Who Are You – Tobey Kai

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Using music as rehabilitation, a talented Calgary musician overcomes a Traumatic Brain Injury, and is an inspiration for others.

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Before last year my social media experience was limited to Facebook, but that changed last year when I decided that the time had come for me to do something different with my life. Having a larger presence on social media would go a long way towards accomplishing the things that I wanted to do, so I now have accounts across several platforms.

An Instagram account was a no brainer, and I soon found out that there was more to this app than just the Kardashians and other assorted “influencers” (I can’t believe they get paid for this shit, honestly). As I scrolled through the accounts that Instagram thought I’d be interested in, one stood out.

I was first drawn in by her photo. She is possessed of those qualities that are highly desired by those shallower aspects that are inherent to men. In short I thought she was hot. I started to follow her and checked out her profile. She was a local girl with an incredible musical talent, university educated, and she had also suffered a Traumatic Brain Injury. I needed to find out more about this intriguing person, named Tobey Kai.

Natural talent

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From Tobey Kai’s Facebook page.

Tobey’s musical talents come naturally, both of her parents are musicians who came to Canada in the mid-’80’s. From a young age, she showed an interest in music, taking her first piano lesson at only 6years old. She says that her singing abilities came from her mother, who also sings opera.

The family would come to Calgary by way of Vancouver, and Tobey continued to study music, enhancing her natural born talent. She has a younger brother, and an “adopted sister” who has been in her life since her teen years.

You might think that Tobey would pursue a music education at the Alberta College of Art, but her interests also extend beyond music. Instead, she has not one but TWO bachelor’s degrees, and they have absolutely NOTHING to do with each other, holding degrees in biology and economics.

Animal lover

Courtesy Facebook

http://tobeykai.com/

Equal to her passion for music is her passion for animals. She combines the two at her music studio where she gives private music and singing lessons. She has resident cats and dogs that will like to come and visit while she’s giving lessons, and she mentions this on her website giving anyone who might have allergies a heads up.

Conservation of the world’s oceans is another one of her causes and she is an advocate for the world’s sharks, whose populations have nearly been wiped out in Asia due to poaching. Shark fin soup has long been a delicacy in some Asian countries, but ever decreasing numbers have led to the dish been banned.


All life is precious. Meet Freyja, one of my many daughters I’ve had the honour of caring for over the years. A ferocious predator (not unlike a shark), but has never struck me because I haven’t given her reason to. 
Don’t be afraid of what you don’t understand. 
#alllifematters

To her, all life is precious, and she would soon come to know just exactly how very precious it is. On the home page of her website, you can listen to a song she wrote called “Ondine”, which she has dedicated to ocean and shark conservation.

A cagey polyglot

As if all of this weren’t impressive enough, she also speaks fluent German. I figure that she would be able to carry out lengthy conversations in at least three languages: English, Mandarin, and German. I ask her how many languages she can speak, and she’s coy about answering saying only that she “does dabble in a few languages”. Based on what I’ve learned about her so far, it wouldn’t surprise me to find out that she could single-handedly interpret a meeting of the UN Security Council.

https://www.instagram.com/stories/highlights/18021109522098021/

Touched by Alzheimers

In 2017 Tobey began writing a song about her grandfather, whom she lost to Alzheimer’s disease. Called “Who Are You”, it recounts her grandfather’s final words to her “Who are you, young lady? Are you lost?” It is a poignant song about an experience that many families go through, and can relate to. It would be several months before she would record the song however. At the beginning of 2018, something would happen that had a lasting and profound effect on her life.

Who Are You – Written for Alzheimer’s and brain injury awareness.

Everything changes in an instant

For Tobey, recreation is something done outdoors no matter what season it is and whether it’s on a bike or a snowboard, physical activity is just as much a part of her life as music. She’s as much at home on the back of a bicycle as she is on a snowboard, and it was while enjoying a day on the latter that things would change forever.

Sunday, January 14th was a pleasant day to be in the mountains, with temperatures only a couple degrees below zero. Deciding to take advantage of the beautiful weather, Tobey decided to go snowboarding at Nakiska that day. At the end of her first run, when she got to the bottom of the hill, she slipped and fell to the ground.

Moments later a skier collided with her, impacting her left temple. Almost immediately, she knew that something was very wrong. She had lost feeling below her neck, her fingers were twitching, and she knew that she was bleeding from somewhere underneath her helmet. Emergency crews were able to stabilize her and transport her to Calgary by ground ambulance. She remembers much of the hour long ride back to the city, but some memories are gone.

Subarachnoid hemorrhage

Image result for subarachnoid hemorrhage
Image result for subarachnoid space

Your brain is covered by a thick, fibrous membrane called dura mater. Beneath the dura mater is the archnoid mater, under which cerebralspinal fluid helps to cushion the brain. A tear in a blood vessel can cause blood to accumulate in this space, putting pressure on the brain. Surgery may have to be performed to drain the blood and stop the hemorraging.

The odds of making a full recovery are against someone with a subarachnoid hemorrage as only one third of patients will have a good out come, another third will survive but with a disability, and the remaining third will die.

