Antibiooteille vastustuskykyinen MRSA-sairaalabakteeri (methicilliini-resistantti Staphylococcus aureus) leviää Yhdysvalloissa sairaaloiden ulkopuolella, kertoo Reuters (linkki). Sairaaloiden ulkopuolelta on löytynyt kaksi uutta bakteerikantaa, jotka eroavat selvästi sairaaloissa leviävistä. Tämä uutinen tietysti jää sikainfluenssa uutisoinnin jalkakoihin, mutta pitää siltii muistaa, että on niitä vakavia sairauksia ja tauteja monia muitakin kuin kulloinkin otsikoissa komeileva mediaseksikäs ja huipputrendikäs tauti.

Ensisijaisia keinoja tautien välttelyssä ja niistä selviämisessä ovat kohtuullinen hygienia ja hyvä fyysinen kunto, vasta sen jälkeen seuraavat rokotukset ja lääkkeet. MRSA, kuten myös moni muu vaikea tauti, on hoidettavissa, mikäli se huomataan ajoissa, joten lopulta terve järjenkäyttö on kaiken A ja O. Niin ja tietenkin on myös oleellista elää sellaisessa paikassa, jossa terveydenhuolto toimii.

Listen to the story

Story originally aired June 24, 2009

If you work in medicine, or spend a lot of time in hospitals, or just have a soft spot for the TV show House M.D., you probably know what MRSA is. If you don’t, MRSA is what they call a “superbug”–a kind of bacteria that’s extremely resistant to antibiotics. You usually find superbugs in hospitals, but that’s not the only place the dwell. You can also find superbugs on big farms. Industrialized agriculture uses antibiotics in the everyday feed of chickens, pigs, and cows, and that use means that superbugs are developing and growing on farms around the country. Nathan talks to Dr. Ellen Silbergeld, a professor in the Environmental Health Sciences department at the Johns Hopkins Bloomberg School of Public Health, about this phenomenon and the risks it poses.

Then we call Richard Lobb, spokesperson for the National Chicken Council, to get the other side of the story.

Johns Hopkins Magazine article on Silbergeld’s research

Paper on antimicrobials in chicken feed co-authored by Dr. Silbergeld

Could this be the mutated Strains of known Bacteria whose growth /mutation may be attributed to indiscriminate use of Antibiotics?
WASHINGTON (Reuters) – Cases of a drug-resistant bacterial infection known as MRSA have risen by 90 percent since 1999, and they are increasingly being acquired outside hospitals, researchers reported on Tuesday.

They found two new strains of methicillin-resistant Staphylococcus aureus — MRSA for short — were circulating in patients and they are different from the strains normally seen in hospitals.

Ramanan Laxminarayan of Princeton University in New Jersey and colleagues studied data on lab tests from a national network of 300 microbiology laboratories in the United States for their study.

“We found during 1999-2006 that the percentage of S. aureus infections resistant to methicillin increased more than 90 percent, or 10 percent a year, in outpatients admitted to U.S. hospitals,” they wrote in a report published in the journal Emerging Infectious Diseases.

“This increase was caused almost entirely by community-acquired MRSA strains, which increased more than 33 percent annually.”

MRSA is now entrenched in U.S. hospitals. It was also known to be circulating in the community but it was not clear whether patients were carrying the infections out of hospitals, or the other way around.

Laxminarayan’s team found that many more people were being diagnosed with the community-acquired strains, and these strains were not replacing the known hospital strains. Instead, they are just adding to the overall number of MRSA cases.

“Our findings have implications for local and national policies aimed at containing and preventing MRSA,” they wrote.

For one thing, new, fast tests are needed so patients can be diagnosed and treated quickly. It is possible to treat MRSA but doctors need to know straight away so they start patients on the correct antibiotics.

“Lastly, infection control policies should take into account the role that outpatients likely play in the spread of MRSA and promote interventions that could prevent spread of MRSA from outpatient areas to inpatient areas,” they added.

MRSA is one of the most common causes of hospital-acquired infections. It can also now be picked up in schools, at fitness centers and elsewhere.

Symptoms range from abscesses to bloodborne infections that can kill quickly.

The researchers estimate that 20,000 people in the United States die each year from MRSA, and treating MRSA can range from $3,000 to more than $35,000 per case.
http://www.reuters.com/article/healthNews/idUSTRE5AN0N020091124

The other shoe finally dropped. Remember my visit to the emergency room (ER)  in October?  Yesterday I received three actual envelopes in my mail-two out of the three were health care related. You can tell that the health care business is important to the Postal Service.

One envelope was the Explanation of Benefits (EOB) for the hospital charges from my 3-4 hour visit to receive IV antibiotics for an infection (cellulitis), treated as if it was MRSA. This was the balance of the charges.

The bill (before the PPO adjustments) was $1282.13. This is in addition to the charge (previously noted) for the physician.  This was for the second visit in one day for a cellulitis (skin infection) that was treated as if it was MRSA. I was in intense pain, which probably was nerve pain from the inflammation.

Part of my bill was .23 for pharmacy services. I do not recall what that was. I may spend more than .23 in someone’s time and query the company as to what that was for.

I think that if the burning, sharp, recurrent pain in my head had been described differently by me, (and interpreted differently by the physician) that I might not have needed to go back to the ER, because it would have been treated correctly on the first visit-7 hours before.

My share of the bill is $149.09 (after the $100 ER co-pay).

