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Messages - tillamook

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1
Legal and Activism / Re: Medical Waiver Lawsuit Filed
« on: July 15, 2022, 08:15:34 AM »
What is more sad is that I've had to do the mental health waver for some military personnel who were incorrectly diagnosed by the mental health "professionals" at the VA in Honolulu.   Not only denied rights (even though they had no restrictions to firearms while on base), they were diagnosed completely wrong by the VA.  I've taught 3rd year medical students who would have done a better job.    Just sad on so many levels.   
2
Political Discussion / Re: The COVID Cult
« on: November 10, 2020, 02:23:44 PM »
but WE listen to the science!

this is not science

no it is confirmation bias.  :) 
3
Political Discussion / Re: Oregon legalizes drugs
« on: November 04, 2020, 03:59:33 PM »
that's what I am seeing here in Hawaii. Treat homelessness with more personnel and money and the govt incentivized the homeless condition. It's a tough problem - I was almost homeless coming out of high school.

Years ago my step-daughter was homeless.  She ditched highschool with 2 weeks left to live with a homeless kid her age the moment she turned 18.  She got pregnant and after coming home again we decided that in order for her to continue living at home she'd need to finish that highschool diploma with one 1/2 day class a week.  Despite that only requirement, she felt this was too much work and went homeless again.   She lived with several homeless young people who didnt need to be homeless, but they just did not want to do anything at all.

It was sure eye opening being exposed to that part of the homeless situation in Portland hearing about quite a lot of people who were homeless by choice.   Her SNAP benefits were pooled by their little group to sell for cash so they could buy drugs or occasionally get food from it.  All of them learned about loopholes to abuse the system. Several of them were getting food stamps from more than one state.     They lived in the HHR I had bought her previously by a park and never once did the police interact with them.   
4
Political Discussion / Re: Oregon legalizes drugs
« on: November 04, 2020, 03:15:02 PM »
so...bad govt decision?

The Oregon state government could take the best looking plan on paper and ruin it.   When they made the C&R FFL illegal I knew that there was no trusting any of them.

Just like being as friendly and hospitable to the homeless lead to giant homeless cities and garbage for miles on the highways.  You could drive 60 minutes out of Portland into the wilderness and find a whole living room of furniture and garbage in the trees where the meth users would do drugs all day.  We'd have to clean it up just to put a good light onto the gun owners who shot at public locations like that.   Friends would have homeless living in trailers in front of their house and dumping garbage onto their lawn and if they called the police they would say the City wont let them deal with it. 

So if it works as well as their lack of dealing with the homeless, Portland should be a tourist designation for drug users coming from all over the country to squat and do what ever they want.   
5
Political Discussion / Re: Oregon legalizes drugs
« on: November 04, 2020, 02:40:57 PM »
interesting .
What is your medical opinion on the govt legalizing previously illegal narcotics?

Since I used to live in Portland and would not go back under any circumstance I'd be happy if they built a 50 ft wall around Portland, delivered unlimited meth and heroin and let it simmer for a few months.   I'd make sure to invite everyone from Salem and also all the leadership of the Oregon Health plan. 

But I guess that is not really a medical opinion.   
6
Political Discussion / Re: Oregon legalizes drugs
« on: November 04, 2020, 08:23:53 AM »
Spin it however you must, but when YOUR future teen overdoses on heroin, you'll be asking why something so lethal isn't being controlled by government.

Sometimes a "tiny amount" is enough to kill.

Interesting being a physician and I had to pay for a course and pay for an additional DEA license to prescribe suboxone for at most 35 patients a year.   Suboxone being a medication that can treat opiate addiction and pain and is much safer by far than opiates.   

So in order to treat addiction in this country I have to pay out of pocket to do extra training and get an extra license to prescribe a much safer medication to a few patients.  But if I was to prescribe fentanyl or oxycontin or morphine, it is literally sky the limit. 

Almost if the government wants me to continue to prescribe the highly addictive, dangerous pain meds and keep people addicted for the rest of their lives paying drug companies rather than get people off their addictions. 

my partner had his phone bugged by the DEA and had them send in officers as fake patients trying to trip him up and catch him doing something wrong with that 35 patient suboxone license.  They didnt find anything wrong but he refuses to deal with opiate addiction now because he might have his phones bugged again. 

