*** PLEASE NOTE ***





*** PLEASE NOTE *** I use no other social media, and my comment section here remains closed due to chronic harassment/repeat impersonations by a certain individual. Also, I rarely comment anywhere; when I do, only from this blog as "Chrysalis" or with my real name from email (see correct spelling my profile). If there is ever any question as to legitimacy, please contact myself or Mark via email or phone.


Friday, July 31, 2020

"Troll Policy" and "Civil War?"

Oh, now I'm a troll, simply because I politely and sincerely asked (exact copies of my comments below) for a link to any data research that perhaps I hadn't seen yet on hydroxychloroquine?  

Lol, dohkay.  I mean, I've been called worse. 

Look, my request has nothing whatsoever to do with politics - has to do with public health.

COVID-19 is real and it is not political - it doesn't pick and choose who to infect based on political persuasion, skin color, gender, religion, or anything else - it doesn't discriminate. 

COVID-19 has only become political because political-minded people (and the overly paranoid) have made it political.  

Even if the conspiracy theories were true -  that there was some political group responsible for this virus - that would still not help us actually prevent and cure this thing.

That is why, IMO, it doesn't help to speculate about who to blame -  it's just not productive, it's wasting time and energy, which would be better spent on how to prevent and cure it - energy spent how to actually help.


Working in healthcare myself, I know that despite what press and politicians are saying, despite even what clinical trials are saying - doctors in the real world ARE willing and able try virtually anything to make their COVID patients better - including hydroxychloroquine.

In fact, here in America, there is no federal, state, or local mandate against using hydroxychloroquine - doctors are welcome and willing to prescribe it for you, if you want it. 



Again, the way pharmaceutical utilization works in America is, you often have to step through certain FDA-approved (which based on clinical trials and various infectious disease journals) and your insurance-plan-approved protocols first, regardless of public or private insurance, to get to desired drugs.

HOWEVER - all bets are off with COVID, because there isn't a true COVID-treatment protocol yet - there isn't anything else at all.

So you CAN step outside the box and try other things, when all else fails, and many doctors do - *with their organization's approval and insurance-plan approval.*



In fact, prescriptions written for hydroxychloroquine skyrocketed in March and April, but dropped sharply by May - NOT because of press or politics or even controlled clinical study data - but because it just didn't save as many people in real-world utilization, as they'd hoped.

It was effective in reducing the lung inflammation in a few of their patients, but not all, or even most - and the reason for that difference (possible subgroups?) is not yet understood; thus, the need for further study and clinical trials.

There's nothing "political" or "suspicious" about that - it's just real-world utilization of hydroxychloroquine has taught us  hydroxychloroquine hasn't turned out to be that blanket miracle cure, for  even most people, that we'd all hoped for.


Also, my interest is not only professionally, but as a Christian, I believe "loving my neighbors" includes getting the correct data-driven information for public health and safety.

That is the only reason I have commented there at all, which as you know, is a grand total of 3 times in the last four months, always about COVID.


FYI, usually, if I do look at your blog, I don't usually read it - I look at the comments bar, to see what people I know have commented.  

However, I read this post and commented for more info, because it was about COVID-19.

The fact that you were unable to provide that info doesn't make me look bad for asking for your data source - it makes you look bad for refusing that request, deleting that request, calling me a troll for even asking, and then saying you needed to remove it due to "Civil War?"

(Well, DR did later provide a link to white paper that actually provided no actual data at all - just a thinly-disguised smear-campaign of Fauci, which included a easily disproved misquotes and false accusations about his supposed past association with a 2005 study -  which he was not, and was on a totally separate virus, mind you - written by a small group of people whose spokesperson believes vaccinations are actually "demon sperm)" 

Clearly, the problem here is not even actually about politics, right OR left- the problem is about you as an individual. 

You want people - especially women - to just believe what you say as gospel truth without question, never disagree with you, and never ask for proof - and if they do, you label them "trolls" who are "attacking" you, especially if you don't actually have a credible source or a rebuttal -  and any disagreement becomes "part of the political civil war" to you.

Dude, the only "civil war" going on is mostly in your head, because you clearly want one in real life so badly.

But guess what?  


I won't oblige you - I won't be a part of anybody's "civil war," either real or imagined.

So have a good weekend anyway :)

_______________

PS - In fact, I just left a comment to the above effect: 
Well, I've been called worse than a troll.  But FYI, in all sincerity, this is where I'm coming from.  
Working in healthcare myself, I know that despite what press and politicians are saying, what even is the current advised official protocol for COVID-19 - doctors are willing try anything to make their COVID patients better - including still trying hydroxychloroquine.

So in fact, there ARE some doctors still trying hydroxychloroquine for COVID - they'll try anything to help their patients, especially if we don't have anything else. 

Unfortunately, however, in the real world, though hydroxychloroquine may help the inflammation in a few cases, it doesn't help in most or all, and they don't understand why that is, just yet - hydroxychloroquine just hasn't turned out to be that blanket cure people hoped for.  

I was sincerely asking for anything that you'd seen otherwise, but unfortunately you failed to provide that information, and the info that DR left was not data at all, it was on a study from 2005 on a totally different virus, falsely accused Fauci for being associated with it, and provided no new data on the current virus. 
This is not political - the only people making it political are political-minded people.
I'm sorry that you confuse anyone who questions you, asks for sources, or even politely disagrees with you is a "troll" on behalf of some civil war you have going on, mostly in your mind - perhaps wishful thinking?
Well, I will not be part of anyone's civil war real, or imagined.  
So have a good weekend anyway.





Thursday, July 30, 2020

In Case You Missed It, Let's Recap ...


For those who missed my final update to the post below, a link with source was finally provided under the social media post and comment.

The problem was, it directly linked to the white paper written by "America's Frontline Doctors"about whom I wrote a rather lengthy post about, this morning, before even reading and engaging in this nonsense.  

To recap, first and foremost, here is the direct link to that NIH hydroxychloroquine study published on August 22, 2005.

It was mentioned in white paper provided in the link by the commenter, published by "America's Frontline Doctors," which accused Dr. Fauci of being involved with the study, as well as previously agreeing with that study, back in 2005, but does not now. 

However, as you can see for yourselves:  

1.)  Dr. Fauci's name is nowhere on this study - as author, contributor, or study clinical staff - nor can you find any mention of him regarding discussion of that study in the Virology Journal, (or anywhere, anytime else, that I could find).

2.)  The 2005 study immediately and readily admits at the very beginning of the study that it was limited, because it was not performed on live people - just cells in lab plates and petri dishes.

3) Note the study was performed - on a completely separate virus. 

4) Lastly, note both the study's conclusion, and it's title, does NOT say hydroxychloroquine is a "cure" - even for that separate 2005 virus - it only claims it was "effective treatment."


That separate virus, from 15 years ago, was called SARS-CoV.

The current virus causing COVID-19 is called SARS-CoV2 -  which is a related, but completely separate and distinct virus.


