User talk:Davidruben/Archive 2

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Archive 5

Medical Education in the United Kingdom

Hi David,

Thank you for your minor fix (States -> Kingdom) in the intro of this page. I seem to have made the error whilst busily forming up these new med educ overview pages the other day. I started these pages to try to consolidate info on med ed/training as such information was spread across a number of articles (and was often quite US-specific for that matter).

I see you're a UK based GP. I am not based in the UK so would appreciate any input you may have. I have read of some exciting changes happening to UK vocational training, and it would be good to have some information on this (there is already a sizeable article devoted to entry level training: Medical school (United Kingdom).

Cheers, --Daveb 04:43, 1 January 2006 (UTC)

Howdy, I was wondering if you could help clarify something. I have been told that UK General medicine is analogous to US Internal medicine. Is that strictly accurate? I was under the impression that UK general medicine included some training in pediatrics and ob/gyn, thus being more like US family medicine. Thank you for your attention. --DocJohnny 10:06, 3 January 2006 (UTC)

Medicine in the UK

Thank you for your response. The differences in the categorization of subspecialties between our two nations is fascinating. And the fact that the language is similar but not identical adds quite a bit of confusion. I would be grateful if I could prevail upon you to clarify a few points. We just use the same words in different ways. We hardly ever use the word "General Medicine" except to describe family medicine. When we discuss Medicine vs. Surgery, we use only the word medicine. And our hospital departments have both a broad "Medicine" department which would include Family practice, and "Internal Medicine" which exists under "Medicine".

• In the US, we do not have the distinction between community physicians and hospital physicians that you seem to have in the UK. The distinctions are more often based on employment (private docs vs hospital employed docs). There are 3 major nonsurgical tracks in postgraduate training in the US: Family medicine (family practice), Internal medicine, and Pediatrics.

• Family Practice is a 3 year program, there are no subspecialization options.
• Internal medicine is a 3 year program with a wide variety of subspecialization options, most lasting another 2-3 years.
• Pediatrics is a 3 year program with a similar menu of subspecialty tracks as IM.

Internal medicine specialists can practice in the office, in the hospital, or both. As can pediatricians and family practitioners, although FP docs have a higher proportion of office only practice. Also the term consultant is used differently over here, as is apparently the term physician. I think even more confusion will be forthcoming since we have started hospital only practices (hospitalists).

My questions are:

1. Is General Medicine (Internal Medicine) in the UK only hospital based?
2. Are there pediatricians? Are they hospital based or office based?
3. Are there pediatric subspecialty tracks?
4. Are there office based subspecialists? ie cardiologists, gastroenterologists, oncologists...

Thank you, --DocJohnny 05:13, 4 January 2006 (UTC)

"unlike US where you seem to suggest a 3-way split of hospital doctors into Internal Medicine, Paediatrics & Surgery"

The split is internal medicine (usually just called medicine), pediatrics, and family practice. Some basic terminology differences exist. In the US, the following holds true:

• Physician is interchangeable with doctor and applies to anyone with either the MD or DO degree in any specialty.
• Consultant is a term describing a doctor's relationship with the patient and the doctor of record, not a specific title. It is usually used to distinguish between the patient's doctor of record during that particular admission and the other doctors on the case. A patient may be admitted under a general surgeon for cholecystitis and then develop pneumonia. The surgeon would be the attending, and he can consult an internist to manage the pneumonia, the internist would then be the consultant. Or the reverse can occur, a patient may be admitted with pneumonia under an internist who would be the attending. Then if the patient develops cholecystitis the internist can consult a surgeon who would then be the consultant.
• The word Attending or Attending physician is probably equivalent to the UK term Consultant. The term Attending is used 2 ways. One is to distinguish between physicians who have completed their training and ones in residency (Attending vs. Resident). The other is as above, to denote the doctor of record who assumes primary responsibility for the patient during that particular admission (Attending vs. Consultant).
• Our generalists (Family Medicine/Practice) can practice in the hospital if they wish to. Although, this usually only occurs in smaller hospitals where there is less of a subspecialty presence.
• Limited scope primary care outpatient practices exist, i.e. pediatrics and internal medicine.

--DocJohnny 22:58, 4 January 2006 (UTC)

Health Visitor and District Nurse

Thanks for writing. I've only worked in acute care and unfortunately I'm not very well informed on nursing roles in the community setting, but the equivalent of a District Nurse in the U.S. would be simply a "visiting nurse" or "home nurse". As we don't have anything like the NHS system here, these nurses work for any of a million different private agencies or local health departments. There should probably be a more general article on visiting nurses, with a description of how their names and roles vary in different countries - or else Home care should be expanded. I'm less clear on the nature of Health Visitors; do they practice in a hospital setting or in homes? ←Hob 17:45, 7 January 2006 (UTC)

David thanks for the invitatio to have a look at these topics. My experience is A&E but I will have a look & contribute if I can. I'm also in contact, by a variety of means, with some DN's & HVs & Practice Nurss etc who may be willing/able to contribute & have some strong views about CPD & regulation changes for these professions. My real area of expertise is i health informatics & I notice this is not listed in the medical topics/specialisms lists - do you think it should be? Rod 09:01, 8 January 2006 (UTC)

asthma

your 2nd explntn for the dx of mild azma in athletes is what i had in mind. i'll check my wording, and maybe add something about the abuse of azma meds, which may be another cause of increased "incidence" in athletes.Sfahey 14:47, 11 January 2006 (UTC)

I recently posted on the asthma page regarding OTC epinephrine inhaler use. You state that epinephrine when given via inhaler results in increased cardiac side effects, but this is not true if the medication is used in an appropriate manner. I refer to a study published last year: [[1]] Ann Allergy Asthma Immunol. 2005 Dec;95(6):530-4 Newer medications for relief are of course more selective, but to my knowledge, if used properly epinephrine via inhaler does not result in increased cardiac effects as a result of its selectivity. Please let me know your opinion on the matter. Thank you for your time. '--Iamahalfer 02:58, 19 May 2006 (UTC)'

Ive copied above to Talk:asthma and placed my response there. User:Davidruben

Epilepsy and Driving

Thanks for adding the references on the UK legal issues wrt driving. I was composing my own references additions to the article, did a "show changes" which listed just mine and then a minute later went to save it -- bang! You'd beaten me to it. I think your reference is the best as it is the official site. However, I couldn't find anything about responsibility (doctor/patient) and it does say "These guidelines are intended for use by doctors". So I put in the Epilepsy Action reference that I had prepared and shifted your reference a little. I hope you are happy with the combination. --Colin 19:01, 16 January 2006 (UTC)

