Tag Archives: lungs

HospiceCare – Medicare – Patient Care – Collapses for Hospice Patient

HospiceCare – Medicare – Patient Care – Collapses for Hospice Patient, Mike MacDonald last month.

My hospice experiences have been an overwhelmingly positive, including my own mother’s outstanding care from one in Gig Harbor. Mike’s experience happened in Maine – and makes me wonder how many other hospice patients around the country were and are caught in this latest stress fiasco for terminal patients and their family?

Greetings! Last month Mike MacDonald reached his six month Hospice Care and was ‘discharged.” Mike and his wife, Pat, were left hanging without medical insurance, no oxygen, medications, nothing to pay the doctor or hospital should he need one. The EFFORTS COPD community rallied to help.

Mike and Pat managed to work through their failed Hospice system, but the lingering question is will it happen to us when the time comes? Have patient safeguards been set into place?

One day it will be our turn for Hospice – How is Kitsap County Hospice doing? With Harrison’s hospice announcement recently in this newspaper, Kitsap County now has two for choice.
The Hospice patient and family deserve Hospice CARE – not a toss without medical coverage to sink or sink.
Following is Mike’s failed Hospice story update:
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“Hello friends — A quickie note this time.

For those following my odyssey of hospice-care to no-care, I am pleased to post that all of my prior Medicare access has been totally restored as of June 18. My hospice had been “paused” on May 28 with the intention that I would re-enter Medicare on May 29 and return to hospice when I got a little sicker (my doctor’s crystal ball said that date was most likely to be July 23rd lol). We of course had the foul-up where my Medicare/CMS records weren’t properly updated resulting in my having no coverage (prescription, doctor, hospital or DME) for anything related to my lungs. I am still waiting on the wheelchair to be replaced.

Thanks again to all who wrote/called their congress reps, etc. I was touched and appreciative. We see over and over again what a warm community this is where so many of us rise to help each other often in spite of our own illnesses.

We had a visit yesterday from VNA of Southern Worcester County — a small VNA office based here in Webster, MA with a satellite office in Auburn, MA that provides palliative and hospice care services. As of yesterday I entered their palliative care program. My situation is not normal for them…they most typically step in following a hospital admission. In theory, they will evaluate me for re-entry into hospice services when the time is appropriate. In fact, the “in-take” nurse that was with me yesterday wanted to refer me for an evaluation right then but my wife wouldn’t hear of it (more on that below) and I think it’s premature anyway.

My regular VNA nurse — whom I haven’t met yet — will stop in today. Normally, there would be daily visits initially settling back to 3 times a week when appropriate. I’ve already expressed my wishes that we talk more like 2 times a week. They would be responsible for palliative care which is essentially “comfort” care but not quite so much as in hospice. That’s a little murky: while under hospice, drugs are often dispensed in a manner that’s not healthy over the long term with the theory being that the patient is dying already and so longer-term consequences aren’t as important. Under palliative care, they do care more about the longer-term consequences and there isn’t necessarily any assumption about death. In my case, the nurse and the doctor’s office will have to work that out but some of my drug dosages are probably already into the areas of unhealthy.

To my surprise, this *is* being covered under Medicare. CMS has tightened access to at-home services with the goal being of reducing in-home Medicare expenditures by 14% over the next 4 years. Learning that I seem to qualify for a host of in-home services comes as a very pleasant surprise. I can get an in-home health aid to help me bathe apparently — not that I want anyone to help me that way. I am eligible for occupational therapy which I believe for me means learning how to get around the home, how to conserve energy, etc. I don’t know that I need or want those services either but I’ll be open-minded. They also talked about music therapy to my surprise…I would be likely to use that.

We had entered this with the intention of hiring a “private duty nurse” paying out of pocket to lighten the load on my wife, Pat. I was a little concerned because whereas Pat was talking about 2 hours a week, I suspected 2 hours in-home care was probably more like 4 hours a week after factoring in travel, time talking to my doctor’s office, etc. I could easily see this running $1000 a month. No expense would be too high as far as Pat is concerned…she was really traumatized badly by the disaster with the last hospice organization (VNA Care Network which covers most of central and eastern Massachusetts). Pat actually objected initially when we talked about billing expressing a preference to pay this out of pocket and not involve Medicare at all for fear that they would screw things up so badly again. She’s really quite emotional about this — and understandably so — but I also think there is no danger at this point because we’re not signing away anything (whereas entry into hospice signs away access to care for the terminal illness to the hospice provider).

