BEH PODCAST EPISODE 40
WET AND DRY MACULAR DEGENERATION ARE THE SAME DISEASE

Today I want to revisit something we’d talked about before. It’s been over a year, so I
think it is time to talk about wet versus dry macular degeneration. I get a lot of questions
about this topic. Some of those questions come from the fact that Ophthalmologists are
a little unclear in how they discuss the difference.

THE SAME PROBLEM

To be clear, wet and dry macular degeneration are both the same problem. They’re
both the same disease. So, if you have macular degeneration, it can progress to the point
where you have enough degeneration that you can have leaking and bleeding into your
eye. Once you have leaking and bleeding, that makes it “wet” macular degeneration.
The official term for that is exudative, and exudative means leaking.

The analogy I like to use is diabetes, a different disease but one that people are more familiar with. If you have advanced diabetes, one of the complications is that you have poor circulation in
your legs and you may get a wound that won’t heal. As a result,  now you have a non-healing sore on your leg. The problem is still diabetes, and the non-healing wound is just a complication of diabetes, not a different disease. The same is true with the eye in macular degeneration.

WHAT EXACTLY DEGENERATES?

If you have a degenerative disease in your eye, the things that degenerate are not just the complicated neural cells, it’s not just the neuro-epithelial cells, the nerve cells responsible for vision. Those are not the only thing to degenerate. The structural components of the eye and the blood vessels all break down too. This is the case mostly with Macular degeneration, but you can see it some in Stargardt and rarely in Retinitis Pigmentosa. 

But we heard one person announce on the call today that they have a tear in their retina. Getting structural damage in the retina is very common with these diseases. The different types of damage have all kinds of names: macular tears, punctures, holes, buckles or thinning. However, they’re really all the same thing even though they are given different names, it’s all structural breakdown of the retina.

THE ISSUE OF BLOOD FLOW

The vessels can also degenerate, which is significant, because that results in a problem with poor circulation to the eye. That is bad because the eye has a need for blood greater than any other tissue in the body. The eye demands a lot of blood flow. As a result, it needs a lot of blood flow to function well. So even a little decrease in that blood flow compromises the eye. 

The body doesn’t like tissues to be hungry for blood. It has ways that it deals with that. If there’s not enough blood flow to make the eye happy, then the first thing that happens is the tiny vessels called capillaries (that are only supposed to carry a little bit of blood) dilate to try to let more blood into the eye. If the condition goes on long enough, the eye grows new vessels into the eye. That’s called neovascularity.

NEW VESSELS, FRAGILE VESSELS

The part “neo” means new and vascularity means vessels. So, you get new vessels, and that is how the body tries to compensate for the fact that there’s not enough blood flow.


These new vessels that the body builds, and those small vessels that dilate to carry more blood, are rather fragile and are prone to leak and bleed. One of the tests that’s done to measure neo-vascularity is an angiogram. They put a fluorescent dye into your body and they can see the vessels themselves in the eye. A tangle of these new vessels is seen as neo-vascularity and those vessels are prone to leak and bleed. 

They used to do a lot of things to try to destroy those small vessels and thankfully they don’t do that anymore. It didn’t work very well and therefore it did a lot of damage. What they do now mainly is inject drugs into the eye to try and block new vessel formation, neovascularity. Those are the drugs like Eylea and Avastin and Lucentis. All similar, very similar drugs. They do a pretty good job of blocking the formation of those new vessels, but there’s a downside to that.

THE PATH OF DRY AND WET

I’ll talk about the consequences of those drugs in a second, but I just want to come back to talk about what I started out with, the fact that wet macular degeneration and dry macular degeneration are the same disease. If you have wet macular degeneration, that always started out as dry macular degeneration. It’s just that nobody diagnosed it. 

It is common for people to first learn that they have a problem with macular degeneration when their disease is advanced, and they had a problem with leaking and bleeding. The treatments that are done for macular degeneration don’t really treat the disease itself.

DRUGS NOT A CURE

If you Google treatment for macular degeneration, the first articles you usually see are talking about drugs that treat the complications. That’s important to remember, these drugs don’t treat the disease. They’re not done to make your vision any better, and in fact they won’t make your vision any better. They are simply done to try and prevent the formation of those new vessels so you don’t have leaking and bleeding.

