Friday, December 18, 2009

Local Swine Flu News

The numbers nationwide have dropped to next to nothing. Yet the CDC announces the death toll increased 10 fold based on new ways of estimating. The vaccine hasn't been used widely in this area because of the shortages, and the protective effects take 2-4 weeks to materialize. The reason the numbers are dropping is because EVERYONE had the infection. Ok not everyone; but close enough to make it very difficult for the swine flu to spread. But the bottom line message repeated in most of the news casts still is "the most important thing you can do is get vaccinated". Get vaccinated even though one third or more of the population has already been infected? Get vaccinated even though there's no evidence that it prevents infection much less saves lives? Get vaccinated with an accepted risk of adverse reactions on the order of 1 per 100,000 doses?

Why wouldn't the people creating the news ask these experts with the CDC "why did your numbers shift so wildly?" or "why are we seeing decreases in disease rates despite the vaccine not being available?"

"why do 30%-50% of medical professionals still refuse the vaccination?"

Don't they like drama? Doesn't controversy cause ratings to spike?

YAKIMA COUNTY --- Flu numbers are already going down. But experts still warn you; be cautious.

In Yakima County, the number of flu cases dropped from 31% in September and October to only 4% in the first week in December. The numbers count both H1N1 and the Seasonal Flu. While the Yakima Health District calls the numbers promising, they still urge caution. Jessica Brown is with the Yakima Health District.

"Both with H1N1 and the seasonal flu, we encourage people to get vaccinated as soon as they can. With the seasonal flu, we yearly don't see it peak until at least January, sometimes into February or even March."

The Health District thinks vaccines and hand washing have played a big role in bringing the flu numbers down.

Friday, November 20, 2009

Swine Flu Peaks?

But somehow it's STILL important to get your vaccine and take Tamiflu. I want a big scoreboard of the 200 million doses the government ordered for the US that ticks down as the vaccines are actually delivered to clinics and pharmacies. So we can see how many are left over and ask for our money back.

Even better let's see a running total of vaccines actually administered to people.

Great use of health care resources "leaders".

While I'm at it wishing for stuff, I also want to see a total of the profits generated from the sales of Tamiflu and vaccinations.

OK go ahead and include the money wasted on advertising the "pandemic".

Notice how the mutations in H1N1 variety of flu virus occur so consistently with Tamiflu? Yeah H1N1 is really good at mutating into a Tamiflu resistant form. So when the worry was "if swine flu mutates it could be more deadly" why would we promote the use of Tamiflu so widely? So widely that the company ramped up production so high that they surpassed their total production adding up the past 9 years? Yeah the company that makes Tamiflu is making more Tamiflu this year than they have in all of Tamifu history.

A drug without proven benefit other than decreasing the natural course of some flu strains a day.

Well at least the swine flu is decreasing before seasonal flu hits but you wait when seasonal flu hits. We'll hear something like "we can't tell if this is yet another wave of more severe swine flu!"

Who writes this stuff?

Wednesday, November 18, 2009

Creative Piggy Flu Profits

Talks about pharmacies jacking up prices on Tamiflu for children. Mentions that there are 2.2 million children without health insurance. I wonder how many families had to sacrifice some other purchase to cover the cost of this worthless medicine.

Monday, November 16, 2009

The Associated Press on the new recommendations re screening mammograms

It's interesting how the potential harms listed talk about unnecessary biopsies and other false alarms but in my mind it would be much more harmful to be diagnosed with breast cancer unnecessarily.  As stated earlier in this blog,  the best estimate we have state that for every one woman saved by a screening mammogram 10 women are diagnosed with a cancer they didn't need to know was there.   

What exactly do we mean by an "unnecessary diagnosis":
A cancer that would resolve on its own or a "pre-cancer" called DCIS that would resolve on its own or a cancer that was so slow growing that it would never grow large enough to affect the person's life or health or even become clinically apparent.  

So for every woman who has her life saved from screening mammography,  there are 10 women walking around who think of themselves as breast cancer survivors.  They spend the rest of their lives following strict follow up with oncologists and surgeons and getting yearly mammograms waiting for the cancer to "come back".   Most of them underwent surgery, radiation and sometimes chemo to treat their "early cancer".  

The magnitude of harm done over 30 years by screening mammograms will have to be admitted at some point in these disclosures and discussions.  

Interesting also how the title of the article is "new advice".  And throughout the article there's this impression that women between the ages of 40 and 50 are somehow not worth all those resources mammograms represent.  What they don't say is screening mammograms HARM HEALTHY WOMEN.  

The radiology organizations fought successfully to reverse a report by the national cancer institute in 1997 when the NCI's expert panel suggested that there was no proof mammograms between the age of 40 and 50 did more good than harm.  

We'll see if there's a similar backlash this time.  

the US Preventive Task Force Changes Mammogram Recommendations!

The new recommendations reverse longstanding guidelines and are aimed at reducing harm from overtreatment, the group says. It also says women age 50 to 74 should have mammogramsless frequently — every two years, rather than every year. And it said doctors should stop teaching women to examine their breasts on a regular basis.

Just seven years ago, the same group, the United States Preventive Services Task Force, with different members, recommended that women have mammograms every one to two years starting at age 40. It found too little evidence to take a stand on breast self-examinations.

While many women do not think a screening test can be harmful, medical experts say the risks are real. They include unnecessary tests, like biopsies that can create extreme anxiety. And mammograms can find cancers that are better off not found. Some cancers grow so slowly that they never would be noticed in a woman’s lifetime. When they are found, women end up being treated unnecessarily.

This is huge!   The US Preventative Task Force has a lot of impact on what screening tests get done and what doesn't.  After nearly 30 years of recommending a test that does more harm than good,  it's starting to look like there's going to be some recognition and improvement.  This will result in an immediate drop in the number of women needlessly diagnosed with breast cancers that posed no risk to their health.  It will cut the needless anxiety from a false alarm dramatically as well.  

All you hospitals out there that budgeted to make more money on screening mammograms next year compared to this year,  you might want to redo the budget. 

Just sayin'



I'm going to be out of town for the week of Thanksgiving

Will still be checking emails but probably not as often 

Won't be around for house calls,  so no one get sick that week.

Drug Companies Price Gouging to Prepare for Health Care "Reform"

Since the pharmaceutical giants *promised* to shave 80 billion in costs from the national health care bill over 10 years,  they have been increasing prices in preparation.  

