Listen. Hear the laughter? Friday, Aug 14 2009

Hey all you “real Americans”. How y’all doing today? Ya that Obama wants to change health care and do all sorts of bad things to us and our yungin’s. Just as Sara Palin Phd, MS, BS, JD,SOS,UB2,Nin-com-poop, IQ2, (I’m not gonna be gettin’ into all those honorary like dyplomas like MS in Whale Oil, Phd in Hair Tonics, Cellulite creams and Creationism) been talkin bout.

All right morons. Be quiet a moment and you’ll here something surprising. Wait!Wait! Quiet. There you hear it. It sounds, why it sounds like laughter doesn’t it? Yes it is! From the east,north,west and south! The whole damn world is laughing at us! I’m laughing too! Because I always knew that most American’s were somewhere intellectually on the same plane as kangaroos,buzzards and evangelical preachers.  It is without a doubt the greatest show on earth. Hordes of  our country’s citizens egged on by a gaggle of  failed disc-jockeys stifling debate about something they have not the slightest idea about, namely HRA 3200(or for those of you more intellectually inclined Obama’s Socialist, Communist, Evil, Beezlebub’s takover of healthcare). A few things I’d like to point out to you Einsteins of the corn belt:

Did you full bred American’s know that under Obama’s plan bankruptcies due to medical bills would become a thing of the past?

There will be no denial of insurance for those with pre-existing disease?

Smaller businesses would be able to buy into health care plans because they would become part of a large pool of insured, thus drastically reducing price per policy?

Doctors would be reimbursed for discussing end of life issues with patients(such as living wills, health care proxies,etc..Why is this important? Lets say you’re 85 years old and down to 95 pounds due to some kind of illness. You’re in constant pain. your mind is alert but you body is shot. One day your in bed when you feel a warm glow coming over you, the pain starts to decrease, Ah! Rest! Finally rest! Next thing your waking up with a terrific pain in your chest due to some 250 pound paramedic pushing on your chest as if he was attempting to stuff you in a sardine can. “No!No!” you yell,”leave me alone I want to go back to that peaceful place”. But the words never cross your lips. You see you’ve had a severe stroke while you were out enjoying the scenery. Your conscious but you cannot speak, you cannot move. All you can do is lay there as the other medic yells”One!Two!Three!” and your shoved like a piece of rotted meat onto a stretcher for a long ride to the hospital where the half hour is spent made nauseous by the twists and turns the ambulance is making and the wretched smell of the garlic fries the medic gobbled down en route to pump on your chest with all his might. At the hospital you are scooted over to another stretcher where you are disrobed and grabbed and probed by at least 6 pair of hands. Their being convinced your stable you have now lost their interest. They leave you agonized by the constantly chirping alarm of the cardiac monitor that nobody ever pays attention to. Blanket! Not a chance. Shiver on the inside all you want no one is going to notice. Next to your surprise, a drunk is placed in the stall next to you who for the next 5 hours does noting but yell, threaten, piss and shit on himself. You are now ready to go up to you room. Your in the hallway when all of a sudden that peaceful feeling starts to come over you. “Thank God! I’m being released from this living hell”. ZAP!!! Not so fast. You were just brought back to “paradise” courtesy of 360 joules of electricity from a defibrillator that suddenly fills you with empathy for all those who have been struck by lightening or bit through live electrical cords. Thankfully that fat bastard wasn’t around to play Devil’s pattycake on your chest and belch garlic into your unprotected face. Ah, now you’ve reached the floor. Your bed. Here comes one of those angels of mercy to help with a young assistant in tow. “Another plant I’m gonna have to water for the next 12 hours”.” What plant could need 12 hours of watering?” you absentmindedly ask yourself. Then to your widening horror you realize she’s looking at you when she’s saying it. “Come on!” our Florence Nightingale recoils in disgust”she’s full of shit and piss. You know what, I get off in one hour. Cover her up and we’ll make like we never saw her”. Just then there comes that now familiar feeling of drifting away, of lightness, pain easing. Your on your way. Then you hear an electronic “Beeeeeeep” coming from the machine above the bed on your left. Immediately you see standing over you the big brother of the medic, 450 pounds of him with 2 electric paddles in his hand and then…..). This scenario brought to you courtesy of the Republican Party who want to save you from those death panels that will discuss living wills, health care proxies, and Do Not Resuscitate Orders with you.