The extra DVLA information is good. Wrt the broken link – I'd lost the final "l" of "html" in the URL. I think the original page was more suited to the purpose than the one you substituted and had the title given in the reference link. So I've changed it back but with the fixed URL. I've also tidied then DVLA reference and used the full title as used in the PDF version of the web page. It is a shame the PDF has a date in it so it isn't really suitable for linking. If only they had called it "latest.pdf". --Colin 09:15, 17 January 2006 (UTC)

Should you be awake

Doc, which timezone are you in? JFW | T@lk 01:41, 19 January 2006 (UTC)

Gotcha. I had completed my on-call and was doing some watchlist work before dragging myself home. Nightowling all right :-). JFW | T@lk 14:10, 19 January 2006 (UTC)

Electroconvulsive therapy

I don't disagree that I was being a tad overgenerous. I just did not want to get into a 1 man revert war with the anon. --John^DO|^{Speak your mind} I doubt it 00:32, 21 January 2006 (UTC)

References

Thanks for the kinds words. I am glad I had the time to look up those sources, and Uthbrian was a great help. And I agree, we will need to subject the rest of the article to the same vetting as the section by the anon. --John^DO|^{Speak your mind} I doubt it 06:19, 23 January 2006 (UTC)

Re: Your message to Thor (Counter Vandalism Unit)

Thanks for your message David, I will set round getting an administrator to intervene and suspend this user from the Wikipedia if possible. The 3RR looks to have been breached. I will edit this message as soon as I have anything further for you, and I thank you warmly for alerting me to this situation. Regards, Thor Malmjursson 03:38, 21 January 2006 (UTC) Talk to me

Thanks for being patient with me David, and apologies for keeping you waiting. I am going to revert the article one more time, and I have left a warning on the anon user's talk page - see here - This is going to be passed to the AIV team (Administrator Intervention) and I will request that the user is blocked for a period to prevent further edits and hopefully discourage them from doing this again. Your assistance has been most welcome. Please do not hesitate to contact me again if this persists. Thor Malmjursson 03:53, 21 January 2006 (UTC) Talk to me

You misstated the position of the NIMH Consensus conference. they did not state that there is "no credible evidence of harm." They found at least eight months permanent memory loss.Also, just because an agency or institution issues a report does not mean it's NPOV. Bricks and mortar don't write reports---people do! And the NIMH was completely stacked with promoters of ECT, including those with financial ties to the shock machine companies (Sackeim, Weiner). Were you at the conference, and were you involved in the planning of it? I was. There were approximately twelve proponents on the planning committee and only one critic was included at the last minute due to criticism from former patients.

Same goes for the SG---the vast majority of references are to only a couple of, once again, financially conflicted authors. There was quite a bit of international media on the bias of the SG report---if I knew how to link such things, I would link them to here. Once again, I was involved in the SG report for years.—Preceding unsigned comment added by 209.122.225.69 (talk • contribs)

References for medical articles

Thanks for inserting the reference for Impossible syndrome. Is there information or a guidebook anywhere that would help me understand how to locate the article and insert a reference to it? I found Wikipedia:Citing sources quite confusing. Perhaps it would help us all to have something about how to cite sources (and how to use PMID) on the Wikipedia:WikiProject Clinical medicine page. Inability to create proper references seems to be a common problem, unfortunately leading to many articles with no sources cited.... Thanks again! --Rewster 18:56, 22 January 2006 (UTC)

PubMed citation

I was recently asked if there was information or a guidebook anywhere that would help a user understand how to locate a reference article and insert the reference to it. I was going to direct the user to the discussion on your bookmarklet for the PubMed tool but Clinical Medicine's talk page was recently archived. Given that this is an ongoing tool to help with medical articles, I have copied and reorganised the details into the Project's front page under the section about references, here. I think any improvements to the explanation or the javascript should be as edits, rather than as a sequential series of entries seen in a talk page's discussion. David Ruben ^Talk 14:03, 23 January 2006 (UTC)

Thanks for moving the details to a more permanent spot. I think the existing docs are pretty decent (they're a heck of a lot more informative than Wikipedia:Tools/Browser integration, which is where most of the more popular bookmarklets are listed), but I'll add more if anything comes to mind. Cheers, David Iberri (talk) 20:27, 23 January 2006 (UTC)

Tertiary_referral_hospital

This being America, there are actually three commonly used definitions for a tertiary referral hospital, which we tend to refer to as Tertiary Care Centers or some variation thereof. 1) A hospital with a (nearly) comprehensive services usually large and affiliated with a medical school. 2) A specialty hospital with tertiary consultants. For example: psychiatric hospitals, children's hospitals, cancer centers, transplant centers, etcetera. 3) A specific relationship with another hospital or region. A hospital regardless of size or services can be deemed a tertiary referral hospital if it serves as the recipient of transfers from another usually smaller hospital (the secondary) which serves as the transfer recipient of a third smallest hospital.

Usually the third definition coincides with one of the other two. --John^DO|^{Speak your mind} 14:39, 23 January 2006 (UTC)

For example a tertiary care center for a more rural area is [[2]] which is a 350 bed hospital. While it offers fairly detailed services, it is by no means comprehensive in tertiary specialists. By the standards of NYC or Boston, it is a secondary care facility. --John^DO|^{Speak your mind} 21:15, 23 January 2006 (UTC)

Thanks

For the nice meal. I see symptoms of Wikipedia insomnia. JFW | T@lk 08:59, 26 January 2006 (UTC)

Epidemiologic vs epidemiological

Good question. However, things are a bit more complicated. I started out with a mixed version where both spellings occurred three times or so. Like you, I chose "epidemiological" as the better version. However, a quote and a Journal title both containing "epidemiologic" made me think again. So before saving it, I did some checks in PubMed and Google, also contrasting UK vs US English and came up with (1) both versions are ok as per spelling rules (2) "epidemiologic" is the preferred version. What convinced me was a search of the article titles in http://www.epidem.com (Joutnal listed in this article) that (similar to Google) showed a 2.5:1 ratio. Unlike Google, this reflects the preferred use among published scientists. Go figure... AvB ÷ talk 14:54, 30 January 2006 (UTC)

Paracetamol

Very interesting points. I have wondered why there is no common slow-release form for so common a drug. The large size was just speculation from me, so no problem with removing it. The frequent dosage is disadvantage for an otherwise excellent drug, especially as paracetamol is often combined with other drugs using a different schedule. So I thought that it was worth mentioning, it has certainly sometimes affected me when deciding what drug to prescribe. Ultramarine 18:29, 1 February 2006 (UTC)

thanks

...Thimerosal_controversyMidgley 03:41, 3 February 2006 (UTC)

the motivation?

