Thursday, April 16, 2015

Time to End the Personal Belief Exemption

For months, I've been researching vaccinations. "Doing my own research", as the Anti-Vaxxers like to say. I've been doing part of this as background for a piece that has literally taken me six months to write for the Chico News and Review. I pitched the piece and started working on it long before the Disneyland Measles outbreak last December.

I've read much of the Anti-Vaxxer material. I've signed up for all the Anti-Vax websites and read Mercola, Wakefield, Humphries, Sears, Tenpenney and all the other celebrity stars of the Anti -Vax Movement. I've read the critiques of Big Pharma. Watched the "whistleblower" interviews and the supposed secret documents that make the accusation that the CDC is nothing but a patsy for making money for the Vaccine Companies. I've read the websites like the "Farmacy" and "GreenMedInfo", sites that reel in people like me who are generally in favor of eating organic veggies and using lifestyle interventions to increasing public health. That's a no brainer.

But the problem is that these websites and Natural Living Buffoons have such an agenda against vaccines, for no good reason, that it has become more a matter of Natural Living Religion to be Anti-Vax rather than a realistic, reasonable, rational position.

I've interviewed Doctors. I've interviewed Public Health Officers. I've had dinner with Anti-Vax RN colleagues. I've read the Gospel of Offit. I've enjoyed Eula Biss' bestseller. My daily google search alerts for the last year has included topics like "Measles", "Pertussis" and "Vaccinations". I've read thousands and thousands of journalism pieces on the subject. I've paged through the payouts of the Vaccine Court and read about all the alleged injuries in the VAERS reports. I've read the Cochrane Collaboration reports.

The CNR will publish a very sober piece I wrote on the subject soon. But I will say bluntly here what that article states in a more opaque style. As they say in the journalism business: show, don't tell.

My conclusion: We have to do away with the Personal Belief Exemption for school aged children immediately. We must maintain vaccination rates above 95% for all vaccine preventable diseases. This isn't a Big Pharma Conspiracy to rake in billions of dollars; this is about public health and eliminating very dangerous diseases. This is serious business. It is about the right to be free of disease.

Vaccinations are safe. Serious reactions occur but are rare--in the 4 reactions per one million dose range. A fatality from a vaccine reaction is even more rare. One in millions and millions of injections. Autism is not caused by vaccines. SIDS is not caused by vaccines. Shaken Baby Syndrome (and yes, there are Anti-Vaxxers who say this) is not caused by vaccines. Allergies are not caused by vaccines. ADHD is not caused by vaccines. Tenderness at the injection site is the most common reaction. Very rarely, a mild fever.

Recently I had a front row seat watching California attempt to do away with Personal Belief Exemptions. I sat in Richard Pan's office, the co-author of SB277, munching on a wrap and exchanging pleasantries with him and a couple pro-vaccination leaders an  hour before he defended his historic bill in front of the Health Committee of the State Senate. Richard Pan is a pediatrician and a very, very brave and intelligent man. I watched him look every one of the hundreds of critics of his bill's eyes and acknowledge them in the public comment section of the meeting. Some of these hundreds of mostly well intended people, overtly threatened him. One pastor put a curse on all of us who support the bill. Richard Pan remained calm and pleasant even when a few people had to be forcibly removed from the hearing room. Richard Pan was rational and understanding. He has nerves of steel.

I was given a front row seat at the first hearing. I watched hundreds of Anti-Vaxxers march up to the microphone, most of them wearing red "Choice" t-shirts, some of them barely holding back tears, many of them shaking with anger, all of them passionately arguing for their "right" to not vaccinate their children. They do this because of all the normal reasons you can read about if you read Mercola, or Humphries, or Wakefield. Many of them brought their children up to the microphone, most without any sort of blemish that is noticeable, and had the kids say they have been permanently "vaccine injured".

Being "Vaccine Injured" is a badge worn by many of these True Believers. The diagnosis is often given by the parent who needs something to blame for their child's malady. Sometimes the diagnosis is given by a Naturopath or a Chiropractor. Having the diagnosis gives a sense of power to fight against the evil something that caused the problem.  It isn't crazy; it is normal and natural to want to have answers.

This is important stuff. And nobody should care what these people do, if they vaccinate their kids or not, except for one thing: The health of all of us is dependent upon Herd Immunity being maintained. The Anti-Vaxxers do not have the science. They do not have the proper moral argument for their cause. How do you defend your own right to pass on potentially lethal disease to others when a safe vaccine is available to all?

