Any of you prescribing ivermectin?

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10-20% of physician prescriptions are for off-label uses not approved by the FDA.

*I don't support the use of Ivermectin for treating COVID.

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,RCTs of Boracitinib are showing a lot more promise than anything else. Lancet study showed...
Is that FDA approved yet? What if some jerk breaks into a Boracitinib factory, drinks a vat of it and dies? You, alone, would be the reason. Do you feel the shame now?

Okay, good. Consider yourself sanctioned. (/sarc)


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*I don't support the use of Ivermectin for treating COVID.
 
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This is a lot of hypocrisy in medicine but your list is suspect.

Sepsis is bad. And when you know it’s for sure sepsis it might be too late. Admin nurses going to far is a seperate issue. Dexamethasone DOES work. No prescribes azithro and calls themself a good doctor. A lot of hospitals don’t even used dilaudid.

Your point is reasonable just don’t get the list….
You are missing the point. Invermectin has been caught up in politics and the drive to get everyone vaccinated. Anything that even hints at working is dismissed b/c Biden wants everyone vaccinated. If you prescribe invermectin that has little side effects, you will be reported and potentially kicked off the medical staff.

But when sepsis protocols were pushed, people who clearly was not septic/needing admission was getting an IV/abx/2L NS ordered before I even saw them. I can't tell you how many times I cancelled orders when the pt came back looking great with probably rhinovirus. That was and IS bad medicine.

Do you not realize that Dex is NOT recommended in outpt covid treatment?

Even if you got covid, have natural immunity likely equal to the vacinnated, you are still condemned until you get a shot. Can someone show me a study that shows someone that got covid somehow needs to get vaccinated? I remember studying something in medical school that said when you caught something, you have immunity to it.

Please someone send me a link to a study that shows someone with natural immunity has less protection than someone vaccinated because seems like they are black listed.
 
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The findings suggest that natural immunity provides longer-lasting and stronger protection against infection, symptomatic disease, and hospitalization due to the Delta variant, compared with the protection of the Pfizer-BioNTech two-dose vaccine, the researchers conclude.

In addition, those with natural immunity exhibit additional protection against the Delta variant when given a single dose of the vaccine, according to the results.

The researchers are continuing to investigate the long-term protection provided by a third dose, or booster, of this vaccine.


This is the conclusion from the Israel study. So why can someone vaccinated have more freedom than someone who has proof of past infection? So why are people with natural immunity required to get weekly tested by Biden's executive order but vaccinated not?
 
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The findings suggest that natural immunity provides longer-lasting and stronger protection against infection, symptomatic disease, and hospitalization due to the Delta variant, compared with the protection of the Pfizer-BioNTech two-dose vaccine, the researchers conclude.

In addition, those with natural immunity exhibit additional protection against the Delta variant when given a single dose of the vaccine, according to the results.

The researchers are continuing to investigate the long-term protection provided by a third dose, or booster, of this vaccine.


This is the conclusion from the Israel study. So why can someone vaccinated have more freedom than someone who has proof of past infection? So why are people with natural immunity required to get weekly tested by Biden's executive order but vaccinated not?
My assumption is that it's a combination of ease of documenting having received the vaccine (vis-a-vie the difficulty of establishing a prior infection, eg would a doctors note indicating an empiric diagnosis of covid count?) as well as not wanting to encourage idiots to throw 'covid parties' or otherwise attempt to get 'naturally' infected.
 
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While the research does show immunity from prior infection > immunity from vaccination, it also shows immmunity from prior vaccination + prior infection > either alone, so wouldn’t necessarily say it’s bad science. Might be desirable in the case of emerging variants.
 
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Somewhere prior @Birdstrike posted data showing that natural + vaccine immunity is the best.

In any event these vaccine discussions get so tiresome

Honestly I understand the "freedom to do what I want with my body" argument, but we don't have a societal construct that supports that desire without affecting other people's medical premiums. If people want to do what they want with their body, then they should pay every dime of their health care needs.

But we do not have a financial facility for this kind of thinking. So if my premiums are going to go up because other people want to do what they want with their bodies, then I get to, on some level, control their behavior.
 
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The problem is there are libertarians and conservatives who believe the above statement...knowing all too well that they will never be fully responsible for their own health care bill. Its like people wanting tax reform as long as it doesn't affect their own tax bill.
 
