Possibly but hard to say a 3 day exposure exclusively caused the problems. The amniodarone lung issues are more with longer term usage.
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Here you go, @WendyBG âŚ.you need someone who thinks like my husband..âNow thatâs bloody peculiarâŚâ, and writes up a case report which may well end up being an account of a one-off occurrence, but might well be the start of an avalanche of communication from folk whoâve also thought the same but couldnât be sufficiently arsed to put in the effort needed for publication..
Acute pulmonary toxicity after low-dose amiodarone therapy - The Annals of Thoracic Surgery https://share.google/JyoDVaBj3yd5KDQwE
I just asked dh about it and he pointed out that the drug has a long half life (so a short course isnât so short) Liver damage is much more well recognised
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And from the Annals of Stuff You Donât See Every DayâŚ
Ketamine-Induced Sclerosing Cholangitis Associated With Early Inflammatory Bowel Disease During Chronic Topical Ketamine Use - PubMed Ketamine-Induced Sclerosing Cholangitis Associated With Early Inflammatory Bowel Disease During Chronic Topical Ketamine Use - PubMed
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Nope, nor would I deny the obese insurance coverage if they have diabetes. But again, I donât see obesity as a disease. It is more like a condition, like being out of shape. But I also would not oppose smokers and the obese paying higher health care premiums because of their lifestyle choices.
A number of you on this board have described lifestyle changes made to control weight. Do you ask taxpayers to pay for your exercise equipment and running shoes? Of course not. So why should taxpayers foot the bill for those who choose a pharmaceutical solution instead?
Where did I suggest denying coverage for diabetes? Letâs try to keep this discussion honest.
Yes they are. But so is making the overweight, who are the majority of Americans, dependent on an expensive drug for the rest of their lives.
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I find this to be an unfair accusation. If the shelves are full of harmful but tasty products and when the government food guidelines are wrong, the fault does not lie with the individual.
Have you ever checked the sugar content of Monster Energy drinks? When I found I sold my shares!
The Captain
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Your position is illogical if you are not willing to pay for preventive care but are willing to pay for catastrophic care.
YIKES!
âŚand symptoms I recognize as befalling a long long long gone wild friend of mine.
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Weird thing here is that, although folk were labeling this patient as a ketamine abuser, she was adamant she was not. Not technically a patient of my husbandâŚ..a consult, so no real knowledge of patientâs background. He listened to her story, though and she was applying this concoction from a compounding pharmacy to her feet. He told her to stop doing it (I guess no one had suggested that before) so she did, and she improved quite dramatically.
Heâs a lightening rod for Weird Spit
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We wonât know even if we were right.
I hope you are continuing to gain your strength
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I canât say that I haveâŚâŚor even seen a bottle/can, come to that.
It must be found on the shelves where folk who blame government guidelines for their excess weight do their shopping.
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Well, as the GLP-1 agonists are currently approved/marketed/generally used/covered by insurance, itâs not technically âpreventiveâ careâŚ.but rather early intervention. Usually after biomarkers for disease states reach an arbitrary point (which themselves are a late stage phenomenon) Just like my aggressive lipid lowering regimen of high dose statin/PCSK9 inhibitor (added to Totally Righteous Lifestyle choices made for over half a century) isnât actually preventive. Athough I have no symptoms of coronary artery disease at allâŚ..yetâŚ..the disease itself is most definitely there, and has probably been brewing for well over half a century.
Iâm a not fat/never fat, âminor adjustmentâ personâŚâŚmy attitude is along the lines of responding to that first 5lb weight gain else youâll be wearing an extra 50 or multiples thereof in the future. I certainly recognise not everyone has this sort of self discipline and not necessarily for the want of tryingâŚâŚitâs the neurobiology of weight management that defeats them. A good many folk who begin these GLP-1 agonists at a much earlier stage in the trajectory to obesity reckon that theyâd never experienced appetite control and a lack of âfood noiseâ until then. Manifestly, Iâm not suggesting a start at the first 5lb, but Iâm intrigued by the potential gain in health benefits of use well before that first 50lb takes up residence.