Brilliant move on their part.  But hard to imagine how the people will afford the increases during the great recession.  

Friday, November 6, 2009

Kiva Hits 100 Million Today

Kiva Fast Facts

months old


repayment rate

entrepreneurs funded

Kiva users

countries represented

Thursday, November 5, 2009

CDC Flu Charts

Let's look at the laboratory confirmed influenza hospitalization rates for children during different flu seasons and compare it to this year using the CDC's own data.   Now pay attention to the X axis which gives you an idea of the risk of children being hospitalized with the flu.  We're talking around 3 our of 10,000 children for a lot of these seasons.  

This 1st graph shows several years including 2003-4 season where around 8 out of 10,000 children ages 0-4 were hospitalized.  

Compare that to the swine flu, pictures on the left and some recent seasons on the right.  For children ages 0-4 so far we're still below 3 out of 10,000 hospitalized.  This is despite the fact that swine flu infects more children than the regular flu.

So this far into the outbreak,  we're still dealing with a virus that hospitalizes fewer children that most of the seasonal flu viruses for the past several years.  

Interview with an influenza Guru,1518,637119,00.html

SPIEGEL: For a number of years, as part of the Cochrane Collaboration, you have been systematically evaluating all the studies on immunization against seasonal influenza. How good does it work?

Jefferson: Not particularly good. An influenza vaccine is not working for the majority of influenza-like illnesses because it is only designed to combat influenza viruses. For that reason, the vaccine changes nothing when it comes to the heightened mortality rate during the winter months. And, even in the best of cases, the vaccine only works against influenza viruses to a limited degree. Among other things, there is always the danger that the flu virus in circulation will have changed by the time that the vaccine product is finished with the result that, in the worst case, the vaccine will be totally ineffectual. In the best of cases, the few decent studies that exist show that the vaccine mainly works with healthy young adults. With children and the elderly, it only helps a little, if at all.

SPIEGEL: But aren't those the exact groups that influenza immunization is recommended for?

Jefferson: Indeed. That's one of the contradictions between scientific findings and practice, between evidence and policy.

SPIEGEL: So, what's behind this contradiction?

Jefferson: Of course, that has something to do with the influence of the pharmaceutical industry. But it also has to do with the fact that the importance of influenza is completely overestimated. It has to do with research funds, power, influence and scientific reputations!

Wednesday, November 4, 2009

Homeland Security involved in swine flu "control"

The ironic thing to me is that all these products being sold to treat and prevent the swine flu are probably of similar efficacy to Tamiflu and the '09 H1N1 vaccine; ie they don't go much. Additionally, odds are that these "fakes" are less prone to cause side effects or toxicity than Tamiflu and the vaccine. I bet those silver shampoos never cause teens to commit suicide unlike Tamiflu, and I bet the "photon genie" doesn't give you a dose of mercury unlike the vaccine drawn from multi-dose vials.

Movie Night

"The Future Of Food offers an in-depth investigation into the disturbing truth behind engineered foods that have quietly filled U.S. grocery store shelves for the past decade"

Free to watch online but you have to suffer through about 8 commercials
The stuff about Monsanto can be confirmed through other sources and other documentaries. The Bovine Growth Hormone shenanigans aren't touched on in this movie but there are similar themes with that history.

Sunday, October 25, 2009

Time Magazine Article on Cancer Screening'

It's weird to me how no one wants to say "well since these tests are more likely to harm healthy people than save healthy people from cancer, let's not do these tests."

I mean if this was a pill to prevent cancer and yeah it prevents cancer in 1 person out of 2000 who take it for 10 years but the pill causes cancer to be diagnosed unnecessarily in 10 people out of 2000 who take it for 10 years and it causes almost all of them to have at least one false alarm for having cancer over those 10 years..... That pill would be laughed off the market.

I think it's just too horrible to admit such a large mistake.

We made a mistake. The 1st step is to admit it and stop making it worse by continuing to do the same harmful things just because it's what we've always done.

Saturday, October 24, 2009

National State of Emergency Declared

Health and Human Services Secretary Kathleen Sebelius now has authority to bypass federal rules when opening alternative care sites, such as offsite hospital centers at schools or community centers if hospitals seek permission.

That might be a politically correct way of saying "quarantine camps".  I don't know.  I've read that the US like most countries have signed an agreement with the World Health Organization that gives certain powers to the WHO on a local and state level to implement pandemic plans.  

But digging through the national disaster preparedness plan is like reading the small print on the back of a prescription pamphlet

Section 361 authorizes the Secretary to make and enforce regulations necessary to prevent the introduction, transmission, or spread of communicable diseases from foreign countries into the United States, or from one state or possession into any other State or possession. CDC administers these regulations as they relate to quarantine of humans. Diseases for which individuals may be quarantined are specified by Executive Order; the most recent change to the list of quarantinable diseases was the April 1, 2005 Executive Order 13375, which amended the Executive Order 13295 by adding “influenza caused by novel or reemergent influenza viruses that are causing, or have the potential to cause, a pandemic” to the list. Other provisions in Title III of the PHS Act permit HHS to establish quarantine stations, provide care and treatment for persons under quarantine, and provide for quarantine enforcement. Section 311 of the PHS Act provides for Federal-state cooperative activities to enforce quarantine and plan and carry out public health activities. Section 311 also authorizes the Secretary to make available the resources of the PHS to help control epidemics and deal with other public health emergencies. HHS may also engage in certain international activities under section 307 of the PHS Act. Statute 42 U.S.C. § 97, which provides that the Secretary of Health and Human Services may request that Customs, Coast Guard, and military officers aid in the execution of quarantines imposed by states. 

I don't know folks,  maybe this is nothing but there's some spooky stuff that's now legal to contain this "pandemic".  So far we've had adjuvant free swine flu shots but with this madness plus the shortage of vaccinations,  there might come a day very soon where untested adjuvants are added to the swine flu shot and maybe the average person will be compelled to take the vaccination if they want to travel or work or shop?   

Of course I wouldn't put it past our elected officials to just play games to maintain a sense of legitimacy and appearance of being "proactive" in the face of a "pandemic".   