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Honestly I understand the "freedom to do what I want with my body" argument, but we don't have a societal construct that supports that desire without affecting other people's medical premiums. If people want to do what they want with their body, then they should pay every dime of their health care needs.
The counter argument comes from all those that are ‘healthy’ paying a ton for care not provided. I haven’t used a single bit of medical facility care in over a decade, but pay expensive insurance premiums year after year only for others to abuse the system with their constant trips to the ED for ridiculousness. My immunization status didn’t affect that narrative. Nor does it for many. I don’t criticize obese folks, diabetics or COPD’rs for seeking medical care that is almost entirely self induced. I’d prefer a pay for what you receive system with exceptions for societal paid care for aspects like not at fault trauma. I wouldn’t pay for expensive chemo if I got cancer. I also don’t really want elective surgery. If folks want those things, they can pay for them. Before you ask, I pay for insurance I case I happen to experience something like an unforeseen trauma that wouldn’t bankrupt me, but would otherwise be ridiculously expensive without insurance.
 
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While the research does show immunity from prior infection > immunity from vaccination, it also shows immmunity from prior vaccination + prior infection > either alone, so wouldn’t necessarily say it’s bad science. Might be desirable in the case of emerging variants.
I get it but if natural >= vaccine, then why does a natural need to get vaccinated to have the same rights as the vaccinated? That is my question.

Enlighten me. Because it comes across as more bad science giving more ammo to people who don't trust the government.

So as it looks like boosters help, are we going to force everyone to get a booster or have to get weekly testing like the natural group?
 
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Somewhere prior @Birdstrike posted data showing that natural + vaccine immunity is the best.

In any event these vaccine discussions get so tiresome

Honestly I understand the "freedom to do what I want with my body" argument, but we don't have a societal construct that supports that desire without affecting other people's medical premiums. If people want to do what they want with their body, then they should pay every dime of their health care needs.

But we do not have a financial facility for this kind of thinking. So if my premiums are going to go up because other people want to do what they want with their bodies, then I get to, on some level, control their behavior.
I’m pro-vaccine. However, what about other self inflicted diseases. Obesity; Are you suggesting:

Forced weight watchers? Bariatric surgery?

Diabetes: Forced in-home nutritional consults?

Drug or alcohol self-harm: Forced rehab?

All on the grounds that “If you raise my premiums, I take away your rights?”
 
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Somewhere prior @Birdstrike posted data showing that natural + vaccine immunity is the best.

In any event these vaccine discussions get so tiresome

Honestly I understand the "freedom to do what I want with my body" argument, but we don't have a societal construct that supports that desire without affecting other people's medical premiums. If people want to do what they want with their body, then they should pay every dime of their health care needs.

But we do not have a financial facility for this kind of thinking. So if my premiums are going to go up because other people want to do what they want with their bodies, then I get to, on some level, control their behavior.
I would say obesity has a bigger load on our health system than any other controllable healthcare costs. But no one in Washington will touch this with a 10 foot pole.

I would say if everyone was fit, the covid deaths/hospitalizations would go down greatly,
 
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I’m pro-vaccine. However, what about other self inflicted diseases. Obesity; Are you suggesting:

Forced weight watchers? Bariatric surgery?

Diabetes: Forced in-home nutritional consults?

Drug or alcohol self-harm: Forced rehab?

All on the grounds that “If you raise my premiums, I take away your rights?”
Politicians and people who hate Anti Vaxxers think inside a vacuum to fit their narrative. Obesity is the single biggest cost on health care. Obese = DM + Htn + lower immunity + Heart disease + Strokes.

I run 3 times a week, can do a half marathon without training. I watch what I eat. I don't smoke. I drink on occasion. Have been to the ER once when I was 18 with a sports injury.

Yet I pay for other people's bad choices. So the talking point that Anti Vaxxers are taking down the health system is a terrible point. If not for all the obese people in the hospital, there would be plenty of beds.

I am vaccinated
 
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I’m pro-vaccine. However, what about other self inflicted diseases. Obesity; Are you suggesting:

Forced weight watchers? Bariatric surgery?

Diabetes: Forced in-home nutritional consults?

Drug or alcohol self-harm: Forced rehab?

All on the grounds that “If you raise my premiums, I take away your rights?”
If we had an easy treatment with a 90% success rate in preventing any serious complications of obesity with minimal side effects, you better believe I'd say we should mandate it.

