Proof that HCV Sustained Virological Response (SVR) is a myth?

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Scanning electron micrograph of a human T lymphocyte (also called a T cell) from the immune system of a healthy donor.

The HCV monster-machines are apparently craftier than we have been led to believe.  Even after IFN/R therapy, and non-reactive (not detectable) standard clinical testing, more sensitive tests prove that HCV RNA still resides in the human body in reservoirs.  The researchers of the small “first” study, Persistence of Hepatitis C Virus during and after Otherwise Clinically Successful Treatment of Chronic Hepatitis C with Standard Pegylated Interferon α-2b and Ribavirin  Therapy (published November 2013) are very confident in their experimental methods, results and conclusions. There is no waffling.  

The study is highly technical but I’ve pulled out some sentences, the gist of which, can be understood by this layperson (with footnotes removed). My remarks are in red.

New terms: occult HCV infection (OCI) which was discovered in 2004 but “rarely investigated.” peripheral blood mononuclear cells  (PBMC). Lymphoid cells

  1. HCV is infectious even in trace amounts, with approximately 10 virions or 20 copies of viral RNA capable of transmitting infection in chimpanzees and with 20 to 50 virions able to establish productive infection in human T cells in vitro. (How many zillions of virions can fit on the nozzle of a jet injection gun?)
  2. The long-term consequences of this essentially asymptomatic infection, termed as occult HCV infection (OCI), remains uncertain; however, OCI coincides with histologically evident protracted low grade liver inflammation and fibrosis in some patients for at least 10 years after completion of antiviral treatment. (My spouse was told he was completely cured.”)
  3. Also, clinically diagnosed sustained virological response (SVR) achieved due to IFN or PegIFN/R does not universally prevent progression to HCC, which develops in up to 3.9% of these individuals. (This is not a good number and how many primary doctors are even looking for HCC in SVR patients?)
  4. Contrary to prevailing opinion based on the currently available clinical testing for HCV RNA, clinical diagnosis of SVR does not reflect molecular eradication of HCV…(They drive this point home throughout the paper.)
  5. In addition to persistence of HCV in plasma during OCI, virus and its replicating genomes were uncovered in PBMC and liver biopsies in individuals for many years after having been considered to be clinically cured of hepatitis C. (Yes, they are still replicating..)
  6. …the accumulated data showed that HCV residing in immune cells fully retains biological competence, including infectivity…(No identity confusion in these monsters.)
  7.  …to fully recognize the sterilizing potency of new DAAs in the context of the extremely high mutagenic capacity of HCV and the virus’ resulting ability to generate drug resistant mutants, the DAA effects on virus replication at extrahepatic sites, particularly in immune cells, should be routinely assessed since these cells also are the site of virus active propagation.  (The expect some to relapse after DAAs who may then be offered INF/R.  Ugh.)
  8. These and other findings prove that immune cells, including T lymphocytes, are targets of naturally occurring virus, they are reservoirs of replicating HCV regardless of symptomatic or occult appearance of infection.  (Is this why HCV is linked to lymphomas?)
  9. Therefore, HCV is not completely cleared during ongoing administration of PegIFN/R otherwise capable of ceasing progression of CHC and virus commonly persists at levels not detectable by the current clinical testing. The findings suggest the need for continued evaluation even after patients achieve undetectable HCV RNA post-treatment. (The VA won’t test my spouse for HCV anymore…but they should.)

The authors are affiliated with the following institutions: Virology and Hepatology Research Group, Memorial University, Can. Center for the Study of Hepatitis C/Div. of Gastroenterology and Hepatology, Weill Cornell Medical College, New York City; Div. of Gastroenterology, Hepatology and Nutrition, Dept. of Medicine, SUNY-Buffalo.  The study has only been downloaded 212 times so far and cited only twice even though it has greatly added to the knowledge base on HCV.

A preview of the book, HCV Infection and Cryoglobulinemia by Franco Dammacco, is available in Google books.  It’s a good resource. Using the keywords, “occult HCV infection (OCI)” I was able to read a discussion about this issue. 

So the upshot for SVRers is to take care of your whole biological system as best you can. 

