Always strive to learn something useful. --Sophocles

Friday night's dinner: leftover pizza from Thursday, plus two pieces of garlic cheese Texas toast.

Not terribly challenging food, right?

Broke a tooth. ON THE TEXAS TOAST!

My right upper 'pre-molar'.

Amazingly, it turned out that my dentist has full hours on Saturday! Even more amazing, they were able to get me in!

And the really cool part? They have a computer-controlled milling machine and MADE ME A NEW TOOTH WHILE I WAS THERE! In and out in 2.5 hours, completely done (unless a problem comes up), and total out of pocket about $375!

I was fortunate in that it didn't cause any hot/cold sensitivity, just pressure, so it wasn't too bad overnight or today before the appointment, and the entire process wasn't too bad, once I was able to wrangle my body into a better position in the chair. I have three fused vertebrae in my neck, and turning my head to the right for a prolonged period of time is a non-starter, but scootching my entire body over and lying more on my right side, that works just fine.

It was a lot less expensive proposition, and simpler solution, that what I was horrifiedly extrapolating in my mind. So that was a good thing. Really, aside from disrupting my entire day, no down side out of it: tooth is fixed, had some really good fish tacos for dinner and brought back some Al Pastor tacos for the spousal unit, picked up some stuff at Target and Sprouts, and got in quite a bit of studying in for my radio license testing over dinner.

Regardless of the severity of your symptoms, vaccination status, or how you were treated for the virus, they would like to hear from you. The survey is anonymous and will take 20-30 minutes of your time.

You will need to know dates of when you were sick and when you were vaccinated.

https://covid-long.com/

Last December a City of Reedly (close to Fresno, CA) code enforcement inspector was driving in a warehouse district and noticed something that should not be: a water hose going into a supposedly unoccupied warehouse. His followup discovered a pharmaceutical lab housed inside.

The lab had twenty-some infectious agents, including Covid-19 and HIV. It also had genetically-engineered mice, many dead.

From the article: Jesalyn Harper, the city of Reedley’s code enforcement officer, thought the call would be routine - following up on an anonymous complaint about a business operating without a permit in an old warehouse. But when she found a jury-rigged garden hose sticking through a rear wall and a ventilation fan blowing foul-smelling air through an opened back door, things took a turn.

Harper knocked on the front door of the decades-old cold-storage warehouse for an inspection. What she discovered inside on that December day was almost the stuff of science fiction: Dozens of refrigerators filled with vials of blood, viruses and bacteria; containers of chemicals; hundreds of laboratory mice; and an array of stored laboratory equipment – all inside an unpermitted business operating illegally.

“I wasn’t looking for an unpermitted lab,” Harper told The Fresno Bee this week. “I was just looking for an unpermitted business.”

Prestige Biotech Inc., a company whose owners live in China, was using the building near Reedley’s downtown for storing and shipping an array of diagnostic test kits for COVID-19, pregnancy, drugs and more after apparently being booted out of their Fresno location in late 2022. The inventory of biological agents in the refrigerators include coronavirus and other exotic contagions, such as malaria, Hepatitis B and C, chlamydia, human herpes, and rubella, among others, used in the production of various test kits.

It is quite a story. The company had been kicked out of several sites before popping up in Reedly.

https://www.fresnobee.com/news/local/article277836263.html


And it gets worse. The FDA has issued a safety alert on several pregnancy test kits from several brands that may have been made from this outfit!

https://arstechnica.com/health/2023/08/dont-use-pregnancy-tests-linked-to-illegal-california-lab-fda-warns/

Long Covid is closer to being considered an umbrella descriptor to what may be described as any of several different types of causes: autoimmunity, immune system dysregulation, organ injury, viral persistence, and intestinal microbiome imbalances (dysbiosis). A study recently published in JAMA, the Journal of the American Medical Association, of 9,700 patients, applies weighting to take that list of 200 common symptoms down to twelve.

From the article: "They came to a core list of 12 symptoms and assigned each symptom a score that represented the odds of it being related to COVID-19. The scores for each of the 12 symptoms ranged from 1 to 8, and the researchers added up the symptom points for each person in the trial. Based on the spectrum of score totals seen among uninfected people, the researchers concluded that a score of 12 was a reasonable cutoff for determining if someone had long COVID. And that cutoff was validated when they looked at how it correlated with the participants' reports of quality of life and health."

They are:
Symptoms Score
Loss of smell or taste 8
Post-exertional malaise (feeling tired after minor physical or mental activity) 7
Chronic cough 4
Brain fog 3
Thirst 3
Palpitations 2
Chest pain 2
Fatigue 1
Changes in sexual desire or capacity 1
Dizziness 1
Gastrointestinal symptoms 1
Abnormal movements 1
Hair loss 1


https://arstechnica.com/health/2023/05/long-covid-is-still-a-puzzle-but-scientists-identify-12-core-symptoms/

Reading about conuly having problems getting much needed antibiotics, I decided to share this.

