ACP Is an excellent writer and exceptionally clear. He is transparent & honest. His approach is different from mine. I have not recommended vaccination beyond the first 2. I did not recommend vaccination for anyone under the age of 50 in any case as there were treatments that were successful. Because omicron is not that morbid, the program I have been using in a 70 kg or so adult is 20 mg of prednisone twice a day for 2 days and then 20 mg once a day for 3 more days. An alternative is simply 20 mg a day for 7 days. This is how I have treated 150 patient's with only one hospitalization & virtually everyone feeling well by the second day. I do not recommend Paxlovid but will prescribe it if the patient requests. 100% avoidance of cow and goat milk dairy products, vitamin C 500 mg TID, vitamin D 5000 IU, quercetin, lactoferrin and sulforaphane. Standard nose sprays and inhalers + montelukast if necessary. If purulence develops late, an antibiotic. HRS, MD, FACC
As you all know, I highly value the skeptical cardiologists' point of view. While I had no intention of taking Paxlovid if I got another case of Covid, I had previously reviewed the list of possible drug interactions and thought I retained at least a faint familiarity. Out of curiosity, I checked my medications against the list of interacting medications (https://www.fda.gov/media/158165/download?utm_source=substack&utm_medium=email) and found 3 medications in the prohibited group. Thank you Skeptical Cardiologist!
ARR or absolute risk reduction is going to be determined by the underlying risk of the patient population.
Let's say you were high risk, 10% for serious hospitalization or death from COVID. If that is reduced by 88% you have 9% absolute reduction in risk which is huge. I give several links for measuring risk in my post on the 4th jab.
Aside from a serendipitous IgG initial surge with the ancestral strains, there was never an intent nor expectation of prevention of infection or transmission. Vaccines were, and have been expected to reduce serious disease, hospitalization and death. In that regard, they've been successful, and even the monovalent boosters have proven successful with that benchmark against BA.1, BA.2 and BA.4. BA.5 was "relatively mild" although it resulted in hospitalization of a tremendous number of people, although most recovered to discharge. Omicron, esp. BA.5, did result in more pediatric infections and hospitalizations than most realize, though.
Red Cross was testing for the antibodies at that time for convalescent plasma. That treatment has fallen by the wayside. Just thought it was interesting that I had long lasting levels. No idea what remains since they stopped testing the next time I donated. From my results in April:
The Red Cross is also testing donations for antibodies to the SARS coronavirus-2 (SARS-CoV-2), the virus that causes COVID-19, using the Ortho VITROS® Anti-SARS-CoV-2 IgG Quantitative test. This test is authorized for use by the U.S. Food and Drug Administration through its Emergency Use Authorization (EUA) mechanism.
This was part of the Mayo convalescent plasma study. Both qualitative and quantitative antibody assays were used. Mayo also looked at in vitro neutralization by convalescent pooled plasma. Initial studies showed no statistical benefit but there was some absolute benefit. A later study (and I'm too lazy to go look in my archive right now) demonstrated a better result than the initial study for convalescent plasma.
The reason the antibodies appeared to linger was because we were, at that point, still trying to determine how long humoral immunity persisted after infection and naturally acquired immune response. At the point the study was terminated the duration was fixed at, if memory serves, 7 months. Immunity derived from vaccination appears to persist somewhat longer and trains the cellular immune system on more than solely the RBD on the spike protein. On the other hand, naturally-derived immunity (infection) may activate the cellular system, esp. B-cells, to recognize and produce antibodies, once activated, against proteins associated with the nucleocapsid or other vulnerable elements of the virus.
Re: "Recent evidence, however, supports use of the bivalent booster(s) for improving response to serious illness, hospitalization and death." The recently published evidence is all observational. Because those who choose bivalent boosters early will differ significantly from those who don't in many areas (including COVID-19 mitigations measures) I am not convinced by the modest effectiveness shown. But if I were higher risk I might still choose to get the vaccine. I don't counsel patients who are over age 65 or with risk factors against it.
