Please, please, please, unless your patient will die without a fluoroquinolone antibiotic, and there is no other possible drug that could save them, please do not prescribe fluoroquinolone antibiotics and spread the word that they can cause horrific symptoms and lifelong debilitating. Especially when prescribed concurrently with a cortical steroid in a patient over 60. FDA black box 2008. Nerve damage is 2016. I forget what your aortic dissection is. And there are countless other ruinous risks to patient mobility and balance and lifetime health.

Undisclosed to patients. Like me. Had my exceptionally negligent Kaiser Permanente Crenshaw cornea surgeon disclosed the risks of FQs, I would’ve asked for an alternative that did the job without these risks. And there are three.

And yes, despite FDA egregiously & unscientifically claiming risks of systemic absorption are only from oral & injected, they are also from eye and eardrops. Case reports of both + I’ll campaign to get both researchers to study this so that can be brought out more than it has been by Sullivan and others, and press FDA to stop this absolutely scientifically unwarranted & harmful claim that only the oral and injected forms have systemic effects.

Has no one heard of Carl Sagan? and beyond case reports from ocular and ear drops, there are surely numerous undiagnosed cases of patients suffering FQ debilitation due to eye & eardrops.

Tho this sparse evidence DOES exist, Sagan: “Absence of evidence is not evidence of absence.”

As soon as I complete my absolute egregious fight since October 7 to get Kaiser to give me the diagnostic imaging I need to know which tendons are in danger of rupture so I can minimize or avoid use of those parts, and get tests for the progressive and progressing large fiber & small fiber neuropathy symptoms I have, I will fight to help other patients get care and I will also follow through on asking @SecKennedy to have me (as a medical expert in both transdisciplinary medical science and delivery of care) testify to FDA about denial of care now endemic at numerous medical institutions.

I’m also good with talking with an expert at the FDA to petition them to recognize the problem. I prefer testifying so it is transparent to the public and I can post it on social media and let people know.

I already have solutions (see Chap 2, GOING MENOPOSTAL: What you (and your doctor) need to know about the real science of menopause and perimenopause (@BenbellaBooks).

Essential is making up for lack of evidence behind much of our medical care, bc med schools obscenely turn out class after class without training them how to read and critically evaluate research. Med institutions must backstop doctors’ lack of knowledge/ability to read research and frankly, lack of time to read it at an institution like Kaiser.

They see patients every 20 minutes + have onerous elec medical record keeping requiremts. As I’m sure many of you do.

You either go home at 9 PM after transcribing audio recordings of patient sessions or you look into your screen thruout appt & possibly miss a subtle signal like a twitch in your patient’s face that suggests a potential serious problem.

@KPMemberService Kaiser Permanente is behaving monstrously—to exactly the wrong person. No patient should be treated this way. But this patient is an expert on laws on delivery of care; I write correct ICD-10 codes inc new FQ diag code, & I even wrote the only correct MRIs I’ve gotten. Put in for me by my fucking hero gynecologist.

Phys med head (who opened appt by calling Chinese “medicine” a “different way of seeing” & talked of meridians—pseudoscience!) is so terrible at her job that she didn’t know to write separate hand & joint (wrist) MRIs, which meant field of view was too large to pick up need detail.

Instead of clinical condition of FQ tendonopathy &signs of it like surrounding tissue edema that proceeds rupture, she sloppily &wastefully wrote MRIs for “diffuse pain.” (1/2) Tragic waste of 4 MRIs that need to be redone. Simply evil arrogant carelessness. At least other phys med doctor I saw by using fact that I’m entitled to a 2nd opinion by law looked at MRI sequence I wrote at my request & ended up copying it word for word. Bc yes, I can write MRI orders that well, & believe me I had no idea how to write one in September.

I know the laws on delivery of care, I have filed such a strong IMR with the California Department Of managed care that they didn’t wait 30 or 45 days but went after Kaiser in under a week.

Still, my care is inappropriate and denied in many cases or they just don’t know the test or how to perform it. And we’re talking 3 mm skin punch biopsy for small fiber neuropathy. This is a Neuro standard and the head of neurology, who does not know what reactive oxygen species are, and thus did not test me for the mitochondrial harm and oxidative damage that he does not understand. Only inflammation metrics which I knew were fine. 0.3 CRP. Sed rate of 3, etc. I had to scheme my way to mito health/oxidative harm (MMPs + excess ROS) through begging various doctors.