Which means, essentially, their "white paper" not only failed to delineate this was not the same virus as the current one, but misquoted/misreferenced the hypothesis and conclusion of the 2005 study, as well as failed provide any other studies or evidence to substantiate their belief in the efficacy of hydrochloroquine against COVID.

In fact, this was not a scientific-data driven "white paper" at all, but thinly disguised an attempt at a written indictment for Dr. Fauci.

However, because of all the misattributions, misquotes, and misreferences of both Fauci and the 2005 study, it is, and should be, considered nothing more than what it is - an attempt to undermine, discredit, and defame Dr. Fauci's character via false accusation - and therefore could legally be construed as libel.

Regardless, again, "America's Frontline Doctors," is a small group of quacks, who are NOT on the "front lines" of anything - meaning not a single one practices in infectious disease, virology, epidemiology, emergency medicine, or clinical research, and do not practice at any accredited major university or reputable clinic. 

Even worse news for their credibility, their chief spokesperson - featured in the video Trump Jr. shared/was suspended from Twittter for - is Dr. Stella Immanuel, a Houston pediatrician -  who also moonlights as an evangelical pastor.





She believes in "astral sex with demons and witches" done without your consent and "demon sperm," as well as that immunizations are actually Nephilim demon DNA, disguised as treatment.

Don't believe me? 

Once again, here is one of Dr. Stella Immanuel's "sermons" on the subject.








Additionally, there was a small pic of a portion of someone's social media post that the blog owner posted in the post itself that we were commenting under, which quoted Dr. Fauci in Virology Journal in August 2005.


However, again - after a thorough search of Virology Journal in August 2005 -  though the above study is mentioned - Dr. Fauci is not mentioned or quoted in the Virology Journal, on or near that time. 

Thus, at this point, I have two choices as to what to believe about the people still trying to pass off this BS.

The first choice is that they really do suck at reading comprehension, cannot understand even the basics about scientific studies, and really are that stupid and crazy.

The second choice is that they think we are really that stupid and crazy, and that they can sell us a load of BS, and that we'll believe it -  just because a small group of people wearing labcoats in a video wearing said so - and that we won't vet any of their credentials and background, and/or actually read for ourselves the studies, while wearing our critical thinking caps, paying close attention to the details and differences. 

If it's the former choice - you're really that gullible, stupid, and crazy that you really believe this stuff yourselves - I don't know what to say to you -  but perhaps passing around information that you can't even read/don't understand yourselves isn't your forte.

If instead it's the second case - that you already know it's a load of BS, but just think we're that gullible, stupid, and crazy to believe you - I am happy to disappoint you :)

Also, if the latter is the case, I would really appreciate it, if you would stop being so deceitful, unethical, and dishonest, while in the same breath declaring yourselves Christian.

I really don't appreciate my Lord and Savior being even remotely associated with that kind of falsity and deceit, thanks, especially out of nothing more than your lust and greed for political control - particularly since Christ was "anti" all of the above. 


Regardless, as I said below, I've wasted enough time trying to make sense of crazy today, and I should know better ;)




  

PS - A Reply to Someone Elsewhere on Hydroxychloroquine ...


(Updated x3) 

After I wrote my below post, I went looking around on other social media sites, and found someone still trying to tout the wonders of hydroxychloroquine, trying to use its recent trials in oncology as "proof" Dr. Fauci is "hiding something."

I sincerely don't understand what that commenter is trying to say.  

Thus, I wrote the below reply, here's an exact copy: 

DR – Hydroxychloroquine has anti-inflammatory properties, much like steroids – neither of which are an actual cure for anything, as far as we know (at least we do not have the evidence yet) – just treatment to reduce inflammation caused by varying diseases, it’s essentially symptom treatment.
Hydroxychloroquine is also a powerful immunosuppressant, and thus has become of interest in combination with newer immunologic treatments for cancer. However, it can also actually make you susceptible to other infectious diseases, because of that immunosuppression.

Regardless, although there are some strong correlative links found between virology and certain types of cancer, at present, there still is not enough evidence, and cancer/oncology is still a completely separate field than infectious disease and virology. 
Thus, I’m having trouble connecting the same dots you’ve connected here, I guess I’m not understanding your point?
I’m also having trouble understanding why you do believe hydroxychloroquine is the answer – is there some actual data and evidence we’ve overlooked? 

Because I could state that common aspirin is the cure for COVID – doesn’t mean it is, without evidence, and it also doesn’t mean you’re hiding something, just because you disagree with me about aspirtin, based on that lack of evidence.


____________________________________



Update:  Though "DR" returned and commented in the same thread, he completely ignored me -  and the  actual blog owner answered me instead, with this non-answer: 


Certainly is, by the doctors and the reports that got out from under the smothering blanket, as we’ve shown some of.



Thus, my reply: 


Sorry, JH, I don't read here everyday, must've missed them - would you mind sharing those studies and sources on the actual efficacy of hydroxychloroquine against COVID again?  

However, the real question, here, was addressed to DR, asking if he could explain further the connection he was trying to make between the use of hydroxychloroquine in oncology vs its use with COVID, because he lost me, that time.



_________________________________




Update x2 - Though my 2nd comment was initially published publicly (at least an hour or so ago?) - it has since disappeared.  

Thus, I tried to paste the comment again, in case it was a mistake -  but apparently, I am blocked now???


Strange, I'm sure I saw this comment published earlier, but it's now disappeared? Here is it again:  
Sorry, JH, I don't read here everyday, must've missed them - would you mind sharing those studies and sources on the actual efficacy of hydroxychloroquine against COVID again?  
However, the real question, here, was addressed to DR, asking if he could explain further the connection he was trying to make between the use of hydroxychloroquine in oncology vs its use with COVID, because he lost me, that time.


However, I've apparently been blocked from commenting now, it would seem - and why is that?

Talk about stuff seeming fishy and hiding things basic on politics, and encouraging us lefties not to believe things blindly, just because certain people say so.

Thus, though of course, I haven't proof, odd antics such as that DO lead me to wonder, if this isn't yet another clear-cut case of projection by Trump-supporting political right - accusing others of what they do/would do, themselves? 


How can Trump-supporting right wingers expect anyone to seriously consider listening and reading what they have to say, trusting their "alternative information," if they refuse to provide links/sources when asked, and can't even be ethical and honest about goings-on in their own comment sections? 

Never mind, I just answered my question myself, should've been rhetorical lol.


Update x3:



It appears that DR has since left a link - which is of course leads directly to a white paper - that references studies, without presenting any itself - written by the small group of whackos known as America's Frontline Doctors - LOL!

Hilarious - are they serious with that?

OMG - they were.

Please see this morning's post on the spokesperson's strange beliefs about "demon sperm" and vaccinations by their leader, Dr. Stella Immanuel, written this morning, before I even read there. 


Thus, I left this comment under another post, just in case it was a glitch under the other post, but apparently I was blocked there too? 


