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  #1   ^
Old Mon, Sep-02-19, 01:19
Demi's Avatar
Demi Demi is offline
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Default Statins review ‘urgently needed’ to find out if millions are benefiting from drug

Quote:
Statins review ‘urgently needed’ to find out if millions are benefiting from cholesterol drug

Science and technology chair says move necessary due to never ending contradictory claims about pros and cons of statins.


Boris Johnson’s new Chief Medical Adviser should carry out an immediate review into statins to help clarify whether millions of patients are actually benefiting from the cholesterol lowering drug, according to the chair of the science and technology committee.

Norman Lamb said the move was necessary due to the number of neverending contradictory claims being made about the drug – by far the most common in the UK with more than eight million people prescribed them.

The Lib Dem former health minister revealed he started taking statins following a mini stroke last year but then stopped due to side effects. He told i he also supports a call from around 20 leading health professionals who have written to him asking for his committee to carry out a parliamentary inquiry into the drug.

The letter, seen by i and signed by those who are “sceptical, neutral or agnostic about statins”, states the group believes there is now an “urgent need” for a full independent parliamentary investigation into statins.

‘Lack of transparency’

It was organised by Dr Aseem Malhotra, a NHS cardiologist and anti-obesity campaigner, and signatories include Dr Fiona Godlee, editor in chief of The BMJ, Sir Richard Thompson, a former president of the Royal College of Physicians, as well as GPs and international cardiologists.

“All are strongly of the view that such confusion, doubt and lack of transparency about the effects of a class of drug that is so widely prescribed is truly shocking and must be a matter of major public concern,” they write.

The group’s central argument is a lack of transparency over the raw data in statins trials dating back several years has prevented a clear picture emerging for the public over the benefits of the drug compared to any side effects, which they argue have been “underplayed”.

The letter states: “There is so much uncertainty and inconsistency about the true, absolute benefits of statins, and the rate and type of side effects, that a completely independent review by scientists without financial or scientific conflicts is urgently needed to give confidence to the prescribers and the public.”

Dr Malhotra said: “Rather than mass prescription based on incomplete and selective information, patients and the public deserve an objective account so that individuals can make their own informed decisions.

“Other studies, looking at whether statins increase in life expectancy have found that, in high risk patients, they may extend life by approximately four days, after five years of treatment. Doubts have also been raised about the claims of benefit in otherwise healthy people aged over 75, in whom statins are now being actively promoted.”

The National Institute for Health and Care Excellence (Nice) says that statins are safe and cost effective for use in people with a 10 per cent risk of cardiovascular disease (CVD) over 10 years. It does not say everyone with a 10 per cent or greater risk of CVD within 10 years needs to take a statin, but that patients should be guided by information on the trade-off between benefits and risks.

The British Heart Foundation says statins are estimated to save at least 7,000 lives each year in the UK. The NHS says the risks of any side effects also have to be balanced against the benefits of preventing serious problems. A review of scientific studies into the effectiveness of statins found around one in every 50 people who take the medication for 5 years will avoid a serious event, such as a heart attack or stroke, as a result.

Mr Lamb, who announced last week he will stand down as MP for North Norfolk at the next election, was advised to take statins following his stroke in March last year but said he experienced a lot of pain in his legs, over a year on, as well as shortness of breath while running.

He told i: “I came off the statins I’d been put on because of a fear this might be a side effect. I don’t know ultimately whether it was the statins that caused this – and I’m going through checks with a cardiologist to go through all that – but it has led to a significant amount of NHS time and money spent in checking me out.

“But if it is a side effect I just think ‘goodness, how many times is this being replicated across the country getting themselves checked out?'”

Public health issue

Mr Lamb said the debate over statins is “clearly a very significant pubic health issue, given the vast numbers of statins prescribed”. He said he will write to Chris Whitty when he replaces Professor Dame Sally Davies as the UK Government’s chief medical adviser and chief medical officer for England, in October. Professor Whitty is currently chief scientific adviser for the Department of Health and Social Care.