I missed the second hearing but I followed it on-line. The Education Committee seems to have lost focus. They seem to have bought some of the hundreds of protestors message, parroting things like "What if they are right about Autism?" Dr. Bob Sears, a patron saint MD in the Anti-Vax cause was at both hearings. He has rock star status who flopped big time at the first hearing. At the second hearing he outright lied and said he was there for all the Autistic children who, presumably, have been created by vaccines. The bill stalled in this committee.

Will it make it out of committee? We are confident it will. And if it doesn't, we will be back. Vaccination rates have gotten so low that a return of the diseases is almost a given. Disneyland couldn't have happened anyplace else in the US because of California's lax laws. It will happen again and we will be back.

You can count on that.

Saturday, April 4, 2015

My First World Hospitalization

It has been about 48 years since I was last admitted to a hospital. Back then, in 1967, hospitals had "Wards". I was just a kid, in the hospital to have my tonsils out. A common practice back then---and since I never have sore throats, perhaps not a bad practice. I know in these days where anything natural is worshipped and Turmeric is the new Ibuprofen (except you don't really know what is  in the Turmeric because of the lack of standards; one study showed a high percentage of mouse shit in Turmeric pills sold as a supplement).

I digress.

The last time I was a patient in a hospital, I was placed overnight in a children's ward. There must have been five or six kids in that room. I remember lying in the bed, looking across what seemed like a massive expanse of a room, really almost like a gymnasium---looking at the back of a television set of the kid across the room from me. I guess hospitals wanted to make money back then too, so your parents could rent you a TV to watch while you recovered from your ailment. I remember feeling sorry for myself that my parents were too poor to rent me a TV and I so desperately wanted to see what the rich-kid-who-must-have-been-loved-a-whole-lot-more-than-me, was watching.

That room way back then was utilitarian. If you think about it, the nurse working that unit didn't have to walk 15,000 steps in a shift to take care of us. We were all right there.

Fast forward 48 years. I am driving on a lonely two lane highway between Chico and Corning. As has happened three times in the last ten months, I heard a rush in my ears. Then, slowly, like a tilt-a-whirl just starting to spin, the world starts to revolve.

"Ah, Shit", I think to myself---because I know in about a minute  this Tilt-a-Whirl will be going fast. I know I won't be able to walk. Driving is out of the question. I know that all I will be able to do is lie down and close my eyes.

And so I have about a minute to find a place to safely get off the road and park. I do so. I find a nice little, lonely place to pull off the road about half a mile from the Strip Joint that is just outside of Chico.

The world starts to spin. Fast. Really bad.

I call my client and cancel. I call Joni. "Should I come get you?" she says.

"Probably would be a good idea", I say.

The car is too uncomfortable to sit and spin in. Too much clutter in the car to get comfortable. I've got file boxes and lots of books; trash from the last 30 days of takeout food I've consumed. I have nursing papers and stethoscopes, more papers and more books that I've been meaning to return to the library. There's extra clothes in that car. Shoes. Backpacks. Bottles to be recycled. I can't get comfortable; too much junk. I wander outside and find that the best, most comfortable position, is to sprawl myself across the hood of the car. It is 6:00 pm on a very busy highway. This section of road is ripping with commuters during rush hour. Nobody stops to see why this guy is sprawled out on the hood of his car.

I hang onto the car like I am holding onto it for dear life. I am. I feel like if I let go of the car, I would be spit out into the void. Into a chasm. It would be like falling off a cliff. I feel like I am hanging onto the rim of the Grand Canyon.

That's how Joni finds me when she and Kylie show up.

Joni gets there in the van and I stagger to the back. Lie down. Spinning. Joni and Kylie transfer the contents of my car to the van and we leave. Where to go? They go to the grocery store.

I lie in the back of the van and spin. Of course this is just a ploy on her part because she wants me to go to the Emergency Room. After a half hour of trying to convince me I should go to the ER, she wins. We go to Enloe.

The world is still spinning. I am assessed by a team of RN's. I know what they will do as I am a Male. Mid-50's. Obese. History of Coronary Artery Disease. Vertigo. BP of 135/113. Some chest pain. They decide to get me back to a room quickly, but not quick enough for me not to vomit in front of all the dozens of people sitting in the waiting room of the ER.

Another notch on the bucket list: public emesis.

And so I am quickly brought to an emergency room. I get an EKG with a monitor. A CT of the head. Labs. All the normal stuff. My cardiac enzymes are fine so I am not having a heart attack. My EKG is okay except for my normal PVC's. Most vertigo patients would be sent home, but this episode is worse. My head feels like it is going to explode and I am nauseous.

They give me morphine for the headache. This doctor doesn't mess around.

