If I were in charge of the public health response to COVID-19, I would implement the following:
Pharmacy Boards should never get between a doctor and patient except in matters of life and death or illegal practice. Politicians, State Medical Boards and our House of Medicine professional organizations should defend our legal practice of medicine rather than threatening physicians and changing the rules during a pandemic.
2. Encourage shared information & fact-checking among physicians as part of our missions of education & transparency.
JAMA review of masks, August 2020
4. Where a high percentage of the local population tests positive, local authorities should consider – and have the ethical responsibility to – impose higher isolation measures like masks and public distancing. The threshold for mandates must be locally determined with public input, and explained – clearly, frequently.
This means you, anti-maskers!
5. Stress that surgical procedure masks are nearly as effective as N95 masks, blocking nearly as much aerosols and viral particles for both wearer and those around us. Medical providers and those with a high risk of prolonged close contact need fitted N95 masks, the rest of us don’t.
Single layer cut-up T-shirts and homemade masks, balaclavas or bandannas, aren’t very effective protection at all, either for the wearer or the people around us. N95 Masks with single valves are a money-maker, but not nearly as effective as surgical masks, even with an added filter layer.
8. Begin early prophylaxis with hydroxychloroquine/zinc and/or inhaled steroids for the willing & likely exposed.
REFERENCES
Treatment dosing (always allowing treating physicians who prescribe determine need & frequency of alternate doses & monitoring)
This isn’t a prescription!
Hydroxychloroquine: 400 mg. twice on day one then 200 mg. twice a day for either 5 or 10 days;
Azithromycin: 250 mg. tablet, 2 on day one, 1 on day 2 to 5;
Budesonide: unit dose via hand held inhaler or nebulizer twice a day. (I’m looking for references for this one. )
Zinc 150 mg. to 250 mg. a day indefinitely. (Best evidence for lozenges or syrup multiple times a day. See references.)
Vitamin D, 1000 IU a day, up to 4000 IU is safe
Vitamin C, No set dose, but extra will be excreted in the urine or feces, can cause diarrhea.
References
Journal of the American Medical Association review. Published August 11, 2020. (Free, with Tables)
CDC recommendation on cloth masks:
https://wwwnc.cdc.gov/eid/article/26/10/20-0948_article
John’s Hopkins recommendation:
Zinc:
https://www.uchealth.org/today/zinc-could-help-diminish-extent-of-covid-19/
Journal article on treatment for the common cold: https://www.acpjournals.org/doi/10.7326/0003-4819-125-2-199607150-00001
Hydroxychloroquine/azithromycin protocols
International Journal of Infectious Diseases (Henry Ford or Ashad report):
https://www.ijidonline.com/article/S1201-9712(20)30534-8/fulltext
https://www.ijidonline.com/article/S1201-9712(20)30600-7/fulltext
On synergistic effect of hydroxychloroquine plus steroids:
https://www.ijidonline.com/article/S1201-9712(20)30613-5/fulltext
Budesonide
Description of study in progress on treatment for loss of smell in patients without severe symptoms:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7370627/
Vitamin C safety:
Note: comments are off. Please comment on my Facebook page, Beverly Nuckols.
Edited 31/08/20 12:30 for mis-spellchecked word. BBN
A long post written for Facebook, pretty much self explanatory:
Friday, as I often do, I wrote a blog for WingRight about (and posted an additional link to an informative interview with) Dr. Scott Atlas.
Although I seriously considered tagging you, I decided not to. I certainly don’t add the heading, “to my Democrat friends.”
I enjoy discussing ideas, ethics, and politics, but try to avoid disharmony and criticising personalities as much as possible. I’ve muted your posts because the hostile tone and – frankly – the rude and sometimes obscene posts from your other friends.
Did you hear about the peace deal brokered by President Trump between Israel and the United Arab Emirates? The expectation is a domino effect among other Middle East nations.
As to the new Postmaster General: Mr. DeJoy ran a successful and profitable freight and supply chain business for 35 years.
The mail delivery horrors you list are pure politics and distraction. We have a PO Box in the USVI, but, as with our businesses in the US, we have always used FedEx for time-sensitive mail. Even Amazon had slowdowns over the last 5 months, due to volume, staffing difficulties, and the practical matter of barriers to product delivery from (China) foreign manufacturers.
The collection box removals have been going on for years. The changes in the USPS are reportedly being made to improve productivity, but politics…
Assume Democrats that oppose the President, as well as Republicans that support him, work for the post office and that Republicans want every one of their ballots properly and efficiently delivered, too.
For the response to COVID-19, I recommend the interview between Dr. Atlas and Peter Robinson on Stanford University’s Hoover Institute “Uncommon Knowledge.”
The facts are that most virus mitigating measures were State responsibilities and there is no legal way for Federal involvement.
It’s not “all age groups.” Under 60 years old, the risk of severe illness is equal to the risk from influenza.1/2 of cases are asymptomatic or very mild symptoms. 99% of deaths are in people over 25 years old.
