Malnutrition: vegan madness and kwashiorkor

a vegan influencer living in Malaysia dies of malnutrition.

no I don't have a lot of sympathy for her. One wonders how many others she influenced have developed medical problems: being vegan is a cult. Remove organized religions (That have 2000 years experience in what is good and bad) and all sorts of crazy ideas proliferate: but the main reason I am not sympathetic is that these types are rich upper class types who are hoity toity to the rest of us (both deplorables and poor people). And quick: How many vegans work with the homeless etc. When PETA was out in Manila demonstrating, I didn't see them giving food to the poor street kids nearby. In contrast, most churches do outreach to the poor here.

Dirty little secret:

Vegan diets are lacking protein and certain vitamins. There are several reports out there about children in the affluent west suffering malnutrition and even dying because their crazy moms didn't feed them corectly

the  UKMail article shows photos of a severely undernourished lady. She was an influencer and like other cult learders this lady got lots of positive feedback on how wonderful she was, never mind that she was pushing bad advice.

Or is it a variation of anorexia nervoxa?

Ironically a lot of so called medical sites are very sympathetic to those idiots and their diet. Because too many fat people fill up the clinics. (Is it gluttony, or Plastics?)

And of course the green idiots running the world are pushing vegetarian diets so often cite their health benefits: Ignoring that yes they don't get diabetes or obesity but ignore that malnutrition makes you vulnerable to infectious disease.

In medical school, we used to call such malnourished people as having "PPP" i.e. P=ss Poor Protoplasm....

Many of these people were usually poor from the slums who couldn't afford meat and ate lots of bread but few veggies or fruit and not a lot of meat/milk/eggs due to poverty, (and the difficulty in buying food in slums aka food deserts...). Things have now improved since I was in medical school: food stamps and the WIC program have made these problems less acute.

 but I left the USA before the big homeless social epidemic hit and I suspect docs are seeing a lot more malnutrition....

 I worked mainly with the rural poor and on the Res, and we had a lot of alcoholics who got most of their calories from alcohol. 

Nowadays, meth would do this, but ironically when I worked on the res, we didn't have meth and only a little cocaine: mainly marijuana and alcohol. So I know a lot about nutrition but not much about vegans or drugs.

and we had outreach to our diabetics, and WIC  that helped stop malnutriton in babies (and we stressed breast feeding). There is a reason the Public Health Service staffs these hospitals: outreach...and now the tribes are taking them over but often the staff are trained in preventive medicine and tribal customs and there is Indian preference in hiring and that helps too.

Racism is real...Yes but not race per se but ignorance or disdain for people who don't think and act like upper class white elites.

However, most of my expertise in nutrition was when I worked in Africa.

We had a lot of kwashiorkor and marasmus among babies when I worked in Africa. 

Marasmus was usually babies whose moms got pregnant too soon and the babies couldn't eat/digest adult food. But Kwashiorkor was in older toddlers who had been weaned: Meaning they now had no breast milk and the adult diet lacked protein.

We had a nutrition village to educate moms into learning to use a proper diet; Stressing chickens in cages (hybrid high egg-laying European chickens cross bred with local chickens who had resistance to local diseases) We kept them in cages because of feral dogs and also so when they laid eggs the eggs could be gathered. Part of the training was to give the egg to the kid, not the father. 

This might be seen as male privlege, but the reason the father gets the protein and food first is because if the father dies, the entire family could die, since it requires a man to plant maize etc with an oxen (women planted what we would call kitchen gardens, veggies and grain but not enough to feed everyone, but often sold for money to buy other things).

That is also the reason that the custom was that if the father died, the wife would marry his brother, to care for her and his brother's kids.

globalization pushed men and women to work in cities or overseas and send money home to keep the family going...And of course now China got rich using the same idea (bring peasants to work in factories let wifey at home with the kids to care for grandmom). 

Sigh. Both good and bad in this: but that's anothe discussion.