Keep up the fight America! I haven’t seen such good comedy since Sanford and Son was canceled.

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H1N1: It coming to get you Tuesday, Jun 2 2009

Man, I tell ya its been hard working in the emergency room these past few days. You’ve seen the news stories about school closings(a small percentage), people wearing masks on the subways and hospitals overrun by patients.This Swine Flu has got everybody scared(and for “really no good reason” as is intimated by the tone of the majority of these reports). Come on you know the story well by now. Hoards of parents anxiously rushing their children to already overcrowded emergency rooms with such mild symptoms as sniffles, coughs, sneezing,104 fevers, dehydration,etc. That’s right, you gullible New Yorkers! 104 degree fevers, dehydration, shortness of breath. Dozens of children in the last couple of days have showed up during  my tours of duty needing multiple doses of Tylenol and Motrin to control fevers, intravenous fluids to correct dehydration, asthma treatments, one even had a febrile seizure( fever due to rapidly spiking fever).

I am constantly getting hassled for performing flu tests, the majority of which are positive(the Centers for Disease Control has stated that any flu test with a positive result is presumed to be H1N1).”It’s not necessary”, “what’s the difference, not a lot of people are getting really sick”, I’m told , often with a menacing grin.I was even told by one doctor”they(who? I don’t know) are trying to stop the influenza probes from running out”. So let me get this straight:

if a patient has probable signs of the flu and he and/or close family contacts have underlying illnesses like asthma, you don’t test.Everybody gets Tamiflu. Well that’s  damn smart; you don’t test to see if the patient has influenza because your worried about wasting cotton tipped applicators but you hand out Tamiflu as if there were infinite quantities of it? Furthermore, we don’t have an accurate account of the number of cases, just a lot of speculation( see how much speculation sucks when it’s your kid that is sick)

Meanwhile, no one is notifying the schools that these children are testing positive for influenza insuring that their not yet symptomatic playmates will be lined up and marched into schools the next day ready to share their “gift” with all the others.

Let me make this clear for you out there. If my experiences of  the past few days are any indication of what’s going on in the rest of the city, then the media and city officials are not being forthright about the magnitude of this illness.

But, why? What reason would anyone have for not reveling all the details of this current epidemic?

Several, including:

Schools close, parents can’t get to work. “Business”(you know nothing is personal these days. It’s all business) slows, economy slows. Less taxes, less money for the scoundrels to play with.

People call out sick from work(officially you’re told “stay home if you’re sick”. Yeah, go ahead and try it; see how long  it  takes before you’re on a first name basis with the people at the unemployment office)

Tourists stay away(the tourists, they no come a to New York and spenda the money, the government no getta the tax)

And the granddaddy of them all, to avoid”panic”(45 years of disaster research has proved that “panic”- as  commonly defined as irrational behavior, hysterical flight, selfishness, helplessness- is a myth not worthy of consideration by anyone with the most rudimentary knowledge of emergency and  disaster management. Anyone that uses “panic” as an excuse for withholding information from the public should have “imbecile” branded on his/her forehead and given directions to the nearest unemployment office). It has been suggested that historically more people have died from efforts to avoid panic than have ever died as a direct result of it.

So what are you to do? Act like sheep or demand accurate information? Watch your children get sick and suffer needlessly or assume your responsibility in protecting them?

My kid is protected. Is yours?

One more thing, be wary of the term “confirmed cases”. I’ve explained in an earlier post the torturous process of confirming H1N1. Citing  confirmed cases(usually a very low number as compared to the nation’s population) is used as a diversion to keep the public in the dark and ignorant.

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Swine Flu and BS: Something smells and it ain’t bacon Wednesday, May 27 2009

The Center for Disease Control puts the current confirmed and probable cases of H1N1(the disease formally known as Swine Flu) at close to 7700 people in 48 states.

http://www.enewspf.com/index.php?option=com_content&view=article&id=7763:h1n1-flu-swine-flu-cdc-update-tenth-death-confirmed-may-25-2009&catid=88888984:h1n1-virus-swine-flu&Itemid=88889934

Yes ladies and gentlemen 7700 confirmed and probable cases out of  a  population 330 million. So why is everyone making such a big deal out of this illness? More people slip in the tub…and become impaled on their faucets each day; more people riding motorized wheelchairs are cited for DUI each day than get the flu; more call the Maury Povitch show each day asking for help in finding out who their babby daddy is.  I could go on and on. But wait, one more thing.

