The FDA and FMT regulation, part 2. (Jul 2024, HumanMicrobes.org) I met with the FDA. Here's what I shared with them, and their response. Blog 

Hopefully the same goes for his general tone about other people, the state of the world, and the role of his own work in the whole thing.
It's factual information that needs to be said because you can't solve a problem without diagnosing it first. If you have alternative theories for the state of things, or counter arguments against my statements, you're free and encouraged to write them.

My criticisms are backed by a plethora of evidence, and I think they are more than appropriate, especially coming from a disabled patient whose life is being stolen from them by incompetent and apathetic people.
 
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Michael Harrop at Senator Bill Cassidy's office Senator Cassidy:​

I have been waiting outside Senator Cassidy's office most days. At first, it seemed like he and his staff were avoiding me, but then for two days in a row he acknowledged me and I nodded to him without saying anything. He finally approached me and said hello and I asked him if his staff had told him why I was there. He said no. I gave him a brief overview of the situation and handed him more info, and he said he'd look into it.

He seemed less informed about FMT than Marco Rubio. However, during the 2nd RFK hearing he had a laptop with him and looked up one of RFK's citations in real-time, so he seems capable and inclined to learn about new science himself. During the hearing, he said he's been out of medical practice for 15 years. From my interaction with him, and the hearings, he seems likable, genuine, and competent. He convinced me that he would learn more about the microbiome and FMT over the next week and get back to me.

Cassidy's HELP staffer:​

For the past couple of days, I also left flyers under the doors of the HELP staff offices. After Senator Cassidy talked to me, I decided to wait outside the HELP staff office instead. Around 2 hours after I talked to the Senator, and around the time I was waiting outside the Health Majority office, Senator Cassidy's HELP staffer emailed me:

Hi Michael,

My apologies for this delayed response. I appreciate the work you are doing and the importance of FMT as a cutting-edge intervention that may have clinical benefit for a wide array of patients.

Unfortunately, the information you’ve received from NIH and FDA is accurate, to my knowledge. To receive NIH funding, many patient advocates choose to partner with researchers at academic institutions to submit applications. If you have not done so already, as a next step, I recommend seeking out likeminded academic researchers or small businesses to identify any opportunities to collaborate and apply for NIH funding.

Given our role overseeing HHS agencies and ethical considerations, the Committee does not weigh in on NIH or FDA decisions related to individual applications for research funding or regulatory approval. Your home state senators, however, may have different office policies that enable them to weigh in with NIH and FDA, or they may be able to work with you on developing draft legislation to address this issue if you would like to do so.

I’m sorry that I cannot be more helpful to you and am unable to provide further assistance.

Best,

It's erroneous information that I'll dispute with her, and which highlights that she didn't even read all the information I shared, but it also highlights the potential for @indigo34's Senator to play a key role, and lack an excuse to dismiss us without helping, given that he is both her home Senator and on the HELP committee. They promised her they'd respond in two weeks, so that's something to look forward to. He seems like a friendly guy as well. A while back, he walked by me near the entrance to the building and said hello to me (a complete stranger) and other people.

I'm doubtful that this email was a result of Senator Cassidy talking to her about it. I think there's hope that Dr Cassidy will still review it on his own and see how promising and important it is.

Her response does highlight the fact that there's not a clear solution here, and the bullet points of minimum requirements that I created can probably be improved. Part of the problem is that they keep asking me for a solution and I don't know what exactly they're capable of. I need them to discuss it and come up with possible solutions.

When I was telling Dr. Cassidy about it, he asked "So what do you want from me?". I handed him the flyer with the bullet points, but I also said "I think you need to discuss it with your staff and NIH".

I'm considering changing the bullet points to something like:
  • There's a cure for numerous diseases, including mine.
  • I should be able to access this cure.
  • I should not be responsible for making this cure available.
  • I will never be able to access it unless someone in the federal government does something.
I think I'm even going to shorten the whole flyer to that.

RFK hearings:​

https://forum.humanmicrobiome.info/threads/incoming-trump-admin-with-rfk-signals-new-start-for-fda.706/post-2063

Staffers:​

Since it seems that overwhelmingly, the congressional staffers ignore this issue, don't fully review it, and don't pass it on or discuss it with the Senators, our best hope is likely to directly reach a Senator who cares and is willing to do something.
FMT, FDA flyer
After leaving flyers with the Health minority staffers, I saw some of them reading them and laughing. Here's one of the flyers.

I'm now thinking it's possible that @Otto Kretschmer and @SFBayFMT5 may be right about some of the staffers being incompetent and apathetic, and perhaps reacting with derision to something new & unusual to them. I certainly did not get that feeling from Sanders' HELP staffer I met with. She seemed knowledgeable, competent, and willing to help. That hasn't been the case for Cassidy's HELP staffer. I have followed up with Sanders' staffer and haven't heard back.


