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The Medical News Report #128 September, 2022 Samuel J. LaMonte, M.D., FACS |
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Do you want to subscribe to my reports? If you are already getting my reports monthly, you are subscribed! My mailing list has grown enormously, thanks to the interest in my reports over the past 12 years. The subscription is free, there are no ads, and I don’t sell your name, etc. to anyone, like business, and some hospitals do. This is my ministry, and my way of giving back for 30 years of a fabulous private practice. Just email me at samlamonte@gmail.com, and I will add you to my confidential list. I will confirm you are on the list when you request it. Put me on your contact list to prevent me from being blocked. Share with your friends and family. Thank you, Dr. Sam Subjects for September, 2022 1. Concern about our Country—my opinion 3. COVID updates; Biden rebounded with COVID; new CDC relaxation of guidelines, again! 4. Abortion Controversy--OB/GYN Series—Part 5—Roe vs Wade 6. Some Sunscreens recalled—benzene causing cancer
IMPORTANT REMINDER!!!! PLEASE READ!!! I remind you that any medical information provided in these reports is just that…information only!! Not medical advice!! I am not your doctor, and decisions about your health require consultation with your trusted personal physicians and consultants. The information I provide you is to empower you with knowledge, and I have repeatedly asked you to be the team leader for your OWN healthcare concerns. You should never act on anything you read in these reports. I have encouraged you to seek the advice of your physicians regarding health issues. Feel free to share this information with family and friends, but remind them about this being informational only. You must be proactive in our current medical environment. Don’t settle for a visit to your doctor without them giving you complete information about your illness, the options for treatment, care instructions, possible side effects to look for, and plans for follow up. Be sure the prescriptions you take are accurate (pharmacies make mistakes) and always take your meds as prescribed. The more you know, the better your care will be, because your doctor will sense you are informed and expect more out of them. Always write down your questions before going for a visit. Thank you, Dr. Sam
1. Concern about our country—my opinion! We are in scary times in this country, and we need to change it before it is too late. 2024 is too late. I am very afraid that conservatives are not fired up enough to realize how disastrous this latest climate change act is now called, erroneously, the inflation protection act. It is just one more lie from our current administration. Education gives people ammunition, and this report will do that. Please read carefully. November elections will make or break our country. Republicans, independents, libertarians, and moderate Democrats are not being aggressive enough to stand up against the overt actions of a radical left running the Democratic Party. The only reason the radical left is running the show is financial backing from billionaires who want to destroy our country and have teamed up with the radical left Democrats, since they will do anything to take control of our country permanently. With their continued dominance of the Congress after November, the institution of many of the promoting factors to turn our country into a socialist/Marxist society, starting with the institution of climate change tactics will begin a regulatory tsunami. THIS MUST CHANGE!! The so-called Inflation Reduction Act (really the Climate Change Act), was never debated in Congress. This has come as an executive action, and that is not how our democracy shouls work. Don’t you see this Democratic Party is trying to transform our government right before our eyes. Politicians work for us, not the reverse…..they are trying to change that…don’t let it happen. Add the now near 5 million illegals since Biden took over, who have come across our southern border as another tool to increase the size of the poor class (to diminish the size of the middle class), who will be spoon fed by the federal government in an effort to get their votes, and promote one more control factor to transition us to socialism/Marxism, and ultimately communism. Many people do not understand it is not about the enviornment, rather it is about domination by a one political party to run our country that will take over and destroy the very principles that were the reason the United States of America was founded. Support every conservative running for office from the local school board to Senate and House Representatives. Take back our country!!! The justice system including the FBI has turned their back on over half of this country with their political bias, lying, and corruption. They are the instrument to attempt to remove Trump from running in 2024. I wish we had a perfect candidate, but we need a fighter and we have the best, with Governor DeSantis with him. And plan on the Republicans and Independents battling Michelle Obama in 2024. Mark my word! The media is backing the FBI 100%, as they are pawns of the executive branch, when the judicial branch of our government should be independent, and by law they are. This FBI must be put in its place ASAP, but first we must take back the House and the Senate first. One step at a time!! If you want a safe and proud country for the future, get energized and remove these socialists. When white people are banned in certain areas of Berkely’s U. California off-campus, you must see how far this critical race theory has progressed. We are in a fight, and by the way, isn’t segregation illegal?? 4.6 million illegals have crossed our southern border with and without the help of Cartels making over $100 million per week for their services including human and sex trafficking. The revenue from illegal drugs laced with fentanyl is not in the above figure. We have enough fentanyl now in America to kill 6X the population of the U.S. The irony of Biden’s reach out to liberals to support him (which they don’t—only 40%) is that the most important group to please are Blacks, and yet that race of people are being hit harder than any other race(except American Indians) by the fentanyl crisis and deaths, poverty, and homelessness, with 39% of all homeless who are black, and 50% of homeless who have children who could be helped greatly with the billions being shoved on climate change. This is part of the healthcare crisis ignored by the Democrats. How can we have only 27,000 border patrol and watch Biden hire 87,000 more IRS agents (we already have 74,000), and will spend $89 billion to hire them.
Continued abuse of the COVID money being spent on a variety of non-COVID issues is a blatant example of how our tax money continues to be mismanaged. Forget the name the Inflation Reduction Act (which it won’t help and name it what it really is…the Climate Change Act). Now Biden wants to spend $400 billion to forgive 60% of all people who have federal student loans (Pell grants get $20,000 forgiveness and non-Pell grant recipients $10,000) for people who make less than $125,000 a year or $250,000 per couple. This is in the face of inflation that is the worst in 40 years, with a recession occuring for most Americans. Speaking of abuse…Dr. Fauci is retiring….good riddance. He abused his power at all levels, lied to Congress on the U.S.’s involvement in the origin and funding of the changes made in the coronavirus to make it a weapon, and became a political hack just like the rest of those politicians. I am proud of his efforts in the days of HIV research, but embrassed that his ego overtook him when he was named chief advisor for Biden on COVID management and blew it!! We will find out all of his underhanded moves in time. Do not be soft in your approach regarding your political support, and encourage every person you know to vote these socialists out of office. It is our American right, and there is no excuse for not voting(hopefully in person) and help take back our country. We need both the Senate and House to start turning some of this craziness away. Dr. Sam
2. More on Socialism/Marxism and the threat to our Healthcare-Part 2— Climate Change is the engine for Woke Communism If you love this country, you need to carefully read Part 2 of my discussion on how the Woke socialist/Marxists are trying to destroy our country with outrageous attempts by the radical left Dems to destroy democracy, the constitution, and states’ rights for the country, if given a chance. There are those supporting a central government to remove the rights of the individual. And sadly, green energy and climate change strategies are an integral part of that move. It is a perfect issue to control the population with overpowering regulations and massive taxation. Everyone knows how important a clean environment is, but at what expense?? Why is it not proposed in phases that could have bipartisan support? They continue to attack our former president by raiding his home, while Clinton (both of them) never saw a hand on all of her deception, classified documents destroyed, etc.. We are becoming a Banana Republic, and that has to stop. The Dems will sacrifice our country to a “third world level” to get their way, and while keeping Biden on vacation (except a couple of speeches). It is critical to read the fine print in this climate change bill as always. Add $89 billion to $369 billion for 87,000 new IRS agents likely to attack conservatives, lying about not auditing people under $400,000 income. Please, if you did not read last month’s report Socialism/Markism, part 1, please take the time to do so (globalism, CRT, political correctness, gender discussion, etc.), as this report continues with the radical left’s attempts to promote Karl Marx and Saul Alinsky’s Radical Rule with 8 levels of control aided greatly by academic institutions (including medical), social media, the television media, Hollywood, BLM, Antifa, big corporations and 56% of the Democratic party that are necessary to support a socialist state. There is nothing more important than healthcare control (#1 factor)by the government to promote socialist ideologies. The gross mismanagement of the pandemic (recently admitted by CDC Director Dr. Walensky) and handouts (stimulus money) of $billion to half the country shut our industries down with people making more money from the government from the stimulus packages still going on, and now they are including financial handouts to the illegals coming across our southern border. Please review the steps for the radicals to take to turn us into a socialist/Marxist country.