Nothing short of miraculous

For a very brief time Tobey was comatose, but she wouldn’t be unconscious for long. For the first few weeks, she was unable to walk and had to re-learn how. Her neck was also injured, and she would find talking painful. She began to wonder if she would ever sing again. But she persevered, and began to use music as rehabilitation.

To say that her recovery was miraculous would be an understatement. She learned to walk again and has been able to not only speak but return to singing the way she did before the accident. Only six months after the incident at Nakiska, Tobey appeared in the local media and performed “Who Are You” live. She looked as though nothing had happened at all.

She did not make a complete recovery however. She lost her short-term memory, something that she says is the one thing she regrets losing the most. She has also lost her sense of taste, and as is to be expected after a TBI, she has had some personality changes.

I ask her if her physical fitness had anything to do with how quick she was able to recover. She attributes it more to mental fitness, sheer determination, and stubbornness. I’d say she has the mental fitness to win an Ironman marathon while the competition eating her dust.

Most of all though, she credits music for pulling her through and giving her the motivation. She was composing again before she was allowed off bed rest. She also credits her life experiences for being able to maintain a sense of calmness through it all.

A song dedicated to our troops, our veterans, and their families.

On Remembrance Day 2018 Tobey released a new single titled “Time”. It is her emotional tribute to our active duty personnel, our veterans, and their families. Together, “Time” and “Who Are You” would make the perfect anthem for those verterans with the Acquired Brain Injury (ABI) caused by mefloquine toxicity.

People like Tobey are very rare to find. With natural talent and beauty, a social conscience, an amazingly resilient brain, and the ability to inspire others, we are lucky to have someone like her.

In the future, when history recounts those individuals who have had a major impact on Calgary, and were among this country’s brightest shining stars, the historians will count Tobey Kai among them.

D.B.

https://www.facebook.com/tobeykaiofficial/

Meeting The Mefloquine Cowboy

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As Shaun Arntsen fights the biggest battle of his life, he’s reaching others who are doing the same, and saving their lives.

I first heard from Shaun Arntsen about four days ago. He sent me a message on Twitter, where he is known as The Mefloquine Cowboy. He tells me he’d like to collaborate with me on something, a video and written media project about mefloquine. As I’m go through his posts on Twitter, one grabs my eye, it’s a You Tube video whose title warns me that I am about to see something emotionally charged. I watch the video, and it is what the title promises, and then some. Intrigued, I tell him that I’m very interested, and would like to talk. The next day, I hear back from him, and arrange a time to talk on the phone. It was at this point that I found out his real identity.

We exchange messages the following morning before finally connecting over the phone. In one of his messages, he lets me know that he needs to rest. I come to find out that Shaun in plagued by sudden debilitating headaches, and one has just taken hold. It is but one of a number of symptoms that he has experienced over the last 17 years. The symptoms began when he was deployed to Afghanistan in 2002.

When we do connect a short time later, he begins to tell me about the symptoms he is experiencing, symptoms that the Department of National Defense attributes to PTSD. He exhibits many of the symptoms that appear with PTSD, anxiety, depression, nightmares, but, he also has symptoms that are not seen in PTSD either.

He often experiences a tingling, pinprick sensation in his hands, has problems with his digestive system, and experiences episodes that he calls seizures, which, from his description of them, sound like petit mal seizures. He tells me that the things that trigger his anxiety are also unusual, in that they aren’t the normal triggers that one might see in PTSD. He tells me of how walking into a supermarket can be one of the biggest triggers of anxiety for him. The lighting in particular bothers him.

He then says something that catches my attention, when he talks about not getting anxiety from loud noises, and says something about being bombed in Afghanistan. Wait, did he just say he got bombed in Afghanistan? That didn’t make sense, our guys never got bombed in Afgha… is about as far as I thought before the words “Tarnak Farms” had popped into my head. A few moments later, he would confirm this, and I would suddenly realize who I had been talking with.

The Incident at Tarnak Farms

Canada’s first troops in Afghanistan were members of the elite Joint Task Force 2 special operations unit, followed soon after by the 3rd Battalion, Princess Patricia’s Canadian Light Infantry (PPCLI) in January of 2002, led by Lt.Col. Pat Stogran, as part of Operation Apollo.

The battalion took part in Operation Harpoon in March before commencing training for future operations. The live fire training would take place at a location known as Tarnak Farms, which had previously been an al Qaeda and Taliban training area, and was known to pilots to be in friendly territory.

On the night of April 17th, a section from “A” Company was conducting nighttime training, when an American F-16 flying overhead saw the tracer fire down below. In a stunning display of incompetence, the National Guard pilot dropped a 500 lb bomb on them. Four men were killed, another 8 were wounded.

Although close by, because of where he was at the time of the explosion, Cpl. Arntsen escaped physical injury that night. The same could not be said for his psyche however and there isn’t a single normal human who wouldn’t be effected similarly. It should go without saying that an incident like this will result in Post Traumatic Stress Disorder, and he would begin to display the classic symptoms of it while still in theatre. The only thing was, what was happening to Shaun Arntsen was far more than just PTSD.

