Wolfmont and Honey Locust - Health

Medical thriller? Swine Flu? Not hardly!

nospam@example.com (Tony Burton) — Mon, 04 May 2009 20:03:50 -0700

Probably many of the people who read this blog have read medical thrillers. Stephen King's THE STAND is one such, as are FOREIGN BODY by Robin Cook and HARVEST by Tess Gerritsen. I don't read these very often--not because they're not gripping or well-written, but because they scare the bejeebers out of me. I get enough doses of scary reality to want to avoid such books. If you like them, that's great! Go ahead and read 'em--I'm not saying don't do it.

I guess what makes them so doggone frightening to me is that my wife is a long-time ER and ICU nurse who is also a CNP, and I hear the horror stories of medicine all too often. It may seem like fiction to you to hear of some of the horrible things that can happen in a hospital: sponges left in patients, doctors operating while intoxicated, nurses failing to connect telemetry so patients die without anyone knowing. The problem is, these things really do happen, so that makes the medical thriller a bit too close to home for me.

How's this for a thriller concept? Doctors discover an antibiotic-resistant infection that spreads easily and is very, very deadly.

"Ha!" you may say. "That's been done, and besides, it's a reality. They call it MRSA, or 'mersa' in the nurse's lingo."

True. All too true. So, let's put a kink in it. Classic MRSA typically is transferred through a wound and/or mucous membrane, by exposure to a person sick with MRSA or his/her body fluids. It is contracted over ninety percent of the time when a person is in a hospital, nursing home, dialysis center or other such place.

So let's make it more suspenseful: the new "bug" is spread through casual contact with physical objects that other infected persons have touched. Remember wa-a-a-ay back when people worried about catching AIDS or VD from a doorknob? Well, would it up the suspense ante if the new bug could literally be caught from a doorknob... or by touching the handle of the shopping cart at WalMart... or from the toilet in the public restroom... or by picking up the hymnal at church?

And would it make it even more horrifying if this new version of the bug often causes necrotization of the tissue (necrotizing fascitis)? (That means that the skin and underlying flesh starts to die and rot--similarly to what happens from the bite of a brown recluse. (Warning: NASTY pictures after that jump!)

Guess what: it is not fiction. This relatively new version of MRSA is called Community Acquired Methicillin-Resistant Staphyloccus Aureus. CA-MRSA, for short.

The nurses at the hospital were warned about this a few months ago, but the warning was emphasized again in today's training. Here's a kicker, too: Purell and other alcohol-based "hand sanitizers" don't do squat to fight this. You know those little dispensers you may have seen near the entrance of your local grocery store (ours have them, anyway) that have what look like baby wipes in them? Those things have a mild form of bleach in them, and that's the only thing that kills the CA-MRSA on surfaces. Standard germicidal wipes with alcohol are useless against CA-MRSA.

Now, for some reason people are worried silly over H1N1 influenza.

Why? Because the pharmaceutical companies have pushed this as a big risk.

Why did they do this? Because they have HUGE stockpiles of influenza vaccine and TamiFlu that they need to sell before it goes out of date.

There are about 290 confirmed cases of H1N1 influenza in the U.S. right now. There has been one death: a Mexican toddler whose immune system was compromised. To me, this is not a pandemic, as sad as the death of a child may be. One death in 286 is a mortality rate of about one-third of one percent

Here are some facts on deaths from MRSA: "In 2005 in the United States alone, 368,600 hospital admissions for MRSA—including 94,000 invasive infections—resulted in 18,650 deaths. The number of MRSA fatalities in 2005 surpassed the number of fatalities from hurricane Katrina and AIDS combined and is substantially higher than fatalities at the peak of the U. S. polio epidemic." (Taken from the American Academy of Orthopedic Surgeons News.) That is a FIVE percent mortality rate in 2005. The CA-MRSA has developed since that time, so the infection rate is increasing because people are contracting CA-MRSA outside the hospital.

By this point you're probably wondering why in the WORLD I am blogging about this. Well, it does tie to writing and fiction in a number of ways.

Medical thrillers and medical suspense novels are a big part of the crime fiction scene, and this sort of information is great background info for such novels.
Reality is often stranger than fiction, and it actually makes the fiction scarier if people face up to the fact that such things can really happen. (For example, don't you think people would find zombie stories scarier if they really believed that they could find a horde of brain-hungry walking corpses in their front yard one night?)
The scare tactics about the swine flu (H1N1 influenza) are, in my not-so-humble opinion, blown-out-of-proportion statistics and largely fictionalized, and designed to help the pharmaceutical companies rather than help individuals. If the number of cases and mortality rate were any indicators, they would be falling all over themselves to inform people about MRSA and CA-MRSA... oh, but wait! People can use simple antisepsis (washing with bleach water) to avoid MRSA and CA-MRSA, so the pharmaceutical companies wouldn't make much money from that, would they?
Lastly--if it IS or if it is NOT a scheme to sell flu meds and clear out stockpiles--well, it makes a heck of a story, don't you think?