The 8 factors of control for a socialist state (Saul Alinsky) 1. Control Healthcare—it controls the people—socialized mediocre medicine. 2. Increase poverty by filling the country with uneducated people with no skills (right through the Southern border). Poor people are easier to manipulate 3. Increase debt in the country—debt requires increasing taxes, so that makes people poorer. 4. Gun control—without guns, the people can’t protect themselves. 5. Welfare increased—Food, housing, and income controlled 6. Control Education—CRT, political correctness, cancel culture, gender identity, dumb down education, equity, not equality (breeds the same level of opportunity to all regardless of motivation, intellect, and means to excel). This includes academic medicine today, including the national medical organizations, such as the AMA, Academy of Pediatrics, etc., who are all in on wokeness. 7. Remove religion—take away any higher power making the federal government the highest power. This is critical to keep our religious views strong and worship our Creator. 8. Create class warfare—separates classes of people pitting them against each other, including race, income, making it easier to tax the rich and support the poor. 9. I must add Climate Change as the 9th factor. Regardless of how important it is, the regulations that will come with it and tax burden on us is the real issue. Again, I remind all to read Mark Levin’s Book on American Marxism. It is very short, but extremely educational, and emphasizes all these dangerous factors with an extremely indepth chapter on climate change as a manipulative factor promoting socialism.
A. Healthcare coverage at stake, and the key to a Woke Socialist and Marxist future The expanding American population is a big reason why we are in trouble trying to cover everyone with health insurance of some kind. Flooding the borders with illegals (4000+ per day) has created the need for more subsidized healthcare and perpetuated the pandemic, which has been a valuable tool for this administration to abuse its power. It is estimated that the 4 million employees are staying home, declaring they have long COVID syndrome. With the pandemic allowance of Medicaid eligibility lowered, because of the pandemic, Americans now have dropped the percent of uninsured to 8%, according to the Department of Health and Human Services. We get closer and closer to Medicaid for all, but private insurance must continue and keep Medicare separate for seniors. Allowing the government to control all of healthcare will be disastrous. In early August, Dr. Michelle Walensky, CDC Director, admitted that their management of the pandemic has been poor. Most of us following her wishy-washy recommendations have been critical of her, because we knew the White House (Fauci) was running the show, not her. Now, she admits it, but won’t point the figure where it should be. As I have said many time, the FDA and CDC must be independent organizations. We are not a healthy nation with the increased weight, diabetes, heart disease, etc. starting now in childhood. The AMA predicts a large spike in the number cardiovascular cases and deaths in the next decades. But by the way, the radical left wants fewer people in our country, so I guess these spikes in death are ok.
Part of their solution might be to segregate groups based on age, wellness level, and ability to pay to deal with disease. There are many solutions being proposed, but this accounts for only half of Americans. The other half is already on a federal single payer system—Medicaid, Medicare, and VA’s affordability, proper management, fraud, and over-regulation are in serious question with healthcare costing more and more of the GDP (over 7%). The radicals will create one size fits all healthcare, which is why I constantly state that they will create Medicaid for all, nothing close to providing the present Medicare program. The shortage in medicine and all healthcare professionals (including nurse practitioners and PAs) is rising with retirements and lack of filling primary care positions. More and more foreign trained doctors are filling the slots, some of whom do not have the level of quality training as American medical schools. Current Medicare recipients will be very disappointed with what they will get with a socialized government controlled healthcare program. The pandemic has had so many unintended consequences that I have enumerated in previous reports. We will suffer for decades to come from these consequences. There is a huge push to select Medicare Advantage. It is mostly an HMO, and almost half of Americans have chosen it. It is a good plan if healthy and less expensive, but when a serious issue arises, the out of pocket costs are huge. For most seniors who have ongoing serious health issues, it is a poor choice. As mentioned last month, 18% of requests for elective procedures are being initially refused or denied. That is also happening in standard Medicare, which I just personally experienced regarding approved for my carotid stent, having to jump through extra hoops to get approved. Tightening of services is already being applied. The narrowing of available health networks is a big problem with Medicare Advantage. Access is becoming a large problem especially in rural America. Overall, healthcare in America is good, and if you have good healthcare, please be kind to the caregivers and stick with them. Medicare has provided good care for our poorer and older populations, but expanding it all people will kill the system. Standard Medicare is, however, subsidized greatly by the federal government and most people do not know this (as much as 40% of the bill you never see). The overall cost is skyrocketing because of the number of seniors turning 65 years of age and the escalating number in Medicaid recipients including all the illegals (4 million by the end of the year since Biden took over). By 2027, healthcare will cost $1 trillion dollars with $625 billion for federal programs (Medicaid, Medicare, CHIP, and Obamacare). Nearly 2/3 of that money goes to Medicare. Even though Americans paid a Medicare tax with every paycheck, it is still not enough to sustain it, having needed subsidization from the feds. Medicare will be depleted by 2028 or before, and Social Security by 2035. Greed by corporate hospitals and large healthcare systems have increased as they decrease salaries to employed physicians and staff (average of about 15%), setting them up for even less revenue with socialized medicine (as much as 30% less). Medpage did a nice job of enumerating some major concerns about the future of a one payer system: (i.e. socialized medicine, universal healthcare): 1. Lack of access for chronic diseases and delay in getting necessary but elective procedures approved (i.e. joint replacements). 2. Healthcare choices will be taken away from physicians and put in the hands of the government with layers and layers of bureaucracy which has paralyzed the system thanks to the university academicians who were put in place to make medicine unaffordable ultimately forcing the country to socialized medicine. That includes medical schools. 3. Strict allocation of care will be imposed by a socialized system with restriction of costly care (nursing facility care, hospice, etc.) especially surgery on elderly or higher risk candidates (rationing of care). We may age out of a system like this, and be told we are just to old to get care. 4. Recipients consider a single payer system essentially “free care” and abuse it easily. The young already expect free care with socialism. Access to doctors for routine care and non-emergent care will be delayed, which is going to be a huge issue. 5. Waiting time for diagnostic procedures will be prolonged. In Canada and other countries, it takes months to have diagnostic procedures such as MRIs, CTs, angiograms, etc. Many Canadians purchase additional healthcare policies from the U.S.(since Canada does not allow any insurance other than the Canadian socialized system). Many of the Canadians that spend half their year in the U.S. are getting private American insurance, a secondary health care plan, if we go socialized, there will be a private (non-governmental) secondary insurance offered, only affordable to the wealthy, the so-called two tier system. This will increase the cost of healthcare exponentially, and the government won’t pay a dime for that second insurance. 