Battle For His Life

I wanted to get a sense for who the man was before I talked to him, so I did my online homework on Shaun Arntsen. I’m struck by the things that I find in his various social media accounts, and they start to give me an idea about who he his. First, in order to get a true sense of who he is, you have to look at all of them together. To simply view him through the lens of a single social media account will only leave you with a partial understanding of him.

Looking pictures of him, my first impression is that Shaun is someone who epitomize the word rugged. With his long hair, beard, and tattoos, he would look natural on the back of a motorcycle, and like many former soldiers he is active in the Canadian Veterans Motorcycle Unit. This group of motorcycle enthusiasts works to raise awareness of veterans issues on his community and across the province.

He describes himself as a “jack of all trades” and is just as comfortable operating heavy equipment as he is a camera. Using the knowledge and skills he picked up in the military, he offers tactical firearms instruction through his company Tactical Yoga, and is also an assistant coach with the Nakiska Alpine Ski Association, teaching and mentoring youth.

He’s a talented photographer, and appears to be just as comfortable in front of the camera as he is behind it. The pictures that he has taken, and those that he appears in himself, could very easily be in any number of glossy magazines, used to promote a men’s fragrance or to showcase a new clothing line.

Yet, there is another aspect to Shaun that you can’t see as much in those pictures. It’s the veteran, haunted almost continuously by demons that first appeared in Afghanistan. Like many veterans of that conflict, he’s had his struggles with drug and alcohol abuse and he’s been in trouble with the law. There are times when he’s filled with an uncontrollable rage, and he has had outbursts in public that have left some feeling uneasy, even unsafe.

During these episodes, although they may appear frightening from the outside, his rage is not directed towards any individual, and he has not attacked or otherwise menaced anyone during these episodes.

Over time, the retired corporal came to the realization that what was going on with him was more than the PTSD that the military said that he had. Many of his symptoms weren’t consistent with the diagnosis, and since they began 17 years ago, he has shown no improvement whatsoever over that time. As more and more stories about mefloquine began to emerge, it soon became clear that this was responsible for the nightmare playing itself out in Shaun’s brain and body.

He was perilously close to making the decision that many Afghanistan veterans have made, ready to end his own life in order to find himself free from the hell that he was living each and every day for years. But Shaun also is possessed of an incredible strength of spirit, and he decided to document his struggle on YouTube. His videos tell the story of a day in the life of a man who was poisoned by a neuro toxic substance that his government ordered him to take.

They are raw, edgy, and emotional, but also inspirational. Shaun Arntsen has a way of reaching his viewers the way very few people can. There’s no pretense to the man, what you see is what you get, and what you get is a dose of the reality that he and thousands of others experience daily. He can connect with people, and is a no bullshit kind of a guy, which is why he is quickly establishing himself as someone to be reckoned with, and someone that can be turned to for advice, or a little bit of support, or a message of hope at a time when it is so desperately needed.

With lawsuits pending, and a campaign of public awareness building, mefloquine will soon be getting the attention of the Canadian public at large, but there is still a lot of work to do. Every day, veterans are hearing about mefloquine and the damage it causes for the first time. For many, it almost comes as a relief, since it would provide the answers to a lot of questions that they may have been asking themselves.

Helping to lead the charge here in Canada is Shaun Arntsen, the Mefloquine Cowboy, who is saving lives as a result of his efforts. He is a man on a mission, and I’m hoping to be able to help him along in his quest to help his brothers in arms. He proved himself on the field of battle in Afghanistan, and his efforts now are nothing short of heroic.

D.B.

Dedicated to the memory of the first four. Godspeed soldiers.

Sgt Marc Leger, Pte Richard Green, Pte Nathan Smith, Cpl Ainsworth Dyer

Pandemic Depression

Keeping the “Black Dog” at bay.

person raising hand during daytime

It was recently pointed out to me that I haven’t been posting very much in the last while. Apparently there are a few of you who have noticed my absence enough to make mention of it to me (thank you, that means a lot). The fact of the matter is I simply wasn’t capable of writing anything more than a grocery list. The motivation and inspiration I’d had left me completely and my ability to concentrate was all but nonexistent.

It would be fair to say that the mental health of a significant portion of the population at this moment is not at its best. Like millions of others I suffer from depression, and had fought it for decades prior to the arrival of COVID-19 and, like millions of others, the pandemic has taken a significant psychological toll on me. I was in the process of grieving and healing from some personal losses which I had experienced last year when the world changed forever. On Friday, March 13th, and in the days and weeks the followed I began to sink deeper into the all enveloping darkness of hopelessness and despair that accompanies depression. The “black dog” that had hounded Churchill in his life was once again nipping at my heels, and I was finding it very difficult to outrun it.

In the beginning I felt a great deal of disbelief. How had things come to this? Something like this simply wasn’t supposed to happen, and if it were to ever happen it would look a lot different than what was happening. My fear was that there was a very great potential for complete social breakdown to occur here and in the United States. Even if the worst of it was limited to the US, Canada would still feel the effects from our closest neighbour and biggest trading partner.

