He said, “AIDS and HIV Are FAKE Diseases Created By the Condom Industry To Sell Their Merchandise To The Unknowing Public.”

“Wise Words” by Jaden Smith …

Screenshot (6)

Believe it or not, this is actually a thing: HIV denialism. Reading these denialists’ blogs/ listening to them online just gives me the heebie-jeebies considering how devastating the effects of HIV  have actually been for patients who contract the virus. In addition,with new medical developments and decreased mortality rates, a new complacency has set in with condom use. Unfortunately, a lot of young adults seem to think it is “uncool” to use condoms or that it is a sign of “having something” when a partner advocates for condom use or the excuse of the weakest of all personalities, in my opinion, – it shows “lack of trust”. Besides the various significant social and mental health impacts of this disease, it costs approximately one million Canadian dollars to treat one patient through a life time of the disease, according to HIV Edmonton. Yet, 15605 people shared this apparently “ground breaking epiphany” by the then 14 year old Jaden Smith , 7351 people thought it was something they should recognize as one of their favorite tweets. Incredible!

*Sigh*

Let’s do a Risk Vs. Benefit analysis of Jaden’s “theory” just for shits and giggles.

Risk if you believe HIV is not real and you use male condoms anyway: You wasted <$2; may reduce sensation (perhaps last a little longer), interrupt foreplay in order to place the condom on penis properly AND make those awful Condom Manufacturers rich.

Benefit if you believe HIV is not real and you used male condoms anyway: You reduce your risk of: unplanned pregnancy, Gonorrhea,  Chlamydia, **Hepatitis B,  Lymphogranuloma Venereum, Trichomoniasis, *Herpes, *Syphilis, *Human Papilloma Virus, *Cervical Cancer, *Genital Warts. You may prevent premature ejaculation (in some men). You may reduce your risks for spontaneous abortions and infertility in the long run.

Don’t know about you, but it seems to me that the Benefits by far outweigh the Risk of being conned by those Condom Manufacturers.

My hope is that the kid was just being sarcastic..or thought he was just being a hilarious 14 year old… that being said.

…I’m seizing my Pharmacist Counselling Moment of Glory Here to Share Some #CondomPoints!

#POINT : HIV is real, as ~ 34,000,000 people living with HIV can attest to this point.

#POINT: We can get to Zero infections by sharing sound knowledge and actively participating in harm reduction efforts (BC has nearly eliminated cases of AIDS).

#POINT: When used consistently and correctly, there is evidence that, male condoms reduces unplanned pregnancy and reduces risk in both men and women of gonorrhea, chlamydia, trichomoniasis, syphilis, herpes, HIV and HPV.

#POINTCondom use does not undermine sexual risk reduction efforts by causing high-risk sexual activity or increasing the frequency of high risk behaviour – evidence from a systematic review of 174  sexual risk intervention studies.

#POINTThere is good evidence that when one partner in a couple has HIV and the other does not, consistent condom use reduces the risk of acquiring the infection by 80 to 95%

#POINT: Different sexual behavior & even positions may affect your risk of contracting a Sexually Transmitted Infections (STI) — More on this topic in upcoming post.

#POINT: STIs, if left undiagnosed could lead to infertility.

#POINT: Whipped cream, a Massage and your Tan might ruin your condoms… oil based products reduce latex condom integrity. Some topical medications, baby oil, suntan oils, vaseline, edible oils, massage oils etc are on this list.

#POINTCondoms are most effective when used with every act – Anal, Vaginal and Oral.

#POINT: New condoms should be used for prolonged sex; and for different types of sex within a single session (for example change after anal sex, before vaginal…)

#POINTThe condom should be used during the entire sexual act. That means, you shouldn’t put it on after genital contact or remove it prior to ejaculation… from beginning of genital contact to after ejaculation.

#POINTNot all condoms are created equal. Natural membrane condoms are made from lamb intestines, contain small pores and should not be recommended for STI protection.

#POINT:  CRAP happens! 2% of the time during vaginal intercourse (rates vary widely across studies and are a little higher during anal); the condom may slip &/or break….
A Back Up Plan? … have several more condoms available, gently wash your genitals with soap and water, though this practice has not been very well studied, washing may reduce your risk of acquiring an STI,  insert an applicator full of spermicide vaginally (to help prevent pregnancy). Note to Girls – Do Not Douche….it does more  harm than good.

#POINTIt is possible to contract an infection during foreplay and non-penetrative sex. A condom placed on the penis before any genital contact greatly reduces risks of infections

#POINTSome infections are transmitted primarily through skin surfaces like herpes, syphilis, chancroid and HPV when the condom completely covers the entire infected area, transmission risks are reduced as well….if the infected area is not covered by the condom then transmission is more likely.