6. A socialized system will continue to deteriorate the doctor/patient relationship as we know it. Universal systems on average pay their professionals 27% less than our current system for Medicare and Medicaid patients, 70% less than what public payers pay, and 120% less from private payers. 7. Taxes will have to rise with a federal single payer system, and it was estimated that in 2016, it would be over $3 trillion (probably over $5 trillion now) There is already talk of increasing deductibles and copays for Medicare patients and increasing the eligibility age to 67 soon possibly (will not affect anyone over 50 years of age).What is the country willing to tolerate? The feds won’t care, and you will be helpless to change it with a socialistic/Marxist government. 8. The loss of competition in any business raises cost including a one payer system. 9. The cost will escalate as the number of people continue to flood the borders and more illegals are accepted (4000 per day cross our borders currently). 10. More corruption will occur, when it comes to who gets contracts to provide services to a universal system. This is a ripe field for fraud and under the table payments to the congress. There is well-known corruption and fraud with military contracts including the VA. Right now, there is a scandal regarding opioid theft within the VA. 11. A single payer system will lead to a two tiered system, as mentioned above, which raises the personal cost of healthcare to Americans. 12. Having access to a world class center could be excluded. Mayo Clinic does not accept direct Medicare or Medicaid payment now. Some other major centers may follow suit and a socialized system won’t cover them either. 13. The average waiting time to see specialists will be greatly prolonged. Here are some figures from Canada: orthopedics-42 weeks, neurosurgery-31 weeks, plastic surgery-27 weeks. The delay are already starting. 14. In Great Britain, the government owns the entire system-hospitals, clinics, lab, x-ray, etc. That is a classic monopoly that our government does not allow in business, but will do so if we let the federal government run all of healthcare, hospitals, and health care workers. 15. The VA, which is a federal system, is currently an unsatisfactory system and very costly because of the regulations and multi-tiered bureaucratic system, typical of federal liberal programs 16. Unionization of physicians could occur and strikes will occur. Doctors in Great Britain have already begun this effort to protect themselves from their own system. 17. Vermont abandoned their single payer system years ago, because they could not afford it. 18. Half of Americans opposed Obamacare (Affordable Health Care Act) for awhile, but are signing up in large numbers recently, dropping the percent of uninsured from 18% to 13.4%, because they can’t afford standard private insurance, which increases us closer to what Obama wanted from the beginning…socialized medicine. Although the Department of Health and Human Services does not have up to date numbers, I am guessing we are approaching only about 20 million without healthcare. Black people poll much higher in approval of Obamacare (68%) vs white younger people (38%). 10% of Republicans and 40% of Democrats approve of the Affordable Healthcare Act (Obamacare). Younger people want free care and 60% of Dems support a socialized federal healthcare system. Reference—Medscape Business of Medicine, June, 2016 Harvard Kennedy School—Institute of Politics HHS.gov 2021 Share the above report with your friends and family and help them understand what is at stake. Don’t be naïve.
B. Climate Change as a tool of the radical left With the passage of the Inflation Reduction Act, now really the Climate Change Act, we are much closer to billions (almost $737 billion) being spent on climate and green energy development. With a slight improvement in the inflation rate (9.1 down to 8.5), the Democrats found time to pass this act which will create more dollars in costs plus major taxes, as the White House lies about those earning under $400,000 will pay no tax for this, while giving billions to those who support climate change. One of the worst parts of the climate change craze is the regulation and extreme federal power it gives them toward promoting socialism/Marxism. Everyone admits, we want cleaner air, water, and safer food, but we must understand this can all be obtained at a pace acceptable to most, however, the Democrats want it at a pace that has created multiple crises, creating even more division in our country never seen before. As this radical thinking through the guise of enviornmentalism, the radical left has coined the “Green New Deal”, which promotes economic regression, equity for all (not equality), and a one-party dictatorship, which overlaps with critical race theory pushing enviornmental justice. At the core of this crusade is the “degrowth movement”, which states that mankind consumes and produces too much, and blames it on capitalism and America, essentially to reverse the massive economic progress resulting from the Industrial Revolution, which created a vibrant middle class and major scientific, technological, medical advancements that have improved the quality of life for Americans. That will stop. Promoters of solar energy have seen degrowth as an appropriate frame of life for the future to take down capitalism including eliminating carbon sources of energy and redistribution of wealth called “equitable”. This concept includes a “maximum amount of wealth”. Part of this promotion includes open borders, establishment of a living wage and reduction of the work week to 20 hours, according to Mark Levin’s book quoting one of the leading degrowthers, Serge Latouche, University of Paris-Sud. While eliminating capitalism, he promotes redistribution and equity, and states that economic production and materialism are the biggest problems. Urban sprawl in the 1930s deployed in the U.S. revived capitalism from the Great Depression, which created a major need for automobiles. That is just one of the reasons why they want capitalism has to go. Do you? Principles upon which America were founded, such as property rights, free flow of commerce, voluntary exchange, the sanctity of the individual, and the establishment of a government around these principles would be dismissed in this new movement, denouncing capitalism for creating abundance.
C. Why are these ideologies part of the Climate change promotion? Global warming! According to Timothy W. Luke, professor of political science at Virginia Polytechnic Institute, global warming is due to mankind and capitalism with mankind reshaping the earth’s natural and artificial envirornments. Climatology occurs from industry creating by-products of mass production and consumption altering the earth’s atmosphere. Environmental justice addresses this using race, gender, pacifism, injustice, classism, and anti-Americanism. According to David Pellow, professor at the U. of California, (the 4 pillars of environmental injustice) the battle for global sustainability cannot be ongoing without addressing the ecological violence imposed on vulnerable human populations, and thus social justice is inseparable from environmental protection. Social inequality and oppression in all forms are agents of social change, which includes the critical race theory and gender identity. Do you realize there are 7 genders?? Another factor comes from the power of the states, and we are seeing a tremendous push for power and control from the Democratic party to reduce the state’s independence, and most Marxist and Communistic countries do not have state’s rights. Another one of Pellow’s pillars is the view that social inequalities from racism to specism are deeply embedded in society and reinforced by state power. This is the rationalization for a totalitarian country. Another Pellow pillar is that the ideology of white supremacy and privilege must be removed, since it is a blockade to racial justice. These principles were greatly developed in Venezuela thanks to Chavez and Maduro, and now the country is broken and devastated. People from Cuba, Venezuela, and other communist countries are trying to get into our country, and sure don’t want our country to become a country they just left. They will vote conservative! These dangerous principles can be appealing when statements are stated such as developing principles of “living in harmony with nature”, guided by absolute and ecological limits moving us away from fossil fuels and other hazardous energies that interfere with Mother Earth, the rights of women, children, gender diversity, the impoverished, and vulnerable minorities.