Weekly Expenses: $149.09

Well, Angel started working on her blog for the night an hour ago… she did post a digital holy card she was happy with..
Her day has been totally skewed. For some reason neither her, nor I woke up until right at noon.. She did her math work with no problem, she’s doing phenomenal in math now, the public schools can suck my big toe!!
Her Spelling work she fussed over, she was anxious to use the computer… but she did finally get it done too. She was actually really interested, and active in getting her Religion work for the day done, which made me proud.
Our day got interrupted around 3, had to take a shower, get dressed, and take Beau to the doctor… he’s got a MRSA abscess on his booty! Owie!!
Angel had only her Reading work and Social Studies to get done.. she took the Reading with her, and while she swore she’d do it, she read about a page and quit working. She finished it an hour ago… spent more of her time fussing and whining about not liking reading!!! This from she who reads so voraciously. Her Social Studies is now waiting until tomorrow, which I totally don’t like.
I think she had a pretty good day… she’s been pretty happy with things.
Beau is on Septra for his bottom, and of course it has to be opened and drained daily… that he doesn’t like. Can’t blame him, I’ve been in the same boat. Cost me a chunk of flesh the size of a satsuma orange!
But, this isn’t about me, this is Angel’s place.
She’s interested in joining the rosary makers guild at church. I’m going to take her Monday, may have to argue… just because she’s 8 you can’t discount her. She’s adult mature in some areas. She’s quiet and attentive around strange people, so she’s not going to be a distraction, and the bead threading is good for her fine motor skills.
She wants to do it so that people who don’t have, or can’t afford rosaries get one. I thought that was sweet. She told that to her brother.
Well, that’s all. It’s late, and I’m going to bed.

I am finally able to sit down and tell you how great the doTERRA convention was. whew! It has been a busy week.

Convention was jammed packed full on training, research, new products, and recognitions.

Training – I now have official AromaTouch technique training under my belt! Watch out family and friends…you are going to be feeling at peace.

Research – all I can say is YAY for Frankincense and Oregano! Cell distinguishing and immune boosting.

New Products – skin care line, chamomile, coriander, PastTense, GX Assist, and bergamot

Recognitions – my team rocks! Premiers include Eugene Kerns, Rita La Voie, and Amber Sellers. I am so very proud to have them on my team

Chicago,, Sebelum terkena bakteri MRSA, Tanya adalah seorang koki profesional yang sangat menikmati hidupnya. Hidupnya berubah 180 derajat pada Maret 2007 ketika Tanya yang berusia 30-an tahun meregang nyawa melawan MRSA. Awalnya, Tanya sedang memotong seledri dan tanpa sengaja jarinya terluka. Saat itu Tanya berpikir kecelakaan kecil itu adalah hal biasa, dia hanya membersihkan luka dengan alkohol dan memplesternya dan kemudian bekerja lagi. Keanehan terjadi setelah beberapa jam, saat mengangkat panci dirinya merasakan nyeri yang teramat sangat. Sembilan jam kemudian rasa sakit itu semakin parah dan dia memutuskan ke rumah sakit. Saat di rumah sakit Tanya diberi pil dan oleh dokter diminta istirahat di rumah. Tapi malam hari suhunya melonjak tinggi dia merasakan ada yang tidak beres dari luka kecil saat memotong seledri. Ternyata bakteri MRSA telah masuk dan bergerak cepat menggerogoti dagingnya. Dalam waktu 60 jam jarinya habis dimakan bakteri. Tanya tertular bakteri pemakan daging dan 9 dokter harus bekerja mati-matian untuk menyelamatkan hidupnya. Para dokter menyaksikan bagaimana bakteri mematikan itu melompat dari lengan ke dadanya tepat di depan mata mereka. Dokter mengamputasi lengan dan bahu kanan Tanya, tapi kemudian menyadari bakteri itu telah menyebar ke payudara kanan. Dokter bedah memutuskan untuk melakukan pengangkatan penuh karena itu adalah satu-satunya cara untuk menyelamatkan hidup Tanya. Beruntung Tanya masih bisa hidup meski dokter harus mengoperasi 9 kilogram daging dan otot untuk membersihkan tubuhnya dari bakteri. Kini yang tersisa di tubuh Tanya tidak lebih dari lapisan tipis kulit untuk melindungi tulang rusuknya dan paru-paru kanannya. “Bahkan cocokan peniti pun bisa langsung menembus ke paru-paru dan aku bisa mati”, kata Tanya sambil memperlihatkan rangka tulangnya seperti dikutip oleh itelly0u. Penyakit MRSA masih terdengar asing di telinga masyarakat Indonesia . Tapi di AS, sudah menyebabkan 19.000 orang meninggal karena terinfeksi bakteri ini. Seperti apa penyakit MRSA? MRSA atau methicillin-resistant Staphylococcus aureus adalah salah satu tipe bakteri Staphylococcus yang ditemukan pada kulit dan hidung yang kebal terhadap antibiotik. Setiap tahunnya lebih dari 90.000 warga Amerika Serikat berpotensi terinfeksi bakteri ini. Jumlah kematian akibat infeksi bakteri MRSA lebih banyak dibandingkan dengan angka kematian akibat AIDS. Saat ini diketahui ada dua tipe dari MRSA seperti dikutip oleh itelly0u, yaitu: Healthcare-Associated (HA-MRSA) yang biasanya ditemukan di rumah sakit dan tempat-tempat kesehatan lainnya. Serta Community-Associated (CA-MRSA) yang baru-baru ini ditemukan penyebarannya pada tempat-tempat umum seperti tempat fitnes, tempat penyimpanan barang (loker), sekolah dan perabotan rumah tangga. Bakteri MRSA biasanya menginfeksi orang atau anak-anak yang memiliki daya tahan tubuh yang lemah, jika daya tahan tubuhnya tinggi tidak akan menimbulkan gejala apapun. Bakteri yang dibawa oleh orang tersebut bisa berpindah ke orang lain dan menyebar dengan mudah melalui kontak kulit dan menyentuh barang yang sudah terkontaminasi. MRSA sama seperti bakteri Staphylococcus lainnya, yang terlihat seperti infeksi kulit, jerawat, ruam, bisul atau gigitan laba-laba. Infeksi ini biasanya menyakitkan, merah dan bengkak. Infeksi ini bisa dengan cepat masuk ke dalam tubuh, menimbulkan bengkak yang menyakitkan. Bakteri ini dapat menembus ke dalam tubuh sehingga berpotensi menyebabkan infeksi pada tulang, sendi, luka bedah, aliran darah, jantung dan paru-paru yang bisa mengancam jiwa. Infeksi MRSA lebih sering menyebar di masyarakat, bahkan diantara anak-anak dan orang dewasa yang sehat sekalipun. Karena bakteri ini bisa menyebar dalam jarak yang dekat. Untuk itu ada beberapa hal yang bisa dilakukan untuk mencegah terinfeksi bakteri MRSA ini, yaitu: Cuci tangan sesering mungkin dengan sabun dan air hangat minimal selama 15 detik. Tutup luka pada kulit dengan perban yang bersih sampai sembuh. Jangan berbagi barang pribadi dengan orang lain, terutama barang yang berhubungan dengan kontak kulit seperti handuk atau pisau cukur. Cuci barang dengan menggunakan desinfektan (1 sendok makan desinfektan dilarutkan dalam 1 liter air). Pastikan menggunakan kain yang bersih untuk menyekanya. Jika Anda berpikir bahwa Anda atau siapa pun dalam keluarga memiliki kemungkinan terinfeksi MRSA, segera hubungi ahli kesehatan. Terutama jika infeksi besar, menyakitkan, hangat jika disentuh atau tidak sembuh-sembuh dengan sendirinya.