Because the leaking and bleeding can be destructive and can cause damage to the eye, treating the leaking and bleeding is not a bad thing to do. Before I talk the downsides of those injections, I just kind of want to bring it back to the program that you’re doing. The reason you all are on this call is you are doing the Better Eye Health Program. One of the things that happens with the Better Eye Health Program is that you’re doing a number of things that improve circulation. 

COMPONENTS OF THE PROGRAM

The color therapy improves circulation. ACU-EYE© points improves circulation. Eye Health Exercises improve circulation. The microcurrent stimulation improves circulation. Even some of the supplements we use improve circulation. But they don’t supercharge your circulation. They heal it and  bring it back to normal.

That is important because you may have a condition that makes you prone to leak and bleed. Fortunately, we’re not pumping up your circulation. We’re merely trying to bring it to normal. The formation of those abnormal vessels came as the result of a stress, and that stress was the poor circulation in the eye that was a consequence of the degeneration. So, if we improve circulation, we remove that stress, and the body feels less need to make new vessels. As a result, that in turn takes the stress off the eye that puts you at risk for leaking and bleeding.


HELPING VESSELS TO GROW

The healing that occurs with this program goes further because it actually helps new normal vessels to grow. There are a number of things that lead to the healing of the eye in this program. It takes time, but it will happen if you stay with it. There have been many studies that have looked at data for this procedure and I’m going to be talking in the future there are some newer studies that have been done.

Most of the studies looking at microcurrent stimulation took place in Europe, and they’re showing that it is of great value. We’ll talk about those studies on a later call because people always like
data. People like to know that there are doctors looking at this treatment, and yes, this is
real and it works.

GRACE'S RESULTS

For example, I looked at the data that Grace and I collected on 120 patients and it showed that this program worked very well for both wet and dry macular degeneration. In fact, in the first 120
patients that I kept careful data on, the first people that I treated, the people with wet macular degeneration actually did better than the people with dry. I saw a higher percentage of people with wet show improvement. 

Now, people ask me that if I start doing this program, and they’ve already had bleeding, will they bleed again. I can’t really answer that. I can’t make a promise there because one of the greatest risk factors, the best predictor of whether you are going to bleed is whether you’ve bled before. There are people that started this program that do have continued problems with leaking and bleeding. But most people, if they stay with the program and they do what we ask them to do, have the leaking and bleeding eventually slow down and even stop. 

INJECTIONS

This has kind of been a long talk, I’m sorry about that, so I will try to start wrapping things up. I did want to talk about why you don’t want to just do the shots. Yes, the shots do help stop the leaking and bleeding. However, the shots do not treat the underlying disease. The shots are not intended to improve your vision. I’ve talked to a lot of people who somehow had it in their minds that shots are a treatment that would improve their vision. 

Then they are very disappointed that their vision continues to decline even though they are getting these shots every month or every couple of months. The drugs that are injected directly into the eye were originally used orally. Then they were using them intravenously, and really, it wasn’t until they started injecting them into the eye that they did any good at all.

DRUG DOWNSIDES

The downside of the drug was something connected to whether they’re given orally, intravenously or injected directly. These drugs reduce the tendency to bleed by reducing blood flow. I just want you to think about this: the body is growing these new vessels for a reason. The vessels are prone to leak and bleed and that is a little bit of problem. But, the body is growing those vessels to try to compensate for a problem. 

The problem is poor circulation in the back of the retina, the back of the eye. It’s an imperfect solution because these vessels are abnormal. Therefore these vessels are prone to leak and bleed, but they do what they are supposed to. They improve blood flow to the retina. These drugs are very effective at blocking the formation of these new vessels. So, when an eye that was growing vessels, because it was starved for blood flow, now has no help in sight. Now what happens is that the eye cells start to die off in the back of the eye.

TRACKING THE ISSUE

The way we can see that are through 3D ultrasounds of the eye. You see overtime, as you do more
and more shots, that the retina thins and you have a decrease in vision. Visual acuity and other things fall off. There is a very real consequence of these shots, which is that they give you some short-term benefit, but in the long run, they tend to lead to further decline in your vision and the health of your eye.

