‘Death Panels’ by any other name…
In the UK. But somehow, something like this could never happen in the USA, right?
[h/t unc]
In the UK. But somehow, something like this could never happen in the USA, right?
[h/t unc]
Magic incantation follows: Not a doctor, not your doctor, not dispensing medical advice. Before the use of any medical information that I’ve aggregated on my site, you agree to review that information with a real doctor before acting on that information. (end incantation)
It looks like the FDA is adding protection against H1N1 in the 2010-2011 seasonal flu vaccine.
Every year, there’s a new crapshoot to guess which influenza strains are going to be “popular” during this year’s season. Then they try to pick three or so viruses to make the vaccine from. While the influenza virus mutates rapidly, there is some cross immunization between strains, at least in theory.
This year they picked:
A/California/7/2009 (H1N1)–like virus
A/Perth/16/2009 (H3N2)–like virus
B/Brisbane/60/2008–like virus.
The vaccine for the 2009-2010 seasonal influenza contained:
A/Brisbane/59/2007 (H1N1)-like virus
A/Brisbane/10/2007 (H3N2)-like virus
B/Brisbane/60/2008-like virus
According to Wikipedia, The H1N1 strain in this years’ batch is the same as in last year’s special vaccine that was oh-so-effectively metered out by the precursor to Obamacare.
I suppose that means that if you did get the special H1N1 vaccine and the standard vaccine last year, you’re only going to grow antibodies from one new strain. If you are like me, and didn’t get the special vaccine, but did get the regular one, you should be building immunity from two new strains.
Last time I went in for an eye exam, my regular doctor wasn’t there. I like my regular doctor because he’s ex-military and understands peep sights, 6 o’clock holds and minutes-of-angle. He’s also the first optical professional that didn’t laugh when I told him my dominant eye sometimes switches. For these reasons I like going to him even if he’s at the awful discount chain around here called For Eyes. I just take my prescription from the Doctor and leave.
The other reason I like him is because he’ll take walk-ins, which is handy if you get flunked on you eye test the day before by the Maryland MVA. The last time I went I had a competent substitute doctor. Since there were no customers, I was able to talk directly to the Optometrist, and I asked when she could fit me in. She said right away, so I asked her if she would provide me with my pupillary distance if I paid her in cash (saving her maybe 2-3% in credit card processing fees, though I’m sure as a professional, she paid her share of taxes in any case). She agreed and then started the exam.
She also showed me how she takes it, and she merely had to read the scale right off the phoropter, which is the big, bulky, “try different lenses until you can see the eyechart” tool. My measurement is 59.9 mm, (though 60 mm is close enough when you get around to ordering.) While optical professionals are required by law to give you a copy of your prescription, the pupillary distance number is left off, even though it you’re going to need it at some point. The excuse is that this is the responsibility of the Optician that actually fits your glasses. If so, the last three Optician I had order my glasses did it wrong (although one used a proper measuring tool after I refused to accept the wrong frame size she chose using a scientific wild-ass guess instead of the tools of her trade).
With my prescription and pupillary distance, I then hit up a few web pages to understand how glasses are fitted, and then I placed my order at an online retailer called Zenni Optical. Getting ready to order, I went over my old, broken glasses with a metal ruler with a millimeter scale. That let me get the proper size of the frames themselves, including bridge the width and the bridge sizes.
There’s about six sites online to order glasses from, so feel free to pick your favorite. At Zenni Optical, at least you can tell that they’re not spending any profits on the site itself, because it’s awful. I spent about two hours browsing the frames before I groked what was going on. The very cheapest frames were like $8, but what they don’t tell you is that not all frames fit all heads. Even worse is the fact that you can’t enter in say, the width of your head or your pupillary distance and be shown only the frames in stock that would fit. Eventually I got it right, but I looked at the return policy to be sure the risk/reward ratio was acceptable to me. It was. Including shipping I could have re-ordered glasses online nine times in a row before breaking even with my last pair of “fitted” glasses.
