as our descent back into the Middle Ages continues


A place for the discussion of all things not closely related to the sport and its competitive side. (as always, locked for the duration of major international championship)

Postby gh » Thu Oct 08, 2009 9:43 am

guru wrote:
BisonHurdler wrote:I don't think the leap people are having difficulty making is from immune system to cancer so much as "vaccines ---> decreased immune system."



Perhaps it's better to think of your immune system like your cardiovscular system. When you exercise, you tax your cardiovscular system, and in the process it becomes stronger and more efficient. Similarly, when you get sick your immune system is kicked into action, repelling the invading organism, also becoming stronger in the process. ...


Med student Bison can give you a better scientific answer than I, but since I took graduate-level immunology lo those many years ago, let me give you a really simple explanation of how this whole thing works.

You get a viral (or bacterial) infection and your immune system, hopefully, says, "holy shit, foreign proteinaceous body alert!" And it begins to build antibodies which bind to the surface of the offending particle and neutralize it.

In vacctionation, you're given some form of the same bacteria/virus, but one that has been modified so it doesn't cause the disease. Your immune system says, "holy shit, foreign proteinaceous body alertl" And it beings to build...... exactly the same process.

How does this prevent a "vibrant" immune system?
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Postby dukehjsteve » Thu Oct 08, 2009 9:43 am

guru wrote:
Marlow wrote:so much for evolution!! ;-)



You wouldn't want to be the person born after several generations of ancestors who were vaccinated for every bug that came along. Trust me.


No, I won't trust you guru. Don't get mad at me ( again ! ) but I think the shots should be taken.
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Postby Daisy » Thu Oct 08, 2009 9:46 am

gh wrote:How does this prevent a "vibrant" immune system?

I think the problem here is that when people read immune suppression it is interpreted, and marketed by naturopaths, as meaning "significantly" weakened. Personally, I doubt that is the case.
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Postby bad hammy » Thu Oct 08, 2009 10:02 am

guru wrote:It's clear we are not going to see eye to eye on this Bison. I respect your stance, but respectfully disagree.

All I know is my personal experience, having never been vaccinated beyond the early childhood regimen. Working around high school kids every day in Ohio winters I get sick maybe once every 3 or 4 years, and never take any medication during the illness. At 42 I plan to stick with what's worked.

Let's see. Where should I get my medical advice. Oh, I know, I'll go to a track and field site and listen to advice from some guy with no formal relevant medical training who refuses to wear a helmet when riding a bike. Thanks for the tips, dude!
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Postby Marlow » Thu Oct 08, 2009 10:09 am

bad hammy wrote:Let's see. Where should I get my medical advice. Oh, I know, I'll go to a track and field site and listen to advice from some guy with no formal relevant medical training who refuses to wear a helmet when riding a bike. Thanks for the tips, dude!

Gosh, that would be as silly as letting some T&F dodo explain to me why California is so effed up!
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Postby BisonHurdler » Thu Oct 08, 2009 10:10 am

In an attempt to not come off flippant and condescending to guru, I will concede that there is evidence suggesting that growing up in areas that are traditionally "dirty" (a very loose definition, but think farms/rural areas) tends to confer a more favorable response in later years as far as allergies go (for fellow nerds following along at home, think Th1 CD4 dominated immune response vs. Th2 . . . same principle behind tuberculoid vs. lepromatous leprosy).

Basically, people who are exposed to more "dirt" (and again, I don't know if this has been formally defined somewhere, so I apologize) at a young age do tend to have fewer allergic responses to environmental allergens.

But as far as any type of bacterial/fungal/viral pathogens, I maintain my stance with regards to immunizations.
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Postby guru » Thu Oct 08, 2009 10:15 am

bad hammy wrote:
guru wrote:It's clear we are not going to see eye to eye on this Bison. I respect your stance, but respectfully disagree.

All I know is my personal experience, having never been vaccinated beyond the early childhood regimen. Working around high school kids every day in Ohio winters I get sick maybe once every 3 or 4 years, and never take any medication during the illness. At 42 I plan to stick with what's worked.

Let's see. Where should I get my medical advice. Oh, I know, I'll go to a track and field site and listen to advice from some guy with no formal relevant medical training who refuses to wear a helmet when riding a bike. Thanks for the tips, dude!