This does not bode well for when it’s time to go the hospice route. I don’t think Pat will go along with that again but for now I have to wait and cross that bridge when the time comes.

Physically, I’m not doing all that great though I think I am a little better the past couple of days. One of the ironic things about the May 28 discharge from hospice was that I was already sliding into an exacerbation on that date. At times, I’ve been fairly ill since then. Still, I don’t think I am near death. I wouldn’t be shocked if that changed 3 weeks from now but I also wouldn’t be shocked if I was writing the same thing 6 months from now. My doctor feels I am dying but admits that I’m tougher than he had thought. I am definitely progressing in the illness and not happy with how compromised I am in my ability to do much of anything.

By way of comparison, I have a friend who I started working with in 1989. We worked closely for 7 or 8 years and remained in touch since. He’s 54 years old and for 2 years has been battling an aggressive bone cancer. He’s been through 5 surgeries now including the replacement of his right pelvis with a bone from a cadaver. As he expressed to me a couple of days ago via email, he really shouldn’t be alive but he’s taking every day he can get and is planning on getting a tattoo next month. I’m not one for tats but good for him. When I think of my own illness, I have only to compare myself to people like him and realize that I’m still a pretty fortunate person…this could be so much worse. I have the means and the support system to deal with this; beyond that, I don’t have much control except for maintaining a positive attitude. For the most part, I do just that.

Thanks for listening and sorry for my blatant lie at the top of this note…I really *thought* it’d be brief.
Mike”
Michael MacDonald
:::Webster, MA

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Thanks for listening…. Sharon O’Hara, COPDer -familien1@comcast.net

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Lung Health Screening – FREE – Spirometry Test – Silverdale Costco – YES!

Sharon O'Hara

Hi Guys … I’m back with joyous news…

Lung Health Screening – FREE

Silverdale, Mickelberry Road

Pharmacy Phone: 360-308-2118

Saturday, 2 November 2013

Start time: 10:00am

End time: 3:00pm

http://content.costco.com/Images/Content/misc/pdf/HealthWellnessClinicSchedule.pdf

“Oh, no! I can’t breathe! I should have gone for an early detection Spirometry test at Costco in Silverdale!”

Here it is – tomorrow at Silverdale’s Costco – FREE!

Thank you, Costco – for the early warning testing to avoid COPD (Chronic Obstructive Pulmonary Disease) – now I’m playing basketball without worry of smothering lungs!

Please – get checked. You do not want COPD – ever. I promise you…get checked tomorrow.

http://www.sciencedaily.com/releases/2013/04/130401111549.htm

Thanks for listening…. familien1@comcast.net

Stay tuned for more Northwoods – I’m a little late … familien1@comcast.net

Sharon O’Hara

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Patients Need to be Educated. Are Some Physicians too Ignorant?

Sharon O'Hara

The other day I was shocked to run into a friend I hadn’t seen recently and to see this formally physically fit verbal person limping gingerly with the help of a walking stick sickened me as I listened to the story – and PERFECT example why communication between patient and physician is paramount to that patients well-being.

A few years ago my bone on bone left hip needed a bone doctor. Before I could get to the local appointment with a bone doctor, the pain sent me to a Prompt Care after a call to my primary physician, Karen Eady, M.D. The doctor ordered x-rays – yes, arthritis and didn’t do anything further since I had an appointment with a local orthopedic doctor in a few days.

The orthopedic doctor didn’t say much of anything but talked in terms of an operation and suggested several over the counter meds for the pain. I take meds for my lungs and other medical conditions and know non-prescription drugs can counteract with each other the same as prescription drugs can and cause huge problems. I’m leery. That said and after a non-informative brief discussion, he walked away and I called after him, “Doctor, what do I have?”

“Arthritis” he called back then disappeared around the corner. Okay. But I had expected him to tell me what I didn’t know and give me the type of arthritis – there are more than 100 different kinds of arthritis.

Sometime later I complained to another doctor about the encounter and he laughed and said orthopedic docs never communicate – sort of a ‘rule’ and laughed again. I grinned but told him that’s wrong. By then, I had visited one of the University of Washington Medical Center’s orthopedic surgeons and he educated me what I had and what it was doing and what we could do about it.