Lockdown

white and black train station

It was sheer absurdity at the very beginning as the greedy and the panicked turned toilet paper and hand sanitizer into commodities more sought after than oil or precious metals. Then there came the realization that there would be a quarantine and we would be living under lockdown. Soon we were living almost like prisoners in a maximum security facility, or so it would fell to many of us, and I was disquieted by the new lack of mobility that had been imposed upon us. I was by and large a homebody before so it isn’t like I was used to galavanting about or travelling the world or anything like that, but even so it was deeply disturbing to me that my freedom of movement had been taken away. It was something that very few of us could have even envisioned happening, and yet now it was the new reality.

For many the lockdown would become time for a vacation from personal hygiene, so I wasn’t alone in this regard. The same would apply for not wanting to crawl out of bed for days. I was alone and locked up with my thoughts and I would suffer a setback in the grieving process for the two people I lost last year, especially my brother. I missed him terribly, but also I also realized that he would have had a difficult time adjusting to the things that have happened since, and so in that regard it was good that he wasn’t around to see it.

It is often said that humans are very much social creatures, which we are, so the notion of “Social Distancing” can seem almost foreign to some. We soon found out what it was like to not be able to socialize with others in the way that we used to like being together as a group and perhaps even harder still what it’s like to not be able to have physical contact with others. We had to see our families through glass and were unable to give our loved ones a hug at a time when we so very desperately needed to feel one ourselves.

Change of Plans

person holding clear glass glass

Change can be one of the biggest stressors in a person’s life. Now a lot of things were going to be changing for people, with little to no warning or time for them to make preparations. There are also a lot of people whose plans for the future were suddenly very much in doubt as a result of this pandemic, myself among them. Hopes and dreams that once seemed attainable were now completely obliterated by circumstance and it was very disheartening to say the least. It has only been in the last few years that I began to discover my purpose in life, that thing that gets me out of bed in the morning. Now it all seemed lost in the enormous shadow of this damned virus.

Fighting Back

If you're going through hell, keep going. Winston Churchill | Tony ...

Eventually I reached the point where I was tired of crying and smelling bad, and so I decided that it was time I dealt with things. Dying simply isn’t an option for me, so it would mean having to deal with this head on and finding a way to live life again. These are some of the things that have helped me along the way, and I thought I would share them in the event they might help someone else.

The Power of Self-Talk

Best Practice Pharma Biotech Medtech - The Power Of Positive Self-Talk

Of all of these tools this is the one that I feel needs to be used first. Being in a negative mindset can be self perpetuating so it is important to actively make an effort to practice positive self talk in order to start having a positive mindset. I can remember scoffing at the idea when it was proposed to me one time by a therapist. I immediately had a vision of myself sitting in front of a mirror like Stuart Smalley (Google if you don’t know who I’m talking about) and telling myself that I was good enough, smart enough, and gosh darn it people like me. But the fact is there is more to it than just a daily affirmation. Negativity breeds negativity, so having a more positive outlook about things will result in a more positive mindset. It’s about constantly talking yourself up in your mind with the ultimate goal of restoring your self-confidence, enabling you to envision victory was once there were only visions of defeat, which leads to victories.

Talk To Someone Else

a man holds his head while sitting on a sofa

No doubt mental health professionals are going to be busy for quite some time dealing with the fallout from all of this. I was fortunate because at the time the lockdown started I had been in grief counselling so I had access to someone to talk to about things that were happening with me in the wake of the pandemic.

Not everyone will be in this position though, so they will have other alternatives open to them. In jurisdictions across the US and Canada a variety of mental health supports are available online or over the phone for those that need it, and as always anyone who feels as though they are in danger of harming themselves should call 911 or go directly to the nearest hospital emergency room.

Keep in touch with your network of people be it family, friends, or both. Do a “buddy check” on a friend by calling them to see how they’re doing and the result could prove cathartic for the both of you. Talking about how you are feeling will be an important step towards finding a much needed and therapeutic emotional release.

Establish A Routine

Creating a Daily Schedule in the Midst of the Coronavirus Pandemic ...

It has been well established in the literature that there are numerous psychological benefits to establishing routines. Importantly, routines and schedules help to alleviate stress and anxiety in times of chaos and uncertainty. They add stability to lives that have been torn assunder and provide a sense of control at a time when we are powerless to do anything in the face of chaos. As the economy begins to open up again many people will find it difficult to go back into “work mode” so getting back into the routine ahead of time will help them to adjust to life back at work again.

Exercise and Nutrition

shallow focus photography of person walking on road between grass

Diet and exercise are also important components of good mental health, not just physical. Studies have shown that exercising or working out regularly contribute greatly towards the improvement in people with depression. How many people do you suppose gained more than a couple of pounds while in lockdown because of a lack of regular exercise and a diet rich in junk food and take-out? Proper nutrition not only feeds the body but also the brain, so a balanced diet is also essential for good brain health as well.