The motivating factor in Midgley getting a star was perhaps related to a certain anon on the Epidemiology and Autistic enterocolitis pages? Kd4ttc 04:44, 3 February 2006 (UTC)

Anti-vaccinationist pages

David,

Just to respond to some points you made and you are welcome to delete this after the communication has been effected, in case it is over long. The tone of dialogue immeasurably improves communication and you have made that effort, for which I am grateful, and to which I am responding. It was unfortunate and regrettable that the text was deleted, but I am not such an idiot to do such a thing intentionally and especially not in such highly charged circumstances.

There are misconceptions about 'anon' users. All users have user page/talk-pages. You will see I have both and WP is identical in all respects so far as I can know, save for the use of email and a couple of embellishments like creating pages.

As for WP posting edit warnings that has only happened to me about three time so far in all my editing and it only happened once on the anti-vax RfD page.

As for editing 4 times after CDN99 had pointed out the deletions, that is pretty easy to answer. You will notice that I even responded to that particular edit by CDN99. Had I realised what had happened and had it been intentional, anyone with half an ounce of sense would have quickly said "Hey guys, I made a mistake". As it was not intentional, I really did not take on board the significance and really only read the parts of the posting that I considered relevant to me after quickly scanning the text.

You will also note that five other editors after the deletion was pointed out made seven edits themselves.

As for never agreeing on vaccination, that is really not a problem. I have no issues with safe effective medical treatments and no issue in principle with vaccination. It is only what I have learnt about it since becoming aware there is a problem, that I know there is.

I am fully cognisant of risk/benefit equations and that is one of the aspects I have been careful to look into. I have looked into it in far greater detail than most and the research will be seeing the light of day in peer reviewed papers with respectable journals, having already trodden that ground.

I know people in your profession who are very uncomfortable with what is happening and the short and long term consequences. We are engaging in an experiment on our children and it started in the late 1960's and early 1970's with measles and rubella vaccines (ignoring the introduction of DPT many years earlier).

What is going on is a race. It is a race to eradicate diseases throughout the world with vaccines and take the collateral damage as a cost. Having looked at hard evidence of the kinds of collateral damage and seen how evidence is suppressed and that people cannot publish and folks in your profession do not report adverse events, I cannot reconcile the extent of the damage with the claimed benefits of the intervention. I have looked very closely at the disease stats and the benefits of the programmes and the risk benefit equation is really heavily going in the opposite direction to that people in your profession are told constantly. That is on top of exaggerated disease risk stats pumped out by officials responsible for promoting vaccination programmes - and I know the stats are, because I have the seen the data.

The foregoing paragraph is the kind view of what is going on and takes no account of the scale and extent of corruption in the pharmaceutical industry which has regrettably corrupted scientific research and the medical profession.

It is deeply troubling that we promote vaccination programmes in the third world, not counting the cost, and knowing the good nutrition and clean water will protect several orders of magnitude more effectively against disease and save vastly more lives than vaccines or any medications ever will. We know all of this because we have the stats showing how dramatically disease rates and mortality have fallen in the west over the past 200 years and especially over the last 100+ as living conditions improved generally.

So the answer to your question can our views ever be reconciled, the answer is yes, when the risk benefit equation is sensible and people stop suppression of the information showing the scale of the problems and the extent of iatrogenesis some of the current vaccines cause - and the heavy economic burdens of treatment for the chronic conditions that result. If all kinds are safe and effective with benefits that outweigh the risks, there may be some who might want to object, who are truly "anti-vaccinationist" but they would likely be few and far between. The odds ratio for multiple sclerosis is significant consequent on Hep B vaccination, so should we give it to all infants when the risk is tiny to non-existent for them but their risk of MS is significant? Doctors who believe no, are they anti-vaccinationists? How about doctors who suggest no 'flu vaccines for children because it is unethical to give them something that puts them at risk of an adverse event and when it only might benefit their grandparents? Are they anti-vaccinationists, as Dr Midgely's definition would have us believe? I really do not even want to consider the potential genetic effects or what might happen in the long term or the consequences of things like mothers losing their natural immunity and cannot pass that on to their offspring. We already have adults at risk of sterility as a result of mumps vaccination programmes as Dr Midgely knows all too well. The Invisible Anon 18:00, 3 February 2006 (UTC)

David, thank you for your thoughtful and careful comments on my talk page. All that separates us is access to reliable information to have informed debate. If the information was allowed to flow freely, the matter would be completely different, but it is not so it is not.

If you look carefully you will find the cited mumps disease risk data is made up figures, cobbled together. There are no reliable sources. On rubella, here is a remarkable piece of detective work from the BMJ dishing the dirt [[3]]. As for measles deaths, in well nourished populations these fell to very low levels prior to vaccination and all in developed nations should be preventable now with treatment. There is also good research to show that just vit A halves measles mortality and reduces morbidity in clinical cases. WHO now push vit A hard in the third world.

And then there is the problem of reliable figures on vaccine adverse events. Who knows when anyone will ever ensure events are reported and the data collated. Then there is the problem of getting anyone to take any notice of it.

The abortion debate is difficult particularly because of the strong moral aspect. Vaccination does not have anything like the same conflict and the outcome is not fatal in all cases as with abortion. There are in my view huge numbers of "convenience" terminations. At the same time, it is preferable that those who would have had backstreet abortions have a legal alternative and then there are always the very difficult cases of threat to mother or the infant born severely handicapped or with some other chronic problems.

We can pick this up another time after your break. The Invisible Anon 13:53, 6 February 2006 (UTC)

Width of images

I've added a parameter to address your concern. Details at Wikipedia talk:WikiProject Anatomy. --Arcadian 15:48, 15 February 2006 (UTC)

IBS Article

Thank you David. Your input is very much appreciated. 70.95.199.228 05:00, 16 February 2006 (UTC)

Nice comment in the IBS talk page

Very nicely put on the IBS talk page. It came across to me as very friendly and just nice. It was so well written you must have spent a fair amount of time on it. I appreciate the effort. Steve Kd4ttc 15:55, 16 February 2006 (UTC)

Extra space in drugbox

Responded at Template_talk:Drugbox. --Arcadian 14:28, 19 February 2006 (UTC)

Bifidobacteria strains

See the comment in the talk page IBS. Steve Kd4ttc 03:42, 20 February 2006 (UTC)

Illegitimate mediaton on Talk:Irritable bowel syndrome

Looking at the Talk:Irritable bowel syndrome the mediation by Cameronian appears to have been invalid. Cameronian is not known to be a memeber of the mediation committee. Likely the issue will be brought up for some sanction against those involved. The discussion about the legitimacy of the mediator can be found at Talk:Irritable bowel syndrome#Mediator called in without protocol Kd4ttc 21:30, 23 February 2006 (UTC)

Chemical structure diagrams

File:Lymecycline.png

Like this...