I told my laughing doctor the U surgeon DID inform me what was going on and gave me options. He seemed surprised that any orthopedic doc spoke more than 10 words to a patient. I shrugged it off and decided that the performance in the operating room must be all that counted.

Seeing and listening to my friend the other day though made me realize that the problem with doctors who do not/can not communicate with their patients is that they must not DO NOT LISTEN to their patients either! Her complaints were ignored by her doctor and it seems to be a big surprise to him that she now has serious medical problems, not just the replaced hip and another operation to fix what should never have happened had he listened to her!

I suggested that my friend run, not walk to the University of Washington Medical Center for a through exam and get things resolved. That she not waste any more time – that she not do what I did all those years ago.

Do not waste one moment on an ignorant physician, folks.

Without exception, every doctor I’ve met at the UWMC is a communicator…they listen.

Orthopedic doctors who can’t communicate with their patients? Let them operate on themselves. A physician who can’t respect their patient enough to communicate with them is not one who listens to them either – in my opinion as a patient.

More later…thanks for listening… Sharon O’Hara

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Lungs Are Us – The State Does Not Protect The Homeowner

Sharon O'Hara

Josh Farley’s, “Kitsap County fined for safety complaints made by former employee”

Struck a nerve and evoked one of my most unpleasant memories with a company based right here in Kitsap County. Protect your lungs – because if you don’t, who will?

“During inspections last fall, L&I staff said the county didn’t ensure an employee working with corrosive chemicals was wearing eye protection and that employees were not informed of the hazards of working with those chemicals….”

http://www.kitsapsun.com/news/2011/jan/30/county-fined-for-safety-complaints-made-by/

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Interesting. Some years ago a Kitsap County company was hired by our insurance company to do some work on the lower floor of our house. I had COPD (Chronic Obstructive Pulmonary Disease) and was protective of my lungs.

The final job the workers had to do was waterproof the downstairs concrete floor in what I called “The Yellow Room” and the rooms off it. It was fully enclosed without ventilation but double wood doors from the yellow room opened directly into the library and on the other side of the library a glass slider opened to the outside gardens.

Side doors off the library opened into the greenhouse along the south side of the house, another door led to an apartment made up for my parents when they visited and a door on the opposite side of the library opened into the double car garage.

The garden and hobby room doors opened from the other side of the garage and weren’t affected.

An open stairway led upstairs along the greenhouse adjoining wall into the main house from the library.

I had warned the workers to wear masks, turn on all the floor fans I had supplied and to keep ALL the doors and windows downstairs open for their safety and my own – that none of the fumes would come upstairs where I could breathe them adding to my already damaged lungs.

A company from Seattle had previously sealed the stairway from the upstairs and wore spacesuits and enclosed helmets when they had removed the damaged and old asbestos linoleum.

The KC Company didn’t bother and when I went downstairs to see how they were doing, I noted the fans were off, the sliding door to the outside was closed and they had no masks on.

The smart mouthed young man poured the liquid toxins directly on the concrete in the yellow room and the fumes filled the air. I ran to open the doors and windows and turn the fans on.

He laughed when I yelled at him and the others to put on masks and asked why he deliberately ignored what I’d told him to do and I choked, my eyes watered up and I grabbed the stair railing and pulled myself upstairs and out of the fumes.

Trouble is the fumes followed and continued to burn my eyes and throat. The only place I had to go for clean air was out on the deck.

The workers eventually finished and left. They had backed down the driveway and parked their van in front of the garage and I was outside on the front deck above the garage when they finished and left. The young man apparently in charge laughed again and joked with his co-workers as they piled into their vehicle and pulled out and up the driveway.

I called their company and spoke to the owner who assured me that safety warning about wearing masks was posted at their place of business and that he did everything the state required him to do in terms of warning his workers to protect themselves.

Nothing, he said, mentioned protecting the homeowner and there was nothing he could do about protecting his workers any more than posting the state required warning.

It was posted in plain sight for them to read.

My point is that workers can and do ignore warnings.

Unless things have drastically changed – there is no protection for the homeowner from irresponsible Rambo type foolish workers.

More later… Sharon O’Hara

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The University of Washington Rocks!

Sharon O'Hara

The University of Washington is a God send to us. I wrote the following in answer to a letter to the editor and decided to add it here as well.

“The University of Washington ‘elitist’? If ‘elitist’ means dedicated fine professors teaching a subject they they live their work. They teach what they are passionate about to kids eager to learn.

