INSOMNIACS place to talk in the wee hours
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Whew
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I second that Spookie!
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Dear Insomniacs and Maniacs....and any other ACKs,
I really am alive! I know that Sassafrass has kept you updated on my sadsackself. I will never catch up here so I won't even try. That seems to be my new motto: Is it difficut? Screw it! It's nice to see that chemo has not changed me.
I love you all and miss you.. I'm just to lazy to do the whole logging in thing...and anything else. I'm on my week off of chemo so that may be why I'm typing.
Chevy and Cammi, you made me snort on page 605. Thank you! (there was no snot involved)
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hi phillwemissusomuchgraham, rest up on your off week..hugs and prayers to you !!!!!!!!
Holeinone....great pic..jealous
I got so much done today. Amazing what sleep can do for you.
Hope all that are not feeling well, are on the mend.
Chemo tomorrow, so I will have a beddyby break for a few days. Well, actually a week.
Talk to ya soon..bye bye
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Just finished watching the news. Sometimes the richest folks do pull through for the common effort - the 25 million Face Book sent to the CDC and the other 29 million from micro soft I think (20 million this week and 9 million last week if I have my numbers correct). How cool that they are helping fund a response to Ebola. I love to see folks coming together to help. Wonderful. We are all on tiny earth together. Super cool they are taking care of Bentley the dog and the Texas nurse received the antibodies from the other missionary doctor. Hope that young nurse pulls through. I was appalled by the mask they had them wear. They showed it on the news. Inadequate, just a shield and open on 3 sides. I can't get over that. Now I think they will call in teams and move the positive patients to the 4 containment institutions best able to care for them. Yay. Sas Schatzi - you were right it appears the antibodies were given to most of the survivors. Duncan didn't get them because of some concern over compatibility.. I don't understand that.
Hope everyone sleeps well, at least 5-6 hours. Night Owlettes. Be well.
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oh yeah! I have to go in for jury duty tomorrow.
Sleep tight everyone.
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Rose, the control of the doc's in the management of Duncan may have been the reason he didn't get a transfusion. Whether there was a CDC doc on the management team to make the suggestion that a transfusion would be warranted may have caused it to happen. But the management team in Presbyterian did they think of it. In the USA with the cases at Emory and Nebraska even while Duncan was being dealt with, the two successful bio-containment groups were in the midst of developing protocols. But Emory and Nebraska did transfusions of plasma early. There success is going to lead everything hereafter.
So much as happened so fast. The common factors are again. 1. early recognition and isolation. 2. survivors received a transfusion of plasma from a survivor. In that plasma was antibodies, that kick starts the immune system response . 3. antiviral medication. What is unknown to the public is the other management of all the systems. How was fluid management maintained.
What many docs on a high high level right now are comparing is the management of Duncan, Teresa, and Nurse Pham. It's not that this hasn't been ongoing, but there is a difference now. It's outside the Africa's. Ebola has only been in Africa. Now, it's not contained. Predictions are dire in Africa for development of the disease within 3 months.
The two stars in Africa are Nigeria and Firestone. Nigeria nipped Ebola in the bud because of the infrastructure to fight polio. Firestone because they had one man, the man in charge, who knew how to use the internet and his management structure on the Firestone rubber plantation in Liberia. The Firestone Rubber Plantation has 80,000 people. I wish I could state that managers name here. He stopped Ebola at ONE. They have treated more, but they came from outside the Firestone plantation. I linked that many pages ago.
I believe that while the family is questioning the treatment of Duncan and Jesse Jackson is trying to make it racist. It will come down too not enough known for the exact time that Texas Resource Hospital was in i.e. if Duncan's scenario had occurred a couple of weeks later the, fact that a plasma transfusion would have helped, he would have gotten it. Bottom line NOT enough known for that two weeks.
What many are looking at is the survivors in Africa. Why did they survive when there whole families died? How did their treatments compare to side by side patients. Is their something about the survivors that gave them an advantage? If their is an advantage how can that be used? I've sent these same questions to the CDC on their website. Plus many more thoughts. It's a for there eyes only type thing because it's things that could cause undue harm by causing anxiety to regular folks, but the CDC needs to think of.