Oh, and make sure you use one of those antibacterial wipes the grocery stores have to wipe down that shopping cart handle. Believe me, you don't want to catch CA-MRSA.

Later addition, 5/4/09, 11:43 PM: Government says swine flu is no worse than regular flu.

The Unexpected

nospam@example.com (Tony Burton) — Fri, 10 Apr 2009 22:09:57 -0700

Tomorrow, April 11, would have been my little sister's 44th birthday. Karen was 23 when she died. She had recently graduated from Kennesaw State University with a major in accounting and a minor in computers. She was very intelligent; she had attended college on a partial academic scholarship. Karen had been married for three years, and had confided to us over the phone (when we called her to wish her a happy birthday) that she and her husband Richard planned to try to have a child now that the pressure of college was over.

Karen lived in Georgia, fairly close to my parents, while I lived in Florida. (I was a sailor at the time.) My seven-year-old daughter was spending a couple of weeks with my parents in June of 1987 when Karen died, and for some time after that we had to deal with her fears of further loss because Aunt Kay (her name for Karen) had promised to come back the next day and go out for ice cream. We learned not to say to her, "I promise I'll be back."

Why am I saying all this? It's not to engender any tears or sympathy. It is to help raise awareness of the dangers lurking in persistent or recurring pain.

When my sister died, she had been suffering with a wretchedly painful headache for almost a week. Nevertheless, she started for work that Saturday morning, to catch up on some work she had not finished during the week. On the way to work, while driving on a little country road, a blood vessel in her head catastrophically burst. Karen had an undiagnosed brain aneurysm that ruptured, causing almost immediate death. Her foot remained on the accelerator and the car ran along the road in a straight line until the road curved. There was an embankment and the car rolled, throwing her now-dead body out and pinning it underneath.

Her horrible, persistent headache was the primary symptom for her fatal condition. Some people have small aneurysms that never rupture, but Karen was not lucky enough for that. Karen was young--only 23--and healthy, or so we thought. The aneurysm was hidden within her, waiting to strike like some random time bomb, though it had been warning her with its pain for about a week.

So often we humans, especially the younger and healthier ones or the more macho ones, will dismiss even a persistent or recurring pain out of hand. "Oh, it's nothing! Don't worry about it; it will go away. I'm always having these..." headaches, bouts of heartburn, stomach pains--you provide the medical issue.

It's easy to get busy, or to think, "It's such a little thing--I'm sure it's nothing." I have spoken with people who were in their thirties or forties when someone finally persuaded them to go to a doctor about this or that persistent problem, and often they said, "I've always had it. I just figured everyone did, and I was like everybody else." Persistent or recurring medical issues are not normal. We don't all have them.

Men: it's not being strong or masculine to ignore persistent pain. It's being stupid. Go to a doctor! Coach was wrong when he told you to just "suck it up!"

Women: the world will not fall apart if you take time to take care of yourself by having your health checked by a doctor. And when the doctor asks if there is any health issue you have had lately, it's perfectly all right to tell him about it!

Anyone: If you have an unusual pain or condition that persists for more than a couple of days, or that keeps coming back, it is probably a good idea to see a doctor. Maybe you will be lucky and you will catch that little problem before it becomes a much bigger one. Or, maybe you will be even luckier, and you will have spent the insurance co-pay for nothing but peace of mind.

Aneurysms are treatable. My sister would probably be alive now, and her kid(s) would have grown up with mine--but she didn't think she needed to go to the doctor. She just toughed it out.

I miss her, and I wish she had not tried to tough it out. I'd rather be singing Happy Birthday to her tomorrow, than visiting her grave.

Don't tough it out. Have that pain checked out.

Do it for the ones who love you, OK?

A Christmas Plea for Compassion

nospam@example.com (Tony Burton) — Tue, 23 Dec 2008 17:26:20 -0700

My wife is a nurse, as I've said before. As a nurse in a small hospital, she sometimes comes home with tales of humor, embarrassment, bravery, hope and despair. But today she told me something that struck at my heart in a particularly potent way. Please read on...