D. Democratic draft on Climate Change (proposed by House of Representative Alexandria Casio Cortez and dozens of her Democratic colleagues in our Congress (right out of the International Margarita Declaration* on Climate Change)—these are some of the points, taken from Mark Levin’s book—read it to believe it!! *Margarita Declaration on Climate Change from Venezuela www.ej4all.org “Whereas climate change, pollution, and environmental destruction have exacerbated systemic racial, regional, social, environmental, and economic injustices, by disproportionately affecting indigenous communities, the poor, low income workers, women, the elderly, the homeless, the disabled, and youth (known as the vulnerable communities), that it is the duty of the Federal U.S. Government to create a Green New Deal to achieve a net zero greenhouse gas emission, to secure for all people of the United States to clean air and water, climate, healthy food, and sustainable environment. This can be done by promoting justice and equity by stopping the oppression of indigenous communities including those of color, migrants, and rural communities. It will require eliminating pollution and green house gases with universal access to clean water, and reducing the risks of flooding and other climate impacts, and by meeting 100% of the power demand in the U.S., by expanding and upgrading renewable power sources, by upgrading all existing buildings to achieve maximum energy efficiency. By overhauling transportation, this will help eliminate fossil fuel emissions,etc. Those leading this charge will work with farmers to create a “new food system” by building sustainable and universal access to healthy foods. This can be attained by guaranteeing a job with a family sustaining wage, adequate family, and medical leave, paid vacations, and retirement security. For all to unionize to strengthen and enforce labor, workplace health, and safety with environmental protection against pollution worldwide. This will ensure a high quality health care, adequate housing, economic security, and access to clean water, air, affordable healthy food, and nature.” This is very close to communism!! The main sources for climate change are the political and economic systems commercializing nature and life. The developed and elite countries have been at fault for most of this deterioration of the earth, according to these leftists, and we must meet their moral and legal obligations to turn away from capitalism, fossil fuels and damaging industries, while education is the fundamental driving force for transformation and construction in diversity of the “new woman and man and respect of Mother Earth”. (I am having a great deal of difficulty even writing this nonsense.) The necessary transformations required in climate change will destroy our country and world including transforming who has the power over the people, transforming food production with new technological innovations, including removing methane gases from areas who raise cattle, eradicating dirty energies and fighting poverty, clean renewable energy with heavy regulations on usage, access to land and urban services using fair and equitable techniques to address climate change impacts, recycling, reutilization, and reduction of all residues. Developing poor countries with global financing, and protection for those defenders of environmental rights are part of this movement. It is globalism at its worst!! We are told by these radical thinking people that fossil fuel is the most common reason for carbon dioxide, the main culprit for climate change, which is absurd. Did they forget plants and trees need carbon dioxide to live? Next month, I will report on the experts who are against the theory of human induced global warming (and cooling). As former President Ronald Reagan said, “ if we want freedom in our country, we must have less government, as the government works for us, not the reverse”.
E. Why no cooperation with cleaner energy and environment promotion from the real polluters? As Hunter Biden’s influence with the Chinese Communist Party (CCP) being paid by certain groups to gain influence with then VP Biden, I am very concerned that is going to play a role in how the U.S. deals with the growing threats from China. I know this is very controversial, but we are facing some very external stresses that could change our lives in an instant, unless we proactively confront the CCP against Taiwan, the South Pacific, and their increasingly commanding influence in our scientific, medical, and technological fields. (even buying ports in the Bahamas for their Navy ships) Biden has not even discussed the fentanyl crisis in our country or with their chairman Xi Jinping, who looks to become a lifelong leader. Drug overdoses and deaths are an all out invasion of the 18-45 year olds in our country with over 110,000 overdoses last year from a drug manufactured in China exclusively and shipped by the truckloads to Mexico to be transported across our borders every day by the Cartels, as they stamp every conceivable drug with it, killing children and younger adults with drugs on the street unknowingly laced with fentanyl, which accentuates the drug effects of most illicit drugs. And we think we will have cooperation on climate change from the parts of the world that are the real polluters (like China and India), who at this very time, are opening coal mines all over their countries, while our 1% improvement in the environment will be meaningful by showing good behavior to the world. No chance!! This climate change ideology is nothing more than a ploy to turn our country into a socialist/Marxist country. As I have said many times, if we could work together to implement a cleaner environment, which we all want, with cooperation from the biggest polluters in the world, which will never happen in my opinion, we could, over a couple of decades, see some real change. Electric cars are just the tip of the iceberg. And all those charging stations require electricity fueled by gas. But we must compromise….something we are seeing less and less with our politicians. With the “shove the climate down the throats” of most of us, creating economic hardships, we will be even more divided, as we who pay taxes, foot the bill for almost $1 trillion, unbudgeted, for regulations, drastic hardships on the trucking and transportation industries (much more than just the fossil fuel industry), and cash back to those who can afford an electric car, etc. The Climate Change Act (formerly the Inflation Reduction Act) even includes money for 87,000 new IRS agents to attack every taxpayer (at a cost of $89 billion) to find who is not paying enough tax. We have already had an attack on Republicans by the IRS during Obama reign (remember Lois Lerner?).
F. What has Biden done for America in 2 years? 1. Economic recession 2. 40 year high inflation 3. Soaring crime 4. Crippling supply chain issues 5. Undermining domestic energy 6. Wide open borders 7. Botched Afghanistan withdrawal 8. Unscientific medical tyranny and military wokeness 9. Radical ideology in school sessions 10. Weakness on the world stage 11. Depleting strategic petroleum reserve 12. Unconstitutional attacks on second amendment freedoms 13. Weaponization of federal agencies including the CDC and FDA 14. Out of control spending 15. Assaults on the First Amendment rights 16. Buying votes from the younger voters by giving a $10,000 handout to those with a student loan (60% of those with loans). Handouts for illegals including driver’s license, cellular phones, medical care, clothing, food, transportation and housing. 16. Mismanagement of the pandemic with massive unintended consequences of isolation, lockdowns, mandates, and unscientific regulations 17. Ignoring the drug crisis coming through the southern border and the 110,000 deaths from fentanyl and the Cartels running the border making $200 million a week; ignoring China’s involvement in the pandemic origin and massive shipments of fentanyl manufactured in China What has Biden done in the last month….vacation!! Vote America!! Save America!!
3. COVID updates—Biden has rebound COVID; the fall booster
A. Rebound after Paxlovid—Biden As a 79 year old somewhat physically and mentally challenged President of the United States has rebound COVID-19 from a known side effect of Paxlovid, his antiviral treatment was short of keeping him well. This is happening to 1% of those taking the drug, touted to successfully treat COVID-19, developed a resurgence of the virus (with a positive test), and symptoms, because he did not take the drug long enough. It is most likely to occur in high risk patients, and Biden is high risk. He violated every CDC rule while he was infected. Most people older or at higher risk should take Paxlovid. Most rebound cases get better in 3-4 days, and should test negative once again. However, the CDC does not recommend testing after an infection when asymptomatic, fever free, and 5 days past beginning of symptoms. Now they have changed their guidance again, and state you should wear a mask from day 6-10, which Biden did not do. Some infectious disease experts feel that as a virus passes through us, there will be some waxing and waning of symptoms and even testing results. The water is muddied as we know that testing can remain positive for weeks after COVID, and the virus may be dead but still create a positive test. There are many theories about rebound, but one of the most obvious issues is testing. Anyone can get a positive or negative test using the quick antigen test, which can have a considerable false negative result, and therefore, unless symptoms dictate, don’t retest. There are no legitimate studies yet to identify why rebound occurs. As usual, non-published, non-peer reviewed studies of fewer than 20 people are where they are getting their information. Sad isn’t it? Also, since most who have rebound illness only have this for 3-4 days, so if Biden hadn’t gotten a “rebound illness”, we wouldn’t even be talking about it, when only 1% have so-called rebound illness. Medpage Today, August 2, 2022 J Clin Infectious Diseases, June 14, 2022 The recommended dosage is three pills twice a day for 5 days. It won’t stop your symptoms but reduce the severity. Talk to your doctor about taking more Paxlovid. It is unclear at this time. The rebound COVID illness may also increase the chances of long term COVID syndrome, and we will see if that occurs. Fortunately, his second rebound illness was not much more serious, but did have to take steroid inhalers for his cough. Unfortunately, he did not wear a mask after testing negative and met face to face with staff, etc., for 3 days. No telling if someone gave it to him or the reverse. The CDC’s newest recommendations for those exposed to people with COVID-19 should wear a mask for 5 days. (See CDC website Morbidity and Mortality Report-August 12, 2022). Fro those unvaccinated, or those 6 months out from their 2nd vaccine, and not yet boosted, if exposed should quarantine for 5 days plus 5 more days of strict mask wearing. If a person has received a booster, quarantining if exposed is not recommended. Test at day 5.