Thursday, October 22, 2009

FDA Doesn't Stand for Fraud..... eventually

“The F.D.A. views any deviation from its high standards for developing or marketing drugs and devices as a potential threat to patient safety and public health,” Norris Alderson, the FDA’s associate commissioner for science, tells The New York Times. “We will take strong action against anyone who chooses to ignore or flout the legal requirements for the products we regulate.”

In a new report, the GAO found that more than half of the debarment proceedings in its review took 4 or more years, and factors contributing to these time frames included internal control weaknesses in the debarment process and competing priorities among responsible staff (read the report).

See if that works this time... Inside the FDA approval process . spooky just in time for halloween

Wednesday, October 21, 2009

When will Peak Swine be?


kinda weird how they didn't bother to quantify the harms and benefits

"Comments are no longer being accepted."   dang,   I signed up just to comment on this story;  there were already 206 when I first looked after just half a day and now they shut it down.  Interesting 

oh wait it's ok this one got in;  it's pretty accurate 

Of every 2000 women screened with mammos (per Cochrane):

200 will have false positives, with resulting worries and potentially mutilating surgeries

10 will be diagnosed but their outcomes are the same whether they were screened or not. Likely, they all feel they were helped, even though data shows their outcomes are neutral.

1 will have her life prolonged

Overall, 200 women are harmed for every one that is helped. I think your opinion on the benefit of screening depends on whether you are one of the 200 or the 1 (or think you are the 1).

Is it worth harming 200 women to help 1? That's the question.

Screening is a value judgment. How many people is it ok to harm to help the one?

Oh my goodness could it be true?

The American Cancer Society, which has long advocated early cancer screening, is rethinking its message, according to The New York Times. Spurred in part by the new analysis, the cancer society is working on a message — to put on its Web site early next year — to emphasize that screening for breast and prostate cancer and certain other cancers can come with a real risk of overtreating many small cancers while missing cancers that are deadly.

Folks with all the talk about health care reform,  THIS little tid bit here could change the course of medicine and save hundreds of thousands of men and women from a needless diagnosis of cancer whilst saving the country millions if not billions of dollars.  

IF the american cancer society follows through on this and changes their "message" to match the available evidence,  ho boy look out.  

This is seriously deep dogma in medicine and if it changes that my friends will be the beginning of something.

Tuesday, October 20, 2009

A little late for national mammogram day but

This means that for every 2000 women invited for screening throughout 10 years, one will have her life prolonged and 10 healthy women, who would not have been diagnosed if there had not been screening, will be treated unnecessarily. Furthermore, more than 200 women will experience important psychological distress for many months because of false positive findings. It is thus not clear whether screening does more good than harm. To help ensure that the women are fully informed of both benefits and harms before they decide whether or not to attend screening, we have written an evidence-based leaflet for lay people that is available in several languages on

Tamiflu FAIL;_ylt=Aozr.6OAC71WjavAlZIAlumS_aF4;_ylu=X3oDMTE1ZGlwc2w2BHBvcwM0BHNlYwN5bi1jaGFubmVsBHNsawNqdWx5NHN3aW5lZmw-

Many of the cadets were treated with oseltamivir, pills sold by Roche AG under the Tamiflu brand name, but they did not get better any more quickly than untreated cadets.
"We did use it in the hope that we would stem the tide of the outbreak but I don't think the Tamiflu was the key player in the outreak resolution," Witkop said.
"I think it was ... the isolation protocol," she added. Cadets stayed in the sick dorm until they were free of symptoms for 24 hours, or for seven days after first getting sick, whichever was longer.

Our first guest contribution!

Barbara sent me this via email;  it addresses the commonly used statistical trick of touting 5 year survival rates as signs of success within out health care system ;  i'll post that and my response to her just after ;  Thank you Barbara for the contribution! 

Cancer Treatment and Health Care Reform

One argument you may hear against health care reform concerns cancer survival rates. The United States has higher cancer survivor rates than countries with national health care systems, we’re told. Doesn’t this mean we should keep what we’ve got and not change it?

Certainly cancer survival rates are a critical issue for people suffering from the deadly lung cancer  "" mesothelioma. So let’s look at this claim and see if there is any substance to it. 

First, it’s important to understand that “cancer survival rate” doesn’t mean the rate of people who are cured of a cancer. The cancer survival rate is the percentage of people who survive a certain type of cancer for a specific amount of time, usually five years after diagnosis. 

For example, according to the Mayo Clinic, the survivor rate of prostate cancer in the United States is 98 percent. This means that 98 percent of men diagnosed with prostate cancer are still alive five years later. However, this statistic does not tell us whether the men who have survived for five years still have cancer or what number of them may die from it eventually.

Misunderstanding of the term “survivor rate” sometimes is exploited to make misleading claims. For example, in 2007 a pharmaceutical company promoting a drug used to treat colon cancer released statistics showing superior survival rates for its drug over other treatments. Some journalists who used this data in their reporting assumed it meant that the people who survived were cured of cancer, and they wrote that the drug “saved lives.” The drug did extend the lives of of patients, on average by a few months. However, the mortality rate for people who used this drug — meaning the rate of patients who died of the disease — was not improved.

But bloggers and editorial writers who oppose health care reform seized these stories about “saving lives,” noting that this wondrous drug was available in the United States for at least a year before it was in use in Great Britain. Further, Britain has lower cancer survival rates than the U.S. This proved, they said, the superiority of U.S. health care over “socialist” countries.

This is one way propagandists use data to argue that health care in the United States is superior to countries with government-funded health care systems. They selectively compare the most favorable data from the United States with data from the nations least successful at treating cancer. A favorite “comparison” country is Great Britain, whose underfunded National Health Service is struggling. 

It is true that the United States compares very well in the area of cancer survival rates, but other countries with national health care systems have similar results.

For example, in 2008 the British medical journal Lancet Oncology published a widely hailed study comparing cancer survival rates in 31 countries. Called the CONCORD study, the researchers found that United States has the highest survival rates for breast and prostate cancer. However, Japan has the highest survival for colon and rectal cancers in men, and France has the highest survival for colon and rectal cancers in women. Canada and Australia also ranked relatively high for most cancers. The differences in the survival data for these “best” countries is very small, and is possibly caused by discrepancies in reporting of data and not the treatment result itself.

And it should be noted that Japan, France, Canada and Australia all have government-funded national health care systems. So, there is no reason to assume that changing the way health care is funded in the U.S. would reduce the quality of cancer care. 