The government isnt saving us from heroin or opiates or anything else.  We need to quit assuming they have us in their best interests. 
7
Legal and Activism / Re: Young v. Hawaii en banc
« on: September 21, 2020, 10:51:42 AM »
^ Thank you for sharing your article. That was a good read.

Also, the Youtube video at the bottom was hilarious to watch, particularly watching Young's counsel trying not to laugh while the attorney was getting picked apart.

Thanks for that.   After watching the department of health self destruct its nice to have confirmation that absolutely no one in this state's government is competent.  I'm going to go figure out what I'm going to spent my state taxes on instead of paying them. 
8
General Discussion / Re: Wuhan Whistleblower done dirty using "gun fear"
« on: September 16, 2020, 09:39:19 PM »
Before covid there was a job posting for head of DOH for the Big Island (under Anderson I guess).   Salary was something like $24,000 a month plus benefits which would have been a huge increase in pay for me (most primary care docs in Hawaii have to work 2 jobs to get by and pay off loans)  Thought about applying for about 20 seconds and figured it would be a working for a corrupt department of sandbags who would want to sabotage anyone who did actual work and made them look bad. 

After having seen the DOH completely fail me and my patients with Covid and now watching the department implode from being a bunch of incompetent stooges I am so completely happy I did not consider applying for that job. 
9
Political Discussion / Re: Are there unbiased media outlets out there?
« on: September 03, 2020, 10:00:32 AM »
none
10
Political Discussion / Re: Big Braddah
« on: September 01, 2020, 10:06:41 AM »
I need a good dumb phone.  Anyone know if the CAT phones work here?
https://www.catphones.com/en-gb/products/featurephones/

11
General Discussion / Re: new Honolulu City order Aug 25
« on: August 27, 2020, 12:27:03 PM »
I think it is the percentage of the tests that come back positive that they are looking at, besides the # of positive tests

Oh well at least traffic will be even lighter :-)

I look at the percent filled ICU beds in the state.  It just went from 53% filled to 62% filled in 1 day.  If critical care beds filled in Honolulu and someone has a heart attack on the Big Island then they are not flying to Honolulu as usual to get their angiogram. 

On 8/4 15 covid patients were in the ICU, yesterday it was 54. 

To get a sense of the lack of critical care here, OHSU hospital in Portland has 80 ICU beds.   Hawaii as an entire state has 244  (actually about 60 more but no staff to run them)

To add to the issue 33 doctors have left the Big Island since January and most likely a bunch on the other islands as well.     
12
Political Discussion / Re: there goes HIPAA
« on: August 06, 2020, 01:35:22 PM »
They reportedly only have 20 trained and active tracers. 🤷🏻‍♂️  I work for a medium/large compaby and we recently had a positive case.  They told us the company HR checked in with them more than the State.

The email I got a week after trying to get a Covid test ordered last March and after I ran up complaints to my representative:


"We apologize that you were unable to contact our physician reporting line, on March 5, 2020.  The Disease Outbreak Control Division and District Heath Offices are experiencing higher volume of calls as a result of the COVID-19 response and has two Officers of the Day investigators in addition to public health nurses assisting with overflow of calls."


Literally the "we are experiencing higher than expected call volumes" excuse.  Turns out they had one person answering the phones.
13
Political Discussion / Re: there goes HIPAA
« on: August 06, 2020, 10:36:49 AM »
So what does a consumer do with that information of a worker infected with COVID19? They will likely avoid that business.
The slippery slope is that govt. would want to expand this mandatory reporting to households. Would you like to know which homes in your area have COVID19 infected people? We already know where the sex offenders are - you know for "public safety".

Yes it can be a slippery slope.  Like I said, I dont trust the state or the DOH.   

But I would avoid the business if they had a bunch of covid positive workers.   I have a 340% chance of getting covid being a healthcare worker (even with PPE) and my statistical risk of dying from it is 10-15% because of my medical issues and age.  Its probably higher because I live on the Big Island which lacks doctors including the specialists who are best to treat covid.   We have one pulmonologist on the island and he isnt running the ICU in my hospital. 

