Sunday, July 25, 2021

Last Day in Vietnam 7/25/1971: We Made It!

 


On my last day in Vietnam, I signed out at 45th engineer Group Headquarters, sent my trunk of whatever possessions I had to be shipped to my home of record in Ohio and went to an out-processing center in Danang to be tested for illegal substances and sent home, if I passed the urine test. The DC 10 jet was packed with 210 people in Danang. After taxiing onto the runway, most of us seemed to be quiet or engaged in conversation with our seat neighbor. Going down the runway with increasing speed the jet seemed to generate total silence in the plane, until we broke ground and, suddenly, there was a spontaneous roar of 210 new Vietnam Veterans with more enthusiasm than the best sports victory we had ever seen. Incredible feelings of intense relief poured through all of us at the same moment.

We made it!

We are goiWe made it!We are going home!

Tuesday, June 15, 2021

Is the COVID-19 Pfizer Vaccine Going to Protect Your Child? Guest Post by Pediatrician Patricia Fine, MD

The past 15 months have been difficult for all mankind. Each one of us have suffered a loss of some kind or another. During this time, we have desperately attempted to protect ourselves and those we care for. Fortunately, we have also learned more about the new SARS Co-V2 COVID-19 coronavirus organism. Recognizing what we have learned and using that information accurately is important when making recommendations for prevention and treatment of this disease.

One important piece of information we now have is that children 17 years old and younger have such a low rate of death if they become infected with COVID-19, that their survival rate is essentially 100%. Their risk of getting post COVID-19 MIS-D (multi system inflammatory disease) is also less than 0.1%. Additionally, there are several treatments available that when given early in COVID-19 infection dramatically decrease the risk of being hospitalised or dying from the infection, even in the most at risk. We have several new vaccine products intended to prevent severe disease that are also available.

However, accepting what is unknown about the COVID-19 vaccines is vital to ensure they do not cause unintended harm. No long-term safety information is available for these vaccines, which have only been used in the general population for approximately six months. The FDA made their decision to grant an emergency use authorization for the Pfizer mRNA vaccine for children aged 12-15 using a single small study with only 1100 children receiving the vaccine. Of those 1100 children there were several serious adverse reactions. The vaccine was still pushed through without further evaluation of the observed concerning reactions. Since the roll out of the Pfizer product for children we are seeing rapidly rising rates of serious adverse reactions to these vaccines in children. Germany’s vaccine advisory board, called STIKO, has evaluated the data and ONLY recommends use of this product in children with underlying medical conditions. The CDC now recognizes there is a real concern and has called for an emergency meeting to discuss this issue on June 18th 2021.

As a pediatrician, I took a vow to first do no harm and to advocate for the protection of the children I care for. Using currently available data, I conclude that the risk of serious adverse reactions in children 17 years old and younger receiving the Pfizer mRNA vaccine is greater than the possible benefit they may gain. I implore all medical providers to first do no harm” as well, and to stop advocating for these vaccines to be given to our youth. I strongly suggest all parents and caregivers stop vaccinating their children with mRNA-based vaccine products until they can be studied further. I request our leaders exercise patience and recommend holding off on COVID-19 vaccinations for those 17 years old and younger until potential risks are better understood. I suggest we all continue to recommend and use well vetted childhood vaccines with a long track record of safety for all children. Finally, we should all educate ourselves on how to rapidly access COVID-19 early treatment options should we become infected. Following these suggestions will ensure each citizen the opportunity to be protected from severe disease from COVID-19 infection with the least potential risk of harm.

Friday, June 11, 2021

Forty-Five Years since June 10, 1976

 I just realized tonight that today is actually June 10, 2021 and it's been 45 years since my graduation from The Ohio State University College of Medicine.   What a journey, from Columbus to Hershey, PA to Granville, OH, to Spring Valley Township/ Bellbrook, OH with practices at The Department of Family and Community Medicine at the M. S. Hershey Medical Center of Penn State University, The Granville Medical Center, Newark (2 different locations in Licking County, OH), Denison University Whistler Hall, OSU Department of Family Medicine, The Frederick A. White Center of Wright State University, The Indian Ripple Family Health Center, Family Health Connections, Inc., The Central State University Campus Health Center, Open Arms Health Clinic, and Neighborly Family Medicine.

I learned so much from, for and about  patients and health and disease and pain and suffering and the amazing talents of the human body by  about 225, 000 interactions with patients.  I'm still learning and listening and thankful for the opportunity.

The Dr. Synonymous photo with this blog was taken on that day.  The Class of 1976 of The Ohio State University College of Medicine has touched a lot of lives.  What a journey!

Monday, April 12, 2021

Family Medicine: Preventing and Treating COVID-19 with I-MASK+ Protocol

Yes, my practice, Neighborly Family Medicine in Beavercreek and the Free clinic where I'm Founding Medical Director, Open Arms Health Clinic (OAHC) both use the I-MASK+ Protocol to prevent and treat COVID-19.  Outpatient COVID Prevention and Treatment

The COVID-19 virus is a huge challenge and an important opportunity for physicians and others to help people and fix many elements of our health care system.  COVID-19 can be mild, moderate, deadly and/or confusing.  Especially the Long COVID-19 syndrome or Longhauler Syndrome as many call it.