Barbara O’Brien


Part of the reason the US has a higher 5 year survival rate in breast and prostate cancer is the phenomenon of misdiagnosis and unnecessary diagnosis sprinkled with a touch of early diagnosis.  Most of the men diagnosed with prostate cancer in the US are via screening PSA testing.  These are early stage largely benign prostate cancers that are incapable of altering the natural life expectancy of the individual,  yet when these men live beyond 5 years after their "cancer" diagnosis it's counted as a victory for 5 year survival.  The best estimates with PSA screening say that for every man who has his life prolonged from the test 48 are unnecessary diagnoses. 
Breast cancer screening via mammography does similar things to our 5 year survival rates.  For every women who has her life prolonged by mammography 2-10 have an unnecessary diagnosis while 10-15 were diagnosed earlier without altering prognosis. 
Our mortality rates have been pretty stagnant since the 1980s while our incidence rate have skyrocketed with our screening tests capturing many fold more patients than benefit from the "early diagnosis"
This has little to do with who pays for health care.  Great Britain is home to the second largest pharmaceutical company on earth, GSK,  and participates in the same wasteful and harmful preventative testing and vaccinations as the US.  We all pay for high health care costs one way or another.  In the US we all pay by insurance premiums going up year after year and wages decreasing to match.  We all pay for the tax money wasted through medicare and medicaid.  We all pay when a member of society is bankrupted by health care costs and unable to provide a good environment for their children to grow up.  We all suffer by being inundated with ads telling us we're not healthy unless we "talk to our doctor" about the latest useless expensive drug to treat a symptom of a sick society. 
The health care coverage debate is a distraction from the fact that the western health care system is a for profit industry.  This is true in so called nationalized health care systems or in the USA.  It is a good thing to prevent the bankruptcies from health care expenses but by simply nationalizing some of the costs we simply spread the pain out more evenly. 

Saturday, October 17, 2009

GSK's big bet

LONDON -- GlaxoSmithKline PLC has spent five years fashioning itself into a one-stop pandemic shop. Now, as the swine-flu virus sweeps the globe, the U.K.-based drug giant will find out whether the world is buying.

Thursday, October 15, 2009

Oh man this is long but it's gooooood

try to ignore the political references to hurricane Katrina etc; there's some good incites in this one on how statistics are used to deceive

Jackson’s findings showed that outside of flu season, the baseline risk of death among people who did not get vaccinated was approximately 60 percent higher than among those who did, lending support to the hypothesis that on average, healthy people chose to get the vaccine, while the “frail elderly” didn’t or couldn’t. In fact, the healthy-user effect explained the entire benefit that other researchers were attributing to flu vaccine, suggesting that the vaccine itself might not reduce mortality at all. Jackson’s papers “are beautiful,” says Lone Simonsen, who is a professor of global health at George Washington University, in Washington, D.C., and an internationally recognized expert in influenza and vaccine epidemiology. “They are classic studies in epidemiology, they are so carefully done.”

The one area where the seasonal flu shot has been shown to reduce mortality (vaccinating the elderly) shows such a dramatic decrease in mortality from ALL CAUSES that some independent thinkers had to dig deeper.

Tom Jefferson, a physician based in Rome and the head of the Vaccines Field at the Cochrane Collaboration, a highly respected international network of researchers who appraise medical evidence, says: “For a vaccine to reduce mortality by 50 percent and up to 90 percent in some studies means it has to prevent deaths not just from influenza, but also from falls, fires, heart disease, strokes, and car accidents. That’s not a vaccine, that’s a miracle.”

Vaccine profits

some interesting comments after the article too

This one speaks for itself

An oldie but goodie

2006 study of the practices of the advisory panels for the FDA which are the front lines of the approval process for new drugs and devices

The results indicate that advisory committees recommended approval for 76% of new drugs and 82% of new medical devices. Some committees are more discriminating than others. Many panel members and some committee members recommended approval for every product they considered year after year. For example, 98% of the votes by members of the advisory committee reviewing arthritis drugs over the eight years of the study recommended approval; almost all, like Vioxx®, were recommended unanimously. The committee reviewing medical devices for vision correction and eye diseases unanimously recommended approval for every medical device they considered for the last six years of the study. About 96% of these drugs and devices were subsequently approved by the FDA.

Tuesday, October 13, 2009


Thanks to Joel I've gone twitter crazy. There's still time for people to push back against this mindless swine flu vaccination campaign. There's still the forums to get started (finally) but between seeing sick children and doing sports physicals, I've been working on ways to encourage debate over the swine flu mandates throughout the health care industry. Most of you are aware of Memorial Hospital's decision to force all their clinicians to accept an untested bio pharmaceutical or suffer the consequence of wearing a mask on hospital property for 5 months: A very public questioning of their individual clinical judgement.

I have a slide show to get published looking at the CDC data on the swine flu epidemic.

Join twitter if you haven't already to participate in spreading the knowledge.

Any of you who want to sit down and talk about anything, I'm an email away. I've enjoyed the meetings I've had with folks so far.

Wednesday, October 7, 2009

Wed 10/7/09

I'll be in a cardiology conference most of today; don't know if i'll have internet access there but I bet I will

will be out of that thing and home by 630 if not

still working on the forums deal, getting closer

thanks for all of the great advice and assistance

Monday, October 5, 2009

Slow Money

Slow Money's Mission
• To steer significant new sources of capital to small food enterprises, appropriate-scale organic farming and local food systems; and,
• To catalyze the emergence of the nurture capital industry— entrepreneurial finance supporting soil fertility, carrying capacity, sense of place, cultural and ecological diversity, and nonviolence.

Sunday, October 4, 2009

Conflict of interest

The problems I've discussed are not limited to psychiatry, although they reach their most florid form there. Similar conflicts of interest and biases exist in virtually every field of medicine, particularly those that rely heavily on drugs or devices. It is simply no longer possible to believe much of the clinical research that is published, or to rely on the judgment of trusted physicians or authoritative medical guidelines. I take no pleasure in this conclusion, which I reached slowly and reluctantly over my two decades as an editor of TheNew England Journal of Medicine.
--Marcia Angell, M.D. (born 1939) is an American physician, author, and the first woman to serve as editor-in-chief of the New England Journal of Medicine (NEJM). She currently is a Senior Lecturer in the Department of Social Medicine at Harvard Medical School, in Boston, Massachusetts

British doctors plan to refuse swine flu shots

Saturday, October 3, 2009

check out how many folks have high levels of antibodies naturally to swine flu

For all you health care professionals looking at this for Flu info

"There is no evidence to show if regular influenza vaccine is beneficial to people with CF"

Influenza (flu) is a highly infectious disease, caused by viruses. Influenza has been thought to cause asthma attacks. Few trials have
been carried out in a way that tests whether asthma attacks following influenza infection (as opposed to following the vaccination) are
significantly reduced by having influenza vaccination, so uncertainty remains in terms of how much difference vaccination makes to
people with asthma. The included studies suggest that the vaccine against influenza is unlikely to precipitate asthma attacks immediately
after the vaccine is used.