Sure a solid 50% of doctors would be out of work but it would be worth it.
 
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If we had an easy treatment with a 90% success rate in preventing any serious complications of obesity with minimal side effects, you better believe I'd say we should mandate it.

Sure a solid 50% of doctors would be out of work but it would be worth it.

I have an easy treatment for Obesity. I will say that I have no issues with Obesity and can lose weight quite quickly with minimal side effects. Just because people can't help but stuff their face with food while watching the Bachelor doesn't make losing weight hard.

5 yrs ago I went to get another life insurance policy and my regular check up had a slightly high cholesterol which would have affected my premium. So I went on a strict diet for 2 months, lost 5 lbs, and my numbers normalized. I would say that it was quite easy.

And before people jump down my throat, I am not talking about people with medical issues but the 95% that make poor choices.
 
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The counter argument comes from all those that are ‘healthy’ paying a ton for care not provided. I haven’t used a single bit of medical facility care in over a decade, but pay expensive insurance premiums year after year only for others to abuse the system with their constant trips to the ED for ridiculousness. My immunization status didn’t affect that narrative. Nor does it for many. I don’t criticize obese folks, diabetics or COPD’rs for seeking medical care that is almost entirely self induced. I’d prefer a pay for what you receive system with exceptions for societal paid care for aspects like not at fault trauma. I wouldn’t pay for expensive chemo if I got cancer. I also don’t really want elective surgery. If folks want those things, they can pay for them. Before you ask, I pay for insurance I case I happen to experience something like an unforeseen trauma that wouldn’t bankrupt me, but would otherwise be ridiculously expensive without insurance.

Ah but it does. it ever so incrementally adds cost to your premiums. Have you kept in touch with companies charging their employees who want to be unvaccinated more money?

Delta Airline Company estimates it costs them $50,000 for the average COVID-19 hospital stay. So they are charging those employees who want to remain unvaccinated an extra $200/month on their health care plan.
 
I’m pro-vaccine. However, what about other self inflicted diseases. Obesity; Are you suggesting:

Forced weight watchers? Bariatric surgery?

Diabetes: Forced in-home nutritional consults?

Drug or alcohol self-harm: Forced rehab?

All on the grounds that “If you raise my premiums, I take away your rights?”

Idealistically yes.

At least with things like obesity and smoking...the health harms are insidious and take decades to develop.

With COVID, you're a goner in 1 month!
 
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I have an easy treatment for Obesity. I will say that I have no issues with Obesity and can lose weight quite quickly with minimal side effects. Just because people can't help but stuff their face with food while watching the Bachelor doesn't make losing weight hard.

5 yrs ago I went to get another life insurance policy and my regular check up had a slightly high cholesterol which would have affected my premium. So I went on a strict diet for 2 months, lost 5 lbs, and my numbers normalized. I would say that it was quite easy.

And before people jump down my throat, I am not talking about people with medical issues but the 95% that make poor choices.
Weight loss isn't actually easy for everyone.
 
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Ah but it does. it ever so incrementally adds cost to your premiums. Have you kept in touch with companies charging their employees who want to be unvaccinated more money?

Delta Airline Company estimates it costs them $50,000 for the average COVID-19 hospital stay. So they are charging those employees who want to remain unvaccinated an extra $200/month on their health care plan.
I’m ok with higher premiums for conscious lifestyle choices that affect preventable illness. However, many don’t pay premiums so that doesn’t really work from a system standpoint.
 
The cost of obesity on society is greater than just healthcare. I weight 160. If someone weight 320, they will cost more gas/fuel to drive/fly thus more fossil fuel thus more CO2, thus worse climate.

If we really care about our healthcare system, we should attack obesity first and most diseases would drop drastically.

I am a protector/proponent of individual rights but if I were not/president, I would executive order that all obese people need to drop weight or they can't participate in society just as with covid antivaxxers.

Look at the morbidly obese people that continually come to the ER with their heart/kidney diseases. Even taking care of simple stuff like getting a gallbladder out makes everything 10x more complicated. Try to get an CT on a morbidly obese person and sometimes we have to send them out to the animal CT.
 
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Well sure, literal starvation will do the trick.

I've lost 27 pounds in 2 months doing OMAD or intermittent fasting. OMAD = one meal a day.

