“…
At another hospital, junior doctors freely admitted that the forms were filled out by medical teams without the involvement of patients or relatives.
…”

[h/t unc]

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.

Can the seasonal flu vaccine provide protection against other seasonal flu viruses even if the vaccine is not a “good” match?

Yes, antibodies made in response to vaccination with one flu virus can provide protection against related viruses. Vaccine effectiveness may be lower than if the vaccine and circulating strains are most alike but the vaccine can still provide enough protection to prevent or lessen illness severity and prevent flu-related complications. (However, a flu vaccine is not expected to offer cross-protection against viruses that are very different genetically from those in the vaccine.)…

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.

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.

—
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).

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.

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

A month ago, I was told that one shot of the vaccine was enough, now I’m being told that some people are going to need two.

Today, I was told that if one opts for the nasal spray, one can’t take both the seasonal vaccine and the H1N1 vaccine spray within a certain amount of time. Where they utterly fail at “due diligence” here is that they don’t mention that the nasal mist is 1) fairly new on the market and does not have years of real world testing. 2) hasn’t really proved very popular, unless there are shortages of the regular injectable vaccine, and the biggie, 3) contains actual, live, disease causing viruses.

The third point is fairly important, and the reason why the mist is reserved for only healthy adults in a certain age range. Your body has to defeat the live virus and produce antibodies against it, but it’s possible to actually come down with the flu from the mist. I’m sure the odds are abnormally long, but I’m also sure at this point that I can’t trust the data provided by the manufacturer or the federal government.

With the recent change in dosing practice for the polio vaccine (it’s no longer recommended to give kids the oral vaccine for the first dose because of a number of cases of vaccine-induced polio), I would think that informing people to the fact that the spray mist does contain live cultures would be required to comply with “informed consent”.

Since it took decades to change the recommendation against three doses of the live oral vaccine for polio, I personally think, (in my dirty, worthless, layperson option , that the relativity new nasal vaccine spray isn’t worth the risk at this time.

Update, 10 PM: I did some googling, and I need to cite for the record that many local news sources do indeed inform their readers that the spray mist is a live virus product, so it’s just the lamesream media, to include the local news source I use during my commute. Also noticed was that there’s a fair bit of people out there with the tinfoil on, shiny-side out. Trust me conspiracy clique, If they really wanted to spread the virus, all they’d need to do is to slip it in something from the school lunch program. Hiding it in plain sight in the fine print on the vaccine nasal spray would take entirely too much effort.

A tattoo removal story by Rob over at Cockeyed.  Rob presents a story in a sometimes humorous, yet informative matter. If you want to cheat, you could jump to page 5, where the money quote is [1], but I’d recommend reading the whole series (a quick read) to get the feel for how the solely market-driven, profit-motivated endeavor manages to improve the technology while steadfastly decreasing in price.

This story is refreshing because after years of reading Cockeyed.com, I’ve gotten the impression that Rob would probably place himself left-of-center. He’s certainly not a GOP poster boy.  Nor is he a Obama delegate who is not a doctor but plays one at town hall meetings.

[1] …And by “money quote”, I mean the price quote. A laser tattoo removal session drops from $150 to $125 to $100 during the series.

It goes like this. The cornerstone of Roe v. Wade, a landmark Supreme Court case on the right for a woman to have an abortion, is privacy. Medical privacy. As in “the government may not stick their nose in a woman’s medical care because to do so would invade their privacy” type of privacy.

Furthermore, I also happen to note that the most “vocal”|”fringe”|”progressive”|”leading edge” of the feminist bunch almost universally support government run “universal”|”single payer”|”socialized”|”ObamaCare” type healthcare. One of the promises of the plan they are trying to promote is that there will be a “cost savings” by letting the nanny state safeguard your own medical records in some kind of digital format.

If you can’t see the elephant yet, I’ll spell it out for you. If you think of your medical records as private, how in Lilith’s name is it logical and prudent to hand over safekeeping to the state?

I mean this is the government that has been rightly condemned for misusing the Census data to round up the Japanese and put them into internment camps. The same government that has been doing all that warrantless wiretapping. The same government that has been torturing and detaining non-POWs while ignoring Habeas corpus.

I’ve always asked this question every single progressive pro-choice feminist I run across who speaks fondly and approving of state-run, taxpayer supported healthcare schemes. So far I’ve gotten zero responses. I’ve been left to guess the lack of response is some kind of self-defense mechanism; a cognitive shut-down to avoid a warp core breach.

The Honourable Representative from Louisiana’s 4th District has the following to say in an article in the online version of the New York Post:

“So I’ve offered a bill, HR 615, to give them a chance to put their “health” where their mouth is:…”

However, if you go looking up on Govtrack.org for the “bill”, don’t search for “HR 615″ or you’ll get the “Antifreeze Bittering Act of 2009″. Instead search for “H Res 615″, at which time you likely conclude that this is a non-binding resolution, rather than a proposed law. Here’s the highlight:

Resolved, That it is the sense of the House of Representatives that Members who vote in favor of the establishment of a public, Federal Government run health insurance option are urged to forgo their right to participate in the Federal Employees Health Benefits Program (FEHBP) and agree to enroll under that public option.

(Emphasis mine.)

That’s some strong language there for a non-binding resolution!

So, will the real opponents to Obama-ized healthcare please stand up? I know the socialist faction is going to pull every single trick in the book. I’d like you to respond in kind with the usual standard mischief; including obfuscated language, last minute riders to “must-pass” legislation, keeping the actual text of the bill out of Thomas.gov until after it’s been voted on, having anonymous “staffers” secretly editing text without anyone noticing, killing things in committee, and the always effective “poison pill” amendment.

In the upcoming “medicine show” that will promote “ObamaCare”, it seems that our overlords have exempted themselves from the healthcare rationing for the masses. This will also seem to keep their private medical records from being mingled with our own “government safeguarded” digitized records, (digitized solely as a cost savings measure, or so they claim).

I’d cite some bills, but instead I’d like to call on our congress-critters to fix Thomas.gov first, before trying to “fix” healthcare.