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COVID-19 vaccine discussion


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16 hours ago, Neonmoon said:

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You didn't even read my whole post did you? Yeah, because Covid, vaccines and insurance liabilities exist in a vacuum. I take it you support the hypocritical policies of being an unhealthy human blob but only raising rates on the unvaccinated? I'm all in for lifestyle and voluntary preventative health pricing structures based on risk data. That includes the unvaccinated, smoker, sedentary, etc. I am not for singling out those with uncontrollable health conditions such as auto-immune disease, genetic disease, etc. Poor lifestyle choices (rampant obesity, poor diet, scant participation in preventative health) are at the core (with other factors) of why we spend so much on healthcare in this country and rank poorly in healthcare outcomes. We are floating our health debt like the US dollar. You're not going to move the average US citizen to action for better health with clever campaigns and pleading public service announcements. And all you are going to do "taxing" and singling out the unvaccinated is cause more triabilism. 

Do you have a rebuttal or just another clever gif?

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18 hours ago, Newdoc said:

And then we jack up insurance rates for the obese and the non compliant diabetics and those who don’t eat leafy green vegetables five times a week or don’t exercise. I’m all for it bc Americans only respond to their pocketbooks for health stimuli but it’s a slippery slope you aren’t prepared to go down. The AHA put a stop that anyway.

While we’re at it let’s tax processed foods to death (kinda serious)

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2 hours ago, Newdoc said:

You didn't even read my whole post did you? Yeah, because Covid, vaccines and insurance liabilities exist in a vacuum. I take it you support the hypocritical policies of being an unhealthy human blob but only raising rates on the unvaccinated? I'm all in for lifestyle and voluntary preventative health pricing structures based on risk data. That includes the unvaccinated, smoker, sedentary, etc. I am not for singling out those with uncontrollable health conditions such as auto-immune disease, genetic disease, etc. Poor lifestyle choices (rampant obesity, poor diet, scant participation in preventative health) are at the core (with other factors) of why we spend so much on healthcare in this country and rank poorly in healthcare outcomes. We are floating our health debt like the US dollar. You're not going to move the average US citizen to action for better health with clever campaigns and pleading public service announcements. And all you are going to do "taxing" and singling out the unvaccinated is cause more triabilism. 

Do you have a rebuttal or just another clever gif?

The binary choice of taking a vaccine versus not taking a vaccine is in no way comparable to the very complex web of reasons why a person is or is not obese, overweight, or unhealthy. Comparing the two is idiotic, which is why I replied with the gif. I am glad you enjoyed it. Choosing to not take the vaccine is comparable to smoking. One either chooses to smoke or chooses not to smoke. There are no other variables involved. Guess what, people are charged more for insurance for being a smoker. 

"Poor lifestyle choices (rampant obesity, poor diet, scant participation in preventative health) are at the core (with other factors) of why we spend so much on healthcare in this country and rank poorly in healthcare outcomes."

This sentence is not based on facts. 

US spends so much more money on healthcare for a simple reason. Prices. US citizens are charged more and we don't enact measures to stop it. 

Study #1

16 years later. New Study. Still Prices

You are correct. US has the highest obesity rate, the worst preventative health, etc. There are a lot of very good reasons why, other than American are lazy pieces of shit, while true, other countries have lazy pieces of shit and manage to take care of their health problems. 

 

 

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46 minutes ago, Neonmoon said:

The binary choice of taking a vaccine versus not taking a vaccine is in no way comparable to the very complex web of reasons why a person is or is not obese, overweight, or unhealthy. Comparing the two is idiotic, which is why I replied with the gif. I am glad you enjoyed it. Choosing to not take the vaccine is comparable to smoking. One either chooses to smoke or chooses not to smoke. There are no other variables involved. Guess what, people are charged more for insurance for being a smoker. 

I stated that our poor baseline health is PART of the reasons our healthcare is so expensive. An upside down healthcare system that rewards sick care is very much at the heart of the matter. But compared to other first world countries, our obesity, diabetes and metabolic syndrome rates are at the top. We keep a lot of sicker people alive way longer than we used to and longer than we should.

You cannot argue against the obesity analogy and use smoking. The factors for nicotine addiction are also very complex and are on par with opioid addiction. Smoking was an easy target for the insurance industry and politically acceptable at the time. There are even politically incorrect analyses that show smokers may save on retirement and healthcare expenditures because they 1) pay high taxes on cigarettes and 2) die sooner and faster without necessarily dragging out healthcare expenditures like a lot of chronic conditions.

