Now that we know, what should be done

Sometimes we can't know what we don't know. What happened from March 2020 through today (when I saw people still wearing masks inside their cars with several dirty masks on the dash) would have been unimaginable in western, democratic, free countries as recently as December 2019, but did happen. 

• The vulnerable and most at risk for the disease weren't protected
• Those not at risk were forced to comply as though they were in danger of dying
• There were mass violations of civil liberties
• Unknown risks have been passed on to the next generation because pregnant and lactating women were included in the madness
• Young men in the prime of life have been forced through peer pressure, government edict, and threats of job loss to take heart risks with odds they would never consent to for a plane flight
• Laws involving elections were violated or made up on the spot
• Minor, unelected officials assumed great authority and power 
• Small businesses were ruined; massive businesses got wealthier
• People skipped treatment for cancer and heart because government was protecting hospitals and not patients
• Safe alternative treatment options were forbidden--even their names could not be spoken
• Anxiety and mental health issues soared from both lack of care and the sufferers being terrified and sickened by media
• Lockdowns separated the dying from their families, their last comfort, or contributed to their early death
• Even when it was learned that the jabs didn't prevent getting the disease and didn't stop transmission to others, ridiculous rules stayed in place, controlled by teachers' unions, businesses, the White House, and CDC
• "Trust the science" became a joke and punch line with our elected officials bowing to the power and money, not laws or common sense or honoring the people who elected them
• One unelected man, an aging bureaucrat controlling two presidents and billions in grants to pharmaceutical companies, claimed to be the face of "Science" and if we distrusted him, we were traitors 
• There should be town halls in every village, town, city, church, business, club and university to sort this out. Maybe financial reparations will never happen, but we deserve an explanation for the cowardliness of our so-called leaders who needed to step up and STOP THE INSANITY. 
• For the friends and family who died, for the grandparents who didn't see their grandchildren for 2 years, for the jobs lost, the friendships destroyed, the trust stomped on we need to make sure it never happens again.

The effects of the lockdown on health, by 3 California doctors

I met Robin and Karen on our trip to Scotland in 2017 and we’ve stayed in touch via e-mail and Facebook.  He’s a conservative, and an immigrant via Germany, Holland, and Canada.  He lived in a Nazi camp as a young child. Although not originally a Trump supporter, he definitely knows he’s not a Nazi or racist, because he has lived that.  Sometimes on e-mail I see things with no attribution and that distresses me (retired librarian).  This piece hasn’t been published on-line because it’s a “private” letter that has been made public by the authors. Three doctors in practice in California. Robin sent me (Norma) the following:

-----------------------------------------

Full disclosure;  co-author Dr Hopkins is a urologist.  I am his patient and he is an exceptional physician.  This letter bears serious consideration. 

This letter was published last night (Dec. 14) by 3 well known ER doctors from John Muir Hospital in Walnut Creek, CA.

 

Dr Farnitano and Contra Costa County supervisors, 

We are writing to you with deep concern regarding more lockdown measures for our county. We feel the science is clear that more lockdowns lead to much more non covid morbidity and mortality as supported by the CDC.

We are confused as to why this is happening as we are often overcapacity in our hospitals and ICUs every winter and we have never done this previously. We also run our ICUs normally at a high rate of occupancy as this is most cost effective. 

Here are the issues in a nutshell: 

1. Excessive PCR testing is leading to numerous false positive results.  The specificity of PCR testing is really unknown but I have seen many authorities claim it is no higher than the low 90% range because of the attempt to be 100% sensitive using cycle threshold standards of 40. (sensitivity is inversely related to specificity)

2. For the sake of illustration, I will assume a 97-98% specificity which is likely far too high. Back in March when the county could only perform 300-400 tests per day, a 98% specificity would only lead to 6-8 false positive tests. Now we have reached up to 8000 tests per day. With a 98% specificity, that would lead to 160 false positive cases a day in our county. With a population of 1.1 million that would put us at 14.5 positive cases per 100,000 population and we would find ourselves in the worst possible tier based solely on false positive tests!!! This is absolutely a fact of epidemiology/science.

3. Again we have normal ICU and hospital winter surges that happen every winter and we never had any county lockdowns.  Our county figures on your website show essentially a stable ICU occupancy from July 1st to today. In addition on your website, we only have a minimal surge in hospitalized patients as compared to last year.

4. When you test like this for everyone that comes into your hospital, 'hospital covid patient" numbers will rise simply because you are capturing more asymptomatic disease in patients who otherwise are visiting the hospital for other reasons.