Re "there are some clinics now recognizing Long COVID at 8 weeks, or even shorter intervals from onset, so falling to the WHO criteria isn't necessarily certain."
I agree this is happening and will definitely increase the number of patients identified with long COVID. I don't know if this is good or bad.
Re "On the issue of myocarditis/pericarditis, the interval you describe from your previous booster to the last booster seems inconsistent with the spate of myocarditis cases seen, and associated with (without true causation) mRNA boosters. It's been repeatedly noted that the incidence of myocarditis from infection is much higher than from vaccination. It's not impossible; I'd have wanted the ECG and troponin, personally, but the course would likely have been the same, save an abnormal result from either test would have landed you in the hospital."
Agree on the interval being too long. I did take AliveCor readings during this time to see if I was having PVCs. I wasn't. I also attempted a 12 lead using my Apple Watch. And I had a normal hs-CRP. If I had had PVCs, worrisome ECG changes or an elevated CRP I would have called another cardiologist gotten the trop and real ECG.
Sometimes, an observational study is adequate. They certainly aren't my first choice, but at this point, with the bivalent boosters, they're all we've got. Recall I mentioned being Reviewer #2: I'm pretty critical and conservative about what I'll accept. I'm currently comfortable with the modest, and somethings more than modest gains in morbidity and mortality prevention with the bivalent boosters, and I'm comfortable with the MMRW-detailed processes to get their report out.
The elevated CRP was hardly a surrogate for troponin but if that's easier and in skilled hands for interpretation, so be it. I suspected you'd have an AliveCor handy, but didn't mention it. I do not have one, so I'm still a little skeptical on their capabilities. When I get one, soon, it'll be the 6-lead version. Although I am comfortable with L2 and V2 for ICU monitoring, I want to see the augmented leads, at least, for diagnosis and chest leads for something really interesting. Still, I think your screening method just worked.
Paxlovid was difficult to get in the UK - there was no obvious option to get it within the first five days of illness. If you were part of a research trial you could potentially have Paxlovid (in that treatment arm) - otherwise there was an option to try out Ivermectin.
I had the bivalent vaccine this autumn to have another booster - and I had Covid (presumably Omicron) in June this year (after I got sloppy about wearing masks). After having had the virus I felt safer for the summer, although I continued to use face masks in supermarkets and in many other shops. Since having the booster I hardly use masks at all, and I’d say that this is because so few other people use them now. I would certainly admit to having been an advocate of face masks; what’s more, I read a number of articles on a medical website which were positive about the value of wearing them. However, even if I hadn’t read them, I’d have used some face covering or other - I wore a buff stuffed with a folded tea-towel while shopping for groceries in the first year of the pandemic.
Wow, I just got the 5th shot yesterday. I haven’t had COVID and don’t want it. Makes me wonder if I should have shunned it. This subject is getting more murkier if anything. Just turned 79 and never get sick. Have had Afib in the past but with an ablation in normal sinus rhythm.😔🤨
Appreciated the list of drugs that interact with Paxlovid. Seems interaction with most statins should have been amplified by YOU! Disappointed on a few points of your post as was Gerry Creager below ... and surprised you are spreading misinformation. Masks have been proven to lower risk of transmission. Perfect? no, but its about all we have. Plus the Vinay article referenced is perpetuating a lie about Katie Porter. Yes, the bivalent vaccine was not tested in clinical trials but neither is the modified flu vaccine each year. Reactions to the vaccines seem to be person-specific. I've had no side effects other than injection-site muscle soreness for 1-2 days. Your post comes off as cavalier.
"Paxlovid looks to be very effective. In a randomized controlled trial in non-hospitalized unvaccinated symptomatic patients with confirmed SARS-CoV-2 it reduced the proportion of people with COVID-19 related hospitalization or death from any cause by 88% compared to placebo among patients treated within five days of symptom onset."
Isn't it still true that Paxlovid is only tested in the unvaccinated?