I am way more aware of the complex reasons for obesity than you are but most of our American obesity issues come down to poor lifestyle choices and a food industry all to willing to make a buck on cheap processed metabolically inflammatory food with our ignorance and willingness to eat it. And we have failed as a country in teaching healthy lifestyle choices in primary education. We have passed the tipping point where any politician and even most healthcare workers are not willing to flat out tell people that their lifestyle is killing them and straining the healthcare economy because we are almost more obese than not as adult Americans.  But still, financially motivating people to reduce their risk factors maybe a major stimulus needed to reduce the economic burden of obesity.

Yes, there are people who have BMI's in the obesity range that are metabolically healthier than normal weight people but this is more the exception than the rule.  When infected with Covid, obesity (even with normal metabolic parameters) in the non elderly population was overwhelmingly a risk factor for hospitalization and death. This was very much glossed over by both administrations, the CDC and the media.  The vast majority of obese people could reduce most of their health problems with a 10-15% loss of excess weight. It sometimes isn't necessary to have a normal BMI. 

So if you are going to single out the unvaccinated for insurance rate hikes then it is fair game to single out other relatively controllable health factors as well. Furthermore, you can now exclude rate hikes for natural immunity from Covid because it has been shown to reduce this risk of bad outcomes in subsequent Covid infections, especially true since Omicron's emergence. We should give credit for people who are seropositive for previous Covid infection as equal to vaccination if the data continues to show equal outcomes. I don't recommend natural immunity as a primary means of obtaining immunity however.  People were really rolling the dice by waiting on natural infection.

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20 minutes ago, Deej said:

Not Newdoc.

If the new vaccine shows reduction of serious illness, hospitalization and death over previous vaccination and/or natural immunity OR shows reduction in contagiousness of Omicron when infected then yes, I will get it and recommend it, especially for high risks patients. 

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2 minutes ago, Newdoc said:

I stated that our poor baseline health is PART of the reasons our healthcare is so expensive. An upside down healthcare system that rewards sick care is very much at the heart of the matter. But compared to other first world countries, our obesity, diabetes and metabolic syndrome rates are at the top. We keep a lot of sicker people alive way longer than we used to and longer than we should.

You cannot argue against the obesity analogy and use smoking. The factors for nicotine addiction are also very complex and are on par with opioid addiction. Smoking was an easy target for the insurance industry and politically acceptable at the time. There are even politically incorrect analyses that show smokers may save on retirement and healthcare expenditures because they 1) pay high taxes on cigarettes and 2) die sooner and faster without necessarily dragging out healthcare expenditures like a lot of chronic conditions.

I am way more aware of the complex reasons for obesity than you are but most of our American obesity issues come down to poor lifestyle choices and a food industry all to willing to make a buck on cheap processed metabolically inflammatory food with our ignorance and willingness to eat it. And we have failed as a country in teaching healthy lifestyle choices in primary education. We have passed the tipping point where any politician and even most healthcare workers are not willing to flat out tell people that their lifestyle is killing them and straining the healthcare economy because we are almost more obese than not as adult Americans.  But still, financially motivating people to reduce their risk factors maybe a major stimulus needed to reduce the economic burden of obesity.

Yes, there are people who have BMI's in the obesity range that are metabolically healthier than normal weight people but this is more the exception than the rule.  When infected with Covid, obesity (even with normal metabolic parameters) in the non elderly population was overwhelmingly a risk factor for hospitalization and death. This was very much glossed over by both administrations, the CDC and the media.  The vast majority of obese people could reduce most of their health problems with a 10-15% loss of excess weight. It sometimes isn't necessary to have a normal BMI. 

So if you are going to single out the unvaccinated for insurance rate hikes then it is fair game to single out other relatively controllable health factors as well. Furthermore, you can now exclude rate hikes for natural immunity from Covid because it has been shown to reduce this risk of bad outcomes in subsequent Covid infections, especially true since Omicron's emergence. We should give credit for people who are seropositive for previous Covid infection as equal to vaccination if the data continues to show equal outcomes. I don't recommend natural immunity as a primary means of obtaining immunity however.  People were really rolling the dice by waiting on natural infection.