5. Public policy is being based on these erroneous numbers and assumptions.

6. Public policy with shutdowns (various closures) leads to excessive non covid related deaths. Please see attached CDC article which shows clearly that these excessive deaths are most pronounced in the 25-44 year old age range with numerous weeks during this year that 40-50% excessive deaths are seen in this age group. When you measure in terms of life-years lost as compared to life-years lost with actual covid deaths, it is not even close. We are harming more people in our community who do not have nor are at risk of having significant covid disease with senseless closures of businesses and schools. This is data supported.

7. The CDC and pediatric societies across America have voiced their support of opening all schools. School age children are not significant vectors of the disease. 

With this information above, can you answer the following questions: 

1. how do you account for these high numbers of false positives with the county tiering system? Do you throw these numbers out so that only true positives are counted?

2. Why did you not intervene with any type of community closure in the past winters when our hospitals were at overcapacity? What is different now?

3. What data do you have that supports closures of businesses like gyms and outdoor dining while keeping other businesses open like walmart? What data do you have that supports that we stay indoors as opposed to outdoors? (all the science that we have reviewed supports a predominantly 99% indoor vehicle of transmission).

4. Why have you gone against the medical experts in not recommending the opening of our schools?

5. What about our county's ICU figures caused you to trigger a closure? As you can see on Contra Costa County website, ICU occupancy has been stable between 75 and 80% since July 1st despite changing covid admissions. Please be specific here. When we run normally at 75% occupancy, why is 85% so terrible? We handle these surges every winter. It is expected. 

We look forward to your reply. 

Sincerely, 

Pete Mazolewski, MD, FACS, USAR

Brian Hopkins, MD,

Mike deBoisblanc, MD, FACS, USAR

 

What else should Trump have done?

We spent a lot of time the 3rd week in February in ICU with our son, and there were no Covid19 protections then and visitors wandered in and out with no problem. The only hint there was a problem was a sign in the waiting area that if one had traveled to China recently, to wear an (optional) mask. There were visitors in his room almost around the clock--none of us wore masks. Even for normal infections, it was terribly casual. This was 3 weeks after Trump announced closing travel to China. And now the Democrat Mafia want to make it about his leadership (constitutional authority he doesn't have). Any excuse to cover for their duplicity and bigotry.

Misreporting, not reporting, and fudging the Corona virus statistics

That's interesting. There were 13,276 diagnosed Covid19 cases in Ohio by April 22. "Not everyone who is diagnosed is being admitted to the hospital, about 25 percent are." Stephen Markovich, President and CEO, Ohio Health, "Caretaker in Chief," Columbus CEO, May 2020, pp. 8-13. When you hear the number of cases reported on the news or on social media, have you ever heard that? 75% don't get admitted?

We have four enormous hospital systems in Columbus: Ohio Health, Ohio State University Wexner Medical Center, Mount Carmel Health System and Nationwide Children's Hospital. In March the CEOs of these behemoths were even considering turning our Greater Columbus Convention Center into a field hospital. That was the size of the panic, fear and inaccurate models. But as of yesterday during the entire pandemic there have been less than 3,000 confirmed cases in this county (the majority of which didn't required hospitalization), and only about 3,800 hospitalized in the entire state! We're a state of 11.75 million with a number of major cities.

Why are we judging the entire country and its needs by what happened in the New York metropolitan area with a Democrat governor who kept inviting people to come and ignore the fear even on March 2? There was an Italian film playing at Lincoln Center. He urged people to see it. In a month NYC was the epicenter of the pandemic and the rest of us have had to suffer from his carelessness.

Coronavirus is novel, but the old fashioned is bad, too

While coronaviruses aren’t new, this particular one (known as 2019-nCoV) is. “We’ve seen coronavirus before, but this is a new version,” Gonsenhauser says. “So any time there’s something new people automatically go to Ebola and the zombie apocalypse, thinking that it’s untreatable and deadly. That’s not what we’re seeing. It’s certainly spreading more rapidly than SARS did, but it’s not more dangerous than other viral strains.”

As U.S. Health and Human Services Secretary Alex Azar stated in a Jan. 28 press briefing: "This is a very fast moving, constantly changing situation,” adding, “but, at this point, Americans should not worry for their own safety."

https://www.yahoo.com/lifestyle/the-flu-has-killed-10000-americans-as-the-world-worries-over-coronavirus-221101770.html

We’ve been sitting in a hospital for 5 days and observing a lot of sick people with relatives and friends coming and going.  Face masks, tissues, gloves, hand sanitizers and signs in Chinese seem to be everywhere.  Still, I see a lot of medical personnel ungloved, perhaps an allergy to the latex?

I’ve been out of the news loop for some time, but I think I heard on a radio news show that 750,000,000 Chinese have been quarantined.  I can’t even imagine that—twice the population of the USA and they are restricted in movement?  I keep wondering—who gets out to repair things that break down?  Who is stocking the stores? Who is doing the transport?

