Tag: Medicine

I can’t even with this

This popped up on one of the nursing forums I lurk on so I can’t absolutely vouch for its authenticity, but it seems unfortunately plausible. Someone wants to put themselves on extracorporeal membrane oxygenation at home rather than get vaccinated.

As a point of information, this is what someone on ECMO looks like:

I assure you there is a patient under all that equipment

And just for further fun, this is what happens when a component on the ECMO circuit fails and you have to swap it out for a new one:

That was a real patient (I was filming) and once my two colleagues there put the clamps on the circuit the patient was, by some quite reasonable definitions, dead and wasn’t really alive again until they took the clamps off.

So yeah, go ahead and do this at home. Good plan. WAY better than getting vaccinated.

Edited to add – Looking at the picture and video above, I am almost positive they are the same patient. I remember when we were getting set up to change the oxygenator there was a great deal of unease because the patient was entirely dependent on the pump to keep his blood circulating. His heart was not actually beating at all.

A normal person with even a minimally functioning heart will produce a tracing on an arterial blood pressure line that looks similar to this;

The red line there measures the pressure changes in an artery (usually the radial artery in the wrist, the same place you feel for someone’s pulse) with every beat of the heart.

If you look closely at the two monitors in the picture above that have an art-line tracing on them, you will see this;

Those lines are, in fact, flat. This is not all that unusual for people with bad hearts that have a pump doing all the work for them but what it does mean is that if something stops the pump, like someone clamping the circuit so they can change the oxygenator, all the patient’s blood pressure goes away. Not “low blood pressure” but “no blood pressure”.

So again, go ahead. Do this at home. What could possibly go wrong?

If you want to learn more about extracorporeal membrane oxygenation, check your local library!

Or just ask and I’ll talk about it for as long as you’ll let me.

In the spirit of transparency

Too much information alert!

Proceed at your own risk

This is another one of those things that I would ordinarily keep to myself, both because I didn’t want people around me to worry, and because I genuinely don’t know how much it should be worried about at all.

Since Friday I have been having symptoms very much like a urinary tract infection. This was kind of curious. While I have more reason than some to have a uti, it’s pretty much been life as usual for me for the last month or so and I would think that any infection issues related to the BCG treatments would have popped up before now.

So I went in to urgent care (my primary care doctor was scheduled out for the next month or so), dropped off a urine specimen, picked up a prescription for nitrofurantoin and went on my way. A couple of days later I got a call reporting that my urine culture was negative. Which would almost certainly mean I didn’t have a uti.

And yet I continued (and continue) to have symptoms very much like a urinary tract infection, only thing missing is fevers. So what is causing the symptoms?

The answer is, of course, “I don’t know, but probably not anything I’m going to be happy to find out about”. I already have an appointment with the urologist in three days and I don’t think three days is going to make any difference with anything one way or the other.

We shall see.

The List of Medications

One of the more common objections to the covid vaccine is that no one who claims to be a Good Christian™ (and it’s always Christians) can get the vaccine because it was made using “aborted fetuses”.

As anyone with more than two functioning neurons could guess, reality is a bit more complicated. The Oxford-AstraZenica vaccine was, in fact, developed using Human Embryonic Kidney 293 (HEK-293) cells. These cells are commonly used to replicate viral proteins which are then used to deliver mRNA sequences. The HEK-293 cells themselves are not a part of the finished products.

“But wait,” you might say, “If the AstraZenica vaccine is the only one that is manufactured using HEK-293 cells, why don’t they just take one of the other ones?” Well here’s the thing, HEK-293 cells are also frequently used in the early stages of development to test the function and potential toxicity of a new drug, and every single one of the covid vaccines was tested on HEK-293 cells. What can a Good Christian™ do but decline to take these vaccines that were tested on the cloned cells of an immortalized cell line originally derived from the kidneys of a fetus that was either aborted or miscarried, no one is quite sure which, in 1973 poor innocent murdered babies.

The problem is that there are a METRIC CRAPTON (2.2 imperial craptons) of drugs that are tested for safety using HEK-293 cells.

