

Biodiesel Essentials class in Marietta, OH May 17-18, 10-5 each day
at Washington State Community College Auto/Diesel Truck Systems department, room 121.
$120, no one turned away for lack of funds

This two-day class will teach you everything you need to know to get started making high-quality biodiesel fuel out of waste vegetable oil. We will also have a full ‘home-scale’ biodiesel system on a trailer on site, and will discuss equipment design for larger systems. This class is a good preparation for the Chicago-area advanced ‘farm-scale biodiesel production’ class happening at the end of May (see www.girlmark.com/tour for details).

To register for the class, please go to www.girlmark.com/tour or simply show up on the morning of the first day.
map of campus, you’ll be looking for Auto/Diesel Truck Systems department, room 121:
http://www.wscc.edu/Main/maps.asp

For the past few months I’ve been slowly working on the van. I have two biodiesel classes coming up in the Midwest, one in Ohio next weekend, and one in Chicago after Memorial Day. Earlier this winter, I replaced the computer and parts of the the glow plug system, and the only real problem left has been that my vacuum pump is starting to go and I didn’t want to mess with the incredible hassle of working inside the cramped engine compartment of my van. My friend Gimpy calls working on van components “ship in a bottle” work because of the lack of access.

I’ve been planning on getting North Carolina license plates this week but had temporarily misplaced my second ID when it took a nap in my lab notebook by accident, so I was stymied a few days ago when I’d planned on turning in the California plates.

I rented a car so that I could still do a whole bunch of errands while the van is out of commission, and a few days ago, Matt and I went down to Chatham Alignment to leave them the van. Chatham Alignment is a heavy truck shop 10 minutes south of town, and for years they have been the default repair shop for all of the co-ops horrible and abused old trucks. The co-op is really hard on trucks. I think I may have presided over the last days of the janky dodge last month when it, on my watch, it developed an inexplicable electrical problem that no one can find. The Janky Dodge now shuts off on it’s own, but only when in the midst of a drive around the traffic circle in town. Last month Matt nearly lost his brakes in the (1989 model) BioDually, which has already received a new engine and transmission on the co-op’s shift. I believe that the BioBox, which burned up this fall after burning up an enormous amount of co-op dollars, it is still sitting somewhere on the property while Matt tries to sell the remnants on Craigslist. I hear that someone at Chatham Alignment once called it the BioJunk. As we drove away I made comments to Matt on how huge their lifts and bays were. He made fun of me mercilessly for liking big lifts. I can’t help it. Mechanic girls like big tools even more than mechanic boys do, we need them more.

Today I remembered that they still hadn’t called me and that this was surprising, considering that a vacuum pump doesn’t take that long. I was a little bit concerned that perhaps this meant that something else was wrong with the vehicle. Oh well, no matter, I don’t really need it until next week.

One of my rental car errands took me down to Sanford, an industrial town 20 miles south of Pittsboro. I was down there to take a look at the community college, and more importantly, the drive, as I’m considering taking some classes next fall. I’m 99% sure that I can’t handle the drive down to Sanford everyday- I don’t have any other reason to ever go to Sanford, the school is on the other side of town meaning I’d have to deal with extra traffic on local roads, and my martial arts school is 40 miles from there, in the opposite direction from Pittsboro. The branch of Central Carolina Community College that’s down in Sanford has an excellent ‘mechanical engineering’ program-that’s mechanical engineering as in machining, boiler and plant maintenance, not as in ‘practicing engineer’. I’m trying to figure out where I’m going to learn machining- and this sounds like actually the perfect school for the skills I want to learn next, but one of the things I hate the most about living here is having to drive 20 miles to get to anything that’s not available in Pittsboro. I don’t think I can handle a drive south, followed by a drive north in the same day for kung fu, so I’m not sure what I’m going to be doing in the fall.

On the way back, it was after work hours, and I didn’t think that Chatham Alignment was going to be open. I kept my eyes peeled for their driveway just in case it looks like someone was working late.

In the driveway was a sheriff car. And police tape. My eyes followed the tape, straight up to the building, and saw- each of the big truck bays boarded up with fresh plywood, topped with big streaks of black smoke damage. The shop that had a serious fire. I screeched the car to a halt and ran in to the driveway, frantically looking for my van. No van. Oh shit. No wonder they didn’t call today.