You stated 

1 hour ago, Neonmoon said:

Poor lifestyle choices (rampant obesity, poor diet, scant participation in preventative health) are at the core (with other factors) of why we spend so much on healthcare in this country and rank poorly in healthcare outcomes

Do you believe this sentence is arguing poor lifestyle choice are “at the core (with other factors)” or “PART of the reason”?

Eating food and smoking are not similar. You know because science reasons 

 

 

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If the new vaccine shows reduction of serious illness, hospitalization and death over previous vaccination and/or natural immunity OR shows reduction in contagiousness of Omicron when infected then yes, I will get it and recommend it, especially for high risks patients. 

Yeah, that’s where I am. If it shows a material benefit, then sure, I’ll get it.
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15 minutes ago, Neonmoon said:

You stated 

Do you believe this sentence is arguing poor lifestyle choice are “at the core (with other factors)” or “PART of the reason”?

Eating food and smoking are not similar. You know because science reasons 

 

 

Dude don't argue semantics. There can be more than one thing in a core. Like a nucleus of an atom. You know. Because of science reasons.

Reward centers and parts of the brain affected by smoking and food ingestion do cross over. 

Because science....

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Just my opinion, but I still can't believe that all the new vaccines in development target the spike protein alone. If they developed an mRNA vaccine against replication proteins and the spike protein, we would have improved morbidity and would require fewer boosters.

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36 minutes ago, Newdoc said:

Dude don't argue semantics. There can be more than one thing in a core. Like a nucleus of an atom. You know. Because of science reasons.

Reward centers and parts of the brain affected by smoking and food ingestion do cross over. 

Because science....

You can move the goal post all you want if it makes you feel better. 

Tell me, which one is needed to keep living as human? Food or smoking? 

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37 minutes ago, dcar00 said:

what would you consider material?

I don't know yet.  But these are the criteria that Newdoc listed:

1 hour ago, Newdoc said:

reduction of serious illness, hospitalization and death over previous vaccination and/or natural immunity OR shows reduction in contagiousness of Omicron when infected 

If it shows one or more of those things, and the effect is more than negligible (a 1% reduction in serious illness etc. would be negligible.....90+% would be huge.....everything in between is "let's see and decide how all the factors play together").  It would be stupid of me to give an arbitrary number -- "if it is a 20% improvement, that's material, but if it's 19%, no way!"  We shall see.

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17 hours ago, Brisketexan said:

I don't know yet.  But these are the criteria that Newdoc listed:

If it shows one or more of those things, and the effect is more than negligible (a 1% reduction in serious illness etc. would be negligible.....90+% would be huge.....everything in between is "let's see and decide how all the factors play together").  It would be stupid of me to give an arbitrary number -- "if it is a 20% improvement, that's material, but if it's 19%, no way!"  We shall see.

Best we can do is 15% reduction in serious illness and 18% increase in download speed.

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Data point of 1 but the booster is holding up well for me. Finally got around to the final blood draw for the UT Health antibody study yesterday. Boosted with Moderna first week of December after getting Pfizer initially in March-April 2021. Antibodies > 2500 and negative for prior infection. This with antibodies in the 900s in the draw immediately before the booster.

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On 4/20/2022 at 4:48 PM, Neonmoon said:

You stated 

Do you believe this sentence is arguing poor lifestyle choice are “at the core (with other factors)” or “PART of the reason”?

Eating food and smoking are not similar. You know because science reasons 

 

 

90% of healthcare costs occur at the extreme beginning and end of life. The US treats pre term infants and futile elder care differently than every other industrialized country and I have never seen a healthcare cost comparison that adjusts for those factors. Many countries don’t even count preterm births as births when calculating infant mortality, much less try and keep them alive. Cardiovascular procedures, dialysis, and ICU care in the elderly and futile chemo in all age groups are much less common outside the US.
 

Drug and medical device costs definitely need to come down as well

 

Still a large percentage of our healthcare dollars goes to lifestyle induced morbidity. I say this having eaten cold pizza washed down with a Dr Pepper zero for breakfast 

Edited by Sawbonz
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7 hours ago, gmr548 said:

Data point of 1 but the booster is holding up well for me. Finally got around to the final blood draw for the UT Health antibody study yesterday. Boosted with Moderna first week of December after getting Pfizer initially in March-April 2021. Antibodies > 2500 and negative for prior infection. This with antibodies in the 900s in the draw immediately before the booster.