One that's easy to talk of is, if the transfusions has been a benefit to survivors here in the USA. What is happening in Africa? Why not use transfusions of plasma with antibodies from survivors to help the sick? There is a stigma attached to the survivors because of African beliefs. Rather than being seen as valuable survivors, they are seen as "something evil". Their blood right now can turn around this epidemic.
It's a two for one: 1. Halt the epidemic by transfusion of plasma to the infected 2. The stigmatized become the saviour's(sic). There is a public health issue that is resolved and a societal problem of association with the disease.
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Phylissishere!!!notintheklinker!!!!! Yah, happy to hear from you ! We miss & love you back! Keep in touch when you can, hang in there with the shitty tx & give them hell !!!
Susan, hope the chemo is gentle, catch up on whatever brings you peace, crap TV, old movies, dirty books...I got hooked on Words with Friends, during chemo. Does anyone here play? It's scrabble. I am not very good, but I still play a lot. If anyone here wants to try it let me know, I have always liked the game, just not a word wizard. I have a acct. & can play anyone that also has it on there computer or IPAD, iPhone.
Rose, I am on the 8-9 hour sleep plan. It is probably more than necessary, but it works for me. I can certainly function with less, but not for more than a few days.
Mags, sorry you missed out on your LAST chemo....arrrrg, it will be there when you are ready. There is no bell at my center, just a certificate of completion. Such a strange, difficult thing to think you are done with. My heart & soul are guarded on that one.
Night to all....
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Mags, because it says a dx code of pulmonary embolism it doesn't mean that you were actually a patient that had a serious consideration for a PE. I hope I can explain this well. Because Spookie's mad at me, and I love Spookie.Generic patient entry into ER with respiratory complaint. Standard minimum CBC and BMET and chest xray. Depending on Physicians assessment a CT. In order to get reimbursement for the CT they have to give a diagnosis that that will cause reimbursement by insurers. They can't use the term rule out pulmonary embolism. They have to use the term Diagnosis: Pulmonary Embolism.
What happened in the last 20 years is Er docs learned to depend on CT as a "cover your ass", CYA, for everything chest and abdomen was order it, using a qualifying diagnosis --covered their ass.
In 2004, The national regulating body of radiology published a position statement on the overuse of radiologic procedures that exposed people to too much radiation. One Ct scan is the equivalent of 200 chest xray's. One of the goals of the publication was to educate ordering physicians in the more judicious use of CT. I came across the publication on Medscape in 2006 doing a search on something else. I watched what was happening.
THEN I became a BC patient in 2009. The number of CT's ordered were amazing. My question always was "Is there another imaging source available. i.e MRI or Ultrasound. In the first three years after I was dx'd I was given a PET scan . In the third year, Part of the canned statement was we are now going to do a Cat Scan and then the Pet scan begin. I was shocked. I hadn't studied PET scans. Low and behold, I screwed up. I didn't know that part of the PET was a CT. I missed the amount of exposure I was getting with a PET.
Interestingly to me, my Mo when questioned about a PET after that avoided the question. Didn't say it wasn't indicated, just diverted. I know there is controversy about usage now, but can't say b/c I'm not current on the literature. My MO stated said we didn't need to do PET scan any more. Was it because they weren't needed or because the 2004 implications of radiation exposure finally made it the training to the ordering physician? AND why was the addition of the phrase "now we will do the Ct scan before we start the PET scan. AND AND what is the Radiation exposure of PET scan. Since I was at the end of needing PET's I decided enough--I don't want to know.
The difference between you and Spookie's s/s' s was stark.
If your CT had shown evidence of PE's you would have gotten the same treatment as she did. You wouldn't have left the ER
But based on your entry symptoms to ER, I think your symptoms didn't warrant a CT. But I wasn't there for your initial evaluation. I have however been under the same circumstance and had a spiral CT for PE. It was long before the 2004 radiology paper was produced, and I concluded in retrospect it was a CYA test. Again CYA is a cover your ass test.