Editor’s note: To all of you who VA says are SVR, this is the smoking gun you need to rebut with. When they say you are pure as the driven snow, wave this one in their face. Take note Malcolm!

Posted in Guest authors, HCV Health, HCV Risks (documented), Jetgun Claims evidence | Tagged , , , , , , , , , , , , , , , , , , | 8 Comments

VBA-PLEASE KEEP EXIT AISLES CLEAR

 Willy Gunn says 'We be gone'.

Willy Gunn says ‘We be gone’.

As I predicted several months ago, the stampede to the exits is in full swing. Following  Petzel’s lead were Joan Moody and Willy Gunn who didn’t even wait for the jumpmaster or a green light. Dr. Brown, Under Secretary of VHA Health (acting) is certainly not the last. The USS Vermin Ave. is alive with the sound of resumé music.

Joan Moody: " I need more time with my kids. At fifty, I feel my mission at VA is done''.

Joan Moody: ” I need more time with my kids. At fifty, I feel my mission at VA is done”.

We’ll never know why Moody took the poison pill. At 50, she’s not ready for retirement. This isn’t going to have a smiley face on her resumé but I’m sure she can get some of her former bosses at Vermin Ave. to write glowing endorsements on her ability to advocate for bonus awards and her exquisite grasp of Congressional and legislative affairs. After all, that was her strong suite at VA. I see a glowing future as the Veterans Service Center Manager in Manila, Philippines after a suitable hiatus as a talking head on the  VA’s problems with CNN.

What will be interesting to see is how the VA, and it’s possible new Secretary, Ronald McDonald, reorganize the personnel roster. If this merely results in a Punxsutawney Phil approach with no visible shadow, involving the same employees with no new ones chosen from without, then we are doomed to six more decades of winter at 810 Vermin Ave. NW. punxsutawney-philThat is the crux of our dilemma. Given VA’s propensity to ignore public sentiment and common sense, it appears we’ll merely see a new cast of characters with similar sounding names. Expect to see Laura Eskinazi move to Willy Gunn’s slot. Prepare for Hickey’s exodus and fresh meat like Lucy Filipov to replace her.

Musical chair affairs at VA’s Central Office are amusing and oh-so-predictable. Much like the military, having time in rank determines promotion. Intelligence, sadly, is not a prerequisite. When the music stops, there will be no body slams for the last vacant chair. Musical chairs at the VA do not obey the childhood game. There’s always a seat for you. Everyone politely acquiesces to the one most senior to inhabit the one with a corner-office view of Lafayette Square. The reason is simple. For decades, you were virtually guaranteed a seat at this dance. You simply had to wait your turn. If someone stepped on his necktie and just could not be rehabilitated or repurposed to Fort Harrison, Montana as the VSCM, you got an early Christmas present and a parking spot in the basement sooner that you expected. Merely being able to fog the mirror with the air escaping your nose was sufficient to maintain your seniority and guarantee the next step in pay.

With the new paradigm, those days would appear to be over. The operable word here is “appear’. VA has been intransigent in the past and had the chutzpah to fly in the face of adversity- indifferent to public opprobrium. While the recent resignations might imply this is no longer the case, I suspect the majority are still waiting for the SS Carpathia’s lifeboats to arrive and begin transferring the senior managers to their new digs. The majority of them are too obtuse to absorb the concept.

Hickey’s abysmal performance and abject self-degradation up on the Hill the other day was belied by the press release the following day announcing the ‘All Clear’ siren and the raising of the SOSDD  flag out on Vermont Ave. That’s the endemic problem we have to contend with. Mea culpas at the HVAC have to be accompanied by the gomers going through the motions to appease public and congressional disfavor. Sackcloth and ashes are the uniform of the day but VA hasn’t gotten that email yet. Moreover, they can’t conceive of that apparel nor will they ever.

VA’s hierarchy has been indifferent to public opinion for over twenty five years. Following the inception of the New World Order of the Court of Veterans Appeals (COVA) in 1989, the VA paid lip service and proceeded merrily on their way just as they had for the prior seventy years. BVA judges continued to write medical opinions in violation of the Colvin decision as if it had never been decided. Ratings were denied with no C&Ps. Due process was a hollow phrase that made a nice matching bookend to Benefit of the Doubt.