(Blatantly stolen from https://www.patheos.com/blogs/throughcatholiclenses/2021/01/if-any-drug-tested-on-hek-293-is-immoral-goodbye-modern-medicine/)

Common over the counter medicines tested on HEK-293 cells or derivative cell lines.

  1. Tylenol / Acetaminophen (1, 2)
  2. Advil / Motrin / Ibuprofen (1, 2)
  3. Aspirin / Acetylsalicylic Acid (ASA) (1, 2)
  4. Aleve / Naproxen (1, 2)
  5. Pseudoephedrine / Sudafed / / SudoGest, Suphedrine (1, 2)
  6. Diphenhydramine / Benadryl (it is used so much with HEK293 that it has a page for using it and HEK293 together for further studies on the FDA site, 2)
  7. Loratadine / Claritin (1, 2)
  8. Dextromethorphan / Delsym / Robafen Cough / Robitussin (1, 2)
  9. Guaifenesin / Mucinex (1)
  10. Tums / Calcium Carbonate (1, 2)
  11. Maalox / Aluminum Hydroxide and Magnesium Hydroxide (1)
  12. Docusate / Colace / Ex-Lax Stool Softener (1, 2)
  13. Senna Glycoside / Sennoside / Senna / Ex-Lax / Senokot (1)
  14. Pepto-Bismol / Bismuth Subsalicylate (1)
  15. Phenylephrine / Preparation H / Vazculep / Suphedrine PE (1, 2)
  16. Mepyramine / Pyrilamine (1, 2)
  17. Lidocaine / Lidoderm / Recticare (1, 2)

Common prescription drugs tested on HEK-293 cells or derivative cell lines.

  1. Levothyroxine / Synthroid / Tirosint / Levoxyl (1, 2)
  2. Atorvastatin / Lipitor (1, 2)
  3. Amlodipine / Norvasc (1, 2)
  4. Metoprolol / Toprol XL / Lopressor (1, 2)
  5. Omeprazole / Prilosec OTC / Zegerid OTC / OmePPi (1, 2)
  6. Losartan / Cozaar (1, it is used so much in testing the FDA has a page on using it with HEK293)
  7. Albuterol / Salbutamol / ProAir / Ventolin (1, 2)
  8. Sacubitril / Valsartan / Entresto (2 studies mentioned in FDA application)
  9. Tenapanor / Ibsrela (1 study mentioned in FDA application, 2)
  10. Enbrel / Etanercept (1, 2)
  11. Azithromycin / Zithromax (1, 2)
  12. Hydroxychloroquine / Plaquenil (1, 2)
  13. Remdesivir / Veklury (1, 2)
  14. Dapagliflozin / Farxiga / Ipragliflozin / Suglat / Enavogliflozin / Jardiance (1)
  15. Ivermectin / Stromectol (1, 2)
  16. Canagliflozin / Invokana / Sulisent / Prominad (1 study mentioned in FDA application)
  17. Metformin / Glucophage / Riomet / Glumetza (1, 2)
  18. Cerivastatin / Baycol / Lipobay / Fluvastatin / Lescol / Pitavastatin / Livalo / Pravastatin / Pravachol / Rosuvastatin / Crestor (1)
  19. Simvastatin / FloLipid / Zocor (1)
  20. Oxbryta / Voxelotor (1 study mentioned in FDA application)
  21. Lisinopril / Qbrelis / Zestril / Prinivil (1, 2)

Take particular note, if you will, of numbers 12 and 15 on the list of prescription medications and you may spot some familiar names if you’ve been following the trends in quack covid treatments.

Essentially, if Good Christians™ are going to take a moral stand against being vaccinated because of their opposition to abortion, they’re pretty much going to have to give up on modern medicine. Fortunately, at least one employer is asking anyone requesting a religious exemption from the vaccine to do just that.

If it’s a sincerely held belief, you have to be consistent, right?

So how am I doing?