What we must protect ourselves from is "cover your ass test" Radiation is radiation. If it is truly indicated-yes. CYA -no
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Sandra in u r pocket tomorrow hugs
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Spookie your case was different than Mags------please, don't be mad at me . Mags did the right thing when the unknown was present, she sought care, That WAS EXTREMELY IMPORTANT, her care was similar to yours, her outcome was different. If her CT had shown a PE they wouldn't have let her leave the hospital. Your's showed a PE, you got a filter, you got Coumadin. NOT all cases are alike.
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OMG! Phillywiththeanklebracelet has been bailed out! Who KNEW! SOMEone has posted her bail! Probably those kids all got together that she used to splatter with her paint-ball guns from her front porch! She called US maniacs? Is this the pot calling the kettle black? Well SHE should KNOW.... by the way.
Miracles DO happen! Cammi, did you hear THAT? I wonder if BIG ALICE, or was it BIG BERTHA was with her.... I know she was having problems awhile back! Those things happen when you stray from the straight and narrow! Maybe she can give us lessons, on how to NOT run afoul of the law?
ANYway miss phillidink, I'm so glad you are HERE! Just leave that.... um..... friend behind.... we don't like her... probably.
HAPPY DANCE!
Okay let's be Frank and Earnest here.... YOU be Frank, and I'll be Earnest! This Ebola is just not going away... I'm trying to stay under the covers, and not know anything about it, but it's just there! Maybe with all that is going on, we/they will learn a lot more.... I just KNOW if will all be taken care of! Good things are also happening... it's just that too many lives have been taken, from what sounds like in-ept workers and not following standard protocol!
THERE! Cammi, are you still there? I was actually talking seriously there for a minute.
Morning HiHo, Sassy and Smarty! I woke up, was putting in my hearing aids, and DROPPED ONE! MY GOD I ALMOST THREW UP! So DH got up, helped me with a flash-light, and we FOUND it! Those things are like little spiders! I've had them over 3 years, and haven't lost one yet! So now the day can progress...
JURY DUTY? I hope you act like you are down-right prejudice to whatever that person did, and they will excuse you! Don't act smart Smarty!
Susan and Rosie.... Good Morning! We are with you Susan!
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Okay Sassy, I forgot! Do me and Spookie have to meet you for lunch again, and determine who is right, and who is almost right? Or wrong? I forgot what you guys were even talking about!
Spookie.... Just pretend, like I do, that we prefer to know nothing, see nothing, and hope for the best. Go take 2 aspirin and call me in the morning.
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Phyllo, I am thankful you stopped by. I've missed seeing you here.
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Good Morning.
Phylosicko--so glad to hear from u--what u'r going thru is all so strange to me, but then the concept of everything is strange to me. Hoping to hear from u more often. We all miss you.
Chevy I can't get to serious about all this horror of ebola, it's to scary to me and how the hell it got here. I watch to many shows about terrorists to think normally anymore or am I thinking logically? see what I mean.
OK I saw u'r pics, Chevy u have pants on and the FL gals have shorts, true tourism amateurism , but u'r smiles and looks are just beautiful, so glad to see them. Thanks Mods our Chevy really needs lots of help.
It rained all day yeaterday and I loved it--no storms just wet and not to chilly either.
Well as I told u Joey is taking the clarinet, he's no Benny Goodman or Kenny G, more like Joeyit'll never happen--I encourage the triangle but no one listens to me.
Mags it's best to stop and evaluate things and go from there--they're watching out for you.
OK I hve to get set up for work, that means get my 2nd cup of coffee, organized where everything is and most importantly putting my hands in position for prayer that no one calls.
I hope everyone' s day is good.
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Sas I'm not mad at you. Yes CHEVY, lunch for any reason is a good idea. Cami, we TRIED to tell her to wear shorts.
