The following pain management protocol of Stuart L. Weg, M.D. is presented as an adjunct therapy to the antibiotic protocol for inflammatory rheumatic diseases presented on this web page, particularly for patients with intractable pain.

Dr. Weg is an anesthesiologist specializing in pain management. He practices at several locations in New York - West End Avenue and Grand Central in Manhattan, as well as in Mt. Kisco, NY (Westchester), Suffern, NY, Latham, NY (near Albany) and also in Broomfield, NJ. He can be reached through his secretary at 1-201-320-6758.

He is a member of the following organizations:

Diplomat American Board of Anesthesiology with added Qualification in Pain Management
Fellow American College of Anesthesiologists
Diplomat American Academy of Pain Management
Member American Board of Oxidative Medicine


Part One - Patient home therapeutics

Home oxidative therapy with hydrogen peroxide for all patients:

A. Peroxide baths: Mix 3-4, 16 oz. common brown bottles of 3% peroxide in a hot water bath with 2 cups of Epsom salt. Soak for 30 minutes. Do this at least 1 to 3 times per week (no vitamins should be taken 4-8 hours before bath). This is the preferred way to take peroxide. Still better is a Jacuzzi with the jets turned on. This enhances the effects. A home whirlpool such as Polinex (cost about $110) fits on a standard bathtub and also greatly improves the effect. Increase the amount of peroxide and Epsom salt proportionally for the larger tub sizes. For economic bulk purchase of peroxide, consider obtaining the concentrated 27% solution sold by the gallon as a cleaner in some swimming pool shops. It is called "Baqua Shock". This product is dangerous to the skin right out of the bottle. It must be diluted in your bath. Use about 1/10 the volume needed of 3% peroxide in your baths.

B. Peroxide sponge/spray bath: Apply straight or dilute 3% peroxide, less than a full 16 oz. bottle in total, to your skin. Use liberally directly over as much surface as you can. Leave this on for up to 5 minutes and then wash off. This technique can work very well especially after a work out, hot shower or hot tub, when you are warm and/or sweaty with your pores open. To obtain results equivalent to a bath, it is required that you first apply the tanning product described below and wait about 5 minutes for your skin to flush before applying the peroxide.

HIGHLY RECOMMENDED - The use of Swedish Beauty "type A" or "Platinum" tingle factor 2 or 3 brand of tanning accelerator (available at tanning salons) applied to your skin and left on for 5 minutes before you sponge or bathe greatly increases the absorption of peroxide. The phone number of the manufacturer of this product is 1-800-532-9035. Note: The tanning accelerator should make you red and flushed before you apply peroxide to the skin. Try it on a small area first and then increase with each bath/sponge as tolerated.

Other home oxidation techniques

C. Oral Peroxide: Use 3% without preservatives. Take one capful in a full glass of water daily as tolerated, on empty stomach. (Substitute 35% food grade drops if possible). This is recommended only in cases when baths or IV's are not available. CAUTION: Although approved by the FDA as a food additive, some doctors believe oral H2O2 can be dangerous.

D. Peroxide mouth irrigation: Use 1 part 3% peroxide with 2-5 parts warm water three times a day. Vigorously swish this mixture around in your mouth for 5 minutes rinsing several times. (Use 3 times daily for acute migraines or other head, neck or dental problems - especially recommended for sinusitis.) Using a Waterpik device for this treatment greatly enhances its effectiveness.

E. Peroxide enema: 1-4 tablespoons in 1 liter instilled rectally (works well in CFIDS)

F. Ozone baths in hot tubs etc. with ozone sterilized water may not contain enough ozone to have much therapeutic effect. If adequate ozone levels are achieved, the effect is excellent.

G. The exposure of the skin to the sun or tanning salon without UV blockers will cause a systemic oxidizing effect by the UV rays reaching the blood near the surface. The use of the Swedish Beauty tanning accelerator greatly enhances the effect. High levels of oral vitamin C help avoid skin damage, but gradual, controlled exposure is important to avoid injury.

Note: You should have vitamin C out of your system (at least 4 hours) before getting peroxide in any form. It's not dangerous if you forget. It just makes the peroxide treatment less effective. Vitamins should be resumed immediately after the peroxide.

H. Immersion baths with sodium bicarbonate (baking soda) or lathering up to the neck with alkaline bar soap (Fels Naptha laundry soap) will help with achy flare reactions that can occur after oxidative therapies.

Essential Nutrients for all patients

1. Vitamin C . Push to bowel tolerance. This means take 500 mg to 3000 mg (1/2 to 3 grams) at a time and throughout the day until you get diarrhea, gas etc. then back down to what you can handle. Keep that dose daily and increase in times of flare to as much as 20,000 mg (20 grams) daily. Tablets are for daily use and one teaspoon of powder for flare problems. One level teaspoon of ascorbic acid powder equals 5 grams of Vitamin C. A typical dose is around 2-8 grams daily.

2. Acidophilus with Bifidus, taken daily. This should be taken in doses of 2-3 times recommended on package. Buy several brands and dissolve some in bottled chlorine free water before ingesting. If you have rectal mucus you should consider taking enemas of this supplement. This is the simplest and safest way to enhance colon health.

3. Mixed fiber daily 30 grams or more. This may be adjusted for people who consume lots of fruit, vegetables etc. Both soluble (oat, psyllium, flax) and insoluble (wheat, rice) bran must be included. Omit wheat bran if you are on a wheat free diet. This is needed for two reasons: First to avoid constipation associated with narcotics and second to promote colon health by reducing stagnation and overgrowth leading to high levels of bacterial translocation.

4. Grape Seed extract (also known as pycnogenol) 100 mg daily. This is an anti-fungal and anti-microbial, especially in the bowel.