This account, assembling stories from various sources, sounds quite draconian.  Even stories of people be welded inside their apartments. Have no idea if it is authoritative of just click bait. https://www.theorganicprepper.com/quarantine-in-china/

I’ve learned to spell abscess

One of my cardinal rules is don't post about family without permission, but I'm claiming James 1:5, asking for wisdom and in faith receiving it. Our son Phil is in ICU so I'm crowd sourcing prayers for this setback from those who know him and us. Even if you're a total stranger--that's OK. This has nothing to do with his brain cancer, but has resulted from an infected tooth, which created an abscess, swelling and closed his airways. We took him to the ER (local small hospital near his home) on Saturday afternoon and after testing and waiting for a room, he was transferred to St. Ann's in Westerville late in the evening. Sunday morning the hospital chaplain called about 5 a.m. to say he'd been intubated so the four of us went right out. We were with him most of the day, and by late afternoon it looked like the antibiotics were kicking in and he was trying to kick butt for all the indignities of tubes, machines, beeping, noise, mother hover, etc. So that's a good sign. Don't mess with Phil. He can't talk right now, but he can say a lot with a thumbs up or an eye roll every mom knows. As soon as he is strong enough, there will be surgery.

The pastors from his church have visited and had prayers with all of us, and Pastor John said they played his favorites in church where he’s in the praise band.

Catholic hospitals and life issues

JAMA publishes little research blurbs either too short or too weak for prime time in the back of the journal as "Research Letters." March 19, 2019, vol. 321, no. 11 has one that Catholic hospitals should note. . . they are coming for you. First an ominous note on how Catholic hospitals increased by 16% between 2001 and 2011, and then a search to see if Catholic hospitals mentioned in their websites and mission statements that they were Catholic, so patients knew ahead of time about the Church's moral teaching on the "reproductive" and end of life care.

I make 2 observations here. One would have to know zip nada zilch about Christianity and Catholicism to miss it since 79% had the word "Saint" in their name. And 77% of the ones that didn't have Saint, had Jesus, Christ, or Gospel in their name. And if you don't know the Catholic Church's position on contraception, sterilization, abortion and euthanasia, you really should, since it's about the only church in America that actually has strong documents on life issues.

Also, the paper was funded by a grant from the Society of Family Planning, an organization that advocates for abortion and contraception and which is lobbying for new guidelines for facilities (clinics, offices) that offer abortions (or maybe in this case working up to battling facilities that DO NOT offer abortions).

Also, 3 of the 6 the articles cited are by one of the authors, Maryam Guiahi who seems very concerned about Catholic hospitals and "reproduction." I looked up her name, and found a much more extensive article on this topic (it's common to reuse and massage information so you can show more publications on your vita). In another one of her articles, "Mystery callers phoned 144 clinics nationwide that were found on Catholic hospital websites between December 2014 and February 2016, and requested appointments for birth control generally, copper IUD services specifically, tubal ligation and abortion." When pro-life people do that sort of research, they end up in court and sometimes jail.

She has a cottage industry in just her many publications for finding "concerning" behavior and rules in Catholic hospitals. The Left has driven the Catholic Church out of the adoption business; it wouldn't surprise me if her research is much more sinister.

Monday Memories--my ablation and hospitalization

From a letter. "I had my ablation (AV node reentry slow pathway) on January 18th [2002].  Then while I was wearing a Holter monitor on the 29-30th, it picked up some serious a-fib again (this was my fault for doing too much while we were moving to our condo and having the house closing).  Apparently the pulmonary veins don’t know the ship has left the dock and they continue to do what they’ve always done.  So it was back to the hospital for 3 days to be put on Rythmol. It sure is good to be out of the hospital!  The doctor didn't make rounds until about noon, so I didn't get out until about 1:30 Friday. I had lunch there--it was pretty good, a vegetable lasagna.

I only got 2 hours sleep each night.  The woman in my room was on some sort of machine suctioning fluids and gurgling--sounded like a creek running through the room.  A long time smoker, she had emphysema and an aneurysm. Plus, because her surgery was so serious, there were always medical staff trooping in and out, and when they weren't testing her, they seemed to be taking my blood pressure or temperature or giving me medication, but not all at once, just spacing it out so I couldn't sleep. Anyone who can survive in a hospital must be pretty darn healthy. I felt sorry for this woman's daughters though. They had flown in from different states, and would sleep in the lounge and then come in and try to watch her. They were exhausted, and of course, it is pretty boring just sitting. And they frequently had to alert the nursing staff to problems, so I think it is very important that family be around when there is surgery recovery.

