If there's one thing about living in Michigan that is truly irritating, it is that the legislature is currently controlled by a bunch of right wing Tea Party-style Republicans, while the governor is Rick Snyder, someone who sold himself as "one tough nerd" and a reasonable centrist businessman but who's consistently refused to stand up to the worst elements in his party. Oh, and he was also asleep at the switch, contributing to the Flint water crisis. Add to that my state senator, Patrick Colbeck, who not only has antivaccine proclivities, but "questions" evolution and, of course, denies climate science. Politically, it's a painful place to live right now in a lot of ways.
One area, however, where Michigan has done pretty well during the last three years or so is in vaccine policy. In response to increasing nonmedical exemptions to school vaccine mandates and falling vaccination rates, as well as pertussis outbreaks, particularly a big pertussis outbreak in 2012, the Michigan Department of Health and Human Services (MDHHS) decided to do something about it. In brief, the state emulated California's first attempt to combat the rising tide of personal belief exemptions (PBEs). Basically, starting January 1, 2015, the MDHHS altered the rules regarding requirements for parents to claim personal belief exemptions to vaccine mandates. Basically, it patterned its policy change on California Bill AB 2109, a bill from a few years ago that sought to tighten up requirements for PBEs in California. AB 2109 required parents seeking PBEs to meet with a physician or other enumerated health care practitioner to receive counseling on the risks of opting their children out of school vaccine requirements. The physician would then have to sign the PBE form to verify that he had counseled the parents. Of course, in the wake of the Disneyland measles outbreak a year ago, California passed a far stronger measure, SB 277, which, beginning with the 2016-2017 school year, eliminates PBEs in California.
In contrast, Michigan’s policy requires parents seeking PBEs to visit their local health department office to:
- Be educated by a local health worker about vaccines and the diseases they are intended to prevent.
- Sign the universal state form that includes a statement of acknowledgement that parents understand they may be putting their own children and others at risk by refusing the shots.
So basically, it’s just like AB 2109, only with more teeth. Not just any doctor or nurse will do. Parents have to visit their local health department for the counseling. It’s a creative modification to a strategy designed to make obtaining a PBE at least as difficult as getting one’s children vaccinated. Indeed, part of the problem in Michigan, as it was in California before AB 2109, is that it’s been easier to obtain a PBE by simply signing a form and sending it to a child’s school than it is to actually get that child vaccinated according to the CDC schedule. Even better, there's now evidence that this policy works.
Not surprisingly, antivaxers absolutely hate this policy, and unfortunately there are legislators sympathetic to antivaccine views willing to pander to them. We met some of them when I discussed Del Bigtree's foray into Michigan to visit with state legislators, the better to persuade them that "freedom" demands that parents have the ability to choose to leave their children vulnerable to vaccine-preventative diseases. In late 2015, legislators introduced HB 5126 and HB 5127, which specifically eliminates the authority of the Michigan Department of Community Health to make or enforce a rule that allows a local health official to exclude a child who lacks documentation of immunity from school when a child in that school has a communicable disease and to reverse the rule change by the MDHHS that required parents seeking PBEs to undergo counseling at a local state or county health office. Fortunately, neither bill passed.
Unfortunately, that hasn't stopped legislators who are either antivaccine-sympathetic or antivaccine from, fresh off of celebrating the first case of measles in Michigan this year, having another go at it:
Yesterday marked the start of National Public Health Week.
This is a blog about some of Michigan’s conservative elected officials who clearly did not get the memo.
Michigan Republicans have decided to throw established science and concerns for public health out the window by introducing bills that are clearly catered to the anti-vaccine crowd — and will ultimately put the public’s health at risk.
According to MLive, “parents seeking an exemption to vaccinations must be educated by a local health worker about vaccines and sign a universal state form, which includes a statement of acknowledgement that parents understand they could be putting children at risk by refusing the shots.”
Under the proposed bills, the rule would be eliminated.
According to health officials, this rule helped drive down vaccine waivers, which led to more kids getting immunized. Data from 2015 showed that Michigan ranked 43rd lowest in the nation for immunizations covering kids from 19 to 35 months. So clearly, we still have some work to do.