So how do you do outreach to traditional communities to improve health and nutrition?

Andrew Webwafa has a lot of videos up on youtube about his outreach clinics, including nutritional ones, if you want to know how this outreach is done.

racism in reality is not recognizing cultural differences

 basic public health always clashes with rights.

So when Diane Feinstein tried to close the bathhouses that were at the center of a Hep B and syphillis epidemic among gays, an election recall was started and the politicians got the message: Don't restrict places where anonymous promiscuous sex was happening. 

This isn't the only time this happened: The Hepatitis A epidemic caused by poor hygiene at homeless encampments went on for over a year before someone said hey maybe we should do basic sanitation 

So now we read a cdc report on the MPox epidemic shots in California

 https://www.cdc.gov/mmwr/volumes/72/wr/mm7230a4.htm?s_cid=mm7230a4_x

poorly written as usual, 

Demographic disparities among persons completing the 2-dose mpox vaccination series have been previously described.

What are the implications for public health practice? Route of administration of the first dose was not associated with lower overall 2-dose series completion rates.

translation: the SC vs IM rate doesn't matter. This is basic observation so okay

MY problem is with this part:

White persons (64.1%), persons aged ≥65 years (72.6%), and adults with male sex assignment at birth (62.1%); series completion was lowest among non-Hispanic Black or African American persons (51.3%), persons aged 18–24 years (42.9%), and adults assigned female sex at birth (42.8%).

well, at least they use the part about sex assigned at birth, because it is well known that trans females, born men, retain the sexual practices of men. In other words they sleep around a lot. So putting them in the female cohort would bias the findings

Among 119,345 California residents who received their first JYNNEOS dose during August 9, 2022–March 31, 2023, a total of 71,317 (59.8%) completed the 2-dose series

hmm... that's a lot of people out there at risk.

the high rate of vaccination in gay white men was due to person to person education of each other, because they essentially become a clan group. In blacks and Hispanics, however, often these men are bisexual: they hide their MSM practices out of shame. So the outreach should have been different to that community

A lot of what they call "racism" is actually not being sensitive to the cultural differences, in this case, the religious background of shame

they actually acknowledge this: 

Issues including access to vaccination, assessment of patient risk, and communication to disaffected populations by trusted messengers might be considered for future studies on disparities in vaccine acceptance.

left out of this: that a lot of the spread could be lessened by closing places of anonymous sexual encounters such as certain bars, bathhouses, or raves.

I used to tease my smoking patients that the only sin in today's world is smoking tobacco cigarettes. stuff like misusing alcohol or taking drugs, promixuous sex, and riskly sexual behavior, no problem.

Sigh 

they are coming for your organs

be afraid. Be very afraid.

Thirty years ago. when bioethicist Arthur Caplan moved to Pennsylvania and applied for a driver's license, he asked about adding the organ donation permission to that document, and the clerk warned him: Don't do that: if you do they'll let you die.

already, many in minority communities refuse to sign living wills or no resusitation orders, because they don't trust the medical profession: The Tuskegee experiment is remembered in the Black community, and the collapse of trust by many after the Covid response will make things worse.

If this is approved, it will mean the Catholic bishops will object

But of course don't expect the MSM to warn you. They will quote elite bioethicists to prove it is okay, and if you oppose it, hey look at all those nice people dying.

It also pushed furthur the idea that people with severe brain damage are better off dead: and this will just push the idea it is not just cruel to keep them alive, but their death will save other, so let's kill them. Could euthanasia be far behind?

No I am not being paranoid, becuase there are reports killing depressed people and then donating their organs is going on.

Actually, when done carefully, the diagnosis of brain death means just that: no brain. No reflexes. No blood circulation to the brain. No brain to control your bodily functions and so the body will die when the machines are removed.