B. More updates on the COVID vaccine Sadly, the Omicron subvariants are much more resistant to the vaccine currently used, even with 4 doses. And the latest information about the new Omicron containing viral protective vaccines available this fall is not much better than the booster currently used, according to Medpage Today, July 29, 2022. Even with BA.4/5 protection, the trials are still showing milder cases with as little as 44% symptomatic in a recent study, but as all of the fully vaccinated, protection against hospitalization and death is good. The value of the current vaccine is 35% protection, but with a booster, the protection rate rises to 75%. This is according to the CDC from South Africa and UK data. However, the bivalent subvariant BA.4/5 vaccine out this fall has no evidence scientifically that it is any better than in the current booster. The latest variants also are showing much shorter incubation periods (2 days instead of 5 when alpha and delta variants were predominant), so people need to be aware they can infected in a matter a couple of days after being around others. It is pretty clear seniors and those with other risks will probably choose to be vaccinated with this upcoming vaccine even without good evidence it is valuable. Research from The University of Michigan report 70% over 70 will get the poke. Only 19% under 50 will get the booster. What happens when there is another variant that crops up? Will it be convered? The vaccine companies say yes, if you believe them. We need data!! Medscape Medical News, August 12, 2022 Those with autoimmune disease were found to respond less well to the vaccine and should probably be the only group getting every booster available, but must wait at least 6 months between injections to ge the best immune reaction albeit less than desired. Lancet Rheumatology, August 9, 2022 Testing and taking Paxlovid is still an important tool to use to prevent more severe disease. Just go to the pharmacy or clinic and get tested with an quick result and get a prescription (Biden authorized pharmacists to prescribe, but I still recommend people checking in with their doctors about being positive. Unfortunately, patients are still receiving steroids and antibiotics unnecessarily (including a relative of mine).
C. Comparison of complicated pregnancies pre-pandemic vs pandemic Pregnancies were of concern during the pandemic, because of less prenatal care, and lack of access. This group also were very reluctant to get vaccinated. It has already been seen that those pregnant infected women had higher complications in their infants than those who were vaccinated. This study in JAMA Network, August 21, 2022 compared over 800,000 patients in both groups regarding complications in the women and deaths, with COVID excluded. There was a significant increase in mortality from 5.17 to 8.69 per 100,000 pregnancies, primarily due to hypertension and bleeding complications. The possibility that prenatal care lessened during the pandemic may be one of the compelling reasons. Whether the decrease was the lack of access or women just not willing to go to their doctor for prenatal checks is not known.
D. Infection immunity better than vaccine A recent study continues to reinforce the data that infection gives a person significant defense against a future severe reinfection, better than the vaccine. The fact that natural infection was ignored on purpose by the federal government (which includes the FDA and the CDC) to push the vaccine is understandable (in their minds), but it created great discrimination and confusion. To this date, they are in a category being mandated to receive the vaccine, when they have better immunity in most cases than those who were vaccinated. It is this kind of pressure you will see as the pressure to socialize (central government control) our country continues. Don’t let it happen!! We must retain states rights and OURS! Sadly, some schools (and many colleges) are requiring masks inside and out, and mandatory vaccine for little school children with no plans for teaching online. The latest articles are reporting as many as 56% of those who think they have not been infected from Omicron without symptoms have in fact been infected and remained asymptomatic. Even a significant number of those who were vaccinated 2 years ago have minimal immunity are getting infected with no symptoms. And yet this administration continues with mandates for vaccination.
E. Long COVID Syndrome Long COVID continues to occur more often in unvaccinated people and those with underlying disease whether vaccinated or not, but whether that continues to be the case, is not known yet, with the BA.4/5 variants. We do know that if people continue to have symptoms, their immune system is dysregulating and can cause problems in any organ, which includes nerves especially to the blood vessels and neuromuscular system. This is essentially like an autoimmune disease I have been reporting on for months. If you have prolonged symptoms, certainly being evaluated by a physician is highly recommended to investigate them and be able to treat the symptoms. Whether proven to have prolonged syndrome, it is estimated that 4 million workers are staying home because of prolonged symptoms. Long COVID syndrome is defined as symptoms that persist 3 months or more. Since fatigue and memory problems are included, some studies report as many as 40+% of patients. Medscape Medical News, August 5, 2022 Some countries are reporting long COVID in as many as half those who had significant symptoms. However, it concerns me that many are using this syndrome from going back to work.
F. Fourth dose value? The question has been….take the 4th dose of the current vaccine, or wait til the new variant booster is available?? The answer is not as clear as it was first touted. First, do not take another dose of the vaccine unless 6 months have passed, as the effect will be less. Talk to your doctor about this. For now, I would wait for more data on the added effectiveness of the new BA.4/5 variant fall vaccine booster, because the data has yet to be clear. Most people have not received a 4th dose anyway, since it only gives about a month or so of added immunity, and we may not have much greater length of immunity with this new fall dose either. I would want data from independent sources, since the feds have been less than reliable. As a writer, it is very frustrating to have to provide data that comes from few participants, is only observational, and almost always comes from other countries. Israel, South Africa, and the UK provide the most data and continue to be the CDC’s main source, but their populations don’t always match ours. The FDA has stated that all people under 50 should wait for the fall new Omicron targeted variant vaccine rather than receiving the current vaccine. But there is no data to prove the fall Omicron variant bivalent vaccine is more valuable. People that die from COVID (350 adults per day) are mainly unvaccinated or immunocompromised or at higher risk, the same thing I have stated for several months. However, new data report 40% of hospitalized patients have had some vaccine. High risk patients don’t have to be actively ill with their risk factors, but when infected, those risk factors play a significant role in determining the severity of the illness. If a person has been infected with the Omicron variants, they are much better protected from getting another Omicron variant illness than those who were infected with the alpha or delta variant. They were found to have more than 14 months high immunity from a study in Qatar. Medscape, General Surgery, July 12, 2022 Most experts agree we can’t boost ourselves out of this pandemic. The bottom line, we must produce better vaccines, and the fall vaccine dose is not one of them. Their final conclusion is for those needing maximum protection to go ahead and get the current booster and then wait for at least 4-6 months before getting the new fall/winter Omicron targeted variant vaccine coming this fall/winter. There are no “magic bullets” out there, and we can’t vaccinate our selves out of the pandemic. Just more rules from the government and more money for the vaccine companies. It is important to remember, with the percent of the country having been infected and or those who were fully vaccinated, have created herd immunity even though the CDC continues to refuse to use the words. Medpage Today, July 29, 2022
G. CDC changes their recommendations again! Ending COVID Safety rules by the CDC The risk of medically significant COVID-19 has decreased so that the initial recommendations may no longer be necessary. Social distancing, quarantining, and testing children while allowing them to stay in school, and may no longer be necessary for most Americans. They spend an entire paragraph defining herd immunity without using the word. We have been in this position for several months. The reason for optimism comes from better treatment, population immunity and tools that prevent spread. Of course, those with higher risk should continue to practice a multi-layered approach to staying safe (good ventilation, well-fitting high quality masks and testing). Of course, the White House has their own rules. These were published in the CDC’s Mortality and Morbidity Weekly Report, August 11, 2022 The emphasis has moved to what public health services are best known for: a) focus on ways to reduce risks for severe infection. b) monitor community COVID levels to guide prevention efforts. c) expand access to vaccination and treatment for immunocompromised people. d) offer reliable information to high risk people to know their status. e) encourage testing for those who are symptomatic and isolate for 5 days or longer when infected.