But guess what? Since the rule change the state has reported a 35% decrease in the the overall PBE waiver rates. So what do lawmakers want to do? They want to screw it all up and risk backsliding by eliminating that rule, and, unfortunately, it's a familiar name behind the effort in the state Senate, at least. Yep, it's Patrick Colbeck:
“The rules enacted by DHHS pertaining to parents who wish to opt out of vaccinations for their children go beyond the intent of the current law, which was to inform parents of potential consequences of their choices, but now seems to have a punitive intent,” Sen. Colbeck said. “Whenever a department promulgates rules that go beyond the intent of the legislation, it is then the role of the Legislature to make sure those rules are reined back in. It was never the intention of the Legislature to see a vaccination opt-out procedure put into place that essentially mandates that parents have to take time off of work to meet with specific people, view videos, or sign inflammatory forms to exert a right they should be able to exercise more simply.
“State legislators are increasingly concerned about departments implementing rules that go beyond legislative intent. There is a strong desire to reform the administrative rule-making process across the board, thereby limiting the need for retroactive correction.”
There are two bills in the Senate (SB 299 and 300), co-sponsored by Colbeck, and a bill in the House, HB 4425, sponsored by Rep. Tom Barrett and a bunch of other Representatives, and HB 4426. Both are designed to strip the MDHHS of the authority to make a rule like the one that requires counseling by a public health official before a vaccine waiver is granted. The text of HB 4425 is virtually identical to that of its predecessor (HB 5126) (I can't find the text of SB 299 or 300 on the Michigan website as of last night):
(2) A child is exempt from this part if a parent, guardian, or person in loco parentis of the child presents a written statement to the administrator of the child's school or operator of the group program to the effect that the requirements of this part cannot be met because of religious convictions or other objection to immunization.
(3) THE DEPARTMENT'S AUTHORITY TO PROMULGATE RULES UNDER SECTION 9227 DOES NOT INCLUDE THE AUTHORITY TO PROMULGATE OR ENFORCE A RULE THAT IMPOSES A DIFFERENT OR ADDITIONAL REQUIREMENT FOR A CHILD TO BE EXEMPT FROM THIS PART THAN THOSE DESCRIBED IN THIS SECTION OR THAT REQUIRES THE EXEMPTIONS DESCRIBED IN THIS SECTION TO BE ON A FORM PRESCRIBED BY THE DEPARTMENT.
(4) IF THE DEPARTMENT PROVIDES INFORMATION TO THE PUBLIC ON THE EXEMPTIONS DESCRIBED IN THIS SECTION, THEN WITH THAT INFORMATION THE DEPARTMENT SHALL INCLUDE INFORMATION ABOUT THE EFFECTIVENESS AND POTENTIAL RISKS OF IMMUNIZATION FOR DISEASES FOR WHICH THE DEPARTMENT REQUIRES IMMUNIZATION UNDER SECTION 9227.
Basically, this law, if passed, would handcuff the MDCH by explicitly forbidding it from making it any harder for parents to claim a PBE than to present a signed written statement to the school administrator saying, in essence, "I don't wanna." You can tell the antivaccine influence in this bill by the language about the "potential risks of immunization."
Like its predecessor, this bill is even worse than that, though. Not content to eliminate a strategy that has worked to drive down the rates of PBEs in Michigan, Colbeck and like-minded legislators in the House want to make it harder to prevent outbreaks of vaccine-preventable diseases in schools:
(2) THE DEPARTMENT'S AUTHORITY TO PROMULGATE RULES UNDER SECTION 5111 DOES NOT INCLUDE THE AUTHORITY TO PROMULGATE OR ENFORCE A RULE ALLOWING A LOCAL HEALTH OFFICER WHO CONFIRMS OR REASONABLY SUSPECTS THAT AN INDIVIDUAL ATTENDING A SCHOOL OR GROUP PROGRAM HAS A COMMUNICABLE DISEASE TO, AS A DISEASE CONTROL MEASURE THAT IS NOT IN THE CASE OF AN EPIDEMIC, EXCLUDE FROM ATTENDANCE AN INDIVIDUAL WHO LACKS DOCUMENTATION OF IMMUNITY OR IS OTHERWISE CONSIDERED SUSCEPTIBLE TO THE COMMUNICABLE DISEASE. AS USED IN THIS SUBSECTION, "GROUP PROGRAM" MEANS THAT TERM AS DESCRIBED IN SECTION 9211.