I can't seem to reply below, but the link that DR provided below is written by America's Frontline Doctors, who I wrote about earlier this morning before reading here.  
It is headed by a small group of non-infectious disease, emergency medicine, virology, epidemiology, or clinical research physicians, headed by Dr. Stella Immanuel - who also believes that you can have astral sex with demons and witches. 

https://youtu.be/CJrJG9xymts








Additionally, I was unable to find Fauci's contribution to the Virology Journal from August 22, 2005, but even if he did, the study says that it was effective for that particular virus, in controlled cell dish experiments - not live people. 

And just an FYI ... 


In fact, this link is to the NIH study published on August 22, 2005 on the SARS-CoV1 - *NOT SARS-CoV2* - which is the current virus.


Additionally, note there's no mention of Fauci's contribution or authorship.  

Also,  I have since searched directly the Virology Journal, August 2005, which was  also quoted by the actual blog owner within the post itself, via a small pic of a portion of someone's social media post; however, I was unable to find any articles or studies by, or even even discussion with, Dr. Fauci, on this subject. 

Lastly, I need to add, here, there was actually a typo in my last reply - I typed "America's Firstline Doctors," when it's actually "America's Frontline Doctors," which I've corrected in the above copy of my comment for clarification.








Trump, Trump Jr., and Dr. Stella Immanuel: Hydroxychloroquine, Astral Sex, and Demon Sperm?









Okay, I'm a day late to this party, but I had OB/GYN issues to resolve  - and no, those issues did NOT involve "demon sperm" like Dr. Stella purports (LOL).

I'm also 100% certain that the benign uterine fibroid tumor they found on my ultrasound yesterday wasn't because "astral projection dream sex with demons," - like Dr. Stella Immanuel says they are -  and instead are caused by some combination of being genetically-predisposed, a perimenopausal hormone imbalance, and environmental factors/lack of a completely healthy diet. 

I'm also 100% sure my only sexual partner, my husband, isn't a demon.  However, I don't know who he sleeps with in his dreams, I've never asked him/don't care, you can't control what you dream about. 

But it's true, my OB/GYN provider didn't do an actual pelvic exam yesterday, because of the amount of bleeding, so when I go back, I'll ask her if she sees any demon sperm, dancing around, up in there, too?  It certainly feels like it ;)  

I AM, however, pretty sure my ex-husband was a demon, but we didn't have any children together, so what about that - Stella?  ;) 

LOL

(Yes, the last 2 above paragraphs especially are complete sarcasm.) 

For anyone who still doesn't know what I'm referring to, it's about the Trump Jr. video that was removed from Twitter for dysinformation, and Trump's later insistence at the WH Coronavirus press briefing that Dr. Stella Immanuel, the main doctor speaking on the video, was "impressive."

I'm not going to show you the original Twitter-removed video, promoted/launched by infamous and overly harrassing/aggressive conspiracy-theorist whack jobs, QAnon (the same proof-challenged nutters responsible for Pizzagate), but here's a still photo.

If you still want to see it, especially after reading this post, rest assured - Breitbart still has the video up as "news" and "fact." ;)






The gist is, Dr. Immanuel is a pediatrician in Houston, who is among one of apparently 12 other quacks - erm, I mean, outlier doctors - who despite being called "America's Frontline Doctors," do not practice in emergency medicine, infectious disease, virology, epidemiology, OR clinical research, but are all nonetheless touting hydroxychloroquine as a COVID cure, despite lack of data and evidence.



However, what neither the Trumps, Fox News, Breitbart, Qanon, nor the removed video itself shows/tells you - but the below video does show.tells you - is that Dr. Immanuel also believes that Nephilim demons can turn into a woman and sleep with your husband in his dreams, steal his sperm, then turn into a man and sleep with you, resulting in demon-husband sperm mix babies - or conversely, that your dream sex is actually astral sex with a witch, also resulting in demon sperm.




Either way, it's all our fault, because we're cursed women for tempting Adam, I guess, didn't satisfy our husband's sexual needs correctly, and/or lusted after others in our dreams?!? lol.



She also says this is a common problem with women, in that they have astral-sex dreams with Nephilim, which will will result in woman engaging in infidelity, financial ruin, health ailments such as reproductive cancer, uterine fibroids, and ovarian cysts, and of course, above all, half-breed-Nephilim demon children.



Once again, thanks other women, for continuing to help misogyny out by continuing to help victim-blame/blaming JUST women for everything!



I'm not kidding, I couldn't make this shit up - here's an example of one of her "sermons," on unedited video, which she verified as authentic, and continued support, even after the press found it and went nuts over it  ... 












Additionally, although not noted in this particular video,  she has repeatedly made clear her platform on vaccines in general - that she believes "they" - meaning the government and corporations (which always curiously and inexplicably exempt Trump as both CEO and POTUS?) -  are "injecting Nephilim DNA into people, to stop them from being religious." 


She even allegedly once stated she got this information from a conversation with a half-reptilian Nephilim, herself. Not even gonna ask how that supposedly came about. 




Mkay.  Wow, great choice, Trump and Jr. - that IS "impressive!" 

Just ... not at all in the way you said it, but more in a "How on earth did such a belief-trumps-evidence person make it through medical school, become a doctor, and is actually licensed and allowed to treat other human beings? 





Now, I was raised by an evangelical family, and though I've seen a lot of crazy sh*t that hundreds of people overlooked, passed off, and even promoted as part of Christianity, even I was shocked by that one.

Because though Nephilim actually does have brief mention in the bible - not like that!


Specifically, in Genesis, the story of Noah. 

 Our interpretation of Genesis 6 says, they "looked down and lusted upon the daughters of man and lay with them."


There are various translations which say everything from "Sons of God" to "Fallen angels" to "Nephilim"  - but in all cases, not a single translation/interpretation says they "came upon them" spiritually, like the Holy Spirit is said to have "come upon" Mary - all translations/interpretation say "lay with" the Daughters of Man  - meaning they had actual physical sex with them.

There is also absolutely nothing in the bible whatsoever indicating they had the power to negate free will through sexual spiritual trickery, in any biblical story about sex with spiritual beings - either "the Daughters of man" having physical sex with Nephilim in Genesis and the Book of Enoch - OR Mary in the gospels - all chose their fate in free will, for better or worse.





Now, at the end of Noah's story, nothing survives except Noah's family and the animals that Noah had on the ark. 

However, there's also the Book of Enoch - a long debated removed book of the bible - supposedly because of "lack of authenticity," but then how the heck can you prove anything is authentic or inauthentic in the bible, anyway?

The Book of Enoch goes into great detail stating that the Nephilim spawn were, in fact, not all wiped out, and Nephilim returned, and that in fact, the reason God allowed the flood was destroy half-breed Satanic blood line. 

Because Book-of-Enoch believers believe that since Satan couldn't create, Nephilim was Satan's only way of creating his own race - and the great flood was God's attempt to destroy Satan's bloodline on this earth, who were wreaking havoc and tempting even God's bloodline towards evil.

However, once again -  even in the removed/debated Book of Enoch - free will was STILL always involved, there was actual physical sex involved, and no one was "tricked" into anything without their consent. 