It was the University of Washington’s Medical Center Specialties and Dr. Raghu specifically with then, Super Fellow, Christopher Goss, who gave me an open lung biopsy and found the granulomas and fibrosis in my lungs to prove Sarcoidosis added to emphysema (COPD)

When I had a sudden loss of ability to breathe, the local pulmonologist just handed me a steroid inhaler to add to the others he had prescribed and I was on my way out the door.

Mom’s worry. My mother worried that her daughter all of a sudden lost even more ability to breath and nothing was being done. She strongly pushed for me to get evaluated through the U or the Mayo Clinic. We needed to know.

I went to the U. The following letter is a direct quote from a Thank you card I have written out but forgot to leave there last week after my appointment.

Dr. Raghu –
Dr. Goss –

“Thanks for all you do for us now and in future to make the next generation of lung patients fewer, I hope, living quality lives.
When I first came here I never expected to live out the year much less be here years later and looking at tomorrow.”

The doctors at the U are open minded, they look and think about the entire body, not just lungs. Had I not gone there, I would not be sitting here now.
Their doctors are open minded and actually THINK. They treat their patients like partners in their own care and work together.

The old type doc and his “I Tarzan, You Jane’ mentality is over. Patients have a right to be involved and understand what is going on and what they can do to help themselves.

The University of Washington offers stellar, quality, educated medical people and professors. Who wouldn’t want the best training available?

That said, my own primary care doctor, Dr. Eady, is right here in town. If she ever moved I’d have to move too…same with my pulmonologist at the U. They, and others, are examples of medical care and caring not easily found these days.

I haven’t even touched on the superb Nursing Program at the U…in fact they lead THE COUNTRY…ask US News and World Reports…they are #1.

Is this what you call ‘elitist?

University of Washington – you rock!

Read more: http://www.kitsapsun.com/news/2010/jun/09/my-turn-is-university-of-washington-only-for-the/?comments_id=233309#ixzz0qyxBonTy

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Lungs Win the Fight Against Fat

Sharon O'Hara

If we are in a boxing match, Fat in one corner, and Lungs in another, Fat wins every time.
Why?
Fat takes up the chest room Lungs need to expand and for lung patients, fat compromises our ability to breathe.

The fat v lungs slammed home to me a couple weeks ago when a granddaughter, taking a new class on her way to becoming an RN, told me she just learned that each pound of excess fat is fed by SEVEN MILES of blood vessels.

I went online that night and found an airport-scanned photo (Digg) of a 250-pound woman next to a 120-pound woman. Fat filled her stomach and chest crowding her lungs and heart. Heaven knows what all that fat is doing as it surrounds and crowds the kidneys, bladder and other organs….it cannot be good!

Look, fellow Tubby’ettes and join me. To date, I have lost 133 miles of excess blood vessels supporting nineteen pounds of excess fat.
Regular Tubby’ettes is lucky if their health is not yet compromised.

Lung patients, easing the fat surrounding our lungs will not change the PFT numbers, but we are bound to feel a sigh of relief from our lungs as the fat around them retreats and they can finally expand to capacity and add to our quality of life.

********************
Obesity and the lung: 5 • Obesity and COPD
Thorax 20 08;63:1110-1117 doi:10.1136/thx.2007.086827
Abstract
Chronic obstructive pulmonary disease (COPD) and obesity are common and disabling chronic health conditions with increasing prevalence worldwide. A relationship between COPD and obesity is increasingly recognized, although the nature of this association remains unknown. This review focuses on the epidemiology of obesity in COPD and the impact of excessive fat mass on lung function, exercise capacity and prognosis. The evidence for altered adipose tissue functions in obesity—including reduced lipid storage capacity, altered expression and secretion of inflammatory factors, adipose tissue hypoxia and macrophage infiltration in adipose tissue—is also reviewed. The interrelationship between these factors and their contribution to the development of insulin resistance in obesity is considered. It is proposed that, in patients with COPD, reduced oxidative capacity and systemic hypoxia may amplify these disturbances, not only in obese patients but also in subjects with hidden loss of fat-free mass. The potential interaction between abnormal adipose tissue function, systemic inflammation and COPD may provide more insight into the pathogenesis and reversibility of systemic pathology in this disease.”
• Review series
1. F M E Franssen1,
2. D E O’Donnell2,
3. G H Goossens3,
4. E E Blaak3,
5. A M W J Schols1
1. 1
Department of Respiratory Medicine, University Hospital Maastricht, Maastricht, The Netherlands
2. 2
Division of Respiratory and Critical Care Medicine, Department of Medicine, Queens University, Kingston, Ontario, Canada
3. 3
Department of Human Biology, Nutrition and Toxicology Research Institute (NUTRIM), Maastricht University, Maastricht, The Netherlands
1. Dr A M W J Schols, NUTRIM School for Nutrition, Toxicology and Metabolism, Department of Respiratory Medicine, University Hospital Maastricht, P O Box 5800, 6202 AZ Maastricht, The Netherlands; a.schols{at}pul.unimaas.nl
• Received 15 February 2008
• Accepted 30 April 2008
• **************************
• http://digg.com/health/Body_Scans_of_a_250_lbs_Woman_vs_120_lbs_Woman
More later… Sharon O’Hara

