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wathe

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Everything posted by wathe

  1. CSACI position statement applies to both adults and paeds. The only reasons I can see to use benadryl for allergic rhinitis or urticaria are 1) financial barrier precludes 2nd gen AH --benadryl is dirt cheap-- or, 2) you actually want the side-effects of drowsiness, tachycardia, dry mouth, constipation etc -- there are some specific circumstances where the side effects themselves are therapeutic.
  2. This is the role of government funded science: doing important scientific work that has no commercial benefit. Also driving important social change that has no commercial benefit, for the benefit of all citizens. We live in a world where we produce colossal amounts of waste because "commercial benefit" to corporations is more important than anything else (more important even that having a habitable planet). Litigiousness of American society is also a factor. Drug waste is a huge issue. As are drug shortages. Extending expiration dates to match actual stability of products would constitute wise use of resources on a population level. It would require government intervention and regulatory change. I don't know if that would be possible in the current American political landscape. IME, a stable, affordable, and socially responsible drug supply should be a public good.
  3. Second gen antihistamines as per CSACI position statement for allergic rhinitis and hives I personally like cetirizine: available both oral and IV. Systemic allergic reactions get epinephrine. Threshold for epi is low.
  4. I think of drug expiry dates as like warranty periods. Guaranteed potency until dates specified, but useful life generally extends beyond warranty period.
  5. Yes. 2019-nCOV was the provisional name for the virus, also called Novel Coronavirus, for a short while. Then the scientific community settled on SARS-CoV-2 for the virus and COVID-19 for the syndrome. Varicella-Zoster Virus (VZV) causes two different clinical syndromes: Varicella (chicken pox) and Herpes Zoster (shingles). In this case, the syndrome names existed long before science figured out the common causal virus - hence the hyphenated name.
  6. Covid terminology did change really fast. Early on, we were calling it 2019-nCOV. I still have grand rounds notes from Feb 11, 2020, and that's the term that was in use on that date. By March, the terminology had shifted to COVID-19.
  7. Talk to your doctor. In general, first gen antihistamines are not recommended for kids at all anymore (have been removed from formulary from my local paeds hospital), and definitely not recommended for sedation. Paradoxical excitation is a concern.
  8. Infuriating! But not necessarily doomed. Masks and ventilation really do work. You very well may be able to mitigate your way through.
  9. Sawyer Squeeze and other water filters will remove bacteria and protozoa, but not viruses (like Hep A). Fine for backwoods water treatment in North America. A water purifier, like the Grayl, or MSR Guardian, will remove bacteria, protozoa and viruses like Hep A, norovirus, rotavirus. A better choice for travel to parts of the world where these are a concern.
  10. I haven't been to India, but have traveled elsewhere in the tropics. I would strongly recommend a travel medicine clinic consult. Getting travel health advice from HR seems unwise, especially since the advice you've quoted contradicts the CDC: Vaccinations: https://wwwnc.cdc.gov/travel/destinations/traveler/none/india. (For me, personally, up-to-date standard childhood vaccinations including polio, up-to-date tetanus/diphtheria, fresh covid and flu boosters, and Hep A/B vaccination would be a bare minimum.) Malaria: From CDC Yellow Book: "Transmission area: Throughout the country, including the cities of Bombay (Mumbai) and New Delhi (the capital). No malaria transmission in areas >2,000 m (≈6,500 ft) elevation in Himachal Pradesh, Jammu and Kashmir, or Sikkim" Travel advisories: https://travel.state.gov/content/travel/en/traveladvisories/traveladvisories/india-travel-advisory.html#:~:text=Exercise increased caution in India,the potential for armed conflict. Travel advice (Government of Canada - comprehensive, well formatted, easy to read, good law and culture section) https://travel.gc.ca/destinations/india#health I would want one of these for purifying water.
  11. Yes. And also, the better prepared I am, the more I have to offer.
  12. I don't think we have a pay-fo performance funding model for education in Ontario. I think the teachers would revolt. Their union is very strong, and they are reasonably well paid. Starting salary $50k, topping out at about $100k, with an average of $73k Pay-for-performance funding for hospitals is another story. The same paradox: the best performing hospitals get bonus funding, and the one who struggle -- too bad for them.
  13. I love this trick for winter camping. It makes a huge difference. I'll be winter camping with the scouts this weekend with my trusty nalgene!
  14. We don't have a generator, but all our rural neighbours seem to have one. When power fails, we lose water, septic and heat. The biggest problem without a genny is losing heat in winter. Frozen pipes are my biggest worry. We have a high efficiency fireplace that we can use to heat the house enough to prevent frozen pipes. We keep a cord of wood. But someone has to be home to feed it. We back onto a creek that we can use for water to bucket flush until the septic fills. Rain barrel in summer. I have a camping chemical toilet for back up We store 60L drinking water. I have a hiking water filter and a jug of bleach to treat creek water or rain barrel water for back up. We keep battery banks charged for phones. I have a camping solar panel that makes enough power to charge phones. We also have an old fashioned non-portable land line that works without power. We keep talking about getting a generator, but then we keep coping just fine during power failures, so we never seem to get around to getting one. ETA: The other worry in my area is flooded basements when the sump systems fail. We are fortunate that our house doesn't rely on a sump system to stay dry.