Male age 81 widowed...I got the 1st two and the flu shot (small dose) April 2021...My immune system is high and I chose the smaller dose, and have continues wit the lo-dose flu since I have been getting the flu shot...Went back for Booster when indicated and result was severe vertigo for about 30 min, then cleared. I have NO desire to go any further with Covid Shots as I keep reading about these otherwise healthy athletes falling dead from "heart attack" and I have A-Fib (controlled) and got this years flu shot on schedule late September 2022. My mother died day after she got senior flu shot (age 88) from heart attack, this was December 1997. So I now have NO plans for any further COVID VAX shots until I feel it is safe and appropriate...My cardiac EF is 60.Impaired Diastolic Atrium. No symptoms but with all the meds, strange side effects that are labile. Dr's not concerned at this point. Alcohol use glass of red wine every night dinner, cocktail 1oz Dewars Scotch once a week...rare occasions 2x week. Non smoker.
I do have Left Bundle Branch Block that was noticed in 2015, but have recorded no effect and told this is not common, and also not dangerous unless other serious heart problems are present, which as of now are not. At my age, things just happen to fall off the shelf of advancing age but I have not been concerned, nor do I need to be.
"The reports of athletes dying from vaccine-related "heart attacks" are designed misinformation and unsupportable."
I've also seen tweets suggesting that the Foo Fighters drummer died due to Covid vaccination and there does not appear a shred of credible information to support this.
Naturally many will disagree with my assumption...there have been many instances reported only once that indicate that otherwise healthy people are suffering (my term...Cardiac Malfunction resulting in death). Even tho there seems to be no basis in medical agreement, I have spoken to both my PCP and my Cardio team, and told them what I felt, thought, and will do...AND THEY AGREED...and approaching 83 in May they assured me that under current circumstances they will assist me in the possession of the necessary proof of vaccination, just to be on the safe side. I still get regular flu shot and appropriate jabs as needed when needed. I also have been shown in many blood tests that my immune system is unusually strong for my age, and my bone density is that of a 40 yr old. I will keep in touch.
While I certainly yield to your medical expertise, somehow the "Law of Random Purpose" would suggest that most of the vaccines are designed and pass all assurances of reliability as the deaths are not a grouped result, but rather a random selection that somehow takes a life here, and another there, and another far away, yet over time the number becomes quite large and their common denominator is the loss of heart function in most of the deaths I speak about, and in otherwise healthy people. Your summation is medically acceptable but the Random Specifics still make me highly skeptical.
I believe that 2023 will have its challenges, and by all means I wish happiness and success for you and yours for the New Year. ~JMR
The reports of athletes dying from vaccine-related "heart attacks" are designed misinformation and unsupportable. I'm a bit younger than you. I've gotten all the boosters, including the bivalent Moderna booster and the worst effect I've had, or for that matter seen clinically, has been a sore arm and fatigue for no more than 24-36 hours.
Your LV EF is normal. a dyskinetic left atrium suggests some evidence of coronary artery disease. Most of the meds I can imagine you'd be prescribed will have some side effects.
Your mother's demise, was very unlikely to have been associated with a flu shot save temporally. The safety of that vaccine is very well established. I'm sorry for her death, but I fear it was merely a random event, and almost certainly (vanishingly disconnected) to have been associated with the vaccination.
I personally support the concept of a glass of wine with dinner, but I prefer, for my periodic spirits, either a really good bourbon or a nice, old single malt whisky over a blend. To each his own.
I left a reply, don’t know where it went. Anyhow I have a glass of a fine Cabernet w/dinner nightly and once a week 1oz of a Dewer’s over ice that is just sips of heaven.
I agree about the vaccine being a random event, because if it were bad for everyone, that would provoke panic attacks. I still believe that these vaccines are a danger only to certain people with certain cardio-vascular conditions which make them susceptible to random kinds of reactions which all happen to end in death. Now I am in the population with cardiovascular conditions that just may put me in a danger zone that the majority would not be subject to. Until I change my mind, and I have been assured that my immune system is strong, I will continue to “Axe the VAX”…until I can see that my mind will be changed by changed circumstances. Thank you for your response.
