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FAA change of acceptable EKG range.


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This link is making the rounds on airline pilot union boards.  The new range is, apparently, fact.  The cause for the new range is speculation.

https://stevekirsch.substack.com/p/the-faa-has-very-quietly-tacitly

This might be good if your EKGs have raised the FAA's "interest".

A local AME has opined that the FAA is too slow and too disorganized for this to be a reaction to anything and this was something probably in the works for years...after that he added, "But I'm not going to get any more boosters". :lol:

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24 minutes ago, Mooneymite said:

This link is making the rounds on airline pilot union boards.  The new range is, apparently, fact.  The cause for the new range is speculation.

https://stevekirsch.substack.com/p/the-faa-has-very-quietly-tacitly

This might be good if your EKGs have raised the FAA's "interest".

A local AME has opined that the FAA is too slow and too disorganized for this to be a reaction to anything and this was something probably in the works for years...after that he added, "But I'm not going to get any more boosters". :lol:

I saw this as well. I was immediately skeptical not only of the reason for the change but that the change happened at all.  After reviewing, the change is indeed as you said a fact. I am interested in hearing from folks who might know the reasoning for the change.  Almost all of the literature on line (NIH, Harvard and others) suggests that the normal range for a PR interval is 120-200 milliseconds with exceptions made for the very old.  Interesting piece below that references data from the pilot population.

https://www.sciencedirect.com/topics/neuroscience/pr-interval#:~:text=The PR interval%2C measured from the onset of,AV conduction may be a more appropriate term.

 

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From the link in my post above:

"A PR interval longer than 0.2 second occasionally is seen in apparently healthy individuals. It was found in 0.52 percent of 67,375 asymptomatic male pilots examined by Johnson and associates."

Increasing the interval range by 125% seems like a significant increase.  Perhaps the they have found that most prolonged intervals are benign.  It would be interesting to see the data on first class medicals in from 2022 and see if the .52% of test population number remains.

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I originally thought this was a link to an Onion article but was disappointed to learn (that like some Onion articles) people are taking this crap seriously. I loved the “Why we (sic) sure it was the vaccine that did it” and his very scientific approach to this problem.

For my mental health, I try not to argue with manipulative nut jobs on the internet (too much) but if you find his arguments persuasive then go ahead and skip the vaccine. I read 20-30 EKGs a day at work and order at least 10 high-sensitivity Troponin tests every day and have been doing so since before the first vaccine came out.  I think if there was some real widespread cardiac damage from the vaccines I would have seen it (and so would have thousands of other people who do the same thing I do).

But don’t believe me. I’m clearly just part of the conspiracy.

“Why we sure it was the vaccine that did it

There are several clues that are consistent with “it was the vaccine and not COVID”:

  1. They were quiet about it. If it was COVID, you can be public. But the vaccine is supposed to be safe.

  1. The timing. October 2022 is late for COVID. If it was due to COVID, it would have happened well before now. They can make changes every month.

  2. The vaccine creates far more injury to the heart than COVID (which creates NO added risk per this large-scale Israeli study of 196,992 unvaccinated adults after Covid infection).

  3. Anecdotally, cardiologists only started to notice the damage post-vaccine.

  4. All the sudden deaths started post-vaccine”

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The plain and simple answer which has been missing from so much of the Covid discourse from our public health officials is "we don't know". How can you know the long term effects of a vaccine created at "warp speed" on a new and novel virus using a relatively new process at a level never before seen? Billions have got the vaccine and there is little near term effects, but by definition we can't know the long term. "I don't know" I learned is very powerful when I became a Captain in my PA to my passengers. When you don't know, just say so. By doing so, it puts us all in the same pot and battle together. 

