StudyLTCOVID.com

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What follows on this page has nothing to do with COVID-19, the principle subject of this site.

But this is my webpage, and that allowed me to place here, the following thoughts.

For German and French versions, see below...

Für die deutsche und französische Version siehe unten...

Pour les versions allemande et française, voir ci-dessous...

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This review is really not about the seller.

The product arrived well packed or protected, intact when opened, and with a reasonable shipping delay.

As others reviewing here have noted and which I confirm:

- it is possible to expect from the presentation of the product that one is buying two sensors. It is only one.

- one might think that in buying the Reader of the sensor, that that would be a complete set or kit, including a sensor or two. Everything ready to go for your first glucose reading. Are you kidding? Not !

- when I followed the instructions and placed the Libre 2 sensor, 7 times in a row it informed: “not ready yet, try again in 10 minutes.” After 80 minutes delay, it never worked.

- just as bad, after a few hours it simply informed: “Sensor Ended. Start a new Sensor to read glucose.” I looked in my medicine cabinet, but did not have another sensor. Delay to get one (even with Prime) 7 to 10 days. Why should I even worry about my blood glucose level for 7 to 10 days. Vacation !

Clearly (as with others who have lived this same experience and reported here) Amazon is selling defective product for the FreeStyle Libre 2 device.

I don’t think that Amazon is plotting to do this and trying to get away with it. I think they just needed to hear more feedback. They don’t know yet. Abbott may not care.

And Abbott it too large a company to try to push its shelf stock like that either (or so I hope). The Directors don’t like the idea of having to pay their attorneys even more than they do already.

Of course, the FreeStyle Libre 3 (three) is the updated product. It is more expensive that the 2. The sensors for 3 are more expensive than the 2.

They proclaim the 3 is it more accurate and works better than the 2. I don’t know. I could not compare with the 2 since my 2 has a sensor that has been Kaput right from the start.

I don’t need to know the details about those decisions. I don’t want to invoke a corporate-driven conspiracy. But at the price I paid for these objects, especially when a simple fingerstick machine is so much less expensive (and the golden standard referred to by Abbott when their product’s results seem questionable), this represents a reprehensible outcome for the the manufacturer, the seller(s), and especially, the client. Also, could be very dangerous if a person was counting on this to check his or her sugar before deciding on a dose of insulin to administer.

“Go buy a new sensor.”

Oh.

Other things I have learned:

- today as well, the Freestyle Libre 3 sensor worked without any problem. I read the interstitial fluid glucose results with the application on my iPhone. No problem. But when I tried to confirm the reading with the Libre 3 Reader: it informed me that the sensor was already matched to another device (the iPhone app) and would not read the sensor. So I suppose that if I buy another Lbre 3 sensor and stick it on my body somewhere else, the Reader will now find it. But not the iPhone app ! Ridiculous ! And once again, what could have been interpreted as a box with 2 sensors (on the images) was only 1 sensor for FreeStyle Libre 3.

- the person sending the sensors included in the package a special deal: a sensor for 80€ instead of 98€, undercutting the Amazon price. But at this special price only if purchasing 2 sensors. So 160€, special deal, for my next 2 sensors.

So don’t be an uninformed consumer. Throw away your Freestyle Libre 2 today. Do it right now. Then order a Freestyle Libre 3. Don’t forget: the sensors (perhaps 5 or 6) but also the Reader. Or get the iPhone app. (No Smartphone? Buy one at the same time. Then get the app. Then get the sensors).

I’m a physician, and perhaps from what has now become “the old school.” But I find this yet another example of how businessmen have entered Medicine for only one reason. Profit. Because we (physsicians, patients, insurers) let them get away with it. They would respond something useless like: “These are simply market-driven decisions. That’s how we operate.” Well my results were much better than theirs so far, when I used to operate beneath hot lights, with cold steel. And when they have completely ruined Medicine, not a problem. They’ll simply sell shoes or bowling balls or fishing poles, just like before.

Caveat emptor ! Caveat aeger !

(Let the buyer beware ! Let the patient beware !)

William O’Neill, MD

-------------  Wie oben, auf Deutsch  -------------

In dieser Rezension geht es eigentlich nicht um den Verkäufer.
Das Produkt kam gut verpackt oder geschützt, unversehrt beim Öffnen und mit einer angemessenen Versandverzögerung an.
Wie andere, die hier rezensiert haben, angemerkt haben und was ich bestätige:
- Aufgrund der Präsentation des Produkts kann man davon ausgehen, dass man zwei Sensoren kauft. Es ist nur einer.
- Man könnte denken, dass es sich beim Kauf des Lesegeräts des Sensors um ein komplettes Set oder Kit handelt, einschließlich eines oder zweier Sensoren. Alles bereit für Ihre erste Glukosemessung. Machst du Witze? Nicht !
- Als ich den Anweisungen folgte und den Libre 2-Sensor sieben Mal hintereinander platzierte, kam die Meldung: „Noch nicht bereit, versuchen Sie es in 10 Minuten erneut.“ Nach 80 Minuten Verzögerung funktionierte es nie mehr.
- genauso schlimm, nach ein paar Stunden meldete es einfach: „Sensor Ended.“ Starten Sie einen neuen Sensor, um den Glukosewert zu messen.“ Ich schaute in meinem Medizinschrank nach, hatte aber keinen anderen Sensor. Es dauert (auch mit Prime) 7 bis 10 Tage, bis man eins bekommt. Warum sollte ich mir 7 bis 10 Tage lang überhaupt Sorgen um meinen Blutzuckerspiegel machen? Urlaub !
Offensichtlich verkauft Amazon (wie auch andere, die die gleiche Erfahrung gemacht und hier berichtet haben) ein defektes Produkt für das FreeStyle Libre 2-Gerät.
Ich glaube nicht, dass Amazon dies plant und versucht, damit durchzukommen. Ich denke, sie brauchten einfach mehr Feedback. Sie wissen es noch nicht. Abbott ist das vielleicht egal.
Und Abbott ist ein zu großes Unternehmen, um zu versuchen, seine Lagerbestände auf diese Weise zu erhöhen (zumindest hoffe ich das). Den Direktoren gefällt die Idee nicht, ihren Anwälten noch mehr bezahlen zu müssen, als sie es ohnehin schon tun.

