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Agoraculture
Agoraculture
4 years ago

I have some leftover Hydroxychloroquine that was prescribed to me (off-label) 7 years ago for Lyme. Is it still good? (I can’t find my copy of the Shelf Life Extension Program and am too late to ask Doc Bones as he was on 2 weeks ago.)  Thanks!

Corona with a twist of Lyme, lol.

 

Justin McMillan
Justin McMillan
4 years ago
Reply to  Agoraculture

JM- Certified Pharmacy Tech

7-year old medication bottles are about 5 years past expiration. The average shelf life of drugs in the manufacture’s packaging is around two years. Anything dispensed in a regular Rx bottle is given a 1-year shelf life. That being said, I personally wouldn’t throw it out in the middle of a pandemic, but the efficacy of expired meds is questionable. We all have a habit of not wanting to toss medications, but this is a good time to go through medicine cabinets to see what can be given to a medication recycling program.

Grog
Grog
4 years ago

Jack,

Do the needful, take care of yourself first.

Thanks for all you do.

Regards,

Bobby
4 years ago

Ca you give the theee supplements you need to battle covid? Thanks

Rorschach
Rorschach
4 years ago

Though there is some discussion in the paper above of some reason to believe hydroxychloroquine + azithromycin may be an effective treatment.  This study (https://www.mediterranee-infection.com/wp-content/uploads/2020/03/COVID-IHU-2-1.pdf) shouldn’t really give anyone that much confidence for 2 major reasons: there is no placebo group, and it is not blinded.  I know you think you answered the objection of placebo group when you pointed to the general data available, but we don’t necessarily have people in the same hospital under the same physicians with the same level of skill, equipment availability, etc.  and the only difference is the additional drug treatment and left unknown to the researchers because of: https://en.wikipedia.org/wiki/Observer-expectancy_effect.  There are studies were effects disappear once you do more carefully designed studies.  For instance when they used calcium to treat elevated lead levels, and it worked! Then another study with a placebo did the same thing and it worked again, but there was no difference between then calcium, and placebo group.  Over time researches ended up finding oral Vitamin C helped reduced serum lead level.  Science is riddled with false starts, but I think this is still worth pursing since there does seem to be some basic science data to suggest it might work. It may be easy to be swept up in hope or anger at the Orange Man, but we really need to work at getting the answer right as quickly as possible.

Rorschach
Rorschach
4 years ago

There is not really a set percentage of people the improve in a placebo groups and the common teaching around placebo groups has created false thinking (https://sciencebasedmedicine.org/the-placebo-effect/). For instance, placebo groups with pancreatic cancer have terrible outcomes, but the placebo group in treating a mild viral infection with antibiotics does extremely well.   The reason you have a placebo group is because you don’t know what percentage of people will spontaneously improve without data, and if you don’t know the Denominator, as you have made clear, then you don’t have the data to determine what percentage will improve spontaneously.

Rorschach
Rorschach
4 years ago
Reply to  Rorschach

Yes(kind of), and no.  I was making 2 points.

1. We may have some idea what is likely, but in both examples the pancreatic cancer, and antibiotics for viral infection, the placebo effect in studies for all intensive purposes is zero because the pancreatic cancer patient is going to die at the same rate whether you treat them with a placebo or not, and the person with the viral infection given antibiotics is going to get better whether you treat them this way or not. Placebos help researchers remove their biases, not treat patients.

2. You can’t calculate and determine the effectiveness of a treatment unless you know the untreated outcome of the condition, and in this case we don’t really since we don’t know the denominator.  There have been assumptions by experts about what the underlying reality of the coronavirus spread in the Oxford vs Imperial models debate, and one group or both is going to end of up being wrong (though I think one will be closer to the truth).  Even experts in a field need to actually measure the data. 

surfivor
surfivor
4 years ago

Jack,

 

good job on chloroquine but trying to convince people it is effective is going to be like promoting conspiracy theories at this point. A web search mostly seems to turn up sites that say it won’t do much.