 

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1 hour ago, GeeBee said:

How can you know the long term effects of a vaccine created at "warp speed" on a new and novel virus using a relatively new process at a level never before seen?

this is really two points that are no necessarily related the the way you describe
 

1. how can we know the long-term effects? we don't, and this is true for any drug, and some of the long-term effects of rx drugs have taken decades to show up (HRT increasing risk of breast cancer) and often have indirect effects, such as long-term benzodiazepine usage inducing falls. the question is one of weighing the long-term risks against the benefits

2. "warp speed", novel virus, new process, etc -- its worth reviewing the counter-arguments for these types of claims: https://www.umms.org/coronavirus/covid-vaccine/facts/testing

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As someone who spent years in the chemo room with his wife getting drugs on "clinical trials" I am all too familiar with clinical "testing". The tests are rigged. They don't simply put someone with a given condition in the chair, there are very narrow parameters for clinical trials and those parameters do not reflect the population at large. For instance, my wife desperately wanted to be in a trial but could not, because her blood potassium was too low. Try as she might to raise it including an infusion of potassium, she never made the trial. Here is the dirty secret, lots of cancer patients have low potassium so why exclude them? Years later when that therapy came out, there was no limitation on potassium levels, it simply was touted as safe and effective. Simply put, you don't know and you can't know longer term effects on an entire population at large. 

Look at the recent shingles vaccine. We were told it works, now we are told it does not work in the long term. Everyone now needs to get a new vaccine, shingrix. Equally so look at the recent upset in Alzheimers research. We have all these drugs, that are based on bad assumptions

As to the cite from umm.org allow me to quote:

"The FDA and Centers for Disease Control and Prevention (CDC) continue to monitor the safety of the vaccines and alert the public about health problems that are reported after vaccination."

That is short hand for, "we don't know the future"

I'm not saying that is a bad thing, but have the humility to say it. We don't know and we won't know for years how it affects the general population.



 

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6 minutes ago, GeeBee said:

As someone who spent years in the chemo room with his wife getting drugs on "clinical trials" I am all too familiar with clinical "testing". The tests are rigged. They don't simply put someone with a given condition in the chair, there are very narrow parameters for clinical trials and those parameters do not reflect the population at large. For instance, my wife desperately wanted to be in a trial but could not, because her blood potassium was too low. Try as she might to raise it including an infusion of potassium, she never made the trial. Here is the dirty secret, lots of cancer patients have low potassium so why exclude them? Years later when that therapy came out, there was no limitation on potassium levels, it simply was touted as safe and effective. Simply put, you don't know and you can't know longer term effects on an entire population at large. 

Look at the recent shingles vaccine. We were told it works, now we are told it does not work in the long term. Everyone now needs to get a new vaccine, shingrix. Equally so look at the recent upset in Alzheimers research. We have all these drugs, that are based on bad assumptions

As to the cite from umm.org allow me to quote:

"The FDA and Centers for Disease Control and Prevention (CDC) continue to monitor the safety of the vaccines and alert the public about health problems that are reported after vaccination."

That is short hand for, "we don't know the future"

I'm not saying that is a bad thing, but have the humility to say it. We don't know and we won't know for years how it affects the general population.



 

then I recommend you don't take them.

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2 hours ago, GeeBee said:

The plain and simple answer which has been missing from so much of the Covid discourse from our public health officials is "we don't know". How can you know the long term effects of a vaccine created at "warp speed" on a new and novel virus using a relatively new process at a level never before seen? Billions have got the vaccine and there is little near term effects, but by definition we can't know the long term. "I don't know" I learned is very powerful when I became a Captain in my PA to my passengers. When you don't know, just say so. By doing so, it puts us all in the same pot and battle together. 

 

Realize the the long term testing, which is the only thing that got shortened, is only to determine how the efficacy degrades over time.  They just had a much bigger test group.  And that testing is typically 2 years.  So we are already past the end of any testing under the normal time line.