#POINT: Next time your partner says condoms reduce the sensation/ are too sterile, remember that condoms come in a variety of shapes, sizes, colors, thickness, with or without lubricants/ spermicides, with or without reservoir-tip or nipple-ends. They can be straight-sided or tapered toward the closed end, textured (ribbed) or smooth, solid-colored/ nearly transparent, and odorless, scented or flavored — Perhaps this comment should simply be taken as a challenge to discover the “sensational” condom…I propose that all sexually active people should own Sex Kits containing one of each…(plus a travel sized kit… latex condoms can probably be carried, for convenience, for up to one month) 😉

#POINT: It is true that the odds of your partner having an STI in Canada are generally low — From the latest reports that I could find in 2010: 277.6 overall cases of Chlamydia per 100,000; 33.4 overall cases Gonorrhea per 100,000; 5.2 overall cases of Syphilis per 100,000; because HIV is not yet curable, I’d share the number of people living with the disease not the number of new cases/ year. In 2011, 71300 were estimated to be living with HIV in Canada plus 17,890 who were potentially unaware of it; meaning, 89280 people were likely carrying the virus out of 34.34 million Canadians that year.

These odds may increase significantly depending on various factors such as age, gender, race/ethnicity, sexual orientation, incarceration, intravenous drug use, number of sexual partners, marital status, residence in an urban area, new sex partner(s), history of prior STI, illicit drug use, contact with sex workers, intimate partner violence.

#POINT: Your knowledge of the low statistical odds, of meeting someone with these infections in Canada, is in fact meaningless to you, because you are not a science experiment, and as such, you are not the statistical average of 35 million people. You do not as a matter of fact know you & your partner’s status at every possible moment. You do not know the exact virulence factor of the bug(s) you may/ may not be exposing yourself to.You do not know how your odds of infection are skewed by the intersection of all the aforementioned factors in your particular case. For example, those odds of having Chlamydia in 2010 could shift from ~ 1 in 360 overall to closer to 1 in 50 if you were a 23 year old female living in Canada at the time.

… On The Twitter Philosopher….

This is the problem with everyone having a platform to share their thoughts, crazy ideas and pseudo-journalistic efforts, people use their influence to spread non-evidence based non-medicine nonsense about very important medical topics. Our patients are inundated with these messages, news and ideas daily. It is for this reason, I think it is crucial that we (actual Health Care Professionals) consider developing the skills required to engage with our patients through these new platforms of communication. A social media presence is becoming more crucial than ever imagined to share good quality messages with our patients. Our social capital as healthcare professionals place us in an ideal position to influence general thoughts and ideas about various topics and hopefully fix damaging content that sometimes end up forming general opinion. I wish there was a forum for our colleges and regulatory bodies to list advisories/ warnings about bogus sources of health information too. Bad information can be as bad for one’s health as administering an inappropriate medication.

There is a distinct dearth of engaging health media. It would be helpful if more critically evaluated evidence based medicine starts getting shared in patient friendly language online.

For now, I have created my tongue in cheek tool tip for my patients who show up at the pharmacy, having self-diagnosed via Oprah/ WebMd/ Dr. Oz. I plan to actually hand this out, the next time someone comes in with some absurd knowledge acquired from the internet or television; I’ll keep you all updated about how my first use of this card goes

Source Checker

…. Back to Jaden …

$2

vs

Reduce your risk (even when already low) for HIV &/or unplanned pregnancy  &/or Gonorrhea &/or Chlamydia  &/or Hepatitis B  &/or Hepatitis C &/or Lymphogranuloma Venereum  &/or  Trichomoniasis &/or *Herpes&/or  *Human Papilloma Virus &/or *Cervical Cancer &/or *Genital Warts &/or Syphilis .

???

It seems to me that if you are upset about condom companies getting rich, then you should buy stocks and get rich with the condom companies too! (May I suggest the Female Health Company Nasdaq: FHCO? They are doing particularly well…)

get tested and…

use the damn condom!

*Even with use of condoms, HPV (which could cause Cervical Cancer & Genital Warts), Herpes and Syphilis may still be contracted depending on what part of the genitals is infected. For the giver of oral sex, a condom may reduce risks of contracting HPV, Herpes & Syphilis as well.

**Hepatitis B is the smallest sexually transmitted pathogen; laboratory studies indicate male condoms are an effective barrier against this too.

I specifically referred only to male condoms in this post, because most of the efficacy data available are related to those more so than female condoms.