Certainly was a typo. I was moving too fast. Thanks for catching that.
I am currently drinking the occasional good bourbon, having learned of the huge assortment of really good bourbons arising in Kentucky (thanks to a conference and a dinner outing), and bourbons have the added benefit of being much less expensive than my preferred, older single malt whiskys. My taste in beer runs toward either unfiltered IPAs or imperial stouts.
Yes. The LA is a pretty good conduit. I never really mastered M-mode, but did some conceptual development work once upon a time for a 3D system. Most of my research work was in mechanical support of the failing circulation including early LVADs and an artificial heart similar to the Jarvik design employed one time in the 1980s, prior to the resurgence of cardiac transplantation in the US. Cyclosporin looked really promising. We spent a lot of time looking at the post-transplant hearts after that, and there was a lot of interest in both RV and LV diastolic filling, but with less than stellar appreciation for the nuance.
With the neointimal/endothelial involvement associated with SARS-CoV-2 infection, I expect more late cardiac involvement. Arrhythmia, vascular changes and subsequent atrial and more likely, ventricular dysfuntion. Not just arrhythmia.
Thank you for sharing all that. Pretty amazed that you did not get some testing after having symptoms after the booster. I am a 67 year retired radiologist I agree that the boosters are a personal decision. Last fall, when boosters were just being promoted, I asked my primary care physician if he had had one. He had and it had knocked him on his can for 2-3 days. So I elected to take my chances. Got COVID at New Years and was exhausted for 2-3 days, but did not consider Paxlovid nor was it offered when I emailed my positive test to that PCP. My son, who had been boosted 8 weeks previously caught COVID from me. So I am not too impressed with the efficacy of the boosters. No sequelae as far as I can tell.
BTW, I donated blood 4 months later and Red Cross indicated I had therapeutic antibody levels.
The definition of "therapeutic" antibodies is a moving target in the highly variable variant domain we're living in. Clinically, you were a prime candidate for Paxlovid but some practitioners are afraid of side effects or drug interactions. and don't offer it as readily as I believe they should. There's NOTHING in the clinical expectations that suggests the vaccines will protect you from infection save the rather unexpected IgG response to the mRNA, and subsequently J&J adenovirus-vector vaccines. The original goals included at least a 50% reduction in severe disease, hospitalization and death. Most of the announcements, and media traffic failed to make this point, likely because the nuance was beyond most of the reporters.
I was formally enrolled, as a convalescent plasma donor, in the Mayo Clinic trial and subsequently ended up a bit deeper than most participants because I was a medical professional. I, too, had a high level of what were considered "therapeutic antibodies" that likely helped, along with boosters, to protect me from my first infection (Jun/Jul 2020) to my second (Feb 2022). In both cases, since I'd masked and taken all available precautions (save isolating at home and never venturing out) it's most probable I'd been exposed to someone spreading with an extremely high respiratory load of reproducible virus. At the time of my second infection, Paxlovid was not available and I didn't qualify for other antiviral or monoclonal agents. I both infections, my symptoms were mild (save loss of smell, rough for a cook!) and recovery was prompt.
Thank you. So far, so good.
ACP Is an excellent writer and exceptionally clear. He is transparent & honest. His approach is different from mine. I have not recommended vaccination beyond the first 2. I did not recommend vaccination for anyone under the age of 50 in any case as there were treatments that were successful. Because omicron is not that morbid, the program I have been using in a 70 kg or so adult is 20 mg of prednisone twice a day for 2 days and then 20 mg once a day for 3 more days. An alternative is simply 20 mg a day for 7 days. This is how I have treated 150 patient's with only one hospitalization & virtually everyone feeling well by the second day. I do not recommend Paxlovid but will prescribe it if the patient requests. 100% avoidance of cow and goat milk dairy products, vitamin C 500 mg TID, vitamin D 5000 IU, quercetin, lactoferrin and sulforaphane. Standard nose sprays and inhalers + montelukast if necessary. If purulence develops late, an antibiotic. HRS, MD, FACC
As you all know, I highly value the skeptical cardiologists' point of view. While I had no intention of taking Paxlovid if I got another case of Covid, I had previously reviewed the list of possible drug interactions and thought I retained at least a faint familiarity. Out of curiosity, I checked my medications against the list of interacting medications (https://www.fda.gov/media/158165/download?utm_source=substack&utm_medium=email) and found 3 medications in the prohibited group. Thank you Skeptical Cardiologist!