We have reached a crossroads-a perfect storm- where fourteen years of continuous war have finally brought our wounded chickens home to roost. No longer can we look the other way and try to ignore the plethora of warriors missing large parts of their anatomy. The profusion of aftermarket arms and legs is becoming a de facto totem of the Afstan conflicts. How we did this after Vietnam was disingenuous-we popped smoke and corralled them at Walter Reed out of sight. Afterwards, we  quietly salted them away in their hometowns with fat VA SMC ratings-again-out of sight. Well, fat if you think like the gomers at the Central Office. Compared to their wages, we now know that it was pretty skinny largesse-and still is.

The ‘knickknack, paddywhack, give the Vet a bone’/ this paraplegic went rolling home’ metric isn’t going to fly anymore. No amount of wool-pulling is going to hide the problems at VA. Were the egregious actions of VA’s hierarchy truly just a recent, maladroit error or minor misfeasance by a few, the media and Congress might have been more forgiving. That they rise far above that to endemic, long-term malfeasance by all involved (collusion) cannot be swept under the rug. So, too, can Congress’ turning a blind eye again and again to these shortcomings of the VA no longer be ignored.

imagesThe Piper awaits-nay-demands his pay and will not accept payment for hamburgers today come Thursday next. Americans demand our Vets get a fair shake now. Unfortunately. VA cannot produce the golden egg as promised all these years. Asking for another ‘one time’ infusion of twenty or thirty billion dollars on the heels of the same, similar requests in years past seems to be falling on deaf ears up on the Hill. It’s not that the request is ill-timed or untoward. It’s because the request is as tired and predictable as thunder following lightning. Were the VA to retrieve all those illegitimate bonuses for the last decade or two, they would have the funds needed. Had they been paying wages commensurate with job requirements, they would have the funds. Had they not engaged in an orgy of Human Resources cheese and wine tastings with General Patton look alikes and ice sculptures, they wouldn’t be so funds-challenged.

Could have, would have and should have seem to populate the problem list at VA today. Seeing that Congress is loathe to apply the salve of ‘mo’ money, honey’ again, it’s no wonder the resumé template on VA’s antiquated Central Office Adobe 2 programs is running so slowly. Everyone is packing his/her parachutes and checking that of his/her fellow employees’ against the inevitable upcoming massacre. While I admire Sen. Bernie Sanders’ recent epiphany that Vets are getting the sharp, brown end of the punji stick, I have to disagree with how we can fix it. As long as we continue to shoot the messengers and reward the bank robbers, there can be no change. No amount of money can fix stupid and greedy.

Merely promoting from within without purging the pollution of longevity serves no logical purpose. Unfortunately, being a governmental organization does not permit a wholesale Saturday night massacre and infusion of new personnel. Nothing can change due to the built-in resistance to change. Removing bonuses won’t drive out intelligent, competent dedicated employees. Those are oxymora. There simply are none to be found at the VA.

Posted in VAMC Scheduling Coverup | Tagged , , , , , , , , , , , , , | 2 Comments

DAY 25–SOVALDI

download (1)Day 25 dawns with a nagging headache. This is # 7 since beginning the new prophylaxis. Additional noted complaints include itching (yes Leigh, me too) in odd places never mentioned in public, anemia, idiopathic thrombocytopenic purpura on exposed arms, pruritus, dizziness, and RUQP. Mind you, I am not complaining. These represent minor inconveniences on the way to a longer life without the dragon breathing over my shoulder.

In other news, Diane C. remains SVR after a year. Mark (Hepsick) is SVR after 6 weeks and will be coming up on another SVR assessment soon,. My own first checkie-checkie for less bugs per square inch of blood will be next Tuesday. That will mark the one month milestone we all look forward to and dread simultaneously.