By Yvette Martyn

Antibiotic resistance is on the rise

Antibiotics became resistant in a process very similar to Darwin’s theory of survival of the fittest. Lots of bacteria populated inside a person, random mutations occured in the bacteria’s DNA and one day antibiotics were given and the random mutation lead to the bacteria being able to fight off the antibiotic.

Just like the giraffe with the long neck which reached the leafs enabling survival, this bacteria found a way to get around the process the antibiotic used to kill it.

Staphylococcus Aureus did it (hence the superbug MRSA, Methicillin Resistant staphylococcus Aureus). Methicillin is an antibiotic, one day the drug was given to a person with the infection which attacks skin and wounds and the bacteria fought it off.

So is MRSA incurable?
No, great big corporations exist in this world called drug companies and they find other antibiotics which can take the place of resistant drugs and fight off the resistant bacteria. In MRSA’s case we have good old Vancomycin. But they find them quite slowly hence the need to prevent antibiotic resistance.

How do we prevent antibiotic resistance?
If doctors give out too many antibiotics it increases the chance that those sneaky bacteria will find a way to stop the antibiotic killing them. For example some antibiotics kill bacteria by preventing the bug generating food in a specific pathway.

If a doctor gives lots of antibiotics out it’s increases the chance that one day a bug will exist which will find another way to generate food, the antibiotic won’t work and furthermore the “superbug” will multiply in that person and then be passed onto another person, etc, etc.

But the drug companies will find new antibiotics?
Wrong, drugs aren’t actually that easily found, hence why we continue to use Sir Alexander Fleming discovery, penicillin. Which was found all the way back in 1928.

But it’s just bacteria, right, not viruses like that swine flu?
Wrong, viruses can become resistant to antivirals too, this might mean if you’re young and healthy and catch swine flu, health care professionals could be unwilling to give you the antiviral medication.

Image: Michelle Meiklejohn / FreeDigitalPhotos.net

NutraSilver® Destroys MRSA SUPER-BUG

According to the _*Mayo Clinic “MRSA infection is caused by Staphylococcus aureus bacteria — often called “staph.” MRSA stands for Methicillin-Resistant Staphylococcus Aureus. It’s a strain of staph that’s resistant to the broad-spectrum antibiotics commonly used to treat it. MRSA CAN BE FATAL.”

You’ve probably read the news reports that deaths from MRSA infections are now outpacing deaths from the AIDS virus, here in the U.S. and throughout the world. MRSA is responsible for an estimated 94,000 serious infections and over 18,000 deaths a year, according to the October 17, 2007, issue of The Journal of the American Medical Association. The use of silver was tested against MRSA and staph in several studies and found to be effective.*
NUTRASILVER® KILLED 1,339,999,000 (read BILLION) MRSA CELLS AT
THE RATE OF 99.9999% IN 60 SECONDS!
Read the Full FDA-certified lab test here

What more proof do you need??? Get started now: BUY NOW!
A Brigham Young Clinical Study Proves Silver Kills MRSA

In this study, conducted in October 2006 at the Department of Microbiology/Molecular Biology of Brigham Young University, and published in the journal Current Science, Vol. 91, No. 7, October 10, 2006, it was found that “a number of the antibiotic drugs which formerly killed MDR (multiple drug-resistant) pathogens such as MRSA could actually be restored to full efficacy against the deadly pathogens, but only if a liquid silver solution similar to colloidal silver was used in conjunction with the drug!”

That’s why doctors are so frightened. They know that MRSA infections – which were once confined to people with fresh surgical wounds under long-term hospital care – are now moving rapidly into the general population. And, anyone who comes into contact with groups of people on a regular basis – such as in supermarkets, churches, hospital rooms, business offices, gyms, or other places where people congregate – are susceptible.
What are you waiting for? Get yourself protected today!