Gorgo.
ARR or absolute risk reduction is going to be determined by the underlying risk of the patient population.
Let's say you were high risk, 10% for serious hospitalization or death from COVID. If that is reduced by 88% you have 9% absolute reduction in risk which is huge. I give several links for measuring risk in my post on the 4th jab.
Dr. P
Old Man,
Yes. The studies were done in unvaccinated. I am unaware of any randomized controlled trials in vaccinated inidividuals.
Dr. P
Correct. I am also not aware of RCTs in unvaccinated people.
Barry,
Re" Not impressed with the efficacy of the boosters."
One thing that I think is universally accepted now is that the boosters do not reduce your changes of getting infected.
Re: "therapeutic antibody levels"
I wonder what test the Red Cross used and what level make them therapeutic?
Dr. P
Aside from a serendipitous IgG initial surge with the ancestral strains, there was never an intent nor expectation of prevention of infection or transmission. Vaccines were, and have been expected to reduce serious disease, hospitalization and death. In that regard, they've been successful, and even the monovalent boosters have proven successful with that benchmark against BA.1, BA.2 and BA.4. BA.5 was "relatively mild" although it resulted in hospitalization of a tremendous number of people, although most recovered to discharge. Omicron, esp. BA.5, did result in more pediatric infections and hospitalizations than most realize, though.
Red Cross was testing for the antibodies at that time for convalescent plasma. That treatment has fallen by the wayside. Just thought it was interesting that I had long lasting levels. No idea what remains since they stopped testing the next time I donated. From my results in April:
The Red Cross is also testing donations for antibodies to the SARS coronavirus-2 (SARS-CoV-2), the virus that causes COVID-19, using the Ortho VITROS® Anti-SARS-CoV-2 IgG Quantitative test. This test is authorized for use by the U.S. Food and Drug Administration through its Emergency Use Authorization (EUA) mechanism.
This was part of the Mayo convalescent plasma study. Both qualitative and quantitative antibody assays were used. Mayo also looked at in vitro neutralization by convalescent pooled plasma. Initial studies showed no statistical benefit but there was some absolute benefit. A later study (and I'm too lazy to go look in my archive right now) demonstrated a better result than the initial study for convalescent plasma.
The reason the antibodies appeared to linger was because we were, at that point, still trying to determine how long humoral immunity persisted after infection and naturally acquired immune response. At the point the study was terminated the duration was fixed at, if memory serves, 7 months. Immunity derived from vaccination appears to persist somewhat longer and trains the cellular immune system on more than solely the RBD on the spike protein. On the other hand, naturally-derived immunity (infection) may activate the cellular system, esp. B-cells, to recognize and produce antibodies, once activated, against proteins associated with the nucleocapsid or other vulnerable elements of the virus.
Gerry,
Thanks for your detailed and informed comment.
Re: "Recent evidence, however, supports use of the bivalent booster(s) for improving response to serious illness, hospitalization and death." The recently published evidence is all observational. Because those who choose bivalent boosters early will differ significantly from those who don't in many areas (including COVID-19 mitigations measures) I am not convinced by the modest effectiveness shown. But if I were higher risk I might still choose to get the vaccine. I don't counsel patients who are over age 65 or with risk factors against it.
Re "there are some clinics now recognizing Long COVID at 8 weeks, or even shorter intervals from onset, so falling to the WHO criteria isn't necessarily certain."
I agree this is happening and will definitely increase the number of patients identified with long COVID. I don't know if this is good or bad.