 

The reason I am such a prolific author today is because I had a phlebotomy yesterday. The check engine light has been on ever since. Seems when you’re anemic, removing another pint of blood has consequences. Mine is a push. Allow the contaminated AO blood to fester or pump it out. Either way, my Sovaldi minder is going to be in for a rush when she sees next week’s results. They do have a laissez faire attitude about all this and didn’t exactly tell me not to keep getting phlebotomies. What I find interesting is the poster on the wall at the blood bank. It clearly points out that you cannot donate any more frequently that every 57 days. How is it I can do a phlebotomy every 30 days-and have been since November 1992? The little black spots in the corner of my eyes are my constant companions now like my dogs. They follow me everywhere. And for those who wonder, that’s thirty one gallons of blood down the tubes. Well, they claim they’re throwing it away but you know how that works…

My heart goes out to all of you who were subjected to the triple-drug cocktail VA was pushing (VERTEX) when they knew full well that Sovaldi was on the horizon and active trials were in progress. Perhaps it was part of that VA scheduling snafu that’s in the news these days. Damn Vets refused to keep calling back in to keep their desires for treatment current. What’s a VA scheduler to do? Roger that. Create a ‘secret list’ so they don’t lose track of these lazy sons of guns. Some day they’ll want that appointment and it pays to have proof you were just doing your duty trying to keep up with their desires.

P.S. If anyone finds that ten lbs. I lost or misplaced, please send it back. I guarantee the postage.

 

Posted in Medical News, Sofosbuvir | Tagged , , , , , , , , , , , , , , , , , , | 10 Comments

BVA–NEW 2ND QUARTER DECISIONS POSTED

scThe second batch of 2014 decisions were put up today and the increase of cases being won via jetguns is finally getting some traction. Here’s the very first one I looked at and the turn around in VHA “expert” opinions shows 30 pieces of silver aren’t enough to hush their mouths.

With regard to receiving injections from air gun jet injectors, the expert found that such exposure is as least as likely as not to have led to the Veteran’s current hepatitis C exposure. In support, the expert provided that currently, multi-use jet gun injections and injectors are no longer medically recommended due to the risk of transmission of blood-borne diseases. Further, because there is a lack of showing of any other possible means of transmission through other identifiable risk factors, to include sexual transmission, as there is no medical evidence establishing any such risk factors, the only plausible means that remains at least as likely as not is the air gun injectors.

Finally, after 22 years, they are willing to admit (and grant service connection) that there is a link between the jetguns and the bug. I’m sure Gary Lupole is smiling down from somewhere above and saying “No duh.”

Gentlemen, start your keyboards.

Posted in BvA HCV decisions, HCV Risks (documented), Vietnam War history | Tagged , , , , , , , , , , , , , , | 4 Comments

FORT FACEBOOK–JOGSTRAPS AND MORE

10386271_10152496181925700_3349862854289483951_nEver wonder who creates all those intriguing videos of “stuff”? Me, too. More importantly, why? They get no credit or monetary gain. They get no accolades or attaboys from anyone but friends who know they were responsible yet they keep on plugging away producing them. Nevertheless, it befalls me to bring them to your attention and share them. You simply cannot go through life without a jogstrap if you enjoy jogging. 

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10474544_10152496189510700_4272191009020996984_n10342771_925862980763974_7986569147803151846_n10338758_10152517972967908_3240241186683372531_n10484147_864932140187652_7703918551349400501_n1526103_10151935143718227_265631968_n

In the comments section below this, I would hope many of you readers would add:”Thank you for sharing that.” or “That made my day.” or perhaps “Where can I get my own  jogstrap?” We at asknod work hard for your accolades. Fort Facebook is a valuable tool for humor as you can see. We need humor. We deal with the VA virtually every day so our depression levels are usually in the tank. I hope these vignettes in some small way ameliorate the angst.