Scientist world-wide have been fighting this bacterial infection for many years. The problem is that this bacteria mutates to become impervious to antibiotics. As new antibiotics are developed, the bacteria again mutates to resist the antibiotics. MRSA CAN NOT DEVELOP A RESISTANCE TO NutraSilver® so the problem appears to be resolved.

“Most MRSA infections occur in hospitals or other health care settings, such as nursing homes and dialysis centers. It’s known as health care-associated MRSA, or HA-MRSA. Older adults and people with weakened immune systems are at most risk of HA-MRSA. More recently, another type of MRSA has occurred among otherwise healthy people in the wider community. This form, community-associated MRSA, or CA-MRSA, is responsible for serious skin and soft tissue infections and for a serious form of pneumonia.”

“Staph skin infections, including MRSA, generally start as small red bumps that resemble pimples, boils or spider bites. These can quickly turn into deep, painful abscesses that require surgical draining. Sometimes the bacteria remain confined to the skin. But they can also penetrate into the body, causing potentially life-threatening infections in bones, joints, surgical wounds, the bloodstream, heart valves and lungs.”

Dr. Daryl S. Paulson, President and CEO of BioScience Laboratories, has extensive experience in skincare research designs, clinical trials, and biostatistics. He is the author of the standard texts of the industry — Topical Antimicrobial Testing and Evaluation, Applied Statistical Designs for the Researcher, and Handbook of Regression and Modeling: Applications for the Clinical and Pharmaceutical Industries — as well as the editor of the Handbook of Topical Antimicrobials: Industrial Applications in Consumer Products and Pharmaceuticals (Manufacturing Engineering and Materials Processing).

I stopped into the walk in medical clinic in my area today for a MDs opinion of what  I thought might be a chronic ear infection that would not go away.  He checked my ear and since my eardrum looked red and “not happy” he gave me a prescription for an antibiotic.   I am not the type to go running to the MDs office looking for a prescription for every problem but in this case due to the chroncity I believe the prescripton may be warranted. 

The point of me telling you this is to share a surprising piece of  information that was posted on the bullentin board of the exam room.  (I had to read something while I waited on the paper lined table for 35 minutes for the doctor to come in). There was a poster titled  The Children’s Antibiotic Creed. I came home through the wonderful powers of goggle I found this document was based on the work of a McMaster University professor named Ross Pennie.  Dr. Pennie is an advocate against the over prescription of anitbiotics, especially to young children and infants.  He has authored several journal articles on the subject.  

Methicillin-resistant Staphylococcus aureus (MRSA) or "superbugs" resistant to normal antibiotics are created by the current abuse of prescription antibiotics

I would encourage health professional, parents and people working with young children to read about this “Antibiotic Saftey Zone” .   The first statement  reads  ” We aviod prescribing antibiotics unless they are clearly needed because sometimes antibiotics can do more harm than good.”  On the website you can download PDF posters and handouts to post in your home, office or day-care centre. 

Needless to say I am pleased that certain members of the medical community have admitted that antibiotics are not the answer to every complaint and recognize that in many cases if left alone the body can clear the illness on its own.

Swine Flu, AIDS, West Nile Virus, E Coli, Bed Bugs, MRSA, etc. came from? This is what an open Border has done. There are thousands upon thousands of people within the Medical, Catholic, Local Government, Federal Government, Unions, Lobby Groups, LULAC, LA RAZA (The Race) and you name groups and communities that are in collusion with sneaking these infected people into America. It’s going to take more than a Swine Flu shot to survive this. You better have the Mutated Delta 32, +O Blood Type and of a Hearty European Ancestral Stock.

Humans have been separated for thousands of years due to Geographic Location. During this time groups have developed different immunities and resistance to indigenous Viruses, Bacteria and Germs. Now take these same individuals and put them into close proximity and what do you think is going to happen? You got it! There will be Cross-Mutations of their respective Viruses and Bacteria.

A new guideline from the American College of Physicians takes no stand one way or the other on the use of hormonal testing or hormone-based treatments for erectile dysfunction (ED). For initial treatment, it says, most affected men should try one of the available phosphodiesterase-5 (PDE-5) inhibitors, based on their own preference, ease of use, cost, and side effects. (Full text is available for free.)

RESULT: Hormonal Testing and Pharmacological Treatment of Erectile Dysfunction
Annals of Internal Medicine | Oct 19, 2009

The journal has also published the systematic review behind the guidelines. It finds no differences in effectiveness or adverse effects among the various PDE-5 inhibitors.

RESULT: Oral Phosphodiesterase-5 Inhibitors and Hormonal Treatments for Erectile Dysfunction: A Systematic Review and Meta-analysis
Annals of Internal Medicine | Oct 19, 2009

Search: erectile dysfunction

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OTHER RECENT SEARCHES ON SEARCHMEDICA

Search: physician leadership

RESULT: How Perceived Physician Leadership Behavior Affects Physician Satisfaction
Mayo Clinic Proceedings | Nov 19, 2008

Physicians’ satisfaction with their physician colleagues in leadership positions is shaped by five key factors, according to this study from the Mayo Clinic. Ironically, the factors that led to the greatest satisfaction were the ones least often displayed.

Search: MRSA infection

RESULT: MRSA infections in patients treated with tumour necrosis factor inhibitors
Annals of the Rheumatic Diseases | Nov 1, 2009

Patients may already be carriers of methicillin-resistant Staphylococcus aureus (MRSA) when they start taking tumor necrosis factor (TNF) inhibitors for arthritis, warn the authors of this 430-patient retrospective study from Maryland. Among the 15 patients in whom MRSA developed, most infections were severe and required hospitalization. Seven of those patients had recurrences of MRSA after TNF inhibitor treatment was restarted.