Natürlich ist der FreeStyle Libre 3 (drei) das aktualisierte Produkt. Es ist teurer als die 2. Die Sensoren für 3 sind teurer als die 2.
Sie verkünden, dass die 3 genauer ist und besser funktioniert als die 2. Ich weiß es nicht. Mit der 2 konnte ich keinen Vergleich machen, da meine 2 einen Sensor hat, der von Anfang an kaputt war.

Ich muss die Details dieser Entscheidungen nicht kennen. Ich möchte keine von Unternehmen betriebene Verschwörung beschwören. Aber bei dem Preis, den ich für diese Objekte bezahlt habe, insbesondere wenn eine einfache Fingerstickmaschine viel günstiger ist (und der goldene Standard, auf den sich Abbott bezieht, wenn die Ergebnisse ihres Produkts fragwürdig erscheinen), stellt dies ein verwerfliches Ergebnis für den Hersteller und Verkäufer dar (s) und insbesondere der Kunde. Es könnte auch sehr gefährlich sein, wenn eine Person darauf vertraut, ihren Blutzuckerspiegel zu überprüfen, bevor sie sich für eine zu verabreichende Insulindosis entscheidet.
„Geh und kauf dir einen neuen Sensor.“
Oh.

Andere Dinge, die ich gelernt habe:
- Auch heute funktionierte der Freestyle Libre 3 Sensor problemlos. Ich lese die Ergebnisse der interstitiellen Flüssigkeitsglukose mit der Anwendung auf meinem iPhone ab. Kein Problem. Als ich jedoch versuchte, den Messwert mit dem Libre 3 Reader zu bestätigen, wurde mir mitgeteilt, dass der Sensor bereits mit einem anderen Gerät (der iPhone-App) verknüpft war und den Sensor nicht lesen würde. Ich gehe also davon aus, dass der Reader ihn jetzt findet, wenn ich einen weiteren Lbre 3-Sensor kaufe und ihn woanders an meinen Körper klebe. Aber nicht die iPhone-App! Lächerlich ! Und wieder einmal war das, was man als Box mit 2 Sensoren hätte interpretieren können (auf den Bildern), beim FreeStyle Libre 3 nur 1 Sensor.
- Der Versender der im Paket enthaltenen Sensoren erhält ein Sonderangebot: einen Sensor für 80€ statt 98€, was den Amazon-Preis unterbietet. Allerdings zu diesem Sonderpreis nur beim Kauf von 2 Sensoren. Also 160€, Sonderangebot, für meine nächsten 2 Sensoren.

Seien Sie also kein uninformierter Verbraucher. Werfen Sie Ihren Freestyle Libre 2 noch heute weg. Mach es jetzt. Dann bestellen Sie einen Freestyle Libre 3. Vergessen Sie nicht: die Sensoren (vielleicht 5 oder 6), aber auch den Reader. Oder holen Sie sich die iPhone-App. (Kein Smartphone? Kaufen Sie gleich eines. Dann holen Sie sich die App. Dann holen Sie sich die Sensoren).

Ich bin Arzt und vielleicht aus dem, was mittlerweile zur „alten Schule“ geworden ist. Aber ich finde, dass dies ein weiteres Beispiel dafür ist, dass Geschäftsleute nur aus einem Grund in die Medizin eingestiegen sind. Profitieren. Weil wir (Ärzte, Patienten, Versicherer) sie damit durchkommen lassen. Sie würden etwas Unnützes antworten wie: „Das sind einfach marktorientierte Entscheidungen.“ So funktionieren wir.“ Nun, meine Ergebnisse waren viel besser als bisher, als ich unter heißem Licht und mit kaltem Stahl gearbeitet habe. Und wenn sie die Medizin völlig ruiniert haben, ist das kein Problem. Sie verkaufen wie bisher einfach Schuhe, Bowlingbälle oder Angelruten.

Caveat emptor ! Caveat Aeger !

(Der Käufer soll auf der Hut sein! Der Patient soll auf der Hut sein!)

William O’Neill, MD

------------  Même que ci-dessous, mais en français  -------------

Cet avis ne concerne vraiment pas le vendeur.
Le produit est arrivé bien emballé ou protégé, intact à l'ouverture et avec un délai d'expédition raisonnable.