Less essential nutritional supplements

5. Milk Thistle daily as directed on the bottle. (This herb is very important if you take medication.)

6. Coenzyme Q10 - 100-300mg daily. (This supplement is very important in heart patients.)

7. Flax seed oil - use on food daily

8. Vitamin E 1200 I.U. daily

9. Good high potency multiple vitamin with trace minerals daily

10. Bioflavinoids (usually contained in vitamin C preparations)

11. Selenium +/- 100 mcg daily

12. Calcium 1000 mg with magnesium 500 mg daily

13. Borage oil is available in capsules. Take 1000 mg daily.

Very useful supplements in selected patients and conditions:

14. Cranberry concentrate tablets are very effective with uncomplicated urinary symptoms, enhancing secretion of shed urinary bacteria. Use only as needed.

15. Bismuth 120-240 mg tablets (available as Formula SF734 by Thorne Research) are reported by many patients to be highly effective for gastric discomfort. This is a mandatory replacement for H (stomach acid) blockers that are specifically avoided on this protocol. Use only as needed.

16. Undecyn 150 mg. 1-5 tablespoons orally 2-3 times daily. This is an anti-fungal for people intolerant of Nystatin or wanting to use an over the counter product etc. Pharmacies and physicians can order this from Thorne Research, Product #SF742, 1-800-228-1966.

17. Glucosamine sulfate & chondroitin sulfate (separate or combined pills). Many people are now reporting that this is effective for joint and general pains. Take the recommended dosage on the bottle.

18. N-acetyl-cycteine or NAC is specifically recommended for assistance in drainage of sinus infections. Use only when needed.

The following are promising and under investigation. They are optional due to limited physician experience.

19. Catsclaw 1,000-3,000 mg/daily. Take this intermittently. The tea seems to work better than the pills. Find a brand that is best for you.

20. Wheat, milk and sugar free diet. These foods may be reintroduced after one month, one at a time

21. L glutamine for digestive/gut problems

22. Cartilage products (shark, beef, chicken). Hylauronic acid (in the cartilage) is a potent anti-infective substance.

23. MSM taken in dosages of about 1500 mg per day is useful for muscle aches.

Very important things NOT to do

Patients must cease using tobacco products completely and greatly limit alcohol if they expect any of these therapies to be successful!

NO cortisone, prednisone or any other corticosteroids should EVER be used. This includes nasal or lung sprays and any skin products whether over the counter or by prescription.

Patients must also try to avoid all nonsteroidal medications including aspirin and Tylenol as well as all of the other over the counter pain remedies such as Motrin, Aleve, Excedrin, etc. These medications will make the pain and disease worse over the long run. Pure narcotic analgesics can be used as needed without this danger.

Part Two - Medications and treatments that can only be given under a physician's supervision

Oral antibiotic medications:

1a. Low dose or Dr. Brown Protocol: Minocycline/doxycycline 50-200 mgs M-W-F for extended periods

1b. High dose or Dr. Nicholson (Gulf War Illness) Protocol: Doxycycline 200- 300mg/day for 6 week cycles. (May also substitute/rotate Biaxin, Cipro, Zithromax, and minocycline.)

Editor's note: We have discovered ALL minocycline is not therapeutically equivalent. The only generic proven to work consistently is the one by Wyeth Ayerst (Lederle). We discovered this problem back in 1997, and a number of people in the support group reported they had 'lost' up to 2-1/2 years on this therapy because of being on an ineffective generic.

2. Sporanox for visible foot or skin fungus, 200 mg daily one week per month or one day per week rotations. Diflucan is being used in some patients.

3. Nystatin tablets for suspected GI candida 1-3 million units/day. (Typically patients alternate 1 week of Sporanox with 3 weeks of Nystatin) The liquid is preferred over the tablets.

4. Nystatin Liquid is sometimes necessary for stomach or nausea problems. (It may be used with Bismuth). It is formulated as 100,000 units per ml. Take a tablespoon (15ml) several times a day instead of the tablets. Rinse your mouth after use, but try to avoid swallowing anything for at least 15 minutes to get prolonged coverage of the stomach and esophagus with the drug.

Home daily IM injection therapy:

These assist in selected cases such as MS or CFIDS or where pain is associated with fatigue.

1. Kutapressin 2 ml. IM QD

2. B12 1000 units/ml injections 1cc IM. QD. (This can be given in the same syringe as Kutapressin)

Office treatments

Oxidative therapies:

1. Photoxidation of blood with ultraviolet light - UBI Technique (Knott) with added H2O2, O2 and or ozone up to 0.5 to 5% of total blood volume per treatment.

2. IV H2O2 Infusion - Farr formula (.03 - .10% H2O2 in 250 ml D5W with magnesium and manganese)

3. IV high dose Vitamin C 10-50 grams with added vitamins and magnesium in 250-500 ml of sterile water.

4. Chelation therapy with IV EDTA

5. Ozone therapy, bag technique, rectal insufflation, Hemoautotherapy.

6. Injection technique for painful areas mixing ozone gas and/or peroxide with 1/2 - 1% lidocaine then infiltrating.

7. High dosage (8-25,000 units of hydrocobalamin IV) B12 infusions are very effective for neuropathies in MS, Lyme, DM etc., given with Ascorbate in sterile water or D5W.

Antibiotic therapies:

8. IV doxycycline 100-200 mg.

9. IV or IM clindamycin 300-1200 mg.

10. Injections of painful areas: Preservative free freshly mixed 1/2% lidocaine with 1 to 400,000 epinephrine plus 0.2 ml 3% peroxide per 10ml of local. Then a second pass - optional (after 15-30 minutes) - 150-600 mg of clindamycin per 10ml of sterile water - selected cases only.


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