2/3 of deaths in many states were nursing home patients. 80% in Michigan. (The latest rumor is that it was *intended* by the Democrat Governors to cut the elderly population.)
The “killing” happened due to 1.) failing to protect our elderly and forcing nursing homes to accept COVID-19 positive patients and 2.) lost lives and years due to the lock downs, closing schools, and destruction of the economy. Excess deaths are greater than those explained by the virus. (Deaths due to delayed treatment for strokes, heart attacks, cancer, but as high as a 35% increase in some areas of Michigan, in ER visits for severe child abuse.)
California served as a lab for testing draconian methods like prolonged lock downs, chained parks & banned beaches, even requiring masks while exercising out doors, i.e., running and cycling! Yet, the hospitalizations, and deaths equal or exceed States that reopened, like Texas.
I had hoped that naming Harris as nominee for VP candidate would stop the Democrat talking points about adultery. At least no one claims that Trump built his career by an affair with a married power broker.
And, since you bring it up, “bullying” should be off the table, too. Harris put people in jail for marijuana, blocked possibly exonerating DNA evidence in a death row case and kept people in jail after they should have been released. This fact check from January, 2019 about Accusations made by Biden and others, is actually very fair,
The Epstein talking point conveniently skips the history: Trump banned Epstein from his properties back in the early ’90’s, after the sexual predator was exposed. The one woman who claimed to connect Trump & Epstein filed and dropped 3 suits in 2016, using a fraudulent address in the first.
Trump explained the comment about Maxwell: his 1st thought, like that of many of us, was that Epstein didn’t kill himself.
My politics focus in ethics and defending inalienable human rights and the Constitution. Abortion infringes the right not to be killed and mocks the concept of all the rest.
Even the 2nd Amendment goes beyond defending and enforcing the 1st Amendment and the rest of the Constitution: the right to self defense is a corollary to the right not to be killed.
You should really lose the accusation about children in cages since those pictures were from 2014, Obama’s ICE. The result of the huge caravans.
The rest of your comments are pure opinion, even going so far as to ask whether Melania is happy.
Ending on a positive note: Trump isn’t racist!
Dr. Scott W. Atlas, former Chief of Neuroradiology at Stanford University Medical Center, current Senior Fellow at Stanford’s Hoover Institute, author, and public health policy consultant was added to the White House COVID-19 task force this week. Unfortunately, he and his appointment have already become a political target by some.
Far from being unqualified, or someone who “clearly wouldn’t know science if it kicked him in the atlas” (see above link – I refuse to give clicks to the original source or the ignorant woman who spoke those words), Dr. Atlas speaks common sense, science-based truth, as in this video from 23 June, 2020 interview with Peter Robinson of the Hoover Institute’s. “Uncommon Knowledge.”
In fact, Dr. Atlas states what I’ve been saying since I heard about the virus outbreak in Italy, while attending Carnivale parades just a few miles away in
Carnivale float, Nice France, depicting Chinese labor in Fashion industry.
Nice, France: the reaction by governments and fearful people has been just as bad if not worse than the results of the infection itself.
The initial lockdown was correct, but we have new data – and new models – every day. Yet, we are still acting as though the early models were accurate.
Worse, instead of “flattening the curve,” the call is to conquer or eliminate the virus “at all costs.” The latter has never happened and will never happen with a Coronavirus. There is the possible exception of the elimination of smallpox, a much more deadly disease, at the cost of egregious human rights violations and even deaths.
I’m surprised that anyone would attack Dr. Atlas or his qualifications. Before you dismiss him, please listen to his testimony and critique the facts rather than the source.
14 minute interview with Houston TV reporter.
She’s a warrior, all right! Worth your time!
I would like to see some data, but lots of other doctors report the same results, and I’d like to see some of their patient information, too. (Ages, other meds, vitals, timing, symptoms.)
She does say wear a mask if you can’t be on prophylaxis and to make other people comfortable. I would call her regimen a “treatment” rather than a “cure.”
But the biggest fuss has been about Dr. Immanuel’s religious beliefs. I’ve heard Baptist, Assembly of God, even Church of Christ preachers say much the same about the hidden powers in the world. Maybe not the origins, but their existence and, as Jesus Himself said, the need for prayer and fasting to deal with them.
I’ve been told that her religious views are a distraction and counter-productive for the Medical issues and “science.” But Dr. Immanuel doesn’t even bring up her religion until she’s questioned in this interview and didn’t bring it up at all in DC.
The detractors don’t understand the cultural background and how many Christians – across the spectrum from those who believe in the indwelling of the Holy Spirit to those who only remember the story of St. Michael – will recognize the theme.
Were you triggered by the religious views of Nigerian born and trained, Texas licensed and practicing, Dr. Stella Immanuel?
(As of Midnight, 30 July, the video was available at https://www.bitchute.com/video/09K3kIwzeewO/?fbclid=IwAnR2E-LChNhpqOktcV4GPeT0ZS79cdf1tjdlnfNSlpGNWMCW6vVYYnHLCbjU so I was able to watch the rest of the docs.I am impressed especially by Dr. Joseph Ladapo, beginning at minute 33.)