Find/Maintain Your Purpose

person wearing black leather shoes standing on gray concrete floor

For years various authors and self-help gurus have been charging people a lot of money in order to pass along some wisdom, that is quite simple though perhaps not quite so obvious to a lot of us. Knowing it and acting upon it could mean the difference between life and death for some, and what it boils down to is finding a reason to get out of bed every day. Find a (your) purpose for yourself. If you haven’t yet done so with your life up until this point, now would be a perfect opportunity to start doing some reflecting.

Maybe you had already found that purpose but because of the pandemic it looks as though you might have lost it. It can seem as though you’ve lost your purpose and are now wandering rudderless in rough seas.

It’s important to remember that all might not be lost, it will just be put off for a little while longer than originally planned. Take advantage of this time to retool your original plans, or if you were in need of purpose to begin with, this would also be a good opportunity to do some deep thinking about your life and examine your priorities in light of current events.

The Power Of Prayer

praying hand neon signage

There also really must be something to be said for the power of prayer. I’m not going to tell you who you should pray to or how you should be doing it, just pray. Simple.

Be Kind

To yourself and to others. We’re all going through some shit right now and frankly it would just be nice.

white and black quote print

Difficult Days Lie Ahead

Bad Moon Rising" by Creedence Clearwater Revival. (With images ...

Forgive me if this seems negative but the reality is that we are going to be in for some very difficult days ahead, we simply have to accept this and prepare ourselves. That said it’s difficult to prepare for the unknown. What we do know is that people’s mental health will continue to be at increased risk for the forseeable future, especially as the economic impacts of this pandemic become clearer and start hitting home.

With this in mind, maintaining mental health in the face of these challenges will be a difficult road for us all, so it will be important to be as prepared as possible and to have the tools available at your disposal to assist you.

Ironic Liberal Staffer Wants Social Distancing Scofflaws Shot By Sniper

Liberal hypocrisy knows no bounds

Liberal staffer says those who break social distancing should be shot by snipers

https://thepostmillennial.com/liberal-staffer-says-those-who-break-social-distancing-should-be-shot-by-snipers?fbclid=IwAR1K4PbCyX0dE7p8ILogAPP8E62-Xnn1wm4Gzfa8Zhg8pme6MSA2OsBKuw4

Yet again another Liberal staffer has managed to put both feet in his mouth as The Post Millennial reports Mark Elyas, a federal Liberal riding executive, posted controversial comments on his Facebook page about people who break social distancing rules. He said:

“Shoot people on sight who defy curfews (snipers can be posted anywhere about 2 kilometres from targets. That will kill the spread of the virus and then we can go back to normalThis fool has made other stst

Mark Elyas Facebook Page

This isn’t the first time he’s made foolish statements on Facebook either. In a 2018 post he says “Trump supporters are pieces of shit.”

Courtesy: Facebook

Wrong on so many levels

I mean where to begin? The fact that he’s calling for the execution of Canadian citizens by snipers? While his boss is bandying about a ban on firearms? This absolutely disgusts me on so many levels too.

Be wary my friends

Governments like to seize opportunities like this to strip citizens of their rights, and it’s happening here in Canada. We need to be extra cautious now, so that we don’t lose any more.

The Argument Against Chloroquine

Why Chloroquine Isn’t The Panacea For This Pandemic.

Trump touts chloroquine for 'immediate' use treating coronavirus ...

On March 19th, 2020, it had been roughly three months since the first reports of novel coronavirus-2019, COVID-19, began to appear out of Wuhan, China. According to some reports the White House had intelligence of an outbreak in Wuhan as far back as November. In those early days of the outbreak, Donald Trump dismissed any notion that a national and global crisis on a scale never seen before was about to unfold. Then, six days after that Friday the 13th when everything in the world changed, Trump made an announcement that caught everyone by surprise. The antimalarial drug chloroquine would be a “game changer” in the fight against COVID-19 according to the American President.

There has been a great deal made about the fact that there is still not enough data available to state whether or not chloroquine is effective, but I haven’t heard much about the potential adverse events that can and have occurred as a result of chloroquine. This is not a benign substance, it is toxic and potentially dangerous or even deadly in some instances. Therefore a great deal of care must be exercised and all available information about it must be made before anyone can or should make a decision about taking this or any other drug.

Disclaimer

I want to make it clear that the reasons for my position on this are by no means political in nature and that they come from scientific and anecdotal information that I have acquired over the course of the last several months.

Hydroxychloroquine sulphate

Available in the United States under the brand name Plaquenil, chloroquine is used as an antimalarial and is also widely used off-label in the treatment of Rheumatoid Arthritis (RA). Not long after Trump’s endorsement, a number of statements about chloroquine began to circulate online with two of the more common being:

  1. The safety profile of chloroquine is well understood from its use in over a billion people for malaria.  As you would be aware, despite the similar sounding name, chloroquine is not mefloquine and does not share the same adverse events, and;
  2. A range of national and international organisations such as the World Health Organisation and the Gates Foundation are coordinating worldwide efforts to test these compounds to determine their efficacy.