  15. The US must have something like the CRTC with a list of broadcast and emergency alert distributors? Tuning in to a local station on the hour gets you the news, and almost certainly any emergency info would be broadcast with the local news. The bigger the emergency, the more frequently the info will be repeated. I listen to CBC or local radio while in the car, so I know the frequencies. We keep our dyno-powered radio pre-set to CBC. Otherwise, scanning the band to find a local station takes a little trial and error, but it's straightforward. (I feel old -- this was the only way to get emergency info and other important info (like school weather closures) when I was a kid. I really hadn't occurred to me that people might not know how or not think to do this)
  16. Don't abandon radio as a way to disseminate emergency information. Text alert and social media are great only when cell systems and internet are working. When power goes out and phones run out of charge or internet goes down, radio often still works.
  17. They should be fine. Data: Stability of the COVID-19 At-Home Test after Exposure to Extreme Temperatures
  18. Yes. DH purchased a kit of Amazon. We did this about 3 years ago. The phone is still going strong (now used as a kid's phone). ETA worst case scenario is that you break it and have to buy a new phone. Which would be doing anyway if you elected to replace the phone rather than fix the battery.
  19. If you like wine, Niagara is the premiere wine region of Canada. Load of wineries who do tours, tastings etc. ETA one of the world's main icewine regions
  20. My kids loved this. There is a museum in St Catharines with a lot of Welland Canal content We would make a day of it: watch shipping and locks in the canal, then watch shipping go under the Hamilton lift bridge, then watch trains go by at a busy Hamilton rail bridge. My kids were easy to entertain 🙂
  21. Butterfly conservatory is year-round There are loads of walking trails in the Niagara Parks system. Free. The botanical gardens are very nice. Free. There won't be a lot of flowers in April, though. You can get great views of the falls from the public sidewalk. Free. It's always busy, but not necessarily crowded. Toronto is 1.5h drive if one avoid rush hour. Commuter train service from Burlington (45min drive) is excellent. There is also commuter train service from Niagara Falls, but fewer choices of trains/times. Toronto has all the things you would expect of a major world-class city.
  22. I have a cheapie drugstore-brand digital oral thermometer. It's great. Still working after 15 years. The ear IR ones are sometimes unreliable because of earwax or a twisty ear canal blocking the device's "view" of the tympanic membrane.
  23. Re speculation on timing of tests and procedures and assumption of extensive diagnositics - this is all as seen through a US healthcare culture lens, I think. US healthcare is an international outlier, with, relatively, much over-testing and much cultural medical anxiety as compared to peer nations. Cultural expectations about what constitutes appropriate and best care that I see on this board are often strikingly different to my Canadian experience. Especially WRT testing/diagnostics and timeframes. I'm sure King Charles gets the very best care, but what that means may be different in the UK than in the US.
  24. My kids still mask at school. There are very few others. Of course masking is the right thing to do when ill with a contagious acute viral respiratory infection. Whether covid, flu, or other respiratory virus. Just like covering coughs and sneezes, and washing hands is the right thing to do. It would be much more effective if everyone did it, but just because most don't doesn't mean one shouldn't. For my kids and I, it's enough to know that we, personally, aren't making others sick. (ETA: Covid is still landing plenty of people in hospital, and still killing some of them. In Ontario, we've had >6000 hospitalizations and >950 deaths since August. Flu disappeared for more than a year back when we were all masking. Now it's back, with more >3000 hospitalizations in Canada since August 2023. It's important to my kids and I that we, personally, aren't making others sick, hospitalized or dead, over a simple thing like wearing a mask in public when ill)
  25. This tells me everything I need to know about the program culture. Blech. 16u age elite players who currently play on an 18u team, being sent to 16u tournaments as ringers to help win games and boost their individual stats, while still playing full-time on their 18u team. Displacing 16u developmental level players who have put in the work, and built a team of their own. Does this program accept government funding or other non-profit org funding? This sort of funding usually comes with conditions that stipulate youth development goals: ie advancement of education, beneficial to the community, eg "focus on building participation and engagement in recreation and sport to enhance the broader health and well-being of the community". If the program is in violation of its funding agreement, then that's actionable Is the program itself a non-profit or charity for tax purposes? There will be similar community engagement and youth development criteria. If the program's behaviour jeopardizes its tax status, that's very actionable. Is the program under the umbrella of a state or national sports org? Most youth sports in Canada are, as it facilitates insurance and administration; I imagine the US might be similar. What are their org mission, vision and standards? Fair-play policies for developmental levels? and if it's anything like the sports we're involved with, there will be all kinds of diversity, inclusion, development of athlete-as-a-whole-person, sportsmanship, integrity, dignitiy, kindness, growth and development content. Most of this info will be google-able. My approach with a similar situation has been 1) put some parent skin into the game - attend annual meetings, get involved as a parent volunteer/manager, get onto the bench as a trainer. This gets you Street Cred. 2) establish myself as a Person Who Knows The Things and Is Paying Attention: familiarize self with org constitution, standards, values and mission, codes of conduct, all at the club and umbrella org level (provincial and national, if relevant), funding model, legal/tax status (non-profit vs charity), strings attached to funding. Go to annual meeting where budget is presented.
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