That’s why the shots are not a good long-term solution. But as far as first aid, they can be helpful. If someone calls me and they are a little panicked because they have leaking and bleeding, and maybe they’re seeing a dramatic decrease in their vision. I might recommend they get a shot or two because they have a real problem that needs to be dealt with quickly. The shots are the best way of doing that. 

CONCLUSION

I would then suggest they do a program like the Better Eye Health program, which is a way to treat the underlying disease, the root of the problem. Hopefully they would need fewer or even no shots in the future. Sometimes, that first aid is necessary and I’m glad that it’s there. If you have
any more questions about wet or dry macular degeneration, I’m going to ask you to bring them to the Q&A session that we are about to begin.


BEH PODCAST EPISODE 43
DOES IT HELP ME TO JOIN A CLINICAL TRIAL?

Today, we will cover the last of our “should ask” questions that I propose people should ask. This involves a more general discussion, and the question today looks at whether it is advisable for people to involve themselves in a clinical trial, specifically for their eyes, or really for anything medical. In general, my recommendation is no. Do not involve yourself in a clinical trial.

About the only time I recommend a clinical trail is if you had a truly life-threatening disease where the only possible chance of survival involved enrolling in a clinical trial. Even then, my answer is still a qualified maybe. If that situation arose, we’d have to talk. 

THE ISSUE WITH CLINICAL TRIALS

The whole discussion of clinical trials is complicated by the controversial nature of medical research. Controversial in terms of how studies are set up. Controversial in terms of what even is the placebo. The simplest way to think about this, and what I propose to you, is not encouraging someone to run to the front of the line for a new and unproven study.

In a clinical study, there is a very good likelihood will end up placed in the non-treated group, the placebo group. You might go through a lot of time and a lot of effort and not even really receive any kind of treatment. This delays your chance to do something positive for yourself. 

There is another reason, which connects to changes in clinical studies. In the old days, it was considered a great favor to the field of medicine and medical research if you stepped forward to take part in a clinical study. Now, clinical studies number one design focuses on getting a drug on the market. There’s virtually no clinical research for any of the kinds of therapies and treatments that I  propose as a first line of therapy for most diseases.

THERE IS A COST 

They are also not free anymore. Very often, you pay for the meds, the visits and even some of the lab tests. Alternatively, they might charge your insurance company, so you pay the copays. In addition there is a huge amount of time involved: invasive studies, lab work, blood sticks, meal sticks and even the possibility of paying for the doctor’s time. I’m glad that studies are done in general, but this is why I’m not a big proponent of many of these studies. 

OTHER FACTORS

Another issue is many studies are now done overseas. They are done in 3rd world countries. Part of the reason is connected to cost. You can pay people a small stipend, a small token to get them involved. The bad news of that setup is that when a study doesn’t work out, the data, including adverse effects is hidden. The drug companies are very selective about only showing you results that they think are positive and that benefit their product.



BEH PODCAST EPISODE 42
WILL VITAMINS ALONE HELP MY EYES

The topic that I wanted to talk about today is one I get frequently from people who are first considering the program. They are told they have some serious eye problem. They are told by their doctors there’s nothing that can be done, except maybe take some eye vitamins. The thing I wanted to address is what happens if you only do what your eye doctor recommends, which is only to take the basic vitamins. For instance, something like the AREDS formula or OCUVITE. What could you except?  What would happen if you did not do anything besides that? 

THE REASON FOR THIS QUESTION

The reason I pose this as a question and address this today is that the answer to that is very well known. The reason that this is well known, result in studies dating back to the 1950s and 60s, which attempted to look at the effects of different vitamins, formulas and supplements on the natural history of these diseases. When I say these diseases, I mean things like Macular Degeneration, Retinitis Pigmentosa and Stargardt disease - these degenerative retinopathies or degenerative retinal diseases. The results of hundreds and even thousands of studies are interesting. One of the things they’ve shown is that there is no vitamin that anyone has ever tried that  stopped or reversed these diseases. 

JUST SLOWING THINGS DOWN

They simply slow down the course of these diseases. The natural history of all these diseases is that over time, your eyes gradually get worse. There is no point on the course of these diseases, where there is remission or things get better for a while. What’s more typical is that you may have something happen and you lose a certain amount of visual function and then you may plateau.