Re "On the issue of myocarditis/pericarditis, the interval you describe from your previous booster to the last booster seems inconsistent with the spate of myocarditis cases seen, and associated with (without true causation) mRNA boosters. It's been repeatedly noted that the incidence of myocarditis from infection is much higher than from vaccination. It's not impossible; I'd have wanted the ECG and troponin, personally, but the course would likely have been the same, save an abnormal result from either test would have landed you in the hospital."
Agree on the interval being too long. I did take AliveCor readings during this time to see if I was having PVCs. I wasn't. I also attempted a 12 lead using my Apple Watch. And I had a normal hs-CRP. If I had had PVCs, worrisome ECG changes or an elevated CRP I would have called another cardiologist gotten the trop and real ECG.
Dr. P
Sometimes, an observational study is adequate. They certainly aren't my first choice, but at this point, with the bivalent boosters, they're all we've got. Recall I mentioned being Reviewer #2: I'm pretty critical and conservative about what I'll accept. I'm currently comfortable with the modest, and somethings more than modest gains in morbidity and mortality prevention with the bivalent boosters, and I'm comfortable with the MMRW-detailed processes to get their report out.
The elevated CRP was hardly a surrogate for troponin but if that's easier and in skilled hands for interpretation, so be it. I suspected you'd have an AliveCor handy, but didn't mention it. I do not have one, so I'm still a little skeptical on their capabilities. When I get one, soon, it'll be the 6-lead version. Although I am comfortable with L2 and V2 for ICU monitoring, I want to see the augmented leads, at least, for diagnosis and chest leads for something really interesting. Still, I think your screening method just worked.
Thanks for taking the time to respond.
gc
and I wore glasses and a face visor.
Paxlovid was difficult to get in the UK - there was no obvious option to get it within the first five days of illness. If you were part of a research trial you could potentially have Paxlovid (in that treatment arm) - otherwise there was an option to try out Ivermectin.
I had the bivalent vaccine this autumn to have another booster - and I had Covid (presumably Omicron) in June this year (after I got sloppy about wearing masks). After having had the virus I felt safer for the summer, although I continued to use face masks in supermarkets and in many other shops. Since having the booster I hardly use masks at all, and I’d say that this is because so few other people use them now. I would certainly admit to having been an advocate of face masks; what’s more, I read a number of articles on a medical website which were positive about the value of wearing them. However, even if I hadn’t read them, I’d have used some face covering or other - I wore a buff stuffed with a folded tea-towel while shopping for groceries in the first year of the pandemic.
Wow, I just got the 5th shot yesterday. I haven’t had COVID and don’t want it. Makes me wonder if I should have shunned it. This subject is getting more murkier if anything. Just turned 79 and never get sick. Have had Afib in the past but with an ablation in normal sinus rhythm.😔🤨
Based on your admitted age and history, I'd have advised the booster. I think you did right.
Thank you. So far so good.
Appreciated the list of drugs that interact with Paxlovid. Seems interaction with most statins should have been amplified by YOU! Disappointed on a few points of your post as was Gerry Creager below ... and surprised you are spreading misinformation. Masks have been proven to lower risk of transmission. Perfect? no, but its about all we have. Plus the Vinay article referenced is perpetuating a lie about Katie Porter. Yes, the bivalent vaccine was not tested in clinical trials but neither is the modified flu vaccine each year. Reactions to the vaccines seem to be person-specific. I've had no side effects other than injection-site muscle soreness for 1-2 days. Your post comes off as cavalier.
From your 1/5/22 letter:
"Paxlovid looks to be very effective. In a randomized controlled trial in non-hospitalized unvaccinated symptomatic patients with confirmed SARS-CoV-2 it reduced the proportion of people with COVID-19 related hospitalization or death from any cause by 88% compared to placebo among patients treated within five days of symptom onset."
Isn't it still true that Paxlovid is only tested in the unvaccinated?