I was at 366 six months after my first two shots of Pfizer. Six months after my booster I was >2500.

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3 minutes ago, Immaculate Vibes said:


 

Well you are going to get called an antivax chiropractor but people that actually pay attention see what is happening at the FDA.  It's not just C19 vax shit, it's not just aduhelm but that is a really good fucking example. It's accelerated approvals based on surrogate endpoints branching out from oncology and HIV to highly prevalent conditions and a total undermining of the scientific credibility of the regulatory function. And it goes far beyond the regulatory structure and threatens the entire system. The FDA needs to be brought to heel. 

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So, I got Moderna booster #2 this week.  Very painful left shoulder after the shot, maybe some mild fatigue or I was so anticipating it that I just flopped the day of the shot and until noon the following day.

It's the damndest thing though.  With the first and second vax jabs and the booster, my "body aches" basically consituted the shoulder pain from the left shoulder extending across my shoulders to my right shoulder, on which I broke my collarbone a couple of years ago.  

And that pain has persisted all this time, since April 2020, manifesting as what feels like a light case of  frozen shoulder both left and right, and actually a bit worse on the left.  The collarbone shoulder had been pain and trouble free until the vaccine.  The pain is worst after sleeping on them (side sleeper) and I can mostly alleviate it with PT-type mobility/range of motion exercises.

After the first booster, when the acute left shoulder pain went away after a day, both shoulders were pain free for a few days.  Same now.  Hope it sticks this time.  The pain is more annoying than debilitating.

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Then don’t give your kids boosters.  Jesus this isn’t hard.  (Not you, Twice)
 

And yeah if you’re a chiropractor on Twitter with 90% of followers posting anti-vaxx responses then people will be inclined to consider you likely anti-vaxx.  Again, don’t give them boosters if it bothers you so much.


This whole ‘freedom, can’t tell me what to do you…Amurica baby, I got my American flag skivvies on fuck your feelings’ group sure likes to tell people what to do.   

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11 hours ago, Anastasis said:

Well you are going to get called an antivax chiropractor but people that actually pay attention see what is happening at the FDA.  It's not just C19 vax shit, it's not just aduhelm but that is a really good fucking example. It's accelerated approvals based on surrogate endpoints branching out from oncology and HIV to highly prevalent conditions and a total undermining of the scientific credibility of the regulatory function. And it goes far beyond the regulatory structure and threatens the entire system. The FDA needs to be brought to heel. 

This is pretty egregious. 
 

The same revolving door phenomenon that has taken over other regulatory purviews of the government (hello Treausury, SEC) has moved in on the #science. 
 

11 minutes ago, Homercles said:

Then don’t give your kids boosters.  Jesus this isn’t hard.  (Not you, Twice)
 

And yeah if you’re a chiropractor on Twitter with 90% of followers posting anti-vaxx responses then people will be inclined to consider you likely anti-vaxx.  Again, don’t give them boosters if it bothers you so much.


This whole ‘freedom, can’t tell me what to do you…Amurica baby, I got my American flag skivvies on fuck your feelings’ group sure likes to tell people what to do.   

You’re missing the point. 
 

The apparent bar for officially recommending these boosters is so low that it damages the credibility of these orgs. That’s putting aside any effect that these recs could have on mandates for school children in some pasts of the country. 
 

Embarrassingly small sample. Secondary endpoint that isn’t guaranteed to actually affect outcomes. Basically no risk/benefit analysis at all for a pediatric population when the benefit is already guaranteed to be extremely low. 

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9 hours ago, TwiceHorn said:

It's the damndest thing though.  With the first and second vax jabs and the booster, my "body aches" basically consituted the shoulder pain from the left shoulder extending across my shoulders to my right shoulder, on which I broke my collarbone a couple of years ago. 

RIP, brother.

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10 hours ago, TwiceHorn said:

So, I got Moderna booster #2 this week.  Very painful left shoulder after the shot, maybe some mild fatigue or I was so anticipating it that I just flopped the day of the shot and until noon the following day.

It's the damndest thing though.  With the first and second vax jabs and the booster, my "body aches" basically consituted the shoulder pain from the left shoulder extending across my shoulders to my right shoulder, on which I broke my collarbone a couple of years ago.  