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Cancer Survivors? Yes. COPD Survivors? No.

Sharon O'Hara

A government controlled Health Care System is Shudder Worthy and may have inspired the recent letter to the editor from a breast cancer survivor and doctor objecting to the cut back on mammograms for women. Their letter prompted mine and I am posting it again here.

People may not be aware of the real life discrepancies between medical conditions and one is not better or worse than another. They are all challenging to the patient and her/his medical team.
The difference is in the research and patient education.
Perhaps one day a patient can say, “I am a COPD survivor.”
For now, there are no COPD survivors.
******************************
“Debbie Belew-Nyquist, Ed.D., Bremerton and Joseph L. Johnson, M.D., Silverdale should be applauded for speaking up for their belief.

My sincere congratulation to all cancer survivors, especially lung cancer survivors.
The lung cancer patients have a higher fatality rate, I understand, due to lack of reliable early detection testing. By the time its detected, the disease is advanced.

That said: COPD (Chronic Obstructive Pulmonary Disease) kills more people per year than breast and lung cancer combined.
It is the 4th leading cause of death in the U.S., 5th in the world.

A simple and inexpensive Spirometry test done in any doctor’s office offers early detection of a disease that generally takes twenty years before a patient develops symptoms bothersome enough to mention the shortness of breath to their doctor. By then, they have already lost about 50% of their lungs.

The Spirometry test is inexpensive and offers the patient knowledge they have COPD. Early warning testing gives most patients the opportunity to stop the disease from developing further.

The glitch is many doctors will not use it, I’ve been told, because they do not believe the patient will make life style changes to stop the disease.

I think they sell us short – the Spirometry early detection, nay-saying docs do not give us the opportunity to make decisions.
They most certainly have not given us the opportunity to make the changes.

The Spirometry test shouldn’t cost more than $100.
If the simple test shows that further testing is needed that is more costly, but far less so than allowing the disease to develop further. COPD gets ugly and a slow smother to death.
Worse, the non-rolling stone COPD gathers moss.
The medical ‘moss’ of COPD acts as a magnet for the other disease stuff. Some of it is really unpleasant.

Cancer detection and research development has been alive and well.

COPD (Chronic Obstructive Pulmonary Disease) has little to no research and most of our drugs were developed for asthma, not us…quite a different disease.

“We have come too far than to start going backwards with health care.”

COPD is already backwards. It is time to bring it into the present.”

Read more: http://www.kitsapsun.com/news/2009/dec/20/my-turn-the-real-cost-of-limiting-cancer/#ixzz0bFFMSOk9

More later… Sharon O’Hara
Happy Holidays to all!

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QUALITY LIFE- TOO EXPENSIVE?

Sharon O'Hara

QUALITY LIFE- TOO EXPENSIVE?
CHEAP DEATH – IS IT REALLY?
WHO DECIDES?

Since when does living a quality life for the medically or physically challenged mean too costly for taxpayers?

Living a quality life, to me, means seeing and feeling the world around us…seeing the sparkle and sharp colors of new daybreak splash slowly across the horizon and its new dawn promise, the muted and soft streaks of a sunset inch across the sky at day’s end, the happy, funny gurgle and contented baby coo, a bee’s buzz as it flits from flower to flower, the busy chirp and chat of birds, the cheery tug of anticipation at the shout of “STRIKE ONE!” when your child or grandchild is at bat, the intoxicating smell of freshly mowed grass, an unexpected hug from a friend, the excited bark of a welcome home greeting and the warm feel and tangy smell of a horse and the soft nudge of her head for a carrot treat – all blend together.