The Front Line COVID-19 Critical Care Alliance (FLCC) worked together since March 2020 to identify re-purposed, existing medications that could prevent and treat SARS-CoV2.  They also developed an inpatient protocol called MATH+ Hospital Protocol for COVID-19

Most physicians seem to be, unfortunately, unaware of these protocols.  The FLCCC site  (FLCCC web site ) includes the protocols, Information to share with your doctor,  Information about Ivermectin for COVID-19Prevention and Treatment Protocols, and more.

Here is a list of Doctors who prescribe Ivermectin, most of whom use the whole I-MASK+ Protocol (with personalized variations):  Doctors who Prescribe Ivermectin,  including Dr Jonas under Ohio (A. Patrick Jonas, MD in Beavercreek, OH.  Physicians are allowed to treat patients via video visits, which we do almost daily, only for patients in our own state).  We have a more flexible schedule than most physicians, enabling Dr. Jonas to provide the COVID-19 support service.  Our practice is one of a growing number of Direct Primary Care practices in the US which don''t accept insurance as payment for services.  We have zero contracts with insurance companies.

Since the start of the Pandemic, patients recorded in our EHR at Neighborly Family Medicine with a diagnosis of "At risk for COVID-19 exposure", "COVID-19 exposure", "COVID-19" and "COVID-19 Longhauler" include more than 30, 44, 72, and 12 people respectively.  Most of these are after June, 2020.  Many other friends and family members of these patients  had similar diagnoses, but didn't seek care from my practice.  The patients with COVID-19 or Longhaulers that I've treated with the I-MASK+ Protocol (57+ patients) included persons with CHF, CAD, Diabetes, AFib, Renal Failure, Asthma, Allergic Rhinitis, Prostate Cancer, Chronic Lymphocytic Leukemia, Obesity, Chronic Anticoagulation, Depression, Anxiety, Bipolar, Ehlers Danlos Syndrome, Hypertension, Stroke History, Rheumatoid Arthritis, High Cholesterol, Migraine Headache, Irritable Bowel Syndrome, and others.  They included persons from age 24 to 94 (6 persons in their 80's).  After starting the protocol, everyone got better except 2 of the Longhaulers (who are improving) and no one was hospitalized or died.  The Longhauler treatment is based on the I-MASK+ protocol with personalized variations for the chronic inflammation and evolving literature about the Long COVID-19 Syndrome.

I've been pleased with the effects of the protocol on my patients so far.  Together, we actively go after prevention or treatment of COVID-19 and the Long COVID-19 Syndrome.

We're finding that many persons also want to prevent COVID-19 until they get their COVID-19 shot(s) or until an important event.  Many ask about using the protocol after they are vaccinated, if they ever get infected with a variant and/or find out that they are one of the 5% who didn't get full immunity from the vaccine.  Some are waiting for the oral vaccine (at least one is in development)  while others only want to get one shot and many are vaccine hesitant because of new shot technology and so forth.  

I'll be broadcasting about this post on my Blog Talk Radio Show during the next week to further clarify.

More later

 

Saturday, November 7, 2020

Family Medicine: Straddling COVID-19, Influenza and Life

 What can we and our patients do as the cold and flu season nears and COVID-19 lingers?

First is to check what Dr. Google says about these infections, all of which are viruses.  What do we know about viruses?

Physicians have read a lot recently about SARS-CoV-2 also called COVID-19, coronavirus, Rona and other nick names.  Formally SARS-CoV-2 is the name, but COVID-19 is widely accepted and used, so I'll refer to it as COVID-19.  In spite of our reading and a wide variety of ongoing research, there are many mysteries about COVID-19.  With over 200,000 deaths in the United States attributed to COVID-19, it has generated a myriad of responses and expense from our whole society and its leaders. Most recently, schools have reopened with variations on the learning models including a lot of online and home learning.  

There is at least one dashboard for school data about the models of learning and COVID-19 impact.  School COVID-19 related data

How will physicians adjust the COVID-19 oriented systems we've organized for the Pandemic to respond to cold and flu season?

This question and many more pop up as we start to think about coughing, aching, febrile miserable patients who want to see their physician.  Will video visits suffice  for the coming viral onslaught this winter?  Will patients want to enter an office where coughing people have been?  Will we further develop the parking lot approach to patients with a drive through, service in your car approach?  Or a drive through or walk through tent in the parking lot for privacy during the physical exam?  Will we still do the ENT- ears, nose, throat - part of the exam or the lung exam which includes "take a deep breath in and out through your mouth" for each lung area? 

Many questions and many options arise as we ponder our response to the waves of mucous, droplets and mists of microbes that will greet us from our patients.   

One aspect of the viral mucous challenge is a major concern for physicians- the being unavailable for 14 days of practice.  Many patients will have needs for care during those 2 weeks of quarantine.  What will they do?  Will the physician have enough energy and focus to offer phone or video visits during the 14 days?  Will revenue generated or not generated during the time away from practice combined with losses during the first two months of the Pandemic lead to closing or selling the practice?  

Lots of family physicians went out of business already during the Pandemic.  There is very little in financial reserves for many who made it through the first half of 2020.  What's next?

Flu shots.