Allow me to restate the first line of my paragraph, with slightly larger font since they say eyesight is often the first to go in advanced age -

All I know is my personal experience
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Postby BisonHurdler » Thu Oct 08, 2009 10:19 am

guru wrote:
bad hammy wrote:
guru wrote:It's clear we are not going to see eye to eye on this Bison. I respect your stance, but respectfully disagree.

All I know is my personal experience, having never been vaccinated beyond the early childhood regimen. Working around high school kids every day in Ohio winters I get sick maybe once every 3 or 4 years, and never take any medication during the illness. At 42 I plan to stick with what's worked.

Let's see. Where should I get my medical advice. Oh, I know, I'll go to a track and field site and listen to advice from some guy with no formal relevant medical training who refuses to wear a helmet when riding a bike. Thanks for the tips, dude!



Allow me to restate the first line of my paragraph, with slightly larger font since they say eyesight is often the first to go in advanced age -

All I know is my personal experience



Noted and respected; however, this is the problem that underlies the bigger issue: many people take this stance, and as explained earlier, if someone has never seen a measles epidemic, as far as they're concerned that disease doesn't exist.

So why immunize?

[Answer: because in the first half of 2008 there were 64 deaths due to measles in the US, 63 of whom were not vaccinated against it]


I understand your stance pertains more to adult vaccinations, but the principle is essentially the same. It's just much much more worrisome when people adopt your stance in regards to childhood vaccinations.
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Postby guru » Thu Oct 08, 2009 10:28 am

And by the way Mr. Hammy, I do have two years of pre-med college, and currently own a business in the medical field(admittedly not in the field of immunology, but I'm also not an uninformed "some guy" when it comes to things medical).
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Postby DrJay » Thu Oct 08, 2009 10:40 am

guru wrote:
bad hammy wrote:
guru wrote:It's clear we are not going to see eye to eye on this Bison. I respect your stance, but respectfully disagree.

All I know is my personal experience, having never been vaccinated beyond the early childhood regimen. Working around high school kids every day in Ohio winters I get sick maybe once every 3 or 4 years, and never take any medication during the illness. At 42 I plan to stick with what's worked.

Let's see. Where should I get my medical advice. Oh, I know, I'll go to a track and field site and listen to advice from some guy with no formal relevant medical training who refuses to wear a helmet when riding a bike. Thanks for the tips, dude!



Allow me to restate the first line of my paragraph, with slightly larger font since they say eyesight is often the first to go in advanced age -

All I know is my personal experience


Guru, That's like saying I haven't had car insurance for thirty years and have never had an accident so haven't needed car insurance so won't purchase any now.

Something like 36,000 people die of influenza-related complications each year in this country. The majority of those are elderly and/or have chronic problems like congestive heart failure, emphysema, etc. Those folks ceratainly should have an influenza vaccine. Younger healthy adults? May not be so important, and I don't know if any data exists proving "herd immunity" with the flu vaccine, i.e. guru gets the vaccine so I'm less likely to get influenza because there will be fewer cases out there.
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Postby DrJay » Thu Oct 08, 2009 10:40 am

gh wrote:
guru wrote:
BisonHurdler wrote:I don't think the leap people are having difficulty making is from immune system to cancer so much as "vaccines ---> decreased immune system."



Perhaps it's better to think of your immune system like your cardiovscular system. When you exercise, you tax your cardiovscular system, and in the process it becomes stronger and more efficient. Similarly, when you get sick your immune system is kicked into action, repelling the invading organism, also becoming stronger in the process. ...


Med student Bison can give you a better scientific answer than I, but since I took graduate-level immunology lo those many years ago, let me give you a really simple explanation of how this whole thing works.

You get a viral (or bacterial) infection and your immune system, hopefully, says, "holy shit, foreign proteinaceous body alert!" And it begins to build antibodies which bind to the surface of the offending particle and neutralize it.

In vacctionation, you're given some form of the same bacteria/virus, but one that has been modified so it doesn't cause the disease. Your immune system says, "holy shit, foreign proteinaceous body alertl" And it beings to build...... exactly the same process.

How does this prevent a "vibrant" immune system?


Well put. You are a smart guy.
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Postby DrJay » Thu Oct 08, 2009 10:42 am

gh wrote:
guru wrote:...

Posted already, but here's a nice synopsis.

http://www.mercola.com/article/vaccines ... ession.htm


Sorry, but I place osteopaths right up there with phrenologists in the level of medical quackery.