But less strict definitions are fuzzy: one third of people in PVS (aka persistant vegetative state, note that Orwellian term implying they are not humans to be loved but vegetables?

but sometimes lay people think that when doctors say there is no hope so pull the plug, or that a person is a "vegetable" so stop treatment, it is the same as saying they are brain dead. It is not.

and as far back as 1990, there were books written by ethicists saying hey let's limit treatment by law to people with low quality of life

and yes, this is being done in places like the UK where the N.I.C.E. can stop your treatment because of your quality of life

Yes NICE, again a nice fuzzy term to hide what they are doing.

One saw this type of forbidding treatment during covid, of course, where drugs that might or might not work were forbidden to be given and some docs are in danger of losing their license for giving a drug with few side effects to people dying of covid

At the same time, there is a difference between stopping extraordinary treatment or deciding not to get everything done for your disease, and euthanasia. THis also is a fine line: So when we stopped the ventillator on Joy's father who had a massive stroke, we did it after five days when brain swelling had gone down, and he died the next day. IF we had stopped it the first day, it would be considered removing extraordinary treatment, so again it would be permissiable, but the family would have felt Hey maybe he would have recovered so what was the hurry. But once brain edema had gone down, and he could breathe without a respirator, then removing the machines meant he could go to a regular room and have family there.

And Lolo decided against chemotherapy and died in his bed: he was 90, and the chemo probably would not have prolonged his life because of his other medical problems.

Personally I am happy I am retired now and since I live in the Philippines, where sophisticated medical treatment is available, but refusing extraordinary treatment is less controversial and there is respect for the elderly not present in the USA.

the myocarditis coverup

 When I took the AZ vaccine in summer 2021 I was aware of the blood clot problem but it was higher in young men, and my risk/benefit ratio as an elder was low.

But the mRNA vaccine coverups are disturbing. Especially as many boosters are being pushed on low risk people.

So Dr C points out a European study on the Moderna vaccine that causes (probably a temporary) myocarditis problem: why important? Because there is a screening test for it, and it's not being done, and many of the anecdotal stories have been noticed and pushed by conspiracy anti vaxxers, and ridiculed by the experts.

So what if the crazies turn out to be true?

Sigh.

Update: Legal insurrection summarizes the article: there is a lack of a control group comparison and no measurement of troponin etc before the shot.

However, the high level of evidence suggests that the shot should not be given and the Swiss gov't no longer recommends it especially since most people have immunity to covid.

atypical dengue

 When I was hospitalized with dengue, I did not have any headache or muscle pain (except for my normal aches and pain).

What happened is that I went to the bathroom and fell and literally couldn't get up. No it was worse than that: I could barely move to put my hands out to have the family get me up. And I could not turn over or try to get on my knees. The weakness was generalized, not a local paralysis, and the weakness was partial: i could move a little but I was weak. 

Reminds me of the commercial of the little old lady pushing her panic button saying I'm weak and I can't get up.

I figured it was hypokalemia, and after 15 minutes I told the family to call an ambulance to get me to the hospital. I remember sitting in the outside ER waiting for my test for covid to come back, and I remember thinking: Please start an IV with potassium in it so I don't feel weak. But actually my potassium (and covid) were normal, so I was admitted on IVs.

I literally don't remember what time this happened, or why the family was with me (early evening) and I think I was running a low fever because I thought I had a UTI since I had no other symptoms.

But essentially I don't remember that day, and much of the time in the hospital I don't remember much, except Joy sitting with me texting and talking on her phone, and being encouraged to drink fluids. I remember having blood drawn a lot, but I don't remember having a physical examination done on me, nor getting a chest x ray, nor having my clothes removed and being put into a hospital gown. after two or three days I could sit up and by the time I went home I could walk a bit but got a portable potty because I douln't make it to the bathroom.