There is no high quality evidence that vaccinating healthcare workers reduces the incidence of influenza or its complications
in the elderly in institutions
There is evidence that vaccinating the elderly has a modest impact on the complications from influenza. There is also high quality
evidence that vaccinating healthy adults under 60 (which includes healthcare workers) reduces cases of influenza. Both the elderly in
institutions and the healthcare workers who care for them could be vaccinated for their own protection, but an incremental benefit of
vaccinating healthcare workers for the benefit of the elderly cannot be proven without better studies.

In long-term care facilities, where vaccination is most effective against complications, the aims of the vaccination campaign are fulfilled,
at least in part. However, according to reliable evidence the usefulness of vaccines in the community is modest. The apparent high
effectiveness of the vaccines in preventing death from all causes may reflect a baseline imbalance in health status and other systematic
differences in the two groups of participants.

Influenza vaccines are efficacious in children older than two but little evidence is available for children under two. There was a
marked difference between vaccine efficacy and effectiveness. No safety comparisons could be carried out, emphasizing the need for
standardisation ofmethods and presentation of vaccine safety data in future studies. Itwas surprising to find only one study of inactivated
vaccine in children under two years, given current recommendations to vaccinate healthy children from six months old in the USA and
Canada. If immunisation in children is to be recommended as a public health policy, large-scale studies assessing important outcomes
and directly comparing vaccine types are urgently required.

Friday, October 2, 2009

these are the same people recommending swine flu shots

when you heard the CDC recommends something, we're talking about this committee


Well folks,

Looks like this weekend we should have a forums site which will be much more organized and searchable

I was thinking we could use a section for stories about the hard economic times made worse or caused by the cost of health care. I've heard over the last 9 years more and more stories of folks stuck with unpayable medical bills that they are forced to deal with in the middle of an illness. Even more frequently I hear about the rising copays, deductibles, insurance denials, hard time affording medicines etc.

The financial stress the system causes sure isn't good for our health.

So I'm looking for contributions and personal stories once the forums is up and running. Everything you contribute can be annonymous.

Those of you who aren't getting email responses from me, check your spam folders. These email programs nowadays love to randomly put email in the spam folder. Yet another reason to get on the instant messenger.

Those of you who are overwhelmed trying to figure out the computer stuff, I can always come over and set stuff up for you when I make home visits.

Thursday, October 1, 2009

Things I Need Help with

ok tons of yall are asking how you can help

here are things I can think of you can give me:

1) Your time and consideration and skepticism for a few of the issues I raise on this blog that grap your attention; ask questions on IM or email or in person , I enjoy explaining this stuff

2) Anyone who can make a forums site out of this hodgepodge of posts here go ahead and set it up

3) I want to plant; I want my front yard to produce food, like a couple fruit trees mixed in with rows of peas and beans and what not; the problem is , i'm clueless on how to turn the water, soil and sunlight into something edible; i know that i probably have to start by rototilling the yard? any expertise or assistance would be appreciated

4) research medical topics and send me the links to good sites and i'll post them up ; politics, science , policy it doesn't matter anything that educates benefits the entire community

5) Request the fee scales from every medical establishment with whom you interact. There's some law that clinics and hospitals and radiology suites have to give you a copy of their services and charges if requested. Get those pieces of paper and give them to me and up they go.

6) Ask every doctor you interact with about their take on swine flu. Ask them the risks of getting the swine flu, getting hospitalized from the swine flu and the benefits of the vaccine to come. Ask them if they believe in mandatory vaccinations of children in the public schools , health care workers, the general population. Ask if they believe this virus warrants forced quarantine.

Your questions have a profound impact on our practice, trust me. It doesn't take many patients asking the answer to something we don't know before we start dusting off our brains.

Thank you

Swine Flu at the CDC

this is really hard to read and there's a ton of "spin" in the reporting but just check out the map at the very bottom of the page

this was for the week ending 9/19

you can see how most of the country has widespread flu activity; most of that if not 99% of that activity is the 2009 H1N1 AKA swine flu

the outbreak is happening yet the news doesn't talk about it for some reason; probably because people will naturally ask "why give the vaccine after the danger has passed?"

they are being a little sneaky with the reporting of hospitalizations and deaths from the swine flu since that's limited to confirmed cases ; see at least half the time when you have swine flu you test negative , so we don't get a clear picture of how many people are really infected making it seem like a larger % of the people infected are getting hospitalized or dying


Three influenza-associated pediatric deaths were reported to CDC during week 37 (Texas [2] and Virginia). These deaths were associated with 2009 influenza A (H1N1) virus infection, and occurred between August 30 and September 19, 2009. Since September 28, 2008, CDC has received 117 reports of influenza-associated pediatric deaths that occurred during the current influenza season (25 deaths in children less than 2 years, 12 deaths in children 2-4 years, 35 deaths in children 5-11 years, and 45 deaths in individuals 12-17 years). Forty-nine of the 117 deaths were due to 2009 influenza A (H1N1) virus infections, and four of these have occurred since August 30, 2009.
Of the 50 children who had specimens collected for bacterial culture from normally sterile sites, 19 (38.0%) were positive; Staphylococcus aureus was identified in 13 (68.4%) of the 19 children. Six of the S. aureus isolates were sensitive to methicillin and seven were methicillin resistant. Seventeen (89.5%) of the 19 children with bacterial coinfections were five years of age or older and 12 (63.2%) of the 19 children were 12 years of age or older. Nineteen (38.8%) of the 49 children with confirmed 2009 influenza A (H1N1) infection had a specimen collected from a normally sterile site; five (26.3%) of the 19 children had a positive bacterial culture (methicillin sensitive S. aureus [2], methicillin resistant S. aureus [2], and Streptococcus constellatus


so in the middle of a wide spread outbreak (between August 30 and September 19, 2009) when the population is an unimmune to the swine flu as they can get we had 3 pediatric deaths nationwide

it then goes on to talk about staph bacteria coinfecting children with the flu; our problems with rampant resistant staph infections probably has more to do with the deaths caused from viral infections like the swine flu than the virus itself

our food supply being supersaturated with live stock antibiotics and one of our childhood vaccines (prevnar) exacerbate the antibiotic resistance problem

"The use of the vaccine created an ecological vacuum, and that combined with excessive use of antibiotics to create this new superbug," Pichichero said.