CNN has an opinion piece disguised as a report on yesterday’s “hearing” with Attorney General William Barr. Even as the author, Jerry Herb, repeatedly declared statements by Barr and President Trump as “false,” he took note of the poor treatment of Barr by the Democrats.
“Jerry Nadler of New York and the panel’s Democrats did not offer Barr any niceties congressional witnesses typically receive. Democrats repeatedly cut off Barr’s responses, accused him of being wrong or lying and made clear they weren’t interested in the explanations he was offering. Barr wasn’t allowed extra time at the end of each lawmaker’s five minutes to respond to questions that witnesses typically receive — forcing Republicans to use their time to let Barr push back on the Democratic accusations.”
(“I’m reclaiming my time!” “I’m reclaiming my time!” “I’m reclaiming my time!” It started sounding like one of the rioter’s chants.)
There were few questions with an opportunity to answer, only
character attacks and accusations that the AG is guilty of politics and doing the bidding of the President. (Wingman?)
More than once AG Barr was accused of racism and causing people to die. One man flatly declared that the Attorney General of the United States was guilty of breaking his oath of office. And, of course, there were threats of impeachment.
Is there supposed to be a “quota?” Isn’t hiring according to race the definition of “racism?”
I kept waiting for someone to have a stroke – not the AG, he was usually amazingly cool and calm.
(Or spontaneously combust?)
General Barr is, however.
(This is an edited version to clear up typos.)
“Police made no effort to interfere…” This is happening to Americans all over the US and multiple factions compare their opposition with the abusers of Nazi Germany.
There’s been looting and vandalism in broad daylight, and 2 months of nightly destruction of property and fires in Seattle, Washington and Portland, Oregon. (And Atlanta, Georgia, New York City, Chicago, Minneapolis, St Louis and virtually every large city in the US) This weekend in Columbus, Ohio, a peaceful rally was disrupted by obscene “Black Lives Matter” protestors, with one woman waving what looks like severed male genitals (here, at about 6:35).
Local police are being *ordered* to stand down and limit their efforts to interfere by Mayors and Governors, but when they do – or Federal law enforcement is sent in – who is criticized, even called the “Gestapo?”
House Majority Whip James Clyburn, D-S.C., compared federal law enforcement in Portland to Nazi Germany’s Gestapo police force on Monday.
Sometimes, even “Black Lives” are victims of both vandalism and assault.
The parallels with Kristallnacht are not precise, but they’re there: the rioters have unofficial approval from the same local governments that are throttling down law enforcement. Only, this time, another governing body would stop the vandalism if allowed.
The question is not whether Godwin’s law has been broken, but whether we learned anything from history in general. I’m also reminded of the chair of the French Revolution which ended when the original leaders were sent to the guillotine, and George Washington’s response to the Whiskey Rebellion with an army of Federal soldiers attacking members of the mob who were accused of harming Federal agents and burning the home of one a official.
How long will the voting public allow their elected officials to be “distracted” by the anarchy and politics?
(Edited for grammar 21/07/20 17:30. BBN)
We made every decision in Stone’s case, as in all our cases, based solely on the facts and the law and in accordance with the rule of law. The women and men who conducted these investigations and prosecutions acted with the highest integrity. Claims to the contrary are false.
Mueller must live in some alternate reality. Since we know that Mueller’s team didn’t uncover the lies used against Carter Page or Michael Flynn – and some of them actually were the ones who lied – how can anyone believe that the Stone prosecution was more honest? Why are we supposed to accept that no evidence in favor of Stone has been withheld, no accusations are known to be false?
The Mueller investigation and charges and even the whole FBI surveillance of the Trump Campaign reminds me of 1995/96 when I was foreman on a Federal District Grand Jury in San Antonio during Bill Clinton’s impeachment hearings for perjury & obstruction of justice. Many times, when I swore in a witness, some jury members and even the witness would laugh. “Nothing but the truth.”
Integrity? Laugh or cry.
“”You had this political conspiracy theory that the deaths in nursing homes were preventable,” said Mr. Cuomo.””
At a press conference today, New York Governor Andrew Cuomo insisted that his March order requiring NH’s to accept COVID positive patients from the hospital didn’t cause deaths – in spite of the fact that it’s estimated that those orders caused more than 6300 such transfers.
Click to view the percentage of death in NH by State
NY didn’t mandate NH testing until mid-May. NJ required testing by May 26th!
There’s a right way and a wrong way to change a law. The Constitution doesn’t provide that the Courts make the big decisions, leaving the inconsequential matters to Congress. And yet, nominally “textualist” Supreme Court Justices Gorsuch and Roberts joined with the”living document” Progressives to do it the wrong way.