My first morning there, about 5 a.m., I was watching two male staff, one teaching and one learning, drop off our medication.  They unlocked the two boxes for 4007 for bed A (Bruce) and bed B (her name), and I heard the one tell the other “this is for Bruce,” and he pulled out box B, looked at the name, and put mine in it, thus mixing up our medication.  The learner was definitely old enough to need glasses and he had a white pony tail hanging from his almost bald head. So when the RN came in I told her.  She went over and unlocked the boxes, looked at the names, and switched them.  The next morning, I noticed he was wearing glasses.

Holly brought in dinner Thursday night to the hospital, and all the stuff for a manicure (a huge bag of colors to choose from) and gave me a nice relaxing manicure. So that evening I had Bob, Lindsey, Holly, and Mark and Phoebe at my bedside, but only one chair. Phoebe brought me tapioca from the Chef-o-Nette which is located in our old neighborhood.  Either the manicure or the tapioca could be a special gift to anyone in the hospital.  Holly has artificial nails, but knows how to do it. Phil stopped in on Thursday and Friday morning and brought me Caribou coffee from my favorite coffee shop."

Wired and transmitting

The heart monitor I’ve been wearing since September 16  apparently transmitted something I was ignoring, the doctor was contacted by the company, and then I was called about 7 p.m. Wednesday evening and told to go to the ER. Isn't technology amazing--all sorts of things going on behind our backs we don't know about!

I'm home now--released from the hospital late yesterday afternoon. When the cardiologist walked in with the flock of young docs in training, I'd already heard the discussion held outside my room. I don't know how often Huffington Post is listed in the record as a possible cause of heart problems, but it's in mine. Because of the medical school down the road at OSU, you see a lot of doctors coming through the ranks. They all seemed to know what Facebook and blogging are.

I met the most interesting people--asked most of the staff who had the time how long they'd been working at Riverside, career goals, etc. The woman cleaning my room turned out to be a former neighbor in the 1970s when we lived on Abington Rd. One guy had changed careers from real estate after the 2008 downturn; he began in a very low level job (which he hated) and kept applying within as jobs opened up. The echocardiogram guy had relocated from Cleveland where there were many med tech schools but no jobs, and we had a good laugh about Columbus residents and the first snow flake to fly.

One lady doctor looked to me to be 15, so I just had to ask--she was 28. One lady intern had the most fabulous bedside manner and special touch, that I hope she's around the next time I need her.  And I got to give my name and birthdate at least 30 times. 

The food was excellent—fresh and tasted “homemade”--and you could order any time.  All the staff seemed to have special training in being friendly.  When I raised the blind, I looked down on the new addition to the hospital.  It is always expanding.

“Atrial fibrillation is an irregular and often rapid heart rate that commonly causes poor blood flow to the body. During atrial fibrillation, the heart's two upper chambers (the atria) beat chaotically and irregularly — out of coordination with the two lower chambers (the ventricles) of the heart. Atrial fibrillation symptoms include heart palpitations, shortness of breath and weakness. “ http://www.mayoclinic.com/health/atrial-fibrillation/DS00291

Current Drug Shortages--Some hospitals are in tough shape

What's behind this? Seems to be a much bigger problem than 2007 and 2008. Is it the impending doom of Obamacare? Years of over regulation? Loss of profit by the manufacturers, who afterall, aren't in this as volunteers or church ladies.

"The supply of these drugs has tightened in recent years as the generic-drug industry has consolidated, with many of the drugs now made by just one or two companies. In many cases patents have long expired and the original brand-name drug is no longer being produced.

Federal regulators have also stepped up enforcement of quality standards, limiting the ability of large manufacturers to ramp up production.

The drugs—typically used in hospitals and outpatient clinics—often require complex manufacturing processes with long lead times. Because factories produce many kinds of medicines, companies say they can't easily make more of one without creating a shortage in another.

The Food and Drug Administration reported a record 178 drug shortages in 2010, up from 157 the year earlier and 55 five years ago"

Drug Shortages Distress Hospitals - WSJ.com

The Reality of Drug Shortages — The Case of the Injectable Agent Propofol | Health Policy and Reform

Read list of Drug Shortages > Current Drug Shortages

Dementia is a leading cause of death in the U.S.

That sounds really scary unless you realize that our research and technology have extended the lives of people who would have died of different diseases, and safer roads and automobiles have prevented thousands of deaths. Dick Cheney and Bill Clinton for instance have both been saved several times of dying of a heart attack. All that means is you live long enough to die of something else. Deaths from heart disease, stroke, prostate and breast cancer all decreased between 2000 and 2006, but Alzheimer's (about 70% of dementia cases) was up 47% in the same time period. And I doubt that too many actually die from dementia, but from something related like pressure sores, kidney infections, or pneumonia from aspirating food.