Male age 81 widowed...I got the 1st two and the flu shot (small dose) April 2021...My immune system is high and I chose the smaller dose, and have continues wit the lo-dose flu since I have been getting the flu shot...Went back for Booster when indicated and result was severe vertigo for about 30 min, then cleared. I have NO desire to go any further with Covid Shots as I keep reading about these otherwise healthy athletes falling dead from "heart attack" and I have A-Fib (controlled) and got this years flu shot on schedule late September 2022. My mother died day after she got senior flu shot (age 88) from heart attack, this was December 1997. So I now have NO plans for any further COVID VAX shots until I feel it is safe and appropriate...My cardiac EF is 60.Impaired Diastolic Atrium. No symptoms but with all the meds, strange side effects that are labile. Dr's not concerned at this point. Alcohol use glass of red wine every night dinner, cocktail 1oz Dewars Scotch once a week...rare occasions 2x week. Non smoker.
I do have Left Bundle Branch Block that was noticed in 2015, but have recorded no effect and told this is not common, and also not dangerous unless other serious heart problems are present, which as of now are not. At my age, things just happen to fall off the shelf of advancing age but I have not been concerned, nor do I need to be.
John,
I agree with Gerry's response
"The reports of athletes dying from vaccine-related "heart attacks" are designed misinformation and unsupportable."
I've also seen tweets suggesting that the Foo Fighters drummer died due to Covid vaccination and there does not appear a shred of credible information to support this.
Dr. P
Naturally many will disagree with my assumption...there have been many instances reported only once that indicate that otherwise healthy people are suffering (my term...Cardiac Malfunction resulting in death). Even tho there seems to be no basis in medical agreement, I have spoken to both my PCP and my Cardio team, and told them what I felt, thought, and will do...AND THEY AGREED...and approaching 83 in May they assured me that under current circumstances they will assist me in the possession of the necessary proof of vaccination, just to be on the safe side. I still get regular flu shot and appropriate jabs as needed when needed. I also have been shown in many blood tests that my immune system is unusually strong for my age, and my bone density is that of a 40 yr old. I will keep in touch.
While I certainly yield to your medical expertise, somehow the "Law of Random Purpose" would suggest that most of the vaccines are designed and pass all assurances of reliability as the deaths are not a grouped result, but rather a random selection that somehow takes a life here, and another there, and another far away, yet over time the number becomes quite large and their common denominator is the loss of heart function in most of the deaths I speak about, and in otherwise healthy people. Your summation is medically acceptable but the Random Specifics still make me highly skeptical.
I believe that 2023 will have its challenges, and by all means I wish happiness and success for you and yours for the New Year. ~JMR
The reports of athletes dying from vaccine-related "heart attacks" are designed misinformation and unsupportable. I'm a bit younger than you. I've gotten all the boosters, including the bivalent Moderna booster and the worst effect I've had, or for that matter seen clinically, has been a sore arm and fatigue for no more than 24-36 hours.
Your LV EF is normal. a dyskinetic left atrium suggests some evidence of coronary artery disease. Most of the meds I can imagine you'd be prescribed will have some side effects.
Your mother's demise, was very unlikely to have been associated with a flu shot save temporally. The safety of that vaccine is very well established. I'm sorry for her death, but I fear it was merely a random event, and almost certainly (vanishingly disconnected) to have been associated with the vaccination.
I personally support the concept of a glass of wine with dinner, but I prefer, for my periodic spirits, either a really good bourbon or a nice, old single malt whisky over a blend. To each his own.
I left a reply, don’t know where it went. Anyhow I have a glass of a fine Cabernet w/dinner nightly and once a week 1oz of a Dewer’s over ice that is just sips of heaven.
I agree about the vaccine being a random event, because if it were bad for everyone, that would provoke panic attacks. I still believe that these vaccines are a danger only to certain people with certain cardio-vascular conditions which make them susceptible to random kinds of reactions which all happen to end in death. Now I am in the population with cardiovascular conditions that just may put me in a danger zone that the majority would not be subject to. Until I change my mind, and I have been assured that my immune system is strong, I will continue to “Axe the VAX”…until I can see that my mind will be changed by changed circumstances. Thank you for your response.