None have a price tag. One or more of these things and many more, give a quality life without a price tag.

Yes, for seniors, when major disease requiring intensive treatment costly to the body and pocketbook is diagnosed, open and honest dialog between the patient and doctor is a vital step to making the right decision for each patient.

If the patient is already under treatment for life altering medical conditions and treatment, the patient must be fully informed of the new estimated treatment, length and intensity of recovery, adding the cause and effect to the existing medications and prognosis.

Who should make the decision? The patient knows when his/her quality life is over. For me, it is when I can no long feel anything but the pain …when the world around me ceases to matter…before I can no longer take care of my personal needs and can’t recover…its time.

I know, understand and approve age and other limits on lungs and organ transplants. I don’t get mammograms, apps or colon tests simply because should any prove positive, I won’t do anything about it.

My doctor and I have already talked about quality of life and she is incredibly wise and informs, yet accepts my decisions about my own health care. My family knows exactly how I feel and it is not their decision, it is my life and my decisions.

It is not your decision either. I think the patient’s doctor and other medical professionals – NOT including the government – need to present the facts to the patient in a kind, straightforward manner and let the patient and medical team make the decision regarding treatment or no treatment.

IF the facts are presented properly and honestly in each case, very few, if any, senior patients would choose to undergo serious surgery, intensive recovery time, loss of ability to care for their own personal hygiene and waste what remains of their time on earth. Each situation is different and individual.

I was once present when an elderly patient was taken to the emergency room. He clearly had dementia, yet was given – it seemed – a test on every new and old machine in the hospital. One scene stands out in memory…the technician reading aloud the instruction booklet as she hooked the patient to the machine. None of the tests were productive. I’m sure it was an expensive visit.

Keep terminally ill folks comfortable … but all these things should be discussed with the PATIENT long before emergencies and urgency cloud the overall issue.

I doubt my grandmother had much quality of life after she entered the nursing home. Her false teeth were stolen along with other personal items. She fought to get out of bed and walk until she was drugged to keep her compliant and easy to care for. Soon she couldn’t get out of bed by herself and was eventually spoon fed and diapered.
Quality of life? She was over ninety, did not recognize anyone and had forgotten how to speak English. The grandmother I knew was gone.
Why hadn’t she been allowed to walk and maintain a quality of life? Too expensive?

Keep government out of health care and a single pay. Let the free enterprise system flourish and see the health care costs diminish and patient care increase. Let the insurance companies compete for business across the nation. Allow our system to work and use the system we already have in place to correct and make the needed changes. NOT GOVERNMENT.

Remember the $600 toilet seats government bought and regular folks only paid about $50 for the same seat? How about Social Security? How many years before its bankrupt and the people paying into it now will probably never get to use it?

How has the government run Clunkers worked out for our tax dollar and the economy? Well, a lot of folks bought, free, thanks to the Clunkers program, electric golf carts.

Medicare is government run…is it successful?
Please.
The government run Medicare and Medicaid is the reason the medical profession is the only profession I know of in this country that is penalized for being in health care and treating seniors and Medicaid patients.
Patients are cheated, physicians and health care professionals are cheated…and some cheat in return.
Keep government out of the health care business… for your kids’ sake.

No one in this country is denied health care…hospitals have shut their doors before or after the bankruptcy for treating patients without payment. No one is turned away. However, how long can any organization last without revenue?

In addition, ask yourself how long a civilization can last or should last, if their citizens are evaluated and cared for based on dollars not spent?

Frank and open honest discussion with the patient – educate them – will make a difference…not manipulation based on dollars. .

NO to government health care.

More later … Sharon O’Hara
This blog post was an answer to a post on Rob’s blog and tantalizing title: http://www.kitsapsun.com/news/2009/oct/16/rob-woutat-a-dying-person-needs-death/

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The Swine Flu May Love Obese Folks Best

Sharon O'Hara

Greetings …
The Swine Flu may love us to death.

It seems that a study for one thing led to a surprising discovery directly affecting the obese and the Swine Flu and I care because after quitting a forty-year smoking habit, I grew eligible to join the lofty, spread out and huge Tubby Club and have a personal health interest in this study.

“…the cases of 10 patients at a Michigan hospital … were so ill they had to be put on ventilators.
Three died. Nine of the 10 were obese, seven were severely obese, including two of the three who died”
(EFFORTS Newsletter 13 Autumn 2009)

I have been waiting for this news to become public beyond the Centers for Disease Control and Prevention weekly report, but if it has, I’ve missed it.