 Boy if I had a 10% chance of dying if I went to home depot today I would sure as hell not go to home depot today.  I dont give a crap if that ruins their quarterly numbers.  Of course I would want to know if a business has a high chance of killing me.   

I already assume everyone around me has Covid, I dont need to know which houses have it.   But that's a bit hyperbole I think.  They are not going to start labeling houses with who has Covid.  The department of health is so incompetent that they cant answer the phone when I call.   To think of them actually having the ability to do that level of patient tracing and identification is absurd.   I suspect they have trouble even putting their pants on in the morning.  I should not have to call my state representative to get him to call the governor to get them to call the department of health leadership just to get them to do contact tracing on a family who's family member tested positive 3 days ago.  But that's what I had to do.   My dog could run the DOH better. 


14
Political Discussion / Re: there goes HIPAA
« on: August 06, 2020, 09:11:28 AM »
I understand the consequences but why stop at diseases.
How about reporting on employees who are convicted child predators? Any employee that has been convicted of assault because the other day I saw a Times employee challenge a customer to a fight. I understand that employers want to be more proactive in the Covid afforts but they shouldn't be required to disclose on their employees health conditions.
In regards to healthcare professionals like yourself that are mandated to disclose, I am assuming that the information is kept anonymous? ANd is for mapping purposes and surveillance.

Can you see how govt can and most likely will abuse this mandate /law?

Oh yeah, there is abuse everywhere.  The whole reason we have HIPAA is because an oncology clinic was selling their patient contact information to a drug company who would direct market antidepressants to the cancer patients. 

I dont share any patient medical information with employers unless I have to on a FMLA leave form.  The resorts are particularly bad employers on the islands and will use any information against their employees.  I've had to threaten a few of them legally in order to protect patients. 

But if for some reason a private business is doing covid testing or knows the covid results of their workers HIPAA is not going to cover that as a breach of privacy.   

Reported infections to the state are supposed to be kept private but all the patient's information is sent to them.  Often the lab will send them the results before we even know them.  So just like the state reviewing medical records for gun permits, its all about how much you trust them (me, very little).   The department of health has shown their incompetency in this pandemic.  But they seem to keep patient information private
15
Political Discussion / Re: there goes HIPAA
« on: August 06, 2020, 08:19:05 AM »
HIPAA does not really apply to non-healthcare private businesses reporting positive cases that they know about.   

And there are already exceptions for reporting dangerous infectious diseases to the state.  I have a list of 35 infectious diseases on a form right next to me that I am legally required to report to the state immediately even if it is against the wishes of the patient.  Stuff like measles, tuberculosis  and small pox.    You can probably imagine the issues that would occur if I could not report an active tuberculosis case to the state because the patient wanted their privacy and then they proceed to go to a big family party and start spreading around multidrug resistant tuberculosis.   That is unless you want to make Molokai a leper colony again. 
16
Political Discussion / Re: so why quarantine?
« on: August 06, 2020, 07:58:29 AM »

The bad economy is already increasing the death toll as a side-effect of "prevention".  People are afraid to seek medical help out of fear they will be preventing someone with COVID-19 from getting help, or because they are terrified of getting the virus -- so they stay home.


Not true in my area.  I am overwhelmed with patients in my clinic.   I am still doing telemed for about 25% of the patients but the rest want to come in.   This was true early on that people did not get care because of fear of covid or not wanting to take a hospital bed from someone with covid but now they are overwhelming us. 

Other factors are at play.  remember that the state fired 2 of the 3 state psychiatrists for the Big Island due to lack of funding the same week the legislature passed the bill funding the gun commission. 
The Big Island lost 32 physicians since January, my area is down 8 physicians, they are all leaving.   This state is a terrible place for a doctor to work and if we are losing physicians who are going back to the mainland during a pandemic where we have low covid numbers then there is a major problem with healthcare already in this state. 