Gorsuch wrote the majority opinion in Bostick v. Clayton County and got at least two points right:
- “When the express terms of a statute give us one answer and the extratextual considerations suggest another, it’s no contest. Only the written word is the law, and all persons are entitled to its benefit.” and,
- There’s no way that the 1964 Congress would have intended for the word “sex” to include sexual orientation or gender identity.
In his 37 page argument, Gorsuch stuffed and fluffed strawman after strawman to fit an extratextual interpretation of “because of …sex” into the redefinition of “sex.” As noted in the dissents by Justices Alito & Kavenaugh, his is a redefinition that wasn’t even attempted when SCOTUS redefined “marriage” in Obergefeld.
In other words, as Justice Alito wrote in his dissent, Gorsuch and the majority “legislated.”
I agree that this law needed changing to give more protection to employees in the public market place. Congress should have been encouraged to work out those protections, while also preserving religious freedoms and single-sex spaces and even women-only sports. I can’t help but wonder whether – perhaps – both political Parties took a dive, hoping the Supreme Court would do exactly what they did.
And the Country will witness lawsuits, year after year, that might have been averted.
In the meantime, though, I’ll bet Senator Chuck Schumer feels caught in a whirlwind of his own. What price, now, Chuck?
The Democrats and their allies in the media lie about the small things, it shouldn’t surprise us when they ruin lives by lying about the real issues.
From just one weekend, just three of the petty lies:
About that tear gas, there’s proof in the photos and videos they didn’t falsify (yet?): the police aren’t wearing gas masks.
Here
And, here, where neither the horses nor the police are affected the way they would have been by tear gas.
Please leave comments at my WingRight Facebook page.
The “Right to Life” means the negative right not to be killed by intentional acts. It’s not the right to force others to invest our life, liberty or property other than the duty to intervene against infringement. This is a basic negative right, not a positive right.
There’s a huge difference between personal responsibility in avoiding a risk to yourself and actively causing harm to someone else. Self-defense rather than selfish demands, using only appropriate force on others.
You know, the old “your right to swing your fist ends at my nose!” (Especially Appropriate in this case.)
*You* take the actions *you* believe are responsible. Only frequent places/businesses that require masks if you want, do the work necessary to maintain the social distancing you are comfortable with. Don’t force everyone else to do your work for you.
This all makes me physically ill. Documents withheld for over 3 years.
Special ProsecuterMueller’s investigation had some of these documents. Did Horowitz?
I have said that justice died the day that Kelo was decided and Terri Schiavo was killed by medically pulling her feeding tube & threatening her mother with Sheriff’s deputies guarding her to ensure dehydration.
Then, Comey pulled his Hillary stunt and the DOJ handed out immunity like candy. Then, the Russia hoax, and impeachment with Schiff claiming ownership of interview documents.
Law enforcement forcing the elderly to sit on sand rather than beach chairs and parents arrested for playing with their own children.
Now FISA courts subverted, 66 yo’s are arrested in their homes in SWAT assaults, and this, with Flynn. The FBI leadership planned to go after Flynn, in order to prosecute or get him fired.
Then, the documents and others proving the plan were held – hidden – for over three years in spite of a judge ordering them turned over.
The real story is the lies they told, and especially the fact that they hid these documents 3 years after they were ordered by a judge to turn them over!
They didn’t appeal the judge’s rulling: they obstructed justice, hiding and denying their existence! The Sztrok/Page texts were supposedly destroyed, remember? Then some were turned over as if the complete record.
Justice is dead and the body has been repeatedly mutilated.
Edit: 509 PM AST 30/04/20 To add 2nd & 3rd to last paragraphs BBN
Biden quote link, here
Link, here
It seems that an advocate of Euthanasia and Assisted Suicide (EAS), which is legal in Canada since 2016, complained to the “The Protection of Conscience Project” administrators about their use of the word, “killing,” rather than “Medically Assisted Death” (MAD) when writing about the law. The wording of the objection exposes the potential limitations even on thoughts, much less the act of refusal, of physicians who object to participating in EAS.
(*EDITED An earlier version stated that licences were at risk. Not yet.
BBN 11 February 2020 12:30 AM)
I was asked about the #BabyTinslee case and what we should do, what can we do, in the disputed cases.
We need to educate more. People don’t understand basic medical ethics in this day of “choice.”
Autonomy doesn’t supersede nonmaleficience. In other words, the First Principle of medicine, “Cure when possible, but first do no harm,” always should guide us, rather than “wants” or “choice.”
In the end, doctors are the ones actually performing the acts and we’re most likely to understand the projected outcome. We benefit from oversight by colleagues and the community, both informally and in the process prescribed by the Texas Advance Directives Act.
Some people demand that every one of these cases go to court, for “due process” and “cross examination.”
But judges and courts can’t be as knowledgeable as doctors are. Their decisions are necessarily informed by dueling (paid) lawyers and (hired) medical experts.
In all the cases that have gone to court, the family has had quite a lot of notice, but the 48 hour notice before the committee meeting is perceived as too abrupt, especially since the relationships all appear to be adversarial by that point.
(And who could get your family to a meeting in 2 days?)