Ask a real doctor.

edited to note that I hyperbolized in my original post; it's homeopaths who are with phrenologists; osteopaths are on a slightly lesser level of hell


My doctor....who is one of my partners....is a D.O. We have a lot of them in the Springs and they are as good as the M.D.s . Not many of them do manipulations (or whatever they call it) anymore. Their training is just about like that of M.D.s
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Postby gh » Thu Oct 08, 2009 10:57 am

Then I apologize if I'm tarring all DO's with too wide a brush. It's guys like Mercola who give the profession a bad name, but there are quack MD's as well, of course.
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Postby dukehjsteve » Thu Oct 08, 2009 12:13 pm

Hey, it's Jump On Guru time !

You "know by personal experience." ???? Is your one life case a valid statistical sample ? If one man has smoked like a chimney and never gotten cancer, does he know from personal experience that smoking should not be discouraged for others ??

And if I am wrong I apologize, but ( as alluded by someone else above ) are you the one who, a few years ago, stated that you refuse to wear a bike helmet, because you "know how to fall ?? " But then again if you have ridden a bike all these years, without a helmet, and have never fallen ( plus you know how to fall ) then do you recommend to others that they also should not/do not need to wear helmets ? So I repeat, are YOU a valid statistical sample for anything ???
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Postby lonewolf » Thu Oct 08, 2009 12:39 pm

I don't know how this fits in here but I want to cast a vote for bicycle helmets.
I rode bikes for seventy years without acknowledging the need for helmets.
Three years ago, when my bum knee ended my jogging, so I could continue to exercise, my kids gave me, as an final combination Cristmas/birthday present, a 2 oz. road bike with about 56 gears, with the provision that I was to wear the accessory helmet.
This bike is capable of heretofore impossible speeds. On virtually my maiden outing, I was forced into a curb by a yard truck and took a header in an instant. I did not have time to think about "how to fall". Fortunately, I landed on a lush, manicured lawn, whacking my head HARD and suffering numerous bruises and abrasions. The bike was not damaged but I was. I managed to remount and ride the three miles home before rigor mortis set in. I was "stove up" for a week with a pulled groin and rib ouch.
The moral of this essay is: There has not be a reoccurence of this accident but if I had not been wearing a helmet for the (nearly) first time in my life, I might not have walked away.
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Postby guru » Thu Oct 08, 2009 12:58 pm

DrJay wrote:Something like 36,000 people die of influenza-related complications each year in this country. The majority of those are elderly and/or have chronic problems like congestive heart failure, emphysema, etc. Those folks ceratainly should have an influenza vaccine.



And that's exactly what I said earlier in this thread.

guru wrote:As I said, I'm not dismissing vaccines or drug therapy when it comes to life threatening ailments, or certain high risk groups.
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Postby guru » Thu Oct 08, 2009 1:05 pm

Steve, a couple of things -

First, what does whether or not I wear a bike helmet have to do with the subject at hand? Perhaps we could also discuss the color of my shirt or how many pockets my cargo shorts have to determine the validity of my posts.

Second, I've stated some things in this thread you may not agree with. That's fine. But unlike Bisonhurdler you and Mr. Hammy decided to take the low road so I have no interest in discussing the topic with you as I did with Bison. If you have some personal issue with me that's bothering you feel free to PM me your email and we'll discuss that off the board.
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Postby 26mi235 » Thu Oct 08, 2009 1:52 pm

From the data that I have been tracking it seems that the current H1N1 strain has a fatality rate similar to that of the seasonal flu. However, the years of life lost prematurely is much higher because instead of primarily being the death of old people who might have lived 1-10 years on average, many deaths are in young people that might live an order of magnitude longer.

Guru: What if you catch the disease and pass it on before becoming symptomatic and one of the persons that you pass it to dies?

The current variant of H1N1 is not particularly deadly but some strains of influenza in this family have been devastatingly deadly (e.g., 1918; which had a first round that was not very deadly but then evolved over the summer/fall (flu season in the southern hemisphere) into a very deadly disease.

The current H1N1 variant appears to be very transmissible; seemingly more so than the standard seasonal flu, but I am not sure (The Dells school district started having kids out and several days later had more than 200 out and closed all the schools because that were at about 40% infected.