 

Sources:
Therapeutic Choices
UptoDate.com
5 years of great education at the University of Alberta.

White People Problems? – Anorexia – Ultra-Thin Model Ban

This post is a few months due, but I was too busy to write my thoughts when this was more of a relevant topic. Bear with me.

In April, France joined Israel, Spain and Italy, in banning the use of models with a BMI < 18. Use of underweight models, in France, will come with a chance of up to 6 months in jail and a fine of up to $82,000 (USD). Because France is a major hub of fashion and in fact influences a lot of trends and thoughts about clothing and the female body image, I was thrilled about this ban. In my opinion, the media does play a huge role in body image distortion for many young women; I’d go as far as saying your TV, Radio, magazines, books, websites and newspapers could be some sort of risk factor for developing eating disorders.

There are some deficiencies in broadly applying BMI as a unit of measuring healthy weight. A number of theories exist: BMI may underestimate obesity in metabolically obese normal weight people (often referred to as skinny fat people), or may over estimate obesity in shorter people like with people in lower socio-economic classes or also in people with far east Asian heritage… or my personal favourite, BMI overestimates obesity in some athletes, so that lean Olympian with lots of heavy muscle seems more obese than your neighbourhood couch potato if you assessed by just BMI. These theories and truths aside, I do believe this was a great positive message to send to healthy weight girls that forcing yourself into looking like this>>

anorexic… is in fact not representative of most women

… neither is it fashionable or beautiful.

I actually think this portrayal of ultra-skinny femininity as an ideal, is in  fact a public health concern.

I got to wondering about which women (because this is more prevalently  a women’s issue) might be influenced by the ban. Though Anorexia  nervosa is a rare condition, I wondered, if most Countries implemented this ban, would it have a truly global impact in spreading knowledge about healthy body images?

In case you are unaware, I’ll let you in on a well-known, but often ignored secret … There is some temptation amongst immigrants to label certain diseases and conditions, as a problem only for “developed countries” or western societies or in particular Caucasian people in higher socio-economic classes in developed western societies. Pretty much all mental health conditions and eating disorders happen to fall into this box.

There is even a theory about why Anorexia Nervosa might be just a developed society’s problem:

The age-related obesity hypothesis: posits that the otherwise normal tendency by women to seek a youthful appearance can become maladaptive and lead to anorexia nervosa in environments in which thinness becomes the primary indicator of youth, such as in modern industrialized societies”1

Hmmmmm….An interesting sociological determinant of health….

Truth is in most western societies, there exists an obsession with weight loss, staying skinny and attempting to reach crazily unattainable and unhealthy physical attributes displayed by actors and models. This preoccupation unfortunately gets tied into many young adult’s self-esteem and self-image with concomitant psychological effects. Where I’m from, being curvy, voluptuous even fat was an attractive feature (this fact is changing with increased influence of globalization and spread of western media influence), so it is tempting to assume, no one is anorexic in Nigeria. I found exactly 2 case studies of Nigerians in Nigeria diagnosed with anorexia nervosa, which might indicate gross under diagnosis of the condition or the assumption that it is not an African problem or may be related to the fact that most Nigerians still consider fuller figured women as beautiful. Anorexia Nervosa is definitely not exclusive to Caucasian people in Western developed societies, however an increase of this condition has been associated with urbanization and the spread of media – exposure promoting western ideals of beauty.2-5 So, once again, I’ll say I’m pleased that France, Israel, Spain and Italy are making baby steps in altering this particular risk factor.

I know this is not a highly prevalent condition, but I wonder about ethnic minorities in Canada? Are there equivalent rates of anorexia nervosa amongst our ethnic minorities in Canada as in the general population?

I could not find a solid answer to that question. So, maybe you physicians who get to deal with this more often can share thoughts?

 

  1. Lozano GA (2008). “Obesity and sexually selected anorexia nervosa”.Medical Hypotheses 71 (6): 933–940. doi:1016/j.mehy.2008.07.013.PMID 18760541.
  2. Eating pathology in East African women: the role of media exposure and globalization. Eddy KT, Hennessey M, Thompson-Brenner H, J Nerv Ment Dis. 2007 Mar; 195(3):196-202.
  3. Nasser M. Eating disorders across cultures.  2009;8(9):347–50. doi: 10.1016/j.mppsy.2009.06.009.
  4. Becker AE, et al. Social network media exposure and adolescent eating pathology in Fiji.Br J Psychiatry. 2011;198(1):43–50. doi: 10.1192/bjp.bp.110.078675.
  5. Pavlova B, et al. Trends in hospital admissions for eating disorders in a country undergoing a socio-cultural transition, the Czech Republic 1981–2005.Soc Psychiatry Psychiatr Epidemiol. 2010;45(5):541–50. doi: 10.1007/s00127-009-0092-7.