Unfortunately, both of those statements are false or misleading. Chloroquine is used at similar malaria treatment and prophylaxis dosages as mefloquine. This drug can, in fact, cause severe acute and chronic neuropsychiatric reactions similar to mefloquine, at similar frequency. The military developmental history of this drug in Germany and the United States during the pre and post-WWII era also has a close parallel with the development of mefloquine in the post-Vietnam War era. In addition, exposing medical personnel to chloroquine in high-stress environments during the Covid-19 pandemic would likely exacerbate those stresses and/or confound prompt recognition of the prodromal symptoms of toxic encephalopathy.

History

Quinoline antimalarials

In the 1820’s two German scientists were the first to isolate quinine from the bark of the cinchona tree, as the compound that gave the bark its anti-malarial properties.

Quinine is an alkyloid, which are naturally occurring compounds usually found in plants and mostly contain basic nitrogen atoms. Many alkyloids have medicinal purposes and are used to treat a variety of diseases, however they can also be highly toxic to humans. Morphine, strychnine, atropine, colchicine, ephedrine, and nicotine are also alkyloids.

There are also synthetically developed derivatives of quinine such as mefloquine and tafenoquine which were made with the hope that they would be less toxic. However evidence clearly shows that this is simply not the case.

Chloroquine

Eventually malaria became resistant to quinine and a replacement would need to be found. This replacement was first synthesized in 1934 by Hans Andersag, a scientist at the Elberfeld laboratories of the Bayer I.G. Farbenindustrie A.G. in Germany, and given the brand name Resochin. In subsequent trials later however it was deemed to be “too toxic for practical use in humans.”

W. Kikuth, of the Elberfeld laboratories, tested Resochin against bird malaria (1935) and found it to be as effective as Atabrine but slightly more toxic. On the basis of the Kikuth tests, the compound was given to F. Sioli who tested it (1935 or 1936) against blood-induced vivax malaria in four paretics at the psychiatric clinic in Dusseldorf. There are no actual records of these tests but he is credited with reporting it, 1) as equally effective as Atabrine, and 2) as saying that it was “too toxic for practical use in humans.” Whatever his conclusions might have been, the report of its slightly greater toxicity over Atabrine in lower animals seems to have been the factor which brought the decision to abandon it.
This decision by Bayer. . . may have had merit in terms of the times although later it became
known by the Germans as the “Resochin error.”

PITFALLS IN A DISCOVERY: THE CHRONICLE OF CHLOROQUINE*
G. ROBERT COATNEY
https://www.astmh.org/ASTMH/media/Documents/Presidential%20Addresses/1962-G-Robert-Coatney.pdf

Auschwitz: IG Farben and the History of the “Business with Disease”

Kriegsende 1945: Die verschwundenen Schätze der Nazis - WELT

https://www.globalresearch.ca/ig-farben-history-business-disease/5701804

A less toxic compound, methylated Resochin, was formulated in 1936 under the brand name Sontochin and was given to the Afrikakorps during the war. The drug would find it’s way into Allied hands in Africa after a supply was found by French troops in Tunisia who turned it over to the Americans, which would ultimately lead to the release of chloroquine in 1945.

Potential Adverse Effects

Significant risk of permanent neurological damage

The simple fact is that chloroquine, as with the related drugs tafenoquine and mefloquine, is able to cause severe, chronic toxicity including (but not only) lasting or permanent brain damage. I know this because over the last fourteen or so months I have had the opportunity to talk to a number of veterans whose lives were torn apart after they took one of these drugs, some have had the misfortune of having taken all three of them. The adverse effects that many now suffer include:

  • psychiatric disorders including depression, anxiety, bipolar disorder and schizophrenia.
  • cognitive impairments including memory and concentration difficulties.
  • hearing problems including tinnitus, hearing loss and hyperacuity.
  • vestibular disorders including dizziness, vertigo and spatial disorientation.
  • neurological disorders including neuropathies, seizures, Parkinson’s disease
  • and motor neurone disease (MND)

Although exact numbers are not known, a very significant number of individuals who have taken these drugs have died as a result of either suicide or a motor neuron disorder.

It should be noted that while these incidents may only occur in a minority of people, it is nevertheless a rather significant minority and although these and other adverse events are typically seen with long term use and higher dosages, it is possible and has been known for them to occur after a SINGLE dose.

We present a case of a Mr A, who is 32 years old gentleman with no significant past medical or Psychiatric history. He was admitted in general surgery ward of our tertiary care teaching hospital where he was diagnosed with amoebic liver abscess and underwent management in the form of percutaneous aspiration of pus and received intravenous antibiotics during his stay in the ward. He was discharged on chloroquine phosphate 600 mg in divided doses. After discharge the initial 4 days were uneventful. Since the fifth day Mr A started feeling that there is some supernatural power in his room and became extremely fearful and pleaded for constant company of family members. Following day started having irrelevant talk, muttering, aggression and suspiciousness and had a firm belief that some supernatural force is going to harm him. He was brought to our Psychiatry OPD by parents and was admitted as there was a risk of harm to others or self. In the ward patient became extremely aggressive and ran out and smashed random bikes.