And I also wonder if "Dr. Stella" is aware that the most extremist/fundmentalist "Book of Enoch" believers are typically white supremacists, who who believe the Nephilim spawn theory are black-skinned, having twisted it to mean all black people, and this is why their skin is dark, because they're marked?



(Very similar to original aspects of Joseph Smith's Mormon theory, an aspect which has since been denounced by the faith).

Of course, just like Stella's odd tangent belief, based on Book of Enoch theory, not actually being according to the BOE - or any known scripture -  there is also no indication whatsoever of 'Nephilim being marked by dark skin color,' in either the Book of Enoch OR anywhere in the bible.

Sometimes, people - particularly evangelicals - add stuff to the bible that isn't there, just because they WANT to believe it so badly, even saying God told them so personally. 

That's another issue I have with evangelicals - they talk about Satan, demons, and witches, more than they talk about the power of God, constantly in fear that Satan and demons have the power to negate their free will by trickery and take over their minds and bodies without their consent.

(I suspect the only thing having this belief is actually proof of is that on some level, they already know how easily misled and gullible they are, and project that onto everyone else?)


Now - what I suspect has happened, here in particular, with "Dr. Stella," is that she has fused her original cultural animistic beliefs with Christianity in a very odd way.

Most religions of have done that at some point, including Christianity - many of us modern Americans have even fused Native-American animism with Christianity, in many ways. 

However, the best example is in Buddhism - Buddhism was never meant to be a religion or a faith, but today's Buddhism is actually a mixture of the prior culture's belief in ancestor worship fused with Buddhist philosophy.

In fact, Buddha himself said: 


"When I'm dead, do not pray to me, I won't hear you, I'm dead.  Work out your own salvation with dilligence, that is not what I'm here for - I'm here to teach you a better way to live."








That's right - Buddha himself said his philosophy was meant to be adjunctive to your chosen faith, it never supposed to be a religion or faith - it was supposed to be adjunctive to any faith who's goal was also to help end suffering in the world and find inner peace and balance - period. 

Regardless, what has Buddhism mostly become? 

A religion that worships/prays to Buddha and ancestors, despite Buddha himself stating repeatedly not to.

Thus I won't be too hard on Dr. Stella herself, because that's clearly what she has done, fused the two faiths of her original culture, animism, with Christianity -  and she has ever right to do so, in this country. 

I also can't say whether she's right or wrong in this belief - neither of us can because there's no proof either way. 

However, I CAN say, with absolutely certainty, that her belief in "demon sperm" through trickery is not supported anywhere in bible scripture - even in the debated/removed Book of Enoch. 


So instead,  I AM going to make fun of the Trumps and his fringe right-wing nut-job types of Christian supporters, who are either unknowingly pushing this nonsense because of they actually do share these unusual beliefs, or because they're the more devious devious, political-power oriented types of Christians, who know this is complete BS, but figures scaring the hell out of people into voting for them works. 


On that note, people have said to me since the beginning of Trump's bid for presidency, as far back as 2015 - "You know, most people who support Trump just aren't very smart, they're fairly low IQ people."

I said, "That's actually not true - they're less educated overall as a group, yes, but education level is a separate issue from actual IQs/intelligence level, and even some ivy-league- educated people support Trump."

"Thus, my theory is this - if they're not also just generally greedy, dishonest, unethical people themselves, who genuinely see nothing wrong with Trump's behavior - then I often wonder if this is about allowing their belief system to "trump" intellect, fact, and reality."

"In other words, do these individuals have an instability -  or better worded, an imbalance - between their emotional/spiritual beliefs vs. their intellect."

"We all have been given strong brains, strong emotions, and even strong spiritual center (depending on how spirituality is defined) -and I believe that we create most of our own problems when we don't keep these things in check, inn balance -  which is be done by comparing one against the other."

Thus, when I say Trump Evangelicals appear to be "imbalanced," I don't necessary mean in a mentally ill sort of way - I mean they have essentially allowed their emotional/spiritual belief system to run rampant without check points - they've allowed their belief system "trump" their own intellect, clouding their insight and judgment. I'm not sure, but that's my theory."

That was 2015 - and in fact, NOW I'm even more convinced, and I would say now that IQ level doesn't matter at all - what matters is how "dysfunctional family" in belief mentality they are, how imbalanced their belief vs. their intellect is. 

Dysfunctional-family style belief versus reality is a powerful thing.  Mentally ill and addicted people as leaders of dysfunctional families can be highly intelligent, but still be abusive and believe in some crazy crap.


There's no amount of fact you show them that will convince them otherwise; in fact, the more you try, the more you push them further into denial and make them angry, and worse, the more suspicious they become of you - you become "the demon" to them, for even trying to make them look at evidence.    

For example, neither my sisters, nor myself, are evangelical anymore, but my sisters still are in close contact with my mother - who took years for doctors to correctly diagnose mentally ill, because her evangelical Christian cover worked for a very long time - even asking  ask her to pray little incantations over them, as well as they fail to see how much of her mentally-ill belief system still permeates the way they look at the family, themselves, and the world.

Because in evangelicalism, once something is read/told to you about your life or someone else's - by their interpretation - it's gospel and there's no changing it - and there's no question that the evangelical's mouth it came from was correct or sane.

I was actually the first to realize that even though my dad was a complete psychopath, my mom was almost as mentally ill herself, at age 14, when the other two weren't ready to see it and still kept blaming her behavior on trauma. 

Thus, I became the "devil" and "witch" of the family for even stating such a thing, and still am that scapegoat of the family to this day because of it. 


And I'm here to tell you, even if you grow up and out of that dysfunctional system, you really have to dig into some deep therapy to get how sick much of that type of belief system really is, otherwise, you'll still find yourself trapped in a dysfunctional belief system, like my sisters are. 

In fact, I cannot believe that it's taken this long for psychological professionals to really start looking into these types of beliefs as a form of mental illness and addiction - and that it took Trump to do it.

 I've been saying there's such a thing as religious abuse (which includes physical and emotional abuse) since I was 14 years old, but because there are so many of them, particularly in the South, I was outnumber, I guess lol.

Regardless, whether you want to call it mentally ill or "out of balance" between belief and intellect - I'm pretty sure that is not what we want to lead this nation, particularly during health crises. 

God gave us free will and expects us to use it wisely, and not to call things we just made up out 

Wednesday, July 29, 2020

Results? Benign Uterine Fibroid Tumor

So I wrote in this post not long ago that I had something going on and was referred to a OB/GYN again and my concerns with THAT, in this area lol.

However, I was very impressed with the provider, and most importantly, we discovered the root of the issue - I have a fibroid tumor.  No worries, they're benign!

That doesn't mean they're not annoying as hell and can't impair your normal function, because they certainly can.

The cause is not known, but they are largely hereditary and associated with hormonal imbalance.  My grandmother had them, as did my mother - and they can result in hysterectomy, but these days, they often try other things first - although there's not much.

I'm talking about this publicly because I get frustrated with the fact that we have evolved as a society to the point that women can now talk about pregnancy and hormonal issues regarding pregnancy, but for some strange reason, we still can't talk about perimenopause/menopause and it's associated issues - like we're supposed to be embarrassed about our lack of fertility, even though it's a natural process.