Comme d’autres l’ont noté ici (sur l'endroit de 'feedback' d'Amazon) et que je confirme :
- il est possible d'attendre de la présentation du produit que l'on achète deux capteurs. Il n'y en a qu'un.
- on pourrait penser qu'en achetant le lecteur du capteur, il s'agirait d'un ensemble ou d'un kit complet, comprenant un ou deux capteurs. Tout est prêt pour votre première mesure de glycémie. Est-ce que vous plaisantez? Pas ça du tout!
- lorsque j'ai suivi les instructions et placé le capteur Libre 2, 7 fois de suite il m'a informé : "pas encore prêt, réessayez dans 10 minutes". Après 80 minutes de retard, cela n'a jamais fonctionné.
- tout aussi mauvais, après quelques heures, il a simplement indiqué : « Capteur terminé. Démarrez un nouveau capteur pour lire le glucose." J'ai regardé dans mon armoire à pharmacie, mais je n'avais pas d'autre capteur. Délai pour en obtenir un (même avec Prime) 7 à 10 jours. Pourquoi devrais-je m’inquiéter de ma glycémie pendant 7 à 10 jours ? Vacances !
Clairement (comme d'autres qui ont vécu cette même expérience et l'ont rapporté sur leur site comme feedback) Amazon vend un produit défectueux pour l'appareil FreeStyle Libre 2.
Je ne pense pas qu’Amazon envisage de faire cela et essaie de "s’en sortir" indem. Je pense qu'ils avaient juste besoin d'entendre plus de commentaires de leurs acheteurs. Ils ne le savent pas encore. Ils attendent peut-être, le 'feedback' d'une centaine d'acheteurs.

Abbott ne s'en soucie peut-être pas plus que ça.

(
Et Abbott est certainement une entreprise trop grande, (et qui avait toujours auparavant une bonne réputation) pour essayer de pousser son stock de vielle marchandise en rayon comme ça non plus (du moins je l'espère). Les administrateurs n’aiment pas l’idée de devoir payer leurs avocats encore plus qu’ils ne le font déjà.

Bien entendu, le FreeStyle Libre 3 (trois) est le produit mis à jour. Il est plus cher que le 2 (deux). Les capteurs pour 3 sont plus chers que le 2. Ils sont soigneusement et intentionnellement conçus pour être des capteurs non interchangeables. Abbott en informe l'utilisateur si vous essayez d'effectuer une mesure avec le « mauvais » capteur ou lecteur.

Ils proclament que le 3 est plus précis et fonctionne mieux que le 2. Je ne sais pas.

Je suis sûr qu'ils ont payé un prix élevé pour des recherches visant à le prouver avant de le vendre.

Je n'ai pas pu comparer avec le 2 puisque mon 2 a un capteur qui a été Kaput dès le départ.

Je n’ai pas besoin de connaître les détails de ces décisions. Je ne veux pas invoquer une conspiration menée par les entreprises. Mais au prix que j'ai payé pour ces objets, surtout quand une simple machine à piquer les doigts est tellement moins chère (et l'étalon-or évoqué par Abbott lorsque les résultats de leur produit semblent discutables), cela représente un résultat répréhensible pour le fabricant, le vendeur. (s), et surtout, le client. Cela pourrait également être très dangereux si une personne comptait sur cela pour vérifier sa glycémie avant de décider d'une dose d'insuline à administrer.

"Va acheter un nouveau capteur."
Oh.

Autres choses que j'ai apprises :
- aujourd'hui également, le capteur Freestyle Libre 3 a fonctionné sans aucun problème. Je lis les résultats de glycémie du liquide interstitiel avec l'application sur mon iPhone. Aucun problème. Mais lorsque j'ai essayé de confirmer la lecture avec le Libre 3 Reader : il m'a informé que le capteur était déjà associé à un autre appareil (l'application iPhone) et ne lirait pas le capteur. Je suppose donc que si j'achète un autre capteur Lbre 3 et que je le colle sur mon corps ailleurs, le Reader le trouvera désormais. Mais pas l'application iPhone ! Ridicule ! Et encore une fois, ce qui aurait pu être interprété comme un boitier à 2 capteurs (sur les images) n'était qu'1 capteur pour FreeStyle Libre 3.
- à la personne qui envoie les capteurs inclus dans le colis une offre spéciale : un capteur à 80€ au lieu de 98€, soit un prix inférieur au prix Amazon. Mais à ce prix spécial uniquement si vous achetez 2 capteurs. Donc 160€, promo, pour mes 2 prochains capteurs.

Ne soyez donc pas un consommateur mal informé. Jetez votre Freestyle Libre 2 aujourd’hui. Fais le maintenant. Commandez alors un Freestyle Libre 3. N'oubliez pas : les capteurs (peut-être 5 ou 6) mais aussi le Reader. Ou téléchargez l'application iPhone. (Pas de smartphone ? Achetez-en un en même temps. Ensuite, téléchargez l'application. Ensuite, procurez-vous les capteurs).

Je suis médecin, et peut-être issu de ce qui est désormais devenu « la vieille école ». Mais je trouve cela encore un autre exemple de la façon dont les hommes d’affaires se sont lancés dans la médecine pour une seule raison. Profit. Parce que nous (médecins, patients, assureurs) les laissons s’en tirer vers ce but principal: le profit. Ils répondraient quelque chose d’inutile comme : « Ce sont simplement des décisions dictées par le marché. C’est ainsi que nous fonctionnons."

Eh bien, mes résultats étaient bien meilleurs que les leurs (jusqu'à présent), lorsque j'opérais sous des lumières chaudes, avec de l'acier froid. Et quand ils ont complètement ruiné la Médecine, ce n’est pas un problème. Ils vendront simplement des chaussures, des boules de bowling ou des cannes à pêche, comme avant.