The 10 days isn’t thought to be long enough to arrange a transfer, either. Again, in many of the Court cases, the attempts to find another doctor willing to accept the patient’s care has begun before the committee meeting.
Doctors acknowledge the great trust and privileges we are given by agreeing not to abandon our patients. When we have a disagreement with a patient or surrogates (usually a familymember), we accept that we must continue treatment for a period of time. But not indefinitely.
If we could get the reforms that have been attempted to lengthen the statutory timeframe (multiple times) since before 2005, the TADA would be much better. It’s still the best process we have, currently.
We are blessed with a universe that’s predictable and testable, yet we pray for miracles. And we pray for miracles, but act as though human actions can block them. Is the will of the Creator Who spoke the physical laws into existence limited by humans if they act as though the universe is predictable and testable?
Those of us who practice medicine are limited by the physical laws, the predictable and testable, with an emphasis on the tested. Our education and experience is based on these tested predictions and guide our decisions, and we’re watched and sometimes redirected by our colleagues, patients, laws and the community.
And then, there’s the best test of all: time.
In fact, I once noted that a patient who outlived the “10 Day Rule” might have proved the doctor (who instigated the process from the Texas Advanced Directive Act) wrong. There might have been a few cases like this, just as I believe there have been miracles.
However, can you tell me how to measure these events and predict their occurrences, much less practice medicine based on them?
In the majority of TADA cases when treatments weren’t withdrawn, the patient died in the exact manner the doctors predicted, after the same interventions -and sometimes more invasive and tortuous “treatments” than the ones the doctor originally objected to.
“We’re doing things to her. Not for her.” (Wini King, spokesperson for Cook’s Children’s Hospital, January 3, 2020) This may be the best description of a very sad case.
Tinslee Lewis was born prematurely on February 1, 2019, with severe heart and lung defects. She had cardiogenic shock and was admitted to the Cardiac ICU at Cook’s Children’s Hospital immediately. ♡(See Cardiac Pathology ♡below.)
Even after three open heart surgeries, a fourth to close her sternum, a short time on ECMO (essentially, heart-lung bypass) and constant ventilator since July, of 2019, Tinslee’s enlarged heart and small, damaged lungs can’t keep up with the necessary blood circulation and exchange of oxygen and carbon dioxide, even with the assistance of multiple blood pressure medicines, diuretics and the ventilator on high, except when she’s still and quiet with the help of sedating and paralyzing drugs.
In response to a lawsuit against Cook’s Children’s Hospital, where Tinslee has been in the CICU since birth, Tinslee’s medical records were submitted to the Court. I’ve been able to review approximately 200 pages that are now public record, describing the constant, repetitive interventions necessary to keep Tinslee alive on the ventilator.
Tinslee’s doctors (and, the notes show, the nurses and staff) believe that they are being forced to cause Tinslee pain and suffering, while keeping her paralyzed and sedated. They report increasing difficulty with managing the ventilator so that her damaged heart & lungs can maintain oxygenation. She requires repetitive heart, lung and blood tests to guide adjustment of meds & treatments and has had several infections requiring treatment. In contrast to my earlier presumption, the notes in the records show that the ventilator and all its required meds and manipulations are indeed causing undesired problems, including fluid overload, infections and cardiopulmonary distress, in addition to her underlying lung disease. Even the baby’s growth, something we usually celebrate, increases her risk of cardiopulmonary insufficiency.
Those records also contain notes from many attempts to explain and council Trinity Lewis, Tinslee’s mother, about her baby’s underlying problems and prognosis and the reasoning behind, in contrast to some past media reports.
Ignoring the fact that doctors, not hospitals, practice medicine in Texas, Texas Right to Life Lawyer Joe Nixon is quoted, claiming that the “hospital ” has decided to withdraw treatment. Texas Attorney General, Ken Paxton, is shown to have Tweeted that the problem is a “legal issue,” rather than an ethics and justice matter of forcing doctors (and by their orders, nurses and other staff) to cause pain and suffering for a little girl who is dying as her body fails to heal, in spite of every intervention possible.
Many people, out of compassion, object that “the family ” should decide when to withdraw life support. Yet, the family members aren’t watching the oxygen levels drop while they rinse Tinslee’s airways with a bicarbonate solution to keep her lungs clear. And it’s certainly not the lawyers that are probing, injecting, measuring and adjusting constant, innumerable hourly interventions done to a baby who must be sedated and paralyzed to prevent cardiac and respiratory distress.
In spite of the diligent complicated interventions and care of the doctors and nurses at Cook’s, there have been comments in blogs and social media that the “hospital” wants to “kill” Tinslee. Startlingly, AG Paxton called the latest Court ordered, indefinite hold on removal of life support a “Stay,” as though the doctors, not her multiple medical problems, would kill Tinslee. He also misrepresents the process that Cook’s Children’s Hospital and Tinslee’s doctors followed,
“The statute fails to require that physicians provide an explanation of why they refused life-sustaining treatment and provide the patient’s family with adequate notice and opportunity to argue their position prior to the committee reaching a decision, effectively allowing the government to deny an individual’s right to his or her own life and to do so without due process.”