Posted in FACE HUMOR | Tagged , , , , , , , , | 2 Comments

HCV infection and veterans’ oral health

dental

Click image to read this report–Dental and Orofacial Health and Hepatitis C. Image: Cover of report by Australasian Society for HIV Medicine

According to a 2012 report published for dentists by the Australasian Society for HIV Medicine, which also covers hepatitis, health problems associated with HCV are numerous. The report, Dental and Orofacial Health and Hepatitis C contains a few graphic images including one of an oral Non-Hodgkins lymphoma lesion (fig. 7).  

abq va

One smart starving Vietnam vet who accidently lost his dentures and lost several pounds because he couldn’t eat, turned to a News program for help with the Albuquerque VA. CLICK FOR STORY. Image credit: KOAT TV

Medicare is no help because “Congress has not amended the dental exclusion   since 1980 when it made an exception for inpatient hospital services when the dental procedure itself made hospitalization necessary.” The VA isn’t much better if a veteran is not 100% service-connected but there are a few exceptions (page 3).  To download a Word document describing the VA’s classes of care, click: Class VI

Shamed Phoenix VA nicely states:

Established eligibility for dental care is required to receive dental care from the Dental Department. If you are without service-connected eligibil­ity for dentistry, and your medical con­dition may be aggravated or adversely affected by your dental condition, you may be evaluated and treated upon consultation between your physician and the Dental Department….

Finger-wagging, Minneapolis VA adds: finger

…Be aware that this does not automatically make you eligible for routine care, and treatment may be limited.

(If you have a dental emergency, you must go to the ER first and may be charged $500+.)

 If the treating physician won’t give a referral, can you write up a NOD?   The VA’s new pay-for-your-own Dental Insurance programs, even the most expensive Met Life plan, has massively high co-pays for say, gum treatments.  Delta is worse and throws in waiting periods.

After viewing the images of the awful HCV-related dental deterioration and oral diseases (beginning on page 4) such as Lichen Planus, lymphomas, it’s clear that the VA should provide all vets with active HCV or SVR veterans suitable dental care.

Do you have experiences in trying to get VA dental care while under care for HCV (or any other condition) that fits the above statement. If HCV treatments are causing dry mouth, and then painful gum disease, can you see a VA dentist? Or, if you are SVR, and due to gum disease caused by HCV and medications, are you out of luck when your teeth start falling out?   Any advice for accessing VA dental care for non-100% SC vets will be appreciated.

 

 

 

 

Posted in Guest authors, HCV Health, HCV Risks (documented) | Tagged , , , , , , , , , , , , , , , , , , , | 6 Comments

VA-WE WANT OUR SPLENDID ISOLATION BACK

Warning. Rated X. Not appropriate for children under 10 years of age to view.

We are reaching the point of absurdity. Hardly a day passes that another VA upper-level manager manages to leave incriminating evidence lying around to be found. That a member of Congress would think reading that evidence of perfidy a horrible intrusion on the offending VA official’s privacy and even offer prayer up to Him to spare her job beggars the imagination. In addition, who let USB Allison  “au natural” Hickey out without any makeup on yesterday?  All these queshuns. 

Having had the benefit of twenty years playing ball with the VA, I know that the present situation is a compendium of many problems that have come to  represent the Perfect Storm for them. The invention of the internet, social networking, Google/Bing Search!, FacePlace and so on leads to the loss of anonymity. With everyone a potential paparazzi armed with their camera phones, no one can expect any privacy for very long. Eventually, the house of cards comes tumbling down and you are exposed for all to see.

VA has somehow attempted to put off the inevitable, crushing reality of their problems with, of all things, attaboys, stupendous bonuses, and a Nero-esque approach of letting it all eventually burn down around them. They simply have moved the inevitable date of doom forward again and again with false assurances, new programs, and a bonus program that rewarded some of the most egregious behaviour ever documented statistically. When confronted, they blinked. What had they done wrong? This was business as usual. Where were the apologists to bury this uncomfortable revelation?

Like a cheap Wal Mart sweater from China, this puppy is coming unraveled faster than we can catalogue the cast of characters and get a program typed up. Representative Jeff Miller has been chasing this tar baby for over three months. Each day brings new evidence of the criminal intent, the intransigence and the unwillingness of VA’s senior staffers to realize the USS Vermin Ave. NW is sinking. They proceed apace as if the whole imbroglio will clear up in the next few days and weeks, the ponies will be saddled and trotted out and the dogs brushed and groomed. And then, back to the status quo of bonuses, single malt scotch and low golf handicaps.

