Quick Update from BKK, and Happy Thanksgiving!

[Roy]

First off, Happy Thanksgiving to all us Yanks (and even non-Yanks) who enjoy this holiday. I’ll be having my turkey dinner right across the street on Soi 4 Sukhumvit in a few hours, at a popular expat hangout called the British Pub. I sure hope they know that a turkey ain’t no pigeon! :shock:

Hey! Who was it that called me fat a week or so ago? :x I think the right word is fit. Latest stats from Dr.Virat at Bumrungrad: height 6 foot, 1 inch, weight, 91 kilos, BP 126/76, resting heart rate, 76, age, 55, (as of yesterday, the 23rd). Oddest of all my test results were my liver tests. All were well within norms. “Huh?” Yup, being the guy that holds the record at Nuris, (standing now for over 6 years) for the most martinis consumed in one sitting, (and not needing to be carried out), I was very surprised myself. Looks like it’s going to be one heck of a turkey day for me! Dr. Virat says that I’m in my fighting prime, so look out Daniel, Jeff and Mud…as I’ll be back soon enough, and ready for more!

A primary objective I had at Bumrungrad was to secure as much Tamiflu as I could. Anyone who knows Bali only in a slight degree is well aware of how chickens and ducks roam very freely within villages and are seldom contained. Well, it doesn’t take a rocket scientist to figure out that if bird flu gets started in Bali, (at the kampung level), it’s going to be very bad.

In Bangkok, most pharmacies sell most any medication over the counter…no prescription needed. Checking ten drug stores, I only found one with any Tamiflu and they were down to their last box of ten…for 5,000 baht! That works out to about US $125 per ten capsules, or $12.50 each. In checking the internet, I noted a few “companies” targeting Asia (offering guaranteed delivery of Tamiflu) for about the same amount.

The policy at Bumrungrad is to not sell Tamiflu to anyone without a doctor’s prescription, and of course all the appropriate symptoms of the disease. I was able to meet with the head doctor in charge of infectious diseases at Bumrungrad, Dr. Ardat, (A Fellow at Harvard), and convince him, by describing my village), to part with a modest supply of the drug, (at the “real price” of US $2.00 per capsule). In addition I was able to secure a number of surgical masks, which he contends is the best protection in the event of an outbreak.

My visa renewed, my mission at Bumrungrad totally accomplished, I’m ready for a few days of “rest” and coming home on Sunday.

 

[Tommy]

Good to hear your in good health and everything is going as planned. Like the name of that .. town? Bum-Run-Grad :lol:

 

[Bert Vierstra]

And a happy birthday !!

I stille have some cake, cheese and beer from the other thread left.... so....

 

[rafalution]

You went all the way to banggers for Tamiflu, gee the media sure has got you running scared, well at least Donald Rumsfeld is making his christmas bonus.

Or is it really just soi 4 you came for! :wink: Yes i'm sure it is a great pub you've found, :lol: .

 

[balijeff]

Roy,

Good to hear you're in good health.

Although, like raf, I find tamiflu stockpiling a dubious endeavor at best. But I understand the sentiment.

Jeffrey

 

[matsaleh]

Many happy returns for your birthday Roy! Sorry we missed it.

 

[Roy]

Thank you Mats!

Raf and Jeff,

If you lived in a traditional Balinese village, with it's traditional compounds, and with all the chickens, ducks, and geese running freely around the village, often from one compound to another, you would take the threat of bird flu VERY SERIOUSLY.

If you were a responsible parent of three young kids, and were living in this environment, you would take the threat of bird flu even MORE seriously.

Having some Tamiflu and surgical respirators on hand is diligent and responsible planning. If you guys want to think of it as paranoia or over-reaction, that’s up to you. For me, I sure hope I am never able to tell you guys, “I told you so!”

 

[rafalution]

Very seriously?, i'm not so sure about that, so i should worry because the media tells me too? I'm sorry but I believe the Bird flu hysteriea has been blown out of all proportion, and the hysteria is certainly to the advantage of some groups and individuals. H5N1 has been around for a long time, it was found in domestic chickens in the UK over 50 years ago so who knows how long it has been in wild bird populations. It has not mutated so far and the only reason we have got to believe that is will definitiely mutate is because of a long line of experts telling us it will happen.

Sure no one can tell what the future will bring, and history tells us flu pandemics happen every 20 years or so but a flu virus with a mortality rate of 50% is totally unprecedented in history. The 1918 virus was not a mutated virus, although it is thought is was a bird flu but scientists cannot say what type of bird it is, certainly not one that is thought to be a threat today and ceretainly not a chicken, a duck or a goose. Anyway there are significant differences between the circumstances surrounding the 1918 epidemic and today. Anyway the following article may be of some interest.

http://www.investorsinsight.com/otb_va. ... tionID=217

So why the hysteria now? Follow the money, I always find it's a good rule of thumb. I also feel that the greatest risk to peoples health is caused by the paranoia these almost continuous health scares that the media put out causes.