The February 10 issue of JAMA has an article on using feeding tubes with nursing home residents with "advanced cognitive impairment" i.e., dementia [Hospital characteristics associated with feeding tube placement in nursing home residents with advanced cognitive impairment," vol 303, no.6, p.544-550]. Using feeding tubes in patients with advanced dementia does not improve survival. So why is it done and why do the rates vary from hospital to hospital? That's what this study was supposed to explain. I'm not sure I understood all the details, but I did see that only 5.8% of hospitalized nursing home residents had an order to forego artificial hydration and nutrition despite the fact most nursing home residents say they would rather die than live in dementia with a feeding tube. (I'm not referring to people like Terri Schiavo who didn't actually need a feeding tube and wasn't dying--she was inconvenient for a husband who had received a very large monetary settlement and had started another family.) Also, I didn't see a distinction between hydration and feeding in this article. (Dehydration is an extremely painful death.) Also, it appears that feeding tubes don't solve any of the problems like pneumonia or pressure sores, which actually are the cause of death. The research also demonstrated that practices vary widely among hospitals and that black and Hispanic nursing home residents were more likely to undergo a feeding tube insertion. So is that more aggressive care or a reflection of how indigent people are treated?

As the authors of this study comment, the results raise more questions than they answered. For instance, the rates decreased during the 8 year study. But one thing I know, conservatives unhappy with Obamacare shouldn't use reluctance to use feeding tubes or counseling about preferences as a sign of an attempt to dispatch the elderly. There doesn't seem to be any evidence that feeding tubes help those suffering the end stages of dementia.

It's not health care reform

This op-ed piece in the Pittsburgh Post Gazette finds the real problem, and it's not insurance:

Health care costs too much in our country because we deliver too much health care. We deliver too much because we demand too much. And we demand it for all the wrong reasons. We're turning into a nation of anxious wimps. I still love my job; very few things are as emotionally rewarding as relieving true pain and suffering, sharing compassionate care and actually saving lives. Illness and injury will always require the best efforts our medical system can provide. But emergency departments nationwide are being overwhelmed by the non-emergent, and doctors in general are asked to treat what doesn't need treatment. In a single night I had patients come in to our emergency department, most brought by ambulance, for the following complaints: I smoked marijuana and got dizzy; I got stung by a bee and it hurts; I got drunk and have a hangover; I sat out in the sun and got sunburn; I ate Mexican food and threw up; I picked my nose and it bled, but now it stopped; I just had sex and want to know if I'm pregnant. . . . Our society has warped our perception of true risk. We are taught to fear vaccinations, mold, shark attacks, airplanes and breast implants when we really should worry about smoking, drug abuse, obesity, cars and basic hygiene. If you go by pharmaceutical advertisement budgets, our most critical health needs are to have sex and fall asleep."

HT Kat

State of Emergency--dialysis for illegal immigrants

The University Medical Center in Las Vegas is a tax supported hospital and is required by federal law to treat illegal immigrants. Illegals (or foreign nationals) come to the ER for kidney dialysis and the cost at UMC can run from $11,000 to $18,000 per visit for an emergency dialysis patient because of the testing required and because they are so sick when they come. The federal government has kicked the can down the road on the immigrant health issue as it has on many unfunded mandates, and the costs land on the local medical facilities. Read the full story. This is just one hospital spending $24 million a year; it's even worse in California, and nationwide it’s in the billions.

This story punctures the myth that the poor don’t have health care, or that the billions spent on illegals for their health care isn’t a huge problem which the federal government, regardless of who’s in the White House or Congress, has steadfastly refused to solve. Mexico really doesn’t want its citizens to come home. If the brilliant minds from anarchist to liberal to libertarian in Washington haven't been able to solve this small piece of the puzzle for just one disease for one specific group, what makes you think they can take over the whole enchilada without a huge, ongoing case of indigestion?

I worry about the losers in this contest

I realize that these days you have to have contests and rewards to encourage workers to do what's expected of them, but hand washing should not be negotiable!

"100 Percent Hand Hygiene Club Congratulations to staff on 8 Rhodes (Progressive Care and ICU) for 100 percent hand hygiene compliance in October. They were selected from inpatient units in UH, Ross, Dodd, UH East and outpatient areas that had 100-percent compliance. To properly wash your hands, wet them with water, apply soap and rub your hands together for 15 seconds. Rinse and dry with a disposable towel, and use the towel to turn off the faucet to avoid re-contaminating your hands. You can also use an alcohol-based hand rub for routinely decontaminating your hands." News story from OSU MEDICAL CENTER Today.

