Jump to content

Menu

wathe

Members
  • Posts

    3,214
  • Joined

Posts posted by wathe

  1. 1 hour ago, kbutton said:

    A quote from the article:

    Other meds. Lastly, there are many other medications that have possible interactions with Paxlovid. Some are related to heart disease, including blood thinners and blood pressure medications. For these, it also seems highly unlikely that skipping them for 5-10 days would be as dangerous as passing on Paxlovid among the truly high-risk population that benefits from it. The same analysis as above would also apply to those medications; the upshot is that the short-term risk of a fatal heart attack is just not that high, even among fairly recent heart attack survivors (that is, more than a few months out).”

    I’m a bit distressed reading the fine print on his blood thinner comments. Not all blood thinner patients are on them to avoid heart attacks!!! Many have a blood clotting disorder and a history of repeated blood clots. Some are on initial anticoagulant therapy, meaning they clotted recently! And if someone has autoimmune clotting (antiphospholipid syndrome/APS), they are at much higher risk of a catastrophic presentation of their disorder, which causes systemic clots and has a high fatality rate. Illness of any kind is a risk factor for this presentation.

    Blood thinners are not just for heart attack risk. 

    I usually love his information, but it’s like he had a total brain fart about who ELSE takes anticoagulants (and there may be other categories). 

     

    I agree that the paragraphs you've quoted are really bad advice.

    Stopping a statin is usually no big deal, but some other meds can't be safely stopped.  And others might be OK to stop individually, one at a time, but stopping a combination of them all at once may turn out to cause harm.   Especially since the evidence for paxlovid is so poor to start with --- the only population with RTC data that showed benefit pretty much no longer exists (unvaccinated and high-risk and no previous covid exposure)

    Stopping meds with known benefit in order to take a med with unknown/unproven benefit seems unwise. 

    I do think it's worth making a distinction between meds taken for long-term prevention (statins for CAD to prevent future MI, thinners for a-fib to prevent future stroke, ace-inhibiter for  long-term renal protection diabetics) and meds for treatment of active conditions (thinners for existing clots, anti-convulsants for active seizure disorders etc, antihypertensives for severe essential hypertension).   I wouldn't be so worried about holding the former, but would be much more concerned about holding the latter, even though in some cases they might be the exact same medication, the very same meds can be used for different indications.  The indication matters, I think.

     

    • Like 3
  2. 29 minutes ago, KSera said:

    These articles might help you feel reassured:

    Vaccine Ingredients — DNA

    Do DNA Fragments in COVID-19 mRNA Vaccines Cause Harm?

    “Dr. Paul Offit explains why it’s virtually impossible for DNA fragments in COVID-19 mRNA vaccines to cause harms, such as cancers or autoimmune diseases.

    Dr. Offit describes what would have to happen in order for DNA fragments to cause harm by explaining three protective mechanisms in our cells that DNA fragments from mRNA vaccines cannot overcome. First, the cytoplasm has immune mechanisms and enzymes that destroy foreign DNA. Second, the fragments would have to enter the nucleus, which requires a nuclear membrane access signal that these DNA fragments don't have. Third, even if they were able to enter the nucleus, the fragments would need to have an enzyme called integrase to become part of our DNA, which they also don’t have.

    These facts should be reassuring to anyone concerned about a health risk caused by DNA fragments in vaccines.”

    Adding to above post:

    DNA fragments in vaccines is not a new thing.   Multiple vaccines have residual DNA from host cells, both human and animal.  Live attenuated vaccines that contain DNA viruses (Chickenpox, mpox and smallpox vaccines) will also, by definition, have quite a lot of viral DNA in them.

    Philadelphia Children's Hospital has a nice info page on this, with some references.

    Vaccine Safety: Myths and Misinformation

    Our bodies deal with foreign DNA all the time.  Every time you eat or have any kind of viral infection.

     It is true that some viruses are oncogenic, but this is in the context of infection.   I haven't seen any robust evidence to support vaccine oncogenesis from approved vaccines.  Quite the reverse, actually --  e.g. we vaccinate for HPV to prevent cancer, quite successfully.  

    I am much more worried about covid infection as a cause of cancer than I am about covid vaccine.  I think it's plausible that covid vaccine may actually turn out to prevent cancer if covid turns out to be oncogenic in the long run.  We have no idea what this virus has in store for us in terms of long-term sequellae.