Chloroquine Induced Psychosis in an adult patient with
Amoebic Liver Abscess: a case report
http://www.indianmentalhealth.com/pdf/2019/vol6-issue1/CR1%20CHOLORQUINE%20CASE%20REPORT.pdf

Other potentially serious adverse effects

Apart from the neurological damage it can cause, chloroquine can also prove toxic to other organs in your body such as your heart, eyes, and ears.

Cardiotoxicity

Chloroquine by itself is cardiotoxic and can potentially lead to life threatening cardiac arrhythmia causing death. The proposed treatment regimen for COVID-19 calls for chloroquine to be used in conjunction with azithromycin, which also carries with it the very same risk making it more dangerous.

A small study in France enrolling 26 treated patients and 16 non-randomized controls showed that hydroxychloroquine alone or in combination with azithromycin shortened the time to resolution of viral shedding of COVID-19.1

Based on this study, clinicians in many countries have begun using these medications in clinical practice, and multiple randomized trials are being initiated. However, chloroquine, hydroxychloroquine and azithromycin all prolong QT interval, raising concerns about the risk of arrhythmic death from individual or concurrent use of these medications.

Ventricular Arrhythmia Risk Due to Hydroxychloroquine-Azithromycin Treatment For COVID-19
https://www.acc.org/latest-in-cardiology/articles/2020/03/27/14/00/ventricular-arrhythmia-risk-due-to-hydroxychloroquine-azithromycin-treatment-for-covid-19

There would seem to be a consensus amongst the scientific community that a great deal more research remains to be needed.

Balanced against the clear life-saving benefits of giving effective antimalarials promptly in malaria, with the exception of halofantrine, concerns over cardiotoxicity have not limited the current use of the quinoline and structurally related antimalarial drugs.

The importance of robust detection and evaluation of extremely rare and serious adverse events such as sudden unexplained death in real-world populations and the implications of such findings for population-based drug administration strategies underscore the need for ongoing synthesis of all available clinical evidence. 

The arrhythmogenic cardiotoxicity of the quinoline and structurally related antimalarial drugs: a systematic review.
Ilsa L. Haeusler
Xin Hui S. Chan
Philippe J. Guérin & 
Nicholas J. White 
BMC Medicine volume 16, Article number: 200 (2018) 
https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-018-1188-2

Ocular Toxicity

Optical Coherence Tomography (OCT)

According to some, the risk of eye damage is perhaps on of the biggest risks. Chloroquine can cause retinopathy, permanent damage to the retina, as well as damage to the cornea and/or lens which would have a detrimental effect on vision. “Even when the clinician and patient adhere to screening guidelines and retinopathy is detected in a sub-clinical stage, discontinuation of chloroquine or hydroxychloroquine therapy may not stop the progression of retinopathy to a stage where the patient loses vision.”

Chloroquine (CQ) is used to prevent and treat malaria and amebiasis,[1] while hydroxychloroquine (HCQ), a less toxic metabolite of chloroquine, is used to treat rheumatic diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), juvenile idiopathic arthritis (JIA) and Sjogren’s syndrome.[2] Both medications can cause corneal deposits, posterior subcapsular lens opacity, ciliary body dysfunction, and most important, irregularity in the macular pigmentation in the early phase, a ring of macular pigment dropout in the advanced stage, and peripheral bone spicule formation, vascular attenuation, and optic disc pallor in the end-stage. Ocular symptoms of retinopathy include blurred and partial loss of central vision, side vision and in the later stage, night vision.  Symptoms of corneal deposits include haloes and glare.  

Chloroquine And Hydroxychloroquine Toxicity
Thomas J. Stokkermans; Georgios Trichonas.
https://www.ncbi.nlm.nih.gov/books/NBK537086/

Ototoxicity

Although there isn’t as much risk of hearing damage as there is vision damage, it is still a distinct possibilty.

Hydroxychloroquine (Plaquenil®) is an antimalarial agent which is approved for rheumatoid arthritis, systemic lupus erythematosis, discoid lupus erythematosis, prophylaxis and treatment of acute malaria, and photodermatosis [1]. In the Netherlands it has been approved since 1966.

Hydroxychloroquine is chemically closely related to chloroquine (Nivaquine®). Hearing loss or ototoxicity are not mentioned in the SPC of hydroxychloroquine [2]. The SPC of chloroquine states both hearing loss and deafness as possible ADRs.

Until May 31, 2005 Lareb received three reports of hearing loss associated with the use of hydroxychloroquine. No cases have been reported in association with the use of chloroquine. Report A concerns a female aged 69, who experienced hearing loss (especially low tones) and tinnitus several months after starting hydroxychloroquine for indication lupus erythematosis. The hearing loss was confirmed with an audiologic examination. Five years after discontinuation of the hydroxychloroquine, functioning of her right ear is still impaired.

Case B was reported by the MAH and concerns a female aged 57, who experienced deafness and tinnitus 4 years after starting hydroxychloroquine. Hydroxychloroquine was withdrawn and one year later the patient had not recovered.

Recently we received a third report of hearing loss (C). It concerns a female aged 51, who experienced hearing loss 7 months after starting hydroxychloroquine for the indication scleroderma. An audiogram showed a bilateral perception hearing reduction of 30 to 50 dB for high frequencies. The hydroxychloroquine has been withdrawn, 2.5 months later patient has not recovered.