Just suppose for a moment that you are an elderly person. Your spouse passed away years ago and you live on a pension, in a small apartment. There are no close-by relatives, and hopping a plane to California or New York to visit and "impose on" relatives is not an option for you. You have a variety of the ailments that afflict the aging, and take medication for those ailments, to ease their symptoms and provide some comfort. But that comfort does nothing for your soul, for your emotional heart.

One day as you sit alone in your tiny apartment, you are watching television, a show about someone around your age who has been admitted to the hospital. The sick woman in the hospital show has people visiting her... has other patients to speak with... has nurses and other caregivers coming by on a regular basis to check on her. In its own way, it is a more pleasant setting than your own. And so you think....

A couple of days ago an elderly woman (in her mid-seventies) was admitted to the hospital where my wife works. She was suffering from a variety of problems, to which I am not privy and which really make no difference to the story. My wife noticed that she was particularly eager to talk, and that she would bring up all sorts of subjects to keep my wife engaged and close by in her room. While this might be annoying at another time, there was something about this lady that drew my wife to spend extra time with her. She was desperately, achingly lonely.

After a while, this woman revealed to my wife that she simply did not want to spend Christmas alone again. So, a few days previous, she simply stopped taking some of her medication. Over a few days, she felt worse and worse, and ultimately was transported to the hospital emergency room, where she was admitted to the Intensive Care Unit.

Both my wife's eyes and my own eyes teared up as she told me of what this terribly lonely woman had done. She was not a fool, no senile dotard. She had the full capacity of her intellect; she knew full well what she was doing and the risk she was taking by neglecting her medication. But to her, it was worth the risk to her own health to be near people again at Christmas, to feel connected with other human beings who cared what happened to her, even if it was only their job... to have someone to ask about their family and their life and perhaps for them to ask her about her own.

As my wife was leaving her shift at the hospital today (she works the night shift), she went in to speak to the dear lady once more. Her vitals were back within the range where they should have been, and her body's chemistry was relatively balanced now. She would be going home, probably sometime today or early tomorrow, Christmas Eve. "I guess it will be okay to be home by myself at Christmas," she said wistfully as my wife stood at her bedside. "I have one neighbor who comes over sometimes and watches TV with me. Maybe she can come visit."

It wrenches at my heart to think of this. Unfortunately, my wife is working Christmas Day, or I would probably go and get the dear old soul and bring her here for Christmas dinner. I may yet.

I wonder... is there anyone you know who is alone at Christmas? Is there someone nearby who is so painfully lonely that they would rather be in a hospital bed with some companionship than alone in his or her house at the holidays?

If there is, would you consider perhaps doing something to ease that pain? How about dropping by with a plate of cookies or fudge? Or maybe calling them on the phone and spending some time just chatting about things? Or perhaps you could go all the way and invite this person to Christmas dinner, or Kwanza'a meal, or Hanukkah... or if you are not religious, how about just some pleasant personal time over coffee and cake?

I'm not the most religious or "churchy" person in the world, by conventional standards. But I like what James the Apostle said in his New Testament letter to the churches: "Pure religion and undefiled before our God and Father is this, to visit the fatherless and widows in their affliction, and to keep oneself unspotted from the world." That last part is pretty hard to do, but I think we could all manage to accomplish some of the first part.

How about you?

Early-morning Visitation

nospam@example.com (Tony Burton) — Thu, 18 Dec 2008 16:13:37 -0700

Sherlock Holmes says, in A.C. Doyle's "The Boscombe Valley Mystery": "It is, founded upon all my experience, that there is no-place on earth that has a more dreadful record of sin than does the smiling countryside. There are laws in London whereby there is no street so dark or alleyway so vile that the thud of a drunkard's blow or the scream of a tortured child does not beget sympathy from some neighbour. But look at these lonely homesteads, each within their own grounds. Think of the deeds of hellish cruelty that may go on year in and year out in such places, and no-one the wiser!"

I live in the "smiling countryside" and for the most part my life is relatively peaceful. Oh, recently my faithful dog Buddy dragged up a couple of large deer forelegs that some unthinking hunter had cast off when he field-dressed the product of his hunt, but usually it is a fairly quiet life.

Last night I worked late on a project, and finally got to bed about 3:00 AM. My wife was working her normal 12-hour shift at the local hospital ICU. At precisely 6:50 AM I was wakened from a warm, comfortable sleep by someone pounding on my front door. Has Lara forgotten her keys? I wondered... then realized that without her keys, she never would have been able to drive home.

So, wearing very little I stumbled to the front door where I could observe a face trying to peer through the small frosted-glass pane there. "Who is it?" I yelled through the door. (Though it was raining, I'm not such a fool as to open the door to any stranger who comes pounding at odd times.)