In fact, though, it is the lawyers, particularly at Texas Right to Life, who are turning a little girl’s tragedy into a continuation of their legal battle against the Texas Advance Directive Act. I’ve covered the benefits of and the struggle to improve the Act – repeatedly blocked by TRTL and their lawyers – for years on both WingRight.org and Lifeethics.org
The Act, TADA, was hammered out in 1999 by a group of stakeholders including patient and disability advocates, hospitals, doctors, ethicists and lawyers. Texas’ prolife organizations, including TRTL and the organization for which I served on the Board of Directors for 15 years, Texas Alliance for Life, and for whom I wrote this essay.
Briefly, TADA allows a balance and legal options when there’s a difference in opinion between a patient’s desire for a given treatment and the medical judgment (a combination of education, experience, and the standard of care) of the doctors who are tasked with the most difficult medical and surgical cases.
I’ll admit that it’s my opinion – and only my opinion – that the lawyers hate that TADA provides a safe haven from lawsuits if doctors follow the law (!). I slowly came to this conclusion over the years because at virtually every Legislative hearing and stakeholders’ meeting about any changes to the Act, the lawyers bemoan the fact that doctors don’t have to go to court over each of these cases and that they face no legal penalty or “liability.”
Poor Tinslee Lewis will most likely never leave the hospital alive. Disease and death don’t respect “due process,” but, they are predictable and an inevitable part of life. Hopefully, we will see her mother and those who love her come to find peace with her death, celebrating the time they’ve had to be with her, especially these last 2 months. However, I fear that the lawsuits will continue for years, adding to their grief.
Edited 1/19/2020 for a typographical error: in the secondparagraph, “cardiogenic” replaced “carcinogenic.” BBN
♡Ebstein Anomaly – Cardiac Pathology 101, about as simple as I can make it (and understand, too);
Babies born with Ebstein Anomaly have a malformed right and atrium and ventricle and misplaced (tricuspid) valves between the right sided ventricle and atrium. The larger right ventricle can’t pump efficiently.
In addition, the blood the right ventricle tries to pump into the lungs leaks/flows/churns (risking blood clots) back into the right atrium, which grows even bigger, with even thicker walls. The ventricle also grows bigger. When the muscle fibers of the chamber walls get stretched apart enough, they are less inefficient. (Think of two hands gripping at the fingers. The farther out the grip, palm > 1st joint > fingertips, the less strength and pull on the opposite hand.) (For the geeks: Frank-Starling law.
The lungs aren’t efficiently filled with blood, they don’t expand, the pressure builds up in them and efficient exchange of gasses doesn’t take place.
In the meantime, the blood backs up in the body, the liver, kidneys and extremities & eventually the left side of the heart, which can hypertrophy , too.
The enlarged heart puts pressure on the lungs and nearby soft tissue, including the blood vessels coming to the heart.
The combination of leaking high pressure blood vessels and the body’s increasing fluid in order to try to pump what oxygen there is, leads to edema or swelling of the body.
Sometimes, the fetal atrial-septal defect stays open, allowing mixing of the un-oxygenated blood from the right, with the oxygenated blood. This malfunction can help, temporarily.
With the high pressure, poor flow, and actual physical damage due to the mass of the heart, none of the organs can function well. Increased activity, stress, and growth will increase the demand for oxygen, kidney & lung function.
I don’t believe it’s appropriate for a child to undergo transition at such an early age, but there’s a few gaps in this story.
There is very little media coverage of the case, with opinion from only one side published online. I picked the report about the court decision that’s most comprehensive, even with some errors.
Mostly, this appears to be an especially ugly divorce battle. The dispute about transition has been going on since the child was 3 years old.
The child is one of two twins conceived by in vitro fertilization using the father’s sperm and a donor egg. The mother carried the two to term and delivered.
The mother filed the suit to end joint custody, but the father demanded that the jury decide custody, rather than the judge.
The jury was charged with 2 questions: should one parent have sole custody and should that parent be Mr Younger. They answered yes and no: one should have sole custody, but it shouldn’t be the father. The judge will rule this week on who gets custody & conditions.
I’m not sure, but I’m reading that there’s no immediate plans for puberty blockers & finding quite a bit of info that the blockers aren’t permanent.
I can’t help but hope there’s more to this story, because I still can’t accept a decision like this, at this age.
Dems used to just act as though government owns your current and future earnings. Now, they want to know the value of your wedding ring, grandma’s China, the homestead, & your golden parachute. The plan is to tax them *every year* until you have to sell them (to them?) to pay those taxes.
- A wealth tax like the one proposed by presidential candidate Sen. Elizabeth Warren would make ultra-wealthy Americans pay the federal government a small percentage of their net worth each year.
- Sen. Bernie Sanders released his own proposal for a wealth tax on September 24 that his campaign claims would cause “the wealth of billionaires would be cut in half over 15 years.”