And if you're pregnant and need a couple hours off, everyone's fine with that, but if you say, "I need to go home a bit early today; I have a migraine, I've vomited twice, I'm falling asleep at my desk, my uterus hurts like a B, I'm bleeding like a stuck pig, and I feel like bitch-slapping the next person who even mentions Trump's name to me, when I normally don't feel THAT vehement about it (lol) " - that's not considered a "real" medical excuse for anything, even though it's the same hormones cranking just as much, or even more, than when you're pregnant!

Why is that not an excuse?  Because no life will be produced from it?

Seriously - we need to get over looking at everything from a religious standpoint, as well as wrongfully associating Christianity with reproductive issues - even our obsession with reproductive issues as Christians, when Christ was barely concerned with them - Christ's message was much bigger than that :)

(But I digress, I, personally have some pretty wonderful bosses, who know I work my ass off, every day, even 7 days a week, if needed, and that I would come to work if my arms fell off, so when I asked for day off, recently, they knew it must be bad, completely understood, and were completely supportive - but that's not everybody, or even most people.)

Thus, the first thing I want to say is, if you are experiencing heavier than normal bleeding, prolonged bleeding, or pelvic discomfort or pain in between periods, sudden-jump weight gain, particularly in the lower abdomen - don't just chalk this up to perimenopause - it could be something else that needs treatment - because even though fibroids are benign, they can grow if left untreated, and the bleeding can lead to anemia.

My symptoms were daily bleeding for three months, sleep problems, night sweats, low/no energy,  nearly daily migraines, rapid mood changes, nausea/vomiting, sudden rapid weight gain/distended lower abdomen, and pelvic discomfort even between periods. (I sat "discomfort," whereas others might say "pain," but I'm pretty good with physical pain, so I call it "discomfort.":)

Thus, I am going back on hormone therapy/birth control, a different kind (the first kind two years ago caused a couple of spots of cystic acne) - a lower-dose progesterone, in the hopes they can medically shrink it and prevent more.

Having been on them three years ago, and again for 10 days to stop the bleeding until I could see the OB/GYN (reduced appointments due to COVID), I can tell you, based on how I feel when on them versus when I'm not on them - take the birth control/hormone therapy, it feels like a miracle drug - all of the above just magically goes away.

And for anyone who is anti-birth control on religious grounds -  not understanding that birth control is NOT just used to prevent childbirth, but to treat medical conditions like hormonal imbalances, polycystic ovarian disease, and fibroid tumors  - may I just say, based on how I feel at the moment, awaiting my new prescription - a big F*ck You  lol.

I'm sorry, but it's like night and day on them, and based on how I feel at the moment, waiting for the prescription, versus how I feel when I'm on them. 

And that may be my uterus talking.  At the moment, she's screaming, but the good news is, mostly at me :)


(The mood shifts trigger my depression/self-verbal abuse, which I cope with some good CBT, reminding myself that everything is actually now SUPER good in my life, better than ever, and that I am not, in fact, the very devil, and that this too shall pass. That is not to say these aren't normal feelings, just more intense, hormonally-fueled, - so I simply remind myself of that, no matter how loud my uterus gets lol ;)


Like I say, most of it is directed at myself, but I have caught myself snapping a bit at my husband, realizing it immediately after and apologizing.

Like the other night, he was watching "Jarhead 2" or some other military movie, with bombs going off and shooting and it sounded like it was right in my ears. When a migraine is coming on, I'm especially sensitive to light, sound, and smells - all get on my nerves.


I said, "Oh my God, that's so loud, turn that war shit DOWN!"


No stereotypically "please," just a snap demand - which is unusual for either of us -  neither of us normally communicate with each other in that way :(


HOWEVER, I realized immediately that came out and worse than how I meant it, so I said, "OMG, I'm so sorry, I don't know where that came from it just came out of me!  It's not your fault, it's mine, right now, I'm sorry."

Than I hauled my cranky, oversensitive, migraine-aura-ed butt off to the bedroom to read, because it's not anybody else's responsibility to make my environment comfortable - I need to take my irritable ass in the other room and read and let him watch, listen, eat whatever he wants, at whatever level he wants! lol.

To his credit, he didn't want to make things worse, so lowered the Jarhead volume a bit anyway. He also told me he can see in my eyes when I don't feel well, whether I say anything or not, and he knows I'm hurting and it's okay - and that he still thinks I'm beautiful and sexy, with or without a functional uterus. God love him for being such a good liar lol

Now - on that note of hormone therapy/birth control and it's original purpose of preventing childbirth, I have some feelings about this, too, stage in my life.

I guess it's hard for everyone to realize and accept you've reached a certain age - but I have to say that I don't care who you are, or how career-hard woman you think you are, there is something about not being able to have children anymore if you wanted to - that affects you.  Our bodies (not our brains and voices) are biologically pre-disposed and designed for this basic function - and now we just can't anymore.

And even though I intellectually know that my value as a woman is NOT just based on my ability to have children and youthful attractiveness, we've all been socialized to believe that.

So again, for anyone, male or female -  who helped socialize us to believe our only worth as women was reproductivity/attractiveness, when I know Christ valued us for much more (or he wouldn't have given us brains and voices, nor first appeared to women first after his resurrection) - again, I say, "FU."

I know, that's not Christ-like, but I never said I was Christ, just a Christian.

I'll ask for forgiveness later, but at the moment, like I said, my uterus is doing all the talking for me lol.

So, I had a few seconds of tears over it, truth be told - the acceptance that my youth and fertility are gone - but then I do have a hormone imbalance right now, and could likely cry over a Hallmark commercial lol.

And I just have to adjust - and remind myself that my worth as a woman is NOT just based on my fertility - thank you, Jesus  - and I mean that sincerely! :)

Mostly, I'm just glad it's benign and something that can be easily treated - and grateful for a strong sense of humor as a coping skill :)





Tuesday, July 28, 2020

The Madness of Attorney General Barr ...



... who is set to testify before Congress today, on why he thinks federal agents are justified and needed in Portland and elsewhere, despite not being requested by these city or state officials, nor their local police forces.








Let us not forget, this is the same man who shocked the world, when he approved - and was actually present - with the use of tear gas on peaceful protesters in front of St. John's Church in Lafayette Square in Washington, D.C, just so Trump could take an unwelcome photo op photo there, with (an initially upside-down) bible. 













First of all, if you have a brain -- especially one still capable of non-brainwashed, independent thought - you should've been asking yourselves from the get-go:

"Why Portland?!?"

Portland isn't even ranked in the top 100 most dangerous cities in America - and though it has had small nor has it been hot spot of shootings, burnings, lootings, or statue razings during the protests?!? 




No one knows the answer to that question - other than the answer we are given, which is that the largely peaceful protests have gone on "too long" (for nearly 60 days straight) compared to other cities (because Portland's police force has had race problems in the past).

No city's protests have been without small incidents of violence - there's always at least one in every crowd - but their protests have, by and large, been mostly peaceful - especially compared to other major cities.