Given my symptoms are worsening, they can't rule out a stroke or a TIA. The best way to do that is to admit me for observation and to get an MRI the next day when the lab technicians show up.

The ER MD wants to admit me. That's five thousand dollars down the drain, as that is what my hospitalization deductible is. I consent to the admission. Joni leaves.

Up to the room. Room 5584. I later learn that one of my clients was just discharged from that room earlier in the day. The room is private and has a great view of  the brand new Enloe Hospital Helicopter.

This room is nothing like the Children's Ward when I was a kid. The bed is super fancy and automatically weighs me. Just lie down and get your weight. I am still dizzy, so the nurses put me on FALL PRECAUTIONS. I am not to get up alone; I may not use the toilet. I must pee into a urinal.

Of course, I am still morphined up because of my head, so this isn't that bad of an experience. If you are going to go into a hospital, you might as well do it like Hunter Thompson. In the meantime, the nurse goes on and on about the benefits of Lavendar and how I can have scented oils to help me sleep. It is 4 AM by the time the admission is through.

Lavender, my ass. Give me some pain pills and something to relax! I sleep.

The next day I get the MRI. I was given Vitamin V (valium) prior to getting into the big machine. The MRI Technician puts a helmet on my head before sending me into the tunnel. I feel like Hannibal Lecter. "Good bye Clarice", I say to the Technician. She laughs, catching the Silence of the Lambs reference, and says nobody has ever said that before. I guess it was the valium talking.

Back to the private room to wait. This room is really a bit too nice. There is a distinct New Age feel to the place. Guided Imagery available. Essential Oils. Nice hardwood floor. The whole experience is designed to be like a Sedona Red Rock Healing Resort. Except you are in a hospital and there are no energy vortexes and no red rocks. It is a hospital trying way too hard to be a spa; something it can never be. And I don't know if all this splendor is needed. All the state of the art computers and call lights and $10,000 bed that blows up like an air bag and weighs you automatically.

On the TV: a choice between CNN (another weekend of a jet crash) or Fox News. This hospital needs MSNBC. Or C-Span (to promote sleep). Or maybe Amy Goodman and Democracy Now! to be played in an endless loop.

I watch Fox News with all the leggy female anchors who ask right wing questions endlessly. I think to myself: How do they live with themselves? Do they really believe this shit? Amy Goodman is much more sexy because she has a brain.

But here I am in this hospital stuck with Fox News. At least the nurses are nice; they don't let me walk around without watching me. I learn late Saturday that I didn't have a stroke or a TIA. Yet they hold me another night. The MD has gone home.

Okay. So I get up and do something I have always wanted to do. I walk the halls of the hospital in one of those backless gowns. Except I am wearing hospital pants, so there isn't any full moon out. I walk the halls feeling like an old man. Am I becoming an old man?

I ask for meds and sleep like a baby Saturday night. Since I am on a neural unit, I am there with all the dementia folk who have bed alarms that go off everytime they try and get up. I sleep through it all. The rocket helicopter lands at 2:00 am with a highway drunken trauma accident. The helicopter lands outside my window. I don't hear it and sleep like that 6 year old that slept in the Children's Ward in the hospital in Winona, Minnesota all those years ago.

Sunday the MD comes in. I get a diagnosis: Meneers versus Benign Positional Vertigo. The doctor thinks the latter. Evidently, the vertigo is caused by calcium deposits that roll around in your ears, wreacking havoc. It is treatable with physical therapy.

Joni comes to get me. I pack up my emesis basin, tub, hospital toothbrush, and all the other freebies they give you. I get escorted out of the hospital and off we go to the car.

Which has been broken into; Window smashed; Garmin stolen; Satellite radio stolen. So much for the safety of parking for two days next to a Strip Club.

Quite a weekend. $5,000 worth. At least. All of it amazing with the CT's and the MRI"s and the blood tests and the pills that make you sleep even though helicopters with rocket engines are landing outside your window.

And yet, it is all so First World. I know there are people in the Third World who can't even get a measles vaccine. Or an anti-biotic.

Perhaps we should go back to having wards and less expensive care. Perhaps we should do away with the concierge service and just make sure everybody has some health care access rather than spending all this money trying to attract the paying customers who have insurance like myself.

The nurses and everyone were wonderful. The care was exceptional. I wonder if maybe it isn't too exceptional? I don't think I would have minded being in a ward. Especially if that meant that everyone got healthcare too.

Just some thoughts. With high praise for the nurses and doctors and CNA's and ancillary staff of Enloe. They did an awesome job. They have my respect and appreciation.