That 7700 number is bullshit. Wanna know why?

I’ll use NYC as an example:

In New York City the only people(in the majority of cases) being tested are those who are admitted to the hospital with life threatening respiratory illness. Otherwise it is being communicated throughout the medical community not to  test those that a medical provider believes is infected with only a mild case of the flu (one could use their judgment in testing those with underlying illnesses). Yes, I know you can go to your primary care doc and squeeze him into doing it. But to a large swath of NYC’s population the emergency room is their primary care office(and they have security!). So  the number of “confirmed and probable cases” may be just the tip of the iceberg(sorry for the old cliche but had a hard day at work and I’m tired).

So here’s how I see it:

1. There are many more cases of Swine Flu out there than we’ll ever know

2.When city officials explain rising absenteeism in New York City schools as being mostly due to  parent’s baseless fears of their children contracting H1N1, remember many children are being given a presumptive diagnosis of influenza by either their doctor or by emergency room staff. This may be the true reason these kids are not in school( remember also these are not counted as “confirmed or probable cases”)

3. These presumptive diagnosis’ are not being reported to schools, so the kid who was fine yesterday but absent today may have had the flu and no one but they may ever know(why is this important: because a kid that came into contact with the sick one yesterday may not be showing symptoms until the end of the school day today. By that time your child was probably breathed,sneezed and coughed on dozens of times). If that child’s parents had been notified that he/she had contact with a schoolmate with H1N1 the parents may have kept the kid home (or the school may have insisted on it).

4. Guidance from NYC’s Department of Health and Mental Hygiene advises that  those who are believed to be infected with flu and who have underlying underlying illnesses such as asthma be treated with antivirals such as Tamiflu. Included would be  household members and other close contacts with the affected person also having underlying illnesses (Relenza is not prescribed for people with asthma because it could induce asthma attacks).

Now here’s a hypothetical situation(well, maybe not so hypothetical;)

Kid comes in with cough, fever, bodyaches, chills for 2 days.

No test is done. Presumptive diagnosis: Influenza.

Discharge instructions include: Rest; tylenol or motrin for fever or pain; insure the child is adequately hydrated; return to school 24 hours after symptoms resolve; return to the emergency room with any problems or concerns. Simple enough.

But wait! The kid’s 3 other siblings(all present)  have asthma so according to the NYC Department of Health and Mental Hygiene they should be treated with Tamiflu(the sick kid without asthma is not).

Problem number 1: we didn’t test the kid so we’re not sure she had influenza. So are we giving the other children prescriptions for Tamiflu unnecessarily and thus helping to waste a key resource in battling the flu(and a scarce resource at that)?

Problem number 2: I’m going to give you the link to Roche Pharmaceuticals and a letter they sent to  healthcare providers in 2006 regarding a little idiosyncrasy involving Tamiflu and children(it’s in pdf). See what you think about it.

http://www.fda.gov/Medwatch/safety/2006/Tamiflu_dhcp_letter.pdf

In my opinion this illness is much more widespread than is being reported by the media either because our government officials were  caught unprepared , were too busy chasing schizphrenic, crack smoking , purse snatching terrorists(you know, the Four Imbeciles of the Apocolypse recently arrested in NYC for sleepwalking through a terrorist plot) or are  looking to avert “panic”.

My advice to government officials would include:

-closing schools early this year, at least for our kid’s sake(you know those little tykes  always used as tools for tears and outrage when your trying to raises taxes on cigarettes and booze or trying to collect fines through seat belt, helmet and leash laws )

-re-think this business of handing out antivirals in such haphazard a manner. I mean you would tar and feather anyone found wasting water in such fashion

-being a little more forthright with the public when giving details of this epidemic.