That's the given answer - which still doesn't make any sense.

In fact, Trump's own tweet -  dated July 27th - inadvertently admits none of this has happened in Portland yet - he's just warning them NOT to ...








Which leads us to question whether or not the real answer is most likely a show of force, by Trump Republicans, in the most liberal Democrat city in a America, the message being:


"Even though you're not even in the top 100 most dangerous cities in America - and there's been no looting, burning, shooting, and tearing down statues, like in other cities - we have the power to manipulate/convince people that you ARE dangerous, just because you're liberals/Democrats."

"We've been very successful thus far in convincing half this country that all liberal Democrats are our Godless, amoral, violent enemy, in need of monitoring and pre-emptive strike force, because of what you MIGHT do, if left to your own devices."
"Look, we can even physically bully, intimidate, and dominate you into submission with impunity, and there's nothing you can do about it ... nanny nanny boo boo."

Oh, good, it's a giant involuntary game of rugby, that no one wanted to play, except Trump-style Republicans, who are obsessed with making people who disagree with them into their Godless enemy - thus, people must be thrown into one of two boxes, labeled "winners and losers," in Trump's America!

Regardless, whether anyone wants to admit it or not, this is clearly a case of trying to provoke Portland into actual violence and the tail wagging the dog, justifying the need for federal agents in reverse - and it's starting to work. 

It's expected that Barr's testimony will include the necessity for federal agents because some protesters "might" get violent or tear down government statues/building.

Well, you would think after almost 60 days, if that was going to happen, it would've already happened.



I'm pretty sure that our constitution does NOT say: "Well, you can punish people based on subjective suspicion on what they've done, or what they MIGHT do, if given the opportunity, despite not having any evidence." 


No, our constitution says, "Innocent until proven guilty in a court of law, with the right to attorney representation."

(I would only add the caveat that though our constitution doesn't say it, those with the most money and power, to afford the nastiest/most unethical lawyers, will often win, despite their guilt or innocence.) 


So by Barr's logic, we could've sent federal agents to tar and feather Smug-Face Kavanaugh, based on suspicion, or drawn-and quartered Trump based on his collusion with Russia, the Ukraine and other countries to win elections. 

But you see, Trump and Barr's warped sense of unconstitutional justice with impunity is only permitted because it's towards Democrats, people of color, immigrants, non-Christians, and LGTBQ, not their own ;)

But keep on calling state mask orders and shut-downs for public-health reasons in the wake of COVID, "socialism/communism," instead, Trumpers - it amuses sane people. 


_____________________________________________________


PS - The Wall of Moms and BLM have now sued Trump and the federal government.

The hope is to force the federal government to provide evidence that there was any group violence or rioting whatsoever until after federal agents had been tear-gassing, flash-banging, baton-beating, and shoving them for several days.





Monday, July 27, 2020

Thank you, Olivia ...





I have waxed poetic (or something like it?) many times, on my adoration for the Divine Ms. D - Olivia de Haviland, including most recently here, in this post, when Kirk Douglas died. 

At 104, she was the last remaining member of the Golden Age of Hollywood, the Queen - managing to change labor laws in Hollywood that still stand and are being used to this day - no easy feat, especially for a woman.

Despite her outspokeness on issues she cared about (for which she was briefly black-balled from Hollywood) - and a never-ending smear campaign by her overly competitive sister, Joan Fontaine (also an Academy-award winning actress) - she was able rise above it all and win them back over, with her grace, poise, professionalism, maturity, and integrity :)

Interestingly, before she died, her sister, Joan Fontaine, apparently tried to reverse years of Olivia-reputation smearing by claiming it was all press that made the sibling rivalry, they'd "never had a quarrel" - but Joan's own supposedly tell-all autobiography on Olivia, that you can still purchase, says otherwise ;)

Olivia, to her credit, refused to ever speak publicly about her sister at all, and if she did, it was positive about her talent and to make eye-roll dismissive light of her sister's antics towards her.  

From what I've read, it appeared Joan constantly tried to make herself an innocent victim of Olivia, and in her autobiography, Joan even tried to take credit for Olivia's getting the part of her most famous role of "Miss Millie" in Gone With the Wind, that she never would've gotten it if it wasn't for her. 

Now - one true thing about Olivia, on the other hand, was that she was famous for cutting people off, personally and professionally - permanently.

What Hollywood called her "legendary grudge-holding" I actually found pretty healthy.  

Because after admittedly trying to reconcile with her sister several times early on, as well as some people in show business, Olivia was the sort that once she felt she'd given you enough chances, once she said she was done with you, she was done - you simply didn't exist to her anymore.   

It's not that she hated or didn't love Joan, nor did she bad-mouth anyone she cut off - she just refused to ever work with them again without ever stating why, just "no thank you."  

In fact, she never mentioned them again, and/or changed the subject if anyone ever brought them up  lol. 

Thus, based on the very few words Olivia has spoken on the feud with her sister, we know that she once alluded to the fact that they were both pretty ugly to each other as children, instigated by their mother pitting them against each other - once even expressing regret for her part in their childhood rivalry and competition.  

Thus, it at appeared, at least outwardly, that Olivia grew up, whereas poor Joan never did (either regret anything or grow up lol).

Regardless, their lifelong family feud was not all there was to Ms. D  - and in fact, had very little to do with her, except that she managed to succeed in Hollywood anyway, despite it. 

Also to her credit, though I'm sure she has a few ugly stories Olivia could tell about Joan, we will never know - because whatever happened between them, she took these stories to grave with her - she died without ever once telling her side of the story, or wrote a "tell-all" autobiography, being a big fan of protecting her own privacy (and everyone else's privacy) unless she felt the behavior was criminal. 

That takes class and a strong will power, not to allow yourself to get dragged down in the mud-slinging pit with them - I, myself, have tried to do this and failed, after a time lol.

Nope, they don't make them like that, anymore, especially in Hollywood. 

So thank you, Ms. D ... for De Haviland's law, as well as Miss Millie, Camille, Virginia, Miriam, and so many other characters that set the gold standard.  





Saturday, July 25, 2020

"Wall of Vets" Now Joins Portland Protests ...











Yesterday, Portland experienced their biggest number of BLM protesters yet, which now includes the "Wall of Vets," as well as the "Wall of Moms" :)









They have now joined the protest in response to the baton beating of Navy veteran, Christopher David, who was not involved/supportive in the protests, until he saw videos of peaceful protesters being shoved into unmarked vans. 









Mr. David approached an officer to ask him a question, and despite having a U.S. Navy sweatshirt on and hat, he was hit repeatedly with a baton.


I tell you what, it doesn't surprise me, in this country, when people of color, women, or even children are beaten by power-abusing law enforcement, federal or not - but having the audacity to abuse your power insofar as to beat with a baton an actual Navy vet, without even blinking?

That DOES surprise me.

And it proves just how far the Kool-Aid-drinking, brainwashed, Trump-Nazi mentality has grabbed hold of the American mind, objectifying anyone who doesn't agree with them as the "enemy," therefore justifying themselves for doing God knows what to them.