I suspect that interventions at far earlier stages in the disease process are likely to become standard of care in the future for proactive individualsâŚ..and biomarkers such as an A1c of 5.6 (or whatever) will be laughed at as an âupper limit of normalâ. Maybe paying for treatment for those who arenât so proactive is the price to be paid for information and understanding (of absolute vs relative risk for one)
I didnât bother to think like this as recently as 4 years ago, BTW⌠in my imagined heart healthy, pre-CAC scan days. Knowledge can concentrate the mind to no end!
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https://www.monsterbevcorp.com
Next time you go shopping look for this image in the beverage section
At @7-Eleven
You must get out more and see the rest of the world. 
The Captain
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We play the cards we are given. We can swap out a few cards during our life times. Most people choose their problems. While some problems are bad luck, some can still be selected or maintained.
Older age problems come with the territory. Those are not selected the precursors can be.
Your CAC readings were not your choice, but sympathy for the cards others are dealt would be fairer. Young people chose lifestyles sight unseen.
Anything eaten in excess is probably going to be bad for you. It doesnât matter how healthy your food pyramid or diet happens to be, if you eat 3000 calories and burn 1500 per day, you will become overweight. There is nothing inherently bad about a Twinkie. Eat one a week as a reward for mowing the lawn and there wonât be any negative health impacts.
Obesity occurs because people abuse food. It is really that simple. Look at the data from 1960-2013
That extra 800 calories eaten by 21st century Americans compared to their thinner 1960 counterparts have nothing to do with food pyramids. Current American have simply chosen to become gluttons and now they want their more disciplined compatriots to subsidize an easy drug-based solution. Bah!
What kind of country have we become? The simple solution is to eat less (try using smaller plates), walk more, do your own yard work, wash your car by hand, donât use voice commands to turn on your lights, put your remote on your TV so you have to get up to change the channel, go to the supermarket every other day to buy fresh vegetables and park at the other end of the lot when you do, all very simple behavioral changes.
Iâll repeat, we eat almost a thousand more calories a day than our parents/grandparents did in 1960. Thatâs why we have an obesity problem and they didnât. Itâs not genetics. Itâs not food pyramids or the evil corporations or Madison Avenue. It is simply that we are a wealthier generation and have decided to use much of that wealth to stuff our faces.
This isnât ideology, this is data. 2900 calories/day in 1960 compared to 3700 cals/day today. If you are fat it is your fault. It is because you eat too much compared to past generations. Letâs stop kidding ourselves.
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We also need to pay attention to our own body.
The official guidelines tell me that I should eat 2000 calories per day. But I know from tracking my intake and weight that if I eat 1700 calories per day I will gain weight but I will maintain my weight at 1500 calories per day. To lose weight I will have to cut back to 1200 calories per day which is very hard for me to do.
As you say, I have to stop kidding myself. Thatâs my personal reality.
Wendy
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Well, theyâve been aided and abetted by the food industry and its tendency to âsupersizeâ everything. All part of the US as the best, the greatest, the biggest, where weâre in a nation in which size always seems to matter. The US population has seemingly bought into this on all levels.
Pete
For the sake of discussion, letâs agree that everything you stated above is factual.
If someone gets cancer from smoking, it is entirely their fault.
If someone is speeding and breaks their back in an accident, it is entirely their fault.
In such cases, we donât tell such individuals that we will not provide them healthcare or health insurance (even if we make the smoker pay a higher premium for such).
Would it not make sense for us to subsidize smoking-sensation programs to reduce the future likely socialized cost of lung cancer?
Blame/fault - who cares. If it is more cost effective to help people not be obese than to treat obesity related medical issues, then we should probably do so.
The nature of a free market and democracy is to give people economic and political choices. The underlying assumption is that people are sufficiently competent and responsible to make those choices. In the case of obesity, people have chosen immediate gratification/pleasure over long-term health. Nothing wrong with that as long as they are held accountable for the consequences.
If people are not competent to be held accountable then maybe a free market and democracy is too sophisticated for modern Americans. If so, then government needs to limit the available choices, i.e., the so called nanny-state.
Reality is far more nuanced than you are arguing. I am in favor of preventative medicine like vaccination programs, reducing environmental toxicity, mitigating climate change, etc. But in every case the emphasis is on providing government assistance for the things people canât control while limiting that intervention for things individuals can control to education. The food pyramid is a relevant example. The government doesnât force people to eat certain things, it just gives advice.