Caveat emptor ! Caveat aeger !
(Que l'acheteur se méfie ! Que le patient se méfie !)

William O'Neill, MD

<<< Home

Who lead us into this dark forest?

In a Facebook Group devoted to sharing information for those with “long-term” COVID-19, something seemed to manifest for me that I’ll now share.

Several individuals presented a deep level of dedication to what I’ll call “knowing more” about a specific topic in the domain of Cardiology: Heart Rate Variability and its measurement.

And without a doubt, several expressed a level of mastery of that topic.

Now, perhaps they are Cardiologists. But instead, I think they are simply students of this topic who decided to get real close to that subject of Heart Rate Variability. Why? Well, because they or someone they are close to has “long-term” COVID-19, isn’t over that entity yet, and inspiring hope that Heart Rate Variability may help to make it all better one day. At least, be a piece of, “better.”

Where did that come from? Who leads into (and hopefully, out of) the woods of HRV?

Some would say that it comes directly from today’s current system of Medicine and medical practice. Others might add that it comes from contact with people who have instruments and other things to sell. (No reason to exclude medical practitioners from that association).

Knowing one’s value of Heart Rate Variability is just one example. Scanning blog comments and replies will provide a host of other variables, and each with a willingness expressed to share what one has learned so far from and about, the illness at the center of such discussions.

That’s all very heart warming. When Medicine fails the patient, the patient turns elsewhere. And that includes to other patients for advice. That has certainly blossomed during the COVID era but isn’t new. The Internet makes it bigger. Suddenly, your neighbor is everywhere.

The abandonment of Medicine’s extant system is not complete. Most still seek out consultatons with medical professionals. But let’s get specific in our approach here: these individuals are increasingly closing in on principles of physiology, and the measurement tools involved, that in the not too distant past, belonged to those guys with white coats, running around in labs and hospital corridors.

Not just physiology of course. Sharing pharmacology tips is just as or more prevalent.

It's not "their" fault. The system has lost its way and "they" aren't waiting around for its guidance.

So is that a problem?

Most Medical Centers have given up on applying leeches to patients with congestive heart failure and fluid overload.

Is Heart Rate Variability measurement and expertise just the latest leech?

Let’s get a little more rigid with the extant system and its results.

Here below is a graphic representation which may help me make a point.

We’ll see.

Let me help with the above graph.

It’s the number of published articles about Heart Rate Variability, referenced and available through PubMed. Years 1993 and 2003 are thrown in for comparison. But its mostly that from 2013 to 2023, year by year. Clearly, more articles about HRV were published than in preceding years.

A total of 4 602 publications. Year 2024 is a projected value since it’s not done yet.

So it looks like one could find from these data, evidence for ever-increasing published output about HRV.

Here below is one more graph …

“Papers per author” is another metric used to follow such output of publications, and once again, as found through PubMed. Using other sources, the numbers may vary a bit, but not the trend. Have a look.

Understand that this metric reflects the results of playing the game of “Publish or Perish.”

Included is a definition of how this metric is calculated, but don’t get lost in that. Essentially, it reflects the output or paper productivity of those who are recognized as experts in the field of HRV: mostly Cardiologists but others as well.

If it helps to make the point for the reader, below are same data as above, but with additional years added to better appreciate the evolution of publications on Heart Rate Variability.

In the earliest years, the interest was mostly on heart rate variability in diabetes and neo-nates, with or without SIDS. Its use to explore links between the autonomic nervous system, cardiac function and exercise appeared in in 1991.

See a significant change during the "COVID years?"

I don't. And recall that 2024 data are a projection, so we'll see.

A valid question: "What's driving this ?"

And another: How much is that "driver" making choices and taking decisions along the route of scientific travel, to help those with LTC ?

If you interpret this as showing increased output year by year (2024 is again projected based on past values) then you’re on the right path.

So?

Is knowing one’s HRV going to get you over your problem, specifically if you’ve got “long-term” COVID-19 ?

Lots of people would like that.

Depending on the region of the globe and how it gets counted, that’s 10% to 20% (W.H.O.) of those who caught COVID-19. Commonly seen figures ? 13.8% up to 45% in a study published in the Lancet. Or, 6% to 16% in various U.S. States. You may land on a figure that says that in Europe, about 17 million people have “long-term” COVID-19 (I’ve stuck with that phrasing of this illness, since 2020). One can find estimates presented by experts that suggest that those figures are much too low.

So ?

Well the goal of Medicine might be stated as: “Relieve suffering, and heal the sick where possible.”

Have the 385±86 papers published per year since 2013 told us how to do that through Heart Rate Variability measurements for those with “long-term” COVID-19 ?

Or just supported sales of all types ?

And an important aside, even though I didn’t read all 4 602 papers, some do report a lack of value in applying HRV measurement in certain settings where it has been applied. Does it really accurately reflect your level of sympathetic nervous system stress ? Depends on who you ask, even in Cardiology circles. The graphs suggest HRV is still a hot topic. And yet at recent yearly Cardiology conferences, other electrophysiology topics (like electroporation for A-fib) seem to have pushed HRV off the stage.

Perhaps you can explain to me how it has consistently relieved suffering and healed the sick in the setting of LTC, if you know.

If not, perhaps we should agree to send HRV the way of the leeches.

You may like to add: “Well it’s just one little piece of the larger puzzle. But very important and should not be overlooked. Here’s where I bought mine.”