    • Like 7
    • Thanks 3
  3. Additional points to consider:

    Surgery and anesthesia necessarily entail risk, even with the very best team -- even the very best surgeons, anesthesiologists and OR teams all have bad outcomes sometimes.   It is wise to optimize non-surgical options (physio, bracing, medication) first, and then consider surgery only if/when they fail.

    Don't get too hung up on numerical outcome data.   Surgeons with the very best outcome data tend to be surgeons who are choosiest about who they operate on in the first place; surgeons who only take easy cases have great looking data, but may not be the best fit for you.  Surgeons who take hard cases have numbers that look worse, but might actually be better overall and may be a better fit for you.  So take outcome data with a large grain of salt.   Your PCP should be able to help you choose a surgeon who is the best fit for your particular needs.

    • Like 4
    • Thanks 2
  4. On 12/31/2023 at 11:06 AM, mommyoffive said:

    Always good to hear that one way masking does work.  I know it might not every single time, but it is good to know it still is useful.

    Yes, it does work, thank goodness.  

    My personal anecdotal evidence:  I work in a very overcrowded ED and am steeped in resp virus every shift --- up close with sick people, doing high risk procedures etc. I am diligent with my n95, and  I have not yet caught a viral resp illness from work.   I lasted 3.5 years, and finally got covid during international travel, on a trip where eating indoors with others in crowded spaces  and sleeping indoors in shared spaces was unavoidable.

    ETA: vast majority of colleagues can also trace their covid infections to outside-of-work social contact.  Usually their kids bring it home from school, or acquired during travel.

    • Like 11
  5. 2 hours ago, PronghornD said:

    What approach do you think should be used within the household after the five days of isolation are over? We can mask and interact, although my DH probably will not mask. But what about meals? How long should we retreat to separate rooms to eat? A full five more days? This is not the cozy college break we dreamed of!

    Another strategy to add to masking is to ventilate assertively and filter the air.  Open windows.  Run a HEPA air cleaner or a Corsi-Rosenthal box.  Tougher in winter, but still do-able -- even just cracking a couple of windows in common areas while you are together can make a big difference.

    • Like 5
  6. My kids are similar.   

    During their busiest seasons, they have daily gym class, then 1.5 hour school team practice daily (longer on game days), then 2h club team practice.   They also do workouts together on top of that.  Plus tournament weekends about once a month, sometimes more.  There are periods where their lives are pretty much nothing but school, exercise, feeding, and sleep.

    some kids just seem to need this.  I don't think it's pathological.

    Older kid needs to move this much.  Younger kid really loves his sport.  It's a free choice for both of them.  Both kids are happy.

    I would be concerned if I were picking up on body dismorphic disorder clues, or eating disorder clues.  Neither of those seem to be an issue for my kids -- they just want to jump high and run fast and be strong and play their best, for the joy of it.

  7. tl;dr version of post above:   Of those who got sick with a resp viral illness and presented to care and were covid tested, those not boosted were more likely to be sick with covid than those boosted.  Alternatively stated, those boosted were more likely to be sick with something else than those not  boosted.

    • Like 4
    • Thanks 3
  8. I had a look at the study posted above.

    It's a quick and dirty chart review study.  

    One important point is that it only looks at people who 1) presented for care with acute resp illness symptoms and 2) received a diagnosis of viral respiratory infection and 3) were tested for covid

    Completely missing from this study are those who did not get sick in the first place.

    So maybe the booster works way better than reported - we have no idea how many in each group didn't get sick at all, or didn't get sick enough to present for care.

    Or, for the sake of arguement, maybe it doesn't change covid risk at all, but rather increases risk of getting sick with other viral illnesses, or those boosted are just more likely to present for care when ill with other viral illnesses (very extremely unlikely, but the data would look the same -- this study protocol could not tell the difference).

    My real world experience tells me that the booster is probably better than this study suggests, at least for elderly and vulnerable patients.  We are seeing a lot of those in my ED needing hospital admission, almost all unboosted.  Our community fall booster base rate for >65's is 45%.  We aren't seeing the boosted ones.  

    slightly older, but still relevant local data: My health unit reported 39 covid deaths Oct-Nov 2023.  All but one >65, and all but one of those unboosted.  The boosted case was <10 days post-booster.  This booster is keeping seniors out of hospital and keeping them alive.