Was hard for the first week...but I've come to realize that we really don't need to eat 3x/day. The big fear is this notion that your hunger grows and grows and you just become miserable. That isn't the case. It comes in waves and when it does come it isn't profound. It's just normal, routine, hunger. I'll drink some water or green tea and it goes away.
 
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Somewhere prior @Birdstrike posted data showing that natural + vaccine immunity is the best.

In any event these vaccine discussions get so tiresome

Honestly I understand the "freedom to do what I want with my body" argument, but we don't have a societal construct that supports that desire without affecting other people's medical premiums. If people want to do what they want with their body, then they should pay every dime of their health care needs.

But we do not have a financial facility for this kind of thinking. So if my premiums are going to go up because other people want to do what they want with their bodies, then I get to, on some level, control their behavior.
That’s why delta airlines is charging their unvaccinated employees $200/ month more for their health insurance… sure
You may have the freedoms to make choices… but you have to face the consequences.
 
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funny story my dad, who barely graduated high school, had a hog farm for 40 years. Called me and asked if this ivermectim is the same stuff he sprayed on pigs back in the day for scabies. When i said yes, his response - why the hell would people take that??
I once had to use ivermectin cream for my guinea pig 😂
 
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I would say obesity has a bigger load on our health system than any other controllable healthcare costs. But no one in Washington will touch this with a 10 foot pole.

I would say if everyone was fit, the covid deaths/hospitalizations would go down greatly,
Or maybe if obesity was actually covered by insurance, then we could actually treat it…
 
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Well sure, literal starvation will do the trick.
I’ve spent a decent amount of time abroad. I have no sympathy for people that overindulge without discipline while people literally starve to death around the world. You want to complain that it’s hard to lose weight, then tell that to the person who has no food to eat. You seem very reasonable based upon your posting history. I doubt you disagree with me. This rant is more to the general public than to you.
 
Yet I pay for other people's bad choices. So the talking point that Anti Vaxxers are taking down the health system is a terrible point. If not for all the obese people in the hospital, there would be plenty of beds.

If we had an easy treatment with a 90% success rate in preventing any serious complications of obesity with minimal side effects, you better believe I'd say we should mandate it.

My sister is pulm/CCM and has, obviously, been inundated with wave after wave of COVID patients.

She and I were talking the other day and she wondered why an ICU full of obese diabetics who have had a cardiac procedure or an amputation, COPDers with failing lungs due to their 60 pack year history, or liver patients who drank a pint of scotch a day for years doesn't bother her nearly as much as an ICU full of unvaccinated people dying of COVID does.

And I think it's because the anti-vaxxers dying of COVID made one, very simple, easily reversible bad decision. Having COPD or obesity or diabetes or cirrhosis means a lifetime of bad decisions, but not any one single decision caused it - one fudge sundae didn't cause your diabetes, a lifetime of frequent fudge sundaes did. It's more bothersome to see a terrible disease from one single bad decision than to see a bad disease from a lifetime of dysfunctional behavior.
 
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My sister is pulm/CCM and has, obviously, been inundated with wave after wave of COVID patients.

She and I were talking the other day and she wondered why an ICU full of obese diabetics who have had a cardiac procedure or an amputation, COPDers with failing lungs due to their 60 pack year history, or liver patients who drank a pint of scotch a day for years doesn't bother her nearly as much as an ICU full of unvaccinated people dying of COVID does.

And I think it's because the anti-vaxxers dying of COVID made one, very simple, easily reversible bad decision. Having COPD or obesity or diabetes or cirrhosis means a lifetime of bad decisions, but not any one single decision caused it - one fudge sundae didn't cause your diabetes, a lifetime of frequent fudge sundaes did. It's more bothersome to see a terrible disease from one single bad decision than to see a bad disease from a lifetime of dysfunctional behavior.

Agreed and makes sense. I wrote something similar but not nearly as clear above.
 
I've lost 27 pounds in 2 months doing OMAD or intermittent fasting. OMAD = one meal a day.

Was hard for the first week...but I've come to realize that we really don't need to eat 3x/day. The big fear is this notion that your hunger grows and grows and you just become miserable. That isn't the case. It comes in waves and when it does come it isn't profound. It's just normal, routine, hunger. I'll drink some water or green tea and it goes away.
I lost 30 pounds over 5 months doing both intermittent fasting and weight watchers. I still do the IF most of the time to keep my weight down and balance out bad times like vacations.

My wife followed the exact same diet except with coffee (heavy cream only) in the AM. She plateaued at 8 pounds lost.
 