“Being a carrier of MRSA has increased a lot, especially among school-aged kids,” said Lyn Finelli, chief of influenza surveillance at the CDC. “And being colonized may put them at risk for a severe staph aureus infection when they get the flu.”

Whether the current increase in severe community-acquired S. aureus infections, including methicillin-resistant S. aureus (6), is partially caused by the recent introduction of the pneumococcal conjugate vaccine is yet to be determined.

Wyeth Sees Prevnar Vaccine Sales Reaching $3 Billion In 2009 –
NEW YORK -(Dow Jones)- Wyeth (WYE) expects sales of its Prevnar vaccine to rise to $3 billion in 2009, driven by overseas growth and new launches,

A trial with a 7-valent pneumococcal-conjugate vaccine in children with recurrent acute otitis media showed a shift In pneumococcal colonisation towards non-vaccine serotypes and an Increase In Staphylococcus aureus-related acute otitis media after vaccination. We investigated prevalence and determinants of nasopharyngeal carriage of Streptococcus pneumonlae and S aureus in 3198 healthy children aged 1-19 years. Nasopharyngeal carriage of S pneumonlae was detected In 598 (19%) children, and was affected by age (peak Incidence at 3 years) and day-care attendance (odds ratio [OR] 2.14, 95% Cl 1.44-3.18). S aureus carriage was affected by age (peak incidence at 10 years) and male sex (OR 1.46, 1.25-1.70). Serotyping showed 42% vaccine type pneumococci. We noted a negative correlation for co-colonisation of S aureus and vaccine-type pneumococci (OR 0.68, 0.48-0.94), but not for S aureus and non-vaccine serotypes. These findings suggest a natural competition between colonisation with vaccine-type pneumococci and S aureus, which might explain the Increase in S aureus-related otitis media after vaccination.

Monday, September 28, 2009

In the News Swine Flu Shots

with any pharmaceutical preventative product you want to know the risks and benefits

well with the swine flu shot let's focus on the benefits

less chance of contracting the swine flu
less chance of dying from the swine flu

what are the baseline risks? we don't know how many people have had the swine flu. we have only a tip of the iceberg view since most people are never tested for influenza when they have this mild viral illness and even they are tested our best estimates of the test accuracy is 50%. whatever your risk might be, that number is rapidly dropping as most of the country has outbreaks now effectively vaccinating the population the old fashioned way.

The chance of DYING of the swine flu decreases as the outbreak fizzles out and the mortality numbers just aren't out there that I can find. I saw somewhere the chance of hospitalization with swine flu is about 2 out of 100,000.

So we have 2 unknowns then we give the shot; we have no idea how effective the shot is but assuming it's 100% effective we'll vaccinate all 197 million of the people the government has kindly purchased vaccine doses for and then hope there's more people helped than harmed.

Sound public health spending if I ever heard it

I wonder who makes a profit from all this "medicine" and "science"

I wonder who foots the bill

All this for a medicine that has a small but unknown benefit IN THEORY and an unknown risk; how can we counsel patients on whether to get this vaccine when there's so little to gain and no proof of effectiveness?

In the news Mammograms

this article was in the Yakima Herald Republic around July 10th 2009 but i can't find it now online 

LONDON (AP) -- One in three breast cancer patients identified in public screening programs may be treated unnecessarily, a new study says. Karsten Jorgensen and Peter Gotzsche of the Nordic Cochrane Centre in Copenhagen analyzed breast cancer trends at least seven years before and after government-run screening programs for breast cancer started in parts of Australia, Britain, Canada, Norway and Sweden.

The research was published Friday in the BMJ, formerly known as the British Medical Journal. Jorgensen and Gotzsche did not cite any funding for their study.

Once screening programs began, more cases of breast cancer were inevitably picked up, the study showed. If a screening program is working, there should also be a drop in the number of advanced cancer cases detected in older women, since their cancers should theoretically have been caught earlier when they were screened.

However, Jorgensen and Gotzsche found the national breast cancer screening systems, which usually test women aged between 50 and 69, simply reported thousands more cases than previously identified.

Overall, Jorgensen and Gotzsche found that one third of the women identified as having breast cancer didn't actually need to be treated.

Some cancers never cause symptoms or death, and can grow too slowly to ever affect patients. As it is impossible to distinguish between those and deadly cancers, any identified cancer is treated. But the treatments can have harmful side-effects and be psychologically scarring.

"This information needs to get to women so they can make an informed choice," Jorgensen said. "There is a significant harm in making women cancer patients without good reason"

Jorgensen said that for years, women were urged to undergo breast cancer screening without them being informed of the risks involved, such as having to endure unnecessary treatment if a cancer was identified, even if it might never threaten their health.

Doctors and patients have long debated the merits of prostate cancer screening out of similar concerns that it overdiagnoses patients. A study in the Netherlands found that as many as two out of every five men whose prostate cancer was caught through a screening test had tumors too slow-growing to ever be a threat.

"Mammography is one of medicine's 'close calls,' ... where different people in the same situation might reasonably make different choices," wrote H. Gilbert Welch of VA Outcomes Group and the Dartmouth Institute for Health Policy and Research, in an accompanying editorial in the BMJ. "Mammography undoubtedly helps some women but hurts others."

Experts said overtreatment occurs wherever there is widespread cancer screening, including the U.S.

Britain's national health system recently ditched its pamphlet inviting women to get screened for breast cancer, after critics complained it did not explain the overtreatment problem.

Laura Bell of Cancer Research UK said Britain's breast cancer screening program was partly responsible for the country's reduced breast cancer cases.