Mr Lamb said: “It’s clearly an area of very significant contention and controversy – there are people who very strongly defend the use of statins, as I found myself when I went to hospital and spoke of my concerns.

“The claims that are made for statins are clear and powerful – that they are necessary for many people to reduce the risk of heart attack and stroke, and that the chances of side effects are minimal. Given the numbers of people who take statins, the strength of the claims made and, critically, the fact that the raw data has never been put into the public domain leads me to feel there is a case – a very strong case – for Chris Whitty to undertake a review.”

Mr Lamb’s science and technology select committee published a report in January criticising UK universities for failing to comply with clinical trials transparency requirements. He said any potential inquiry into statins would be an extension of that area of investigation.

“Surely, there must be an unanswerable case for the data to be made publicly available so that others can scrutinise the raw data to reach conclusions. The central issue is transparency for me,” he said.

‘We recognise concerns’

The National Institute for Health and Care Excellence told i it is in the process of updating its guidelines on cardiovascular disease.

A NICE spokesperson said: “There is a growing body of evidence in this area which we acknowledge needs to be looked at in an update of our ‘cardiovascular disease: risk assessment and reduction, including lipid modification’ guideline and preparations are being made to do this.”

Professor Sir Nilesh Samani, cardiologist and medical director at the British Heart Foundation, said: “Statins save lives. As one of the most widely-prescribed drugs, they’ve been the subject of huge amounts of in-depth scientific research, which time and time again has shown they’re a safe and effective way to prevent heart attacks and strokes.

“If you’re at high risk of a heart attack or stroke – either from having suffered a heart attack or stroke in the past, or because your calculated risk is high – it’s particularly valuable for you to take your statins as prescribed. If you have any concerns, speak to your doctor.

“We recognise people’s concerns about side effects and we want patients and their doctors to be able to make informed, evidence-based decisions about taking and prescribing these medicines. The BHF is doing its bit by funding researchers to gather, analyse, and make available all the individual participant data from large clinical trials into statins. Putting an end to this debate should help to stop conflicting reports, which can put people off taking their statins as prescribed.”


https://inews.co.uk/news/health/sta...er-norman-lamb/
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  #2   ^
Old Mon, Sep-02-19, 02:44
s93uv3h s93uv3h is offline
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horse, meet cart. i see myself going back to statins when you know what freezes over lol.

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  #3   ^
Old Mon, Sep-02-19, 08:44
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bevangel bevangel is offline
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i see myself going back to statins when you know what freezes over...


Ditto! For statins to be so "well tolerated" and side effects to be so "rare" and so "minor," it's amazing to how many people I personally know and how many more I've met online who either quite vocally refuse to accept a statin prescription ever again or who privately admit that they don't actually take their Rx but don't tell their doctor b/c they don't want to argue about it!
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  #4   ^
Old Mon, Sep-02-19, 09:40
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Little Me Little Me is offline
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I was prescribed statins because my CAC score was 512, all in my LAD, the “Widowmaker.” Anything over 400 is eyebrow-raising territory. So I had a nuclear stress test which showed I had something wrong. My mother died from a heart attack at age 64 (I am 70) and she bequeathed me hypercholestemia. I also have a bundle-branch block. Oh, and hypertension. So...let’s up the statin dose, just to be on the safe side.

Then I had an angiogram, which showed nothing. Arteries all clear. Cardiologist said, avoid red meat and maybe come back in a year. I see my GP Thursday. I’m going to ask to get off the statin. I fought him over this for years.
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  #5   ^
Old Mon, Sep-02-19, 09:47
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Meme#1 Meme#1 is online now
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So you had an angiogram and everything was fine?
Wow, what's that about and how does that happen if the CAC said something else?
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  #6   ^
Old Mon, Sep-02-19, 11:02
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Little Me Little Me is offline
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Quote:
Originally Posted by Meme#1
So you had an angiogram and everything was fine?
Wow, what's that about and how does that happen if the CAC said something else?