Regardless, the "Wall of Vets" showed up last night (and again today) - and despite protesting peacefully, they, too, were tear gassed :(









So far, all of the (masked) Portland protesters have carried leafblowers and batons for self-defense, but no guns.

In fact, no violence at all has been reported, with the exception of one reported stabbing, just last night (not federal officer involved) - but that was the only reported violence, other than what has been inflicted upon them by federal agents. 

I know it's getting hard for the protesters to not defend themselves, and I'm praying they can hold out without violence, but they are human, after all - and now you're dealing with vets. 

Also last night, a federal judge denied the State of Oregon's request for a lawsuit against the federal government, on the grounds that they did not have the authority to file a lawsuit on the behalf of the protesters.

Okay.

So our constitution says that we have the right to peaceful protest and that the President can only intervene without local government request under case of emergency.

So if that is in question, who can sue on behalf of the people?

I understand the Justice Department is conducting an investigation.

Oh, I feel better, U.S. Attorney William Barr provides oversight, who directly gave Trump permission, and looked on, while peaceful protesters were tear gassed in front of St. John's Cathedral, so Trump could take a photo op with an upside down bible!

(Sarcasm, of course.)

Sigh, Lord have mercy  ... and I mean that sincerely as a prayer :)

Regardless, the vets and moms and everyone else came back today - with even more reinforcements - still armed with nothing by leafblowers and batons themselves, for self defense - still praying for you Portland, thank you  :)









Preliminary Thoughts on Trump's Drug-Price EO's








Okay, so as we all know, drug prices ARE out of control, here in America, a problem that we all had hoped ACA/Obamacare would help with - the idea of insuring everybody, by creating a government fair-market price to compete with regular price.

The government "fair-market" insurance option to compete with commercial insurance options was brilliant in theory, but had some major problems in practice when it came to income limits and tax penalties, most of which have been fixed - but with the main problem has not been fixed, and can't unless we come up with some form of price regulation itself. 

Because in response to ACA/Obamacare, instead of lower their prices to compete with the government market plan, all that participating commercial insurance companies and pharma companies did was just raise their prices, so that prices all around, government market and regular commercial insurance, were even higher than before (just like gas prices can raise and lower their prices at whim) and then tried to blame Obamacare for making their doing so necessary.

So it became clear that we do need some sort of restrictions - but the question is then how can we do that, while still maintaining fair-market competition?

And as we all know, I'm a Democrat, so you would think I would like these new EO's, yes?

Well, I'm still reading on it, these are just my preliminary thoughts, so forgive me if I'm off in full understanding - but from what I've read thus far - not so much.

Why?


Because these are complex systemic issues that putting a single-cap threshold on price/out-of-pocket cost won't solve.

That's exactly the problem with Medicare as it is - Medicare is not allowed to negotiate the price of drugs, like commercial insurance companies - they're only allowed to just give a blanket threshold cap on price (which affects, but does not limit commercial price) -  which is why we know a cap threshold won't work (see this and other reasons why below.)

Also, it's not JUST the fault of pharma, like Trump said - it's also the fault of insurance companies themselves (again, see below).

More importantly, EO's don't carry as much power/weight as congressional law, especially in healthcare - they won't make much, if any, difference.

In fact, Trump's decision seems more of a reckless, sudden, desperate "karate chop" of a slapping a Band-Aid down on the gushing-artery of a systemic, complex, bleeding problem.

(Perhaps after largely ignoring/neglecting the issue entirely, for the last 3-1/2 years, as well as because he's dropping like a rock in the polls behind Biden in the polls, after his Portland stunts and COVID response? ;).


Although, I'm a Democrat, contrary to propagandized and popular belief, we do NOT want everything free - we just want more assistance to people who genuinely cannot afford certain necessities, and we want more consumer protection laws and labor protection laws for them as well.

Thus, I'm a fan of fair-market competition, because it actually works -when it truly is "fair-market competition," and includes both consumer protection laws and labor protection laws.

(Also, valuing "fair-market competition" should NOT be confused valuing "trickle-down economics" - they are not one in the same. "Trickle down" theory has been repeatedly proven to only work locally, and has never once proven to work at the national corporate or international corporate level.)

The problem is, it's NOT a fair, competitive market, it's being abused with little to no consumer protection - and despite Trump blaming JUST Big Pharma for that - both pharma AND insurance companies should share the blame.


Because even though we have generics and biosimilars on the market, some prices still never come down, the way they're supposed to when there's lot of viable competition - which is the fault of pharma.


*HOWEVER* insurance companies are equally to blame, especially for the patient out-of-pocket cost share.

That is because insurance companies choose a particular drug as being on preferred or non-preferred formulary, often based more on whatever contracting deal with discounts/rebates that they receive from the manufacturer, rather than the actual efficacy and safety of the drug.

They DO take clinical efficacy into account, but if there are two similar drugs, they're going to put the one on "preferred" formulary if the manufacturer gives them the better deal, even if somewhat inferior. 

In other words, out of two similar drugs, insurance companies will often choose to put on their preferred formulary  (cheaper-cost to the patient) - whichever drug  manufacturer offered them the biggest discount and rebates - even if that drug has been proven less effective and less safe than the other option. 

As a result, you, the patient, will often have to step through and trial/fail the generics AND the preferred brand first, before you can get to the better/safer drug - simply because the more effective/safer drug did not offer the insurance company better rebates/discounts versus the other one - which will cost you, the patient, more out of pocket, because it's on the "non-preferred"formulary, based on the manufacturer-insurance contracting deal.


As you might imagine, this broken aspect of our current healthcare system pisses off doctors and pharmacists like nothing else, because they believe they should have most of decision power on treatment for a patient, not the insurance company. 


 They're okay with passing checkpoints for coverage, but are NOT always okay with the fact that in the end, the insurance company decides what drug treatment the patient is on, based on the almighty dollar being king.

You will also find that most doctors, ethical ones, don't even care if they, personally, get to share in the drug-manufacturer rebates - they still would prefer choosing the best treatment over the cost/rebates (at least the ethical ones, do) - because they took an oath to provide the best care possible to the patient, not provide the best bottom line profit.

This is why I say corporate health insurance companies are just as much to blame as Big Pharma, and why we Americans say that healthcare has become too commercialized, as well as why we would all like more transparency on how commercial insurance companies make their formulary decisions on a particular drug, as well as want to allow Medicare to be able to negotiate price, just like commercial insurance does.



Thus, one threshold-cap price oversimplifies all of the complexities of the actual clinical aspects of the drugs themselves, not taking into account that all drugs are not equal even in the same class - what drugs have already been tried/failed, safety and tolerability, black-box warnings/drug-drug interactions, routes of administration, mechanisms of action, subgroups that would benefit from a certain drug versus another, etc.

As I've mentioned, I currently have two gigs as a contractor - one as a medical transcriptionist for a large university hospital and clinic, and the second is transcribing the interviews between independent marketing research companies, who have been hired on behalf of various pharmaceutical manufacturers.