Suuure it is. That’s what they said about the income tax in 1913. (and you can keep your doctor, too.)
By 1918, the highest tax rate went from 1% to 67%, 77% in 1918. The lowest on incomes less than $4000, went from 0% to 6%.
Yes, in a (coco)nut shell, that is it. If you want the tax break, all you have to do is abandon everything you own, book a flight and never return, or at least not that much anyway.“ (HT: The Points Guy)
If you denounce your citizenship, you may be liable to an “Exit tax” calculated as though you sold everything you own on the day you “expatriate.” And you can’t get your citizenship back.
So, what we have is a bunch of 70 year olds who have enjoyed their wealth and some 20- to 30-somethings who don’t want to pay their student loans and don’t really want to work hard enough to accumulate wealth on their own.
Eat the Rich. It’s a thing.
Nite: comments disabled. Please comment on my Facebook page.
If everyone gets a trophy, why should anyone get a statue? Especially men?
Yes, here’s the next woke thing:
The New York Post reports that a City commissioner proposes to “Replace male statues in Central Park with women.”
“”A member of the commission that oversees art and architecture on city property suggested Monday that instead of simply adding statues of historical female figures to Central Park, the panel yank out some of the male ones first.
““There are what, five or six [male] statues that I think could easily be replaced by individual statues of each of these women,” said Hank Willis Thomas, a painter who serves on the Public Design Commission, at a hearing at City Hall.
“Thomas appeared to be specifically fingering statues including that of Scottish poet Robert Burns, in the park’s Literary Row, and the one of Christopher Columbus in the park, near the famed second one of the explorer in Columbus Circle, for removal.”
Goodbye Columbus indeed!
Texas’ Governor Greg Abbott ( @GovAbbott ) isn’t trying to change Texas law with last week’s Executive Order – in contrast to the claims I’ve seen on my Facebook news feed.
Instead, he called for law enforcement agencies under the executive branch to establish policies and training, and financial incentives to encourage “improving reporting channels and closing ‘information gaps’ when members of the public or law enforcement agencies worry that a person might be a threat to commit violence.“
The last three mass shootings in Texas tell us that we need to improve how our law enforcement and agencies follow current law on following up on reports and investigations.
The Sutherland Springs Church shooter in South Texas should have been rejected at point of sale background check because of his prior conviction and incarceration for domestic violence crimes while in the military. Unfortunately, he was never reported to the Federal database. (And so, Texas law probably couldn’t have made any difference.)
However, the Odessa shooter threatened and brandished a weapon at his neighbor, but local Law Enforcement Officers didn’t follow up because his house wasn’t on their GPS maps and was difficult to find!
The El Paso shooter’s mother tried to report him, but the LEO who spoke to her on the phone dismissed her concerns. No record of the call was made, according to the Allen police department.
I’m not sure that current laws would have (or should have) allowed any action against the (future) shooter by authorities, but it looks like that question and reporting procedures are what Governor Abbott wants clarified. From the Executive Order:
“”Within thirty days of this order, the Texas Department of Public Safety shall develop standardized intake questions that can be used by all Texas law-enforcement agencies to better identify whether a person calling the agency has information that should be reported to the Texas Suspicious Activity Reporting Network.
Within thirty days of this order, the Department of Public Safety shall develop clear guidance, based on the appropriate legal standard, for when and how Texas law-enforcement agencies should submit Suspicious Activity Reports.”‘
The question should be whether the “standardized questions” and reporting processes might have made a difference. Unfortunately, I’m not reading questions: I’m reading accusations that the Governor wants to impose “red flag laws” and confiscation of guns without due process of law.
The Governor previously directed the Texas Department of Public Safety to implement the “iWatch app” in June, 2018, allowing the public to report suspicious activity. There was no outcry then, and there doesn’t appear to be any “red flag” incidents because of this initiative.
Why do people think the Governor wants gun control now?
Twice this week, I’ve heard the false story that President Trump has decreed that children born on US soil will not automatically be US citizens!
There was an announcement of a policy clarification by the United States Citizenship and Immigration Services.
In spite of all the hyperbole last weekend, there hasn’t been much clarifying coverage in the news. Raise your hand if you’re not surprised.
The “Highlights:”
•Clarifies that temporary visits to the United States do not establish U.S. residence and explains the distinction between residence and physical presence in the United States.
• Explains that USCIS no longer considers children of U.S. government employees and U.S. armed forces members residing outside the United States as “residing in the United States” for purposes of acquiring citizenship under INA 320.3
Not the hype you’re reading about in the news.
Edit: Penultimate sentence: “18” instead of “28.” On September 3, 2019. BBN
We could have done more if President Obama hadn’t blocked Texas from receiving Federal Women’s health or Family planning funds. Texas taxpayers paid into that Federal fund, but were denied its return to us. Texas did our best to fill in the gaps this lost funding created, allocating $32M of our State tax funds to Family Planning and Women’s Health programs in 2013-14.