Those who get infected and for those just exposed With fewer hospitalizations, the CDC dropped their recommendation for isolation when people are exposed to the virus. Obviously, if exposed, monitoring for any symptoms is critical. The CDC is trying to keep up with the latest COVID Omicron variations (BA.4 and 5) and feel the need to change their recommendations if infected, which continues to create confusion with the constant changes in recommendations. Here they are the new recommendations if infected: 1. Stay at home for 5 days and isolate from family, as the chances of transmitting the virus are greatest the first 5 days of symptoms, although in the past they said we are most infectious 2-3 days before symptoms. 2. When around family, wear a high quality mask (where are they??) and in public (you just said to stay home!!). 3. After 5 days, without fever for 24 hours not using fever reducing meds, and symptoms are improving (recently they wanted you symptoms free), or never had symptoms (how would you know you are infected??), you may end isolation. 4. Continue to avoid people who are high risk for getting a more serious infection for 11 days. 5. Wear a high quality mask through day 10. 6. If you had pulmonary symptoms, this means you had moderate disease (cough, shortness of breath, etc.), and need to isolate for 10 days. Biden came out of isolation in 5 days, got rebound or reinfection, still with a cough and laryngitis, while the CDC says differently above. What a crazy government….do as I say, not as I do. These recommendations came out even after JAMA reported that many people are still infectious after 5 days (43% of participants). JAMA, August 3, 2022 I applaud the government trying to get people back to work after 5 days, but when people are still infectious, they are just encouraging this virus to continue to cause infections. I suspect they will change their recommendations drastically after the November elections. Can people not see that they are trying to keep COVID spreading when they are allowing over 4000 illegals to enter our southern border daily. The Dems will do anything to cause fear in our residents and keep them from voting in person with a valid ID and use a mail-in ballot instead of face to face voting. JAMA Network, August 1, 2022
4. Abortion Controversy--OB/Gyn Series Series—Part 5
A. Opening remarks It is my responsibility to share what is in the medical journals, and this subject has been plastered all over the medical journals since the Roe vs Wade decision by the Supreme Court. Academic medicine is totally pro-abortion and has defamed the Justices for their decision, when the constitution clearly does not allow abortions. The liberal editors of these medical journals have published biased articles as much as they are blasting racism all over the medical journals. They are another arm of the socialistic machine. Medicine has gone as woke as the rest of the academic institutions, and since I represent the private practitioner much more strongly, I will attempt to provide a balanced discussion. As we all should know, abortion is occurring as often as it has been….1 in 4 pregnancies end in abortion, either surgically or medically. 54% of abortions are medical, according to Guttmacher Institute, approved for the first 10 weeks, although many doctors prescribe it later than the recommended time. These pills were allowed to be mailed to patients during the pandemic. Online abortion pills are now available in some states. When the Supreme Court ruled against Roe vs Wade and the Pennsylvania vs Casey and they returned the jurisdiction to the states on June 24, 2022 In 1973, Roe vs Wade allowed abortion, and in 1977, the Hyde Amendment banned federal funding of abortion except in medically necessary abortion (woman at risk of dying), rape, or incest. Some states extend their own funds for other medically necessary issues. There are several other confusing issues that states take into consideration, according to Politico. The only thing decided by turning away Roe vs. Wade, is that it is not a constitutional right, and the federal government does not have jurisdiction legally over the issue, because the U.S. Congress never voted on it to codify the decision, even during Democratic majority. Therefore, the Supreme Court of the United States, turned the responsibilty to the states. Unfortunately, this will be just one more issue that divides our country, because more blue states will liberalize their laws on it and more red states will limit or make abortion illegal except in limited conditions. The Biden administration is already getting their political nose in the state’s business, about paying for travel from one state to another, for example. There is even talk of floating abortion clinics, and mobile units as well. Socialism will rid the states of any rights and jurisdiction. There clearly will be abortion funds started online (Go Fund me) to help women access money for abortion. Insurance coverage for abortion has been limited for a long time, but Medicaid does pay if the pregnancy endangers the life of the mother, rape, or incest. However, there are 8 states ban abortion because of rape or incest. The decision of Roe vs Wade opened a huge political issue that will have some impact on the November election, but that includes both sides of the isle. About 10% of women went out of state in 2019 for an abortion, which was 57,000. 2/3 of abortions in Washington D.C. were from other states, the highest rate in the country. California, New Hampsure, and Maryland do not report on their abortions numbers. USA Facts A concern is whether a woman can use their insurance out of state. One source stated the cost for a 1st trimester abortion is $575, and a 2nd trimester procedure $895. A medical abortion, approved by the FDA for use in the first 10 weeks of pregnancy costs $560.
B. Medical Abortion 3 drugs are known to medically cause an abortion—mifesprestone, misoprostol, and methotrexate. Mifespretone is commonly used to treat Cushing’s disease (usually from an adrenal tumor causing large rises in corticosteroids), and when misoprostol is combined with it, is approved for abortion during the first 10 weeks of pregnancy or after a miscarriage.
Pharmacies warned Apparently, some women have complained that pharmacies did not want to fill these prescriptions, so the Biden administration warned the 600,000 pharmacies, that they cannot refuse, otherwise they can be held accountable for civil rights violation and sex discrimination. Medscape General Surgery, July 29, 2022
C. Where are abortions performed? 60% of abortions are performed in abortion clinics, and 35% at nonspecialized clinics, 3% in hospitals, and 1% in physician offices In 2017, there were 1587 facilities providing abortion in the U.S., representing a 5% decrease in the rates. In Florida, a patient must receive counseling and then wait 24 hours before a procedure can be legally performed, according to the Guttmacher Institute. Obamacare will cover only those with life endangerment, rape, or incest. In some states, an ultrasound must be performed and the mother must be offered the chance to view the images of their fetus. In Georgia, they have different rules, but, like Florida, requires counseling, and Obamacare and Medicaid offer coverage for life endangerment. Public employees are covered, and the parent of a minor must consent. Minnesota seems to be a common place women go for abortions, in Green Bay, Madison, and Milwaukee, since the state is more liberal than than the surrounding states. 44% are white, and 31% are Black, as Minnesota and Illinois are the states in the Midwest that attract the most out of staters with costs from $400-2000 depending on the gestational age of the pregnancy. Medscape General Surgery, August 22, 2022 Public funding is provided only in cases of life endangerment, rape, and incest. An abortion may be performed at 20 weeks or more after the last menstrual period only for life endangerment, severely compromised physical health, or lethal fetal anomaly. It is based on the fact that the fetus can feel pain, but inconsistent with scientific evidence and has been rejected by the medical community.