And that pain has persisted all this time, since April 2020, manifesting as what feels like a light case of  frozen shoulder both left and right, and actually a bit worse on the left.  The collarbone shoulder had been pain and trouble free until the vaccine.  The pain is worst after sleeping on them (side sleeper) and I can mostly alleviate it with PT-type mobility/range of motion exercises.

After the first booster, when the acute left shoulder pain went away after a day, both shoulders were pain free for a few days.  Same now.  Hope it sticks this time.  The pain is more annoying than debilitating.

Long winded way of saying it's hard to jerk off

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40 minutes ago, Immaculate Vibes said:

This is pretty egregious. 

IMO, is it not any one decision or action in isolation, it is the broader consequences to the intertwined network of regulatory agencies that is problematic. CDC and FDA vaccine- and pandemic-related actions are at least defensible to some extent given the urgency of the pandemic. Understandable to fly a little looser in that context. Shit like Aduhelm on the other hand is just a fucking shit show, and triggers actions by other agencies (e.g. CMS) to prevent the entire system from falling apart. And further the unintended consequence is going to be reduced access to novel cancer treatments among others. Good job FDA.  Really well done. 

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1 hour ago, Anastasis said:

IMO, is it not any one decision or action in isolation, it is the broader consequences to the intertwined network of regulatory agencies that is problematic. CDC and FDA vaccine- and pandemic-related actions are at least defensible to some extent given the urgency of the pandemic. Understandable to fly a little looser in that context. Shit like Aduhelm on the other hand is just a fucking shit show, and triggers actions by other agencies (e.g. CMS) to prevent the entire system from falling apart. And further the unintended consequence is going to be reduced access to novel cancer treatments among others. Good job FDA.  Really well done. 

Yes, I only tangentially followed the Aduhelm process as was reported in news media but it sure seems like a complete shit show of a process. Do you have any idea about turnover at FDA? The question behind that is, is this something that is typically long-term staffers or more phased with presidential terms. I don't ask to say it's Biden's or Trump's fault but more to wonder if there is a way out of this or if this has been just a long downwards trend that is just becoming evident.

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1 hour ago, Serak The Preparer said:

Yes, I only tangentially followed the Aduhelm process as was reported in news media but it sure seems like a complete shit show of a process. Do you have any idea about turnover at FDA? The question behind that is, is this something that is typically long-term staffers or more phased with presidential terms. I don't ask to say it's Biden's or Trump's fault but more to wonder if there is a way out of this or if this has been just a long downwards trend that is just becoming evident.

Not sure what it says necessarily about the broader dynamics involved, but the most recent example of high profile turnover was two long time CBER reviewers that left after frustrations with the Biden WH messaging on boosters.   

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On 5/19/2022 at 11:06 PM, TwiceHorn said:

So, I got Moderna booster #2 this week.  Very painful left shoulder after the shot, maybe some mild fatigue or I was so anticipating it that I just flopped the day of the shot and until noon the following day.

It's the damndest thing though.  With the first and second vax jabs and the booster, my "body aches" basically consituted the shoulder pain from the left shoulder extending across my shoulders to my right shoulder, on which I broke my collarbone a couple of years ago.  

And that pain has persisted all this time, since April 2020, manifesting as what feels like a light case of  frozen shoulder both left and right, and actually a bit worse on the left.  The collarbone shoulder had been pain and trouble free until the vaccine.  The pain is worst after sleeping on them (side sleeper) and I can mostly alleviate it with PT-type mobility/range of motion exercises.

After the first booster, when the acute left shoulder pain went away after a day, both shoulders were pain free for a few days.  Same now.  Hope it sticks this time.  The pain is more annoying than debilitating.

Well, it's 10 days later plus and the shoulder pain is largely gone.  I think the fact that I have changed my sleeping posture a bit and still doing the range of motion exercises helped.

I think, though, that it was causing some localized inflammation because I can feel the soft tissue around my misshapen collarbone a bit more than usual.  And, rather than frozen shoulder, what I may have been experiencing was likely bursitis (my fraternity big bro is an orthopedic surgeon, so I'm qualified to diagnose this shit).

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On 5/29/2022 at 7:22 AM, StruggleBus said:

I vaccinated my older daughter when they became available for her age group (the vaccine was still extremely effective then). Is there any point in vaccinating my younger daughter that is now five? 