What this provision would do is to prevent a local health officer from keeping unvaccinated children out of school if a a case (or cases) of a vaccine-preventable disease occurs in that school outside of an actual epidemic. I looked at this provision, looked at it, and then looked at it again, and for the life of me I can't figure out the rationale for this. Basically, the only purpose this provision serves is to endanger children who are not vaccinated, thanks to PBEs, while at the same time inserting additional susceptible children into an environment where a contagious disease resides, thus making an outbreak more likely. In the case of a small outbreak of vaccine-preventable disease that doesn't qualify as an epidemic, preventing health officers from taking the reasonable precaution of keeping children not vaccinated against the disease out of school is an excellent strategy to make it more likely that a small outbreak becomes a large one—or even becomes an epidemic. By the time you have an epidemic, keeping unvaccinated children out of school becomes much less effective, as it's a strategy that works best early in the course of an outbreak. This law, if passed, could easily produce a public health disaster. It's utter madness, and the legislators who are promoting such policies are clueless when it comes to public health.
The stupid, it burns. It boggles the mind. It’s unbelievable. Except that it’s not. Believe me, our state legislature right here in Michigan really is that dumb and dysfunctional. We really do have a large number of legislators who conflate "freedom" with the freedom to endanger public health and fetishizes "parental rights" without even considering the rights of the child. It's almost as though they're trying to turn Michigan into Romania, with its massive ongoing measles outbreak. The sheer scientific ignorance and downright stupidity boggle the mind.
This is a case where you have a handful of conservative elected officials pursuing an agenda to appease a small, ideological segment of their base for the votes, while ignoring scientists and public health experts who have the interest of everyone in mind.
Call your state rep and senator and tell them to oppose House Bills 4425/4426 and Senate Bills 299/300 because they are dangerous, anti-science bills that will only create more health dangers for the public.
And here are some handy instructions to do just that:
I guess that the Michigan Legislature, in its infinite wisdom, wishes to decrease tourism rates. I know that I would tell friends and relatives to stay away if there is a VPD going around, like measles. Since I don't develop immunity, even with multiple MMRs AND having had the disease, my trips home will be postponed and I certainly won't go to any places and spend money if I might be exposed.
Meth labs of democracy, indeed.
Basically, the only purpose this provision serves is to endanger children who are not vaccinated, thanks to PBEs, while at the same time inserting additional susceptible children into an environment where a contagious disease resides, thus making an outbreak more likely.
IANAL, but I suspect an ADA case could be made against that provision. The problem, of course, is that nobody would have standing to bring such a case until an outbreak actually happens.
A. All states allow officials the authority to exclude unprotected children during an outbreak. If that passes, Michigan will be unique - in the wrong direction.
B. A federal lawsuit against the rules was dismissed. There was a state suit filed, but I haven't been able to find what happened to it. The federal court found the rules constitutional.
What a joke. Plenty of law in the US demonstrates that your right to make a choice ends at the safety of others. You can't drive drunk because of the increased risk to others on the road, and you can't avoid vaccinating your kids due to refuting science because you are putting people who have real medical issues that prevent safe vaccination at risk of horrible infections.
Some of these Tea Party types have a weird interest in dismantling government in its entirety, except military and law enforcement, that is.
All states allow officials the authority to exclude unprotected children during an outbreak. If that passes, Michigan will be unique – in the wrong direction.
The language isn't clear. It says that a health official can't exclude an unvaccinated child "as a disease control measure that is not in case of an epidemic," but what does that mean? "Epidemic" implies a lot of cases of communicable disease, but what about an outbreak of a few? My interpretation (and, of course, IANAL) is that if it's just a few kids with a communicable disease, which would be considered an outbreak but not an epidemic, this law would tie the health officer's hands and prevent him or her from keeping unvaccinated children out of school. That's an excellent way to make it more likely that an outbreak will turn into an epidemic.