I am going to call some walk in clinics in the area today and see if they would prescribe chloroquine in the event of symptoms etc. The last two times I had to go to the doctor, I just went to a clinic instead. I will try to tell my mother and my sister about chloroquine but I doubt they will believe me. I will encourage them to inquire with their doctor and report back to me what they are told. I will also encourage a few friends the same and it’s more likely I could convince them

i orded 3/4 of an ounce of actual quinine powder derrived from Honduras cinchona bark 4 days ago from bonanza. It’s being shipped from CA. Not sure when it is arriving. It costs $10, some other sites sell a more expensive product but I just ordered the cheapest I could find as I am in a frugal state of mind currently for various reasons

i have a small bottle of zicam which has zinc, I guess that would be effective? Whole Foods seems sold out of zinc

I heard of the first case of convincing coronavirus symptoms of a call in to a podcast I listen to of someone who thinks they have it.

thanks also for the note on mortgage relief. I am going to look at that. It appears if you have mortgage insurance through federal government then you are eligible and some 50% of mortgages supposedly are. If I am eligible for that I think I would be in the state of mind to order zinc online and probably more cinchona bark

33AD
33AD
4 years ago

Major corporations will not alter production schedules to make millions of doses of something with no plans for it to be used.
 

This^

surfivor
surfivor
4 years ago

I emailed my sister about chloroquine, she said sarcastically:
“so glad to have a doctor in the family with insider information”

 

I called my mortgage company but was put on hold indefinitely until it says they will call you back in 3 days or so. I found some other option where it asks you qutomated questions but you never speak to a person.

 

The link below says that if your mortgage has federal insurance then you are eligible for a deferment. I answered a bunch of automated questions and the system said I was eligible for a 3 forbearance which I don’t think means much of anything.  My company didn’t go out of business but I specified “Other temporary situation of unknown length” In a forbearance, from google searches it seems it may mean don’t have to pay your mortgage for 3 months but at the end of 3 months then you owe the money for all 3 mortgage payment that you missed. If there is some rule on how that all works or if it’s up to banks by discretion I was not able to discern that

https://www.edwardjones.com/market-news-guidance/guidance/cares-act-highlights.html

Mortgage Relief for Homeowners: Requires the servicers of federally backed mortgages to postpone mortgage payments at the request of the borrower, provided the borrower affirms financial hardship due to COVID-19. The postponement must be granted for up to 180 days and extended for an additional period of up to 180 days at the request of the borrower.”

 

Rorschach
Rorschach
4 years ago

Re: http://www.thesurvivalpodcast.com/feedback-3-30-20#comment-937004

There was no reply link under this last set of comments

“You know what, placebo isn’t going to stop viral pneumonia so your first point nullifies your second.”

No, because we know these things because they were studied. My first point is that we need unbiased data, so that we can proceed with the accurate calculations that follow in the second point.

“We are not gauging how people feel but viral load, pneumonia and death rate”

How do you know the death rate without knowing the denominator? Each time I have mentioned the denominator you have left it out of your subsequent response.

“In this case it is irrelevant, and if placebo response actually cures 10% FUCK IT, quit being a dip shit here. We know this works and they do too! The more of it that becomes available the more truth is coming out about it”

Making up numbers like 10% isn’t an actual study. Which studies do you think lead them to believe that they know that this.works? Is there another clinical study with a placebo group, at least a large randomized sample public health study to help us determine what the actual denominator is.

“Gonna say they now have hundreds (again HUNDREDS) of health care workers on it as a preventative in NY. Bet you didn’t know that. The plan is for it to be THOUSANDS soon”

I didn’t know this until today’s show, but again no placebo and no denominator. I have been practicing not paying to much attention to the news as you recommend.

“Doctors are literally killing people here and being forced not to. Patients are on it against treating MDs wishes, the MDs are bitching about it WHILE PATIENTS IMPROVE in Detroit. These are patients that are totally fucked already. Get it to people before they need a hospital and we can minimum cut the hospital load in half.”

This is simply emotive and not about how to properly study a problem. Yes, it’s tragic, and I hope it works, but I am arguing that this is not how we KNOW it works. We should spend resources on solving this problems, but if he don’t have answer then we may be wasting resources. Then not only are there the dead, but a greater loss of wealth due to the misallocation of resources.