I saw one of your chemical structure diagrams for a medicine article, I was just wondering what program you're using to create them, and if it's free. Obli (Talk)^? 00:16, 25 February 2006 (UTC)

Re: Asthma

Hi David! It's been a while since we chatted. Hope things are well with health and family.:-D

About the external link (I think it was to a regular website by the way, although I may have missed a blog), it was no problem at all, don't mention it. I daresay a mention of the role of chlamydiae infection in asthma will improve the article; if that editor doesn't add referenced edits, I might add a small bit somewhere, later. As always, best wishes to you and yours ENCEPHALON 03:40, 25 February 2006 (UTC)

Parental Notification

I was wondering if you'd give the edit history of Parental notification a once over, because while I know that you don't endorse my POV you don't seem to be one to ignore facts, and you might be able to mediate and make the article neutral for both sides. Chooserr 18:45, 25 February 2006 (UTC)

Well I haven't known you very long, and know that you don't subscribe to my view point, but you seemed to try to keep emergency contraceptive neutral and attacking both me and my edits. As for the article being US centric I totally agree that it should be expanded to encompass the controversy (if any) in other countries. However I think it should for the most part remain focused on Abortion, Sex Education, and Contraceptives because that is the only thing that makes this really notible. The fact that a university would inform the parents when they find a student plastered doesn't generate to much controversy IMHO. I'll try to look over your message if I get time. Chooserr 05:49, 27 February 2006 (UTC)

Quote

I'm currently checking (google) to make sure that is an exact quote from the Church, but in the mean time I've re-added it for even though it may be slightly repetitive I believe that an exact quote wouldn't hurt, and it would be more verifiable than Wikipedia just coming out and vaguely point in the pro-life direction saying, "this is what they believe". Chooserr 00:08, 4 March 2006 (UTC)

P.S. Have you looked over the Over the Counter bit yet? Just by the link I provided you see that it is at least controversial.

Well I just stated it was controversial originally but it was continuously reverted by Hipocrite - you can see it is controversial here Chooserr 00:38, 4 March 2006 (UTC)

GMC

Yeah, the holiday (and my brother's wedding) was delightful. I'm slowly reintroducing Wikipedia, but hopefully my watchlist patrolling will be less compulsive :-)

There is no longterm solution for the GMC page. We can't leave it protected forever. I have indefinitely blocked the editor who posted the garbage about Sir Graeme. I have a low threshhold for wiping out the history if the items are clearly defamatory. Let me know if this happens again. Such idiocy should also be reported on WP:ANI for rapid wiping of the history. JFW | T@lk 18:41, 6 March 2006 (UTC)

Kidney stones

No, I just rearranged the information on the page [4]. It had a section that was pointlessly titled "More information", so I moved the information to the proper sections, and renamed the section. — goethean ॐ 23:52, 6 March 2006 (UTC)

The image changes

Dave, what's up with all these changes?
I had them on 320px width so the infoboxes have the same width too and to give me some room for the bigger structures. Not only that - the bond length is the same and the font size is the same too, and if you look at structures that are related such as Albendazole.png and Mebendazole.png it can clearly be seen where they differ, just open them in two diferent windows and switch the windows back and forth (it doesn't work so weel on "Dumbxplorer" b/c when you do that the screen "blinks"). I don't think that the chem_infoboxes are completely "standart" as they all have different width on Firefox and Netscape. It seems that these two browsers don't force the image width (when its bigger than the table one) to shrink so it can fit in the table (the way "Dumbxplorer" does), instead they widen out the table to fit the image. Why is the drugbox width 198px only? It looks perfect on 320px. This way you don't have to shrink the images manually.
I ommit the "O" and "N" hydrogens on purpose - first "N" ones give me a major headacke b/c when i transfer the structures from ISIS to MS Paint they change position, font size etc. and i'm just tired of dealing with them; second if i want to color the hetero-atoms (which makes the image look better) i have to show the hetero-atom Hs as bonded otherwise they will have the same color as the heteroatom, and i don't want to do that b/c it looks ugly, but then when shown as bonded Hs overcrowd the image and it looks ugly too but in a different way. In both cases Hs don't provide any usefull information b/c we all know what the valences of O and N are and their relationship with H. The only time where it is worth showing the Hs is when they are part of multicyclic structures, such as steroids, terpenes, etc., and their position reflects the structure of the rings.
Yeah i know that the color of "F" (burgundy) is not much different that the color of "O", but at least is different and it's not the same as the color of "Cl", right? And i'm trying to match the color sheme used by PubChem.
Make sure you check your layout changes on the other browsers too, b/c right now Beclometasone dipropionate and Betamethasone look awefull on Firefox (and i guess on Netscape too). If the string length exceeds the width of the HTML element (the infobox table) these browsers don't "cut" the string and transfer the rest of it on a new line, they aren't that smart you know, you have to insert brakes such as "spaces" and "new lines" for them to be able to do that. -- Boris 06:53, 7 March 2006 (UTC)

Epilepsy

Thanks so much for today's work on epilepsy. It's quite an improvement and it must have been a tidy bit of work. It's appreciated. -ikkyu2 (talk) 22:01, 10 March 2006 (UTC)

Food

After my night shift (again!) we should plan another culinary expedition. JFW | T@lk 01:25, 12 March 2006 (UTC)

The Cite summary is quite comprehensive. I'd discuss it on the Wikipedia:Footnote talkpage and see if this can be made official. JFW | T@lk 13:37, 21 March 2006 (UTC)

Welcome to VandalProof

Thanks for your interest in VandalProof! You've been added to the list of authorized users, and I will do my best to notify you once a download becomes available. AmiDaniel (Talk) 03:07, 5 April 2006 (UTC)

Citations

I will help with the cleaning up of citations on the BI entry, as soon as I learn how to do so. I am very new to editing in Wikopedia. The burden should certainly not fall entirely on you to do so.Jgwlaw 05:11, 7 April 2006 (UTC)

Ordering Question

in the BI article, you ordered the studies in ascending order, from oldest to newest. Don't you think the most latest research should be first, then with older articles?Jgwlaw 21:17, 7 April 2006 (UTC)

No, but with an important reservation that an outline to a complex topic should be given before delving into the finer details (hence the initial paragraph on Systemic effects from Vasey 2003 is useful before the 1999, 2001 etc points). But as the overall main section header is "Risks and controversy" this suggests a debate/arguement/evolution-in-understanding, i.e. there has been a historical process (which in itself should be less subject to POV/NPOV disagreements) as well as an epidemiological body of knowledge for wikipedia to help summarise (whose conclusions are more open to personal assessment/interpretation/debate). If FDA rejected a claimed risk, this logically must come after having sent out in the article what the claimed risk is. Likewise if there are then critisms of the FDA's methodology in coming to their opinion, then this needs to come after setting out what that opinion had been.

