Category Archives: Medicine

I Have A Question

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I’m still waiting for a reasonable, honest answer to this question: why did the State of Arkansas fail to require a Covid test for all healthcare workers?

You’ll note that the Governor goes out of his way to classify correctional carriers and other sectors. Notably absent? Healthcare workers – one of the single most important possible classifications to track.

It has always been in the public’s best interest to ensure that all healthcare workers are tested, yet proposals to do so have been unceremoniously shown the door like a drunken Uncle on New Year’s Eve.

We’re required to get flu shots each year, among other things.

We mandated that non-emergency patients be tested, yet did not conduct a baseline safety test to benchmark how many of the healthcare workers helping them might be carrying the virus.

Knowing how many healthcare workers have the virus would give us insight into the behavior leading to getting it. After all, healthcare workers are presumed to be the most cautious and educated about this sort of public health hazard. Their infection rate leads to immediate recognition of how well what we’re doing is working.

When I point this out to people, they get that recognizable and confused, puzzled look on their faces, the one that immediately indicates that they assumed that sort of thing had happened.

It hasn’t.

This kind of question falls under “public safety and worker safety” guidelines, so I of course am unconcerned about asking such a reasonable question publicly. I’ve asked it at least 500 times in the last two months.

I’m still asking.

It’s the right thing to do, even at this late date.
– X

X’s Observations on COVID

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If you’re being screened for COVID19 and you see that the screeners are using temporal (forehead) thermometers, you need to check your temperature with an oral thermometer. Despite what some might say, an oral thermometer will eliminate environmental variables, assuming you haven’t been chewing whole ice cubes. While the absence of a fever doesn’t preclude that you have COVID, it occurs in the majority of cases. I’ve personally witnessed a 2 or 3-degree temperature difference between oral thermometers and other types. (*Generally speaking, of course.)

If you don’t own a pulse oximeter, you should purchase one. If you are infected with this virus, the flu, or have other health conditions, your 02 level is one of the single biggest ways to answer the question: “Should I be concerned?” It will signal that you’re deteriorating or at what point you need to call 911 or go to the doctor/ER. You should buy one of these even after our current virus crisis is over.

Additionally, the number of medical people being tested is artificially limited by how willing screening clinics are in administering the test. All those saying we haven’t tested nearly enough people are correct. You would be surprised by the number of people refused tests, even those working in the medical or emergency services fields. We don’t want to squander tests needlessly, of course. With anyone in the medical field or those who must be ‘in’ the world on a daily basis, it should be automatic with symptoms. The same guidelines for the general public don’t translate to dealing with medical workers.
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In Northwest Arkansas, there isn’t a big scarcity of testing kits available, compared to other regions. Our bottleneck seems to be the number of labs at our disposal to perform the lab tests. Some people are still being told it might be a WEEK before getting their results. Senator Rand Paul had to wait 6 days for his, and he’s a United States Senator, and he didn’t self-quarantine during that time. (That’s not a criticism of Senator Paul, by the way, in part because he is a Senator and his job duties are critical. *Someone correctly pointed out that he did go the gym and do some stupid things in the meanwhile, though.)

If you are tested, you are now required to self-quarantine until you get the test results, which is of course an improvement over the previous policy. However…

Those who have symptoms or are turned away then return to their jobs or their families, often with the misguided belief that if the screening methodology indicates they don’t need to be tested, that they are in fact, not positive and pose no risk. For the purposes of this post, assume that those who are turned away or discouraged from a test work in the medical field or another field in which their presence is ‘essential.’ They return to their lives, potentially infecting many more people. ‘Not tested’ does not equate to ‘not infected.’ For public health, these cases should be treated as positive, even absent a test, as it is the safest course of action for society as a whole to prevent needless spread of the virus. In a crisis in which the virus spreads so easily, it’s obvious that anyone working in a critical field should be tested immediately, even if their symptoms only include a fever – but do not rise to the critical level. If our medical system did become overwhelmed, which I do not think it will here in Northwest Arkansas, we’d have to reexamine that policy.

If you’re already quarantined, this won’t affect you on an individual level.

By not quarantining even potentially suspected cases as they arise, we’re creating an expanding circle of exposure. (Obviously, I’m referring to those who can’t be at home each day.) We all know that we’re almost all going to eventually be exposed to the virus. It’s not about being able to sidestep our eventual exposure. All of us will ultimately step up to the fact that we’ve been exposed.