Remember Mr. Governor, Mayor, County Executive and all other such barons and  beelzebubs. Our nation’s people have been through a lot this year and have remained remarkably patient. They find out your keeping secret valuble information, they ain’t gonna be happy. And your going to need all the help you can get when this thing comes riding back next season, not like a kid on a tricycle but  a drunk behind the wheel of a speeding Mack truck. Then you may have course to re-think that stinging quote of H.L.Mencken that is the axiom of all elected officials:

“No one has ever lost money or an election underestimating the intelligience of the American people”

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Swine Flu: A little mathematical exercise Tuesday, May 12 2009

Recently Keiji Fukud, acting assistant director general of the World Health Organization was quoted as stating;

“If you look at past pandemics, it would be a reasonable estimate that a third of the population[of the world] would be infected” if the current swine flu outbreak became a pandemichttp://www.thestandard.com.hk/breaking_news_detail.asp?id=14252&icid=1&d_str=

Now lets play a little mathematical game.

The earth’s population currently stands at about 6.77 billion. If the above quote proves to be correct than a little over 2.2 billion people could be infected with this H1N1(Swine) Influenza

Now lets take the mortality rate so far in a first world country with an abundance of resources to combat this scourge. All right, the United States.

As of May 10, 2009, 2800 people have been infected and  3 people have died from complications of H1N1 in the US leading to a mortality rate of  approximately 0.1%. “Nothing”, “a mere bag of shells” you may be thinking.

Maybe? And maybe not!. Consider the following:

In its present state of virulence(and using the mortality rate of the United States as a benchmark) this “mild virus” could cause somewhere around 2 million excess deaths(30% of the world’s population of 6.7 billion becoming infected and an “optimistic” benchmark mortality of 0.1%”).

BTW. Please I am no mathematical genius what-so-ever so if someone finds I erred in my calculations please feel free to let me know.

2 million deaths. 2.2billion made ill. Now remember as a benchmark for mortality I used the United States, a first world country with resources other countries could only dream about . Now think of a pandemic afflicting a third of the population of Africa where some parts of the continent  contain countries with  populations already struggling mightily under the burdens of such diseases as AIDS, malaria and tuberculosis plus drought, extreme poverty and civil war. Or the many third world countries where the best medical care available does not compare in any way to the United States’ worst.  Now you can see why I used the word “optimistic” in using the United States as a benchmark for calculating the world’s total mortality.  Darn, I almost forgot to mention that a significant minority of these people will be those in the most productive years of their lives(to put the term “significant minority” into something resembling a proper perspective remember George Steinbrenner was principle owner of the Yankees with 51% of shares in the team, the other 49% were held by a “significant minority”). Gone may be Joan the cardiologist, John the fireman, Abdul the train operator, Lee the paramedic, Paula the electrical grid supervisor, and a myriad of others who perform those vital functions necessary for a recognizably functioning world.

Oh, and don’t forget that the regular strain of influenza does not take a break during a pandemic(I tried to calculate the combined numbers of pandemic and seasonal flu but had to stop because my calculator started to smoke and make weird noises).

I’ll touch on the glorious complexities of vaccine creation, manufacturing and dissemination in my next post.

PS. Just as I was about to hit “publish” for this post I read that Mexico’s mortality rate has been calculated to be between 0.3 and 1.5% percent of those infected with H1N1.

http://health.usnews.com/blogs/on-parenting/2009/05/11/swine-flu-on-track-to-be-a-pandemic.html

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Swine Flu: Not only the cough that carries you off Sunday, May 10 2009

Usually those people affected with influenza(Swine or otherwise) manifest and transmit the virus to others through coughs and sneezes. Many afflicted by this newest virus(Swine or H1N1) are also experiencing frequent bouts of nausea and vomiting. At this time there is some evidence  the virus may  be able to spread in this manner. That makes hand washing all the more important.

Lather up well and make sure to wash for at least 15 seconds and don’t forget to pay attention to areas like your nails and the webbing between your fingers. Sometimes the best solutions are the most simple. Make sure your kids do the same!

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Swine Flu: Was this just the “herald wave” Sunday, May 10 2009

There’s a lot of talk of overreaction on the part of governmental officials and the World Health Organization(WHO) regarding the virus formerly known as Swine Flu. Many are now skeptical that there was even cause for alarm or think groups with sinister intentions concocted the whole thing. “It was just the governments trying to scare people”, “they were trying to divert attention from the economic crisis”, plus the ever present wackadoodle conspiracy theorists talking about the virus being manufactured to thin the world’s population, transnational medical companies trying to scare up big profits, FEMA concentration camps and a host of other bilge and bs.