As an aside in a normal year flu kills around 500 000 people worldwide. Tamiflu is an effective mediciene against normal epidemic flu. However, how many people will be able to get the drug especailly in 3rd world countries, places where flu is spread more easily due to living conditions. But with the price not up to 5000bht almost a normal monthly salary and it's availility almost dried up how many of the people who really need it will have access to it?

So I commend your dilligence and responsibility and I too hope that you never have ti say I toiod you so. But I prefer not to worry about everthing that MAY happen in this world, if you go down that route where do you stop, there is no way to know anyway if tamiflu would have any effect on a mutated H5N1 because it does not exist, and how praticle would it be to have your children running around in repspirators for months on end if you really are taking the threat VERY SERIOUSLY then surely you have to move as far way from birds as possible. Then of course you might have to consider the health problems of just being in Bali,a) it's polluted and surely you'd have to consider that trhe exposure to all the toxic chemicals in the air must be carcinogenic, b) it's got 3rd world medical facilities, c) the roads are riduculously dangerous, d)it's tropical and that carries it's own health risks, you are surrounded by god knows how many virulent nasties gunning to eat you up at the first oppotunity, and e) you are a target for extremists, form which there have been over 200 murders in the last 3 years.

Anyway I hope the results of your tests continue to show your are in the very best of health. Is that British pub called JOOLS?

 

[balijeff]

Raf,

I agree with your assesment in "follow the money". Despicable if you ask me. I saw a commercial that said, not hinted, said "Billions could die if Bird Flu goes pandemic in humans". Shameless fear mongering. Perhaps some of the forum readers here in Indo have seen it...the one where the word "millions" transforms into "Billions" on top of the flock of pink flamingos...I think it was CNNi. This is what I take issue with.

And a virus with a 50% mortality rate is unheard of because its not a good virus. Good in the biological sense. That is, the virus must propogate itself to others and with that mortality rate, it kills people to well (fast) to spread effectively. Thats why a mortality rate of like 20% is really bad...it kills and spreads er, well.

And Tamiflu resistant virii are already here.

I wonder if the masks he bought are N95 or N100 rated particulate masks. If he bought a hopsital or surgery mask, he may not be getting what he thinks he got. Roy, Id check to be sure.

Jeffrey

 

[MUDCRAB]

Welcome back and a happy birthday.

First off, Happy Thanksgiving to all us Yanks (and even non-Yanks) who enjoy this holiday.

But but didn't you go all out Hindi :shock: , so why are you doing the Thanksgiving thing...your in Bali now, so why the Yank holiday.

and even non-Yanks) who enjoy this holiday

It's not a holiday for the none Yanks thank you very much in fact it's a nothing to us, do you celebrate the Queens birthday like we do, well you're nearer to OZ than America :roll:

It's been quiet with out your tirads

 

[pooochie]

SELAMAT ULANG TAHUN DAN PANJANG UMUR...MOHON MAAF TERLAMBAT

 

[Roy]

Ni Luh! Matur suksma for the birthday card! I really enjoyed that!

Jeff, you write:

I wonder if the masks he bought are N95 or N100 rated particulate masks. If he bought a hospital or surgery mask, he may not be getting what he thinks he got. Roy, Id check to be sure.

Gee Jeff, many thanks for your unwarranted concern. These are all Niosh N95 particulate respirator and surgical masks as manufactured by the 3M company. Since I made it clear that these were provided by the head of virology and infectious diseases at Bumrungrad, (Dr. Ardat), who holds two American Board certifications and is a Fellow of Harvard University, why the hell would you question this!

Thanks too for all your unnecessary input about Tamiflu and the Avian flu, its current strains, likely mutations, etc. If you don’t mind, I’ll take care of “mine” my way and you can all take care of yours, “your way.”

Raf, I’m not concerned with Avian flu because of what the media says, rather because of the environment that my family lives in. I’ve made that crystal clear already, so pall, if you can’t figure it out, then so be it.

 

[balijeff]

Ok Roy,

Here's why you should be concerned:

You got bad advice. Worthless even.

And go ahead and email this to Dr. Ardat. And any other doctor you see fit, the result is the same - bad advice.

Want more? You gotta say "please".

Jeffrey

 

[MUDCRAB]

Do explain please Shocked

Sorry for the hard question

 

[Roy]

Jeff writes:

Ok Roy, Here's why you should be concerned: You got bad advice. Worthless even.

Jeff! You cease to amaze me! Are YOU suggesting that Dr. Asda Vibhagool is WRONG?

Funny thing, while meeting with him in his office, he pulled out one of these exact surgical/respirator masks out of the right pocket of his doctor’s smock. It’s what he wears when diagnosing a patient with ANY infectious disease symptoms. It seems these are good enough for his protection...but NO...the “great Jeff” has “other” information!