GC
Regarding the diagnosis of "Impaired diastolic atrium": I suspect this is a typo.
It has no meaning in the field of echocardiography.
More likely is a diagnosis of "impaired diastolic relaxation" or "impaired relaxation"
I've written about this diagnosis (https://theskepticalcardiologist.com/2021/06/01/does-your-patient-really-have-diastolic-dysfunction/) in detail and it is more often insignificant or incorrect than any thing of clinical importance.
Agree, mom's death at age 88 likely unrelated to the vaccination.
Regarding periodic spirits: I like good bourbon and single malt whisky but my esophagus doesn't, therefore these are rare indulgences.
I'm fairly promiscuous with alcohol and embrace craft ales, red and white wines, and miscellaneous cocktails
Dr. P
Certainly was a typo. I was moving too fast. Thanks for catching that.
I am currently drinking the occasional good bourbon, having learned of the huge assortment of really good bourbons arising in Kentucky (thanks to a conference and a dinner outing), and bourbons have the added benefit of being much less expensive than my preferred, older single malt whiskys. My taste in beer runs toward either unfiltered IPAs or imperial stouts.
gc
Enjoyed your article and it explains your thoughts well. Thanks for posting that. Helps me a lot.
Yes. The LA is a pretty good conduit. I never really mastered M-mode, but did some conceptual development work once upon a time for a 3D system. Most of my research work was in mechanical support of the failing circulation including early LVADs and an artificial heart similar to the Jarvik design employed one time in the 1980s, prior to the resurgence of cardiac transplantation in the US. Cyclosporin looked really promising. We spent a lot of time looking at the post-transplant hearts after that, and there was a lot of interest in both RV and LV diastolic filling, but with less than stellar appreciation for the nuance.
I believe we will see/hear/read more about arrhythmia, pvc's in particular, post covid.
With the neointimal/endothelial involvement associated with SARS-CoV-2 infection, I expect more late cardiac involvement. Arrhythmia, vascular changes and subsequent atrial and more likely, ventricular dysfuntion. Not just arrhythmia.
Thank you for your coments.
Thank you for sharing all that. Pretty amazed that you did not get some testing after having symptoms after the booster. I am a 67 year retired radiologist I agree that the boosters are a personal decision. Last fall, when boosters were just being promoted, I asked my primary care physician if he had had one. He had and it had knocked him on his can for 2-3 days. So I elected to take my chances. Got COVID at New Years and was exhausted for 2-3 days, but did not consider Paxlovid nor was it offered when I emailed my positive test to that PCP. My son, who had been boosted 8 weeks previously caught COVID from me. So I am not too impressed with the efficacy of the boosters. No sequelae as far as I can tell.
BTW, I donated blood 4 months later and Red Cross indicated I had therapeutic antibody levels.
The definition of "therapeutic" antibodies is a moving target in the highly variable variant domain we're living in. Clinically, you were a prime candidate for Paxlovid but some practitioners are afraid of side effects or drug interactions. and don't offer it as readily as I believe they should. There's NOTHING in the clinical expectations that suggests the vaccines will protect you from infection save the rather unexpected IgG response to the mRNA, and subsequently J&J adenovirus-vector vaccines. The original goals included at least a 50% reduction in severe disease, hospitalization and death. Most of the announcements, and media traffic failed to make this point, likely because the nuance was beyond most of the reporters.
I was formally enrolled, as a convalescent plasma donor, in the Mayo Clinic trial and subsequently ended up a bit deeper than most participants because I was a medical professional. I, too, had a high level of what were considered "therapeutic antibodies" that likely helped, along with boosters, to protect me from my first infection (Jun/Jul 2020) to my second (Feb 2022). In both cases, since I'd masked and taken all available precautions (save isolating at home and never venturing out) it's most probable I'd been exposed to someone spreading with an extremely high respiratory load of reproducible virus. At the time of my second infection, Paxlovid was not available and I didn't qualify for other antiviral or monoclonal agents. I both infections, my symptoms were mild (save loss of smell, rough for a cook!) and recovery was prompt.