A word about unclear vaccination status. Michigan has an excellent computer database system that tracks vaccinations in the state. A child who's spent all his life in Michigan will not have an unclear vaccination status because every vaccine dose is entered into the database:
Not surprisingly, antivaxers hate this database too and have tried to get legislation passed to weaken it.
My interpretation (and, of course, IANAL) is that if it’s just a few kids with a communicable disease, which would be considered an outbreak but not an epidemic, this law would tie the health officer’s hands and prevent him or her from keeping unvaccinated children out of school.
If it were my goal to ensure that an outbreak became an epidemic, prohibiting such reasonable measures would probably be the most effective thing I could do. It doesn't take an epidemiologist to figure that out.
Can we describe these legislators as being pro-epidemic? The provision in question does nothing else.
I can't see how the answer to your question could be anything other than yes. In fact, I added the word "epidemics" to the title because your point is good.
Hopefully some credentialed medicos will be writing opinion pieces and letters to the editor pointing out what you guys are talking about - That these measures are tantamount to legislating a pathway for a small outbreak of disease to become an epidemic.
Liberal applications of insolence toward the supporters of the demented measures would not be inappropriate such as taking on the mien of a school teacher explaining to an incredibly thick student how what they think and want to do is idiotic.
You know... ridicule them so they never dare to dip their toe into science and medicine again without consulting with experts to cover their asses.
"clueless, dumb, dysfunctional, ignorant, mind-bogglingly stupid..."
It's WAY past time to retire this sort of language for talking about Tea Party GOP politicians. It leads to vastly underestimating both their political skill, and their venality. IMHO, it's unconscionable to merely say Snyder was "asleep at the switch" on Flint. He's actively complicit in all sorts of ways, first by pushing for the emergency manager law, which was nothing but an outright attack on poor, largely African-American communities, then by stonewalling when the crisis was revealed, then by doing nothing to fix it.
Colbeck and his allies know vaccines work. They know vaccines don't cause ASDs. They know their proposals will greatly elevate the risk of outbreaks. They're not "clueless", they just have no fvcks to give for the people who will be hurt. If they haven't 'earned' the ability to buy adequate protection against [whatever] for themselves, well it's not for the nanny state to molly-coddle them. "Public health" as a concept is just creeping socialism – like "public education" – to be rejected and replaced with privatization and the invisible hand of "the free market. There's no conflation of "'freedom' with the freedom to endanger public health" because the public counts for nothing against 'individual liberty', so the freedom to endanger public health is exactly what "freedom" means.
The only thing more important than this "freedom" is it's raison d'etre: the accumulation of wealth and power. Colbeck may or may not be a true believer, but on e way or another I'll bet these bills address the wish list of some deep-pocket campaign funder. And not necessarily an "anti-vax loon" either. This could be largely a "health freedom" trial balloon, seeing how far they can get with an extreme case, so they can later 'compromise' to position that's still farther out than anything they'd get w/o scaring the piss out of sensibly concerned opposition. Even with vaccines, the strategy may be to drop the provision restricting public health officials to keep an extremely lenient policy on PBEs in an amended bill that can/will pass.
The ideological root of all this is the frankly selfish and mentally constipated view that children are somehow property of their parents, a view with a long religious and patriarchal (in the sense of rigid and male-dominated) tradition.
Children are a trust, a sacred trust if you like, even something like a financial trust, and too many parents want to use their children as pawns to score their ideological points rather than allowing the lives in their trust to grow and prosper.
(If I can stretch the metaphor a bit, both kinds of trust grow more the more interest that's applied to them.)
The sooner the scourge of religion as currently practiced by too many is lifted, the better.
I think this proposed legislation might be even more anti-child than it appears. Here's what I see:
Children are obligated to attend school (of some variety).
If health officers are not allowed to bar unvaccinated children from school (ie give them an excused absence) during an outbreak of a VPD then unvaccinated kids are obligated to go to a place with an outbreak of a VPD and lots of very close contact, where their likelihood of contracting said VPD is higher than in the general community.
Thus, on some level, the unvaccinated child is being forced into a dangerous situation through a combination of not being vaccinated (for medical or PBE reasons) and the acts of the legislature which would prevent the health department from taking actions to protect the child.
