Day 44: The Problem With Vitamin D

A lot of readers demand to know things I’m in no mood to discuss.

Two admirable individuals ask why they haven’t heard much about Vitamin D, our most plentiful nutrient. That’s easy: It’s free. The companies that profit most from Vitamin D are those that lure us to sunny climes in midwinter, offering to dry up our cold, soggy blues. Or fly us there.

OLD-TIME SUNSCREEN: MODESTYThere’s a healthy logic in waving your mammaries at drunks during Spring Break! Or visiting Key West, or Granny in Lake Havasu City, or what’s left of the Big Easy. Retirees heading for the Sunbelt don’t need canasta tournaments to justify the move.

Few sell Vitamin D to us up north. Bottling it is a minuscule business—maybe half-a-billion dollars—compared with marketing sunscreens and osteoporosis pills that might make your jaw fall off.

To get a substance approved for therapeutic applications, you need to conduct big clinical studies with controls and lots of subjects, as this article from the Financial Times explains. Pharmaceutical companies have every reason not to pay for expensive testing that might establish an inexpensive—even free—rival for their products against a stunning range of medical problems. Governments don’t seem to like the idea either.

I also wonder if our way of dealing with illness reflects our society’s obsession with control. We go to doctors to get simple things that make us feel in control of our problems: pills. Writing prescriptions helps those harried professionals feel in control, too. Take two pieces of paper and don’t call me.

Consider Lyme disease, which defies easy testing, diagnosis, and treatment. It’s a dangerous condition that’s out of control, spreading relentlessly through North America. With no brand medicine to counter Lyme, it is more profitable—perhaps even comforting—to worry about restless legs syndrome. There are pills for that.

If I could only think of a kicker....

Day 45: I Am Not Influenza

Okay, okay. I hear you.

Record email has prompted me to check my page hits. This blog is more popular than I’d imagined. Evidently the world cares about my existence in this cluttered hole. Or is at least amused.

I’m still here. The joint’s gotten more spacious.

H5N1 IS NOT ME (Mikael Häggström)

So I stopped in at a library. It was full of chattering kids pretending to read while staffers worked to get the place back up to speed. Revelation came when I saw a sign that read Biog and misread it to say Blog. I flashed on the error of my ways.

I am not bird flu. H5N1 is not me. Mea culpa.

I initiated this blog to report on how people could help themselves and secondarily, to comment on what was going on around me. I didn’t mean in my kitchen or bed. Or even across the street. How does that help anyone?

My partner was right: Like a lot of bloggers, I’ve succumbed to talking about myself most of the time. A waste of all our lives, I assure you.

I’ve stopped. I hope my further ideas aren’t boring. I shall continue to express myself about things that are important. Stay tuned.

Day 46: Broken Gods & Threats of Litigation

I acknowledge blame for the world’s interest in my existence, though I don’t get it.

I was served with a legal notice that I should cease writing about ‘Nina’ because I was making her a public figure. She must have finally read my blog!

Ric steered me to a lawyer who assured me that nothing I’ve said about her is litigable. So long as I remain obscure, she can’t be identified. I salute your ignorance and apathy.

GANESH: SHE MISSED ONESo here’s what happened. We broke up a few days ago, when I discovered she was sick from taking Relenza. She’d gotten word to come back to the office soon and had started inhaling antiviral powder because she decided she was coming down with bird flu and wanted to be 100% present on her first day back at work.

It’s not as if I’d never mentioned to her—okay, ranted might be a better word—that I expected ignoramuses to take Relenza and Tamiflu for hay fever. I’ve warned that when they conduct pandemic post mortems, it’ll turn out that most antivirals were wasted.

This is what I posted three weeks ago:

“Know your flu symptoms…!

Memorize that list.

A hypochondriac with hay fever is a terrible thing to behold.”

She used about a third of my stash before I happened upon a used Diskhaler under a pillow while she was off on a mystery stroll. I had gotten up early to confront her about her apparent condition, but she had already slipped out. It seemed a good opportunity to wash the sheets.

Finding that plastic thing dumbfounded me. It’s risky for pregnant women to take Relenza—another point I had posted. Even if it works, embryos that survive bird flu can be damaged for life.

At first I hoped she was out visiting a doctor. I longed for her to come home and tell me what, if anything, was wrong. I imagined she was keeping silent until she could confirm that she was pregnant, sick, or both. Or neither.

She returned wearily at sunset, marched wordlessly to the bedroom. When I followed her inside to ask about the Relenza, she dumped the window screen on the floor so she could sit on the sill, facing me. (She knows I oppose this because I’m afraid Sneeky will fall out the window—a common, fatal horror in New York.) I tried to ignore her transgression while she readily admitted having taken Relenza.

She glowed in the soft pink light as she refused to explain why she was so convinced she’d caught bird flu. Or why she hadn’t warned me that I must be at risk. She said something weird to the effect that I was probably “safe” because I was the source. I told her I wasn’t ill and she said maybe someone in the LES DIY is and I happened to get too close to her and started carrying flu without symptoms. My perplexed expression amused her for a moment. Then her eyes turned into lasers, firing contempt.