Search: comparison of ilioinguinal nerve block versus regional nerve block in inguinal hernia

RESULT: A Multi-Site Randomized Controlled Trial Comparing Regional and General Anesthesia for Effects on Neurodevelopmental Outcome and Apnea in Infants
ClinicalTrials.gov | Jun 23, 2009

Children’s Hospital Boston is coordinating a multicenter study to test the neurodevelopmental effects of regional versus general anesthesia on infants undergoing inguinal hernia repair. A major goal of the study is to establish  whether general anesthesia is dangerous for infants, and if so, how.

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SEARCH TIP: The virtue of editing

Whoever typed the search above also tried replacing “comparison” with “benefit” in the search term. Both searches delivered two results describing a trial that was recently suspended because of neurological side effects from ilioinguinal nerve block:

RESULT: Local Anaesthetic Following Hernia Repair
ClinicalTrials.gov | Jan 2, 2009

Following its orders to take the first words in the search term (“comparison of”) most seriously, SearchMedica also finds the dated article below, which praises ilioinguinal nerve block as easier and quicker than spinal anesthesia.

RESULT: Comparison of ilioinguinal-iliohypogastric nerve block versus spinal anesthesia for inguinal herniorrhaphy
Southern Medical Journal (PubMed)| Jan 1, 2006

A better choice would be “ilioinguinal versus regional nerve block inguinal hernia” in which this misleading result (from today’s perspective) does not appear on the first page of results.

Last clinical weekend I had a nurse from hell. Not only was she nasty to me, but her attitude even trickled down to my (I guess I should say “our”) patient.  The day started out how clinical days usually do, getting up at the butt-crack of dawn, hot-wheeling (as my children would say) to the hospital with just enough time to grab a cup of Starbucks before running in for report. I find the nurse I’m assigned to—”B”— introduce myself, tell her I’m assigned to such-an-such a patient…all that good stuff. She looks at me like I have three heads. I shrug it off—it’s too early, we’re all a little grumpy and most of us are waiting for the caffeine to kick in. She grudgingly pulls out her little notes to give me report. She tells me a few relevant things about the patient, but mostly just complains that she was “too young to need such total care.” She then asks (herself I’m guessing, because how the hell would I know), “Is this ‘the one’ with MRSA?” And proceeds to go back and forth in monologue about whether or not the patient had MRSA–something you’d kinda wanna to know before going in the patient’s room. We finally did establish that the patient did not in fact have MRSA.

So I go to check on the patient, introduce myself, etc. She’d had a dilaudid PCA from which she was being weaned (or actually by the time I got to her it had already been dc’d). Poor thing was clearly in pain and was wondering why her IV “didn’t seem to be working” so apparently no one had talked with her about it. I got my own set of vitals and asked her to rate her pain for me—which she of course rated as a 10 on a scale from 0 to 10. I reported this back to “B” who replies unsympathetically —“Oh well, she ain’t getting nothing else.” OH-KAY… The patient recently had a lumbar laminectomy, was discharged, then fell and broke her wrist. So she’s laying here with post surgery back pain, which was most likely made worse by her fall, a splint holding her broken left wrist together, and an IV in her right arm which was clearly infiltrated—unpleasant to say the least. So right about now, I’m stumped. Am I supposed to go in and tell my patient that her “real” nurse doesn’t give a crap that she’s in pain?

I return to the patient’s room to find breakfast trays are being delivered—good—a welcomed distraction. I helped her get set up—between the splint and the IV she really had limited use of her hands. She relaxed a little as we talked, but as the last traces of dilaudid wore off you could tell the pain was beginning to bother her again. Usually after breakfast we do hygiene and personal care, but she refused as she was in too much pain and did not want to be touched. I let her be for the meantime and decided to get started with my meds. Nurse Ratched finally allowed me to see my patient’s MAR (medication administration record), so I was able to look up the meds I didn’t know. She did not want to give me the key, nor let me into the drawer so that I could pull my meds. “You don’t need ME, you NEED YOUR INSTRUCTOR!” she snapped. Now at this point I’m seriously wondering what is this chicks’ malfunction? I went to find my instructor, who mind you is running around like a chicken with her head off helping all six of us pull meds (this was the first weekend that ALL of us did meds, previously just one or two of us would). After I returned with my instructor, “B” didn’t want to give her the key to the damn med drawer either!! She walked her devil-red scrubbed arse down to the room with us in tow, unlocked the drawer, and left without a word. Why couldn’t she have just done that 20 minutes ago? So I pull my meds, my instructor double-checks them, and then down the patient’s hatch they go.

At the beginning of the day the nurses were informed that the students would only be doing PO (oral) meds and injections—no IVs. Lo and behold we’re meeting with our clinical instructor in the cafeteria and Nurse Nasty hunts us down, MAR in hand—mind you the unit is two floors up, over the river and through the woods. “Why didn’t you give the such-and-such?” (I don’t remember what it was). I responded that was an IV medication. “Well how was I supposed to know you weren’t giving it?” Now she was really beginning to annoy me. If she took the time to actually l@@k at the MAR which she snatched back from me seconds after I gave the PO meds, she would have seen that I had not signed off on the IV medication—hence I did not give it! My instructor also added “I informed all of you this morning that the students would only be giving PO meds and injections today.” Nurse Nasty turns and leaves, horns just a-glistening. When we returned to the unit she now wanted to know why I also neglected to sign off on the patient’s Desenex powder, “You haven’t even bathed her yet…well what exactly ARE you doing today?” Nurse Nasty aparently forgot that “50” (she referred to all of her patients by room number and not by name) refused hygiene because SHE refused to acknowledge her pain status! Why would I apply desenex powder to a soiled ass behind?!? I figured we (more like I) could give it another try a little later after the oxycontin I had given her had a chance to kick in and her pain was a little more under wraps. Needless to say I could not wait for this day to end.