Here's what St. Raphael says about hand hygiene

Why do we need to improve hand hygiene practices?”
• Serious nosocomial infections
• 90,000 patient deaths per year
• Costs of treatment: $4.5 Billion per year in the U.S.
• Hand washing compliance rates are unacceptable (average 40 percent)

St Raphael is battling this problem at its web site on hand hygiene and bring awareness to the general public and other hospitals.

Makes me worry if there are losing teams

100 Percent Hand Hygiene Club

"Congratulations to physical therapy staff at Morehouse Medical Plaza for receiving 100 percent hand hygiene compliance in July and being recognized at recent supervisory council meetings. Staff were selected from 17 inpatient units in UH, Ross, Dodd and UH East and outpatient areas that had 100 percent compliance. To properly wash your hands, wet them with water, apply soap and rub your hands together for 15 seconds. Rinse and dry with a disposable towel (use the towel to turn off the faucet to avoid re-contaminating your hands). Or, use an alcohol-based hand rub for routinely decontaminating your hands." Seen at OSU Medical College newsletter.

Unfortunately, no one has figured out how to do this

"Yesterday [July 20] the Trust for America's Health released their report Prevention for a Healthier America: Investments in Disease Prevention Yield Significant Savings, Stronger Communities. They found an investment of $10 per person per year (that would be 2.7 or 3 cents a day) in proven community-based programs that included ways to increase physical activity, improve nutrition, prevent smoking, and stop use of other products containing tobacco could save the United States more than $16 billion each year within the next five years. The ROI (return on investment) would be $5.60 for every dollar spent." Seen at the National Nurse Blog

Do you know of any community or private or personal program to increase exercise, stop smoking or lose weight that actually "works?" It has to be a personal decision, and some people have been dealt a bad set of genes and can't really do much. I read health and medical journals like an addiction, and I have yet to see one program succeed. And for all that, you would be, if it worked, adding years in the 80s and 90s, which would eat up any savings, because we've all been told how expensive end-of-life care is.

Do you know what I saw at the hospital on July 2-3 after my return from our fabulous Italy trip? A hierarchy of obesity among health care staff based on education, age and position. I was treated by two female doctors, both trim (and I suspect foreign). They were hospitalists, probably early 30s. The RNs were all attractive with normal BMI (if there is such a thing), but a little older and heavier than the hospitalists. The med techs were younger than the RNs and much heavier, some were obese. The food service women were older and much heavier than the med techs. The housekeeping staff, if foreign born were very thin, if American, extremely over weight.

I'm just saying, if nurses (or the office of a National Nurse) know what to do about unhealthy lifestyles, they can start letting hospital staff in on the secret. I have no idea who Trust for America's Health is, but a quick browse reads like a liberal lobbying group/think tank which will support itself on endless taxpayer and foundation grants and then become a regulatory agency with great power over our
lives.

Eat less, move more. Fight FEMA-tizing your health care.

Hospitals--don't go there

My recent two day stay in a modern, metropolitan hospital, covered by my excellent insurance (although it will still cost me a bundle), has convinced me again there is never a good or safe time to be there if what you have isn't life threatening (although how do you know?). I didn't go to the ER because I was an elderly, poor person with no insurance and no regular doctor; no, the doctor on call for my doctor said to go there when I told her I had severe diarrhea, a temperature over 102, was recently returned from Europe and was napping on the floor of the bathroom and having some A-fib. Silly me. I didn't think to take a pillow and blanket with me. I got to the ER about 7:30 p.m. and was finally in a hospital bed about 5:30 a.m. Thank goodness for Depends, because in ER, if you're not bleeding or throwing up on the staff, you wait. As it was, I just threw some of my clothes away.

Hospitals these days (my first stay since 2002) are high tech, high touch. We had to go through a security check to even enter the ER waiting room. My medical data was entered into rolling computers three difference times, and only the first one knew who my secondary emergency contact was--the other two times I had to provide the information. So even within the hospital, I didn't seem to be connected. But bar codes and RFID (radio frequency identification), and wi-fi were everywhere. No where in these computers was the information that I am right handed, so if an IV is strung up (with all the electronic, data rich, error prone tags), in the crook of my right arm, I will constantly be setting off an alarm that will beep its little heart out until someone arrives to see if I'm dying, scratching my nose, or trapped in the rest room.

One new feature, although I don't know if the info ever got back to my own doctor, was I had two different "hospitalists" from my own doctor's practice. So at least, they knew of him. Every staff member of the hospital, from RNs down to housekeeping, seemed to have been through a "make the patient feel loved" workshop. I never saw so many smiles or had such quick response to the alarm light (after leaving ER).