Recalling that the original purpose of this blog was to be a platform for updates on my cancer treatment and not really a platform for me to bitch about Covid, and realizing that I hadn’t actually made mention of my condition for a while, I have decided to try and rein this thing in a bit by combining a rant about Covid with a brief update on how I’ve been feeling.

I am still on light duty at work. The fatigue has definitely improved but only to the point that it is limiting instead of debilitating. I asked the urology clinic nurse about this, given that it has now been a bit over a month since my last treatment and I still haven’t bounced all the way back. The urology clinic really had nothing to offer other than to say that it would be unusual for the fatigue caused by BCG treatments to last this long. I have an appointment with my primary care doctor to rule out any other possible cause and after that, who knows? There is also a good chance that part of why my activity tolerance has gone to shit is that I am completely deconditioned from sitting on my ass for the last month plus.

Whatever is causing it, I still don’t feel like I would have the endurance to make it through a 12 hour shift in the ICU, especially under current conditions. Which brings me to my rant about Covid;

The two incidents I posted about below (and there are plenty more stories like those circulating around) made me realize that I simultaneously feel profoundly grateful that I am not working on the unit right now and incredibly guilty because I am not working on the unit right now. Every hospital in the country is desperately short of ICU staff and I am, in my own small way, totally not making that situation even a little bit better. Especially if there isn’t an identifiable physical cause for my continued lack of energy, I am going to have a really hard time justifying sitting things out for much longer.

I’m scheduled on my light duty assignment through next week, which will give me time to see my primary care and make sure there isn’t anything weird or unlikely going on physically and then I have a somewhat difficult decision. I would really prefer to not dive right back in, but things out in the world are not likely to improve much any time soon and I am not going to be able to stay on light duty forever, so a return to the ICU is inevitable. With that being the case, is there any point to putting it off?

I think pretty much everyone saw this coming

Two separate incidents, one anecdote from a nursing forum I lurk on and the other a story from NPR.

keep in mind, this isn’t happening at the start of the pandemic, this is nine months after the development of not one, but several safe and effective vaccines. This is something that shouldn’t happen in any, even semi-functional society.

I’m not sure where we go from here.

Follow up

In an 11-page decision, Hamilton County Common Pleas Judge Michael Oster Jr. wrote that there “was no doubt that the medical and scientific communities do not support the use of ivermectin as a treatment for Covid-19.”

“While this court is sympathetic to the plaintiff and understands the idea of wanting to do anything to help her loved one, public policy should not and does not support allowing physicians to try ‘any’ type of treatment on human beings,” he wrote.

Unfortunately, and I really hate that I think like this after close to two years of this nonsense, Mr. Knobstick looks like he might actually survive. I say “unfortunately” because if he does survive he will be held up as the poster-child for the use of ivermectin. Instead of going on every mommy blog and fitness blog on the internet lamenting how Mr. Knobstick would still be alive if only they had given him ivermectin before it was too late, and please follow the link to the Knobstick Memorial GoFundMe page, they will both go on every mommy blog and fitness blog on the internet crowing about how Mr. Knobstick was saved at the last minute when the evil doctors and nurses at the hospital were forced to give him life saving ivermectin, and please follow the link to the Knobstick Legal Defense GoFundMe page.

Oh well. At least this judge knows enough to keep out of the business of practicing medicine.

This is absolutely horrifying

Yes, this is a real story about something that really happened and apparently this isn’t the first time either.

The story, in brief;

  • Unvaccinated knobstick gets Covid and ends up in the hospital
    • to be completely honest, neither side in this drama has commented on the knobstick’s vaccine status but, given the circumstances, I think it’s a safe bet
  • Knobstick’s condition deteriorates and he ends up in the ICU on a ventilator
  • Mrs. Knobstick demands that the hospital give him ivermectin
  • Everyone from the nursing assistants to the Chief Medical Officer at the hospital thank Mrs. Knobstick for the suggestion but inform her that Mr.Knobstick will continue to receive treatments that have actual evidence supporting their use and not something someone on Facebook said was a miracle cure.
  • Mrs. Knobstick goes doctor shopping and finds some quack who prescribes Mr. Knobstick ivermectin without ever having examined, or even seen him.
  • Mrs. Knobstick triumphantly presents Dr. Quack’s ivermectin prescription to the hospital. The hospital informs her that Dr. Quack doesn’t have privileges at their facility and, therefore, isn’t allowed to admit or treat patients there.
  • Mrs. Knobstick SUES THE HOSPITAL AND WINS. The judge orders the hospital to grant temporary privileges to Dr. Quack and to begin treatment with ivermectin