I realize that most of the time the nurses aren’t given a choice as to whether or not they will have a student nurse—I get that. The clear discontent of some of them is quite evident. And while they may be good at their jobs, some clearly do not have the right attitude to teach. But do they have to take out their frustration on us and even worse, the patients?!? Can’t they remember back to when they themselves were students? Sometimes I really do wonder why certain people have chosen this profession.

Thankfully, the next day I was not assigned to any of Nurse Nasty’s patients (which by the way, sucked for one of my classmates). I had a great nurse and two patients both of whom asked if they could take me home with them . It was also the first time that I had more than one patient so I was busy—vitals, breakfast, baths, meds, fall risks, bed monitors going off, safety checklists, care plans…the whole shebang. My older patient (I believe she was 85-yrs-old) had literally about 15 9 a.m. PO meds. It took her three tall cups of water and about 30 minutes to get them all down. On top of the PO meds I had to give her a subcutaneous lovenox injection, “up close and personal,” as she called it. But I must admit that I do love when I give injections and they ask “are you done already?!?” It was an exhausting yet exhilarating day, and before I knew it, it was over.

We have clinicals again this weekend so we’ll see if Nurse Nasty remembers to take her happy pill. I guess sometimes the devil doesn’t wear Prada, but scrubs…

Money, Money, Money. This week some of the ER expenses came in from my visit on Oct. 5th (see blog post)-the fee for the examining physician there  was $266).  Plus I was billed for mail order meds-a prescription I take daily. I don’t think I am saving much money. $23.31 for three months for pills picked up in person and now $19.91 for meds in the mail. A savings of about 14%-ok maybe that is some savings! Plus not going to a pharmacy three times is a timesaver.

(One thing I hate about keeping up with these bills is the paperwork):

• first the papers from the office visit and the receipts for parking etc.
• the EOB’s or Explanation of Benefits (sometimes it feels like Exclusion of Benefits). These are the gross numbers (pun intended)
• finally the provider and facility charges giving you the net due.
• File, burn or shred?

However, this diary is helping me keep track of things in a way that I haven’t before and that is– what could I and the medical establishment have done differently? Should I expect better from them and from myself?

• Should I have gone to the ER at all?
• Why did I receive medical advice from 5 different providers in one week for one problem (either staph caused MRSA suspected cellulitis or shingles)
• How does that affect continuity of care?
• Will there be translation errors (on my side or theirs) like the old game of Telephone with so many people involved?
• What if I wasn’t a persistent person and didn’t have a person to fetch my meds and drive me around?
• What if I didn’t have paid sick leave?

Prescription meds: $19.91, my four visits the week of Oct 5th were billed at $1001-before the negotiated discounts, less my co-pays of $160. Net bill TBD

Keep reading for more thoughts on the issues. Maybe not all the answers, but I can sure ask a lot of questions!

Weekly total: $19.91

Occasionally a piece of news comes up that turns some aspect of conventional medical thinking on its head. Today, there’s a story about the role Sharpie pens may or may not play in the spread of germs in hospitals. Generally, when hospital staffs want to write on patients prior to surgery, they use either Sharpies or special one-use pens with an anti-fungal agent. When they use Sharpies, they discard them after one use out of fear that the pens may spread bacteria from one patient to another.

It seems to make sense: the moist felt tip of the marker sounds like an ideal place for bacteria to be picked up and grown. But it’s not true at all. Doctors in Canada conducted a study that assessed the amount of bacteria that remains on the tips of Sharpies hours and days after writing on a patient. The amount detected was always zero. It turns out that Sharpies contain alcohol, and at a high enough concentration to kill microbes that it contacts. Meanwhile, the special one-use pens with anti-fungals do not kill bacteria and must be thrown out after each use.

The effect that this can have on healthcare is relatively minor. It may save hospitals thousands of dollars a year if they decide to re-use their Sharpies. It’s not earth-shattering, but reducing unnecessary spending anywhere in healthcare is a step in the right direction.

Read more about the study in the LA Times.

AM. Cycle 78km (47km with Jules + 31km) Steady easy. HR127(162)

Went out with Jules for an easy spin, and then did another brisk hour on my own. Still quite mild outside.

Fix me
We watched the BBC Horizon programme “Fix Me” the other night (http://www.bbc.co.uk/programmes/b00nnkqm). It used young people who have health problems that could be fixed by stem cell research to show the state of current developments and the way that they could be used to help them. When I saw Anthony with the amputated leg and he said that he’d lost it by breaking it in a rugby game, I immediately thought that it must’ve succumbed to a secondary infection. Sure enough, when he got the chance to tell his story, that was what’d happened. The break had needed external fixators, but a secondary MRSA-type infection got into the bone and it couldn’t be healed and eventually his lower leg was amputated – pretty extreme for what must, initially, have been a relatively simple emergency condition.

This was a situation I got very close to in 2003 when I broke my left arm in a road race and an infection got into it which blew up a few weeks later. He tried to describe how agressive the treatment was, but I know from my experience in 2003 that it’s very tough. After a series of operations to clean things up inside my arm, I was given very strong antibiotics – initially through a vein in my other arm, but that collapsed it (!) (it’s still missing, you can see it in my right forearm), so then through a tube that went directly to one of the biggest veins near my heart where, when injected, the drugs wouldn’t be so close to the vein walls to damage them. I felt ill all the time and every “edge” of my skin, e.g. around my fingernails, nose, corners of my mouth, etc. got very red and sore. Even after the I.V. antibiotics I spent another 6 to 8 weeks on Amoxycillin.