Another concern that people are misunderstanding is the tendency toward a false negative test. (You have the virus, but the test shows that you don’t.) A false positive might scare you, but at least you’ll think you have the virus and take immediate and drastic measures to avoid spreading the disease. In the case of a false negative, the opposite occurs. Given the way the tests are performed, the margin of error is actually quite high. If you google “Bayes’ Rule for COVID19,” you’ll see that false negatives are the biggest threat for how we deal with the virus.

The truth is that many organizations say that all those tested should be quarantined on the side of caution, even though who are tested negative. In the short term, it may cause needless isolation. That needless isolation of critical medical staff will statistically reduce the spread of the virus. We already know that up to 1/3 of all negative tests are incorrect, depending on the variables in the testing system. For every 100 people testing negative, it is possible that 30 of them are actually positive.

After having said all that, a significant portion of the population has been infected and has no symptoms at all. It gives us a sense of false confidence as we proceed with our lives.

Even though you’ve not read my definition of a public place, here it is: any place outside your house where anyone other than the people you’ve been with for the last 14+ days has breathed. If anyone ‘new’ has entered your house, your house is public for 14 more days.

I don’t personally feel alarmed, even if it kills me. Many of us all are doing to do everything perfectly. Yet, it’s going to hurt someone of us badly. I read your posts and hope that we can get back to being pissed off at each other for stupid reasons.

We’re going to get a vaccine, eventually. It won’t be permanent, though. We’re going to need to invest in and trust researchers and science. We’re going to have to stop pretending that anti-vaxxers have a valid viewpoint. Maybe we’ll finally get universal healthcare. Maybe we’ll manage to achieve a cohesive non-profit nationwide collective of clinics and hospital making decisions from the viewpoint of public health.

Our hospital system will not be overwhelmed here locally. I also don’t think we are going to run out of PPE or necessary medical equipment. You would think I’d be cynical about this. I’m not though. I think we are incredibly more prepared that many areas around the United States. No matter what happens, I hope you remember after all this that I was optimistic in our ability to diminish the impact.

We’re lucky we live in Northwest Arkansas. Comparatively speaking, it’s a great place to be quarantined – and an even better place to be if you find yourself needing immediate medical care for the virus. We have an incredible confluence of food, resources, and medical clinics/hospitals to help us get through this.

P.S. Although a few people missed it, much of my post indicated it referred to those in the medical field or those who go out into the world because they are ‘essential.’ Taking this into account quells many of the comments people might make. ‘Err on the side of caution’ is a clich√© precisely because it is true and fits the commentary here.

Vicks Recipes For Southern Survivors

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Vicks salve was invented in 1905. The same person Frenchman who invented BenGay was ultimately responsible for creating Vicks VapoRub, as he inspired a pharmacist here in the United States to modify the recipe for BenGay.

On a personal note, I’d like to say that I l-o-v-e the smell of Vicks. I like the smell of creosote and diesel, too. None of them are good on a sandwich, an ice cream float, or on a spoon on its way to my mouth, however. As anyone who ever used Vicks in steam can attest, the aroma is inescapable and rich. If eaten or allowed to melt in one’s mouth, it manages to embed itself between teeth and the gums for several hours. If you’ve never eaten Vicks, get a slice of Dominos pizza and put an entire package of mint gum on it, and then topped with vaseline, and attempt to eat it. A slice of Dominos is bad enough, I admit.

The cobalt blue bottles were also immediately recognizable. One could clean them completely with very hot water, followed by vigorously adding soap and wiping them out.

Evidently, Vicks became a household staple thanks to the 1918 flu epidemic that killed millions of people. It’s hard to imagine the effect of such an epidemic, one which killed more people than any other in human history. We don’t hear much about it anymore. At least 7000 Arkansans died officially from the flu in 1918, a huge number, compared to the 600 who died in WWI. Because of the huge number of poor rural people in Arkansas at the time, family history and circumstantial evidence tell us that many more died from the flu. Additionally, because Arkansas was deeply affected by Jim Crow, thousands of blacks also went under the radar. It’s interesting to delve into the story of this epidemic; it’s undeniable that Arkansas lost at least twice as many people as officially reported.

Interestingly, I had heard stories that a great-grandfather of mine died from the flu in 1918. Research proved this to be erroneous, as he died in February 1918 before the first known case in the United States that year. Almost no family escaped death from the Spanish flu that year.

You can’t study the history of Vicks without factoring in the trauma of the 1918 epidemic. I found several news articles from early 1919 regarding the Vicks shortage as a result of the flu epidemic which had killed millions of people worldwide. Vicks was relatively inexpensive and easily obtained. Almost all households in the rural South had a bottle of Vicks. Most were smart enough to avoid eating it. I like to think that some ate it simply to accelerate meeting their maker.