Just as a brief overview of what I'm typing on this second gig, without giving any private info away, the independent marketing researchers have been hired by various manufacturers to get feedback from expert physicians, insurance-company medical directors, insurance CFOs, hospital and clinic P&T finance committee members, pharmacists, and pharmacy directors.  

The interviews are blinded - meaning the respondents (and myself) do not know who the pharmaceutical company is nor the name of their product, and the pharmaceutical company doesn't know who they are.  

The interviews are conducted either before or during a clinical trial, to find out what they'd like to see as far as trial design - primary and secondary endpoints for clinical trials on new drugs -  and/or what they think of the preliminary results of these trials.  

Above all, they always ask their input on price point, especially compared to other drugs already existing in the same class (if there even is a class yet, but usually there is, because we still don't have a lot of actual revolutionary cures yet, besides some gene therapies are promising). 

They will also offer different "what if" scenarios, regarding whether their new drug came in at parity, lower, or  higher compared to other drugs in the class. 

That's about all I can say about that ;)

However, general point being, all of the groups - clinical, payer, pharmacy - are all carefully weighing the efficacy value versus safety value versus the route of administration (oral, infusion, injection) value versus price value of all the other drugs in the class, before they give those answers. 

What I have learned is how complex trying to do this really is, how hard it is to know where to come in, if you have a new product in the same class.   

If you're not an actual cure, but your drug's efficacy, safety, and routine of administration (oral/infusion/injectable) may be better/preferred - which is the case most of the time - you're still competing against a drug that came out three years before your product and has more time of real-world usage.

Therefore, despite clinical trials, both clinicians, and especially insurance companies, are still likely going to reach for what they know and are comfortable with using in the real world, where we know we have lots of patient compliance/adherence problems, versus a controlled clinical trial that shows better efficacy, but where it's ensured patients will receive the dose.

So IMO, not reflective of anyone else but me - the problem is with the price of that very first drug in the class that becomes the key comparator - that's where we need some sort of restriction, but  - not all the "me toos" that come after that have to compete with it, that are often improved versions with better efficacy?

However, this isn't as easy as a "cap" - because there IS value in a drug in a disease that we had absolutely no options in before, and there should be.


HOWEVER, at present, that first drug in class, despite not being an actual cure, can charge whatever they want, the sky is the limit, because there's nothing else in that class to compare it to - even if it doesn't do all that much, isn't all that safe, and they're charging 100 times what it costs to actually make the drug. 

If a drug is not an actual cure and isn't all that safe, there is no good reason it should cost $400,000 a year, I'm sorry - and you know dang well it doesn't cost the company even half of that to make, including research and development and clinical trials. 

Also to be kept in mind, the first drug in class will typically not be the best - within 3 to 5 years, a better brand will come along, as well as generics and biosimilars - and yet, as I said, doctors, and particularly insurance companies - will still want to reach for that tried-and-true, real-world drug they're comfortable with before that new, better one.

However, when I say "some sort of restrictions on that first drug in class," I do NOT mean just placing a blanket threshold restriction on the first drug in class - because what if the next drug in the class truly is better, or even an actual cure - is there not greater value in that?

For example, right now, we have lots of drugs aimed at heart disease with different mechanisms of actions, it's a very crowded space.

At present, we can't actually repair or cure heart disease with a drug - we can only try to prevent or help reduce the calcium plaque burden by lowering cholesterol.

But what if we had a drug that could actually repair heart vessels, reverse the damage?

Though it's first in class, it would ordinarily set the price; however, if there's a threshold cap, it doesn't matter - the price for the actual cure will be the same as the drugs that only help prevent - is it fair the actual cure for the disease would have to come in at parity or lower than the non-cure?

Of course not.

Now, the non-cure still has some value, because it can still help prevent heart disease in people who don't have it yet; so theoretically, according to fairomarket economics, they would lower their price to compete with the cure, right?

However, what incentive would they have to do that, considering the cost of the cure and the non-cure are at exactly the same price threshold?

On the other hand, let's say the drugs have similar mechanisms of actions and similar targets; let's say they both lower cholesterol, but the newer brand is actually better and safer than the first drug in class.   


With a threshold cap, even though the first drug is an inferior and less safe product, they're still priced the same. Is that fair?

Of course not.

So you see the problem with trying to place a single threshold cap price on all drugs.


Some of the interviews I transcribe are international - U.K., France, Spain, Germany. 

Of course, they have varying degrees of socialized healthcare and we don't - but I think we should do a thorough evaluation of their systems, what works and what doesn't, before we start laying down blanket generalization restrictions on things without considering what's happened before us, when people tried to do that.

In other words, study what works and what doesn't, regarding these other systems first. 

Contrary to popular belief, in the U.K, they do NOT just blanket price restrict medications, with one cap price on everything - there are varying levels of thresholds, based on all of the issues I mentioned above - PLUS- QALYs, which is unique to almost all other nation's healthcare systems.

What's a QALY?

QALY stands for Quality Adjusted Life Year - meaning they also take into account quality of life for the patient with a point  system that factors into that price. 

Some people think it's absurd and irrelevant, some people think it's the greatest thing since sliced bread, particularly clinicians.

Because what it means is, unlike here in the U.S., UK's payer system is just as concerned about the quality of life for the patient as the clinicians are - not just better lab values and less costly overall treatment. 

Now, here in America, insurance companies look at bottom line - i.e., do the patient's vitals and labs look better, have they had less days in the hospital/doctor visits?

Doesn't really matter that the patient has missed a week of work, hasn't slept in three years, visits the hospital still once a month instead of 3 times a month - all they want to know is if definable endpoint lab values are met and if they avoided the ER more. 

However, the U.S. DOES have a point with not yet adopting a QALY system - because how DO you objectively measure quality of life?

These assessments are subjective, based on patient and doctor feedback attestation, whereas the other data is objective, measurable data.  

Because you could be having a flare of a disease or a bad day, and are feeling overly negative while your quality of life is being assessed, right?  

Or what if the patient has mild dementia or cognitive impairment and can't assess their quality of life properly, and the physician doesn't know if they're able to complete their normal activities of daily living well?

And yet quality of life DOES still have value to be considered -  because if you're still missing days of work, can't sleep or eat, does it really matter that your lab values show mild improvement and you only go to the ER only once a month  instead of 3 times a month? 

No --  but that's all your insurance company cares about here in the U.S.   They don't care if you miss work or can't sleep or eat, they only care that about what they had to pay for. 

So I'm wondering if there's a balance between the two if there's value between totally ignoring quality of life issues entirely, like we do in the U.S., and overrating them, which often happens in the U.K - that we could perhaps consider and factor into these drug-price issues as well? 

Regardless, these are weighty decisions, that take committees and subcomittees, weighing the true value proposition of a drug, clinically, quality of life, and economic impact - not a blanket-price threshold?

However, I don't have an MBA or an MD - but that's precisely my point - these issues are way too complex for us to just over-simplify and blanket generalize by putting a threshold cap on price? 

Just my opinion.