Yes the economy is terrible.   But the answer isnt pretend covid does not exist and open everything up.   The US is losing 4 times as many Americans a day as we did in WWII.  You cant possible be someone who would look at the shift in the war economy in WWII and say "we really need to be stopping all this and open up the bars"

Hawaii does not have the healthcare system to handle covid even at the small numbers.  One Honolulu hospital is already down to having 2 free ICU beds.   At the current rate 2-3 weeks we will not have enough beds, and more importantly, not enough doctors to help people.    Hawaii loses 200 doctors a year that are not replaced.  This year is already looking worse for that number.   

If we open everything up and pretend nothing is wrong and overwhelm the severely limited healthcare systems in this state then everyone who may need a hospital for any reason will be in trouble. 

Quote
Things are not as simple as you seem to want to believe.

no they are not.   
17
Political Discussion / Re: so why quarantine?
« on: August 05, 2020, 04:13:08 PM »
My local Big island hospital has 35 beds.  We currently send most critical patients to Honolulu.  Heart attacks, strokes, certain types of surgery. etc.   Most of our high level of care is done in Honolulu. 

Queens has a 5 level disaster plan which is for something like Covid.  If they reach level 4 they will not take any transfers from the Big Island (or anywhere else).  So if Honolulu covid starts to overwhelm capacity then Big Island patients will not be transfers and we dont have the level or care to manage them with these serious conditions. 

We are a much different state than New York.  We cant simply put people in ambulances and drive them to the next biggest hospital somewhere else in the state or the next state over.   We do have plans to open a mobile military hospital in Kona but they wont have a cath lab or other high level services that Honolulu has.   I suppose they could drive the hospital ship over here.   

So we prefer to not have covid overwhelm Honolulu hospitals because you cant ship us a few cath labs with a team of cardiologists here on the Big Island to deal with all the problems that get sent to honolulu.   You also cant lifeflight a heart attack to the mainland because after 6 hours the damage is already done.   

Funny, we could have been New Zealand with no cases in the spring time if we actually has a capable government and people staying put for 2 weeks.  But we all know they were busy passing gun commission bills instead and beach parties are definitely cool

18
Phone is half charged.  That should be plenty.  All I got to do is call FEMA right?
19
Don't know his 2A stance but Bud Stonebrakers civilbeat Q&A gave me some tingles. Im leaning towards him at the very least being Not Anti2a, mentions the Constitution and BIll of Rights I'm going to email him.
https://www.civilbeat.org/2020/06/candidate-qa-honolulu-mayor-bud-stonebraker/

"It is the fear-mongering that is keeping our people in a state of panic. Masks are unhealthy. You breath about half a liter of air during normal relaxed breathing. That’s about 2 cups’ worth. This ‘tidal volume’, as it’s called, is decreased when you put even mild resistance on your breathing which a mask creates. Now your brain is getting less oxygen which in turn creates a cyclical state of stress."

100% BS.  Saying it like he has no idea how stupid that sounds.  Does he forget surgeons wear masks for hours on end and are still smart enough to be a damn surgeon?  How about the workers who have to wear full face masks at the job in coal mines or silica mines or working with asbestos who live long healthy lives because of the people who INVENTED THOSE MASKS?  Welders? Painters? woodworkers? hazmat workers? dentists?  They're all harmed by masks?  All those jobs where OHSA makes you take off your mask because of how unhealthy they are? Oh yeah, its zero

I have patients who's oxygen saturation drops to 80% walking 10 ft who can wear a mask.  I wear a mask at the clinic all day.  Still alive.   Still smart enough to know how stupid this idiot is.

Can there be one...single...politician... who is not a freakin idiot!  One, just one.  Not much to ask

20
in case anyone needs to know where to get industrial masks:



If you will be in high risk areas (working with sick patients, on a crowded plane, etc) the industrial supply sites have full and partial face masks in stock.  You have to also pair it with p95 or 100 filters.

I have a set of 3M full face masks that I had in my emergency supplies for VOG but was glad to have them well before covid started. 

MSC has 62 varieties in stock.  remember to get the filters as well
https://www.mscdirect.com/browse/tn/Safety/Personal-Protective-Equipment/Respiratory-Protection/Facepieces-Assemblies-Cartridges/Half-Full-Facepieces?navid=12106762

The advantage of many of these is that filters are washable and so have indefinite lifespans especially when not used in industrial environments.   
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