As for the Congressional aides’ visit to the Philadelphia VARO, it raises an interesting question. Several, actually. Why does VA need (and keep) a room wired for sound and video if they are a nonadversarial agency as they profess? From what budget were the funds allocated? And just exactly how many of these rooms exist across the 57 Regional Offices? This was a blatant attempt to collect negative evidence- illicitly- without the partys’ permission. The discovery of the tablet in the restroom further shows the orchestrated obfuscation preplanned and preordained from on high. “From on high” is the (former) Deputy Under Secretary for Benefits Diana Reubens. She would be the underling beneath the Under Secretary for Benefits Allison Hickey (her boss). Now where would Miz Reubens get the idea that she had the authority to tell the Philadelphia Veterans Service Center (Acting) Manager,  Lucy “in the sky” Filipov, to ignore Representative Miller’s Congressional aides sent to ascertain benefits issues? You don’t suppose Miz Hickey told Miz Reubens to do this? Have you ever heard of the chain of command? With all the fuss, seems that would be the default setting right now at VA.  Miz Reubens:”No ma’m. No way am I going out on the little branches and making a decision of that magnitude! Ignore Congressional aides and surreptitiously record them? Whoa there. That’s  waaaaaaaaay above my pay grade, General Hickey.”

download11Acting VSC Manager Lucy Filipov has evaporated. Deputy USB Reubens has metamorphosed from a butterfly backwards into a caterpillar and now has Miz Filipov’s job. This just gets better and better. That Miz Wonderland Hickey is still trotting out apologies up on the Hill is the even bigger mystery at this stage. I’d have expected her to hook up to the static line and taken the green light before this.

For nigh on four months, this Pony show has been playing. Rep. Miller doesn’t run a “mainstream” committee that handles large appropriations he can manipulate like pork barrel politics. He is reduced to examining the needs for increased VA funding yearly, but cannot partake of the largesse directly. As such, most Congressmen do not aspire to the HVAC committee. Unless they feel the compassion and the milk of human kindness moves them to it. When you uncover a cesspool of this magnitude, which everyone has known about for years, and it metastasizes like a blastoma as you investigate it, it makes for excellent political theatre. It gets you in the news before your constituents just as it did Rep. Filner the skirt chaser. We do pray our Rep. Miller does not have any like foibles which might interfere with his upcoming election in Florida. He seems so talented at what he’s doing. No one before him has really done other than lip-whip Hickey and company. His technique is bearing fruit. Send a couple of sleuths to Philly and see what shakes out. In this case it was Lucy’s marching orders inadvertently left in the bathroom.

I have a friend who strongly believes in conspiracies and this appeases his appetite. He sees Illuminati afoot at Vermin Ave. I just see a wasteland of stupidity aided and abetted by opportunists so greedy that they inadvertently reveal themselves. Think about it. Freud would have a heyday with Miz Filipov leaving the smoking gun tablet in the shitter. It’s proof ( he would say) of her desire to atone for her sins against Veterans and an opportunity to admit her misfeasance as well as that of the VA upper-level management in general. Freud aside, I say she’s simpleminded and conflusticated. She’s underworked, overpaid and not accustomed to having this level of investigation in her castle. At least the VA’s Office of Inspector General (VAOIG) has the decency to drop her a line telling her well in advance they’ll be having a “surprise” visit.

To attribute intelligence to these VA chowderheads gives real career chowderheads a bad name. It besmirches the whole school of Chowderhood by tarring and feathering them with the same brush. Aspiring to management-level chowderheadedness requires years of unearned promotions, absolutely no conception of the job parameters, a personal disdain for Veterans and lastly, a desire to stab anyone in the back in the pursuit of personal gain and bonuses. VA promotes from within. They never go outside the box except for the good old boy (or girl) network. This is one major reason they have a dearth of Decision Review Officers (DROs). Their attrition rate is stupendous and provoked by the DRO wannabes realizing they don’t have the stomach to screw over Veterans with bogus denials. This, in turn, has now ballooned into a full-fledged backlog with few having authority to adjudicate the reviews. Oakland’s DRO reviews are reputed to now be reaching 600 days as of July 1st.