 

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7 hours ago, GeeBee said:

The plain and simple answer which has been missing from so much of the Covid discourse from our public health officials is "we don't know". How can you know the long term effects of a vaccine created at "warp speed" on a new and novel virus using a relatively new process at a level never before seen? Billions have got the vaccine and there is little near term effects, but by definition we can't know the long term. "I don't know" I learned is very powerful when I became a Captain in my PA to my passengers. When you don't know, just say so. By doing so, it puts us all in the same pot and battle together. 

 

@GeeBee, I find your arguments persuasive and probably some of the most rational and well reasoned on this site. You are absolutely correct. We don’t know the long-term effects of anything until the long term has passed. This applies to novel diseases as well as novel vaccines. No one predicted post-polio syndrome until patients who had polio as children developed worsening muscle weakness as adults. People didn’t know childhood mumps led to infertility problems until those children tried to have kids.

In a time of uncertainty we have to choose between multiple unappealing options based on limited information. As an ER doctor, this is something I do every day. As an airline pilot, you probably had to do this as well.
 

Given the choice of the vaccine or the disease, I chose the vaccine. Is it a gamble? Of course. But having seen what the disease did in the short term (and not so short term) I tried to do everything I could to reduce the risk to myself and my family. Other people, given the same information, made different choices. I have no problem with this. What bothers me is people INTENTIONALLY spreading misinformation which they know to be false for personal gain.  I think that is inexcusable. People who don’t know what they’re talking about authoritatively trying to force their views on others is a close second and often seems to be more related to their political views than their particular knowledge on a subject. This is unfortunate.

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It's funny how people constantly attempt to pick apart the scientific process, and can attempt to because it, by its very nature, (should) invite open discourse and debate

I'd speculate this guy would only be open to diatribe, and puts himself in a position where he can't be proven wrong.  That's the sure sign of a quack in my business.

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3 hours ago, ilovecornfields said:

@GeeBee, I find your arguments persuasive and probably some of the most rational and well reasoned on this site. You are absolutely correct. We don’t know the long-term effects of anything until the long term has passed. This applies to novel diseases as well as novel vaccines. No one predicted post-polio syndrome until patients who had polio as children developed worsening muscle weakness as adults. People didn’t know childhood mumps led to infertility problems until those children tried to have kids.

In a time of uncertainty we have to choose between multiple unappealing options based on limited information. As an ER doctor, this is something I do every day. As an airline pilot, you probably had do do this as well.
 

Given the choice of the vaccine or the disease, I chose the vaccine. Is it a gamble? Of course. But having seen what the disease did in the short term (and not so short term) I tried to do everything I could to reduce the risk to myself and my family. Other people, given the same information, made different choices. I have no problem with this. What bothers me is people INTENTIONALLY spreading misinformation which they know to be false for personal gain.  I think that is inexcusable. People who don’t know what they’re talking about authoritatively trying to force their views on others is a close second and often seems to be more related to their political views than their particular knowledge on a subject. This is unfortunate.

It is a crap shoot. I watched my present wife's friend die of Covid this last August. I was right in the room hours before she passed. It was ugly. She was not vaccinated, she believed the nay sayers, she gambled and she lost, big time. Did I fear I would get Covid from being in the same room? Hospital said, "Hey you're vaxxed, you're masked, no problem" but there is so many out there who were vaxxed and still got it. The value of seeing her and raising her up? Worth the risk even if she made a bad risk assessment. You are correct, life is full of risk assessments.

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6 hours ago, GeeBee said:

"The FDA and Centers for Disease Control and Prevention (CDC) continue to monitor the safety of the vaccines and alert the public about health problems that are reported after vaccination."

 

In case you hadn't noticed, they do that for Tylenol and aspirin, too :) That's their job.

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56 minutes ago, GeeBee said:

It is a crap shoot. I watched my present wife's friend die of Covid this last August. I was right in the room hours before she passed. It was ugly. She was not vaccinated, she believed the nay sayers, she gambled and she lost, big time. Did I fear I would get Covid from being in the same room? Hospital said, "Hey you're vaxxed, you're masked, no problem" but there is so many out there who were vaxxed and still got it. The value of seeing her and raising her up? Worth the risk even if she made a bad risk assessment. You are correct, life is full of risk assessments.