In January I stopped taking a med. The previous October, when I was in Phoenix after my dad passed, I had to bend over backwards to get this particular med: I think there were only two Walgreens in the greater metro area that carried it. Come December, I'm back home and out. And the refill is $150!!!

Call the doc, tell them to put me back on the older stuff, a much older drug that's generic and really inexpensive. And it goes back and forth: the pharmacy fax number is down, we called it in, we have to get insurance approval, we called it in, etc. Yet somehow the pharmacy never got the order.

I had a back stock of an older version of the med that I consumed. And when that was gone, spacing out the final few pills in the vain hope that a refill might come through, I stopped taking it.

It was pure front office/management problems that prevented me from getting this Rx filled.

Tuesday I see the NP at the practice again. I see them every five months or so. And we definitely have something to talk about.

The flavor of doctor: NEUROLOGIST.

I hope I elicited a collective gasp.

I have two neuro problems: essential tremors and occasional migraines in the form of brief spike headaches that are normally very consistently located about an inch above my right ear. Essential tremors can resemble Parkinsonism, involuntary shaking. ET is diagnosed when they eliminate the symptoms of Parkinsons and several other muscle spasm conditions - diagnosis by default. We don't know why you're shaking, therefore you have ET.

I was diagnosed with it about 20 years ago, hard to believe. It wasn't a constant thing except early on, it eventually calmed down and would only come back in spurts. We found a connection - but no explanation - to me being physically ill, it acted as a harbinger to let me know there was an illness looming for me, and it was pretty darn accurate.

The migraines, or spike headaches as I called them, were always brief, no more than about 5 seconds, and had no lingering aftereffects like some people get with bad migraines. I don't remember exactly when they started, but they definitely got worse when I was doing database programming at the blind school.

When the migraines started shifting to different locations around my head, but not changing in duration or intensity, the neurologist put me on an anti-convulsant typically used for epileptics, but at low doses found to be effective at controlling migraines. I was on a very low dose to start, just 25 mg, we slowly increased that to 100 over the course of a few years.

And since I stopped taking the med, I haven't had any problems. An occasional headache, but not a spike migraine. No tremors, either, and that's the weird part as I've definitely had a couple of illnesses, a nasty little GI problem a couple of weeks ago, Covid last week, etc. Zero tremors.

Yes, I absolutely know you're not supposed to discontinue a medication unless you're coordinating with a doctor. And a neurological med that should be all the more important! I didn't do this casually, I really had no choice. And I had already begun stepping down my dose over a couple of weeks - which was already a low dose - and had no problems.

So Tuesday's appointment is going to be quite interesting. The question will be whether I should find a new neurologist who has a better staff to get things done.

There's a company out there, Masimo, VERY well known in the medical field as it's the leading maker of pulse oximetry sensors for hospitals and professionals.

A decade ago, Apple had a big meeting with Masimo over their SpO2 tech. And later hired ten Masimo engineers, including their Chief Medical Officer. Masimo has had a long-standing battle against Apple for infringing their patents in the Apple Watch Series 6 and later.

And Apple just lost.

Masimo is seeking an import ban, which would utterly gut Apple's Watch sales until they either license Masimo's patents or invent their own tech from scratch. I think a cross-licensing deal is the most likely outcome.

There's one very significant difference between the two company's engineering. The Masimo line uses an LED and receptor to send light through your finger or earlobe to measure your blood oxygen, apparently based on blood color. Apple's is able to read it from a single point of contact, but apparently stole Masimo's intellectual property to develop that.

https://9to5mac.com/2023/01/11/apple-watch-patent-infringement/

https://yro.slashdot.org/story/23/01/12/225234/apple-watch-patent-infringement-confirmed-as-masimo-seeks-import-ban

Name the movie that line came from and win a Kewpie doll!

Not really, I don't have any Kewpie dolls to give away.

Anyway, the most recent drug I was put on was yet another respiratory drug to improve my lung function called Serevent Diskus. My immunologist, who is effectively my PCP (primary care provider) saw a lung function test and thought there was room for improvement in my small airway passages. And this drug delivered! It did improve those areas.

The problem was that it was $120 a month for the blasted thing. One of the reasons why it's so expensive is that it's very new and thus still under its original patent and no generics available.

That is, until last month, when it became $170 a month.

I don't know if Walgreens is gouging or the vendor is gouging or who, but I'M TIRED OF BEING GOUGED!

And now it is time for me to order refills!

Now, I'm constantly pressured by my pharmacy benefits manager (PBM) to get all of my meds in 90 day supply from them. "It will save you money!" Yeah, while simultaneously enriching you further and taking money out of my local tax base. No effing thanks!