Seeing Anthony with his amputuation now makes me realise why the doctors were so quick to act in my case, and although they made me aware at the time it could be quite serious, they didn’t actually let me know I could’ve lost that arm. I am very relieved I still have almost full use of it (it’s slightly longer than the right arm now, and can’t rotate to the same degree – tricky when typing but OK when I play the piano), and just some nasty scars to show, and some titanium to carry around. I was lucky and evidently in good hands! Some time later I was asked if I’d like to have the plates removed, but it would’ve meant yet another full anaesthetic and I didn’t think it was really worth it – I could also potentially get infected again, although removing the hardware apparently reduces further complication risk by 90%. It’s been a long time now and I doubt I’ll have anything done to it now.

73.4kg

The training has begun! I am walking an average of 3.5 miles a day to prepare for the Avon Walk that I will be doing in just 6 months. The fall foliage and cooler days makes this an enjoyable activity and I also frequent the gym for additional weight lifting and endurance work outs.  I held a fund raising event at the breast care center at Walter Reed Army Medical Center last week and raised 8% of my goal by selling my jewelry creations. So far I am at nearly 30% raised so I continue pressing on with those efforts a little bit every day. Thank you to all who have donated so far! My Avon Walk page can be viewed HERE.

This week my MRI results came back all clear so that was good news! I must admit I held my breath for those 8 days waiting for results.  I am told that this feeling of dread lasts a long time, at least until the ten-year survival point.  Even then, with no cure for breast cancer,  the fear of recurrence looms all the time. The MRSA infection in my arm continues to heal well and is down to a dime-sized scab with some scarring.

In the meantime I celebrate LIFE and help those newly diagnosed whom I meet, which seems to be nearly every week. The numbers of women affected by this disease never ceases to amaze me. Giving them hope and support gives me a reason to continue fighting for a cure.

If you haven’t already learned to disseminate mainstream spin, this is one of the best examples I have seen to date.  I thought it would be fun to do a little “rearranging.”

In September, Deborah Burger, RN, president of the California Nurses Association, reported that a nurse had died from the H1N1 virus, however…

“The Sacramento Bee reports Hays died July 17 of a severe respiratory infection, pneumonia and H1N1, according to her death certificate. She also had methicillin-resistant Staphylococcus aureus, a staph infection that is resistant to many antibiotics.”

Did you catch it?  First, the presumed cause of death was the H1N1 virus, however, she also had a resistant strain of Staphylococcus aureus, commonly known as MRSA.  They chose not to identify the infection as MRSA, but conclude her death was caused by H1N1. Yet, this bacterial infection is extremely dangerous and does cause deaths:

“The Centers for Disease Control and Prevention (CDC) estimates that each year in the United States there are about 1.7 million nosocomial infections in hospitals and 99,000 associated deaths.” Wikipedia 

The last paragraph of the article leaves the casual reader with a definite impression that it was H1N1 that was responsible for the death, but it may have been MRSA.  Yet, to throw fire on the flame of the H1N1 propaganda campaign they have conveniently left out that dirty “M” word.  But there’s more:

The first part of the article speaks of a rally held by medical professionals at the University of California San Francisco against the firing of a nurse who complained to hospital management “about inadequate safeguards after she got the virus.”  The hospital claimed the nurse was ‘released due to performance factors’ during a probation period, according to the San Jose Mercury News.”

No telling what the dismissed nurse would say about it.  I would love to interview her.

There are two aspects to this article that I can’t just blindly accept:

1. That the nurse who died was the victim of H1N1 and not MRSA.
2. The nurse who complained was actually fired for poor performance and not because she spoke out about “inadequate safeguards” i.e. unsanitary conditions at the hospital?

I don’t mean to come off as the ultimate conspiracy theorist.  The point of this article is to show that what we read and hear on the news needs to be evaluated more closely these days.  When it comes to the H1N1 “pandemic” there seems to be much fear mongering by the World Health Organization with our own government and many others complicit. The scare tactics and spin of mainstream news makes me all the more skeptical.  Couple that with the rush to inoculate the most vulnerable first – children and pregnant women.  It’s a very difficult pill to swallow.

I have come to realize that wherever there is this kind of insistence on a government program, big money is involved.  Big money = Big Pharma.  We need to ask ourselves: Who has the most to gain?

With all that is happening in the world today, with all the deception, this should give you encouragement:

“Be on guard, so that your hearts will not be weighted down with dissipation and drunkenness and the worries of life, and that day will not come on you suddenly like a trap; for it will come upon all those who dwell on the face of all the earth. “But keep on the alert at all times, praying that you may have strength to escape all these things that are about to take place, and to stand before the Son of Man.” (Luke 21:34-36 NASB)

 Jesus told us to be watchful – and wise.

 God bless you.

To read the original article for comparison: http://news.nurse.com/article/20090907/CA02/109070021

Reference:

MERSA – http://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus

http://news.nurse.com/article/20090907/CA02/109070021

With the advent of the second wave of H1N1 flu cases and the increase in people showing up at hospital emergency wards and being checked in for flu related symptoms, are we going to see a second and great wave of MRSA cases?

This years’ outbreak of Methicillin-Resistant Staphylococcus Aureus (MRSA, pronounced “mersa”) cases that were contracted in hospitals is by now well-known. While the spread of MRSA seems to be more under control and the number of new cases seems to have dropped, the question that needs to be asked at this time is can hospitals continue to control MRSA with this new influx of H1N1 cases?

Even more alarming is instances where MRSA and H1N1 combine as was recently the case with a teenage boy in NY. The combination claimed his life.

The problem is that Staph is very common; many of us carry the Staph in our noses. When this Staph becomes resistant to antibiotics however, health problems start to escalate rapidly.