She started ranting about things she didn’t bother to explain. I realize now that she assumed I understood them because she knew I was guilty of whatever she was implying. She was speaking in codes she thought I had written. Madness.

Airborne Antiviral Assault

When I said she was poisoning herself and our child, she went volcanic. She was outraged that I had thought she was pregnant. She asked if I was confusing her with someone else. Now her eyes were wider, accusing.

She was certain I had cheated on her the whole time she lived here. With lots of women: Mark’s playmates, the wailing woman, my old girlfriend, even the weird emailer. She had Ric playing a central role in my perfidy—the gay wingman nefariously hooking me up with the sad woman who runs the LES/DIY food service. (With whom I’ve never spoken.)

Soon she was on her feet, hurling what was left of the powder disks at me. I scrambled to find them before Sneeky could start swatting them around, sampling them. She sneered as I crawled.

Then she started throwing bigger objects. One was a brightly colored ceramic of Ganesh, the elephant-headed Hindu god of wisdom, knowledge, and plenty.

I can fling stuff like any angry guy with an opposable thumb, but I’ve never attacked anything that belonged to someone else. If I lose my temper, I smash my own things. I don’t doubt that such eruptions can scare and/or violate other people. I try very hard not to get crazy, but at least it’s me who loses stuff if and when I do.

Maybe she always hated my little Ganesh because my old girlfriend gave it to me. I treasured it. She cracked it.

I placed injured Ganesh on a bookshelf. She laughed and threw him out the window. I heard the statue shatter on a car parked below. An alarm started whooping and beeping.

I went hot and cold, stunned that she hated me so. Furious, I told her to find another place to live as soon as possible. She agreed, smiling for the first time in what feels like weeks.

She insisted on sleeping in the kitchen that night, probably so I couldn’t post anything to my myriad illicit lovers—you.

ATEN WAS A SOLAR REVOLUTIONARYAfter a long night of cycling thoughts and regrets and shock, I walked all the way to Central Park. It was a lush afternoon to feel so desolate. I mulled things over on a big, greasy boulder while high school kids courted and texted and smoked cigarettes around me. Nothing made sense.

I decided to tune up my bicycle soon. She never wanted one.

Peace arrived when I relaxed into the sun’s warm, inspiring glow and discovered Vitamin D. Talk about revelations. I should build a pyramid to Aten.

Two days ago, Nina disappeared. The iMac was gone when I arose yesterday. Late afternoon she returned with a pair of men in ties to pick up her other things. They didn’t look like Mormon missionaries, so I reckon they work with her. Nina’s stuff was evidently moving to the home of a guy with thinning black hair, a lunar forehead, and a hyperactive iPhone with a ringtone from Pink Floyd’s Money.

None of the bankers disinfected when they stomped in, so my apartment got contaminated. I hope it’s okay. Hardly any new cases were reported this week, few of them serious.

I feel as if I’ve lost two people. Y’all really had me going with that pregnancy business.

Day 47: What Flu? (& Where’s That Vaccine?)

The prevailing local strain of H5N1 seems to have mutated to infect a lot more people in Georgia. I bet it’s thriving in lower cell temperatures than it used to require. Noses are cooler than bellies.

The death rate hasn’t climbed much, even with influenza spreading like Sherman’s fire. Every hospital is out of ventilators. Atlanta has shut down. Water supplies from Lake Lanier have been fouled by some kind of chlorination glitch. They didn’t have much water to start with: Georgians have long been praying for rain.

But Atlanta’s so far away. In New York, we’re wearing ‘I caught H5N1 and all I got was hot!’ t-shirts. We’re attending so-called fever parties, where I doubt the powder is medical. And we’re dancing in every bar (which is actually illegal here—check out our bizarre cabaret laws).

PRESIDENT GERALD FORD ROLLED UP HIS SLEEVE IN 1976 FOR A PANDEMIC THAT NEVER HAPPENED Baseball says it’s coming back, but I’m certain H5N1 will win the playoffs. The season had begun well for this Yankees-hating, Mets-loving, Cardinals-worshipping fan. I’ll wait till next year and hope my teams survive.

I still wear gear when I go out. Who wants to be the last soldier killed before a truce is declared? At least 60,000 Americans have succumbed, though it’s always difficult to quantify flu fatalities. History says the second wave may be far more intense.

Who cares? Everyone expects a vaccine by then.

The U.S. Food & Drug Administration says we might see a shot by late July. Others think September far likelier. After what happened with swine flu, you'd think the Feds wouldn't want to promise more than they and the pharmaceutical industry can deliver.

Unless Americans add adjuvants—which heighten a single dose’s effects by supercharging our immune systems—the developed world’s pandemic vaccine capacity will fall way short because two shots are probably needed. Rumors circulate that the FDA has quietly approved a batch of experimental processes and additives that haven’t been fully tested for efficacy and adverse effects. Among the controversial adjuvants is squalene, an oil accused of triggering autoimmune disorders in test animals. While it has never been approved for use in the U.S., European governments embraced adjuvants, particularly squalene, during the swine flu pandemic. Mike Coston makes the case for adjuvants here.