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My sister is pulm/CCM and has, obviously, been inundated with wave after wave of COVID patients.

She and I were talking the other day and she wondered why an ICU full of obese diabetics who have had a cardiac procedure or an amputation, COPDers with failing lungs due to their 60 pack year history, or liver patients who drank a pint of scotch a day for years doesn't bother her nearly as much as an ICU full of unvaccinated people dying of COVID does.

And I think it's because the anti-vaxxers dying of COVID made one, very simple, easily reversible bad decision. Having COPD or obesity or diabetes or cirrhosis means a lifetime of bad decisions, but not any one single decision caused it - one fudge sundae didn't cause your diabetes, a lifetime of frequent fudge sundaes did. It's more bothersome to see a terrible disease from one single bad decision than to see a bad disease from a lifetime of dysfunctional behavior.

What pisses me off is that obesity isn’t contagious. Yes it technically impacts others at a distance and more indirectly. Covid does not. It’s direct and serious. Your freedom ends where it impacts mine, and everyone else’s.
 
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The those who support Ivermectin use observational data (which unfortunately does not differentiate between correlation and causation and thus may not be reliable) and the fact that in-vitro, ivermectin has some activity in the first two categories. Does it have a clinical effect? Who knows. Does it cause harm when taken in the right formulation and at the right dose? Not according to what I've seen so far. Is it some sort of witch-doctor's brew that's absurd at first look? Hardly.
I would agree that ivermectin used in approrpaite doses for approved conditions is extremely safe and effective for those conditions. The problem is in order to get the in-vitro concentrations used in the studies you have to take approximately 72x (I can't remember the exact number) the recommended dose for its approved indications. At those doses, I would argue it is not "extremely safe" to use my previous words.
 
I would agree that ivermectin used in approrpaite doses for approved conditions is extremely safe and effective for those conditions. The problem is in order to get the in-vitro concentrations used in the studies you have to take approximately 72x (I can't remember the exact number) the recommended dose for its approved indications. At those doses, I would argue it is not "extremely safe" to use my previous words.

Ivermectin is just a proxy for the vaccine argument. It’s touted as a treatment for covid, so if there’s a treatment there’s no need to be vaccinated in the minds of many. It probably sucks as a treatment, but the UK study will answer this definitely.
 
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My sister is pulm/CCM and has, obviously, been inundated with wave after wave of COVID patients.

She and I were talking the other day and she wondered why an ICU full of obese diabetics who have had a cardiac procedure or an amputation, COPDers with failing lungs due to their 60 pack year history, or liver patients who drank a pint of scotch a day for years doesn't bother her nearly as much as an ICU full of unvaccinated people dying of COVID does.

And I think it's because the anti-vaxxers dying of COVID made one, very simple, easily reversible bad decision. Having COPD or obesity or diabetes or cirrhosis means a lifetime of bad decisions, but not any one single decision caused it - one fudge sundae didn't cause your diabetes, a lifetime of frequent fudge sundaes did. It's more bothersome to see a terrible disease from one single bad decision than to see a bad disease from a lifetime of dysfunctional behavior.
I was talking to my wife about this idea. Her response is that in reality, these people made lots of bad choices. They woke up every day, had the chance to incredibly easily go get vaccinated, and then they didn't. The next day, same choice. Eventually, that choice caught up with them. I agree it doesn't follow precisely the same timeline as the other conditions you mentioned, but it's the same thing as someone who habitually decides not to wear a seatbelt. Most days, that choice will be fine. Play the odds long enough though....
 
I was talking to my wife about this idea. Her response is that in reality, these people made lots of bad choices. They woke up every day, had the chance to incredibly easily go get vaccinated, and then they didn't. The next day, same choice. Eventually, that choice caught up with them. I agree it doesn't follow precisely the same timeline as the other conditions you mentioned, but it's the same thing as someone who habitually decides not to wear a seatbelt. Most days, that choice will be fine. Play the odds long enough though....
On a gut level, it does seem more frustrating when an otherwise rational person makes a catastrophically bad and senseless decision, as opposed to someone who seems to always make hopelessly bad choices. With the former we had hope. With the latter, we lost hope long ago.
 
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I have an easy treatment for Obesity. I will say that I have no issues with Obesity and can lose weight quite quickly.

It sounds like you've never struggled with obesity. That would suggest to me that you don't have a lot of wisdom to offer those who do.