Hey pall! If you want to write to him, BE MY GUEST: [email protected].

Do keep in mind that you are addressing an expert in his field and that he holds the following credentials:

American Board of Internal Medicine

American Board of Infectious Diseases

Fellow in Virology, Harvard


You’re a real “piece of work” Jeff, but I surely never dreamed you would “take on” a doctor of these credentials, a respected expert in his field of medicine.

Me...I should ask YOU “please?” Not even after hell freezes over! Frankly, I have NO interest in what you post, or in your decidedly warped opinions.

I hope, as you continue to pursue your “B” school studies, you learn that jumping to conclusions is just another form of exercise, and assumptions are NOT considered as worthwhile input in the business field. Jeff, the more you post, the more helpless you appear!

 

[rien.gluvers]

Dear Roy,
I am sorry but Jeff has a point. A Belgium / Dutch site setup for informing the public on health-issues states:


U beschermen met een masker?

Ja, maar niet om het even welk. De klassieke chirurgische maskers hebben vooral als doel de patiënt te beschermen tegen de microben van de chirurgen. Hier is echter precies het tegendeel nodig. Doeltreffend zijn bijvoorbeeld de maskers die gebruikt worden op bouwplaatsen waar veel stof vrijkomt

Translated

Q. Protection with a mask?

A. Yes, but not by every mask. The normal surgical mask is mainly to protect the patients for microbes form the surgeons. Against bird flu you need the opposite. Better are for instance the masks as used by construction workers to protect them from dust inhalation

 

[Roy]

Geez Rien! That's the whole damn point! A particulate respirator protects the wearer too! Good grief Rien, are you pronouncing yourself as a doctor specialist in virology along with Jeff?

Come on Rien! In your country you are lucky to see a humble intern some months after making an appointment!

This mask, that is in discussion, is NOT a typical surgical mask! Do your homework, and check the mask that you say, only protects the patient from the surgeon.

And shit! If you don't believe me, then write to Dr. Asda at Bumrungrad. It's only the number one hospital in all of Asia, and blows Mt. Elizabeth out of her shoes, but hell...don't take my word on that!

Do YOUR OWN research! :evil:

 

[Bert Vierstra]

http://www.natlallergy.com/allergy_reli ... masks.html

 

[balijeff]

Here is the email I sent to Dr. Ardat.

I will forward his reply (if he does so) to all interested in verification. I will also post his repsonse on this board.


Dr. Ardat,

I am writing this email out of some concern for some claims a "patient" has made.

This "patient", whose first name is Roy, recently visited you and has asserted that you emphatically recommended the wearing of N95 or greater masks as the greatest preventative measure against catching bird flu.

I am curious at this recommendation. The CDC and WHO both indicate that bird flu transmission, from fowl to human, seems to be by contact (with fowl or areas while their secretions are found) and not airborne. Secondly, if the bird flu virus is an airborne contagion, then wouldn’t that require the continuous wearing of masks in areas infected and those which had a heightened risk of infection ( a rural village with free-roaming fowl)? Correct me if I m wrong, but isn’t there a window period from the time of infection and the onset of symptoms? Presuming that is true, then when would persons know when to wear or not wear the mask? It is from that I conclude that said masks must be worn 24 hours a day, 7 days a week. So, to summarize: is your professional opinion, that all persons in infected areas or areas likely to be infected, should wear N95 or greater masks at all times and that this is the greatest measure of protection against contracting bird flu?

I also have some questions pertaining to the individual or even communal stockpiling of Tamiflu.

Do you recommend that villages and/or individuals stockpile Tamiflu?

My understanding, again citing CDC and WHO, is that such stockpiling is not only ineffective but counter-productive. Roche recommends that Tamiflu be taken within 48 hours of the onset of symptoms. The symptoms of bird-flu, in humans, are, well flu-like. In the absence of laboratory testing, how will villagers or individuals know to take Tamiflu? Is it possible or even likely that the Tamiflu regimes (75mg capsules twice daily for five days (per Roche), unless infant) will be consumed for ailments other than the intended bird flu? Considering the world wide shortage, isn’t said doses better off in the hands of first responders, not only for their own use but for the use of those who have been proven to be infected with bird flu?

Thank you for your time and forthcoming response in this crucial health care issue.

Jeffrey Wilson

 

[Roy]

Jeff! There you go again putting words in my mouth! In your letter to Dr. Asda, you write:

This "patient", whose first name is Roy, recently visited you and has asserted that you emphatically recommended the wearing of N95 or greater masks as the greatest preventative measure against catching bird flu.

Good grief Jeff! I DID NOT SAY THAT...NOR did HE say that. Jeff, trust me, I’m not the only one who has noted your continued bad habit of jumping to erroneous conclusions and deriving incorrect assumptions, as well as literally misquoting! That’s a nasty habit you have Jeff, and it’s a pain in the butt!