By way of note, my wife is in the Industrial Engineering department at Wisconsin and works for DHS on risk and terrorism strategy issues. She has also done some pandemic planning work for the state. We will all get the H1N1 vaccines. We are not particularly concerned about the seasonal flu (normally get vaccine) but in the southern hemisphere the H1N1 strain so super-dominant (98% or more of all flu cases).
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Postby Marlow » Thu Oct 08, 2009 2:17 pm

bambam1729 wrote:Actually, E. Garry, osteopaths are now fairly close to Western doctors.

OK, I'l admit I never quite understood the difference between an osteopath and a chiropractor, so I just looked it up and stumbled across this little snopes-like item:

http://quackfiles.blogspot.com/2004/11/ ... ittle.html
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Postby BisonHurdler » Thu Oct 08, 2009 2:25 pm

Plain and simple, Osteopaths these days are, for all intents and purposes, MDs with different letters after their names. The have the same curriculum as Allopathic (MD) students, with some extra "Osteopathic Musculoskeletal Manipulation" training added on top of it.

Some of the manipulation and such is pretty useful for musculoskeletal issues. Fewer and fewer are bothering with it for anything else (traditionally, Osteopathy has maintained that MSK adjustments could cure just about anything, similar to chiropractors).

They take the MCAT to get into Osteopathic medical schools (although the standards tend to be lower . . . I won't go into GPAs/MCAT scores that will mean little for most people here, but suffice it to say that the average GPA/MCAT score for an accepted MD student would put you at the very top of most DO schools), and they take similar licensing exams. In fact, most Allopathic (MD) residencies are open to DO students as long as they take the USMLE (the MD licensing exams) in addition to the DO's homologue, the COMLEX.

Anyway, sorry for the alphabet soup. The short and long of it is: Osteopaths are essentially on equal footing with MDs in most cases.
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Postby dukehjsteve » Thu Oct 08, 2009 3:15 pm

guru wrote:Steve, a couple of things -

First, what does whether or not I wear a bike helmet have to do with the subject at hand? Perhaps we could also discuss the color of my shirt or how many pockets my cargo shorts have to determine the validity of my posts.

Second, I've stated some things in this thread you may not agree with. That's fine. But unlike Bisonhurdler you and Mr. Hammy decided to take the low road so I have no interest in discussing the topic with you as I did with Bison. If you have some personal issue with me that's bothering you feel free to PM me your email and we'll discuss that off the board.


Peace and love, guru, peace and love.

Someone else brought up the bike business, not me. But your justifications for both the bike business and the vaccine business have the same rationale ( your personal experience.) That is the only reason I brought it up. I did not intend to be abrasive, or take a "low road", and if you have perceived such, I think you are mistaken, but since your perception becomes your reality, I apologize.

I repeat: peace and love, peace and live. I mean it.
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Postby mcgato » Thu Oct 08, 2009 3:43 pm

Since I agreed with guru earlier, I will come to his defense a little by saying that I also did not receive a vaccine for bird flu. I somehow survived that pandemic. I'll take my chances with this pandemic. I kind of ignore the media when they repeatedly claim that the sky is falling. We've somehow survived the previous fifteen media created end of the world scenarios, I'm sure we'll get through this one.
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Postby gh » Thu Oct 08, 2009 3:52 pm

Whether or not swine flu is media-frenzy is irrelevant, and not why I started the thread. I'm dismayed (beyond belief) that so many educated people would take a stance which flies in the face of public-health common sense.

(FWIW, my university training was in bacteriology & public health)

Picking and choosing which things you think are worth getting protected against has it backwards. You should be thinking about what the consequences are for those around you as much as yourself. Pro bono publico
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Postby scottmitchell74 » Thu Oct 08, 2009 3:58 pm

Agreed. It's why people shouldn't go to work sick.
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Postby Pego » Thu Oct 08, 2009 4:33 pm

guru wrote:
bad hammy wrote:
guru wrote:It's clear we are not going to see eye to eye on this Bison. I respect your stance, but respectfully disagree.

All I know is my personal experience, having never been vaccinated beyond the early childhood regimen. Working around high school kids every day in Ohio winters I get sick maybe once every 3 or 4 years, and never take any medication during the illness. At 42 I plan to stick with what's worked.