Rorschach
Rorschach
4 years ago

“Thank you for proving that the establishment mindset is a dinosaur killing people RIGHT NOW as we both type”
Not sure how I proved this. Maybe you could explain to me argument.  Even if my view is completely establishment, does that mean it’s wrong?  Does the source of idea determine it’s validity? (https://en.wikipedia.org/wiki/Genetic_fallacy) Were not people just as wrong for denying a fact because Trump said it, as you clear to point out earlier?
“This med is safe, you try it and you know it works, it doesn’t work you know it didn’t, it is that simple. Guess what, it is going to be done my way. For that I am grateful beyond words. One does not produce at the quantity being made right now for trials.”
I am not arguing it is not safe but have been questioning the methodology regarding the evidence for it’s efficacy.  They could set up some trials amid all of this.
“Here is a fact, right now in Detroit there are patients getting better taking this, while their doctors are complaining about being forced to give it to them. If you can defend that in anyway, just going to say if you get this shit, give your doses if available to someone else.”
There is a high likelihood I will be exposed.  This is not just academic for me, so I do really want to know the truth.
“And let me add this, MOSTLY up till now this med has been being used on patients already intubated, clearly later than it should be. Yet it still improves the condition.”
Without placebos we don’t know what percentage of people would improve without a specific treatment. 
“Please inform this ignorant duck farmer that is over simplifying this one thing. How can a person sedated to the point of being in a medically induced coma can have a fucking placebo effect?”
I thought I was clear above that placebos don’t treat people, but are part of the process of removing bias from a study.  This is why placebo effect disappear with hard outcomes, and not patient perceived outcomes.  I provided a link above about this. 
“Seriously is your contention that a person in a medically induced coma with a machine doing their breathing for them can have a placebo effect?”
See above.  Also, I have been in a meeting where a doctor confidently proclaimed his use of a specific treatment for years helped his patient, only to have another doctor point out that studies on this specific treatment showed no difference than placebo.
“Not to mention the most recent study was on patients who were not that far but did have sever pneumonia and it was randomized and blind and still reduced viral load in advanced cases by a day faster and improved pneumonia by 2X treatments without it.”
Are you speaking of this one?( https://www.barrons.com/articles/hydroxychloroquine-trial-randomized-covid-19-efficacy-51585748653).  This does seem to be the best study yet, but there still are some concerns about the overall methodology (https://zenodo.org/record/3739134#.XokwW9OSnIU).  They though chloroquine which seemed to have evidence of activity would work for influenza but didn’t when studied (https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(11)70065-2/fulltext)
“Last I don’t know why you people who say you worship science also deny it”.
Did I say I worship science?  I don’t know why people who say they use logic and reason need to put words in other people’s mouths. If you are going to claim the science is on your side then you should better understand why medical scientists do things the way they do (https://en.wikipedia.org/wiki/Evidence-based_medicine, https://explorable.com/research-bias).  You made the claims about science first, and I am explaining why I think your wrong about the science though it is still possible Hydroxychloroquine may have treatment benefit, we just don’t have the kind of evidence that would give me confidence in that. 
“The use of this medication being proven on corona viruses goes back to at least 2005. It is not new, it is not new, it isn’t new.”
The first study I have found in 2005 was in cell cultures in non-human primates(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1232869/).  It is common for animal models to fail (https://www.sciencemag.org/sites/default/files/bmj.g3387.full_.pdf).  It has been a constant sad old refain to read about treatments that were positive in animals that failed in humans. 

Jonathan
Jonathan
4 years ago
Reply to  Rorschach

Is it just me, or did Jack seem to lose his mind in all this. You are bringing up a lot of great points and Jack is sticking his fingers in his ears shouting that he is right and everyone else is wrong.

Nathan Kirby
Nathan Kirby
4 years ago
Reply to  Rorschach

I finally figured it out. I know exactly how to reply to Jack right now. Purely based on how he has handled past event and how he handles online criticism, I know what to say.

Jack,

Ok boomer.

I truly mean that without sarcasm. I know you are “Gen X”, but you genuinely act like a boomer. Took me long enough to figure it out, but I did.