I feel entries should have increasing depth of understanding as one progresses from a dictionary defifinition, a summary basic view, deeper understanding of issues with core research findings to finally appreciating the intricacies of disagreements & debates and continuing ongoing research. In this regards think of all the possible readers from young school chldren (who will only grasp the fefinition of what they are), older children who will be interested in their long use (from their perspective) and that a question of safety raised, to us adults (who will view their use as being "recent") and how complex the issues & arguments go. Of course the overal article must read well (so some flexibility) but there also needs to be some logic to issues advanced :-) David Ruben ^Talk 22:37, 7 April 2006 (UTC)

Vandal Proof

Vandalproof is a windows application only? Boo Hiss. Sorry for so many questions. And thanks for the info on citations. I will digest it this evening and get back to you on it.Jgwlaw 21:19, 7 April 2006 (UTC)

BI article

You don't find it notable that platinum shows up in breast milk? I will re-edit that back, because I do think it noteworthy. If you really don't think so, we can discuss.

above added by User:Jgwlaw 00:31, 8 April 2006

• It was listed along with hair & nails which I don't find nearly as important as long-term retention & accumulation in the body. Certainly if women are affected from long-term presence of implants and if platinum has anything to do with this, then my edit helps highlight this (vs presence in hair & nails, which in comparison are irrelevant).
• I was thinking about the prior discussion over systemic effects to the woman in this. But I get the point you highlight - namely that whilst presence in milk has no longterm direct consequences for the mother (like its presence in urine, hair or nails that are also "lost" from her), it might be an issue for a baby consuming this.
• Yes therefore I agree, seems reasonable to reinsert its presence in milk, but might be clearer as a separate point after discussing its presence in the woman. Given I have only read the newspaper report you kindly provided and the abstract of the original paper (rest is on subscription), one may need to be take with wording:
  • "presence in milk" might not imply a significant quantity (there again the full article might clearly state so)

Mean platinum concentration in breast milk samples from women exposed to silicone breast implants was ~ 100x higher than for individuals with no known Pt exposure. That is most significant.

Possibly, but 100 x a "totally insignificant" amount, might still only result in the less minute "insignificant" amount. Relative levels are interesting, but absolute levels (with respect to international safety levels - of which I have no idea) even more noteworthy. Again, the full article might already be elaborating on this point ... David Ruben ^Talk 03:02, 8 April 2006 (UTC)

totally 'insignificant' amount? I don't know that there are safety standards. The argument had been that platinum was not unsafe in the body and this article challenges that..67.35.126.14 03:59, 8 April 2006 (UTC)

• • I am unaware of how well platinum is absorbed by a babies gut (if poorly absorbed through digestion, but readily accumulated if its source bypasses the gut - i.e. from an implant), then this might not be quite as significant. Platinum#Precautions doesn't seem to help with this. David Ruben ^Talk 00:01, 8 April 2006 (UTC)

I don't know either. It is a very good question.

• Initial quick attempts to search into this yeilded almost incomrehensible studies on chemotherapy cis-platinum given intravenously in chemotherapy. However one report just about understood in mice which seems suggest platinum absorption not problem cis-Amminedichloro(2-methylpyridine) platinum(II) (AMD473), a novel sterically hindered platinum complex: in vivo activity, toxicology, and pharmacokinetics in mice. Hmmm - almost sorry I asked :-) David Ruben ^Talk 00:12, 8 April 2006 (UTC)

ROFL There is some debate on this, I know. Cis-platinum makes me shudder. My father had been given that before he died of mesothelioma.

BI Platinum study

Platinum study Actually it was not from the abstract, but from the actual article. However, I do not have a link for it.Jgwlaw 02:28, 8 April 2006 (UTC)

Maybe, but the abstract is all that I have access to for free... and the abstract is "official" as it is also from the primary source journal. When full article eventually published in hardcopy, then we can update the citation reference; i.e. volume, issue, page numbers & the "offical" publication date - but I think I may be missing your point here ? :-) David Ruben ^Talk 02:35, 8 April 2006 (UTC)

No, I know the abstract is 'official'. My only point is that I have read the article itself. But I do not have access to the website from whence it came, as I do not have a subscription. I have a hardcopy of the article from the website. I can give an internet citation, however, but it won't be of much use.

I mentioned earlier in the discussion that the article says the level of Pt in breast milk is 100 x greater than that in non-exposed individuals.

==Staphylococcus aureus== Sorry. Read through the changes and it looked mainly like formatting, so couldn't see what was different. Please re-insert your changes. Again, I apologise, just sheer unadulterated incompetence on my part. Read the style recommendations and removed the hard italic tags. Thanks for your patience. --Gak 07:47, 8 April 2006 (UTC)

• Many of your recent changes on Staphylococcus aureus are excellent, but I'm concerned about your conversion of the S. aureus references to Staph. aureus. I realize that many folk refer to Staphylococcus aureus this way colloquially, but the Wiki convention has generally been to observe the italicized <Genus> <species> → <G.> <species> format. In summary, then, I agree with your citation of the "no excess italics" rule, but not your application of it in this case. As such, I've changed that portion (and only that portion as I think the majority of your edits were spot on) back to the original. MarcoTolo 00:18, 9 April 2006 (UTC)

BI article

I am not going to allow one editor to vandalize, and pick & choose what he wants to cite out of a study, especially when he directly benefits financially by the approval of silicone implants. Wikopedia is not an advertisement where he can sell his wares. He added studies but only partially described them. He also deleted the statement about critic of the platinum study being an Inamed consultant - instead Oliver elaborated about his qualifications, while saying nothing about the scientists doing the study. This is patently POV. Furthermore, you criticized my citing an FDA report of a 1995 study (that is still cited in a 2004 FDA handbook). Yet you said nothing about the study at the beginning of the entire section -- an IOM review that was done in 1996. (I corrected it, since the study was NOT done in 1999 as previously stated).Jgwlaw 06:12, 9 April 2006 (UTC)

Voting on BI Split

I have changed my mind, after seeing what the plastic surgeon is doing, and thinking about Ombudsman's concerns. After considering this, I agree that the article should NOT be split. I can see where it would be headed - the 'risk and controversy' would be soon marked for deletion. I see now what Ombudsman meant. And, plastic surgeons have already tried to make the BI entry an advertisement for their wares. The BI entry should be kept as one article.Jgwlaw 07:37, 9 April 2006 (UTC)