Every day seems to bring more damnation and ruin on the remaining defenders. One look at Hickey’s countenance in the above photograph tells us all we need to know about the toll of all that lying is doing to her. I’m sure she started with the best intentions but the vicious rat race of VA bonuses is a harsh taskmaster. The final casualty of truth is now exposed even more clearly. Rep. Miller holds all the cards. What is unclear is whether this will once again become a sleeper and return to the depths of the media’s attention. Given VA’s recent propensity to shoot holes in their shoes with their feet on board, I’d be loathe to take a bet that they are going to dig themselves out of this.

Senator Alan Cranston excavated the very same cesspool in 1988 and his colleagues created the present system we have now. By rights, this should have resulted in a Brave New Agency responsive to our needs. Sadly, it just set a new metric for greed. As late as 2009, VA still had no game plan to go paperless. This, alone, shows their mindset; their unwillingness to disturb a hopelessly dysfunctional system with some modern 21st Century far thinking. The agency is bereft of intelligence, guidance, ideas and personnel capable of effecting change. The hierarchy has made that a certainty by firing anyone who declares the Emperor naked. When apprised of his underlings’ lying and mischaracterization of the facts, Shinseki got the ax. The one guy with a modicum of ability is fired for his reliance on bogus employees.

We are expected to believe these misguided upper-management souls can all be returned to the fold. A massive new program of reeducation is touted as the panacea. We can’t fire them? We can’t rescind their bonuses? We just blindly accept their contrition for their sins and absolve them? We’ve had twenty five long years of this mismanagement and purposeful misrepresentation of what is afoot and we are asked to let bygones be bygones. VA is the proverbial junkie brother who comes to visit you every several years. Each time he tells you he has reformed and is about this close to entering rehab. Could you see your way to giving funds for one last fix before the cab arrives?  Meanwhile your wrist watch and the cash in your wallet have already been pilfered while you were in the bathroom. Unfortunately for your junkie brother, he accidentally left the stolen evidence on the back of the toilet while he was shooting up.

That’s about where we stand today. I love this last rejoinder when Hickey could no longer say she’d look into it or have the OIG get to the bottom of it. She’s busted and morally bankrupt in Jeff Miller’s eyes as well she should be. giphy-facebook_sPerhaps the lack of makeup was just in case tears were needed. No woman looks good with runny mascara. Tammy Faye Bakker taught us that much.

“I will not excuse it,” Hickey said when confronted during the hearing. “Without question, it ( planned stonewalling of Congressional aides) is unacceptable.”

Miller was not impressed with the apology. “Your commitment is appreciated but it is not believed,” he said.

Well spoken, Representative Miller.

 

 

 

Posted in VAMC Scheduling Coverup | Tagged , , , , , , , , , , , , , | 9 Comments

HCV patients: Drink coffee, not tea, to slow liver disease progression

coffee picking

A large well- funded study,  Coffee Intake, is Associated with Lower Rates of Liver Disease Progression in Chronic Hepatitis C, was first published in Hepatology (2009) and is now free to read.  The Discussion section summarizes the good news: 

This prospective study of patients with chronic hepatitis C and advanced liver disease who had failed to achieve a sustained virological response with peginterferon plus ribavirin treatment, we observed an inverse association between coffee intake and liver disease progression. Drinkers of three or more cups of coffee per day had 53% lower risk of liver disease progression than non-coffee drinkers. Results were consistent for coffee intake assessed on the baseline questionnaire and coffee intake assessed on a second questionnaire 13 months later. Results were also similar for those with both bridging fibrosis and cirrhosis at baseline. In contrast to coffee, we observed no association with consumption of black or green tea.

The researchers looked at a lot of data and found some amazing things.  For example, ” We observed no association between coffee intake and age, body mass index, cirrhosis status, diabetes, educational attainment, HCV genotype, Ishak inflammation score, platelets, prothrombin time, or treatment group.”

They don’t know which of the “more than 1000 chemical compounds” are so beneficial.   One gets the sense that the researchers are really surprised that coffee is so good for non-responders because they observe: “Coffee intake is also not generally considered to be part of a healthy lifestyle.”