That's a whole new level of cruel.
Sadmar (#9) writes,
They know vaccines don’t cause ASDs.
I respectfully disagree in the absence of apprehension, Sadmar.
Clearly, children and many with ASDs (Autism Spectrum Disorders) have atopy (i.e., many allergies).
Because the etiologies of ASDs are still uncertain, and the incidence has increased, medical procedures that increase atopy could be potentially harmful.
For example, repeated exposure to vaccines that have food proteins and/or a L@TEX WARNING could increase atopy and thereafter adversely affect neurological development (i.e., allergy-induced regressive autism).
It's not a hopeless situation, simply eliminate foodstuff proteins and natural l@tex to improve vaccine safety for everyone.
What IS it with Michigan lately.
Flint wasn't bad enough? The disaster that is Detroit's public schools isn't enough?
I can only think these Tea Party loons realize that the party will soon be over, and are doing as much damage as they can while they can.
I came across this while looking for something else and wanted to pass it on:
Pretty close. The the party that will soon be over is the ecosystem supporting human civilization as we know it. The selfish and mentally constipated billionaires are just trying to become the most powerful kings they can before the next mass extinction. What's a few VPD outbeaks in the next decade or two when we're on track for the deaths of billions in a mere century or two.
ORD@10: I agree that toxic patriarchical religion is a major part of it. But it's more than that: there is a school of thought that says that government should interfere minimally, or better yet not at all, with people going about their business. Ayn Rand would be the prototype for the latter group. Even though Rand herself was an atheist, there is substantial overlap between the two groups.
It turns out there is a real-world counterpart to Galt's Gulch. It's called Somalia. So perhaps the best response to the Randroids is to point out that they could have their ideal governmental system by simply taking the next available flight to Mogadishu. And if enough of them did so, it would be an improvement for both countries.
It turns out there is a real-world counterpart to Galt’s Gulch. It’s called Somalia.
You're right and you're wrong.
Somalia has government. From Wiki - "The Federal Government of Somalia, the first permanent central government in the country since the start of the civil war, was later established in August 2012. By 2014, Somalia was no longer at the top of the fragile states index, dropping to second place behind South Sudan. UN Special Representative to Somalia Nicholas Kay, European Union High Representative Catherine Ashton and other international stakeholders and analysts have also begun to describe Somalia as a "fragile state" that is making some progress towards stability. In August 2014, the Somali government-led Operation Indian Ocean was launched against insurgent-held pockets in the countryside. The war continues in 2017."
But history does provide an example of no government, Deadwood, in the Dakota Territory. To get an idea of what life was like, see the multi-part HBO documentary of the same name.
I live out here in demoron land. One of the VERY FEW times "we" have gotten something right is to make all the punkins get their shots. We have no choice really, over 50% of the punkins may not be from the US out here, and we NEED to get everyone vaccine! We also have the highest TB rate in the US here in the Pit so I think ALL adults should get shots also. Then, again you can do the PC thing and lose some punkins.
Eric Lund: "It turns out there is a real-world counterpart to Galt’s Gulch."
Someone actually tried to set one up in Chile, it failed miserably:
Things have reached a point where I could believe there are those on the right wing who think that a few good ol' epidemics are just what's needed to cull the weak from society and reduce the burden on government, creaking from years of bleeding-heart liberal indulgence...
Who knew that child abuse could be re-cast as a "freedom" issue?
Actually, that point has been raised on numerous occasions - used to justify spanking, whipping, etc. of children to correct behavior.
It is also commonly used by religious minorities to justify not taking their kids to the doctor.
@Chris #19: this situations illustrates the core self delusion of libertarianism and Randism. That is, the ideals can only work if everyone is honest, or is willing to enforce contracts at the point of a gun. And most people are too chickenshit to follow through.
Libertarianism can't work because no society is 100% honest, and without a system to resolve conflicts there is violence and/or fraud that devolves into a strong man system (which is what John Galt was).
Communism has the same exact problem. Karl Marx tried several times to establish a perfect society in Germany. They all failed because he was such a colossal asshhole who personified "some are more equal than others." It didn't take long for Russia to devolve to dictatorship; communism simply became window dressing.