Misc:

I spoke to a nurse outside Cassidy's office. He was dressed well in a suit and at first glance would be taken much more seriously than me. But as he talked it became clear he was worse off than me, largely due to a myriad of health problems, such as sleep deprivation/narcolepsy, ADHD, and more. So much so that he was unable to read and learn the info I shared with him about the microbiome and FMT. It felt like a summary of the past decade -- I need help so badly, and here's this other person suffering and in a great position to help me and himself, but instead of getting help I'm having to carry everyone across the desert with me.
 
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A while back, he walked by me near the entrance to the building and said hello to me (a complete stranger) and other people.
That's called Southern hospitality. One of the nice things about living in Virginia :)

it also highlights the potential for @indigo34's Senator to play a key role, and lack an excuse to dismiss us without helping, given that he is both her home Senator and on the HELP committee. They promised her they'd respond in two weeks,
It has been two weeks and I haven't gotten a response. I can try calling their office next week to follow up. I'll email you the comment I submitted on their website. There wasn't an option for a meeting request unfortunately.
 
It's factual information that needs to be said because you can't solve a problem without diagnosing it first. If you have alternative theories for the state of things, or counter arguments against my statements, you're free and encouraged to write them.

My criticisms are backed by a plethora of evidence, and I think they are more than appropriate, especially coming from a disabled patient whose life is being stolen from them by incompetent and apathetic people.

What I mean by tone is this... in a number of your posts, you come across as if you believe the following:

1. The FMTs you have sold are so much superior to FMTs from ANY other provider, that anyone who uses a different provider is wasting his or her time
2. Building off point 1, you have solved the donor selection problem for FMT once and for all, for all recipients
3. Since your donor criteria don't rely on testing a donor for pathogens more than once, anyone who does so is wasting money that should instead be devoted to recruiting donors from the ~0.0001% (I'm making up a number there--but the point is, it's tiny) of the population who is healthiest.
4. FMT will cure all or at least nearly all human diseases, therefore medical research into most other things is a waste of time and money
5. On top of that, FMT will "cure" things that most people don't even think of as "diseases", like political conflicts, and everyone not being an Olympic class athlete. And going along with this, the vast majority of the population is "ill".
6. Anyone who doesn't believe the above is an idiot.

The reality, as I see it, is:

1. Anyone who follows experience reports from a variety of FMT providers, or who has even personally TRIED FMTs from several providers (like myself), knows that your FMTs have a level of success very similar to that of other providers. Yes, you have a much larger pool of potential donors, and for that reason, it would be significantly more likely for someone to find a compatible donor among them than from a provider with only 1 or 2 donors. However, VERY few of these potential donors have ever been "activated", meaning that in practice you have the same number or even fewer donors actively donating than competing providers.
2. You have a significant amount of valuable experience on which donors work FOR YOU, as well as a decently sized collection of statistics on who else benefits from your donors. However, you have nowhere NEAR enough data to conclude that you could, with certainty, pick a donor for someone else that will work. I recently got worse from a donor that the provider has said had not previously made anyone else worse, and who greatly helped someone I personally communicated with--showing that there is NO perfect donor even if that person has helped many people in the past. And, even if you know which donors work for you, you haven't solved the problem of holding onto them so they keep donating--except for maybe if you paid them millions of dollars--but NO medical system can bear the cost of an intervention that sells for a million dollars for a course of treatment, especially when my OpenBiome donor, who worked extremely well and better than either of the other providers I've used (including Human Microbes), was paid a tiny fraction of that.
3. Testing for pathogens isn't about making sure someone will cure a recipient--it's about screening out KNOWN reasons a FMT might make someone dramatically WORSE. And people with a decent microbiome aren't super rare, most of us get our microbiome as babies from people who are NOT in the top 0.0001% of the population in anything.
4. I agree that a great number of cases of "chronic mystery disease" will respond dramatically to FMT. In other words, things along the lines of ME/CFS, fibromyalgia, PANS, post-Lyme syndrome, etc. In other words, cases where someone goes from being well to feeling "not like himself/herself", in a multisystem way that eludes medical understanding. The same goes for many GI conditions like IBS, IBD, gastric reflux, gallstones, etc., as well as many metabolic disorders. However, I find it very unlikely that FMT will cure late stage cancer, and it certainly won't cause a missing limb to regrow or fix a genetic defect like muscular dystrophy.
5. Most people are well enough to work a decent job and take care of themselves. That doesn't qualify as "ill", and doesn't mean they are horrible donors OR that they need FMT.
6. Most people who don't believe the above are not ready to jump to such conclusions because A) they haven't been sick enough to need a FMT, or B) they are not willing to take the gamble that a donor (including one of yours) might make them worse.


I get that you have valuable information to contribute to the discussion of how to improve FMT. And it's awful that people put roadblocks in your way rather than seeking to use this information to help people. I totally get that the way things are, you can't even DO the experiments that would determine to what degree you're on the right track. But to counter-react by claiming that you, and only you, have the answer to all of medicine, or even that you are the only one who truly even cares about trying to help people, really hurts your cause. That's the kind of thing that quacks say. And I've seen writings of yours where you don't claim this sort of stuff--where you acknowledge that we're still learning about FMT and that you are just doing your part to help move it forward--but you have to make sure that this is the first impression you make to people like the members of Congress in charge of medical policy.
 
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