Sunday, September 27, 2009


How will you make a living?
I can go without making a living for a couple years, maybe 1000 days; this is too important a time to worry about my retirement account anyway. I Appreciate your concern for my finances, but frankly i'm more concerned with the finances of all potential patients. Because, health care expenses can crush you. My financial wealth is worth less because of bloated health care costs and they help make it impractical to open your own business. Fear of health care costs restricts our social freedoms severely because you are bound tightly to your job for the protection that health insurance affords.

What about malpractice insurance?
I can't afford it; I will continue to do my best but will make errors like anyone else. Since I won't have malpractice insurance, all a prosecuting at tourney would have to gain money wise from me are my meager assets.

What about medical records?
I won't be storing your medical records; if you want a note generated for your records and or your PCP's records then i'll provide a note for you to do with what you wish. I don't think I'll have access to your electronic medical records which further restricts how we'll manage medicines. We'll have plenty of time to work around any problems and gather records when needed. It'll take some getting used to.

Can you order tests?
I think so; but we'll have to have the results sent to your PCP and have you get a copy?

Do you have an DEA license?
yes and I don't believe that will be affected by leaving the clinic setting

Do you have a state medical license?

Are you board certified?
yes but I won't be maintaining that since it's only an insurance billing requirement; CMEs or continuing medical education has traditionally been dominated by pharmaceutical sales reps

How's this going to work?
Well you'll sign on to yahoo instant messenger and open a window and talk to me and we'll go from there.

Participate a little or as much as you'd like; there are no hidden charges and no obligations to purchase anything

More later as the questions roll in

Mammography for breast cancer screening

Ok this is not an endorsement for or against screening mammograms. This is just some information that's important to consider before you decide if mammograms for screening is right for you.

Your risk factors may be high enough that mammography screening makes a lot of sense.

The decision should be based on a good understanding of the risks and benefits.

Here's a rough outline of those risks and benefits:

If 1000 women between the ages of 50-74 get mammograms yearly for 10 years

1 will have her life saved by mammography screening
between 2-10 will be diagnosed unnecessarily with breast cancer
between 10-15 will be diagnosed earlier but it won't affect the prognosis
100 to 500 will have at least one false positive test requiring more testing or biopsy
the british medical journal saying is a little differently
talks about false positives ; each mammography center has a "recall" rate. The % of mammograms that are followed by "let's repeat the Xray" results
Our local center in Yakima, Ohana has a recall rate. I don't know the % for sure, but i'm sure we could find out.
this talks about one of the books of required reading if you want to make informed decisions about cancer screening tests

Friday, September 25, 2009

Lame Duck Session

I can not do everything a "PCP" can do, so please go ahead and check out the newly assigned docs and I think you'll like them.

I can provide things the PCP won't have the time for but our common goal will be your health. And like many treatments, combination therapy is superior to monotherapy.

Thank you for your patience

Friday, September 11, 2009

In the News 9/11/9

ok this one is great

notice how the swine flu has hit and is the dominant strain of influenza already all over the country. Ok so that means we basically just vaccinated people all over the country. The outbreak has happened and it's not the end of the world afterall. Since most people are better in 3-4 days, this outbreak is like any unique viral plague with kids missing school and more visits to the doctor's office for reassurance. There are people who get really sick for sure, but this is kinda it. People are getting more and more immune as we speak yet the US government with the full backing of the CDC and major medical societies is the proud owner of 198 MILLION doses of the swine flu vaccine? Who is going to be left to vaccinate?

And notice who is reporting on safety and efficacy data, the companies making the vaccine. Wow sign me up for that shot!

It MIGHT prevent a 3 day illness

It might be safe

Oh and this is a great quote

"Chinese manufacturers gave the first hint a week ago that one dose could be enough. But different manufacturers make different formulations of the vaccine, so more evidence was needed."

Come on! The Chinese vaccine by the way has a different formulation! wonderful

so not only is the vaccine not made by the some people, but there's different stuff you can mix in the shot to make it work better or stay preserved longer

i don't quite remember but wasn't there a deal with chinese made stuff killing pets and poisoning babies?


The local medical community should be signing petitions for a city counsel resolution reaffirming the citizen's right to choose and refuse medical treatments including this untested, largely irrelevant vaccine.

Sounds like a good use of the local farmer's market....

Thursday, September 10, 2009

A work in progress

Since it's the most timely of the issues we face, I'll be working on influeza vaccinations, testing and treatment for the next few days and post more about the plans for the budding community later.

If anyone has expertise in making a forums, feel free to move the posts I have over and I'll work on further educational materials there.

Health care advice must be individualized, but there is a lot to be learned before getting into the room and making a decision. You are the best person to balance the risks and benefits ; medical professionals are simply here to interpret the language for you.

The information can be a little overwhelming until you get used to filtering out the advertisements from the data.

I'm here to supply information ahead of time so you can have a foundation to making an informed decision.

I welcome your questions and starting 10/1/09 I will be available most of the day to answer questions, provide advice and arange for free evals to help keep you away from the aspects of the medical system that do the least good. to send emails, the same ID (doctorcrafts) will be my screen name for the free yahoo instant messenger service
sign up for yahoo instant messenger for online, instant access to your former PCP

I am resigning from the for profit medical system because it is bankrupting and sickening society. The practitioners within this corrupt system are good people who are fighting the good fight in an increasingly unmanageble financial/political landscape. I want to devote ALL of my time and energy toward helping patients separate the wheat from the chaff, the propaganda from reality. I have no financial incentives. My reward is reducing the harms and profits generated by a corrupt, mindless and heartless system. I am no longer your primary care physician (PCP); I am now your health care advocate (HCA). What I have to offer is free of charge.

PS the remainder of these posts probably make more sense if read from last to 1st...

Wednesday, September 9, 2009

The Future

yeah they grow organs in the lab now

Health Care Reform

Here's a great summary of what has been labeled as health care reform which is actually health insurance reform

a lot more to be added to this section later 

This looks interesting

of course a lot of the folks appointed to overhaul the health care payment systems have ties with the industry they are supposed to regulate


Effective July 26, 2009, Washington state law requires that all fees and charges for health care services by health care providers and licensed facilities must be disclosed at the request of the patient. Providers and facilities may refer a patient to the patient’s insurer for specific information on the insurer’s charges and fees, any cost-sharing responsibilities required of the patient, and the network status of ancillary providers who may or may not share the same network as the provider or facility. Providers and facilities must post a sign in patient registration areas indicating that patients may ask about the estimated charges of the health services. This practice will comply with all applicable requirements.