Or: One may not capture actual patient benefit, or be able to count those benefit events, just by following the trends in the numbers of publications.

Hunh ?

Here’s a suggestion.

The mindset that is required to get one deeply into the woods of HRV, leading to a thorough understanding of the topic, may not be the right mindset for those with “long-term” COVID-19.

Just an idea.

“Lost in the thick of thin things.”

Potentially valuable in other diagnoses ? That’s for another day.

But most people were raised with a respect for a system of care that isn’t always on the right track. “One day, they’ll get it right.” Who says ?

Thinking 'out of the box' as a scientist or practitioner in today’s market, may quickly get you and your sought after job, or professional tenure, onto the “Perish!” Side of the “Publish or Perish” scales. Yes, thankfully, one can still find those whose devotion to Medical Practice is life-long and unswerving. It’s the primary force protecting their patients from complications. Especially when they are found wandering in the dark woods of physiology or pharmacology.

For the LTC clan, the apparent productivity seen in the above graphs intentionally limited to HRV, may be wasted energy. The fruit of doing things as we always have: At least, for the last 10 or 20 years. Then, making people fit into the same old knowledge, as though it was something new. And that may be a current trend as one 'Long COVID Clinic' after another opens up. 

Do you have "long-term" COVID-19 ?

You'll probably get, sooner or later, a consultation with a Pulmonologist.

If you're a guy, much less likely that you'll get a consult with a Urologist or Endocrinologist to evaluate your Erectile Dysfunction and testosterone levels.

And yet, the testes have more ACE2 receptors per gram of tissue in the Leydig cells that produce testosterone, than the  broncho-pulmonary epithelium. And yes, testosterone levels have taken a hit and don't bounce back over night.

But when something catches on: ("it's a respiratory virus you know..."), watch out for those other organ systems. Especially those with societal taboos.

Summary:

Increased productivity doesn’t always get the problem fixed. Not without a healthy dose of insight.

What’s your new and insightful idea ? 

How do you plan to pursue it ? (If you can share that before publication).

<<< Home

Need to ship a small carton with a lamp and a stand to someone in the UK ?

Not a problem I suppose.

I've got:

• the lamp
• the stand
• the clamp that goes with the stand
• a UK power adapter for the EU plug
• a box that's just the right size (24 x 35 x 17 cm)
• packing tapes: brown and transparent
• paper to print shipping labels
• a cutting board/ blade device to make perfect cuts for the labels
• the URL address of bpost (here in Belgium) to prepare and pay for my shipping labels
• this directly and conveniently on the bpost site. (I have already done that a bunch of times).

CAUTION ! 

Continuing to read this article may contribute to your present level of bodily stress, increasing it. It is possible that your immune and other organ systems could be affected. (I have no proof of that, but my legal representative strongly suggested including that phrase). To resume: could be affected, and perhaps even damaged, and especially if already suffering from one or more conditions that may have weakened your health. Consider discussing this with your Primary Health Care Provider if you have one. Proceed at your own risk. If that person is not avaiable in the coming month or so, proceed at your own risk here.

We are not responsible for anything. Nothing. Nada.

Hangup Number 1

• bpost has not yet adjusted completely (or very much) to the present Post-BREXIT state that I and my recipients are living in today.
  • the online bpost site does not accept creating a mailing sticker and paying for it, if the destination is UK. Nope. Not Yet. Not ever?

Let's move on nevertheless ...

As my grandfather liked to say: "Patience fait plus que force ni que rage !"

(trans. "Patience will accomplish more than strength or rage!"

At some times, I risk doubting my grandfather's wisdom.

Hangup Number 2

• sending this through bpost (even at the post office) from Belgium to the UK if the contents are all declared as "Gift" no longer works. (a Post-BREXIT phenomenon)
• one has to present a "Facture Commerciale" (Commercial Invoice) or the box simply can't be handled through bpost. Can't be. Won't be.
• OK. How about another carrier? Let's look up another carrier
  • DHL - no commercial invoice required.
  • They handle all of the paperwork for entry into the UK
  • Cost, to ship a 1.9Kg box, (25x35x17cm)? 140 €Euros. x the 4 boxes (at present)? That would be = 560 €uros for the 4 items.
    • Quick delivery method comparison ... taking the Talis Highspeed Train from Brussels to London: €29.50 for me and my 4 boxes.

Should I look around for another potential delivery company, with a better price than DHL?

Well for the UK as recipient, they're all about a wash.

Oh, and another thing, ... I have some neutrophils that I should be measuring.

Back to bpost ...

Let's think about a logical work-around for Hangup Number 2

Initially, I thought that this could potentially turn into a major hangup: Commercial Invoice REQUIRED, even for a Free Gift. Hmmm. . .

The solution needs to be ...

• Something easy
• Something fast
• Something relatively inexpensive
• Something completely within the laws of all countries concerned

The problem is, that we are viewing these items as a gift. Things given by me, to participants in my study. Can you imagine? Can you fathom that? Just giving this still functional stuff to someone else? Free ?! ...

Of course, if I was in the business of making and selling light stands, (I think I do a pretty good job with that), I suppose that I would be incorporated to do that. And I would of course have my cousin here print up a box or two of commercial invoices ("Formulaire de Facture Commerciale - taille A4").

Funny, but up until this moment, I have not encountered the need to do so in my scientific research. Sounds naïve of course. Never too late to learn to take this research thing much more seriously, I suppose. Invoices. Get Invoices.

Is there a work-around for this hang-up?