So here you have a judge, someone trained in law and not medicine, overruling the entire medical staff of a hospital in favor of a single doctor who is promoting a treatment that THE FDA HAS SPECIFICALLY WARNED AGAINST USING

A little more detail on Dr. Quack; he is a member, or maybe the founder, of an organization with some Orwellian Newspeak name like “Front Line Covid Treatment Action Alliance” that actively promotes the use of ivermectin for covid. He also has said that ivermectin is more effective than any of the vaccines at preventing covid (it isn’t) and that the FDA not authorizing its use is comparable to the Holocaust (WTF?!)

The hospital, of course, complied with the court order but the ICU staff did exactly what they should have under the circumstances and refused to administer the ivermectin. No one in the facility had ever given ivermectin before, it wasn’t in the hospital formulary and it hadn’t been verified by their pharmacy. Mr. Knobstick still got the ivermectin but Dr. Quack had to come do it himself.

Neither side has commented in detail about Mr. Knobstick’s condition since starting ivermectin. The most a spokesman would say is that he “hasn’t gotten worse”.

Edited to add; and when Mr. Knobstick inevitability dies from complications of Covid-19, do you think Mrs. Knobstick will change her thinking about vaccines and the validity of FDA approved or authorized treatments? Of course she won’t. She’ll go on Facebook and every mommy blog or fitness blog in existence and lament how her poor husband would still be alive if only the Pharmaceutical-Hospital-Reverse Vampire axis of evil had given Mr. Knobstick ivermectin before it was too late, oh and, by the way, don’t forget to follow the link to the Knobstick Memorial GoFundMe page.

Recovery

It has been almost two weeks since my last dose of BCG. The week of the 16th (the week immediately following my last treatment) was still on the downhill slope but this week I’m starting to feel a little better.

Not well, but better. I’m going to stick on light duty for at least another week but at least I was able to do dishes and clean up around the house yesterday without feeling completely destroyed, just kind of destroyed.

This bodes well for the next few weeks, at least until I have to go back for my next three doses.

Treatment #6

Fortunately this week seems to be going much better than last week, which is not a high bar to get over. I’m back to just feeling stupidly tired all the time but no nausea, chills or bladder spasms, so improvement?

This was the last of the first round of BCG treatments and I am very hopeful that, once I don’t get anther dose next Monday, I will start to recover a little bit of my energy. Of course now that I am (hopefully) a week away from starting to feel better I’ve finally managed to get some sort of light duty sorted out so I’m going to start working again tomorrow doing something for employee health, exactly what isn’t really clear. Never fear though, I do still intend to take full advantage of every minute of light duty I can get, even if I start feeling better immediately.

Fun story; I’ve had a great deal occupying my mind recently and had completely forgotten that, at some point in the semi-remote past, I signed up to take the CES-A exam. No, not Certified Excel Specialist in Accounting, Certified ECMO Specialist – Adult. (aside – what kind of special hell do people who create an initialism that contains an abbreviation go to?) This is a 100 question test developed by the American Society of ExtraCorporeal Technology and the International Board of Blood Management which is designed to demonstrate the subject’s knowledge and expertise in various aspects of extracorporeal life support. The test is at 7 am tomorrow, is supposedly very challenging, can’t be rescheduled, and I haven’t studied for it at all. I did, however, drop $400 for the privilege of taking this test so I am absolutely going to show up and take it anyway, I just don’t have very high hopes about passing.

Wish me luck.