Nathan Kirby
Nathan Kirby
4 years ago
Reply to  Rorschach

If the zinc was so crucial as you stated, wouldn’t it have been still bad until they started using it? Also, didn’t you say there were studies that had patients in terrible condition, yet got better after only hydroxycholoriquine? You don’t seem to realize how much you flip flop on any subject. I’m not saying hydroxycholoriquine wouldn’t help or that it will hurt, but maybe don’t put as much blind faith in it and some of these doctors as you do. I personally have been around plenty of doctors and I can genuinely say that there are more than a couple that make claims that would get their license revoked and have even doubled down on claims in court. Take a chill pill, sit down, and quit acting like you are intellectually superior to everyone.

Nathan Kirby
Nathan Kirby
4 years ago
Reply to  Rorschach

Fun fact, did you know that although they were able to get hydroxycholorquine to kill Covid-Sars-2 in a lab previous studies have shown that the same effects are not always true in animals (to include primates) so what you are spouting might not be true because of how our own bodies react. Also to reiterate, I am not against trying it to try to treat and find something that may work I am only against blindly spouting about it and shitting on anyone pointing out potential flaws that should be looked into. But you know what, you do you boomer.

Nathan Kirby
Nathan Kirby
4 years ago
Reply to  Rorschach

Oh wow, maybe check out these?

https://www.washingtonpost.com/politics/2020/04/13/how-false-hope-spread-about-hydroxychloroquine-its-consequences/

https://www.poynter.org/ifcn-covid-19-misinformation/page/2/?search_terms=chloroquine

https://www.nytimes.com/2020/04/12/health/chloroquine-coronavirus-trump.html

I would love to have your sources where there are “thousands of Doctors reporting it works”. If you are going to spout of something like that  you really should provide some evidence. So far it’s only been a handful.

Also, you never did explain why you say it both helped patients in comas and it also was and is not being not given soon enough to help. So much for me being the one talking out my ass.

Nathan Kirby
Nathan Kirby
4 years ago
Reply to  Rorschach

Good to go, just doubling down for a reply instead of actually checking the information that was sent. I am actually trying to find this information of all these doctors to try and figure out where they are and how it’s being applied, but I guess trying numerous search engines with multiple search criteria and not coming back with the same information you are giving is my fault. Or maybe it just doesn’t exist as you say it does. Quit flip flopping what you say and playing mental gymnastics to “prove” your point.

Brian
Brian
4 years ago

I’m an ICU nurse in PA dealing with this first hand and all our covid patients are getting hydrochloroquine and azithromycin. We are not seeing any effect. The ID docs are prescribing it because there’s a chance it might help and there’s no evidence it’s hurting. But it doesn’t seem to make any difference from what we’re seeing in practice. Wish it looked better, but from my point of view (in the gear up close and personal with the covid patients) it does not appear to be anything like a game changer. To be clear, I wish it was.

Brian
Brian
4 years ago

I have no doubt it’s a great benefit to the vast majority of people who don’t get that sick from covid. Which is why some healthcare professionals are skeptical. It seems like the great benefits reported are for those who are already going to get better. But hey, we’re giving, I hope it works. I do know that the ones who come to icu usually don’t even have test results back. They crash remarkably quickly. I have no idea what happens in the outpatient world, but all inpatients with covid seem to be getting it. Seems to have a placebo effect in that it might make the general public feel better

Rorschach
Rorschach
4 years ago
Reply to  Brian

Are you talking about this study? (https://www.mediterranee-infection.com/wp-content/uploads/2020/03/Hydroxychloroquine_final_DOI_IJAA.pdf)  The end of page 9 is where they talk about viral load under “statistics” which are a little different then what you quote.  Seems promising, but if you read page 10 of the study you will find out the 6 of the 26 patients were not counted in the final data because they were “lost to follow up” in the Hydroxychloquine group with 3 of them transferred to the ICU with 1 dying, and they clearly state that they continue the calculation without these patients.  This is why you need Intent to Treat analysis(https://en.wikipedia.org/wiki/Intention-to-treat_analysis)

Cerilo Melerine
Cerilo Melerine
4 years ago

Where can I find the livestream of the covid segment? Am I dumb? I can’t find it anywhere. I want to share it.

Cerilo Melerine
Cerilo Melerine
4 years ago

Thank you, but I was looking for the one from episode 2628.