The sheriff let me through, as Kevin, the owner, was sitting on his truck in the middle of the damage. As I walked around the cop car, the van came into view. I had missed it in my initial panic. Phew! I ran across the yard, hoping that my vehicle was unhurt. Things still looked good.

Kevin, and his other mechanic, didn’t look so good. I spent an hour talking to him about the fire, his business, his life, and every single retarded little problem that the co-op vehicles had ever suffered, most of which he had had to deal with. After he found out that I was associated with biodiesel, he just unloaded all kinds of well-deserved ridicule on my friends’ mechanical skills and general judgement. In his defense, he did warn me that he was about to talk trash right before the flood of stories started.

Oh, and, the van. I am so blessedly lucky.

Turns out the fire had started right after they had left for the day yesterday. Somebody drove by on their way home from work and saw it, and called 911. This is where I get lucky and my charmed life kicks in. ‘They’ turned out to be a construction crew with several men in a truck.

They dove into heroics. They started trying to push vehicles away from the burning building. They only managed to save two of us. They got one of Kevin’s tow trucks, which was unlocked, pushed down the hill away from the building. The other tow truck that was left behind near the front of the building ended up destroyed. (And, unfortunately, Rachel Burton’s lemon of a diesel motorcycle is still inside some corner of the building, completely unhurt)

My van was parked directly in front of one of the burning bays. It was locked at the time. The construction workers saw my California license plates, and realized that I was a customer and prioritized saving my van, over Kevins stuff. Although it was locked and in gear, they had chain or tow rope with them, somehow tied my van to their truck, and dragged it 50 feet away from the fire to safety.

I begged and pleaded with Kevin to tell me who did the saving, as those people deserve several massive cases of beer, or a fruit basket, or something in between.

oh my god, I’m actually crying about this I’m so happy. If this investigation, or something like it, had happened in the 90’s I would’ve gotten proper treatment the first time and wouldn’t still be sick. Perhaps I’ll post an explanation once I recover my senses. (incidentally while the specific IDSA guidelines that are the subject of the attorney general’s investigation are from 2006, the same players involved have been involved in trying to block chronic Lyme treatment for decades)

********************************************************************

Attorney General’s Investigation Reveals Flawed Lyme Disease Guideline Process, IDSA Agrees To Reassess Guidelines, Install Independent Arbiter

May 1, 2008
Attorney General Richard Blumenthal today announced that his antitrust investigation has uncovered serious flaws in the Infectious Diseases Society of America’s (IDSA) process for writing its 2006 Lyme disease guidelines and the IDSA has agreed to reassess them with the assistance of an outside arbiter.

The IDSA guidelines have sweeping and significant impacts on Lyme disease medical care. They are commonly applied by insurance companies in restricting coverage for long-term antibiotic treatment or other medical care and also strongly influence physician treatment decisions.

Insurance companies have denied coverage for long-term antibiotic treatment relying on these guidelines as justification. The guidelines are also widely cited for conclusions that chronic Lyme disease is nonexistent.

“This agreement vindicates my investigation – finding undisclosed financial interests and forcing a reassessment of IDSA guidelines,” Blumenthal said. “My office uncovered undisclosed financial interests held by several of the most powerful IDSA panelists. The IDSA’s guideline panel improperly ignored or minimized consideration of alternative medical opinion and evidence regarding chronic Lyme disease, potentially raising serious questions about whether the recommendations reflected all relevant science.

“The IDSA’s Lyme guideline process lacked important procedural safeguards requiring complete reevaluation of the 2006 Lyme disease guidelines – in effect a comprehensive reassessment through a new panel. The new panel will accept and analyze all evidence, including divergent opinion. An independent neutral ombudsman – expert in medical ethics and conflicts of interest, selected by both the IDSA and my office – will assess the new panel for conflicts of interests and ensure its integrity.”