I've never struggled with poverty, so I don't think I've got a lot of advice for those who do. If I tried it would go something like this:

Be born into a stable household where your parents send you to a good school every day with a full belly and no worries about your safety. Do well on your standardized tests so you can go to a good college and then graduate Phi Beta Kappa so you can get into medical school. Poverty = solved.

See how that doesn't really help someone struggling with poverty?
 
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What pisses me off is that obesity isn’t contagious. Yes it technically impacts others at a distance and more indirectly. Covid does not. It’s direct and serious. Your freedom ends where it impacts mine, and everyone else’s.

This is exactly it. Not keeping this central to any covid debate seems un-American as the preamble to the Constitution discusses the need to "promote the general Welfare." Trying to contain a highly infectious disease with meaningful morbidity and mortality is about as in-line with this as you can get.

For better or worse, the majority of Americans who are vaccinated probably wouldn't care nearly as much at this point if anti-vaxxers continued poor decisions only posed a risk to their own livelihoods...rather than the rest of the country.
 
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I was talking to my wife about this idea. Her response is that in reality, these people made lots of bad choices. They woke up every day, had the chance to incredibly easily go get vaccinated, and then they didn't. The next day, same choice. Eventually, that choice caught up with them. I agree it doesn't follow precisely the same timeline as the other conditions you mentioned, but it's the same thing as someone who habitually decides not to wear a seatbelt. Most days, that choice will be fine. Play the odds long enough though....

So, I think that I would have agreed with her maybe 6 weeks ago. When I talked to unvaccinated patients in our clinic 6 weeks ago, we could actually talk about the vaccine. They would have questions, and I would answer them. It seemed like they were still "weighing the evidence" and actually thinking it over.

Now, at least in the outpatient clinic setting here in Miami, the unvaccinated patients don't even have a reason for not getting vaccinated. When you ask, they just say, "I just don't want it and that's that." It's like they closed a mental door somewhere. All the excuses that we used to hear ("I'll wait until more people get it," "It's still experimental, I'll wait until it gets full FDA approval," "I don't know where to get it") don't hold up anymore, and so they've just decided that, for whatever reason, they're not going to get it and they're not even up for talking about it anymore. Their minds are made up, so it's not like they're constantly re-evaluating and deciding not to get it each time. They've decided once and for all that they're not getting this vaccine and I don't know what it will take to change their minds.
 
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I’ve spent a decent amount of time abroad. I have no sympathy for people that overindulge without discipline while people literally starve to death around the world. You want to complain that it’s hard to lose weight, then tell that to the person who has no food to eat. You seem very reasonable based upon your posting history. I doubt you disagree with me. This rant is more to the general public than to you.
You do realize that no food is a problem here too, right? Unless you consider Taco Bell, McDonald’s, BK, etc to be food…

there are lots of barriers to eating well… I’m not going to say that we are not a culture of over indulgence… we are… plates that we use for meal here are serving platters in other countries… you can’t get a 3 oz piece of meat in a restaurant.
But when say you have $5 to spend for a meal… you can get a huge Taco Bell box or a few apples…when a person is hungry, which do you think people pick?

obesity isn’t really looked at as a disease state or something that needs to be treated… it’s thought to be about people not being disciplined enough to eat right…

people are not taught about what is good for them and what is bad for them… they may think they are doing what’s healthy but they need the education to understand what is healthy.
And, well, medicine is not focused on prevention… but treatment… the surgeon that cuts out something gets paid more than the physician counseling… that needs to change.
 
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So, I think that I would have agreed with her maybe 6 weeks ago. When I talked to unvaccinated patients in our clinic 6 weeks ago, we could actually talk about the vaccine. They would have questions, and I would answer them. It seemed like they were still "weighing the evidence" and actually thinking it over.

Now, at least in the outpatient clinic setting here in Miami, the unvaccinated patients don't even have a reason for not getting vaccinated. When you ask, they just say, "I just don't want it and that's that." It's like they closed a mental door somewhere. All the excuses that we used to hear ("I'll wait until more people get it," "It's still experimental, I'll wait until it gets full FDA approval," "I don't know where to get it") don't hold up anymore, and so they've just decided that, for whatever reason, they're not going to get it and they're not even up for talking about it anymore. Their minds are made up, so it's not like they're constantly re-evaluating and deciding not to get it each time. They've decided once and for all that they're not getting this vaccine and I don't know what it will take to change their minds.
Talking about their goals of care and do they want to be DNR?
 