"I'm hurt... oh god... I'm freezin' to death... muh shoulder..." was the reply.

I slipped on a pair of jeans and placed a loaded pistol in my pocket. (After having been threatened by drunks and fools on a few occasions, I don't take chances. Yes, I'm licensed to carry, and I do.)

Continuing to talk through the door, I tried to figure out what was going on. Without trying to relate a lot of the conversation here, as much of it from the other side was garbled and slurred because of the man's inebriated state, here's what happened.

It seems that he was visiting a girlfriend up the road from our house last night, and she "called the law" on him. He dashed into the woods in an attempt to evade contact with the local constabulary and became lost in the dark, wet woods. There are a couple of good-sized creeks that run near here, and they are swollen with the recent rains. Since he was unsteady from the alcohol as well as running through unknown woods, he took a tumble down a hillside and ended up in a creek. In the process, it looked like he dislocated his shoulder.

After opening the door and looking at this soaked, bedraggled specimen of injured and drunken humanity, I let him come in and sit down, and wrapped a blanket around him in an effort to stave off chills. He gave me a phone number of someone to call and come pick him up. They seemed none too concerned--I learned later this was his sister-in-law, and she probably had dealt with similar situations too many times before. The first call was at 7:00 am.

And yes, I was going to call 9-1-1, but the man begged me, literally, not to do so. Later it came out that he was (1) a mental patient who had not been taking his medication and (2) on probation.

The sister-in-law lived about three miles away. At 7:30, no one had yet arrived to pick up my 52-year-old foundling. He was sitting in my dining room, getting the carpet wet and slurping down hot, strong, sweet tea in an effort to get him warmed and more alert. I could tell he was hurting--I've dislocated a shoulder before and I know what it's like--but I have to admit I tired of his constant monologue about his pain, his evil girlfriend, how slow his brother was, how he was glad his mother couldn't see him now and so forth. I called the sister-in-law again, but got no answer.

About ten minutes later, I tried again on the phone and she answered, telling me that his OTHER brother was on the way and should be there shortly. He lived about four miles away.

At 7:55, still no chauffeur for my new houseguest. He was on his second cup of very strong tea and becoming somewhat more coherent. At first he was disoriented and had no idea of the time, so he said he must have been in the creek for an hour or so, as he could not remember anything... "I musta hit my head... prolly got a brain concussion or something..." I told him what time it was and he started to cry.

"I left her house at 9:00. I laid down there in that creek all night, then. Just my head was outta the water when I woke up... oh god this hurts.... God musta been taking care of me, right?" Considering the distance he had traveled, it appears he laid in a rain-swollen stream, unconscious, for at least seven or eight hours, perhaps longer. He was lucky that the weather is relatively mild--it didn't drop below 50 degrees last night. A couple of weeks ago, the nightly low was 18 degrees Fahrenheit. He'd have been dead if his little escapade had happened that night.

I agreed that someone must have been looking out for him, and went into the bathroom to secretly call 9-1-1. It was now 8:10 and my wife was due home from work soon. I didn't want her to have to deal with this guy sitting in the house while she tried to get to bed and sleep. I told the dispatcher the necessary information and she said someone would be sent out.

At about 8:15, my wife arrived home. Still no 9-1-1 responders, still no ride for the injured party. I told him that he needed to go to the emergency room and get treatment, but he was insistent that he couldn't go in his present state. His state was: muddy, wet and bedraggled. We didn't mention that my wife is a nurse--no need to create a scene.

At about 8:30 a car drove up in front of my house. It was a sister of the poor schmoe, wide-eyed and concerned. "What happened to you?" she asked him. He didn't want to talk about it right then and there. We managed to get him up from the chair and down the front steps, with much moaning and crying out in pain. His sister, behind his back, tapped her head and mouthed to me, "Mental patient--off his medication."

In a few minutes, peace was restored to our little home. My wife and I looked at each other, and a lot of the commentary was unspoken. She was an Emergency Room nurse for years, and has seen hundreds of these sort of people come in: drunk or high, out of their heads, not remembering where they were, who they were or how they got there.

"Who hath woe? who hath sorrow? who hath contentions? who hath babbling? who hath wounds without cause? who hath redness of eyes? They that tarry long at the wine; they that go to seek mixed wine. Look not thou upon the wine when it is red, when it giveth his colour in the cup, when it moveth itself aright. At the last it biteth like a serpent, and stingeth like an adder." Proverbs 23: 29 - 32 (King James Version)