Blumenthal’s findings include the following:

* The IDSA failed to conduct a conflicts of interest review for any of the panelists prior to their appointment to the 2006 Lyme disease guideline panel;

* Subsequent disclosures demonstrate that several of the 2006 Lyme disease panelists had conflicts of interest;

* The IDSA failed to follow its own procedures for appointing the 2006 panel chairman and members, enabling the chairman, who held a bias regarding the existence of chronic Lyme, to handpick a likeminded panel without scrutiny by or formal approval of the IDSA’s oversight committee;

* The IDSA’s 2000 and 2006 Lyme disease panels refused to accept or meaningfully consider information regarding the existence of chronic Lyme disease, once removing a panelist from the 2000 panel who dissented from the group’s position on chronic Lyme disease to achieve “consensus";

* The IDSA blocked appointment of scientists and physicians with divergent views on chronic Lyme who sought to serve on the 2006 guidelines panel by informing them that the panel was fully staffed, even though it was later expanded;

* The IDSA portrayed another medical association’s Lyme disease guidelines as corroborating its own when it knew that the two panels shared several authors, including the chairmen of both groups, and were working on guidelines at the same time. In allowing its panelists to serve on both groups at the same time, IDSA violated its own conflicts of interest policy.

IDSA has reached an agreement with Blumenthal’s office calling for creation of a review panel to thoroughly scrutinize the 2006 Lyme disease guidelines and update or revise them if necessary. The panel – comprised of individuals without conflicts of interest – will comprehensively review medical and scientific evidence and hold a scientific hearing to provide a forum for additional evidence. It will then determine whether each recommendation in the 2006 Lyme disease guidelines is justified by the evidence or needs revision or updating.

Blumenthal added, “The IDSA’s 2006 Lyme disease guideline panel undercut its credibility by allowing individuals with financial interests – in drug companies, Lyme disease diagnostic tests, patents and consulting arrangements with insurance companies – to exclude divergent medical evidence and opinion. In today’s healthcare system, clinical practice guidelines have tremendous influence on the marketing of medical services and products, insurance reimbursements and treatment decisions. As a result, medical societies that publish such guidelines have a legal and moral duty to use exacting safeguards and scientific standards.

“Our investigation was always about the IDSA’s guidelines process – not the science. IDSA should be recognized for its cooperation and agreement to address the serious concerns raised by my office. Our agreement with IDSA ensures that a new, conflicts-free panel will collect and review all pertinent information, reassess each recommendation and make necessary changes.

“This Action Plan – incorporating a conflicts screen by an independent neutral expert and a public hearing to receive additional evidence – can serve as a model for all medical organizations and societies that publish medical guidelines. This review should strengthen the public’s confidence in such critical standards.”

THE GUIDELINE REVIEW PROCESS

Under its agreement with the Attorney General’s Office, the IDSA will create a review panel of eight to 12 members, none of whom served on the 2006 IDSA guideline panel. The IDSA must conduct an open application process and consider all applicants.

The agreement calls for the ombudsman selected by Blumenthal’s office and the IDSA to ensure that the review panel and its chairperson are free of conflicts of interest.

Blumenthal and IDSA agreed to appoint Dr. Howard A. Brody as the ombudsman. Dr. Brody is a recognized expert and author on medical ethics and conflicts of interest and the director of the Institute for Medical Humanities at the University of Texas Medical Branch. Brody authored the book, “Hooked: Ethics, the Medical Profession and the Pharmaceutical Industry.”

To assure that the review panel obtains divergent information, the panel will conduct an open scientific hearing at which it will hear scientific and medical presentations from interested parties. The agreement requires the hearing to be broadcast live to the public on the Internet via the IDSA’s website. The Attorney General’s Office, Dr. Brody and the review panel will together finalize the list of presenters at the hearing.

Once it has collected information from its review and open hearing, the panel will assess the information and determine whether the data and evidence supports each of the recommendations in the 2006 Lyme disease guidelines.

The panel will then vote on each recommendation in the IDSA’s 2006 Lyme disease guidelines on whether it is supported by the scientific evidence. At least 75 percent of panel members must vote to sustain each recommendation or it will be revised.

Once the panel has acted on each recommendation, it will have three options: make no changes, modify the guidelines in part or replace them entirely.

The panel’s final report will be published on the IDSA’s website.

ADDITIONAL FINDINGS OF BLUMENTHAL’S INVESTIGATION

IDSA convened panels in 2000 and 2006 to research and publish guidelines for the diagnosis and treatment of Lyme disease. Blumenthal’s office found that the IDSA disregarded a 2000 panel member who argued that chronic and persistent Lyme disease exists. The 2000 panel pressured the panelist to conform to the group consensus and removed him as an author when he refused.