Each year there are 44,000-98,000 preventable deaths in hospitals, according to one report I read on an FDA site, and 5% of the patients in hospitals acquire an infection. Here's where technology fails. I saw a housekeeping person once in my room--not that they couldn't have slipped someone in while I was napping or at night when I was asleep. But that's what I saw. She smiled and ran a dust mop on the floor of the room. Didn't empty the trash, take the soiled laundry, or clean the bathroom. I used the wash cloths to clean the bathroom floor and commode myself--then threw them away. What came up on the cloth was just plain old dirt, not evidence of my illness. If that floor had seen any hot water and disinfectant, it must have been months ago. No one offered to bag my soiled street clothes so they were just thrown in a closet, where if I'd been contagious, the bacteria or virus awaited the next patient. I finally asked someone to remove the bathroom trash which was getting quite ripe. God knows when the last time the telephone mouthpiece and keypad or TV remote had been cleaned. When Pastor John visited, he pulled down the window screens to cut the glare--no one else noticed. But then, he sees dozens of hospital rooms a week.

A food service person (smiling and friendly) brought me a tray and menu for the day. With my left hand (very low tech stubby pencil and paper) I circled jello and hot tea, figuring that would be safe. (Why do they have patients decide this?) For dinner I received half a baked chicken, broccoli, salad, coffee and cake. All the hot food was contained in something plastic scuffed, scratched and faded that seemed to be shedding its heat absorbing materials. I'm not phobic about heating food in chemically ladened containers, but really, this equipment looked unsafe at any speed. A little stainless steel dish sitting on hot water might be preferable and easier to keep sanitized.

Even if you don't plan to stay (and I didn't), take your own medications to the ER. You might be admitted, and they'll never get it right. I had such a headache from dehydration I asked for an aspirin. After an hour, I asked again, and was brought 2 Tylenol and a baby aspirin (which is on my daily med list) in a paper cup and it was entered on the rolling computer screen, after checking my barcoded wrist and asking me my birthdate. I don't like Tylenol, but took it anyway, and just had 2 baby aspirin that day. One day they couldn't get my one prescription drug, so it had to be ordered--I'm sure the cost will be out of sight when I get the bill. And why do hospitals give adults chewable 81 mg aspirin when they are much more expensive than the low dose adult kind? I was potassium depleted, and the pills could have choked a horse, but it took me awhile to figure out they were easy to break in half even as weak as I was--no one else suggested it.

One alert, smiling RN, after resetting my IV data monitor numerous times (I left the hospital 10 lbs heavier than I went in), decided to move the IV to my left arm. The smiling young med tech who looked at least 15 was apparently not yet finished with his training, and this took several stabs attempts under her supervision and coaching, but she smiled throughout the whole ordeal and was sympathetic. (It really does help the patient's attitude.) When I could read the BP data, it looked like I was dead--something like 105 over 55; and the high tech thermometer never registered over 97 despite the fact I felt like I had a sunburn.

Hospitals. Don't go there unless you have to.

Comparing Hospitals

Here's a handy website you might want to browse.

"The Hospital Compare website was created through the efforts of the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (DHHS), along with the Hospital Quality Alliance (HQA). The HQA is a public-private collaboration established to promote reporting on hospital quality of care. The HQA consists of organizations that represent consumers, hospitals, doctors and nurses, employers, accrediting organizations, and Federal agencies. The information on this website can be used by any adult needing hospital care."

You can search by your city or zip code--I used zip and then indicated the number of miles. Seven hospitals are within 10 miles, so I compared Riverside and Ohio State. In almost every category Riverside was rated higher than OSU, and also had more patients. Where it wasn't higher they were the same. I haven't figured out all the features yet. OSU had no information for patient ratings of care, so those couldn't be compared, but they weren't particularly ecstatic for Riverside. Maybe patients are just grumpy when they don't feel good? Also, I seemed to lose my place when I'd click on an explanation and had to start all over which was frustrating.

Since we spend so much time at Lake Erie, maybe I'd better take a look at Port Clinton and Sandusky.

Oddies, Endies, and Undies

Yesterday I noted that my husband squeaked through on registration to tour the new Dublin Methodist Hospital to get 3 credit hours in health, safety and welfare for his continuing education requirements. At supper last night (homemade pizza) he couldn't stop raving about the design, creativity and planned well-being for patients. So it is definitely a winner, all around. You folks who live in Dublin and surrounding areas are going to have one super community hospital.