Kaiser has behaved so egregiously to me that it’s mind blowing. I was told by the officious little social worker tasked with throwing me out of the building (or rather having the poor security guard to the dirty work) that Ameen Dinani was behind throwing me out. He told me that about a minute after he told me he was not at liberty to tell me who was who is behind throwing me out, because I am a mediator and I knew what exactly what was happening and I remain the picture of the picture of calm.

I didn’t bite at a single bit of the various forms of bait that the guy threw at me. I believe these were intended to rile me and get me to act out. Poor guy. The more he kept at it, the more I simply calmly and more calmly simply disputed all the textbook Robo-stated therapyspeak the guy was throwing at me. It was rather hilarious. It was like being in a medical car crash that would have no physical damage but was really fascinating.

He had nbeen asking me what my purpose was in the lobby. And the purpose was to beg for a cancellation appointment at another dept that was still open. But he talked over me every time I tried to answer.

And I of course did not raise my voice a smidgen or show anything but cool— the antithesis of the crazy patient making a fuss. Then he gets to throw them out & isn’t he a wonderful hero, this tightly wound little man, with the air of contempt and passive aggressive rage, irate that I didn’t fit textbook upset patient ranting and raving & just sat there probably barely containing a smile as he tried his next tactic: we should use active listening. Mediator tool that makes you sound like a robot. He just needed to use listening listening, like a human being, as the guard was. This poor guard, tall, kind face, African descent, enlisted to throw out a 61-year-old woman who can no longer walk properly. I looked at his kind face. And into his eyes. HE couldn’t help but show that he felt compassion for me. And I would guess probably rightly that he thought what they were doing to me was horrible.

Again, since October 4 when they started in October 7 when I put in the request that kicked off “timely access” rules of @cadmhc that probably only the rare patient knows about but I know about, all I wanted was to try to mitigate the horrific harm by their doctor with appropriate & urgently needed imaging & nerve tests so I might have a chance of stopping the progression of the nerve damage taking my balance and so I could know which tendons were at risk so I could avoid or minimize using those parts of my body.

My calm and continued calm so got this officious little social worker—with those bulging veins in his forehead an angry little eyes—more & more irate that I got him off his game totally.

He blurted out that it was head of BM & rehab at Kaiser West LA, Ameen Dinani who was behind throwing me out! (2/3)

I’m being forced to make a terrible trade-off due to Kaiser Permanente’s ongoing aggressive negligence in the wake of their doctor's breathtakingly negligent prescribing.

I have to risk (possibly irreversible) harm to my tendons to try to stop the neuropathy—nerve damage—that may compromise my ability to balance and move for the rest of my life.

My negligent Kaiser eye surgeon caused both of these debilitating harms by basically using an FDA black box warning about a dangerous drug combination as a recipe for "care." (🧵1/9) FDA 2008 black box on fluoroquinolone antibiotics (there are a bunch more in subsequent years):

Fluoroquinolone antibiotic + corticosteroid in patient over 60—risks irreversible tendon damage, including 46-fold increased risk of Achilles tendon RUPTURE from "routine movement." (🧵2/9)

The West Bank is sovereign Israeli territory. It belongs to the UN-recognized state of Israel and is part of Israel under international law. It is a complete fiction that Israel is "occupying" the West Bank.

As @AviKaner puts it in a post: "It was only called 'West Bank' after Jordan forcibly annexed territory in 1948. It has never been a sovereign state. And of course Israel must maintain security to prevent Hamas Muslim Brotherhood & Islamic Jihad from taking it over like Gaza."

@afagerbakke: "Israel does not intend to 'annex' Judea & Samaria, territory to which it has legitimate claim and that never has been part of a “state of Palestine.” More accurate would be to say that Israel is 'extending Israeli sovereignty' to parts of Judea & Samaria.

@haivri: "#Israel should declare sovereignty in Judea and Samaria based on the fact that it is Israeli territory. All countries who have relations with Israel should honor that."

And here's Jerold Auerbach:
(1algemeiner.com/2020/06/25/ann… Excellent @politicalelle piece here with brief review of the history: (2 thefederalist.com/2019/09/11/isr…

We Jews thought we were safe in America. I no longer feel that with so many mobs on the streets openly calling for the mass slaughter of Jews.

Here in Venice, we just had these terrorism-loving monsters shouting for the slaughter of all Jews -- and note the "from the river to the sea" signs. Marching through a residential neighborhood where many Jews live. It's terrifying and I'm guessing it was meant to terrify.