Well, screw this. I went on their web site to price this drug. Three month supply of the exact same drug? ONE HUNDRED FORTY DOLLARS. And free shipping if I don't mind getting it in 3-5 days.

So I subscribed. I have about 17 days remaining in my current one, which is plenty for them to get me a fresh shipment. And I'll do just fine without it for some time.

I don't get my meds from my PBM for two reasons. The biggest is that it takes dollars out of my local area that directly fund jobs and the tax base. The other is that the PBM already makes a ton of money from me, so screw them. But this is too much. This is over a 4x markup on this stupid drug that has a small but measurable improvement in my health. Ignoring the fact that lung function is important to everybody's well-being, it's very important in mine in that I'm especially susceptible to pneumonia, so the goal of all my meds is to keep my lungs in as great of shape as possible so they can fight off pneumonia if it comes a-knockin'. So I need this stuff, and not at a 4x+ markup!

I'll bet Mister Martin "Pharma Bro" Skrelli, sitting in prison, would say something like "But it's just money, bro! Earn more!" That's not how the world works, and I'm not the one sitting in prison.


And while I won't name the movie, it had a lot of up and coming stars, was released before the turn of the century, and among its stars are Jeff Goldblum, Robert Ito, John Lithgow and Christopher Lloyd.

Apple never confirms rumors prior to the product launch event, but it is rumored that the Watch 7, which will be revealed (I think) in September or October and usually released a month later, will have the ability to record real-time glucose information! This will be a major thing for diabetics and pre-diabetics! And if you're not one of those two, you can still record and log the information and see if you have a trend developing or not.

Apple has been introducing medical monitoring sensors progressively with their watches. The article mentions that Tim Cook, CEO of Apple, says 'we have all these sensors for our cars, and our bodies are far more important.' I completely agree! I personally have little need for a pulse monitor because I'm not an exercise junkie, then I read that article about smart watches detecting COVID early. Now I love the idea!

The Apple Watch 4 had a pulse monitor, the 5 introduced a three-lead ECG, the 6 an SpO2 sensor. The Apple Watch 7 will not be the first smart watch to feature glucose monitoring, apparently Samsung did that with their Watch 4. Still, lots of people prefer the Apple environment, so this opens up that tech for them.

The Apple Watches only work with Apple iPhones and you must have one to configure it and log medical data (you might be able to use an iPad to do that), I don't know if the Samsung watches will work with iPhones or if they require Android phones.

I was reading the comments on the Slashdot thread about this, and some people think it is reading glucose in the interstitial tissue, not directly in blood vessels. This makes sense, as blood vessel positioning is not only variable from person to person, but you might change where you wear your watch during the day, or it might shift a little. Thus an interstitial measurement might make more sense for a little more consistency in measurement. This makes the question of how fast reacting is that measurement compared to blood levels from an event like taking Glucophage is downing a soda or something. I'm not diabetic, I've never studied the disease, I really don't know. Ask me questions about hypogammaglobulinemia, and I can speak with some limited authority.

Still, from what I've read about the accuracy of some of the real-time monitors, it can't be any worse! And if it greatly reduces the number of needle sticks, it will definitely be a blessing.

https://www.macrumors.com/2021/01/25/apple-watch-series-7-blood-glucose-monitoring/

Very brief - on rare occasion I'm capable of brief posts!

There's nothing wrong with walking 10,000 steps, it's perfectly good exercise. I remember reading long ago that the best exercise program is swimming (multiple styles) alternated with running or cycling. Swimming gives you multiple muscle group workouts with resistance and is low-impact, but doesn't give you good cardio.

Basically you'd alternate, daily, swim on day 1, cycling day 2, etc.

Cycling is good cardio and low-impact. Running is good cardio, but not low-impact.

Unfortunately I'm a horrible swimmer: dense bones, fairly negatively buoyant. But walking in water at neck height is also good exercise: resistant and low impact, just doesn't work as many muscle groups.

Just wow.

She "had just returned from a trip to Vietnam, where there has been widespread measles activity, according to “Inside Edition.”

The woman was unaware she was sick when entered the theater at 11 p.m. Thursday. She didn’t leave until 4 a.m. Friday, and she went to the emergency room later Friday.

The woman is now under “voluntary isolation” at home."

So the people who worked at the theater were exposed. Everyone in the presumably packed theater were exposed. Everyone at the ER were exposed. A third address is listed in the article.

I don't get why she wasn't vaccinated before she left for Asia. She's described as a 20something: even if her childhood vaccinations were still strong, she should have been re-vaccinated before going to SE Asia.

https://www.huffpost.com/entry/woman-measles-avengers-endgame-audience_n_5cca0838e4b0d123954dd3a1