The main treatment of dengue is fluis, and of course in the hospital I had a catheter

I remember being pushed to drink fluids, but don't remember eating until the third day ? the maid Lila encouraged me to eat rice and chicken, at which point I vomited and defacated two weeks of hard BM a few minutes later.

and the next few days I got my strength back and was able to sit up. But although my memory was spotty, I could think: and I could interpret my blood tests shown to me. By day three, my IGM test came back positive for Dengue, which is going around, so that was my diagnosis.

and as I improved, I remember being shown my blood tests, and as I got stronger I could watch my platelets go down down down... but never below 60thousand so no problem. And of course my WBC was low. No cough, no pain.

Well anyway, all of this puzzled me: Dengue is called break bone fever and the headache behind the eyes is the way you diagnose it clinically. But I had no pain and no headache. 

Two articles discussing dengue with these problems, but alas the articles are behind a pay wall:

Acute pure motor quadriplegia: is it dengue myositis?

Seven out of 16 patients with dengue infection presented with quadriplegia and they were subjected to a detailed clinical history and examination. Diagnosis of dengue was based on characteristic clinical and positive serum IgM ELISA. Blood counts, serum chemistry, CSF analysis and nerve conduction and electromyographic (EMG) studies were performed in all. Outcome was defined at the end of 1 month into complete, partial and poor on the basis of activities of daily living

,,,Weakness developed within 3-5 days of illness, which was severe in 4 and moderate in 3 patients. Hypotonia and hyporeflexia were present in 5 patients. Nerve conduction and EMG studies were normal in all except one whose EMG was myopathic. Serum CPK and SGPT were raised in all and serum bilirubin in 3 patients. All the patients had coagulopathy and 6 had thrombocytopenia. Muscle biopsy in 1 patient was suggestive of myositis. Six patients improved completely and one had poor recovery who needed ventilatory support.

Conclusion: Dengue virus infection may result in acute pure motor quadriplegia due to myositis. In an endemic area it should be considered in the differential diagnosis of acute flaccid paralysis.

a longer article is here:Neurological manifestations of dengue virus infection

much of the article is about encephalopathy

In the pure motor weakness group, CK was elevated in 5 and EMG and muscle biopsy were consistent with myositis in 1 patient each. The patients with pure motor weakness improved completely...

so apparently it does happen

and I did recover, although weakness remained (more like easy fatigue with exercize: I could barely walk the dogs or attend church) and then when I was getting better, I developed shingles: neuropathic pain along a single nerve of my chest, but no rash.

The doc said it was costochondritis but this pain was different, and responded nicely to Lyrica, which is a medicine for neuropathic pain.

What's worse than Fentanyl? Fentanyl plus Xylazine

 while everyone is hyperventillating about covid and the lies behind it, or trying to replace your aircon, refrigerator, and gas stove to stop global warming, the real problems are ignored

Ninethousand people a month die of drug overdoses. Ho hum. 

and no one seems to want to actually solve it because it means making China mad, and it makes the liberals mad because it means stopping the open border, declaring a war against drug pushers and actually putting them in jail, something that made Kamela Harris popular but now Cornel West says was a crime against humanity. (hey, dead drugies and people dead from druggie criminals is never seen as a problem by those human rights folk, but kill a pusher and the human rights folk will be on your back, as Duterte found out here in the Philippines).

Well, anyway, the latest way to get a longer stronger high from Fentanyl is to mix it with Xylazine: a horse tranquillizer in the same family (alpha antagonist) as clonidine, which is used to lower BP and to alleviate the gitteryness of withdrawing from opioids.

How bad is the problem? 

from the CDC:

Illicitly Manufactured Fentanyl–Involved Overdose Deaths with Detected Xylazine — United States, January 2019–June 2022

Among 21 jurisdictions, the monthly percentage of IMF-involved deaths with xylazine detected increased 276% from January 2019 (2.9%) to June 2022 (10.9%). During January 2021–June 2022 in 32 jurisdictions, xylazine was detected in a higher percentage of IMF-involved deaths in the Northeast U.S. Census Bureau region; listing xylazine as cause of death varied across jurisdictions.

sigh. Like a lot of the CDC reports, the don't mention the actual data you need, like numbers of folks dying.

