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Here's a lesson learned from the last time CMS requested public comments on their Non-Coverage Determination for home oxygen therapy for Medicare Beneficiaries suffering from CH in 2010. Do not write about your personal experience with home oxygen therapy as a CH abortive. It will be redacted and a waste of time. Do write about what you have observed in other CHers using oxygen as a CH abortive. Do write about the cost differential between home oxygen therapy as a CH abortive and the $100 dollar a pop street price for a subcutaneous imitrex injection limited to nine per month. For example, the average CHer experiences three (3) CH in a 24 hour period. When used with proper procedures, an M-Sized O2 cylinder contains sufficient gaseous oxygen for 30 CH aborts at a flow rate of 25 liters/minute (more than 100 aborts using my latest procedure hyperventilating with room air for 30 seconds then inhaling a lungful of 100% oxygen and holding it for 30 seconds). Doing the math, the average CHer will consume 3 M-Size oxygen cylinders in a month. At an average co-pay cost of $30 dollars per M-Size oxygen cylinder after insurance, that comes to $90 dollars a month out of pocket to cover aborts for all CH. The out of pocket co-pay for a single 6 mg/.05ml subcutaneous injection of imitrex comes to $28 dollars. Doing the math, with the limit of 9 injections/month, the total cost comes to $252/month for nine (9) aborts. This doesn't cover the cost of the horrific pain CHers experience without home oxygen as an abortive when they've used up their monthly allowance of nine imitrex injections. Take care and take action. V/R, Batch

Siegfried, What was your 25(OH)D3 serum concentration? Here are my labs for serum 25(OH)D3, Calcium and PTH over the last three years. My PCP understands calcium homeostasis and that I keep my 25(OH)D3 serum concentration this high to prevent my CH during periods of high pollen and mold spore counts. Accordingly, he has no problems with it being this high as long as my serum calcium remains within its normal reference range and as you can see, it has. Did your PCP run labs for your serum calcium and PTH? Take care and please keep us posted. V/R, Batch

For what it's worth, here's the logic and science behind the 12-Day accelerated vitamin D3 loading schedule and why the initial target 25(OH)D3 serum concentration is 80 ng/mL. 1. From the online survey data of 313 CHers who have reported their results after starting this regimen since Dec 2011, we have the normal distribution chart of baseline 25(OH)D3 lab results before starting this regimen and normal distribution chart of the objective (Favorable CH Response) 25(OH)D3 labs after ≥30 days on this regimen. As you can see, CHers reporting in this survey with active CH, went from a mean 25(OH)D3 serum concentration of 24 ng/mL before starting the anti-inflammatory regimen to a mean of 80 ng/mL after ≥ 30 days on this regimen with a significant reduction in the frequency of thier CH. The following chart illustrates the notional change in serum 25(OH)D3 made possible by starting this regimen with the 12-Day accelerated vitamin D3 loading schedule. Data from the online survey confirms the above notional response. As you can see, if the CHer took only 10,000 IU/day vitamin D3 and no loading, it could take well over 2 months to reach a mean 25(OH)D3 serum concentration of 80 ng/mL. The following charts illustrate the favorable CH response to this regimen by day after starting it. The first chart illustrates favorable responses by day after starting this regimen. I used a favorable response as at least a 50% reduction in CH frequency by at least 70% of participants. Data from the survey indicate the mean reduction in CH frequency is 80% by 82% of participants. This second cart illustrates days after start of regimen to a sustained complete cessation of CH symptoms. Survey data collected during 2019 indicate the favorable response rate increased with over 90% of CHers reporting a favorable response. I attribute most of this increase in the response rate to the switch to Bio-Tech D3-50. 2. Why is the initial 25(OH)D3 serum concentration target set at 80 ng/mL? This is where a little statistics and what's called the confidence interval comes into play. In statistics, a confidence interval is a type of interval estimate, computed from the statistics of the observed data, that might contain the true value of an unknown population parameter. Data in the following chart comes from the D* Action database at Grassrootshealth. It represents the results of 25(OH)D3 lab tests from over 10,000 people who take the 25(OH)D3 home blood spot test for their serum 25(OH)D3 every six months reporting their vitamin D3 dose over the six months prior to this lab test. As you can see, the mean 25(OH)D3 response to various vitamin D3 doses is represented by the blue lines and that at a dose of 10,000 IU/day, the mean 25(OH)D3 response is 76 ng/mL. The red lines represent the 95% confidence interval. In simple terms we can say that the results a given lab test for 25(OH)D3 at a dose of 10,000 IU/day will fall between these two red lines with 95% confidence. The green dashed lines represent 25(OH)D3 serum concentrations at 40 ng/mL, 30 ng/mL and 20 ng/mL. Accordingly we can say that at a dose of 10,000 IU/day the confidence interval for 25(OH)D3 response lies between 42 ng/mL and 118 ng/mL with 95% confidence. If you go back to the second chart illustrating the normal distribution of 25(OH)D3 results among CHers responding to this regimen with a significant reduction in the frequency of their CH, you can see this same confidence interval falls under the normal distribution curve. For practical purposes, this is also the effective therapeutic range of serum 25(OH)D3 (40 ng/mL to 120 ng/mL) for favorable responses. You can also see where a lower vitamin D3 dose of 5,000 IU/day results in a confidence interval between 25 ng/mL and 90 ng/mL. In this case a significant number of CHers would not respond to this regimen. As an "Oh by the way..." the following charts from two different COVID-19 studies indicate taking 10,000 IU/day and keeping your 25(OH)D3 serum concentration over 40 ng/mL is a pretty good idea... This isn't rocket science and you don't need to be a physician to understand the importance of this information. Hope this helps explain a little more about the anti-inflammatory regimen treatment protocol. Take care, V/R, Batch