    • Like 5
    • Thanks 12
  9. A game (Azul), a new wallet, and a ZOLL AEDplus

    (This last a weird gift, but great!  Our little rural neighbourhood has a  long ambulance response time.  I will also cart it to scout camps and youth soccer and select other places with crowds that don't have a PAD.)

    • Like 3
  10. 1 hour ago, bolt. said:

    Oh, that's really a hard situation.

    No one should be mad at you that you hosted -- because you did it before you had any noticeable symptoms and had no reason to be concerned. That's the tricky thing about covid, and it's why covid is so successful. Covid "changed things " because it's the only generally transmitted disease (to my knowledge) where you are contagious for a significant period of time before your first noticeable symptom. It means we need to change how we think about the responsibility not to spread germs... we are still responsible not to spread germs *that we know we have* but it's old-fashioned thinking about disease to think a person always knows about their germs. It's symptoms that tell us when to stop socializing. We aren't mind readers. Covid is it's own thing.

    Missing a once per 5 years visit is a big blow! It must hurt a lot -- plus covid makes most of our people extra emotional. Hugs to you!

    Presymptomatic and asymptomatic transmission happens for just about all viral infections.  RSV and influenza and chicken pox and measles (and probably dozens of other respiratory viruses for which we just don't have the data, and others I just haven't bothered to specifically look up).  Lots of other viruses can be transmitted while asymptomatic and presymptomatic too: HIV, Hepatitis A and B, Epstein-Barr (mono), polio, mpox, and on and on.  

    A nice, short review article on asymptomatic and presymptomatic transmission of various pathogens.

    Covid is just really, really, really good at it.   And really, really good at transmission in general.

    • Like 10
  11. What are the legal penalties for providing alcohol to minors in your state?  Because that's what this 18yo has done.  

    Here, the legal repercussions can be serious.  

    I would be having a very hard conversation with the 18yo (legal adult).  He needs to know that this is behaviour with potential real legal consequences, and it is behaviour that you will not tolerate.  Especially in your home - as that may also cause legal repercussions for you.  

    • Like 3
  12. I polled some of my optho friends about it before starting DS on contacts for sports.

    One ophthalmologist recommends sports glasses/goggles instead of contacts, because they add a layer of protection against eye trauma from impact that contacts don't.  

    Another recommended contacts instead of sports glasses/goggles, because they offer a better field of vision, and has seen injuries from broken glasses from impact.

    I don't think that there is any consensus.   I mean, the lesson I get out of this is wear eye-protection for sports that need eye-protection, prescription or not.   

    ETA DS prefers contacts plus non-prescription protective eye-wear for badminton, rather than prescription glasses.  He says that he can see better with the contacts plus non-prescription protective eye-wear combo.

  13. DS14 started at 12. Dailies.  He uses them for sports -- wears them to school on days that he has gym or sports practice, and takes them out when sports are done for the day.  So far, so good.  On non-sports days he wears his glasses.

    • Like 1
  14. I just bought a Speed Queen (Heubsch in Canada), after my 26-year-old Maytag top-loader finally died. Dials  -- but there is a circuit board in there somewhere.   So far it's been great.  Standard load takes 27 min.  

    Our repair professional says that they are what he instals in group-homes where they see very heavy use, and the only repair he ever has to do is replace the belt.

  15. This thread has piqued my interest.

    I can't find even a single case report describing selenium toxicity from eating brazil nuts having actually happened.

    Lots of data on selenium content of brazil nuts.  And lots of data about selenium toxicity in general.  A few reports of selenium toxicity from supplements.  One report of selenium toxicity in China from a foraged high-selenium diet eaten during a drought with rice crop failure. One report of selenium toxicity in rats from being fed enormous amounts of brazil nut meal.  But no reports of actual cases of selenium toxicity from eating brazil nuts in humans, never mind accidental toxicity from snacking.  Maybe I'm messing up my search, but I'm usually pretty good at this.

    I'm not too worried about it.

    • Like 8
    • Thanks 3
  16. 1 hour ago, Elizabeth86 said:

    I asked her and she said she didn’t know the name of it, she’d look later and tell me. 🙄 She said it was blue. lol

    Well, paxlovid is comprised of pink tablets (nirmatrelvir component) and white tablets (ritonavir component), packaged in blister packs with yellow foil over the morning dose and blue foil over the evening dose, in a white  box with blue writing and blue trim with a thin dark pink/almost red stripe.  At least in Canada.  As per google, it seems to be the same in the US.  So maybe?

    • Haha 2
×
×
  • Create New...