But hey the UK Mail has that for you.

An update by the Centers for Disease Control and Prevention revealed that in the year to February there were up to 109,940 drug overdose deaths, which the agency said was probably 'an underestimate'.

That is the equivalent of 9,161 deaths per month, which experts warned was like a jet full of Americans crashing and burning almost every day...

and it is getting worse: 

There are major concerns about a deadly new cocktail of fentanyl and an animal tranquilizer — xylazine — that is cropping up in US drug

this drug prolongs the high of the fentanyl but increases the sedation (i.e. sedation that causes deaths). So even if you get Narcan, it won't work in Xylazine, which has it's own addiction and overdose problems. And to make things worse: It can cause terrible ulcers on the skin.

 How bad is it?  Fox news says the addicts are longing for the good old days of heroin.

On the arms and legs, the wounds might look like a portion of flesh was carved out or maybe a minutes-old chemical burn. Hands and feet may be swollen almost out of recognition.

Sometimes the wounds become hardened tissue. Sometimes they fester and ooze.

"The tranq dope literally eats your flesh," Brooke Peder, a 38-year-old Kensington resident known as the Hood Grandma told The New York Times. Her leg had been amputated because of a tranq-induced infection.

 

 ah, but President Biden is working on it. 

Put more narcan on the streets to save overdoses. Good. and of course add that part of "Increased research and data collection are a priority, Gupta said, "to see the full picture of this threat." 

and the FDA is going to make sure the legal Xylazine is going to the vets who need it.

we took action to help ensure that any xylazine entering the U.S. through legitimate importation pathways is, in fact, headed to valid animal drug manufacturing or research facilities. So far, we’ve found four shipments of unapproved xylazine via our import pathways and placed alerts to watch for incoming shipments from three firms.

Well, duh. This is like when percocet was being used widely, the DEA made it hard for docs to prescribe pain pills to people with pain, so a bunch of pain clinic docs got into legal trouble. But of course most of the overdoses were drugs stolen from actual patients, or more commonly illicit percocet via Mexican drug cartel, and so terrorizing docs by threatening their license didn't stop most of the abuse. 

Attention Mr President: the press actually covers this problem. Chinese companies openly sell both Fentanyl and Xylazine on line. a quick google will get you in touch with these companies.

So Biden is going to ask China to cooperate in stopping it. Good luck with that, fellahs.

China has a big drug problem and is very strict in arresting and even executing pushers. But the big companies find loopholes to sell it openly. 

which is why, as a person living in a country where bribery gifts are given over the table, under the table and with the table (as one local wag put it) I laugh when I read stuff like this article discussing regulations to stop the trade from drug companies in China and India.

the problem? Corruption. If you have companies willing to lie, and regulators who believe the lies then the process is flawed

that article even laments that a lot of the stuff comes in mislabled, so it's not stopped. Imagine that.

But maybe someone will actually do something with teeth to at least try to stop this illicit drug trade:

 Senator Shumer, an honest lefti, is cooperating with some Republicans to impose sanctions on China:

WASHINGTON (Reuters) -U.S. Senate Majority Leader Chuck Schumer will push to include in upcoming defense policy legislation a bipartisan amendment to sanction China over its alleged role in producing the synthetic opioid fentanyl, he said on Sunday...

The Chinese embassy in Washington, D.C., was not immediately available for comment.

Beijing has accused Washington previously of using the fentanyl crisis as a pretext for imposing sanctions on Chinese companies and has offered to work with other nations to tackle drug problems.

Chinese state media have repeatedly described addiction and demand for the drug as U.S. domestic problems.

Schumer said the amendment, proposed by Democratic Senator Sherrod Brown and Republican Senator Tim Scott, would authorize the White House to declare fentanyl trafficking a national emergency and open the door to sanctions.

Go get'em Chuck.

coverup? Problem was mainly with one batch