The Crack Binness vs. The Amway Bizness & The Delusion of Free Enterprise

So… As I was sharing….continuing from my last post
The final meeting was short and not sweet.
Heather’s mentor (I’ll call her Griselda) wanted to know what I thought of it all. I said quite frankly that I did not see a business plan in their “bizness” plan…. Apparently, I was wrong. Of course it was a solid plan; I just had to see the overall vision of the Big Bizness! Griselda knew many people who had retired by 35 as millionaires; this was for a greater good too, to help other young women progress too. She was a charismatic young woman, warm and gentle…not pushy. She sounded sincere, even believed what she was selling. As she spoke, she mentioned often that it was not her job to convince me, the bizness was very simple. There was no need to complicate it with statistics, research or numbers. I simply had to consume $300/m; sell $150/m. I’d earn 35% in savings off personal use and 35% gross margins off sales. I just had to be open to it; see how I might fit in the ultimate goals.

I just do not see how you can call something a business plan without any numbers…

So, I asked for numbers; what would my overhead be?
$49.95/m – Premier membership to get discounts to books, tax info, website access, training, calendar
$5.58/m – Amway fees (paid annually as a lump sum)
$36.95/m – Communicate fees (Communicate is the mandatory Amway audio journal to share your deepest darkest secrets with all the Amway crew)
$25/m – Digital delivery and unlimited DVDs (because anyone still plays DVDs in the year 2015???)
$397.50/m – Inventory costs (with the intention of consuming $300/m; this estimated monthly consumption increases up to $600/ month by the end of the first year for no apparent reason, seems Amway just decided you would need to consume two times more of their “awesome” products per month within the year)

Undisclosed by Griselda but gathered from a friend who was actually suckered into this mess.
~$300 – Upfront sign up fees
$30/m – Book purchases (part of the bizness contract is that you must always have an Amway recommended book on the go – I wish I had that deal to write books with a guaranteed 8 mill in sales it appears that privilege is only for Diamond bizness owners or those higher at the top of the pyramid)
$25/m – Conference  costs (paid as a one time expense ~ $300/ annum initially; this cost significantly increases as you rise up the Pyramid).
??? Unknown costs to purchase recruitment kits
??? Unknown costs Travel, gas & mileage for various meetings
??? Unknown costs for shipping, damages, refunds


Estimated monthly financial cost: $594.98
Projected monthly sales (without any proper market analysis/ p&l disclosure): $150
Performance monthly Bonus (based on $150/m sales): $13.50
Projected monthly Net Margin (per my calculations from their brochure):-$431.48


 

Yes. A monthly loss of -$431.48 (even when I accounted for my current monthly expenses I’d lose – $248.28/m)… And no Break even analysis anywhere in all the DVDs, bizness books, and brochures, just a faithful dream to multiply your efforts at an exponential rate by the base of 18. I deduced a formula from statements and the beautifully illustrated chart bellow, by the second year: Recruits = 18+182; by the third year: 18+182+(182+183); by the fourth year: Recruits equal about 15% of the number of people living in Edmonton and by the seventh year, the plan, by my calculations, involves the potential to have recruited more people than there are living on the planet > 7 billion people….. hmmm

There might be a little flaw in the “plan”.

20150515_193654

Business Fundamentals Which I think Are Fairly Obvious … When One is Not Delusional

1. Big savings sale is really an oxymoron…

If you are consuming your purchase; you are not saving. The two things are mutually exclusive. Yes. All those TV commercials that claim you can save more by buying more lied to you. You save more when you do not buy more. Get it? When you buy what you need at the cheapest price you are being smart and spending less, but you are spending nonetheless. You are not making a profit by buying at a discount. Seems like stating the obvious right?

It is the best plotted racket I have ever seen! These people actually convinced over 3.3 million “independent” bizness owners in 100 countries (or up to 8 million distributors depending on which source you read) to “earn” a living by buying consumer goods for consumption. I think a word should be created:

Amway
verb
To determinedly con people in the most spectacular multi level fashion imaginable.

  • as in: Griselda amwayed Heather till the poor girl literally had thousands in noncash purchase savings and hundreds of thousands in consumed products.
  • or as my Naija people will say: Ma Guy! That Griselda amwayed that Heather maga die!

2. 99% DISCOUNT off of $1000 is still more expensive than 0% DISCOUNT off of $1

Amway products are seriously expensive. According to their brochures, you could spend anywhere between $200/m to $329/m on just facial products. Mint tells me that I spend only $8/ month on my face (cleanser, toner, night cream and lotion purchased in bulk every 3 – 6 months).