In 2015, when the budget improved, we increased State spending for Women’s health and Family Planning beyond historic amounts. In 2019, nearly $400M was allocated, including raising the cut off for eligibility to 200% of the poverty level. $15M+ was set aside to improve post-partum care.
Nevermind that science affirms that the life of each human begins at fertilization. Or that “reproduction” has obviously occurred before any woman has an abortion, ending the life of that other body, her child. (Yes, one commenter tried to tell us that not only women seek abortions.)
But it’s the last paragraph that tells the truth about the author’s agenda, with a little side dressing of racism. Mr Rivard tells voters to end the ,”one-party state” – to force taxpayers to fund elective abortion for both citizens, non-citizens, and illegal aliens alike.
Edit 8/21/19 5:15 EST (France time) to fix typos. BBN
‘“It’s not the baby’s fault for the sin of the father, or of the mother,” King said.‘
Remember this statement when you read or hear that Congressman Stephen King “defended” rape and incest.
In reality, he “defended” every child at risk of being killed because they are the result of a pregnancy after rape or incest.
And all the descendents of past pregnancies due to rape or incest.
Politicians and laymen alike should beware when publicly supporting the ethical position that all humans are, indeed, human at all stages of life and that they shouldn’t be killed: The Leftist liars will attack. In force.
Representative King wasn’t just defending the children of tomorrow: he was defenfing all of their descendents.
“What if we went back through all the family trees and just pulled out anyone who was a product of rape or incest?” King told a breakfast meeting in Urbandale, Iowa. “Would there be any population of the world left if we did that? Considering all the wars and all the rapes and pillages that happened throughout all these different nations, I know that I can’t say that I was not a part of a product of that.”
King was obviously referring to retroactive killing. After all, elective interventional abortion is the ending of a human’s life by intentional acts that are licensed and regulated under the medical codes of the various States.
Regardless of how they were conceived, every human is created equal and endowed with inalienable #HumanRights.
The faithful Left can’t tolerate equal rights endowed on all humans. They will invariably takeba any firm statement against their sacrament of abortion and their tools in the media will pull out sections, ignore the context, and turn it inside out, to spread the big lie.
So much the more if they can twist their lie into a defense of one of their own. Congresswoman Ilhan Omar cited the lying reports as proof of Republican “filth.”
(Nevermind that her own hometown paper, the Minnesota Star Tribune and her Somalian communityare the ones accusing her of biggamy as well as marrying her own brother to commit immigration fraud. Or that she’s been fined for filing false tax returnswith one of her husband’s. Y’all move along, there’s nothing to see, here.)
So tell me: how many people would be left alive if we killed every person who has an ancestors who was conceived in rape or incest?
Claiming that ” ‘conservative’ and ‘Republican’ are now mere team names that have lost all meaning,” pseudo-Conservatives are trying to start a new movement, possibly a new Party. However, their #PrinciplesFirst aren’t Conservative.
The Principles have at least two fatal flaws.
1. They’re based on man-made law & artificial designations of “persons”& “citizens,” not on inalienable rights endowed on “all men” (humans).
The Constitution of the United States is an unique, exemplary document. But its strength and legitimacy depends on the concept of inalienable rights of humans that are not endowed by laws, men or any powers that be of this world. The Constitution can be amended. Human rights can only be infringed.
2. The list also errs in supporting “Each and every family unit – regardless of its shape.”
Would these families include those shaped by polygamy? Why not?
The Republican Platform can be downloaded for reading, here.
The Platform confirms most of the items in the Principles First list. However, the Preamble of the Republican Platform is clear on its origin:
“”We affirm — as did the Declaration of Independence: that all are created equal, endowed by their Creator with inalienable rights of life, liberty, and the pursuit of happiness.”
And equally clear on the”shape” of the family:
“”It is the foundation of civil society, and the cornerstone of the family is natural marriage, the union of TT man and one woman.””
Correct these errors, and the “new” Principles would be indistinguishable from that of the Republican Party Platform. The effort should be to hold our elected officials to the Platform, to strengthen our Party, maintain and expand our Seniority in the Senate, win both back in the House. It’s certainly not Conservative to tear down. #FirstPrinciples
The killings alone are enough to prove the killers are evil and full of hate, but their history and social media portray individuals focused on hate, erasing all doubt. It appears that the Texas shooter identified with white supremacists white supremacists while also professing to be anti-government and anti-corporation, while concerned about the environment. The Ohio shooter was known to be obsessed with guns, had participated while armed in a counter-protest against white supremacists and was politically left-leaning. The motives of the California shooter aren’t clear at all.
“””The age to purchase a firearm is 21. The state requires gun owners to obtain licenses and face background checks as well as imposing waiting periods on firearms purchases. Judges can take guns away from owners who are deemed to be a threat to themselves or others. And recent legislation aims to begin a fingerprinting database of all gun owners in the state.””
“””Apparently it doesn’t work like that. (Someone should tell our elected leaders.)””