Frequently Asked Questions

This list will constantly be changing as I figure out exactly what can and can't be done through this community.  Think of me as a free supplement to your health care;  sort of like supplemental insurance except without the paperwork.  Or think of me as an eccentric retired uncle physician who enjoys giving away his knowledge and skills to family members.  

I'm still not crystal clear on any limits to prescribing authority and ordering tests and labs,  but the goal will be avoid getting into writing a ton of prescriptions or ordering a lot of routine tests since the infrastructure to collect and store that data won't present.  

What can I do?

Provide advice,  answer questions,  do limited physical exams (check ups,  well child checks, sports physicals) 
Deal with acute problems like colds, flues, bronchitis, sinusitis
Help you manage your chronic medical problems such as diabetes,  high blood pressure (you'll still need to involve your primary care provider)
Home visits
Work visits
Group visits
Walk in the park visits
Hiking visits
Biking visits
Educational lectures to small groups, class rooms etc
Blood pressure checks

What can't I do?

Referrals to specialists (that requires dealing with insurance companies) 
Refills of chronic medicines (requires access to medical records and fax machines)
Prescribe pain medicines, benzodiazepines, stimulants or any other controlled substances (that's just asking for trouble)
DOT physicals or other work physicals that require lab work or other special testing 
Hospital care (requires insurance company credentialing) 
Fill out paperwork for your insurance company 
Deal with nursing home faxes or faxes of any sort
Nursing Home visits ( except to visit;  can't write orders there without insurance credentials )

Monday, September 7, 2009

More on Swine Flu with videos!

Here's an interview from the head of the CDC

Stating that what we've seen from this variety of H1N1 in the USA and around the world shows we won't have the 90,000 death toll "if the virus doesn't change"

keep in mind from our past experience with influenza pandemics and epidemics we can reasonably predict:

In their commentary in the Aug. 12 issue of the Journal of the American Medical Association, David M. Morens, M.D., and Jeffery K. Taubenberger, M.D., Ph.D., note that the two other flu pandemics of the 20th century, those of 1957 and 1968, generally showed no more than a single seasonal recurrence; and in each case, the causative virus did not become significantly more pathogenic over the early years of its circulation.
The variable track record of past flu pandemics makes predicting the future course of 2009 H1N1 virus, which first emerged in the Northern Hemisphere in the spring of 2009, difficult. The authors contend that characteristics of the novel H1N1 virus, such as its modest transmission efficiency, and the possibility that some people have a degree of pre-existing immunity give cause to hope for a more indolent pandemic course and fewer deaths than in many past pandemics.


Word from an infamous physician skeptic of mass flu vaccination Dr. Tom Jefferson one of the leaders within Cochrane , more about Cochrane at a later date

The second fellow, I don't know who he is but he brings up good points about how we can not know the effectiveness of the H1N1 vaccine without many months of testing; what will be labeled as testing will be antibody studies ; as far as safety testing goes, well that'll have to come from post mass vaccination surveillance ie the population at large are the test cases

the news folks in the second interview attempt to put the doc in the same basket with autism/mmr folks and otherwise change the subject; and the good doctor throws in the US experience with swine flu vaccination programs back in the 70s but the disease he mentioned (Guillain-Barré Syndrome) it's unclear whether the flu shot caused that or not so everyone in that room is a little guilty of spin (in my humble opinion)

It would make a lot of sense to vaccinate folks at high risk of dying or getting severely ill from the swine flu just as we recommend with regular seasonal flu; it is interesting to note that our vast experience with the seasonal flu shots shows that the benefits are still rather vague and controversial. More on that in another post; mustn't get side tracked


Just for nostalgia, here's some old commercials from the last swine flu scare


There are a couple interesting pieces of legislation being batted around re the swine flu

and don't ask me to interpret this next one but i've read interpretations that say this Mass Senate bill authorizes imprisonment and fines for people refusing vaccinations during a declared state of emergency

(CBS) Federal officials say schools should become distribution centers of H1N1 vaccine shots this fall, an idea that has created some controversy.


more from good ole Doctor Jefferson , this is a really good overview of influenza vaccinations in general,1518,637119,00.html

Jefferson: Not particularly good. An influenza vaccine is not working for the majority of influenza-like illnesses because it is only designed to combat influenza viruses. For that reason, the vaccine changes nothing when it comes to the heightened mortality rate during the winter months. And, even in the best of cases, the vaccine only works against influenza viruses to a limited degree. Among other things, there is always the danger that the flu virus in circulation will have changed by the time that the vaccine product is finished with the result that, in the worst case, the vaccine will be totally ineffectual. In the best of cases, the few decent studies that exist show that the vaccine mainly works with healthy young adults. With children and the elderly, it only helps a little, if at all.


Yeah, by the way, our rapid flu tests aren't terribly accurate.

Profits from the Swine Flu

New York Times from 7/23/09 article detailing the sales of Tamiflu

Roche, based in Switzerland, said Thursday that sales of Tamiflu in the first half of 2009 tripled to 1 billion Swiss francs ($931 million), spurred by retail sales and the stockpiling of the drug by governments and corporations.
For the second quarter alone, Tamiflu sales reached 609 million francs ($567 million), more than 12 times the level of the second quarter of 2008. The second quarter, from April to June, is not usually a heavy season for flu.


Still, Mr. Schwan said that Roche, in cooperation with outside contractors, would increase its manufacturing capacity to 400 million packs a year by the beginning of 2010, about four times the current capacity.
He said that should be an ample volume, given that the company sold a total of only 300 million packs during the last five years — a period that encompassed a bird flu scare as well as the current swine flu outbreak.


But back in 2008, things weren't looking so hot for Roche

The Losers
Meanwhile, sales of influenza treatment Tamiflu (oseltamivir) plummeted by a whopping 64% y/y. The plunge is explained both by a high baseline for the first quarter of 2007 and slowing demand as government stockpiles near completion (see Switzerland: 12 October 2007: Roche Braced for Tamiflu Sales Slowdown as Government Stockpiles Reach Saturation)


Roche can make money off Tamiflu AND rapid flu tests


But it does cost money for Roche


here's a press release from Roche disguised as a news story on the front page of yahoo news