Neither system accounts for human nature. They are utopian in nature, not practical.
Capitalism doesn't exactly seem to be working out all that great for the majority of people either. Just sayin'.
To me, the ultimate fail of "perfect libertarianism" is that there is no way to assure a level playing field at the outset. It's like a race where some get to start halfway to the finish line.
They assume "strict liability" for damages after the fact, will be a sufficient deterrent to torts. That's a lot of comfort after you're mutilated due to someone else's negligence or wrongdoing, and that's assuming that he's not rich enough to hire a battery of lawyers to stymie and delay you at every turn.
Some libertarians are against drivers' licenses. One actually argues that if a doomsday asteroid were heading toward Earth, government would have no right to use your taxes or otherwise compel you to contribute to planetary defense.
Once again I'm posting this link, because it best lays out the problems of libertarianism as generally preached: /www.uwgb.edu/dutchs/PSEUDOSC/NoLibert.HTM
I don't know why the link I posted didn't come through as one, so cut and paste, it's worth your time. If you can, look through more of Steve Dutch's personal pages. He's always interesting.
A true libertarian society is no more attainable than the Soviet ideal of "true socialism". Old Russian joke - 'When we achieve true socialism, you identification will no longer ask what your nationality is. Instead, it will ask, what was your nationality before true socialism?
State rep and senator sent strongly worded notes!
Info on SB299, 300 still not up as of 1pm Thurs 4/6.
Senate adjourned until Tuesday 4/17, house 'til 4/18
@ 24 JP
Capitalism doesn’t exactly seem to be working out all that great....
Heretic, infidel, pagan, socialist Liberal !
Never darken the doors of the Temple of Ann Rand again!
May the ghost of the great and dreaded Milton (Friedman, that is, not Berle) pursue you!
Oh, and have a nice day.
Justatech: That’s a whole new level of cruel.
Cruelty is an American specialty. If you have a heart, you're not a real American.
fern @18: We don't use the BCG TB vaccine in the US because it only provides protection to children from the disseminated form of the disease (which is usually fatal) which is almost never seen in the US, it can't be boosted (immunity wanes over time) and it means that the person who got the BCG vaccine will test positive to TB for the rest of their lives.
There are parts of the world where it is used and it saves lives, but in the US (and most of the developed world) it's not worth it.
PGP @29: That's not true and you know it. Americans are no more cruel than any other large groups of humans throughout time. Which is not to say that some Americans are any less cruel than other people.
Look, I get you're frustrated, but you don't paint with a broad brush, you're using a freaking spray gun.
You're not evil, I'm not evil, JP isn't evil, heck, even annoying ol' MJD isn't evil.
Maybe try to be a bit more directional and specific with your ire at those who really deserve it.
@JP #24 Only because we don't practice free market capitalism the way it was envisioned by Adam Smith. Smith, in his On Wealth of Nations, recognized the need for regulation. He called it "a light regulatory hand." What we practice is crony capitalism; powerful interests control what kind of regulation is passed that favors mature industries rather than emerging industries (ie "corporate welfare"); corporations over small businesses. It's a predatory form of capitalism, and one we've employed since the Civil War.
@ORD #25: you're right. The failure to maintain a level playing field is the greatest weakness and failure of capitalism and liberalism. Again, it requires a selflessness not present in most people.
That's why John Locke talked about social contracts. He understood that we need to be governed in order to succeed and thrive, and that government, drawing power from the people, had to meet the needs of its people. The Founders drew from Locke when the Declaration was written, and it is the underpinning ideal behind the Constitution.
What libertarians don't understand is the Founders always understood there had to be some sort of governmental and social order. What libertarians want is what we had under the Articles of Confederation. It didn't work. So now we have Federalism under the Constitution. It does work.
Libertarians often like to cite Federalist thinkers like Hamilton and Madison without realizing that what libertarianism strives for is Anti-Federalism.