Campaigners

You wrote, "As a typical UK GP I suppose I might be viewed by the campaigners as belonging to the medical orthodoxy." Speaking as one whom you evidently consider a 'campaigner', I now do question your objectivity. After seeing this debacle with implants, I can say that my respect for "medical orthodoxy" has plummeted. But then, I wonder if "medical orthodoxy" has changed. It does appear that a certain 'brand' of medical orthodoxy is more concerned with bashing lawyers, avoiding accountability, and reaping profit than it is concern for patient well-being. Jgwlaw 08:54, 9 April 2006 (UTC)

• Thats not quite the meaning I intended. The other user obviously had been heavily editing and with little regard for encyclopedic style (just awful English, abstract copying and swamping with statistics) or provision of references with full citation details. My discussion on their talk page (as opposed to an article's talk page) was therefore meant to be purely about their editing style (rather than discussion over content which I would reserve for an article's talk page) - I was pretty unhappy at all the work required to resort out the references (I would rather be contributing to an article's content/description rather than copyediting citation styles and phrasing of their inclusion). I was therefore trying to indicate that I have no particular formed view (although "might" be more inclined to support rather than reject their POV) and was only trying to address (at that time) issues of wikistyle/formating. I think (hope) I'm still (I hope) open minded, although I recognise that I "might" be seen as part of the establishment (I am a doctor after all which would tend to make me part of the "medical community" whether or not I agree with all generally held medical-consensus views or not). I was therefore trying to reach out to that edtor by "being nice" in the hope of engaging in discussion on wikiformating, which might then lead to some talk-page discussion on how to best work on the article (rather than the constant editing sequence that seems to be occurring).
• As for my "objectivity" - whilst remaining doubtful on the topic, you'll notice that my recent edits were mostly reductionary in the swamp of "pro" methodology & statistics, and I was quite scathing of how it had been dumped into the article. Whilst that does not prove I am objective, nor does it disprove.
• For what it is (not) worth in wikipedia (all editors should be able to reach agreement on consensus NPOV editing), I am personally split in my opinion - one the hand I am not yet convinced that the evidence confirms CTD caused by BI, against this rates of rupture seem alarmingly high (even if silicone were safe, the implant walls really should not rupture at all) and the suggestion of a previously unrecognised/non-accepted reaction to this seems to have some supporting evidence. Whilst accepting that I have to trust specialists much of the time in order to function (I trust the pharmacist to dispense the right drug, patients not to over or under dose, manufacturers to place right ingredients into the tablets, regulatory body to have verified safety, government to have selected appropriate people for the regulator body, fellow citizens to appoint a responsible government) that still leaves me ambivalent about the regulatry bodies. One the one hand I tend to trust them to have withdrawn BIs from market for valid reasons, on the other I fail to see problem with emergencey contraception & the FDA refusing to license on seemingly political growns. I obviously can't have it both ways and remain unobjectively 'black & white' in my viewpoints - which suggests that I need remain open-minded to the evidence as well as how medical-politics really works (both positively & negatively). All this, I guess, is to state that I remain doubtful (which is not the same as denying that there might not be risks). WP is of course not meant to be Personal Original Research but on this article, at least, it has contributed to my Personal Awareness of some of the Research - and learning is what an encyclopedia is meant to be about. So I look forward to continuing to jointly contributing & learning on this and other articles :-) David Ruben ^Talk 13:47, 9 April 2006 (UTC)

I must say that I am far less trusting of (medical) doctors than I once was. This is probably a good thing. I was raised like many to believe that (medical) doctors were somehow immune to the vagaries of human bias. However, I still am astonished at the attempt to turn this article into an advertisement for BI. I even wondered last night if maybe there really is no possible connection, after all. But then, as you point out, silicone implants were taken off the market in the US. And, there are studies that are not funded by manufacturers that do suggest systemic problems. I also look at my own experience and it is crystal clear not just from subjective, but from objective, information. I am well aware that an individual experience is merely an 'anecdote' statistically. In legal terms, it might be the equivalent of strong 'circumstantial' evidence. And as an engineer, if I saw such behavior in a design, I would want to find out why -- certainly not dismiss it as meaningless. I am grateful that I had a GP that maintained similar 'curiosity'. What would you think if you knew that doctors have told women that silicone in their lymphatic system is 'normal' with breast implants and nothing to worry about? What about if some doctors advise women not to remove ruptured implants, because doing so would not affect their health? Would that strike you as strange? I often wonder if the fact a possible correlation was first raised in court is the reason for such hostility. I don't know.

Oh - even if the sole physical response from silicone rupture is local chronic inflammation and giant cell reaction, would you consider this 'normal'? Would you want this in your body?

The 'dumping' of that plastic surgeon editor still astonishes me. After all my experience, it is very hard for me to comprehend that a ""medical"" doctor would be so closed minded and biased. It goes against the grain of what ""medical"" doctors are ""supposed"" to be in relation to their patients and the public at large. Contrary to what some medical doctors complain, lawyers are subject to an ethical code, the violation of which results in censure or disbarment.

I also agree with you that the FDA is a political body and has become increasingly more so in recent years. The refusal to approve emergency contraception is an American pandering to the religious right. Also political was "President" Bush's insistence that FDA approval should bar citizens from access to the courts -- the FDA never makes a mistake? Oy vey. That lobbying, however, came to an abrupt halt when it became known that Merck had deliberately concealed its own research from the public.

I also do not subscribe to the belief that all pharmaceuticals, medical devices, or the medical profession are somehow suspect. While I have not investigated the 'autism epidemic' controversy, for example, I am grateful that polio vaccine, to name one, was available so that we are not subject to the same risk that our parents once were. I was raised in a family of scientists. My own educational background is math and science, long before law. I have no interest in abandoning medical or scientific advances. However, I am also aware of the (increasing) financial influence and conflicts of interest. The incidence of financial conflict among medical doctors is a growing concern. An example of this is the scandal of doctors only sending patients to labs or clinics in which they are heavily invested. Yet I would never dream of making such bald statements in a Wiki article, in contrast to some comments I have seen about lawyers.Jgwlaw 18:26, 9 April 2006 (UTC)

As to the poor grammar and spelling and dumping, that doesn't say much for the editor who so disregarded good form.Jgwlaw 19:01, 9 April 2006 (UTC)

A Download Is Now Available

I just wanted to let you know that a download of VandalProof has recently been made available. AmiDaniel (Talk) 09:48, 9 April 2006 (UTC)