Do I think they overreacted? No! It was(is) a novel strain  that was(is) killing  those in the healthiest age groups, those 20-50 years old. When had this occurred before? In all three 20th century pandemics(1918, 1957, and 1968). It began in a country that is a popular spot for vacationers from all over the world and spreads somewhat easily from person to person. Overreacted? No, I think they were truly scared.

Now to what scares me. Research has shown that each 20th century pandemic began with a “herald wave”, a less lethal, widespread round of influenza that occurred in the months prior to the onset of each pandemic, mainly the preceding early to late spring. Could this have been Swine’s herald wave? It remains to be seen. This is  why I’m concerned about the upcoming fall and winter flu season. Apathy , skepticism and scare mongering  will only make matters worse. 

If this was indeed a herald wave, then there’s a distinct possibility that we’re going to have some real serious problems come fall and winter.

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Swine Flu and Bio-terror:A note of caution Tuesday, May 5 2009

(A note for emergency managers, public and elected officials)

What do,

Smallpox

Anthrax

and Plague,

all have in common?

1) They can all be used as bio-terror weapons

2) They all manifest  initially with “flu-like symptoms”

Now I’M NOT SAYING that H1N1 is a bio-weapon. I’m saying that some maniac (or maniacs) could use the current influenza outbreak to mask early detection of these agents.

Don’t be like the poor unfortanate that was blinded by the sun as he crossed the street and was creamed by a truck.

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Swine flu: Something to think about Friday, May 1 2009

The CDC recommends that only those people who are strongly suspected of having Swine Influenza, “especially those with severe ilness”  be tested for the virus. I have spoken to several medical professionals in NYC and they have stated that they are only testing those patients who have severe illness and with risk factors for the disease(recent travel to Mexico, infected  close contacts,etc).

What bothers me is  that currently the bulk of samples being sent to the CDC should be from those with “severe illness”.

How is it then that all the confirmed cases so far have been “mild”?

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Swine Flu: Recent studies give cause for optimism Thursday, Apr 30 2009

Recent studies by virologist have found that the Swine Flu virus lacks a key protein that renders the virus much less lethal,

“There are certain characteristics, molecular signatures, which this virus lacks,” said Peter Palese, a microbiologist and influenza expert at Mt. Sinai Medical Center in New York. In particular, the swine flu lacks an amino acid that appears to increase the number of virus particles in the lungs and make the disease more deadly.

http://www.latimes.com/features/health/la-sci-swine-reality30-2009apr30,0,3606923.story

This may explain why there have been so few serious cases of the disease. I’d still like to figure out, though why it killed just those in Mexico.

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Swine Flu: A troubling observation Wednesday, Apr 29 2009

During a conference call with local health officials one of the physicians said something, which at the time I didn’t catch on to but as I thought about later seemed a bit strange. She said that 44 cases of Swine Flu had been confirmed in New York City. Alright, common knowledge. She spoke about the protocol that hospitals follow if they suspect a patient has Swine Flu:

Take a sample from the nose or throat

Send it to your facilities lab to see if its Influenza A

If so send the sample to your particular state’s Department of Health for sub-typing

If the state is unable to sub-type the sample, its probable at that point to be Swine Flu(this is where it gets interesting, but more of that in a moment)

The sample’s final stop would be the Center for Disease who have the ability to confirm it as Swine Flu

So far, simple. But here’s where my curiosity was tweaked. This doctor stated during the conversation that the state’s laboratories were working ’round the clock” as there were so many samples to check.

Think of what she said for a moment, so many samples to check. The state only receives samples that have already been identified as being Influenza A. So either:

1. This year’s expected flu was a lot more prevalent(surprising too that we are at a time when flu season is practically over)

2. There’s a lot more cases of this Swine Flu(remember, the CDC is the only organization that can “confirm” Swine Flu so don’t be surprised to wake up soon and find their numbers of infected people zoomed from 44 to 444 and beyond in very quick fashion).

As for flu precautions, follow this advice from the Staple Singers(and of course your local health department):

“If you’re walkin’ round thinking that the world owes you something ’cause you’re here

You goin’ out the world backwards like you did when you first come here

Keep talkin’ ’bout the president won’t stop air pollution

Put your hand o’er your mouth when you cough that’ll help the solution”

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