Not unless she is immunocompromised or has some other serious health problems. 
 

https://www.cnbc.com/2022/02/28/pfizer-covid-vaccine-was-just-12percent-effective-against-omicron-in-kids-5-to-11-study-finds.html

 

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Hope you all don't mind a long time lurker posting, but after 2.5 years I finally got got and tested positive this morning. My wife and I got the booster in October so I'm probably a month or so overdue.

So far symptoms are like a suckier summer cold with congestion, runny nose sore throat all that stuff. I feel warm but as of yesterday had a normal temperature.

Is there anything I should do to alleviate the symptoms or speed up the recovery process? I need to make an appointment with my primary care doctor tomorrow to maybe get an antiviral which I heard helps. Thanks!

Sent from my SM-S906U using Tapatalk

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3 hours ago, iodeac said:

Is there anything I should do to alleviate the symptoms or speed up the recovery process? I need to make an appointment with my primary care doctor tomorrow to maybe get an antiviral which I heard helps. Thanks!

Fluids and sleep?  

I am on the tail-end of COVID (first time, last boost/shot was back in December).  My symptoms were similar to yours, but milder except for the fever part and the Doctor was not concerned with me needing any medication, but you may have underlying conditions.  I just slept it all off, like a case of the flu.

I have a friend who had COVID last week, and was put on Z-Pac/antibiotics, because of the potential for pneumonia - sounded like he was on the verge (I know he was X-rayed), but that's the only person I know lately who has had any kind of treatment.

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2 hours ago, Homercles said:

Got any horse dewormer?  I’d read on them thar interwebs that it’ll knock dat bugger OUT!

We joke but I still see that shit.  While I didn't mention I was sick this past week on Facebook, a relative who somehow heard about it just had to post on my feed that my vaccines didn't work and I needed Ivermectin, and "Big Pharma is still covering up independent and alternative treatments". I told them that Ivermectin was created by Merck, the 4th largest pharmaceutical company in the world, and literally the very definition of Big Pharma, and here in 2022 somebody had to have fucking told them that one or more times, but anyways, I'm not going to argue this shit with them.

I will say that it was it lasted longer than the flu for me, and I don't know what the current vaccine rate in Texas or the US is, but if more and more people do eventually get the vaccine, and COVID symptoms going forward are similar to what I and a lot of other friends/family who have gotten it recently have experienced, I'm not going to worry as much about it, other than a few vulnerable relatives.

I do know more people who are coming around to getting vaccinated, which is odd.  I figured if they had held out this long, they would keep on holding out.

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13 hours ago, atomheartbevo said:

I don't know what the current vaccine rate in Texas or the US is, but if more and more people do eventually get the vaccine, and COVID symptoms going forward are similar to what I and a lot of other friends/family who have gotten it recently have experienced, I'm not going to worry as much about it, other than a few vulnerable relatives.

I do know more people who are coming around to getting vaccinated, which is odd.  I figured if they had held out this long, they would keep on holding out.

Looked at the dashboards floating around, and it looks like Delta is completely gone in a lot of areas.  Vaccines seemed to have worked really well against it (that and O beat it out).

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13 hours ago, atomheartbevo said:

We joke but I still see that shit.  While I didn't mention I was sick this past week on Facebook, a relative who somehow heard about it just had to post on my feed that my vaccines didn't work and I needed Ivermectin, and "Big Pharma is still covering up independent and alternative treatments". I told them that Ivermectin was created by Merck, the 4th largest pharmaceutical company in the world, and literally the very definition of Big Pharma, and here in 2022 somebody had to have fucking told them that one or more times, but anyways, I'm not going to argue this shit with them.

I will say that it was it lasted longer than the flu for me, and I don't know what the current vaccine rate in Texas or the US is, but if more and more people do eventually get the vaccine, and COVID symptoms going forward are similar to what I and a lot of other friends/family who have gotten it recently have experienced, I'm not going to worry as much about it, other than a few vulnerable relatives.

I do know more people who are coming around to getting vaccinated, which is odd.  I figured if they had held out this long, they would keep on holding out.

I got paxlovid and that made me feel quite a bit better immediately. I’m no longer testing positive, no feve, it’s been 12 days. Still feel just run down and I got a sinus infection after about the 5th day that won’t seem to go away. 

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