Justatech: We have reached the point where Americans can't even agree on whether poor people should have FOOD. Our EPA head has never been outside and hates eagles, the Klan's the closest it has been to power since freaking 1920, our President is a sex predator and wannnabe strongman (and don't even start with the Bill Clinton stuff, because he left underage girls alone and half the stuff that reached the press was just poo flinging by Repubs) and Snyder got reelected despite (or possibly because of) what he did to Flint. And Americans, by and large, are fine with that. Especially if they identify as Christian- I guess feed the hungry doesn't apply anymore.
A very,very tiny amount of Americans, including most people on the board, are not evil, but that doesn't excuse the 95% who are happily going along with the flow.
Also, I disagree with your characterization of MJD. Preying on families of people with Alzheimers and a vulnerable not well informed community is pretty low in my opinion. Not to mention his new sexist attitude and the abuse he's heaped on his kid(?).
(Question mark is there because I'm not sure if he ever actually had a kid.The dude lies about everything.)
Justatech @ #30: Does this apply to people like me who have been give trans-urethral BCG for bladder cancer? My google-fu hasn't sufficed to even come close to finding an answer. I did experience a short fever spike a few hors after dose # 2 (of 6), which I conjecture may have been antibodies escaping from the bladder and going systemic.
Se Hable Espol @34: That is an excellent question. I would suggest you ask your doctor but yeah, it's possible if you get a skin test for TB it will come up positive and you'll need to be pretty persuasive to avoid a chest X-ray.
Good luck on your treatment!
Thanks, JaT. Ths is the standard-of-care treatment, and reports ~89% 5-year survival with no further treatment, just regular monitoring. The monitoring is interesting (and would be to me, even if it weren't personal): trans-urethral exam by "blue-light" cystoscope that causes any tumor cells to fluoresce for the doctor's viewing pleasure. (The blue-light 'scope is too new to be standard-of-care. The local urologists are good, and their clinic can afford the new stuff.) I'll know more about it when it happens, in about 5 more weeks.
At my age, yet another CXR is no big deal.
What strikes me as even more hypocritical as that, at the same time these Republican lawmakers are pseudo-piously destroying public health measures in the name of individual freedoms and preventing government overreach/interference, those same legislators are gleefully attempting to strangle my individual free choices regarding my body and my reproductive health.
These supposedly anti-big-government hypocrites are imposing onerous 'safety' regulations on abortion providers, even though getting a colonoscopy is much less safe than an early abortion, and no one is passing volumes of 'safety' regulations for GI docs. They are pretty much preventing insurance from covering abortion services, burying providers in red tape, allowing employers to decide what health care their employees receive under their health plans, and passing a veritable blizzard of new laws attempting to restrict abortion every year.
Perhaps the ultimate irony is that Mike Pence, who is, after all, the inspiration behind 'Periods for Pence', seems almost like the grown-up in the room next to our ghastly orange liar-in-chief!
@ #33 PGP, I think your numbers may be inflated a bit! Certainly there are any number of selfish, entitled, all sorts of -ist and -phobics, and general slimeballs in any group of people. What evidence do you have that Americans are worse than any other large, diverse group of people?
Granted, I was disappointed, shocked, and horrified at how many people went from "reasonable and mostly good" to "dangerously misguided loons" in my mental Rolodex during this election cycle, but less than 20% actually voted for the guy. Sure, there are plenty of other ways to be evil, but I think the main problem is that the current situation just highlights to us the problems that are always present in any society. Those elements have always been there -- we're just currently noticing them because they have the spotlight right now. Just look at the number of people who are not just marching in protest, but actually stepping up. Donations to the ACLU and Southern Poverty Law Center are up by orders of magnitude, just to give one example!
Alison: We have more Nazis than we did ten years ago, people can commit hate crimes with impunity, and, well, look at the people who got elected this year. Even excluding Trump, a whole lotta vicious dumbasses got elected this year, which means a lot of vicious dumbasses voted.
Colbeck and his allies know vaccines work. They know vaccines don’t cause ASDs.
I'm in Colbeck's district, and I can tell you you're wrong here. Colbeck, while probably not hard core antivax, has shown that he definitely thinks that vaccines might cause autism. Remember, this is a guy who also denies evolution and climate science. It shouldn't be surprising that he might also believe that vaccines might cause autism. His activities on this front are more than just pandering. He really doubts vaccine science.