I’m sorry about your wife’s friend. It is not pleasant at all and unfortunately millions of people have had similar experiences in the last few years. My wife and I both studied public health before medical school. We were shocked and disappointed by how our health system responded to this crisis. Absolute failure. From the moment the CDC told the public to not wear masks I knew this was going to be a sh*t show, I just never anticipated how bad it would get. From the get go the messaging was inaccurate and manipulative from all sides. While I understand the reasoning for the CDC telling people not to wear N95 masks at the beginning (so that healthcare workers could stay protected and stop the spread), it completely backfired and made them lose credibility.  Then the denial and conspiracies started and in an effort to clear the air they made statements which were probably stronger than they should have been and only served to further destroy the limited credibility they still had.

Science is not black and white. Nor is it static. As new information becomes available and further analysis is done, a true scientist  modifies their hypotheses. There isn’t “proof” or “absolutes.” Even when you “disprove the null hypothesis” a scientist understands that you haven’t actually proven anything and your results might be due to chance, bias, confounding or myriad other reasons. Scientists understand this. Epidemiologists understand this. Most physicians understand it. The problem is many lay people don’t understands these issues and think that by using the language that scientists and epidemiologists use that makes them qualified to “interpret the data for myself” and when influencers decide to do this they are remarkably effective at convincing a large number of people of their conclusions, regardless of the logic and scientific merit.

There are many terms that physicians and epidemiologists use that have specific meanings, often different that how the public uses these words. When I say “the flu” I mean “the influenza virus” not that stomach thing that gave you diarrhea after eating Chinese food or the cold you had last week.  When the FDA says something is “safe and effective” that does not mean it carries zero risk or that it is 100% effective at curing disease (or alleviating symptoms). Most people regard Tylenol as safe and effective but a quick search shows that in one year annually there are 56k ER visits, 26k hospitalizations and 450 deaths from acetaminophen. Yet any kid can buy it off the grocery store shelf. People love to point out that the mRNA vaccines have been associated with myocarditis, but somehow ignore the fact that COVID has also been associated with myocarditis - at much higher rates, with much more severe disease and with orders of magnitude higher mortality. Is COVID safe and effective?

All of these words have meaning and if your goal is to confuse people and make them scared then it’s very easy to do so by using fancy words and pointing out how your “common sense” knows better than those scheming scientists (remember the whole mosquito in the chain-link fence analogy?)

As you stated - life is full of risk assessments and risk. At work, I try to give patients guidance so they can make informed choices about these risks and choose the option they feel is best for them. I recently told a patient about two options for dealing with her symptoms and she said she didn’t like either one. I told her I understood it was like asking her if she wanted to eat a day old pizza that was found on the ground or a snickers bar that someone had stepped on. She chose the snickers bar.

Online forums are great ways for people to connect to a broad audience but horrible ways to have meaningful discussions. I appreciate you taking the time to read this and contribute to the discussion. 

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The CDC has been a failure for years. I was part of a working group at my airline when the Ebola crisis broke out. The CDC came over to brief us (they are in the same city) and I asked a simple question. "What do crew members do and what isolation is required if a passenger breaks out with Ebola symptoms?" What I got back was a lecture on not eating bush meat and not coming in contact with human feces. It was lame, really lame even for a layman like myself. As you remember it was Samaritin's Purse who flew a Dr. Brantley back to Emory in ATL in an specially fitted Gulfstream and tested a vaccine on him. Dr. Brantley's news conference is impressive. 

I have suggested to my Congressman that the CDC be dismantled and contracted out to a university to operate much like the DOE operates the nuclear programs.