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So, I think that I would have agreed with her maybe 6 weeks ago. When I talked to unvaccinated patients in our clinic 6 weeks ago, we could actually talk about the vaccine. They would have questions, and I would answer them. It seemed like they were still "weighing the evidence" and actually thinking it over.

Now, at least in the outpatient clinic setting here in Miami, the unvaccinated patients don't even have a reason for not getting vaccinated. When you ask, they just say, "I just don't want it and that's that." It's like they closed a mental door somewhere. All the excuses that we used to hear ("I'll wait until more people get it," "It's still experimental, I'll wait until it gets full FDA approval," "I don't know where to get it") don't hold up anymore, and so they've just decided that, for whatever reason, they're not going to get it and they're not even up for talking about it anymore. Their minds are made up, so it's not like they're constantly re-evaluating and deciding not to get it each time. They've decided once and for all that they're not getting this vaccine and I don't know what it will take to change their minds.
Close friends/family dying of COVID is the only thing I've seen at that point, and that's not even a guarantee.
 
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Talking about their goals of care and do they want to be DNR?

Sadly, I have actually tried that. I just get a blank look and "I'm not going to get COVID. I wear a mask." Or "I'm healthy, I'm not going to get that sick." There's so much magical thinking and denial.

The one that continues to bother me is a patient who is in her late 50s. Overweight, hypertensive, pre-diabetic, smoker. She had some BS reason for not getting the vaccine. I've taken care of her for some time, so I know that she has one child, who is 19, and no relatives - her parents died, she has no siblings, estranged from her ex-husband, and only the one child.

I told her that, with her medical history, if she gets COVID, she's at high risk for complications. If she ends up intubated in the ICU, or with a massive stroke or heart attack from a thrombotic event, her 19 year old daughter is going to be forced to make some very very difficult decisions for her - decisions that no 19 year old is at all equipped to make. If she dies, her daughter is going to have to survive on her own - which will probably mean dropping out of college and working a minimum wage job at McDonalds or Starbucks. Who knows if she'll ever make her way back to college?

When I painted this nightmare scenario for her, she just shrugged and said, "Well, I don't think I'll get COVID."

:bang:
 
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You do realize that no food is a problem here too, right? Unless you consider Taco Bell, McDonald’s, BK, etc to be food…

there are lots of barriers to eating well… I’m not going to say that we are not a culture of over indulgence… we are… plates that we use for meal here are serving platters in other countries… you can’t get a 3 oz piece of meat in a restaurant.
But when say you have $5 to spend for a meal… you can get a huge Taco Bell box or a few apples…when a person is hungry, which do you think people pick?

obesity isn’t really looked at as a disease state or something that needs to be treated… it’s thought to be about people not being disciplined enough to eat right…

people are not taught about what is good for them and what is bad for them… they may think they are doing what’s healthy but they need the education to understand what is healthy.
And, well, medicine is not focused on prevention… but treatment… the surgeon that cuts out something gets paid more than the physician counseling… that needs to change.
I used to say that the US is the only place you see fat poor people. Everywhere else, the poor were skinny/emaciated.
 
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You are missing the point. Invermectin has been caught up in politics and the drive to get everyone vaccinated. Anything that even hints at working is dismissed b/c Biden wants everyone vaccinated. If you prescribe invermectin that has little side effects, you will be reported and potentially kicked off the medical staff.

But when sepsis protocols were pushed, people who clearly was not septic/needing admission was getting an IV/abx/2L NS ordered before I even saw them. I can't tell you how many times I cancelled orders when the pt came back looking great with probably rhinovirus. That was and IS bad medicine.

Do you not realize that Dex is NOT recommended in outpt covid treatment?

Even if you got covid, have natural immunity likely equal to the vacinnated, you are still condemned until you get a shot. Can someone show me a study that shows someone that got covid somehow needs to get vaccinated? I remember studying something in medical school that said when you caught something, you have immunity to it.

Please someone send me a link to a study that shows someone with natural immunity has less protection than someone vaccinated because seems like they are black listed.
Oh yeah I agree with you. Ivermectin for sure has been politicized. Still think it’s pretty far fetched to even consider prescribing it.
And yeah I only give dex to hypoxic admitted Covid patients.
 
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