covid politics

[Tubetec]

Even though the hand sanitiser they have in Lidl here comes from a local distillery producing some fairly good new whiskies and gins , it has a small amount of hydrogen peroxide added . Course I wasnt suggesting drinking it , but no harm adding a warning just in case anyone got the wrong end of the stick . Their are other hand sanitiser products with much more nasty chemicals in them and they are by all accounts more likely to cause dermatitis and other allergic reactions .

Lidl's FestBier is back in stock again , 5.5% ,a rich golden brown colour , and no hint of sweetness as almost all the sugar has turned to alcohol . Like most quality beers ,it doesnt need chilling much below about 8-10 c , ice cold doesnt do the taste justice at all.
Sláinte , Skol ,Cheers

 

[crazydoc]

I was warned about Ortho's wanting to cut everything when I was dealing with plantar fasciitis (in both feet at different times). I avoided the cutters and managed to heal my fascia stretched out using a sleep brace...

JR

Thread drift.

That's a tough condition. As a doctor I used to inject steroids into the plantar fascia - very seldom at all helpful, and a painful injection. Then I got it - nothing helped, even went to a podiatrist who x-rayed it (to demonstrate the heel spur that almost everybody has and has nothing to do with it), and taped the foot and ankle and told me to do it daily. No help.

One day I painted the fascia on my house, up on the ladder all day. Next day the plantar fasciitis was gone! So then I would tell patients they could come to my house, and for $50 I'd let them paint my fascia. No takers, of course.

Several years later, I got it again in the other foot. I'd moved, and the trim didn't need painting. I went to the orthopod who said he couldn't do anything, but he'd refer me to a prosthetist to make me a brace. The prosthetist examined me, then said "I could make you a brace, but try this first."

Stand facing a counter. Place the affected foot about 18" away, and while keeping the foot flat on the ground, lean forward, keeping your leg straight, and touch that hip to the counter - you'll feel the calf muscles and achilles tendon stretching. Hold it for about half a minute. Do that twice or three times a day.

Voila! After a week or so it was gone.

 

[JohnRoberts]

Thread drift.

That's a tough condition. As a doctor I used to inject steroids into the plantar fascia - very seldom at all helpful, and a painful injection. Then I got it - nothing helped, even went to a podiatrist who x-rayed it (to demonstrate the heel spur that almost everybody has and has nothing to do with it), and taped the foot and ankle and told me to do it daily. No help.

One day I painted the fascia on my house, up on the ladder all day. Next day the plantar fasciitis was gone! So then I would tell patients they could come to my house, and for $50 I'd let them paint my fascia. No takers, of course.

Several years later, I got it again in the other foot. I'd moved, and the trim didn't need painting. I went to the orthopod who said he couldn't do anything, but he'd refer me to a prosthetist to make me a brace. The prosthetist examined me, then said "I could make you a brace, but try this first."

Stand facing a counter. Place the affected foot about 18" away, and while keeping the foot flat on the ground, lean forward, keeping your leg straight, and touch that hip to the counter - you'll feel the calf muscles and achilles tendon stretching. Hold it for about half a minute. Do that twice or three times a day.

Voila! After a week or so it was gone.

I gather you may not be a runner?

It was a little unpleasant to sleep in a night splint, but it was worth it ($25) to avoid that painful first step in the morning when your facia that healed up contracted over night gets painfully stretched out (torn) again. The sleep splint holds the fascia stretched out to heal elongated, overnight. Once it heals elongated the pain cycle is gone forever.

I cured it in both heel fascia (two different incidents) then gave my sleep splint away to the MAA (Meridian Athletic Association) to share with other afflicted runners. Hickory is too small to have an athletic association so I had to give it to athletes in the next county 25 miles away.

The ladder cure sounds a little too easy. Stretching is widely advised on the WWW. The sleep splint takes a couple weeks to work, but it really works.

Not to randomly slam the medical community but why isn't this cheap easy cure common knowledge (actually OTC NSAID anti-inflammatories like ibuprofen help speed recovery)?

JR

 

[john12ax7]

Not to randomly slam the medical community but why isn't this cheap easy cure common knowledge

Maybe you are asking rhetorically. But it should be oblivious that a profit driven medical industry has no use use for cheap easy cures. This has played out over and over again including the covid pandemic.

 

[JohnRoberts]

It would make me crazy to hear about some high profile athlete (like a basketball player) suffering from plantar fasciitis being treated by highly paid team sports doctors with no clue about how easy it is to break the cycle of healing overnight and painfully tearing again every morning. No wonder the body calcifies around the repetitive tear site.