BI article - vandalized again

I need your help. Oliver vandalized the article again. He deleted the entire meat of the platinum study findings -- even the sentence you wrote that you found important. Please go look at the history there. Also, I agree that other studies should be included, those that don't agree with some of the FDA findings. I would like your help in finding a balanced way to do this. The chart I think you added is not a bad idea, but it only includes those studies selected by Oliver. Highlighting that suggests the other information is somehow diminished. I still think the better way to handle this is in a narrative form, summarizing some of those studies, without dumping every single one - he included case studies, also, and reviews of studies that were very small or by the same researchers. Many of those are funded by Dow Corning, as well. I would like to go through that with some care, to see what is valid to mention and what is not.Jgwlaw 07:53, 10 April 2006 (UTC) One older study, for example, that he had added earlier at some point, was the Mayo Clinic study. It was my neurologist, who did his residency at Mayo, who first told me that the study was funded by Dow Corning, and that Mayo was a defendant in a lawsuit at the time of the study. In fact, Mayo later sued its insurance company claiming that the study was done for its defense. That took moxy.Jgwlaw 07:53, 10 April 2006 (UTC)

Ok - see the article's talk page (please don't take anything personally too positively or negatively) - there are issues of both content & styling that apply to either Oliver or yourself. I think you have made some good points, but have been a little drastic in some of the changes; hey - this is wikipedia and its main advantage is that the best of many author's contributions can be merged :-). The article is being edited heavily and swinging back and forth - that is an edit war (or content/POV dispute) not vandalism (as I understand its usage in wikipedia). There is clearly a failure to reach a consensus on the article (for want of not "flaming the flames", I'll ascribe no specific blame) which certainly fails to meet the spirit of wikipedia. I think this is heading for a WP:RfC, but have had a go at setting-out a framework on the talk-page for editing to cease for a bit (whatever the article's current state) and trying to reach some consensus.

I don't think each and every part of an article's sub-sections has to be NPOV - Of course there can be a pro & con for each point in turn, OR a single POV's list/table/bullet-points provided that it is immediately followed by a counter-balance. I think its a matter of what suits the article or the particular section best. I think the comment after the table, about the FDA's view on the statistical quality of all previous studies, was quite damming enough - and therefore there is/was no need to over expand on each study with a specific individual praise/critism (but that's just how I interpreted the article on reading it).

Having seen a few content disputes on other articles, don't let this cause too much wikistress, take a deep breath, take a break (if required), seek support/mediation (if required) and/or ask for others to contribute/comment (RfC).... I hope we can sort out this interesting article about an important topic soon ... :-) David Ruben ^Talk 18:17, 10 April 2006 (UTC)

I consider OLIVER'S editing drastic. I do see that you are somewhat biased here, but maybe we can still work it out. Plastic surgeons DO benefit from silicone implant approval and to suggest otherwise as he has done is simply dishonest. By the way, there have also been problems with saline implants, although that seems not to be the focus here.

A whole batch of saline implants had defective valves, and bacteria and mold grew in the implants. They also were black when removed. Women who had these had systemic fungus problems,. among other things. That attitude of plastic surgeons that close their eyes to any research that is not favorable to implants is frightening, to say the least. If there were no conflict, don't you imagine they would wonder about the studies funded by manufacturers? The plastic surgeons that I know and trust DO think that is a problem. (and yes there are a few).Jgwlaw 03:40, 11 April 2006 (UTC)

Drug bias....Interesting article

Hi David, This is exactly why I (and many many others) do not believe Dow funded results. Especially when the sponsor of the study is a defendant in a related lawsuit!! Obviously, this is no big surprise, but still I found this article in WAPO today interesting - it is about the conflict wrt drug manufacturers, but the same principle applies. http://www.washingtonpost.com/wp-dyn/content/article/2006/04/11/AR2006041101478_pf.html Jgwlaw 02:06, 12 April 2006 (UTC)

BI article

It is clear to me that Oliver won't even discuss changes on the discussion board, however. In many instances, I left what he had but added additional findings - which he did not want to include.

I also asked him for a citation and summary for the France article which he refused to provide. For the IAEG, I omitted it because it even stated in the report that it was limited case reports! He deleted comments of mine arguing that case reports should not be included!

I do find him arrogant, offensive, excessively rude and I haven't even started about what I think of his bias. It's scary. Enough I never want to see another plastic surgeon again in my life, for any reason. Well, with the exception of a good friend who is, but certainly not like this idiot. That user is Oliver - it's obvious. His sarcasm is identical to his 'user name' sarcasm. What astounds me most is that one would think (or hope) that a medical doctor (even a plastic surgeon) would be open to the pros and cons of a medical issue. Forget about me for a minute, as I am not a medical doctor (I have a 'doctorate' but but not in medicine). A medical doctor would ostensibly be interested enough in potential problems for his/her patients that he/she would look at all the information. Oliver deleted entire findings, selectively lifted what was convenient... It makes me shudder. Does he do that in his practice? I bet he tells women that breast implants are 100% safe, and the information packet he is required to give them (the FDA packet is now a requirement) is just legal nonsense required to prevent frivolous lawsuits. That is his attitude. Scary. No wonder he hates lawyers. And it is precisely these kind of doctors that make med mal and product liability lawyers necessary.

As to the other - you make an interesting point. Your gov't flyer/newsletter is the equivalent of insurance companies here only paying for generic drugs or older drugs, regardless of the merits. It's a problem both ways. On the one hand, 'new' drugs are often very little different from old drugs - change something minor to license a new patent, when the 'old' patent runs out. On the other hand, sometimes newer drugs really are better, or significantly different. How in the heck are we to know? Then in the US there are the 'off label' uses which the FDA does not prohibit. Pharmas suddently find a million and one reasons for the drug OTHER than what it is FDA approved for, and market this to physicians. Neurontin was one such drug. It is approved for epilepsy (I think) but was notriously used for everything under the sun. I used it for neuropathic pain, but finally quit taking it. Since my explant, that pain that I had had for 5 years has simply gone away. (Did you not the finding about ANA levels, by the way? I told you my ANA is now negative after being 1:640 for 5 years. Presumably 1:640 is still a relatively low titer, but still it is positive).

Finally, there is a serious problem wtih conflict of interest in research. The New York Times had a huge article about this also some time ago, but I do not recall which issue. Dow Corning was (and is) notorious about that. Court documents are rife with evidence that Dow manipulated research.Jgwlaw 04:02, 12 April 2006 (UTC)

Barnstar

		The Original Barnstar
		Davidruben is hereby awarded this barnstar for both his fine efforts at mediation at Talk:Breast implant, and for his numerous other fine contributions! Thank you for your hard work!