• Yes. let's just lie about it.
• If eventually this gets me into prison here, I've heard that the French Fries are pretty good.

So let's create the absolutely and undisputably required Commercial Invoice to put inside each box. I'll include a copy in the plastic envelope, with the two other forms to fill our, outside the box. 

• If I actually do this:
  • I can bring the boxes back to the post office.
  • There's a chance they might even get to England.
• If I do NOT do this:
  • the boxes will stay piled in the corner of my office, gathering dust.
  • they will never go to the UK via bpost (perhaps an important point)
  • they might be of use for participants electing the 'Minimalist' protocol somewhere in the EU.
  • Placing the boxes in my vehicle and driving the things across the channel in the tunnel to deliiver them myself could still be done. Yes.
  • Placing them in two suitcases, taking the train to Brussels, then the Talis train to London once I board it in Brussels, and meeting up with participants in London, or renting a car to drive to Berkshire and other venues once in England, ... Yes, still possible (and completely honest, but not cheap).

Above: Very nice explanation and review of options.

Bottom Line ?

No Commercial Invoice, No bpost delivery towards the UK.

"Yes but, ... you don't understand: This is a GIFT ! "

"No Commercial Invoice, No bpost delivery towards the UK."

"Oh. I see." (Picking up box and walking out of the P.O.)

--------------

Here is my Commercial Invoice:

• The one in color (as seen below) is inside each box.

- This one below in grayscale (which attracts less attention), is folded and placed inside the plastic envelope stuck on the outside with the two other carbon triplicate (pentaplicate?) forms.

(Very discreet).

Hangups 1 & 2, nicely handled ! Let's move on ...

Hangup Number 3a

• Forms to fill out:
  • The Commercial Invoice: well, that's done now. Perfect...
  • The UK designed form to get through UK Customs: just one page. Reasonable print size permitting entry for the 28 or so pieces of information to provide.
  • The "formulaire CN23" (the form CN23) for all non-EU shipments
    • It is a form that has 5 carbon copies so PRESS HARD with your ballpoint (not a pencil; not a fountain pen).
    • Also available online: software for 134€ to print the form 5 times, and place these carefully one on the other, at the top of the plastic envelope,
      • Do this once they have been carefully cut to fit the envelope.
    • Instructions for completing the form are available online (PDF/ 4 pages).
    • Form CN-23 looks like this 
      • below is just an example, already partially completed
      • I picked up 5 copies in case I made a mistake
        • entry mistakes are not tolerated, requiring disposal of the form in an environmentally friendly approved manner and location
        • the clerk at the bpost PO window kindly reminded me of that.
          • this avoided my crossing out a mistake and writing next to it. Not accepted.

Hangup Number 3b

Well, simply put, this requires a little time, a little effort, and a ballpoint pen.

• It takes a little while to complete form CN23 at the PO
  • the people in line behind one in Belgium, tend to stay remarkable patient, so that is good.
  • I have some friends here.
    • So, I left the PO and I went to their house
    • They made supper
    • We filled out the sets of forms for the 4 boxes, after supper
      • 3 people
      • 3 very solid BIC ballpoint pens
      • 4 sets of 3 forms (plus some extras, just in case)
      • This took only about 1 hour. Seems acceptable.
      • one of the 3 did this faster than the other two, because she did not read the instructions on how to fill out the forms. So she did 2 sets, while we each did one. What a dear!

Hangup 3a & 3b, nicely handled !  Let's move on ...

Hangup Number 4

• I wanted these to go out ASAP
  • Friday, the PO was closed in the afternoon, which is unusual, but was not explained
  • Saturday (usually open from 9;30AM to 12noon), was exceptionally closed, I was told on Monday.
  • Monday, I brought in all the stuff at opening time (9:45AM) and got done with the clerk's data entry process at 11:25AM.  (Actually, 10:45AM for the first box).
    • • He and I both seemed relieved once that 1st box was accomplished. 
    • Some people in line became rather impatient (Unusual in Belgium).
    • I suggested that he set aside my task for the 3 other boxes, take care of other clients, and call me when it was time to come back to pay for the bpost services.
      • He liked the idea and accepted it immediately.
    • He called me just before noon, I went in, paid, and we were both, once again quite relieved. 
  • Call these simply, administrative nuisances, but still within the realm of 'possible'.

Hangup 4, nicely handled !  Let's move on ...

Hangup Number 5

• Had to pay the postage to get bpost to send these 4 boxes (Duh..., of course). Nothing is Free, (but let's not get into that once again).
  • How much ? - 157,40 €uros total.
    • That's 36,20€ plus 3,15 € for a 'guarantie de livraison") which I fell for = 39,35 € per box.
    • What a deal ! Less expensive than gasoline cost from here to London+
    • For each carton, or for all 4, more expensive that the train ticket on the Talis, but that assumes no eating, no beverages, and certainly not an overnight stay.

So, bpost comes through in a pinch !

Hangup 5, nicely handled !  Let's move on !

Hangup Number 6a

• This is a potential hangup: Which is, that if my Commercial Invoice simply slides through unnoticed,
  • I may not go to jail, nor have to pay a fine. At least not right away. No hangup there.
  • I have kept a copy on my computer for use in the future as needed - certainly a timesaver. Not a hangup there either. 
  • But, here comes hangup 6b ...