IDSA sought to portray a second set of Lyme disease guidelines issued by the American Academy of Neurology (AAN) as independently corroborating its findings. In fact, IDSA knew that the two panels shared key members, including the respective panel chairmen and were working on both sets of guidelines a the same time – a violation of IDSA’s conflicts of interest policy.

The resulting IDSA and AAN guidelines not only reached the same conclusions regarding the non-existence of chronic Lyme disease, their reasoning at times used strikingly similar language. Both entities, for example, dubbed symptoms persisting after treatment “Post-Lyme Syndrome” and defined it the same way.

When IDSA learned of the improper links between its panel and the AAN’s panel, instead of enforcing its conflict of interest policy, it aggressively sought the AAN’s endorsement to “strengthen” its guidelines’ impact. The AAN panel – particularly members who also served on the IDSA panel – worked equally hard to win AAN’s backing of IDSA’s conclusions.

The two entities sought to portray each other’s guidelines as separate and independent when the facts call into question that contention.

The IDSA subsequently cited AAN’s supposed independent corroboration of its findings as part of its attempts to defeat federal legislation to create a Lyme disease advisory committee and state legislation supporting antibiotic therapy for chronic Lyme disease.

In a step that the British Medical Journal deemed “unusual,” the IDSA included in its Lyme guidelines a statement calling them “voluntary” with “the ultimate determination of their application to be made by the physician in light of each patient’s individual circumstances.” In fact, United Healthcare, Health Net, Blue Cross of California, Kaiser Foundation Health Plan and other insurers have used the guidelines as justification to deny reimbursement for long-term antibiotic treatment.

Blumenthal thanked members his office who worked on the investigation – Assistant Attorney General Thomas Ryan, former Assistant Attorney General Steven Rutstein and Paralegal Lorraine Measer under the direction of Assistant Attorney General Michael Cole, Chief of the Attorney General’s Antitrust Department.

To view the entire IDSA agreement, go to the Attorney General’s website.

http://www.ct.gov/ag/cwp/view.asp?a=2795&q=414284

Today I had one of those interminable airport days, starting with getting a ride to the airport 5 hours ahead of schedule (I slept in the lobby for a while). My second flight involved a guy next to me fiddling loudly with a Rubik’s Cube (which was actually kind of cute, he was friendly and at one point was entertaining the other woman in our row with the solution, which I haven’t thought about for at least 12 years) while my feet fell asleep and my brain just wanted this limbo to end. I have started on a new strategy with the last few flights- getting up and walking around. Yep, not much new news to report in my life!

I’d loaded my laptop with about 100 web pages and forum threads, and waded into the intricacies of the Dieselcraft and Spinner centrifuge threads, info on commodities pricing and what it’s done to commercial biodiesel in this country, and a bunch of oddball permaculture stuff from my hippie social networking site. Eventually this was all read, and my new laptop has awesome battery life, so I was just sitting there noodling away on a piece of workshop syllabus. I was trying to write down every single possible trick there was to teach in the next System Tricks class, when I got slammo’d by a bright new idea for how to caveman-automate the Appleseed process using only timers, Rick’s heater controller, and a couple of extra pumps. I think I can actually make this thing compete with the BioPro for something like $600 of controllers/timers/pumps or $700 more in auxiliary heating equipment, and, no welding needed yet. I started fidgeting in my tiny airline seat and had to fight down the massive urge to get on the internet up there in the air and yell at all my biodieseler friends about the grand new discovery.

I needed to build one here for some future classes anyway, might be doing that this weekend.

I’m so fricking excited.

Marc Franke from Iowa Renewable Energy Association has been quietly putting together a fantastic web site about biofuels and renewable energy sustainability. Before you run out and scream that ethanol is a scam, read his debunking of all the anti-ethanol propaganda we’ve been assaulted with. Apparently petroleum buys a lot of propaganda per gallon…

http://www.itsgood4.us/Renewables.htm

I just had a cool conversation with Jennifer Radtke from Biofuel Oasis about pricing, and their involvement, or lack thereof, in the petroleum market. There had been a raging debate on one semi-local biodiesel forum about pricing of diesel, and we were all speculating that Oasis will soon raise their price, as they’re currently selling B99 lower than the price of diesel.