Hydroxychloroquine and hearing loss
Netherlands Pharmacovigilance Centre
https://databankws.lareb.nl/Downloads/kwb_2005_3_hydro.pdf

The Johns Hopkins Guide

Baltimore, MD, USA – June 28, 2015: The Johns Hopkins Hospital at night from Orleans Street.

Experts from Johns Hopkins Medicine have published a number of guides online including their antibiotics guide, Johns Hopkins ABX. These experts, from the one of the most respected medical institutions in the US, routinely update the guides to provide the most up to date information.

Regarding the proposed use of chloroquine in the treatment of COVID-19, the guide stated that there was “minimal, low quality evidence” to support it. In addition to this it states:

Retinopathy is one of the most serious adverse events associated with hydroxychloroquine and it is NOT reversible. The American Academy of Ophthalmology recommends screening for hydroxychloroquine-related retinopathy: examination prior to therapy initiation to rule out preexisting maculopathy and annual screening after 5 years for patients on acceptable doses and without major risk factors

Hydroxychloroquine has been used in a recent COVID-19 outbreak. Limited available data are largely based on in vitro studies and clinical series and one small RCT showing no effect.

In a small, observational, non-randomized study of (n=36) patients with SARS-CoV-2 infection, administration of hydroxychloroquine 200 mg q8h for 10 days (n=20) resulted in higher clearance of virus (70%) on day 6 compared to controls (12.5%). Six patients also received azithromycin, and authors argued in a post-hoc analysis that addition of azithromycin resulted in even higher, but statistically nonsignificant clearance[1]. This study, however, has many limitations including small sample size, exclusions from analysis of patients who were lost to follow-up (e.g. escalation of care, death), no clinical outcomes were reported or colation of viral clearance and clinical outcomes has been made.

pilot RCT of 30 patients comparing HCQ v. placebo found that on day 7, COVID-19 nucleic acid of throat swabs was negative in 13 (86.7%) cases in the HCQ group and 14 (93.3%) cases in the control group (P>0.05). There was no significant clinical difference between the groups. The study suggests that if HCQ has an effect it is at most modest, so larger studies need to be performed.

Larger and properly designed studies are needed to determine the benefits of hydroxychloroquine in the treatment of COVID-19-positive patients and the role of combination therapy (e.g. with azithromycin).

Johns Hopkins ABX Guide
https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_ABX_Guide/540748/all/Hydroxychloroquine#5.0

Johns Hopkins University also has an excellent online corona virus resource centre available at:

https://coronavirus.jhu.edu/map.html

Response from The Quinism Foundation

The Quinism Foundation Calls for a Reopening of the Somalia ...

Dr. Remington Nevin is an epidemiologist and an expert on anti-malarial drugs. He is also the founder and a director of the Quinism Foundation, a nonprofit organization dedicated to promoting and supporting education and research on quinism, the family of medical disorders caused by poisoning by mefloquine, tafenoquine, chloroquine, and related quinoline drugs. They have been quite vocal in their opposition to the notion of using chloroquine as a treatment for COVID-19.

For more information you can visit the Quinism Foundation website at:

https://quinism.org/

Not the only choice

There are a number of other possible treatments, much less toxic treatments, that are also being looked at. For example studies have shown ivermectin, an antiparasitic, might also be effective at treating COVID-19 so it is important to remember that hydroxychloroquine isn’t the only drug that could work. Under no circumstances should you take medication that has not been prescribed for you by your doctor.

Listen to what the medical community says

I formed my opinions after doing a great deal of research and all I would suggest to you is that you do some of your own before you come to any conclusions. This should be the case any time you are considering a matter that might have life or death consequences. Where you get your information is equally important when it comes to decision making, so I am more likely to rely on academic research and journal articles as primary sources rather than public figures like the President of the United States.

Google Scholar

Right now most of the major scientific and medical journals are offering free access to any articles relating to COVID-19, and Google Scholar has links to all of them. It is a good way to keep up to date with the latest research as it becomes available.

https://scholar.google.ca/

We Got Your Six-Hydroxychloroquine and COVID-19 Part 3

With Hosts Marj Matchee and Kentrina Jenkins

With hydroxychloroquine being hailed by some as a “game changer” in the fight against COVID-19, Marj and Trina are taking a closer look at the subject in a three part series. In part three our hosts engage an international panel that includes Dr. Jane Quinn, associate professor at Charles Stuart University in Australia, and ADF veteran Maj.(ret.) Stuart McCarthy as well as veterans Dave Rimmington from the United Kingdom and Dave Bona from Canada.

We Got Your Six-Hydroxychloroquine and COVID-19 Part 1

With Hosts Marj Matchee and Kentrina Jenkins

With hydroxychloroquine being hailed by some as a “game changer” in the fight against COVID-19, Marj and Trina are taking a closer look at the subject in a three part series. In part one they talk with Dr. Remingtion Nevin, epidemiologist and specialist in anti-malarial drugs who is also the founder of the Quinism Foundation for his take.