Curbside Consult with Dr. Jayne 10/4/21

It’s been a rough weekend at Casa Jayne, with some bothersome side effects from my end-of-week Pfizer booster.

Don’t get me wrong — even with side effects I still like the vaccine odds better than the odds for naturally occurring COVID-19, and I’d do it again in a heartbeat. This time around it was a family affair, as my parents were able to get appointments within a few minutes of mine, so we got to spend some quality time in the observation room together. I was grateful that they were able to get their boosters on a beautiful sunny fall day rather than having to drive through snow and ice and stay in a hotel across the state, as they did for previous vaccines. It was good to catch up in person rather than by phone or text. My dad mentioned that the local farm and home store has a sign that warns people not to use ivermectin on humans. I’ll stick with my FDA-approved drugs (whether they’re under an Emergency User Authorization or not) any day. Except for one person who had a recent “breakthrough” case, we’ve all avoided infection. Now just crossing my fingers for a speedy approval for the Moderna booster for my grandparents, followed by quick scheduling at their retirement community.

Because most of my symptoms involved my dominant arm, I didn’t get much done over the weekend that didn’t involve reclining on the sofa with a pillow under my arm. Big thanks to the hospital auxiliary who made “cough” pillows post-op patients the last time I ended up in an operating room – it was the perfect size for a post-vaccine prop. I did however get a lot of reading done. I finished one novel, downloaded three more freebies, and started going through mountains of email.

One email reminded me to read the HealthIT Buzz blog from ONC, which had some good information on how ONC plans to better communicate with stakeholders. Moving forward, ONC plans to have additional options for communication and education, including more frequent FAQ postings; plainer language on blog posts aimed at non-legal, non-technical audiences; regular leadership blogs reviewing progress on implementation of the regulation; active outreach for public events and stakeholder meetings; and my favorite – “focused posting of Myths vs. Facts on social media to dispel inaccurate information and direct stakeholders to authoritative resources in a timely manner.” Maybe we need a cross between MythBusters and TikTok for ONC to reach both seasoned healthcare informatics folks as well as the newest generation in the workforce.

Another email took me deep into the rabbit hole that is the Theranos trial. There are so many summaries and recaps out there, I certainly had my choice of news sources. I do think that the delay in holding the trial, partially due to the pandemic and partially due to legal maneuvers, might be helping Elizabeth Holmes as she tries to defend herself. There have been many specific questions about individual recollections of conversations and events which occurred years ago, and when those recollections don’t match emails which are later entered into evidence, it certainly reflects on the credibility of the witness testimony.

The overall picture is one of desperation at Theranos, where they so wanted their solution to succeed that they were willing to go to great lengths to make it look like it was performing better than it was. In reading about some of the patient impact, my heart breaks for the women who had erroneous tests of the pregnancy hormone human chorionic gonadotropin. In one case, the patient’s values were off by a factor of 10, leading her to believe she was experiencing a miscarriage. Although she later received a corrected value, it’s hard to undo the level of anguish that someone experiences when receiving the news that she did. Some medical practices figured out quickly that there was trouble at Theranos, but others continued to use the lab, magnifying their exposure for inaccurate results.

The Theranos trial is also a good reminder that work email is not a safe place, and phone records might not be either. There were plenty of emails between Holmes and her boyfriend, former Theranos Chief Operating Officer Ramesh “Sunny” Balwani, that some might find fairly cringeworthy when viewed in the light of day and with consideration of the current situation. Holmes apparently found him to be her breeze, in the desert, her water, and her ocean. They also texted about being able to “love” and “transcend” even in the middle of a major whistleblower investigation. None of the documents I came across included any sexting, so at least we can be grateful for that. But it’s a reminder of how people might want to be careful and avail themselves of other modes of communication than non-secure texting.

The last email that caught my attention was from local government, letting me know that county council meetings would no longer be available on YouTube due to its recent push to remove videos that spread certain types of medical misinformation. The “public comment” portions of the meetings have been so chock-full of conspiracy theories, bad science, and false claims that they ran afoul of the terms of service. YouTube will still allow what it calls “personal testimonies,” but will not permit content that promotes vaccine hesitancy or promotes misinformation. Commentary that vaccines cause cancer, infertility, or contain microchips will also be banned.

Although my vaccine yet again failed to improve my wireless connectivity or make me magnetic, I’m glad I was able to get one quickly and close to home. It was good to have some downtime, albeit forced, because I had loads of end-of-quarter work earlier in the week and probably needed a mental break more than I would admit. I caught up on some TV watching as well – “Blue Bloods,” “Endeavour,” and “Inspector Lewis” to name a few. I’m on a bit of a crime drama kick, I suppose. Of the three, “Endeavour” is my favorite, although it’s so full of details you have to be careful if you’re nodding off while watching, because it will lead to a lot of rewinding.

What’s your favorite TV show for sofa-based recovery time? Leave a comment or email me.

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