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38 minutes ago, GeeBee said:

The CDC has been a failure for years.

But @GeeBee, do you remember when Delta 727 Second officer training was in the CDC building off of Virginia Avenue?  :lol:

I think we all got infected with something....!  :ph34r:

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On 1/17/2023 at 1:29 PM, Mooneymite said:

A local AME has opined that the FAA is too slow and too disorganized for this to be a reaction to anything and this was something probably in the works for years...after that he added, "But I'm not going to get any more boosters". :lol:

This local AME has sent this to me:

On a basic EKG, there is the "P wave", followed by the "QRS complex", followed by the "T wave".
 
The P wave is the atria (upper chambers) firing (contracting), the QRS is the ventricles firing, and the T wave is the ventricles "repolarizing".
 
If the "P-R interval" is prolonged, it is considered "first degree heart block" and it is less than a specified interval, it is considered a "normal variant" and isn't a problem.  The AME can issue normally, and life is good.
 
Up until October of 2022, if the interval was more than 0.20, and less than 0.21, it was considered a normal variant, and issuance was normal.  If longer than 0.2 seconds (200 milliseconds), the AME had to get authorization to issue (usually just a phone call) and issuance was normal.
 
In October, the AME guide was updated, and if the interval was longer than 0.20, and less than 0.30, issuance is now normal.
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28 minutes ago, GeeBee said:

The CDC has been a failure for years. I was part of a working group at my airline when the Ebola crisis broke out. The CDC came over to brief us (they are in the same city) and I asked a simple question. "What do crew members do and what isolation is required if a passenger breaks out with Ebola symptoms?" What I got back was a lecture on not eating bush meat and not coming in contact with human feces. It was lame, really lame even for a layman like myself. As you remember it was Samaritin's Purse who flew a Dr. Brantley back to Emory in ATL in an specially fitted Gulfstream and tested a vaccine on him. Dr. Brantley's news conference is impressive. 

I have suggested to my Congressman that the CDC be dismantled and contracted out to a university to operate much like the DOE operates the nuclear programs.

That's a pretty strong opinion to be based on one interaction, isn't it?  That's like telling someone who's had a gear-up landing their ticket should be taken away, and they should never fly again because they're a failure.

FWIW as a physician, I think they've been a pretty solid agency until perhaps the past 4-5 years.

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16 minutes ago, jaylw314 said:

That's a pretty strong opinion to be based on one interaction, isn't it?  That's like telling someone who's had a gear-up landing their ticket should be taken away, and they should never fly again because they're a failure.

FWIW as a physician, I think they've been a pretty solid agency until perhaps the past 4-5 years.

We here in the ATL have been watching the CDC gravy train for years. 

They failed spectacularly on the Bird Influenza of 2005-2006 

They had a complete institutional failure in the Ebola epidemic. Other agencies had to step in

Now we have the Covid failure which even the director of the CDC admits they botched

We can't afford any more failures. Three strikes. 

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22 minutes ago, GeeBee said:

We here in the ATL have been watching the CDC gravy train for years. 

They failed spectacularly on the Bird Influenza of 2005-2006 

They had a complete institutional failure in the Ebola epidemic. Other agencies had to step in

Now we have the Covid failure which even the director of the CDC admits they botched

We can't afford any more failures. Three strikes. 

Like I said, we probably disagree.  Handing it over to university based agencies and think tanks just opens another can of worms that I think is fundamentally worse.

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It has worked perfectly fine for our nuclear weapons programs.

Lawrence Livermore Labs has been run by UC Berkley with help from Bechtel.

Oak Ridge National Labs is operated by the University of Tennessee

Sandia National Labs is operated by Honeywell Inc.

I think an institution like Johns Hopkins, University of Washington, Cleveland Clinic, University of Pittsburgh et al could all operate the CDC more effectively and serve the United States better. Doctors don't need to be on the civil service payroll to do good research and medicine.

 

 

 

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