I don't blame the doctors for seeking more revenue (maybe the cutters), they just don't benefit effectively from the experience of the other almost 1M doctors in practice. I found this (night splint) cure on the WWW, generally dismissed by the medical community as a source of dangerous information. Of course there is plenty of that too. A necessary skill for surviving modern life is learning how to separate the wheat from the chaff.

JR

 

[Tubetec]

I think we all know in our hearts vested interests and profit very often take precedence over whats best and while that attitude is rife in the medical sphere , its by no means unique to it .

I was just scanning around this morning and found a few interesting stats here ,
https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/5.83 billion doses , enough to vax 37.9% of the global population , of course though the actual figure for fully vaccinated will be considerable lower . Puts things in perspective though .

 

[RSRecords]

Yes, I'd have a question -- not sure you can / are supposed to share though. How is monoclonal infusion faring ? Available in sufficient quantity ? Administered when ? Early stage or also severe stage ?

Seems to be enough to go around in this area at the moment. Early stages it might be helping but they are unsure.Doctors are recommending it at the very onset of symptoms in an effort to keep people out of the overcrowded ERs. Late or sever symptoms nothing has proven reliably effective. That includes ECMO, intubation and rotoproning.

DISCLAIMER: This is not medical advise.TALK TO A LICENSED PHYSICIAN. This is purely anecdotal.

 

[crazydoc]

"The challenge of transfers has also pressured Idaho to allow its hospitals to establish crisis standards of care, which means doctors can triage patients dependent on bed space availability and health care workers without specific training can be brought in to work in the ICU."

"It doesn't matter what you believe about Covid right now. What matters is that our health care system's at capacity," said Pate, of Idaho's coronavirus task force. "I'm just asking people, work with us for a month, six weeks — humor us. Be careful, don't get in a large crowd, wear a mask and please do consider getting vaccinated."

https://www.msn.com/en-us/news/us/i...ts-amid-covid-surge/ar-AAOv8Ac?ocid=bingcovid

 

[crazydoc]

"Kimball went on to suggest that Tampa General was “not a safe place to go,” repeating a pervasive myth that the life-saving treatment at hospitals was the cause of many recent coronavirus deaths. Two days after Prentice’s death, Kimball called for an investigation into Tampa General during the public comment period of the Tampa City Council meeting and accused the hospital of “intubating people illegally.”

https://www.msn.com/en-us/health/we...-problems-for-party/ar-AAOw2OC?ocid=bingcovid

 

[JohnRoberts]

Seems to be enough to go around in this area at the moment. Early stages it might be helping but they are unsure.Doctors are recommending it at the very onset of symptoms in an effort to keep people out of the overcrowded ERs. Late or sever symptoms nothing has proven reliably effective. That includes ECMO, intubation and rotoproning.

DISCLAIMER: This is not medical advise.TALK TO A LICENSED PHYSICIAN. This is purely anecdotal.

I am not a health professional either but my understanding was that infusion therapy was administered as an in-patient procedure. Which could consume limited hospital resources short term, perhaps to free up resources longer term.

I have seen reports about temporary(?) infusion centers being set up in several states. I guess it works and is gaining popularity.

The Biden administration just ordered 1.4M doses of regeneron monoclonal antibodies to prevent shortages. The antibody cost >$2k per dose so more than 50x cost of two doses of pfizer vaccine. This makes the vaccine look like a bargain. Perhaps people who decline to be vaccinated could share some of the extra cost burden of antibody infusions.

JR

 

[crazydoc]

Not to randomly slam the medical community but why isn't this cheap easy cure common knowledge (actually OTC NSAID anti-inflammatories like ibuprofen help speed recovery)?

JR

This may come as a shock to many www surfers, but medical knowledge may not be as simple as many seem to believe, and most times is not driven by profit. But of course, there are many folks who know everything (not directed at you JR), and we poor ignorant greedy doctors just can't keep up.