I’m not certain I want to be vaccinated, even for pandemic H5N1. This article sums up my problems with seasonal flu shots. I’m not so impressed by a supportive study claiming that the swine flu vaccination worked in 72% of adults under 65; it had a lot of holes and that’s not even three-quarters of the poorly collected subjects.

The Cochrane Collaboration, a respected global network of health-care personnel and institutions, has published devastating assessments regarding the usefulness of flu vaccines. A review in 2010 found that even when flu shot components perfectly match the circulating strains—a rare triumph—“vaccination had a modest effect on time off work and had no effect on hospital admissions or complication rates.”

I do not in general oppose the concept of vaccination against disease, though I think we’ve gone overboard. Even in this year of mortal threat, I’m not convinced I want to mess with my immune system. I’ve gotten this far in life and hope my personal protective gear sees me further. I feel blue enough these days without changing color.

The 1976 Swine Flu Vaccine Meltdown

The vaccine business is kind of shaky. Nineteen of 20 U.S.-based vaccine manufacturers quit the business after the swine flu debacle of 1976. A national inoculation program (watch some of its strange and colorful public service announcements) broke down after a higher-than-expected number of recipients came down with Guillain-Barré Syndrome. When that pandemic failed to materialize, American flu vaccine production collapsed. It took massive subsidies to restart it.

Which leads to something that bugs me. In a typical year, elderly subjects are herded by the busload to get seasonal flu vaccines. But in 2009, when swine flu vaccine seemed in short supply, the authorities shoved the old folks out of the line. Sure, young people were hit unusually hard by that flu, and some of the old-timers showed immunity to Novel H1N1 (possibly from so many prior exposures to influenza), but most of them evidently did not. Without much fuss, it was conceded that the elderly don’t respond all that well to flu shots. You know, those tired immune systems....

The problem is that if no one gets annual shots, pharmaceutical companies will stop making the stuff. So once the pandemic receded, the authorities revived the ‘get-out-the-old-folks’ routine. Even my stepmom grew suspicious—and she loves doctors.

Still, I reserve the right to change my mind and stick my arm out for a properly tested H5N1 shot. That’s asking a lot. Washington is teeming with lobbyists seeking emergency federal support for any products and processes their corporate clients conceive. Congress long ago immunized vaccine manufacturers from most lawsuits that might result from nasty reactions to their formulae. The men of the Supreme Court unanimously approved in 2011. (Of three female Justices, two opposed the ruling and the third recused herself because of prior involvement in the case.)

Even if they do maximize production—and enough sterile chicken eggs manage to survive avian flu to make doses for all—millions stand ahead of you and me. The prime guinea pigs will be cops, soldiers, nurses, and firefighters. I won’t envy those human betas baring arms for Uncle Sam. I’ll wish them minimal side effects as I pore over test results from around the world.

At best, it will probably be four or five months until ordinary people begin getting vaccinated. We’re on our own.

Day 48: Plasmapheresis: The Great Red Hope?

DESPERATE MEASURES: FLU ANTIBODIES MAY BE OVERRATEDPublic health partisans have flayed me all day for admitting I’m not dying to get vaccinated against H5N1, even though I haven’t told anyone else what to do. Antivaxers are screaming because I didn’t tell people not to get vaccinated. Of course I know about the mercury in flu shots; people should worry more about all the other ways we consume mercury, starting with fish and coal burning.

Folks, you can all take those threats and shovel ‘em where the sun don’t shine. I’m a free man in a free Village.

My partner disagrees. He says I work for him in a corrupt society and that the antivaxers are right. What shall I do?

Hey, I’ve got it! Let’s call him ‘Fitch’—as in Ezra. H. Fitch, David T. Abercrombie’s associate.

Then we’ll discuss a slightly more natural way to gain immunity to H5N1. I’ve been wondering if any recent flu victims were given transfusions. People are mobbing hospitals for procedures they wanted to undergo in April. What if the blood supply is awash with H5N1?

In 1984 a baby who had received blood in San Francisco came down with AIDS. Even though a local blood donor was known to have died from the mysterious condition, authorities paid no attention. Doctors who warned that the blood supply might be tainted were denounced as alarmists. HIV entered the nation’s blood reserve and 35,000 Americans were transfused with it.

No one panicked. The CDC’s budget was reduced. Federal AIDS researchers were told to cut back on spending for laboratory equipment and conference travel. In 1984, you see, they expected a vaccine within two years for whatever caused AIDS. They didn’t feel like fussing over short-term details.

There’s still no vaccine for HIV/AIDS. But some scientists think blood extracted from avian flu survivors may contain useful antibodies that could help sick patients recover. A few studies from the 1918 pandemic imply that plasmapheresis—also known as therapeutic plasma exchange—might work. I wonder how long it will take survivors to auction their blood on eBay? (I can’t imagine a dumber, riskier purchase than buying injectables from an online stranger.)

Some hospitals claim outstanding results. Others say the difference is marginal. China keeps trying plasmapheresis. Exposure is not reported to have killed anyone.