Hangup Number 6b

• Hold on now. watch out!
• If my Commercial Invoice works perfectly it may mean that recipients of the items enclosed may be asked to pay a fee by the UK Customs Declaration Service
  • Oouf! (Or in French, "Aie, Ya, Y'aie!')
  • This was supposed to have been a gift ! Free ! ("Spare me that again !")
  • Some gift !
  • Potential Participants Take Note i (if in the UK).
    • you can avoid this untoward event by coming to Belgium to participate in my interesting study...
    • below, a few shots of what that looks like on certain days.

So, ...

If this 'UK Customs Fees' thing happens, I (William O'Neill, MD - Principal Investigator) suggest the following:

• Argue on the UK end that these items were always intended to be a gift
• When the counterargument presented to you is: "Well it looks like, that at least somebody paid for this stuff, even if that somebody wasn't you!'
  • start to cry and whine outloud
  • play with a pants pocket as though you have some form of weapon concealed therein
  • Ask: "How much?" and pay it.

• Most importantly (and not a joke)

  • SEND ME A COPY OR IMAGE OF YOUR RECEIPT FOR AMOUNT PAID FOR UK CUSTOMS FEES
  • Or, simply tell/ write me what you paid
  • I will reimburse fully via a Paypal payment to your email address.
  • This may keep the Participant and Principal Investigator on good terms.
  • It simply figures into the cost of doing research (I almost said, 'business').
  • That's it.

• Then,
  • Open the box
  • Set up the stand and light (instructions on this site)
  • Decide when you will be starting your first of 10 days of PBM (light intervention), carefully following the "Minimalist" protocol as described on this site.
  • If lost, write or call for help.

Hangups 6a & 6b, nicely handled !  And that's it !  All done !

"Great job Dr. O' !"

----------------------

Don't you love Post-BREXIT?

Gotta love it.

You must love Post-BREXIT !

We were told you have to respect Post-BREXIT, so do so.

Just like I always and invariably do, and based on meeting all the requirements as carefully explained to me at the bpost Belgian PO last week. 

I am now more completely prepared to be a responsible sender of cardboard boxes.

It's just another type and style of research.

But as one wades out into the great unknown that surrounds Science, it's still research.

Let's try not to get carried off by some current, nor fall in a deep hole.

Let's simply regain our usually calm composure. 

I think I've already made a good start.

And I'm quite happy about not being a fisherman in the UK.

Back to work.

-----------------

"Nous ne faisons que notre travail..."

"We're only doing our job..." 

... That is what they said.

DHL? Who needs DHL?

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Ans.: Perhaps no one, so far.

At least, not a summary statement that discretely answers the question about effect of vaccination (or non-vaccination) on subsequent findings in a PASC person.

There are parts of the components mentioned in the Articla Title above that

have been studied and written about.

To get at this, I went through my personal library and found at least 7 articles that might serve as a good place to begin. I have linked to them below to ease access for the reader.

If one works through these articles, questions like: "If I wasn't vaccinated, was "long-term" COVID-19 (PASC) more probable than if I had been vaccinated?" might be helped by having a look.

Was dysautonomia in its various forms or manifestations more probable for an unvaccinated PASC person ?

The topic quickly gets complicated.

Vaccines had positive effects.

Vaccines had negative effects.

Autoimmunity (example MS, Type 1 diabetes mellitus and other illnesses) quickly

seem to be a related topic in PASC. Vaccines, illnesses, viral illnesses can impact autoimmunity which has been known since quite a while.

Simply put, much of the response to vaccines in those with PASC, seems to be an explosion of the immune system, but of various sizes.

Let's let you read othrs now, instead of me.

Have a look at the articles.

See what they inform, for you.

The effect of SARS-CoV-2 vaccination on post-acute sequelae of COVID-19 (PASC)__A prospective cohort study

Autoimmunity in Long Covid and POTS

Dysautonomia in Children with Post-Acute-Sequelae of Coronavirus 2019 Disease and_or Vaccination

Dysautonomia in COVID-19 Patients__A Narrative Review on Clinical Course, Diagnostic and Therapeutic Strategies

Effect of SARS-CoV-2 Vaccination on Symptoms from Post-Acute Sequelae of COVID-19__Results from the Nationwide VAXILONG Study

Serological response to vaccination in post-acute sequelae of COVID

Risk of Long Covid in people infected with SARS-CoV-2 after two doses of COVID-19 vaccine: community-based, matched cohort study

If you read those (quickly or completely) you at least understand that this is not one topic or subject, but several. Some connections have been made, and others await connection.

If you have more questions than answers after all of that (Oh No !) don't hesitate to ask.

You can even send them to the address that those involved in my studies use to get their questions to me: Questions@StudyLTCovid.com

Through any response, I'll try to share what I have learned in the past 3 years or so.

Can't promise more than that.

And to quote one of my past Professors (Urology, during my training) when he didn't kno...

'I don't know. But if there's an answer, I promise you'll have it in the next 24 hours."

Never saw him break that promise.

----------

PS: a bit off topic - serious side effects of the vaccine ? Were these openly or adequately shared with the public ?

Not a new topic.

Here is a 21 August, 2022 published article on the topic:

What are we aware of, and what are we still unaware of about efficacy and risks associated with certain vaccines? 