For those of us who had ignorant ancestors who made us eat Vicks, most of this tendency is a result of misinformation and the worldwide scare of the deadly flu over 100 years ago. They didn’t mean to unsuccessfully poison us. At least, for the most part. During the epidemic, Vicks was considered to be a disinfectant if applied on or inside the nose. It’s no wonder that even level-headed people began to ingest it directly.

The world was smaller and people didn’t have access to a wider community of people. Home remedies and folksy cures tended to become ingrained in cloistered communities. This is exactly why so many of us were subjected to the stupidity of our parents telling us to eat Vicks, even if the bottle were clearly labeled “do not ingest,” or “toxic.” We can laugh at such goofiness now, despite the fact that the modern internet has brought us anti-vaxxers and other idiots clamoring for attention to spread their modern snake oil ideas.

Vicks also contains varying levels of turpentine, another old folk remedy that can be quite poisonous but was once very popular. It’s important to remember that people scoffed at the idea of germs until fairly recently, too, or believed that blood-letting and blowing smoke up one’s anus could reduce serious ailments such as hernias. (It’s where the term “blowing smoke” originated.) By the way, I’m referring to the mistaken idea that all turpentines are the same, even the ones found in hardware stores versus distilled turpentine oil.

Another point I’d like to make is that so many people could make a living in the South selling Snake Oil. Like all ridiculous claims, Snake Oil appealed to those without a proper understanding of science or medicine. Paradoxically, thanks to the internet, we now find ourselves in reversed roles: some of the stupidest health claims for completely useless products are made by those with advanced education and training.

In the same way that people say, “Riding in the back of a pickup didn’t kill me,” or “We didn’t have seatbelts back then,” people excuse away eating Vicks VapoRub with the same ridiculous claims, “Well, it didn’t kill me!” Any examination of our safety record clearly demonstrates that seatbelts made our lives much, much safer. Science easily demonstrates that ingestion of Vicks is dangerous. Convincing people that they were terribly wrong about such an obvious thing is a difficult feat. They didn’t die after all.

Were my mom still alive, she’d roll her eyes and cluck like a chicken if she heard me picking on her about this. My favorite cousin will point out that my mom learned to feed Vicks to children as a result of my Grandma. In Grandma’s defense, she was born after the turn of the last century and her world was very small, in the Arkansas Delta area around Monroe County. She loved me like no one ever did; she also had some strange ideas about the weather, driving in the dark, and eating things like Vicks. She lived to be over 90 years of age, so it’s difficult to argue with her methods. Plus, she loved bacon, and as you know, bacon is the single best medicine available.

I’m convinced that my mom enjoyed forcing people to eat Vicks. I’m only saying that because she could be quite sadistic, a fact that is a simple truth today, but one which would have resulted in my murder had it voiced in her vicinity as a kid. As I grew older, I joined my brother in reading the labels on ‘medications’ my mom was fond of. Several of them literally had poisonous logos on them. Munchausen Syndrome By Proxy would have been a relief to us both as we endured our mom’s ignorance about all things medical. Mom was one of those people who would not listen to reason and her stubbornness was legendary, even among mules. For most of my childhood, my mom worked at Southwestern Bell and had excellent insurance, yet I never went to the dentist between ages 5 and 18¬† and only got medical treatment after trauma. “You’re breathing!” she’d say.

In 1983, the FDA decided that products such as Vicks couldn’t have more than 11% of a concentration of camphor. Camphor can be fatal to small children and studies demonstrated that it actually made most people less likely to breathe more freely. Weirdly, many people report that it allows them to sleep better.

Any discussion regarding Vicks needs to take into account the historical differences of the ingredients used compared to the modern version. I’ve read anecdotes of people who claim that the bottles once recommended ingesting small amounts. I don’t doubt these claims given the ointment’s history. I can’t find evidence of it, however.

Interestingly, Vicks labels have warned against using it under one’s nostrils for any reason, as well as ingesting it. Obviously, you should never eat it, either, or put it anywhere it can penetrate into the skin. I was surprised to learn that it can damage one’s corneas, too.

Vicks VapoRub actually confuses your brain, which makes it think that you’re breathing more easily while actually reducing your ability to breathe more freely. I think it works the same way that the internet does for modern versions of my mom.

With my new cookbook of recipes, those who survived eating Vicks when they were young can once again enjoy the undeniable taste of this treat. I recommend that you start with a PB&J&V sandwich.