At the moment, they’re getting their fuel from Bentley Biofuels in Minden NV (200 miles away) and Yokayo Biofuels in Ukiah (100 miles away), and like everyone else in town, they’re hoping, praying, and crossing their fingers that Oakland-based Blue Sky Biodiesel starts producing fuel for sale soon. Yokayo and Bentley both make recycled-restaurant-oil fuel, which makes sense for Yokayo since there’s no oilseed farming to speak of in California (OK, maybe cottonseed oil, but it’s not a major player). Both of those producers fuel all their vehicles with biodiesel, and pick up restaurant oil using biodiesel-fueled collections trucks. Bentley uses solar hot water in part of their process, further insulating them from the global energy market.

Jennifer said that the producers indicated they’re not raising prices (at the moment anyway) and that this means that Biofuel Oasis has ‘arrived’ at the success story of being independent of the diesel supply pricing. They’re currently selling B99 below the price of petrodiesel. Obviously two things can go wrong:

1) a distributor can get ’sucked dry’ by customers who are only interested in biodiesel temporarily, while the price is low. Business like this is terrible for planning- you can’t build a distributorship or a production plant with large capacity for these temporary ‘rush’ customers, who will vaporize as soon as market forces raise the price again. Running out of fuel is even more terrible for your loyal regular customers. Most biodiesel vendors have dealt with this before at times of diesel price surge, and this means that biodiesel prices are almost always kept higher than diesel to prevent the ‘rush’ on the biodiesel. Piedmont Biofuels is struggling with this terribly right now.

2) the other concern is of course that customers who shop only for price, ie those who don’t regularly use biodiesel, will fill up without getting properly educated about the special needs of biodiesel, such as filter clogging or cold weather use. Here in the Bay Area there’s no real concern about cold weather at this time, but drive 200 miles to Nevada and you’re in serious trouble this time of year. Of course the whole point of distributorships like Biofuel Oasis is that they do the new customer education and hand-holding that you can’t possibly get by just selling biodiesel via a regular petroleum company convenience store, where the minimum-wage kids working behind the counter can’t possibly provide that service, and you’re stuck hoping that the customer reads the brochure or warning signs that you put up. In 2005 there was a serious problem with cold weather-related issues catching new biofuel drivers unaware due to the fact that gas prices spiked in the fall.

While we don’t know that problem #1 won’t surface once word gets out that Oasis has cheaper fuel, and force Oasis/the producers to raise prices, for the moment, we’re certainly dealing with one really nice thing here. By working with local/distributed sources of biodiesel feedstock and because the producers and distributors have tried hard to be independent of the petroleum supply markets, we’re temporarily seeing them be insulated from the recent price spikes. The money being spent on this biodiesel stays almost entirely local.

My Wilmington ‘biodiesel crash course’ next weekend is nearly full. If it fills up before you get in, please consider coming to one of the many Pittsboro classes I’m teaching this summer:

No experience required:
Biodiesel Essentials- May 3-4
just added- another session of Biodiesel Essentials repeats June 7-8
Biodiesel Equipment Intensive June 14-15

The following two classes are for students with prior experience, or for those who have attended a Biodiesel Essentials class or something similar taught by others:

Biodiesel System Tricks June 28-29
Biodiesel Production Advanced Topics July 26-27

To register for these classes, please see www.girlmark.com/tour

All proceeds from the Pittsboro classes are a benefit for the Piedmont Biofuels summer internship program, and will pay for things like intern stipends, supplies to build an outdoor shower and tent platforms for interns and future visitors, improvements to an on-site classroom, supplies for biodiesel equipment the interns will build, and more. The internship runs from June through August and will involve intensive instruction in biodiesel chemistry and production practices, lab work, experiments, and some work for the co-op and it’s associated farm site. It will be taught by myself and many of the local biodiesel and sustainable homesteading skills experts involved in the Piedmont Biofuels community. For more information about the Piedmont Biofuels summer internship please see www.biofuels.coop

I finally have my computer act more or less together, to the point where the machine is a tool and not an adversary. The brain is also still working normally a month after my chelation therapy (which I repeated a couple of weeks ago). It’s been an uphill battle to get the digital life organized. I’m still installing new software but I feel like I have my tools mostly organized. I blew out my arm injury again last week, but I’m in a position to stop typing if I need to.