Let's see. Where should I get my medical advice. Oh, I know, I'll go to a track and field site and listen to advice from some guy with no formal relevant medical training who refuses to wear a helmet when riding a bike. Thanks for the tips, dude!



Allow me to restate the first line of my paragraph, with slightly larger font since they say eyesight is often the first to go in advanced age -

All I know is my personal experience


That is referred to as anecdotal evidence, totally useless. It's like saying cancer of the lung is not caused by smoking, because I smoked 50 years and never got it.

Your education and business makes your stand on this issue even more bizzarre.
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Postby mcgato » Thu Oct 08, 2009 5:43 pm

gh wrote:Whether or not swine flu is media-frenzy is irrelevant, and not why I started the thread. I'm dismayed (beyond belief) that so many educated people would take a stance which flies in the face of public-health common sense.

I'll just agree to disagree. For whatever wikipedia is worth, here is a quote from their influenza page:
A vaccine formulated for one year may be ineffective in the following year, since the influenza virus evolves rapidly, and new strains quickly replace the older ones.

How many people last year had a flu vaccine and then got swine flu?

If it looked like flu could be eradicated like small pox, I would most likely get vaccinated. That doesn't look likely. As I see it, if I don't get a flu vaccine, I may get the flu. I'll probably survive. If I get a flu vaccine, I may get the flu. I'll probably survive. If I were in a high risk category, my attitude would be different. I've assessed the risks, and chosen accordingly. You've done the same. I'm not dismayed by your choice, but you are of mine. So be it.

This is most likely my last post on this thread.
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Postby Marlow » Thu Oct 08, 2009 6:07 pm

mcgato wrote:As I see it, if I don't get a flu vaccine, I may get the flu. I'll probably survive.
If I get a flu vaccine, I may get the flu. I'll probably survive.

I hope you never go to Vegas with that kind of understanding of how the odds work.
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Postby gm » Thu Oct 08, 2009 6:16 pm

...and may I add -- WASH YOUR DAMN HANDS AFTER YOU USE THE RESTROOM, GUYS!

Yes, every time. No matter what number you go.

Are women as lax when it comes to this, ladies of the board?
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Postby bad hammy » Thu Oct 08, 2009 6:21 pm

gm wrote:...and may I add -- WASH YOUR DAMN HANDS AFTER YOU USE THE RESTROOM, GUYS!

Yes, every time. No matter what number you go.

It's as if you're my identical twin . . .
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Postby BisonHurdler » Thu Oct 08, 2009 6:23 pm

I know a few people who have had the flu in the past few years who were formerly of the "No flu shot for me man, ain't no way ain't no how" mindset. Then they got the flu.

Now that's their first priority when Autumn rolls around.

We're essentially required to get both the standard Influenza Vaccine as well as the H1N1 Vaccine at school.
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Postby DrJay » Thu Oct 08, 2009 7:07 pm

May I digress? There have been some pointed comments back and forth in this thread, with obvious differences of opinion, yet it has not descended into the mire of nasty name-calling and use of expletives that has come to characterize too many Message Board threads in recent months. It has been a little tense (this thread), but generally civil. For the ability of most of the "regulars" here to do this, I am thankful. I just wish some of the posters who are newer and becoming regulars would take a hint and become part of this "lunchroom clique" that was so roundly disparaged on another thread a few days ago. I suspect they would be welcomed if their level of restraint was on par with guru's, who easily could have lashed out nastily in response to some of the above posts, but who, as usual, simply stood his ground with confidence and grace. Thank you all.
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Postby 2 cents » Thu Oct 08, 2009 7:23 pm

DrJay wrote:May I digress? I just wish some of the posters who are newer and becoming regulars would take a hint and become part of this "lunchroom clique" Thank you all.


You're most welcome. If only we all had your bedside manner, Doc....Too many of these jerks are like House....Thanks again Doc.
On a thread related note, I understand that only about 40 percent of healthcare professionals get flu shots...
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Postby BisonHurdler » Thu Oct 08, 2009 7:58 pm

2 cents wrote:
DrJay wrote:May I digress? I just wish some of the posters who are newer and becoming regulars would take a hint and become part of this "lunchroom clique" Thank you all.


You're most welcome. If only we all had your bedside manner, Doc....Too many of these jerks are like House....Thanks again Doc.
On a thread related note, I understand that only about 40 percent of healthcare professionals get flu shots...