Mike1024 (t/c) 00:11, 13 April 2006 (UTC)

“Medicine” on MCOTW

After a bit of inactivity, Medicine has been selected as the new medicine collaboration of the week. I am taking the unusual step of informing all participants, not just those who voted for it, since I feel that it is important that this highest-level topic for our collaboration be extremely well-written. In addition, it is a core topic for Wikipedia 1.0 and serves as the introduction to our other articles. Yet general articles are the ones that are most difficult for individuals to write, which is why I have invited all participants. I hope it isn't an intrusion; I don't make plan to make a habit of sending out these messages. — Knowledge Seeker দ 02:16, 16 April 2006 (UTC)

VandalProof 1.1 is Now Available For Download

Happy Easter to all of you, and I hope that this version may fix your current problems and perhaps provide you with a few useful new tools. You can download version 1.1 at User:AmiDaniel/VandalProof. Let me warn you, however, to please be extremely careful when using the new Rollback All Contributions feature, as, aside from the excessive server lag it would cause if everyone began using it at once, it could seriously aggitate several editors to have their contributions reverted. If you would like to experiment with it, though, I'd be more than happy to use my many sockpuppets to create some "vandalism" for you to revert. If you have any problems downloading, installing, or otherwise, please tell me about them at User:AmiDaniel/VP/Bugs and I will do my best to help you. Thanks. AmiDaniel (Talk) 06:44, 16 April 2006 (UTC)

Breast implant

Hello David,

I just wanted to ask you if you continue to take an interest in the above article. It's in a very poor state at the moment, and will require sustained attention from a dispassionate and experienced editor (or editors). I am pressed for time, and will not be able to take that role, although I will certainly try to help. Would you be so kind as to drop me a note? Best wishes —Encephalon 02:26, 17 April 2006 (UTC)

Breast Implants, again....

Hi David. I thought you would like to know that we are still working and editing....It seems that Oliver was correct in part, about the original saline implants. And I was correct in part. In fact, the more I read about the history, the more contradictory statements I find - in academic journals. I have asked a board certified plastic surgeon (who is quoted in some of these journals) to help with input. He has a hell of a lot more experience in plastic surgery that Oliver, I suspect, and is a renowned expert in the field. He said he would help us with this. He also corrected me on the Baker contracture levels, which neither Oliver nor I caught. molly bloom 03:41, 18 April 2006 (UTC)

I found this was you after I read the history

Please identify yourself on my user page. As to your comments...I would also like to suggest that sometimes the editorial changes are new WIki editors trying to get formatting or other such things in order. At least, that was well over half of mine. In fact, I have not had a chance yet to get in order the references, because when I tried it did not work. Then an editor (the one you referenced) deleted an entire section I had written for lack of reference. And the content of that section is not debatable - Oliver simply collapsed it to a single sentence because he did not want to highlight the local complications. In turn, that rendered a photograph I uploaded meaningless. I later added 3 references to this section, in the format you detest, until I have time and a chance to practice the 'proper' formatting - lest some other eager editor eviscerate what I have written. I have shortened the section considerably, pursuant to your criticisms. Further, if you read the comments fully, you would see that that editor accused me of 'blanking' - which I most certainly did not do. That is very annoying. I would also hope that you refrain from running to an administrator any time someone has multiple edits. I am sure one day I will become proficient at Wiki, but I have been on here less than a month.molly bloom 05:01, 18 April 2006 (UTC)

BI

Thank you for your comments. I was rather taken aback by the accusation of blanking by the other editor... I then realized that he had not read what had been done, or the references. I know if I edit other articles, what not to do -- go in and slash, without reading or comprehending what was written. I don't believe I would ever do that, however. As to references, I must admit I haven't yet figured it all out - I finally got to your notes this morning over coffee. I think I need to 'play in the sandbox' to see better how to do this. Programming or coding was not my forte in engineering. I was an "EMF" engineer (electromagnetism) & telecom. I went to law school as a second career, after many years in engineering. Now I am so glad I did. I now work the hours I choose. I never expected to become so ill, with autoimmune illnesses. My energy level is still not what it should be, although my health has much improved since ruptured silicone implants were removed. I wish I had not been 'graced' with the diagnoses of lupus and MS. It seems the only thing that did for me is to render me uninsurable. (I was not hospitalized with either lupus or MS, however, and would have therefore been excluded from the studies Oliver cited - regardless of definitive diagnoses). I only wish doctors like Oliver could actually see the differences in women like me.. but alas, I fear his mind is closed to these issues. Ironically, it was a medical doctor who first insisted my implants were causing me so many problems, when I initiallly could not believe it. I say ironically, because to hear Oliver one would think all doctors believe silicone implants are 100% safe. I also fear for women who have older implants (over 10 years old) whose doctors insist they should not be removed. Given the fact that now the literature 'admits' that 10 years is the approximate 'life span', it is inconceivable that some doctors still tell women not to remove old implants. I just thank God that I had an internist who knew better, and a friend who was an MD to encourage me otherwise. The difference in my health was dramatic. There is no other possilbe conclusion one could make, but that the ruptured implants were making me very very ill. Had I not had the surgery, I would not be here editing Wikopedia. I would not be working. I may not even be alive. And this is the danger of those like Oliver adamantly closing his mind to the possibility that individuals may have different susceptibility to autoimmune disorders. As a scientist myself, I cannot conceive of such an attitude. It is frightening.molly bloom 14:37, 18 April 2006 (UTC)

other editors for BI

I may have to twist his arm ... I know he is busy. He said he would, though. We'll see.molly bloom 00:26, 20 April 2006 (UTC)

ChildLess Mother - reply

Thank you for your introduction. There is no book called Childless Mother that I know of. My website has several missions: to raise awareness about pregnancy loss and pregnancy after loss, to provide resources and support to individuals in need, and to sell the book Journeys: Stories of Pregnancy After Loss. The last one being ranked last because there are other venues doing that (Amazon, etc). My focus is providing information. I hold a Masters in Public Health and CHES certification from NCHEC and have spent my career working with the underserved. Women experiencing stillbirth and miscarriage definitely are underserved and need support, information and direction. I've given a myriad of talks to support groups, at colleges, at conferences, fundraisers and staff from my state Senator's office. I've been written up in my town newspaper, have written for my town newspaper, and will soon be profiled for my contribution in this field in a more regional paper.

Perhaps I jumped into Wikipedia too soon, given all the comments. I especially wonder the appropriateness of a 20-year old male college student being able to state Childless Mother should be deleted. I'll just figure he has nothing better to do.

I'm not angry or bitter or seeking pity. This topic is due for a major awakening in the world's psyche. I have endorsements for the book from leaders in this field.

I'll accept whatever the outcome of the decision is and perhaps when I'm not helping others will try to draft a more wiki-compatible piece on Childless Mothers.

Elovesme99 13:18, 21 April 2006 (UTC)