More little things, going well.

I drove past a diesel pump in San Francisco this morning- $4.69 a gallon.

I’ll be in Oakland again in May, and we scheduled another System Tricks class at my ‘home’ system:

Thursday, May 22 Introduction to Biodiesel Homebrewing
Friday or Saturday May 23 and 24, two sessions of Biodiesel System Tricks class:

www.girlmark.com/tour has the details…

I haven’t been on the biodiesel forums in so long, I forgot my Infopop login… not to mention the other gazillion forums I frequented less frequently.

sheesh.

in other news, I’m soooo excited about being reunited with my Tankenstein system in Oakland, it’s unbelievable how much an ugly hunk of metal makes me happy.

Biodiesel Production Classes with Maria ‘girl Mark’ Alovert
Spring-summer 2008
www.girlmark.com/tour

Detailed class descriptions at bottom of this post:

Wilmington, NC:
Biodiesel Production Crash Course

April 4: Introduction To Biodiesel Homebrewing
April 5-6 Biodiesel Production System Tricks (must have prior experience or attend Friday class first)

These are two separate classes, you may take both or just one depending on your level of experience and interest.
Sponsored by Cape Fear Biofuels
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Brooksville, FL
April 26-27

Advanced Topics biodiesel class
(must have prior experience or have attended an introductory class- some of my recent students are offering a class in Tampa on March 30, see www.groups.yahoo.com/group/FloridaBiodiesel):

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Marietta, OH
May 17-18
Biodiesel Essentials class
no experience required

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Oklahoma City, OK area
June 21-22
Biodiesel Essentials class
no experience required

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Grayslake, IL
May 30-June 1:

Introduction To Biodiesel Homebrewing:
May 30
Outgrowing The Appleseed: Larger Batch System Considerations (must have prior experience or attend introductory class)
May 31-June 1

The May 31-June 1 class is similar to Advanced Topics, but with a special focus on larger batches and farm/fleet/co-op production falling below true commercial scale.

Sponsored by The Biodiesel Co-op at Prairie Crossing

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Biodiesel Production Series
Pittsboro, NC:
various dates. You may attend one of all of the classes depending on your experience and interest.

May 3-4 Biodiesel Essentials (no experience required)
June 14-15 Equipment Building Intensive (no experience required)
June 28-29 Biodiesel Production System Tricks (must have prior experience or Essentials/Introduction class)
July 26-27 Advanced Topics (must have prior experience or Essentials/Introduction class)

All proceeds from Pittsboro classes benefit Piedmont Biofuels biodiesel internship program

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Central New Mexico
August 9-10

Biodiesel Essentials
no experience required

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Class Descriptions:
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These classes are half of a four-part series:

-Biodiesel Essentials (2 days including ‘Appleseed’ reactor build and more lab time) or Introduction to Homebrewing (one day, more rushed)
-System Tricks- hands-on reactor operations and tricks class for those with some experience or those who’ve taken any prior class
-Equipment Building Intensive (two days, includes building GL1 EcoSystem equipment, methanol recovery, advanced wash tanks, Turk Burners, pumps, and more). No experience necessary.
-Advanced Topics (two days, discussion-based advanced topics class for those with experience or those who’ve taken a prior class)

this spring I’m also offering a special class similar to Advanced Topics:
Outgrowing The Appleseed (similar to Advanced Topics, this is a class on larger processors such as farm-scale systems that do not necessarily use standard commercial technology. Must have prior experience with making small batches of biodiesel)
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Descriptions of classes:

One-day Introduction To Biodiesel Homebrewing
April 4, 9-5, Wilmington, NC
or
May 30, 9-5 Grayslake, IL
No Experience necessary
$75

Introduction class:
This is a one-day, sped-up version of my usual weekend Biodiesel Essentials class.

Biodiesel Essentials:
Pittsboro, NC May 3-4
Marietta, OH, May 17-18
Oklahoma City, OK area June 21-22
Central New Mexico (I’m still working out which town) August 9-10

$120, class is 10-4 each day Sat and Sunday

Two-day class for either beginners or those who want a refresher on quality control.
This is similar to Introduction To Homebrewing, but includes much more time to cover more information, more hands-on time, and a three-hour equipment building sesssion or ‘lab’ session to explore topics you’re interested in in more depth.