I believe that figure refers to healthcare workers in general, including ancillary staff and lab techs, who are less likely than physicians and nurses to get the shot. Either way, regardless of your duties, if you're crossing paths with patients you run the risk of infecting them (and vice versa).
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Postby polevaultpower » Fri Oct 09, 2009 12:40 am

gm wrote:...and may I add -- WASH YOUR DAMN HANDS AFTER YOU USE THE RESTROOM, GUYS!

Yes, every time. No matter what number you go.

Are women as lax when it comes to this, ladies of the board?


What? No, of course not. Women (in the US), as a whole, almost always wash their hands. I rarely see anyone exit the bathroom without doing so. Gross.
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Postby tandfman » Fri Oct 09, 2009 6:01 am

There is an old joke about two guys, one Harvard, one Yale, in the men's room. The joke can be told in either direction, I suppose, but the way I first heard it, it went like this, after the Yalie washes his hands and the Harvard man doesn't.

Yale Guy: You know, at Yale, we wash our hands after we pee.

Harvard Guy: At Harvard, we don't pee on our hands.
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Postby Zat0pek » Fri Oct 09, 2009 7:54 am

I had a regional manager for a national chain of funeral homes in my office a few years back regarding a business matter. At one point he commented about how business had been bad last year.

"Wait, what? Don't people pretty much die at the same rate? How does a funeral home have a 'bad year'?" I asked.

"No flu," he responded. "We don't make any money until there's a good flu outbreak. It's the only thing that is widespread enough to impact the death rate. Most years we break even or just make a small profit. It's flu outbreaks where we're able to gather some capital and really get our heads above water."

A couple of years later, I met with a casket sales rep. I told her about his comment and asked if that was true.

"Oh, sure," she said. "Our inventories are adjusted based on flu forecasts."

In 2006, everybody who attended by youngest daughter's birthday (including my whole family) came down with the flu, including the the pregnant mother of one of the girls. The flu caused her to lose the baby.
Last edited by Zat0pek on Fri Oct 09, 2009 12:08 pm, edited 1 time in total.
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Postby Zat0pek » Fri Oct 09, 2009 8:05 am

gh wrote:Whether or not swine flu is media-frenzy is irrelevant, and not why I started the thread. I'm dismayed (beyond belief) that so many educated people would take a stance which flies in the face of public-health common sense.


I stopped being amazed by things like this a long a time ago. There is a difference between ignorance and studity. Ignorance can be fixed with education, but stupidity cannot. I meet very stupid but highly educated people all the time. I have never met a highly educated ignorant person.

There is also a difference between knowledge and wisdom. I know many people with huge amounts of knowledge and absolutely no wisdom. I also know some very, very wise people with comparatively little knowledge. Give me that latter every time. It's much easier to fix a lack of knowledge than it is a lack of wisdom.
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Postby BruceFlorman » Sat Oct 10, 2009 4:32 am

BisonHurdler wrote:
jhc68 wrote:I don't think anti-vaccine people are neanderthals. They are parasites playing the odds. The mentality is that there is no need for them to be immunized because everyone else will.

Me. I'm old enough to have been in the first generation to get polio shots. It was a common thing in the 1950's to know people in "iron lungs" (youngeer posters won't know what the hell I'm referring to, lucky for them). When reminders of the reasons for vaccinations disappear then it is easy to discount the need for them.

Bingo. People crying out about how 1/1 million people may suffer some moderate adverse reaction forget that the shot they're getting probably protects against one of the diseases that used to infect half the population, while killing a significant percentage of those infected.

Okay, so do any of you folks have any advice for me about how to convince someone who got violently ill after a flu vaccine a few years ago that giving it another go this year would be a good idea?
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Postby Daisy » Sat Oct 10, 2009 4:52 am

Is isolation for the whole winter an easier option?
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Postby gh » Sat Oct 10, 2009 6:15 am

The first question, of course, would be "proof" that it was the flu shot that caused the problem. It's the logical answer, but we get sick all the time for no apparent reason.

Assuming it was the shot, was it the antigen itself or was it some adjunct in the shot that caused the problem? If the latter, might the nasal option work better? (I have no idea if those are formulated differently)

And the biggest question might be, how "violent" was "violently ill"? If the cure is as bad as the disease, thinking twice about doing it again is certainly a viable option.

OK, Dr. House imitation over :-)
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