Serious adverse events of special interest following mRNA COVID-19 vaccination in randomized trials in adults

A link to one of the author's (Dr. Joseph Fraiman, MD, an ER doctor from Louisiana), interviewed by Dr. John Campbell is found here: 

https://rumble.com/v3gwsu6-serious-adverse-vaccine-events.html

Since the above interview runs over an hour, here are some links to specific "snippets":

https://youtube.com/shorts/pyjzJ9sbvRs?si=99XtDBETe7TlGueZ

https://youtube.com/shorts/pdRbBSEkI88?si=PcV1l3xQIucb_ciE

https://youtube.com/shorts/FE4c1laSYLk?si=5MLXd4hKQhM3Be0D

https://youtube.com/shorts/QqKPp8hLxtU?si=Oln1XFnTo2BBFSGl

You should quickly get the point.

Perspective? Well one is trying to crash land a plane (or a project to create vaccines more rapidly than ever before in human history), doing that based on an ideal list of priorities may get a little strained. In general, the feeling is that the plane landed without too many injuries aboard. 

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Here are some articles placed here in response to Michelle Nyland.

"I have a question, why is “Caucasian with red hair and light complexion” specifically called out, specifically? Is there evidence of a trend?"

Ans.

When we provided results from our questionnaire two years ago, results for race looked like this.

Overall, not a huge number of respondents at that time, overwhelmingly 'White or Caucasian' (89%) and those few with 'red hair and fair skin' were less than 5%.

Why had they even been included among the usual choices for race/ ethnicity?

At the time of creating this questionnaire, topics of interest included:

• characteristics of the COVID-19 illness (of course!), but also
• findings potentially related to race
• findings potentially related to use of vitamins/ supplements
• especially Vitamin D as importantly related to COVID-19
• findings potentially related to the ACE-II receptor and other components of the renin-angiotensin-aldosterone system usually thought of primarily related to blood pressure control.

So as subjects for further exploration had through the questionnaire, come to mind,

certain choices were made and the 'red hair/ fair skin' choice included.

During the two years since, most of the above list were confirmed as important with respect to COVID-19 and its clinical presentation.

So the reasoning behind it then was that since Vitamin D has a link to COVID-19 diagnosis and treatment, and since red heads with fair skin make more Vitamin D precursor in their skin than BAME populations (for comparison) and since the entry of the SARS-CoV-2 virus is related to ACE-II which is also found in the skin, ...

... would their be a hint about this in the results of the survey?  Meaning, a proportion of respondents with red hair/ fair skin would be typical of the population (2% to 4% depending on location, of course more dense among the Scots), or not. For the 6 respondents above, supplementation with Vitamin-D and measurement of blood levels was variable. Some took more, some not.

All that to mean that no striking discoveries emerged from this component of our study two years ago. But that's OK.

Would "red heads" create enough Vitamin-D due to their fair skin creating more precursor, and through that have added protection against COVID-19? 

We certainly did not answer that question two years ago! But it did encourage us to be thinking at a cellular level where the problem (and solution) linked to COVID-19 is certainly still going on.

But the 'red hair/ fair skin' topic remains quite interesting. 

Here is a little bibliography from the experts that provides a nice background.

Michael F. Hollick of Boston is certainly a key name to remember when it comes to everything about Vitamin D, and including characteristics of its creation (or its precursor)  in the skin in response to UV-B light. We'll leave the topic of melanoma and other skin cancers in those with the fair skin/ red hair genetics aside for some other venue.

Vita-D and melanin during COVID-19

Red Hair__ A Mutation, A Royal Trait, and Sometimes a Curse (Sheikh 2009)

Vitamin D and Health Evolution Biologic Functions_

The Vitamin D Epidemic and its Health Consequences (Michael F Hollick)

The evolution of human skin pigmentation involved the interactions of genetic, environmental, and cultural variables

Deciphering the Potential of Pre and Pro-Vitamin D of
Mushrooms against Mpro and PLpro Proteases of COVID-19

Effects of Angiotensin II Receptor Signaling during Skin Wound Healing

Association of Vitamin D Status with SARS-CoV-2 Infection or COVID-19 Severity__ A Systematic Review and Meta-analysis

A computational model for previtamin D3 production in skin

Is the shielding effect of cholecalciferol in SARS CoV-2 infection 
dependable? An evidence based unraveling

Aging Decreases the Capacity of Human Skin to Produce Vitamin D3

So the answer to Michelle's question is that all of these components contribute to 

our understanding of why some people catch COVID-19, and some don't, and some several times, and some get sicker than others, and in some it will last much longer (see this article for that recent update to Duration of Illness in our own study).

Certainly who one is (and the genes one carries) contributes to the COVID-19 experience and how it might manifest in each of us: red heads, BAMES, old folks and all the rest! One should not just think of this as "premorbid conditions" but try to get beyond that to a deeper level.

Thanks for the question Michelle !

When I was in Medical School and afterwards a Surgical Resident, I had the pleasure of working with Dr. Alex Breslow. He was a Pathologist best known for his system of analysis of melanomas and their prognosis based on depth of penetration into the skin. I even had the privilege of having him become one of my patients.

Anyway, Doctor Breslow was a wonderful man. Always quite busy of course as head of the Path department and Researcher.

But never too busy for a question.

Sometimes, and rather sheepishly, a student would see Breslow's coat tails flying by and would risk a ... "Doctor Breslow... excuse me but ..." as introduction to a student's question.

Breslow would always wheel around and shout: "Yes?! Please!!" as if to say, thank you for stopping me to ask your question. If his obvious enthusiasm hadn't quickly scared off the student, he would get an answer to his question right then and there. Always.

So I'll close here and in memory of Doctor Breslow, say to Michelle: "Yes! Please!!"

And Thank you for asking.

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