Some topics covered:
biodiesel/SVO/solvent thinning options and history, biodiesel chemistry, testing oil (titration and water testing), (hands-on), making test batches (hands-on), an overview of equipment, a tour of the full Appleseed-type for the Wilmington, Grayslake, and Pittsboro classes, long discussion of quality control factors, quality testing (hands-on), mistwashing and other water washing options, breaking emulsion (hands-on), two-stage base biodiesel, waste water and glycerine disposal, water reuse and uses for glycerine, common pitfalls, hands-on experience recovering from failed batches and emulsion, safety

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Two-day Reactor Mechanics and System Tricks Class
10-4 each day
Wilmington, NC, April 5-6
or
Pittsboro, NC, June 28-29
Must have prior exprience or attend the Introduction class on Friday April 4 or any Biodiesel Essentials class I offer
$120, 9-5

This class is geared to people who already know how to make biodiesel, either in a lab-scale or one-liter setting, or to who already homebrew but would like to compare notes with me on how I manage my system. You may also take this class if you are new to biodiesel but have attended a regular homebrewing class taught by someone else. We dont go into a lot of detail on titration and chemistry here so that’s the info you should have ‘down’ already on your own prior to taking this ’system tricks’ class. If you feel like you’ve researched biodiesel production heavily but have little practical experience this is probably the best of my classes for you if you can already titrate oil and make test batches, and understand the basic steps involved.

In the System Tricks class we make a full-size batches of biodiesel in the Appleseed processor, wash the batch in a heavily modified drum-based wash tank, discuss Graham Laming EcoSystem vapor recovery piping for safety, and discuss methanol recovery (and POSSIBLY run the still in the Wilmington class, depending on our site’s electrical availability, which currently has me limited to insufficient power to run all the equipment at once). We will cover a lot of the finer details that make the process efficient, safer, produce higher quality fuel, cheaper, and produce fewer messes. We will run a multifuel Turk Burner and discuss ways to safely heat using waste oil burners and glycerine-burning methods.

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Biodiesel Equipment Building Intensive:
Pittsboro, NC June 14-15

This class builds equipment and includes a heavy emphasis on system design and equipment theory.
This two-day class will build a reactor, including a possible Apple Turnover system, a methanol recovery condensor, inexpensive homebuilt pumps, wash tanks, other washing equipment, methanol/lye mixing equipment, and a Graham Laming-style EcoSystem vapor recovery system. Contact me if you’d like to purchase parts to build any of this for yourself. In addition, the Pittsboro class will include a tour of the Piedmont Biodiesel Co-op and we will discuss their equipment and it’s advantages and shortcomings. We will discuss experimental continuous process equipment as well.

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Advanced Topics Class
9-5 each day
April 26-27
Brooksville, FL

July 26-27
Pittsboro, NC

Must have prior experience or attend a beginners’ class. Florida folks, see www.groups.yahoo.com/group/FloridaBiodiesel for info on a March 30 class taught by three of my recent students. Pittsboro attendees without experience should attend any of my other Introduction or Essentials classes in the area first.

Topics covered:
Strong focus on quality control, analysis of real-world problems with offspec biodiesel, acid-base biodiesel process, advanced topics in dewatering, testing for soap, methanol recovery and equipment design, testing recovered methanol for purity, waterless washing with Amberlite, Magnesol, and Graham Laming’s process, larger-scale equipment design, ethanol-based and E-85-based biodiesel, treating wash water and glycerine for disposal, testing wash water and glycerine, real-world test results related to biodegradability, in-depth disposal/sidestreams discussion
burning glycerine safely for energy, hydronic applications for biodiesel and wash water heating, more advanced discussion of safety and disaster prevention scenarios for larger-scale processor systems, discussion of regulatory topics for non-commercial producers larger than homebrew, solar heating options, very through discussion/demonstration of several different options in washing, including drawbacks and advantages, greywater systems for wash water recycling.

Pittsboro Advanced Topics Class will include a tour of the Piedmont Biofuels Co-op site, a discussion of a continuous process used by the co-op, and a tour of the biodiesel analytical laboratory a