WHAT CAN HAPPEN TO YOUR VISION

Your vision may stabilize and stay that way for a few years. But then it will slowly keep drifting down. Then if you have a disease, especially something like Macular Degeneration, there is a complication in the later phases of this diseases where it can leak or bleed into the retina, which as a result can cause damage very quickly. Damage meaning, loss of vision and physical damage to the retina. That’s why doctors are so aggressive about treating this problem. What you hear today in 2016 about treatments for Macular Degeneration are not treatments so much as treatments for the complications. 

USING THE TERM MACULAR DEGENERATION

I use Macular Degeneration as the common term for all these diseases. That’s because number one, this is the most common of these problems. But number two, I feel it’s fair to lump them all together because genetically, these diseases are more alike than different. There’s one gene, the ABCR gene, that can look like Macular Degeneration if you have that genetic defect. It can look like RP or it can look like Stargardt.

So these diseases are much more alike than they are different. They all have a very similar natural history. One of the differences is that for things like RP and Stargardt disease, the onset, or the beginnings of problems, can be early in your life. They can happen while you are still relatively young. But, the natural history is just to put it simply progressive loss of vision and progressive damage to the retina. 

SOMETHING REMARKABLE

The natural history does not include any kind of remission or period where things get better. One of the reasons I say that is that you have to understand that this is well described, and well-studied. So, when something comes along like the program we’re doing, where even a few people get better, that is so outside the norm. The result is remarkable. Even with documented cases of people getting better, it has been very hard to get mainstream medicine interested in this program. 

THE NULL SET

One of the hardest things in medicine is defining what’s called the null set. What happens if you do nothing. So one of the reasons that the standard for research and medical research is the double blinded placebo control study is that you can examine results from a study if it’s a double blinded placebo control study. You can decide if the results are significant and meaningful or not - even if you can’t define the null set. 

The classic would be a disease like rheumatoid arthritis. In something like rheumatoid, people can go into remission, where they may have a bit of damage to their joints, but all the inflammation goes away and they are suddenly ok. You know if you are doing a study to do a treatment in a disease where it’s possible that things can just get better on their own, it’s hard to know if the improvement that you see is due to the treatment you did or whether its just a natural healing.

DEFINING THE NULL SET

For instance, when you’re talking about a disease like Macular Degeneration, things never get better on their own. Never, ever, ever do they get better on their own. That essentially defines the null set. The reason that is important is that even if you have just a few isolated cases - case reports - even that data becomes meaningful because you know the definition of the null set. You know what happens if nothing is done, so if something is done and people get better it is by definition, significant. 

VITAMINS ALONE WILL TAKE YOU ONLY SO FAR

So, I just say this because a lot of people feel that they just want to not do anything, take their chances, and just take the vitamins their doctor recommends. And they’re just essentially resigning themselves to a lifetime of seeing their vision dissipate and go away. So that’s all I want to say about that. I’m not saying this to be negative, because all of you who are on this call are doing something that’s at the very least, I would expect, stabilizing your vision, so you’re not going to lose any more. 

CONCLUSION

One of the reasons we’ve added these additional calls with me to the program, you know the 3, 6 and 9 moth calls is to keep better track of this and to look for other things in your health that might be obstacles to your eyes getting better. So, it’s important to realize that if you’re doing everything we’re asking you to do and you’re not getting better, then we need to be talking. That means there’s something we’re missing, because this should work for everybody. That’s the goal, because this is supposed to be a program that just flat out works for everybody.



TRANSCRIPT FOR BEH PODCAST EPISODE 28

CAN YOU HELP YOUR EYES WITH MORE OXYGEN?

Dr. Miller: A question just about oxygen—about adding oxygen.  There are things that people do, things like hyperbaric oxygen.  An easy one to do is what’s called EWOT—Exercise With Oxygen Therapy—where you basically put breath from an oxygen tank next to your treadmill or your stationary bike.  Those are good things to do, but the other thing that’s important besides adding more oxygen into your blood, is to add more blood into your brain. There are several things you’re doing that increase blood flow to the brain; a number of things in this program.  The acupressure increases blood flow; the color therapy increases blood flow; the micro-current stimulation increases blood flow; the exercises increases blood flow.  Some of the supplements that we had for people with more advanced disease, things like the Vinpocetine and the Gingko, those increase blood flow.  So that’s the first five that we do to increase blood getting to your brain.  Meditation also increases oxygenation.