My spouse and I usually start each morning with a cup of Gevalia Espresso mixed in with some cheaper ground coffee.  This morning, we filled some mugs with our a.m. brew. Which are the best health-giving coffee beans?  I don’t know but I’m glad coffee isn’t patented, treats the whole person as well as the liver, is readily available, and is an enjoyable ritual!

Could coffee intake explain, in part, the differences in fibrosis scores among patients who were infected with HCV during the same time span? Could coffee intake support the immune system as well.  Is this the swiss-army knife of beverages?  To recommend your favorite coffee brands, or brewing method, leave a comment.  We’re interested!

Posted in HCV Health | Tagged , , , , , , , , , , , , , , | 4 Comments

VA SCHEDULING FIASCO–LATEST UPDATE

Two Pinocchios

Two Pinocchios

(UPI)Under Secretary for Veterans Benefits (and now titular head of the VHA, too) Allison “In Wonderland” Hickey announced today that the VA’s highly-trained investigators at the Office of Inspector General have finally gotten to the bottom of the VA scheduling snafu down in Phoenix, Arkansas.  

Said Hickey: ” After an in-depth review of all evidence available, our intrepid investigators discovered a heretofore invisible malware program had intruded into the VA’s VISTA medical computer system. Due to the advanced age of the system, which is powered by Windows XP, they were able to access our appointment calendars and effect changes that were purposefully designed to make VA’s Medical Centers look inept and uncaring of severely disabled Veterans. Fortunately, the OIG identified this weakness before an even more serious breach of the records could be accomplished. We have now installed firewalls to prevent this but will need to create a new system. We will be approaching Congress for funding of VISTAPLUS shortly and our IT administrators have endorsed a $1.4 Billion system designed by the Chinese company NORINCO as the best buy for the money.”

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VA Press Secretary Carney illustrating with his hands just how large the disconnected electrical plug was.

USB Hickey then turned the briefing over to VA Press Secretary Jay Carney. Carney opined that the computer virus might never have been discovered if the OIG had not made the surprise inspection. Carney further theorized that if the OIG investigators had not found the computer was unplugged back in the mechanical room, the problem would still be of immense proportions.

The virus, nicknamed VABONUS, is suspected of having contaminated at least two, and quite possibly three other nearby satellite computers outside Phoenix in Little Rock and several smaller Community Based Outpatient Clinics ( Fort Smith, Pine Bluff and Texarkana)). Carney at this time was not able to state with any assurance that the virus might also have hitchhiked on emails back to their Central Offices in Washington, DC. However, he did go on record as saying the possibility was there, nevertheless. ” We scrub all the emails every night and shred the evidence of it. Our IT guys are still reviewing the software doomoflotchies but they tell me the probability of VABONUS in DC is slim to none. We’ll have a new update when we accomplish the review in late January of 2016 after the inauguration. Oh, and one last update. Apparently I was in error.  My assistant informs me that we do not scrub emails but preserve them for posterity off-site on old, repurposed IRS, er, VA computers. ”

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Three Pinocchios

USB Hickey also iterated her commitment to Veterans by pointing out she, too, is one. “Lot’s of people overlook the fact that I was a lifer. I worked hard for that star. You think flying a desk was fun? Try it for a decade or two and you’ll discover this VA gig is a vacation in comparison. Acting VA Secretary Gibson is now hard at work trying to sort out all the problems that prior administrations overlooked and he’s not getting a lot of cooperation. The media needs to cool off and give us time to ascertain the problems. We would also appreciate it if they would give us the names of all the whistleblowers that contacted them anonymously so we can interview them and get an accurate assessment from all stakeholders, not just the ones on record. Knowledge is power at the VA and the more we have, the better our decisional capabilities will be enhanced. The identities and any photographs of the whistleblowers will be scrupulously protected by the OIG.”

Onwards thru the Fog.

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FACIAL INPUT

10352142_712577415481778_2410023227669203271_nAs this was a slow week due to everyones’ being on vacation, I apologize for the dearth of really good humor. The “remove child first” is the only one worthy of reproduction.

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