20150515_193953

 

3. You never get high on your own supply!

It is not a sustainable or profitable situation when you have to consume your inventory. This seems very obvious; even crack dealers know this. Yet…

In this bizness model, you are not only expected to consume $300/m initially, within 12 months you are also expected to increase to a monthly personal consumption of $600. I currently spend $183/m on consumables…

Griselda informed me that all business owners need to support their own business by buying more from themselves; you “earn” 35% in savings and help everyone in your network…Sigh. 3.3 million people bought this line? Really? Imagine if each Starbucks owner drank 7 out of every 10 coffees sold to support their business as well as everyone in their corporate office.

4. Time is money

8 – 15 hours/ week recruiting people
5 hours/ 2 weeks meeting with new recruits and the team
30 mins/ d listening to Communicate and leaving audio journals about your personal life for “mentors”
2 hours/d reading lots of feel good bizness propaganda >>
20150515_193754

some of these powerful books even had highly edjumacated PhD Level graphs like               this one (real picture, from real book) >>

20150515_193808

 

 

 Working 32 hours per week only to lose -$431.48 per month in the  quest to gain freedom from your oppressive time  consuming job is probably not the most PhD-  like decision one can make.

 

5. In order to have a market, one must have buyers who make purchases from sellers … for that to happen, one needs market share

…You know that feeling that there is a Starbucks everywhere? Well, we have 72 in Edmonton, 65 Shoppers Drug Mart locations, 5 Walmart locations …. 4,000 Amway distributors in Edmonton. Imagine 4000 Walmart locations in Edmonton or 4000 Shoppers Drug Mart locations or 50 times more Starbucks locations. Who is buying if almost everyone is selling???

6. The *Oga at the Top makes the most money; so it makes sense to choose the path of least resistance to the top …

To illustrate this point I thought I’d compare the structure of a Crack Dealing Organization (Numbers obtained from Freakonomics) with a typical Corporate retail structure (Salaries obtained from prospectuses and shareholder meeting minutes) with the Amway-not-sure-why-this-is-a-legal-thing-Pyramid (salaries gleaned from the fine print of the Amway Bizness Plan Brochure). The irony is that Griselda, Heather and Bill truly believe they’ve escaped corporate structure for freedom & financial independence to earn those dolla dolla bills y’all…

Crack Binness
Crack Binness

 

Amway Bizness
pyramid

The odds of getting to the top of this structure (or climbing 6 levels) — 0.00000067 if you do not die or get incarcerated (hopefully someone finally wins a court case against this bunch, because it is crazy that this is legal); where you will proceed to make <0.36% of the organization’s income.

Deduced from the fine print of the brochures:  5 in 1000 distributors make $55,000 a year; 1 in 10000 make $111,000 a year; 6 in 100000 make up to $2,657,000 a year….Not exactly a sure bet!

So, if one was lucky enough not to get shot or incarcerated, one has a significantly (>30000 times) better chance at financial freedom dealing crack than by joining Amway.

DISCLAIMER: I do not in anyway endorse or support dealing crack! Just pointing out how ludicrously bad an idea this Amway madness is.

Corporate Business
Corporate Business

I met with the Amway bizness women … later than initially planned, because at some point before hand, I decided to launch a store for my crafts (Side note: Please visit the Crafters Store at 4805 50 Ave, Leduc for some beautiful things from me!)… an actual business! Needless to say, to the obvious frustration of Heather, I did not buy into this bizness. She made sure I was aware of how risky my current career choices were, and how I was not actively mentoring young women or leading a big network as I might want. Griselda made sure I was aware that not everyone was rich enough to invest and the Amway way was a tried and true model to escape quickly into financial freedom.

Well I was definitely not rich enough to invest…in fact if anyone had odds stacked against them it was me: 15 year old, traveler – now immigrant, living completely independent of family by 19, with that beautiful accent (perceived as a language barrier by most), ignorant of politics, biases, stereotypes & systems, without savings, unable to work off campus & denied access to loans (as an international student), required to pay more on down payments (on work permit status)… and more obstacles than I care to think of. If I could save enough to invest and figure out the system without manipulating poor people into a massively exploitative bizness, then in my opinion Griselda, Heather and Bill could to…It has absolutely nothing to do with having a large enough amount of money to start off.

“Nothing in all the world is more dangerous than sincere ignorance and conscientious stupidity.” Martin Luther King Junior.

 

*Oga – A Yoruba word for Boss.