I’ve shown my pair to several people, telling them I bought them online and asking how much they guess it cost me. Everyone was amazed at the price. My first pair cost me about $12 plus maybe a bit for shipping, (I don’t have the receipt handy). Mind you that’s bare-bones with a UV coating only. There are also “memory” flexible frames, eyeglass tinting and line-less bifocals to chose from. Zenni lets you order a frame only for half the cost of the frame + lens price, so I would highly recommend ordering yourself some spare parts at the same time if you are as rough on equipment as I am.
Even if you’re happy having someone locally to yell at if things go wrong for your primary pair of glasses, I would highly recommend you get yourself a few backup pairs. As a minimum, I’d say that you need a spare pair of eyeglasses in every glove box, every range bag and every Katrina Kit. Nowadays that does not cost a fortune.
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This post was inspired by Linoge’s, though mine is solely based on my real life experiences and is completely payola free. I’m not your healthcare provider and I’m not dispensing medical advice, (and this sentence is a magic incantation meant to ward off a lawsuit).
Say, maybe tomorrow morning? I’ll bet they’ll still be shell shocked over the Brown victory.
You don’t want to call or email, that’s too easy. And you don’t want to mail anything, It’ll never get through the anti-anthrax screening on time. Faxes are best.
I haven’t settled on my exact wording, but I will be saying something about how disappointed I am about the backroom wheeling and dealing that’s not on c-span as promised. Oh and I won’t be mentioning the election results in Massachusetts, but I will capitalize on the timing. I’ll suggest scuttling the whole thing because we’ve strayed too far from the ideal bill. I’ll remind them that mid-terms are right around the corner and that I’m not interested in a bill that spends a lot of money we still don’t have and fails to do almost anything to control costs, like allowing overseas prescription drugs.
Apparently there are shortages of the liquid version of Tamiflu, so the CDC has published a handy recipe for whipping up a batch for your kid that has issues swallowing pills.
I find this interesting because it already takes, starting from scratch, six years of study nowadays to become a pharmacist in the US. While they them may be able to technically compound at that point, I believe that many go on and take on additional training to specialize in that branch of practice.
In fact, if I had to wager, I’d bet that compounding without a licence was illegal, (but I don’t carry two lawyers around in my pocket along with the entire US and Maryland state code, so don’t take this as legal or medical advice)
The Brotherhood and Sisterhood of the Collective Compounding Pharmaceutics weigh in:
I originally got wind of this story via Lifehacker, where there’s this comment from a member of the Pharmacist Guild:
@idleuser: I completely agree. I’m a pre-pharm student that works part time as a pharm tech and there’s no way we would recommend patients make their own Tamiflu suspensions. Half the time they can’t even take the correct amount of pills. None of the chain pharmacies around our area compound though. Our store and maybe a couple other local pharmacies do regular compounding. I would urge people to find local pharmacies that can compound Tamiflu for them instead of taking risks with their health or the health of their kids.
here’s a more useful comment further on down the page:
Alot of the Tamiflu coming from pharmacies is in capsule form from the Strategic National Stockpile. These are 75mg capsules only. For most kids under age 10, 75mg is too much; so the above method doesn’t work for them.
For patients mixing Stockpile-supplied drug from home, my state’s Health Department recommends mixing the powder from a full bottle of ten 75mg Tamiflu capsules with 50mL fruit juice. This makes a 15mg/mL solution.
I’d say that if you can’t multiply 75 mg times 10 and then divide the results by 50 mL, if you were never any good at word problems and don’t have or can’t purchase something to measure liquid in cubic centimeters, then perhaps you should leave the math and mixing to a compounding Pharmacist.
Cranky Consumer
Also, someone at Consumerist is angry that a chain pharmacy didn’t volunteer information that they can actually do compounding inhouse right off the bat. I’d say the guy was lucky he was offered that as a solution at all. I once took a prescription that required compounding to a pharmacy on a Friday before a holiday weekend and was not only told they did not do the compounding there, but that the one store that they did do the that was already closed for the holiday. I was more upset at my physician that handed me a Rx that I could not read. Had I done so, I’d have asked her to allow the pharmacy to give me two tubes of ointment and a stir stick. I eventually got my ointment, and I was just charged my usual copay instead of an expected premium.
Additional link
N.J. pharmacists face shortage of liquid Tamiflu, offer alternative