Nicotine and other regulated drugs are addictive to a magnitude not approached by Twinkies and soda. Addiction eliminates the ability to choose. In contrast, the vast majority of overweight Americans can choose between water and soda. I know of no instances of people robbing stores so that they can get their Dr. Pepper fix. So again, a large fraction of the calories eaten by overweight Americans are for foods eaten by choice rather than necessity.
My strategy to avoid obesity is exercise and do my own yard work. By your rationale, shouldnât the government also pay for my running shoes, exercise stuff, and lawn equipment? Why should the government only pay for drug-based âpreventative medicineâ?
Plus Iâve seen estimates of glp-1 treatment being about $1000/month and to my knowledge, when one stops taking glp-1, the weight returns. So we are talking lifetime treatment. CDC says about 75% of Americans are overweight with about 40% obese. I would like to see the calculations demonstrating that subsidizing glp-1 to anyone who wants it is going to be anywhere close to being âcost-effectiveâ.
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Do people abuse cocaine or are they addicted to cocaine?
Do people abuse cigarettes or are they addicted to cigarettes?
Do people abuse food or are they addicted to food?
Never tried cocaine but I was addicted to both food and cigarettes. How do I know, personal experience.
I started smoking at the end of high school and got up to two or more packs a day. I decided to quit. I read a book about it and followed the method. I quit smoking for five years but I was still addicted.
How do I know? I used to put the pack of cigarettes in my shirt pocket. I had two lovely shirts with no pocket that I finally got to use. But a funny thing happened, my right hand would move to the non existent pocket to get me a cigarette! Believe it or not, I would scold the miscreant hand, âWho the hell decides to smoke, you or me?â I had nightmares thinking that at a party a lovely girl would ask me for a cigarette and I would fallback into the habit. My will power was pretty good, i stopped smoking for five years but the desire to smoke, the addiction, never left me. Eventually I started smoking again.
Then I had heart event, I spent ten days in a clinic and when I went home the smoking addiction had disappeared, I have no idea why or how. Years later Larry King told the story of his heart problems and he had the same experience, after going home the smoking addiction had disappeared.
Food addiction
Back in the hunter gatherer era people didnât snack all day. In the 19th century people didnât snack all day.
What happened in 1960? Denny got a job programming at the IBM Service Bureau in Caracas
In the mid-1950s, with improved methods and design, Keys recruited collaborating researchers in seven countries to mount the first cross-cultural comparison of heart attack risk in populations of men engaged in traditional occupations in cultures contrasting in diet, especially in the proportion of fat calories of different composition, the Seven Countries Study still under observation today.
Curious coincidence!
How carbohydrate addiction works
When fat was replaced with sugar in the dietary guidelines the human body had a hard time coping. A bit of sugar the body could deal with but not with a boatload of sugar. Here is what happens, the cartoon version:
- Eat a lot of carbohydrates
- Blood glucose goes way up
- The pancreas sends insulin to get it under control
- After a time the body develops insulin resistance and the pancreas sends even more insulin
- Glucose levels crash
- Laking glucose the bode feels hungry
Itâs the insulin resistance that drives the food addiction and until you reduce the carbohydrate consumption you remain addicted.
We can accuse people of ignorance of the above but not of willful food abuse. What are parents these days feeding their children? Boatloads of carbohydrates! No wonder there is child obesity.
The Captain
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It is a question of magnitude. Anything that gives pleasure can affect glucose levels and other physiological factors and therefore be âaddictiveâ by your argument. Endorphins are associated with pleasure and can affect glucose levels.
But seriously, how many people do you know can no longer hold a job because of an addiction to potato chips? How many marriages have been destroyed because of soda? Food for the vast majority of people is not so addictive that choosing what to eat is no longer possible. Put a bunch of obese on a vegan cruise and no one is going to have the DTs or withdrawal systems beyond stomach growling.
I have personally experienced and still have an âaddictionâ to Bavarian black forest cake. I really like it and I crave it when I think about it or see it in a bakery. But I can choose to only eat it a couple of times a year. I am not all that exceptional.