In the meantime, the Swine Flu is here, real and we tub’ettes need to discuss these findings with our doctor and/or call the Health Department.

The following is taken directly from the autumn 2009 EFFORTS newsletter, verbatim. Thanks JJ and EFFORTS.
*************************************
OBESITY EMERGES AS RISK FACTOR IN SEVERE FLU
People who are obese but otherwise healthy may be at
special risk of severe complications and death from the new
H1N1 swine flu virus, U.S. researchers reported on Friday.

They described the cases of 10 patients at a Michigan
hospital who were so ill they had to be put on ventilators.
EFFORTS Newsletter 13 Autumn 2009
Three died. Nine of the 10 were obese, seven were severely
obese, including two of the three who died.

The study, published in advance in the Centers for Disease
Control and Prevention’s weekly report on death and disease,
also suggests doctors can safely double the usual dose of
oseltamivir, Roche AG’s antiviral drug sold under the Tamiflu
brand name.

“What this suggests is that there can be severe complications
associated with this virus infection, especially in severely obese
patients,” said CDC virus expert Dr. Tim Uyeki. “And five of
these patients had … evidence of blood clots in the lungs. This
has not been previously known to occur in patients with severe
influenza virus infections,” Uyeki said in a telephone interview.

Dr. Lena Napolitano of the University of Michigan Medical
Center and colleagues studied the cases of 10 patients admitted
to the university’s intensive care unit with severe acute
respiratory distress syndrome caused by infection with H1N1.

“Of the 10 patients, nine were obese (body mass index more
than 30), including seven who were extremely obese (BMI more
than 40),” they wrote in their report.

Their study was not
designed to see if obesity or anything else poses a special risk
factor for flu. But the researchers were surprised to see that
seven of the 10 patients were extremely obese.

MULTIPLE ORGAN FAILURE
Nine had multiple organ failure, which can be seen in
influenza, but five had blood clots in the lungs, and six had
kidney failure.
None has fully recovered, the researchers said.

The H1N1 swine flu virus first emerged in Mexico in March
and was spreading out of control in the United States by the time
it was identified at the end of April. The World Health
Organization declared a pandemic in June.

While it is causing moderate illness, all influenza viruses can
be deadly and this one is no exception. It has killed close to 500
people globally, more than 200 in the United States alone.

However, the new virus has a slightly different pattern from
seasonal flu — it spreads in the summer months, attacks young
adults and older children, and may affect the body slightly
differently.

As with H5N1 avian influenza, which only rarely attacks
people, patients seem to survive better if they get Tamiflu for
longer than the usual five-day treatment course, Uyeki said. “We
don’t know if it is necessary for a higher dose of the drug to be
given to patients who are obese,” he said.

“The high prevalence of obesity in this case series is
striking,” the CDC’s commentary accompany the report reads.
“Whether obesity is an independent risk factor for severe
complications of novel influenza A (H1N1) virus infection is
unknown. Obesity has not been identified previously as a risk
factor for severe complications of seasonal influenza.”

http://tinyurl.com/nugz9h
http://www.emphysema.net/Newsletters/Autumn2009.pdf

Talk to you later… Sharon O’Hara

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Update: Good News, Better News and a Puzzle

Sharon O'Hara

The good news…Other than dust and debris in the water from the reservoir, nothing of note was found in the water from the Bi Pap reservoir or from the water from a sealed bottle of distilled water my husband delivered for me to the Twiss Laboratories in Poulsbo to culture for contaminate evaluation.

The better news… The many, out of date unopened bottles of distilled water we have are still good to use.
The puzzle is that I don’t know what the whitish globs of _______ ? were that flowed out of the bottle of distilled water when I refilled the reservoir.

The dust in the reservoir can be explained by the fact I did not change the filters often enough. And, similar to a vacuum cleaner we used to have, the water in the reservoir filtered the dust not caught in the filters. The air flowing through the hose into my mask was dust free and moist…a good thing for airways.

I also called my BiPap server to be sure I had the filters set in the machine properly. Yes, as it turned out.

Did I make too much of seeing the globules in my BiPap reservoir? Maybe.

However, I will continue to be reasonably careful to not hasten further demise of the only lungs I have. Damaged, they still work.

More later… Sharon O’Hara

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