I went out and yelled, repeatedly, "I'm a Jew! I'm a Jew! I support the state of Israel!" and "Am Yisrael chai!"

This horrible bully -- the tall bearded male in the green vest-- kept advancing on me. Gotta show the Jew woman her place, right? Intimidate her into shutting up and going away.

Of course, as a man, he is taller and stronger than I am, and when I told him to back off, he didn't -- kept advancing, clearly to intimidate me -- a thin 59-year-old woman who writes books, out on the street in her slippers.

Well, I was afraid, but I held my ground as much as I could while backing away from him.

It's just what had to be done. I'm still shaking and I can't stop crying. This is America now? Really?

And, from the bottom of my heart, I thank every one of you Americans who stands against this -- like the many beautiful Christians here on Twitter who showed me the Jewish stars they'd just taken to wearing. And I thank the Muslims who express their horror at this, and especially those who do it publicly, like a number of the wise voices I've discovered here on Twitter.

Never again!

Am Yisrael fucking chai!
I was mentioning at the end how Israelis care for Palestinians in Israeli hospitals, giving them the same excellent care Israelis get and putting them before Israelis for treatment if they are sicker.

Israel has a hospital now near the border where they are giving medical care to Syrians.

And they take just extraordinary measures to avoid the death of civilians - which is just terrible, and I lament every one...yes, every Palestinian civilian kills is a tragedy to me - while they do what they must to stop the depraved Hamas terrorist savages from burning Israeli families alive and all the rest on, say, February 7 and May 7.

Hamas is source of terrible evil - not just for Israelis but for Palestinian civilians, as you'll see from the Palestinian social activist who had her eyes opened when she went to Gaza to try to improve the education and other things for Palestinian civilians.

One component of mating intelligence is cross-sex mind-reading. -@CostelloWilliam @HumBehEvoSoc #HBES2023

When to treat interpersonal information (like past behavior…cheating, for example) as diagnostic. @TaniaArline @HumBehEvoSoc #HBES2023

We need to seek status without appearing to seek status. @DavidPinsof @HumBehEvoSoc #HBES2023

Miriam Lindner now up at @HumBehEvoSoc #HBES2023 post-doc research award finalist talks

Michael Rose on the diet that maximizes healthspan — and lifespan. As I see it, if you don’t have your health and you live long…it’s Hobbesian with a twist: Nasty, brutish, and endless.

First, he lays out the opposing viewpoints. Important thing to remember to understand slides for this talk: “x” is chronological age.

In 1992, this Hamiltonian theory…and then the curveball it gets thrown, next slide.

Marco del Giudice #HBES2023 talking on a general architecture for motivation, emotion, & personality. Check out his terrific book, “Evolutionary Psychopatholgy.” Well-worth buying despite how academic books cost you several limbs and maybe a first-born child. Mechanisms that support motivation and personality: reconstructing it from the bottom up, from the specific mechanisms. A mechanistic point of view. These models converge on motivational level of analysis of personality.

Geoff Miller @primalpoly on what evolutionary psych can learn from polyamory. #HBES2023 @primalpoly What predicts anti-poly stigma? Results surprising.

We rely on cues to potential opportunities and threats because we often can’t directly identify them. -Steven Neuberg @HumBehEvoSoc on the evolutionary logic of stereotyping, stereotypes, prejudice, and discrimination. #HBES2023

Slides follow, bc he goes thru this info fast!

It's my experience w/every primary care doc I've ever had (& all specialists, save one) that doctors really, really need better training in diagnostic thinking. Basic errors in logic are frequent, inability to recognize conditions that co-occur are not nec. linked, etc. I read (1 medical literature and lit about cognitive biases and other errors in reasoning, so I am able to self-diagnose in a way few patients probably are. But most patients are at the mercy of a doctor who probably lacks fundamental reasoning skills necessary for figuring out what is (2

LA is lawless shit-hole, bc pols took away enforcement measures police can use to get abusers to curb behavior. Aggressive, loud hipsters (not homeless) "camping" in tricked out van in front of my house. Guy runs motorcycle to make noise/pour fumes into my house. Police powerless Police do what they can to stop abuse of residents & hoped to tow van for expired registration (or use it to get them to move, which wld have been fine w/me). Turns out reg is in prog, so they can't. Now say I shld get restraining order to stop abuse. Afraid to leave house.