As I was settling in for a nap (one of my favorite events of the day) about 2 p.m. I heard a loud crash. I was a bit groggy, but realized the roof was not above me--the master bedroom is there. So I walked upstairs carefully, thinking perhaps a mirror or painting had fallen. When I got to the master bath, I saw that all the marble trim tile had fallen off the edge of the vanity. If anyone had been standing there in bare feet, he would have had a broken toe. I walked downstairs and told my husband (he uses that bathroom), and he said he wasn't surprised, that it was noted in the inspection in 2001 when we bought the condo, but hadn't been fixed.

So I settled in again for my nap. The phone rang and my husband picked it up from the kitchen. I opened an eye and looked at the TV screen. A name and phone number appeared. The conversation was with the buyer of one of the condos that has been for sale for a year. My husband is president of the association, and this purchase has involved many meetings of the board. When he hung up he said the purchase was final. I asked the buyer's name, but he couldn't remember. Was it--and I mentioned the name that had appeared on our TV screen, and he said Yes. Now that's weird. We assume it is something in her phone, because to our knowledge, this has never happened before. Has this ever happened to you?

A nap was definitely out of the question after two interruptions, so I decided to go Christmas shopping. I had four cards from Macy's. Two for $15 off a $50 purchase, and two for $25 off a $100 purchase. The problem was Macy's was also having a one day sale--something like "take another 20% off the already 50% markdown." I'm math challenged. So when I got my carefully totalled gifts (in my head) to the head of the check out line (waited 10 minutes), they only came to $82. So I'm refiguring what we'd agreed on, and go back and pick up an item that was $18 (although the $9 would have done just as well). See, that's how they trap you. In my head, I'm deducting the $25 off my son's gift, so it evens out with my daughter's and son-in-law's, but the receipt shaves each item--and actually totals $26 and not $25. I'll stick with my head on this.

I still have two cards left, so I browse the ladies lingerie department--not for a gift, but for me. My favorite brand of undies (which always seems to be on sale) has a buy 3 get one free (ca. $18), although because of the sale, I have no idea what it will be when I get to the register. So I go down stairs and look at shoes to see if there's something in 8.5 AA, and I select 2 Naturalizers and take them to the desk (no one comes to you these days). You would have thought I'd asked for the moon. "We have no narrow sizes in any style," she sniffed (She was quite large, and I think that's why narrow sizes are disappearing). You see, I thought if I bought a pair of shoes I didn't really need, I'd get the panties I didn't really need almost for "free." Saved from consumer hell by a shoe width.

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Can't blame MRSA on illegal immigrants

That's not a rumor you want to start, but I heard Laura Ingraham mention it right after talking about the TB guy who's made a number of flights legally from Mexico into the U.S. A whole alphabet soup of government agencies have dropped the ball on this one, and it's not an illegal immigrant issue.

Neither is MRSA (what I heard: as an aside she asked where these germs were coming from right after talking about the TB infected Mexican . . . like we can't grow our own!). It's a problem which started in the 1970s with hospitals overusing antibiotics, patients having shorter stays, and the staph bug moving on out to the community. In 1998, the CDC reported on the problem with nosocomial infections (infections that originally preyed on the weakest and sickest in hospitals)

By the late 1980s and early 1990s, several different classes of antimicrobial drugs effective against gram-negative bacilli provided a brief respite. During this time, methicillin-resistant S. aureus (MRSA) and vancomycin-resistant enterococci (VRE) emerged, signaling the return of the "blue bugs." In 1990 to 1996, the three most common gram-positive pathogens—S. aureus, coagulase-negative staphylococci, and enterococci—accounted for 34% of nosocomial infections, and the four most common gram-negative pathogens—Escherichia coli, P. aeruginosa, Enterobacter spp., and Klebsiella pneumoniae—accounted for 32%

The most recently updated MRSA page at CDC was done this week--the earlier one was from 2005, but the recent concern apparently caused them to revise it.

Methicillin-resistant Staphylococcus Aureus (MRSA) is a type of staph that is resistant to certain antibiotics. These antibiotics include methicillin and other more common antibiotics such as oxacillin, penicillin and amoxicillin. Staph infections, including MRSA, occur most frequently among persons in hospitals and healthcare facilities (such as nursing homes and dialysis centers) who have weakened immune systems (see healthcare-associated MRSA).

MRSA infections that are acquired by persons who have not been recently (within the past year) hospitalized or had a medical procedure (such as dialysis, surgery, catheters) are known as CA-MRSA infections. Staph or MRSA infections in the community are usually manifested as skin infections, such as pimples and boils, and occur in otherwise healthy people.

The most recent guidelines run to 219 pages, but to sum it up, WASH YOUR HANDS, PEOPLE, and don't let a medical staff person touch you until they do. "Improved hand hygiene practices have been associated with a sustained decrease in the incidence of MRSA and VRE infections primarily in the ICU (p. 49)"