D. Other issues that could be affected Other issues include laws against abortionists, third party people assisting those who want an abortion (Planned Parenthood), the limitation of medical abortions, or even punishing women undergoing an abortion. There have been multiple alarmist articles in the medical journals regarding any possible aspect of the issue that could possibly be affected, including in vitro fertilization and the possible rights of frozen embryos. Of course, the muddier the water is made by activists, the more incorrect information will be exploited long before most states haven’t even addressed the issue by their legislature. Of course, in vitro fertilization, ectopic pregnancies, miscarriages, and laws against physicians helping patients with any of these issues will be discussed readily right before the elections. All of these elements of the abortion controversy must be clarified by each state, and I suspect there will be confusion abounding. The parent of a minor must be notified and give consent for an abortion. The abortion can be performed after the 24th week since the last menstrual period only in cases of life endangerment. Kaiser Foundation Guttmacher Institute
E. Fetal pain The issue of the fetus feeling pain has been a point of contention for some time. Recently, the federal government has considered legislation requiring doctors to inform patients that the fetus may feel pain with the abortion. There has been discussion requiring sedation after 22 weeks gestational age. The NCI/NIH states that pain can be felt at 26 weeks of gestation on the basis of brain and neurological connection development. They also state that the absence of pain in the fetus does not resolve the morality of abortion but does argue against legal and clinical efforts to prevent such pain during an abortion.
F. When does a fetus have an audible heartbeat When does a fetus have a heartbeat? This is another point of contention. The book states that a fetal heartbeat may be heard between 5 ½ to 6 weeks, but a Doppler or ultrasound usually requires the fetus to be 12 weeks of gestation. A stethoscope requires 18-20 weeks. Healthline.com
G. Emergency measures and abortion laws The medical journals are full of articles concerned about the management of emergency measures when a woman comes to the emergency department with pain, bleeding, and distress in a fetus in the first trimester or even later. Issues such as ectopic pregnancy, losing a dead or dying fetus to protect the mother, are all issues requiring expert decision making by an OB/GYN specialist, and their decisions are protected by abortion laws, however, there are states that have mobilized the lawyers for hospitals and doctors, and have created concerns about fulfilling the proper management for both the mother and the fetus. The U.S. Federal Emergency Treatment and Labor Act (EMTALA) protects these issues, but authors in journal articles are using the possible abuse of this law by states to create more division in abortion rights. Federal law supersedes state legislation, and states must respect this emergency law, and the lawyers need to keep their nose out of it. States challenging EMTALA need to be turned down and accept that it covers abortion as emergency measure when a mother’s life is in danger. Gray zones in state law interpretation must be addressed immediately. Leaving them vague is a disservce to all. A study published in the American Journal of OB/GYN found in Texas that with its tight abortion laws, pregnancy complications experienced worse outcomes. 57% in 2 Dallas hospitals who had delay in management from dangerous bleeding and infection compared to 33% to those who chose faster emergency measures in other states. This article did have significant limitations, and had small numbers to compare. As a physician, I must side with a specialist on the timing of emergency measures, not the hospital administrators and their lawyers. American Journal of OB/GYN, July 4, 2022 These emergency issues will be glamorized to create fear and pressure on the voters not to mention the hospitals and doctors, as well as the mothers. When laws get in the way of sound medical judgement, controversy grows, as it has for so many medical issues.
H. Personal observations As a practicing physician, it has never been an issue I have had to professionally deal with. As a doctor, it was my responsibility to care for my patient, and give the best care I could. I did not let my religious ideologies interfere, but there is much more data about fetuses today, and I also know that there are many gestational conditions that increase the risk of a fetal anomaly, life threatening or not. I never had to tell a pregnant woman they needed radiation and or chemotherapy that might kill the fetus. In my opinion as a physician, abortion is a decision between the woman and their doctor, considering all possible issues, and deserves serious counseling and knowledge before deciding to terminate a pregnancy. It has been my understanding any person who might lose their life because of a pregnancy, rape, and incest, should have options provided to them without bias. I have had to witness situations where a woman decided to have the child who was born with multiple congenital anomalies. It is hard to believe the child is still alive with so many surgeries and disabilities to contend with. The parents have had to dedicate every moment of their life for the care of that child, but have made the best of it and seen to it that the child has had every issue properly addressed. Amazing!! God works in mysterious ways, and it is not my place to criticize anyone who aborts a child or keeps them. If I included my religious bias, I would find it very hard to write this article. As we proceed to the November elections, realize that abortion is not on the ballot, but certainly will encourage thousands of passionate people to vote. If we are to continue to have a democratic country with the freedoms we enjoy, we have the responsibility to voice our opinion and feel free to talk to our politicians. We have no right to assault, damage, or create havoc in public to have our feelings heard. Peaceful protest is just that….peaceful. For those women who have used abortion as a form of birth control, I recommend tubal ligation.
5. Autoimmune diseases-Part-8- Autoimmmune vasculitis, Dermatomyositis, Wegener’s granulomatosis, Pernicious anemia If the readers have been following along on this exhaustive list of autoimmune diseases, caused essentially by our own body’s immune system, it has become extremely clear there is overlap in many of the diseases. How the immune system chooses which organ(s) to attack is still not known, burt some day, it will be discovered that our genes dictate the diseases, and when that occurs, research can develop genetic treatments that can hopefully prevent further disease progression.
A. Autoimmune vasculitis Primary inflammation of blood vessels on an autoimne basis is fairly rare as an isolate instance, but is much more common when it occurs in a myriad of other autoimmne disorders. About 200,000 Americans are diagnosed with this disease annually. With inflammation in the walls of blood vessels, those vessels start to close causing ischemia wherever it occurs. Also aneurysmal dilatation can occur, and can rupture. Blood clots can occur as well. It can occur from an infection, a medicine, or another disease. Symptoms may include fever, swelling, fatigue, and a general sense of feeling ill. Headache, weight loss, and general aches and pains (fibromyalgia). The GI tract, eyes, inner ears, extremities, lungs, and skin can be involved most likely. Ulcers, perforations of the bowel can occur. Giant cell arteritis can occur causing visual loss (also associated with polymygia rheumatica discussed last month). Dizziness from iner ear inflammation can occur. Swelling in the hands and feet, and numbness or pain can ocuur. Cough and even coughing up blood can occur. Red spots in the skin, lumps and sores in the skin can also occur. Causes Hepatitis B and C, blood cancers, other autoimmune diseases, and reaction to drugs can cause vascultis. As almost all autoimmune diseases, this occurs more commonly in women. Diagnosis includes the ANCA test—antinuclear cytoplasmic antibodies, a positive C-reactive protein test, CT or MRI angiography to diagnose narrowed nd blocked vessels, and a positive ESR test-erthrocyte sedimentation rate. These tests are frequently positive in other autoimmune diseases as well. Treatment usually requires the use of corticosteroids. Depending on the disease extent and organs involved, various procedures may be required, and biologic agents.