Doctor Howard Faden of Women and Children’s Hospital in NY explains it this way: “These bacteria have the potential to produce pneumonia, and that’s what happens when you have influenza. The influenza interferes with the ability to clear these bacteria. The bacteria get into the lung, and then patients develop severe pneumonia in conjunction with their influenza infection.”

Being aware of this potential danger is important. If there are cases of MRSA in your immediate surroundings (work, home, school, etc…) you need to notify your doctor, especially if you are being treated for flu-like symptoms. If you go to the emergency room, hospital or doctors office with flu symptoms, be proactive about the doctors and nurses using gloves, respirators and sterile instruments. Let them know that you are concerned about the combination of H1N1 and MRSA.

While my purpose is certainly not to try to give you something else to get tied in knots about, I bring this to you in the hopes that the information will give you the edge, should a trip to the doctor be necessary.

Comments welcome!

Our World

In the last few years I have become concerned about the environment.  Learning from John Robbins’ Diet For A New America and Food Revolution, how commercially raised animals are treated, that agribusiness is responsible for pollution, water depletion, global warming and that through their heavy use of antibiotics they are also responsible for the creation of super bugs such as MRSA, has been chilling.  Genetically modified organisms, animals injected with human genes that are then introduced into the food chain, seeds with terminator genes; it’s like watching a horror movie.  I had been spending a great deal of time worrying about the whole thing, talking about it and doing what I could to lessen my own impact on the environment.  I still do what I can to reduce my carbon footprint; as a matter of fact I have just come back inside from hanging the laundry outside.  I always turn the light off when it is not needed, and I dream that when I own a house again, it’ll be green.

My dilemma here is as follows; the Universe is governed by the Law of Attraction, and when we give our attention to something the Law of Attraction brings us more of the same.  So, by worrying about the environment, by fighting global warming, by being sick in the stomach with agribusiness and their lack of values; what have we achieved?  And for that matter, what has the war against terrorism achieved?  Nothing!

It is becoming apparent that making wars, any kind of war only makes things worse.

Eckhart Tolle makes the same point in A NEW EARTH.

I suppose that as with everything else, we should focus on what we want. Do what feels right to us, such as not wasting water for instance, and then focus on the solution, not the problem.

I was watching television a week or two ago.  John McCain was asked about the war in Afghanistan, and he gave his opinion that the problems in Afghanistan would get a lot worse and that a lot more troops were needed. I was struck by the realization that it is precisely by thinking and speaking like that that we make no progress.

I think that starting with all the news channels, Congress and the White House, we should spend one day (to start with) speaking only of what is good in the world.  We should look for things to appreciate and write lists of all the positive things that we can think of, and whoever writes the longest list wins a pound of organic vegetables from the White House gardens.  Want to bet that the world would be a better place within twenty-four hours?

Come on let’s give it a try, let’s petition Oprah to help us with this.  Oprah, we need your help.  Let’s see how long it takes her to answer the call.

Oops, I just realized that I should ask Michelle Obama about the vegetables, shouldn’t I?

See you tomorrow

Your friend,

Success

Health care-associated infections are on everyone’s mind these days and the costs related to HAIs continue to rise, adding $28 billion to $33 billion in unnecessary health care costs every year. To help combat these costs and dangerous patient care HHS Secretary Kathleen Sebelius recently announced the award of $17 million to fund projects to fight HAIs.

“When patients go to the hospital, they expect to get better, not worse,” Secretary Sebelius said. “Eliminating infections is critical to making care safer for patients and to improving the overall quality and safety of the health care system. We know that it can be done, and this new initiative will help us reach our goal.”

$8 million of the $17 million will fund a national expansion of the Keystone Project, a project started by Johns Hopkins University and the Michigan Health & Hospital Association to implement a “comprehensive unit-based safety program”. Within the first 18 months the program was successful in reducing the rate of central-line blood stream infections, CLA-BSIs, in more than 100 Michigan intensive care units, saving 1,500 lives and $200 million in healthcare facility costs.

The Keystone program involves:

• Utilizing a checklist of evidence-based safety practices;
• Staff training and other tools that can be implemented in hospital units for preventing infections;
• Standard and consistent measurement of infection rates; and
• Tools to improve teamwork among doctors, nurses and hospital leaders.

With additional funding from AHRQ and a private foundation, the Keystone Project is now operating in all 50 states, Puerto Rico and the District of Columbia. The new funding will expand the effort to more hospitals, and settings in addition to ICUs, and broaden the focus to address other types of infections.

For more information and a complete list of the funding: http://www.ahrq.gov/qual/haify09.htm.

Envision Inc.’s Related Video Training programs:

“Preventing Central Line-Associated Bloodstream Infections” (CLA-BSI), http://www.envisioninc.net/index.php/programs/details/preventing_central_line_associated_bloodstream_infections_cla_bsi/

This program is in line with the recommendations, interventions and evidence-based practices promoted in the Keystone Project and is an excellent tool for those facilities following this initiative.

Presented in association with the AVA (Association for Vascular Access), this 15-minute training program includes an in-depth Study Guide, Post Test and Tools: Nursing Checklist for Central Venous Catheter Insertion, and the AVA’s SAVE that Line Poster and Reference Card.

Featuring renowned infectious disease expert Dennis Maki, MD, the program also comes with a Bonus Track Video with additional educational information. The training video features the latest evidence-based practice from the CDC and HICPAC / SHEA / IDSA / APIC recommendations for preventing central line-associated bloodstream infections.

“Infection Control 8-Minute Solution: MRSA”, http://www.envisioninc.net/index.php/programs/details/infection_control_8_minute_solution_series_mrsa/

“Clostridium difficile: A Growing Threat”, http://www.envisioninc.net/index.php/programs/details/clostridium_difficile_a_growing_threat/