As I understand it, the CAC measures calcium plaque in your coronary arteries (the ones that wrap around the heart). The angiogram looks at narrowing in the arteries leading TO the heart. Here is a good explanation.
https://www.umms.org/ummc/health-se...calcium-scoring. As you look at the score ranges, mine is 512. DH was 2600. He now sports two stents (emergency angioplasty) and considers himself lucky. Yes, statins for him, too.

Sorry if I hijacked the thread.
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  #7   ^
Old Mon, Sep-02-19, 11:34
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Demi Demi is offline
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Quote:
We need a Parliamentary inquiry to push for the raw data on statins and their effects

Transparency and raw data is needed to show us who really benefits from taking statins, and what side effects they can have

Dr Asseem Malhotra


It’s been almost 35 years since scientists Michael S. Brown and Joseph L. Goldstein won the Nobel Prize for discovering how blood cholesterol played a central role in the development of heart disease. It was their work that led to the pharmaceutical industry developing statins.

Statins are drugs that lower cholesterol, and they both reduced heart attacks, and extended lifespan, within a few years of prescription. In 1996, Goldstein and Brown confidently predicted the end of heart disease as a major public health problem before the beginning of the 21st century.

However, their prophecy was never fulfilled. On the contrary, the decades-long campaign to lower cholesterol through diet and drugs has completely and utterly failed to curb the global pandemic of heart disease. Indeed, heart disease still remains the biggest killer in the Western world and the UK has recently seen a rise in death rates from the condition for the first time in 50 years.

It is still little known or understood amongst the wider medical community that insulin resistance, linked to excess body fat, is the most important risk factor for heart attacks. It is also a clear sign of impending type two diabetes. A disease which costs the NHS £10 billion annually.

The good news is insulin resistance can be effectively combatted through a combination of dietary changes, moderate activity and psychological stress reduction.

My patient’s experience

A few weeks ago, an alarmed and confused patient in his late forties, who I shall call Mr Smith, came to see me for a consultation. Four years earlier, he suffered a heart attack where severe blockages were found in his right coronary artery. These were opened up and kept open with metal stents.

He was prescribed atorvastatin, which is standard practice for heart attack patients regardless of cholesterol levels. After starting on atorvastatin, he began experiencing severe muscle pain on exercise. His symptoms disappeared within a week of stopping the drug.

As an alternative to his statin, he decided to adopt an ultra-low fat vegan diet which he believed may halt or even reverse heart disease through lowering cholesterol. Within months he dropped his total cholesterol from 5.2mmol/L to 3.2, now placing his levels in the bottom five per cent of the population.

Despite sticking religiously to the diet, he began to develop chest pain when he did exercise, and a repeat heart scan showed a 70 per cent blockage in another artery. One that had been completely clear four years before. “How is this possible?” he asked me, clearly upset. “How could I develop more heart disease in such a short space of time with such low cholesterol?” His case was not unusual, nor inexplicable.

It was clear that Mr Smith had not addressed 20 years of very high-stress levels that preceded his heart attack, and still continued. He described the level of stress as eight on a scale of zero to 10. I suggested mindfulness meditation and a low refined carbohydrate Mediterranean diet. He ended up looking forward to ditching the supplements he needed to take for his nutrient-deficient vegan diet and eating fish and eggs again.

Side effects?

There is still controversy about the true rate of side effects from statins because independent researchers have been unable to access the raw data from statin trials. This is a crucial part of solving the statin and cholesterol puzzle, as it is with all drugs.

In 2014, a Cochrane review concluded the UK had wasted almost half a billion pounds in stockpiling a flu treatment, Tamiflu. Academics from the Cochrane Collaboration analysed tens of thousands of pages of patient data from drug company Roche. Having eventually been allowed access to this raw data, they found the drug to be no more effective than paracetamol. However, they highlighted worrying side effects in some people taking it to prevent flu, such as kidney problems.