B. Dermatomyositis This is another autoimmune disease that can be diagnosed with a patient with inflammatory muscle weakness based on testing and a distinctive rash. Like most of these diseases, they are more common in women and occur in 40s but can develop into the late 50s. It can occur in children 5-15. About 200,000 cases are diagnosed each year. Rash can occur on the face and eyelids, knuckles, elbows, knees, chest and back. It is a violaceous, dusky red rash |
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The muscle weakness involves the muscles closest to the trunk including hips, shoulders, neck, and upper arms. It is a progressive weakness. The esophagus can be involved creating swallowing difficulty, aspiration of food, and shortness of breath if the chest muscles are involved. Calcium deposits in children are not uncommon, but can occur anywhere in the skin. Raynaud’s syndrome can occir as it does in many autoimmune diseases, with blanching of the fingers and toes from cold exposure. These patients are very similar in presentation as scleroderma, rheumatoid arthritis, Sjogren’s disease, and lupus. There is also a predilection for women to develop ovarian cancer, and must be screened.
Diagnosis Elevated levels of CK from inflammation of the muscles is almost present, as are antibodies produced by the body in this disease. Chest X-rays are usually ordered to rule out lung disease. Electromyography is performed to document the weakness. Muscle and skin biopsies are also confirmatory for inflammation.
Treatment It may include corticosteroids plus azothiaprine (Imuran) to decrease the dose of cortisone. Methotrexate and Cellcept can be used as well. Rituxin can be used as alternative. Hydroxychloroquine used in malaria is prescribed (also prescribed very often in COVID without proof of value). Sunscreens are also important as the sun will burn the skin more aggressively. There is an IV antibody treatment called IVlg. Different types of therapies are required including physical and speech therapy for swallowing difficulty. Mayo Clinic
C. Wegener’s Granulomatosis (new term-granulomatosis with polyangiitis) This is another autoimmune disease that must be ruled out in any patient with inflammation of the blood vessels in the upper respiratory tract and kidneys. I saw a few of these patients in my ENT practice with severe infections in the nose and sinuses. It is one of the few immune diseases that occur more often in males in the 40-65 year range. Also, as in many of the immune diseases, it may run in families. The same symptoms occur with fatigue, lethargy, with sinus and nasal infection that is severe. Anytime blood vessels are attacked immunologically, there will be loss of the lining of the respiratory tract causing scabbing and infection from loss of blood supply. Biopsies in the nose (if involved) will demonstrate inflammation of the blood vessels with infection in the tissues with infiltration of white blood cells (cause pus). The same antinuclear antibody blood test will be positive as in other autoimmune diseases, therefore, most of these diseases must be diagnosed with a combination of signs, symptoms, physical exams, and laboratory tests. Treatment is necessary because this can be fatal. Rituxin or Cytoxin combined with corticosteroids is the preferred medication. Other immunosupressives as all these immune diseases may be necessary including methotrexate, Imuran, and Cellcept. The treatment usually is necessary for 2 years before consideration for tapering off the meds. As many as 20% die from this disease after many years of fighting it. Cleveland Clinic
D. Pernicious Anemia Pernicious anemia is a vitamin B-12 deficiency, which is an autoimmune condition that prevents the stomach from absorbing the vitamin. It causes about 1000 cases annually. However, some disease and medications can cause the problem that can be prevented. When the red blood cells can’t get enough oxygen from the B-12 deficiency, the red cells are fewer and larger in size ( a form of megaloblastic anemia). Below are normal red blood cells on the left, and B-12 deficient cells on the right. Note they are larger and fewer.
The disease tends to affect those with Northern European descent in their 30s and 40s. Without vitamin B-12, there are several systems affected because of there is a substance called intrinsic factor secreted by the stomach cells, which allow absorption. Antibodies attack the stomach cells that secrete intrinsic factor, and attack the protein intrinsic factor. This protein carries B-12 to the bone marrow with help from other proteins to make red blood cells. Foods containing B-12--cereals fortified with B-12, meats, vegetables, clams, mussels, trout, and salmon for example; Spinach, potatoes, beets, and mushrooms also. Surgically removing part or all of the small intestine in gastric bypass procedures that will cause the deficiency requiring shots of B-12 monthly. Also Celiac disease and Crohn’s disease of the small intestine can cause the problem. Physicians are aware of these issues and follow the blood count to be sure it does not create anemia in these diseases or those who take the medications that can cause the problem. Other wise the disease would much more common. Antibiotics frequently can cause the problem, as well as certain medications for diabetes and seizures. Also vegan diets do not provide enough vitamin B-12, and need oral supplements. The main symptoms will point to the organs affected—diarrhea or constipation, postural hypotension because of the anemia, loss of appetite, plae skin, shortness of breath from not enough oxygen getting to the body because of anemia. Heartburn is also present. The mouth burns and the lining is swollen with a red tongue, and the gums bleed because of ths swelling. Long term disease causes more neurological symptoms including cognitive symptoms, hallucinations, delusions, depression, and optic nerve degeneration. Pernicous anemia may take several years to appear since it takes that long for the body to lose its reserves of B-12. Clevland Clinic
6. Some sunscreens recalled—benzene causing cancer
Makers of Banana Boat Hair and Scalp spray SPF 30, because of trace levels of benzene, which is a human carcinogen. The sprays when inhaled or absorbed through the skin potentially can cause leukemia, cancer of the bone marrow, and blood disorders. This sunscreen was not meant to contain benzene, but some of their samples of products did contain traces of benzene, probably from the propellant in the spray. The company stated that only three batches were involved, but I would either return the product or throw it away. There has been controversy over sunscreens for sometime, and there are other trace elements that are worrisome. The list of chemicals to be checked in the label are cinoxate, dioxybenzone, meradimate, padimate O, and sulisobenzone. Oxybenzone (hives and skin damage) and retinyl palmitate (cancer). The amount of sunscreen necessary to provide a real concern is never mentioned, therefore, just check the label, and if any of these ingredients are present, do no use them, regardless of it being spray, cream, or lotion. These chemical based sunscreens are the concern, while mineral based sunscreens are safe, according to a dear friend of mine in South Florida, who I worked with for years for the American cancer Society, Dr. Michael Kasper, radiation therapist at Baptist Health South, Boca Raton. Dr. Kasper’s research found 78 products with benzene in them, and these included Neutrogena, Banana Boat, and CVS sunscreen. He said the FDA should recall all sunscreens with any amount of benzene in them. He also stated that a list of all products can be obtained from the Valisure petition to the FDA, a citizens’s petition seeking action from the FDA. If a person is prone to sunburn, wearing safe protective products is critical. Be sure and read the labels of these products, as those with non-benzene products are a better choice especially if a frequent outdoor person.
This completes the September Report:
The October Medical News Report will include: 1. The experts who don’t believe in the current concepts of Global Warming—the other side 2. Genetic tests, a game changer for 50 diseases 3. Epidurals—pre-op epidurals can increase infections post op 4. Head Injuries in Sports 5. Blood tests as good as colonoscopy for colon cancer? 6. Blood and Blood products; Transfusions, Rh factor disease in pregnancy 7. COVID updates
Enjoy football season, and maybe a little cooler weather (except in Florida). Stay healthy and well, my friends, Dr. Sam
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