Plantar fasciitis, a self-limiting condition, is a common cause of heel pain in adults. It affects more than 1 million persons per year, and two-thirds of patients with plantar fasciitis will seek care from their family physician. Plantar fasciitis affects sedentary and athletic populations. Obesity, excessive foot pronation, excessive running, and prolonged standing are risk factors for developing plantar fasciitis. Diagnosis is primarily based on history and physical examination. Patients may present with heel pain with their first steps in the morning or after prolonged sitting, and sharp pain with palpation of the medial plantar calcaneal region. Discomfort in the proximal plantar fascia can be elicited by passive ankle/first toe dorsiflexion. Diagnostic imaging is rarely needed for the initial diagnosis of plantar fasciitis. Use of ultrasonography and magnetic resonance imaging is reserved for recalcitrant cases or to rule out other heel pathology; findings of increased plantar fascia thickness and abnormal tissue signal the diagnosis of plantar fasciitis. Conservative treatments help with the disabling pain. Initially, patient-directed treatments consisting of rest, activity modification, ice massage, oral analgesics, and stretching techniques can be tried for several weeks. If heel pain persists, then physician-prescribed treatments such as physical therapy modalities, foot orthotics, night splinting, and corticosteroid injections should be considered. Ninety percent of patients will improve with these conservative techniques. Patients with chronic recalcitrant plantar fasciitis lasting six months or longer can consider extracorporeal shock wave therapy or plantar fasciotomy.

https://www.aafp.org/afp/2011/0915/p676.html
BTW, I appreciate the PM's or "converations" that a couple of folks have sent. I don't respond, but all is good on my part.

 

[Winston OBoogie]

This may come as a shock to many www surfers, but medical knowledge may not be as simple as many seem to believe

So, I can't replace the racking up of between 4 and 10 years in medical school by simply watching a few youtube videos?

 

[JohnRoberts]

I would bump the night splint, higher up the list of standard remedies. I searched oral analgesics and find creams for tooth pain (benzocaine)?

My doctor at the time (another good one who retired too young), prescribed anti-inflammatory (ibuprofen) to promote blood flow and healing. Instead of prescribing a prescription for stronger doses of ibuprofen, he just advised me to double up the recommended dosage of OTC ibuprofen. He said this would be ok to do for less than a week.

He recommended stretching, I found the sleep splint myself eventually. Before finding the rigid sleep splint that worked perfectly, I experimented with crude orthotics, a padded wrap that goes under the arch to stretch out the fascia while walking/running. Before the rigid splint I tried a too cheap to work sleep sock that had a strap coming from the front toe region tied higher up the leg to hold the foot with fascia elongated at night. This should work in theory but was instead a painful torture device. I even enjoyed some modest improvement sleeping with my affected foot in a boot/heavy shoe that partially held the fascia extended. It took me several months of failed experiments before I managed to heal the PF in my first foot after finding the rigid sleep splint. The second occurrence of PF in my other foot occurring maybe a year later was quickly dispatched since I had a good working remedy available.

I understand the medical communities focus on relieving symptoms (heel pain), rather than mitigating the mechanism that causes the chronic morning heel pain. I am repeating myself, but it really is this simple. 1) Sleeping with the foot relaxed causes the fascia to knit up torn soft tissue healing contracted. 2) Then in the morning putting weight on the foot pulls on the fascia and tears the recently healed soft tissue causing the pain.

Stretching makes sense at night just before putting on the rigid sleep splint... stretching without splinting the fascia to heal elongated seems pointless (might help, might not). Icing the fascia would promote blood flow and healing, likewise anti-inflammatories would promote blood flow and healing, but healing with fascia relaxed (short), just tees up future injury.

But I am not the doctor, doc.

 

[JohnRoberts]

To change the subject back to "covid politics" there seems to be a disconnect between the FDA panel who are saying that current Covid shots "provide sufficient protection against severe disease and death from Covid-19 without additional doses". This could complicate the Biden administrations plans for a 3rd booster jab. The outside panel will review the FDA report on Friday. The Biden administration targeted next week to start distributing booster shots. It could be an interesting weekend inside the beltway.

JR

PS: there are still under vaccinated regions of the world. If we have excess vaccine perhaps share doses where it could save some lives. It appears viruses are fungible and don't respect international borders so wiping it out elsewhere helps us all.

 

[RSRecords]

To change the subject back to "covid politics" there seems to be a disconnect between the FDA panel who are saying that current Covid shots "provide sufficient protection against severe disease and death from Covid-19 without additional doses". This could complicate the Biden administrations plans for a 3rd booster jab. The outside panel will review the FDA report on Friday. The Biden administration targeted next week to start distributing booster shots. It could be an interesting weekend inside the beltway.

JR

PS: there are still under vaccinated regions of the world. If we have excess vaccine perhaps share doses where it could save some lives. It appears viruses are fungible and don't respect international borders so wiping it out elsewhere helps us all.