Rather than accept the need for greater scrutiny, highly influential cardiologists are attacking those who question the benefits of statins. Those who believed that side effects are much more prevalent are denounced as peddlers of “fake news” or “fake science”. They are compared to “anti-vaxxers”. One Cardiologist, Ann Marie Navar, even wrote in a recent editorial in JAMA Cardiology that inappropriate fears about statin side effects are coming from social media wellness bloggers and that “the number of lives lost to inadequate prevention owing to inappropriate concerns about statins could number in the millions”, but this is not evidence-based. The side effect literature and remarkably high discontinuation rate come from very credible sources.

The largest statin survey in the United States, last updated in 2014, found 75 per cent of those prescribed the medication stop it within a year of prescription with 62 per cent of those stating side effects as the reason. Even as far back as 2002, when there was no social media or public awareness of statin side effects, a paper in JAMA of more than 40,000 patients found 60 per cent of heart attack patients aged over 65 will stop the drug within two years.

In 2015, the American College of Cardiology published an article online entitled “statin intolerance, not a myth” estimating a true side effect rate of up to 15 per cent.

In addition to explaining that more than 300 drugs are known to interact with statins, the authors stated physicians should be aware of the most common risk factors associated with statin intolerance. These included being on higher doses, being aged over 70, being female, having Vitamin D deficiency, kidney and liver disease, alcohol abuse, Asian ethnicity, low body mass index, genetic predisposition and excessive physical activity.

So how effective are statins in preventing and treating heart disease? When one removes the industry funded PR and hype, the results appear pretty underwhelming.

In 2015, new research published in BMJ Open found that despite tens of millions more people being prescribed statins across many European countries, there was no evidence that this had any effect on cardiovascular mortality over a 12-year period.

If you strip down the statin trials to their moving parts, the data actually reveals that, even in those who have established heart disease, the benefits are very small. Even in this high-risk group, the average increase in life expectancy from taking the drug religiously for five years is a meagre four days, according to an analysis of randomised trials.

When you combine this with data suggesting more than 50 per cent simply stop taking the medication within two years, it’s easy to explain why there has been no discernible population benefit.

Some highly credible researchers even question whether there is any genuine benefit of statin drugs in those who already have heart disease. Eminent French Cardiologist Professor Michel De-Lorgeril, points out that since more stringent regulations on reporting of clinical trials were introduced in 2006 only one statin has been tested in clinical trials. It demonstrated no benefit at all in four trials, and these included a significant number of patients with established heart disease.

Professor Luis Correia, Cardiologist, and the director of the Centre for Evidence-Based Medicine at the Medical School of Bahia in Brazil told me: “It would be of great benefit to do an independent of industry re-trial of statins in heart attack patients to see what the benefits truly are – if any.”

Sir Richard Thompson, former President of the Royal College of Physicians, said: “In my view, these conflicts of interest and the true incidence of side effects from statins need to be fully and publicly investigated.”

John Abramson, an expert in pharmaceutical litigation and a lecturer at Harvard Medical Scool, told me: “Doctors and patients are having to engage in shared decision making on whether a statin should be prescribed on biased and selected data which itself is non-transparent. It’s not just bad science, it’s ethically dubious too.”

We continue to have an epidemic of misinformed doctors and misinformed and unwittingly deceived patients. In large part, this has been driven by a multi-billion-dollar food and drug industry that profits from the fear of cholesterol.

It’s now time for a full public parliamentary inquiry to push for the raw data on statins to find out who really benefits, and to determine who has been manipulating and hiding data on debilitating side effects. Until then it’s better we focus healthcare resources on tackling the real root cause of heart disease through prioritising lifestyle changes.

Dr Aseem Malhotra is an NHS Consultant Cardiologist and Professor of Evidence Based Medicine


https://inews.co.uk/opinion/comment...-their-effects/
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  #8   ^
Old Mon, Sep-02-19, 13:09
Meme#1's Avatar
Meme#1 Meme#1 is online now
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Quote:
Originally Posted by Little Me
As I understand it, the CAC measures calcium plaque in your coronary arteries (the ones that wrap around the heart). The angiogram looks at narrowing in the arteries leading TO the heart. Here is a good explanation.
https://www.umms.org/ummc/health-se...calcium-scoring. As you look at the score ranges, mine is 512. DH was 2600. He now sports two stents (emergency angioplasty) and considers himself lucky. Yes, statins for him, too.

Sorry if I hijacked the thread.


No you did not hijack the thread. That's the only way we are going to learn about these things is to listen to other's experiences. Knowledge is power I always say.

I know nothing about cardiology so it's all a learning experience and I appreciate the real life info.

DH went to a cardiologist after getting winded climbing stadium ramps for an event with the family. DH made an appt with a cardiologist. He didn't tell me so I didn't get to go and put in my 2 cents at the appt. He did some standard blood work, increased Metformin and got a prescription for Stanton (which he's not taking). So I've been trying to get him to go do a CAC to begin with, at least. He is semi lor carb but not as strict and I am. So now I know there are two areas to check and neither has been done. What good is a doctor then?
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  #9   ^
Old Tue, Sep-03-19, 06:44
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Demi Demi is offline
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Do statins really work? Who benefits? Who has the power to cover up the side effects?

Asseem Malhotra


https://www.europeanscientist.com/e...e-side-effects/

Quote:
Earlier this week, the Chair of the British Parliament Science and Technology Committee, Sir Norman Lamb MP made calls for a full investigation into cholesterol lowering statin drugs. It was instigated after a letter was written to him signed by a number of eminent international doctors including the editor of the BMJ, the Past President of the Royal College of Physicians and the Director of the Centre of Evidence Based Medicine in Brazil wrote a letter calling for a full parliamentary inquiry into the controversial medication[1]. It’s lead author Cardiologist Dr Aseem Malhotra makes the case for why’s there’s an urgent need for such an investigation in European Scientist.
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  #10   ^
Old Tue, Sep-03-19, 10:02
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WereBear WereBear is offline
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Rather than accept the need for greater scrutiny, highly influential cardiologists are attacking those who question the benefits of statins. Those who believed that side effects are much more prevalent are denounced as peddlers of “fake news” or “fake science”. They are compared to “anti-vaxxers”. One Cardiologist, Ann Marie Navar, even wrote in a recent editorial in JAMA Cardiology that inappropriate fears about statin side effects are coming from social media wellness bloggers and that “the number of lives lost to inadequate prevention owing to inappropriate concerns about statins could number in the millions”, but this is not evidence-based. The side effect literature and remarkably high discontinuation rate come from very credible sources.

The largest statin survey in the United States, last updated in 2014, found 75 per cent of those prescribed the medication stop it within a year of prescription with 62 per cent of those stating side effects as the reason. Even as far back as 2002, when there was no social media or public awareness of statin side effects, a paper in JAMA of more than 40,000 patients found 60 per cent of heart attack patients aged over 65 will stop the drug within two years.


Side effects include triggering a form of ALS. Apparently you can be tested for the genetic risk.

But they deny it and don't do it.

Last edited by WereBear : Tue, Sep-03-19 at 11:47.
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  #11   ^
Old Tue, Sep-03-19, 10:23
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Meme#1 Meme#1 is online now
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I'm reading more and more about patients being put on lists for being Noncomplient. That's creepy. Read about this happening at the VA, If patuents complain about wait times or lack of treatment, they're put on a red flag list. If they say anything opinionated they go on a red flag list. Study found the list is secret, only the doctors and nurses see it. Patients can't do anything about it. So now all VA personal think they are a threat to themselves ir others.
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  #12   ^
Old Tue, Sep-03-19, 11:01
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Ms Arielle Ms Arielle is online now
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We have a choice about treatment. Period.

As for VA, we dont do enough for our veterans. Period.
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  #13   ^
Old Tue, Sep-03-19, 12:13
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bevangel bevangel is offline
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Quote:
I'm reading more and more about patients being put on lists for being Noncomplient.


Perfect way to ensure that patients will be honest and open with their doctors!