I think the disconnect is in that the 3rd jab could hopefully protect against mild symptoms while currently it is only protecting against severe disease (unless you are immunocompromised). Again anecdotally but there's been a handful of people around here become hospitalized who were fully vaccinated. One was even intubated but recovered. They were going through chemotherapy at the time of being vaccinated and while it was rough go, consensus is that the vaccine saved their life but with lots of damage.

 

[crazydoc]

Quickly back to the foot, I'm glad that the brace worked for you JR, and the exercise worked for me. However, it's not stretching of the plantar fascia that is at work here (actually too much stretching is probably what causes it in most cases), but rather stretching of the calf muscles and Achilles tendon to allow the foot to be able to dorsiflex (toes toward the head) more fully during walking/running, taking stress off the plantar fascia.

As regards functional risk factors, tightness in the hamstrings, gastrocnemius soleus, and the Achilles tendon are considered risk factors for plantar fasciitis. [21] Reduced dorsiflexion has been shown to be an important risk factor for this condition. [17] Weakness of the gastrocnemius, soleus, and intrinsic foot muscles is also considered a risk factor for plantar fasciitis.

https://emedicine.medscape.com/article/86143-overview#a5
Again, many times there is more to medicine than meets the eye.

I had a patient that nothing worked for, and sent him to the surgeon for evaluation for partial fasciotomy - I don't think he went through with it, preferring chronic disability payments instead.

 

[crazydoc]

So, I can't replace the racking up of between 4 and 10 years in medical school by simply watching a few youtube videos?

Well, the important part of that education is not medicine, but economics. Most of the curriculum covers how to profit from people's suffering.

 

[JohnRoberts]

Quickly back to the foot, I'm glad that the brace worked for you JR, and the exercise worked for me. However, it's not stretching of the plantar fascia that is at work here (actually too much stretching is probably what causes it in most cases), but rather stretching of the calf muscles and Achilles tendon to allow the foot to be able to dorsiflex (toes toward the head) more fully during walking/running, taking stress off the plantar fascia.

As regards functional risk factors, tightness in the hamstrings, gastrocnemius soleus, and the Achilles tendon are considered risk factors for plantar fasciitis. [21] Reduced dorsiflexion has been shown to be an important risk factor for this condition. [17] Weakness of the gastrocnemius, soleus, and intrinsic foot muscles is also considered a risk factor for plantar fasciitis.

https://emedicine.medscape.com/article/86143-overview#a5
Again, many times there is more to medicine than meets the eye.

I had a patient that nothing worked for, and sent him to the surgeon for evaluation for partial fasciotomy - I don't think he went through with it, preferring chronic disability payments instead.

Indeed I have been accused of having tight hamstrings... Not much of an issue now since my bum knee stopped me from running and playing basket ball several years ago. I was never big on stretching, but enjoyed running to support my drinking and eating habits.

Not to argue with a doctor... but in my judgement the remedy for "my" PF condition was to heal the fascia while elongated (using a night splint). No more morning tearing, no more pain... YMMV

JR

 

[Tubetec]

Sounds like a case of facetious planteritis Doc

The budding soldier , cop even criminal set out with barrowloads of youthfull exuberance thinking they can make a difference . By the time the institution of state , political/corporate entity or warlord/crime boss has its hooks in all that hope of making a difference melts away. Its really no more than a game of 'bait and switch' to entice people onto the up escalator . The more you go up the ladder , the bigger the rewards , the more dirt you have to swallow and the greater the fall if the SHTF on your watch .

Im basically a middle class lad by birth , theres fuck all we can do about where we land on this planet , were dealt a hand of cards , its beyond our control .
Just the same as the so called educated people are thought look down on those not so fortunate , theres an equal yet opposite distain built into the common foot soldier towards the 'well healed' . We all have our crosses to bear , higher or lower , the moment we ditch the divisory mentality put the pieces of the puzzle together the man(ipulator) behind the curtain is exposed.

 

[JohnRoberts]

This is not literally about Covid, but obesity is a risk factor for complications (obese is considered a BMI of 30 or higher).

Four more states just joined the high obesity list. I think the article was a little cra cra blaming obesity on stress levels. In my experience obesity was caused by eating too much, and not exercising enough.

CDC reported that 16 states achieved obesity levels greater than 35% in 2020

The demographic data from this article sounds like obesity is a little racist so I won't cite them specifically. Maybe stress is systemic.

link to obesity article.

JR

PS: Hodad I'll save you the trouble of looking it up, MS has been on the obese state lists for years, and no my BMI is <30.