"no doc, I'm not non-compliant. I really don't know WHY the statin you prescribed for me isn't working. Of course I take it EXACTLY as prescribed. It just doesn't seem to be having any effect..."
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  #14   ^
Old Tue, Sep-03-19, 12:37
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Ms Arielle Ms Arielle is online now
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Rofl, goooooood one, Bev.
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  #15   ^
Old Tue, Sep-03-19, 13:22
Meme#1's Avatar
Meme#1 Meme#1 is online now
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Here are some of the details by Michelle Malkin:

I first reported on the VA’s secretive database on “disgruntled” and “disruptive” vets five years ago. Under the VA policy on “patient record flags,” federal bureaucrats can classify vets as “threats” based on assessments of their “difficult,” “annoying” and “noncompliant” behavior. The VA manual says the flags “are used to alert Veterans Health Administration medical staff and employees of patients whose behavior and characteristics may pose a threat either to their safety, the safety of other patients, or compromise the delivery of quality health care.”

What a crock. It’s precisely because so many vets receive inferior care from the feds that they have been forced to raise their voices. Have we all forgotten the 40 veterans who perished at the Phoenix, Arizona VA, which relegated patients to a bureaucratic black hole through secret waiting lists? Among examples of patients’ behavior referred to the red-flaggers in the VA’s “Disruptive Behavior Committees” (Orwell couldn’t have cooked up a better name): venting “frustration about VA services and/or wait times, threatening lawsuits or to have people fired, and frequent unwarranted visits to the emergency department or telephone calls to facility staff.”

Disabled Air Force veteran and veterans advocate/attorney Benjamin Krause has exposed the Soviet-style targeting of veterans flagged for exercising their First Amendment rights or threatening to sue the VA over neglectful care or for simply being too “expensive.” He calls it “straight out of a totalitarian regime.” In 2013, the VA inspector general concluded that the bureaucracy “does not have a comprehensive definition of what constitutes disruptive behavior.” In January 2018, a VA Office of Inspector General report found that large numbers of flagged veterans were being left in the dark about being placed on dangerous patient lists — with no recourse to remove phony flags or appeal in any meaningful way.

Despite rules requiring the “Disruptive Behavior Committee” to notify flagged patients of their status and informing them of their right to amend their reports, the OIG found no evidence in 49% of electronic health records that the panels had provided such notice and disclosure.

In 25% of medical records reviewed, the OIG “found no evidence that patients were informed they had the right to request to amend or appeal” special orders restricting care of flagged patients.

There are undoubtedly patients in the system who may pose real threats. But the “problem with the process is that it is secret,” Krause explains at DisabledVeterans.org. “The review process is done in secret and the veteran will not know who sat on the committee or what the evidence presented was prior to the decision. Only after the decision is made are veterans informed of the outcome and given a chance to appeal the vague allegations. That seems like a due process violation if I have ever seen one.”

Army vet David Scott Strain of Virginia told me recently that he was a flagged veteran. “My grave sin?” says Strain. “I tried to report the abuse of a deaf, infirm, WWII veteran. He was approximately 95 years of age. A male nurse stood behind his waiting room chair and shouted down at the top of his head, ‘Hello! Hello! Hello! If you can hear me, you can come in now!'” Strain describes how the elderly vet “could not hear this, and the nurse went through 3 iterations, while giggling and looking at the wait-room personnel as if we were a comedy club audience. It was one of the sickest displays I’ve ever seen.”

For blowing the whistle on VA elder abuse, Strain says, he was banned from all satellite clinics and only granted access to one main facility. VA flaggers can “manufacture tone, the content of what you’re saying, and will even ascribe actions to you that you did not perform,” Strain warns. “The potential ‘red flag’ laws concern me deeply,” Strain told me. “Why any citizen would think it wise to let the government screw such handles to our backs, to threaten and wag us any which way, is beyond my understanding. However, I fully understand why politicians want it.”

Complain too much. Criticize the powers be. Ask too many questions. Boom! You’re a threat.

If such tyranny is allowed among those who volunteered to protect and serve our country in the name of safety, imagine how it will be implemented among the law-abiding, gun-owning general populace.
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