Sas, will call about 1, must pu grands
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Okay, my "pants"..... well at least they were white! I had compression stockings on a lot while I was there, so they would NOT look exactly "stylin' under my shorts, or capri's!
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The workers weren't inept. The PPE wasn't right. Suoervisors were inept and the hospital managers were inept. AND as a result the shit's going to hit the fan.
Early on I said the fault was at the feet of the CDC and NIH. It is. They said they had people on the ground helping in Dallas. They apparently didn't have anyone at the isolation unit. Otherwise they would have known that the PPE was wrong. The would have known the traffic flow was wrong. They would have known nurses were assigned to other patients.
Contact tracing is going to be an absolute nightmare.. Going to bed.
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Well maybe I used the wrong word?
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Sassy - I sure don't understand coding and how they pick/choose. Do know you can look them all up even vaccines and procedures I think. Do they code for the highest (to me that means worst/biggest reimbursement) diagnosis potential? Had to google BMET - you mean BMP right? I don't think I've heard it called that. CMP/BMP for sure.
Susan - hang tight. We're here. Agree with Miss Golf Girl - do what pleases you. How's your DD doing these days?
Smaarty - about time I get another jury duty summons. DH never gets them. I even got one several years ago for federal jury duty. I got cut in the 1st half thank goodness.
Well I guess anyone watching the news now knows we have healthcare worker #2 ill. She - my bet is another nurse. I know the area she lives, looked up the rents. 40+ year old apts but must still be very popular. Friends lived there in the mid 70's. Sassy - I think the hospital contacts are in more isolation that we've been told directly. I bet very limited contact. BUT none of his family shows any s/s and Oct 19 is almost here.
Phyllonotinlockup - Glad to hear you're still ticking along. Cray Cray as ever. Don't stay away so long next time, you hear.
Mags - hope there is something to enjoy the rest of the week with surprise time off. There was a bell to ring at rads but infusion center is in main doc's office so doubt there is a bell. In fact my MO's office is directly across from it so quite certain there is none.
Dutchy - nice to see you this morning.
GolfGirl (otherwise known as Holeinone) - those falls are beeeutiful.
Rosevalley - I think they did use respiratory PPE. I can't remember what pic you're referring to. I read that both Ms. Writebol (I didn't know about her) and Dr. Brantley offered plasma to Mr. Duncan but were blood type incompatible. Dr. Brantley had rec'd an antibody transfusion in Africa.
That should wake us up.
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Morning gals!Yes, 2nd worker is sick and it is just terrible. I know the area too Goats, there are loads of apartments in that area. I'm just not understanding how the family of Duncan has not gotten sick, it doesn't make sense to me but I'm not an expert on any of this.
I am a corporate travel agent and I've had 2 people today tell me they do NOT want to fly thru DFW because of this. Great...people are getting scared even more now.
Phyll-so glad to see you and dutchi you too..and susan and blondie ((hugs)) oh yes cami you too! all of ya'll have been scarce lately
I'm glad spook and sass are still friends
((hugs))
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after driving all the way downtown in rush hour, I was a little late, got out of jury until January 25. Shhhh, I just want it cancelled!
So have to figure out what I'm doing today. Probably clean up my sewing room a little so I can start another dress for my trip.
Sass, how close are you to Orlando? Maybe might take a short cut and hit Universal studio after back from cruise. Still checking out cost and travel.
Hi all. Glad to see phylliy, Dutch and Cami here.
I don't understand why the hospital doesn't know every single person who worked on mr. Duncan. There should be some kind of sign in for every time someone sees him. Same now for the other two.
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CNN is reporting the second health worker flew to Clevland for a few days. What a mess.
I am having a slow, achy day. I did golf yesterday, so that could be part of it.
Yah, we have had our INSOMNIACS checking in. Good to see you Duchchris & Cami & Blondie....
BBL.....
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morning Owlettes! At least it's still morning here.
Smaarty, hoping you make it a special day, great you don't have to sit for jury duty.
Tang, what was the final decision on the Fair? Hoping you and the family got to get out and enjoy the day.
Hi1, hoping you feel better. Share the achy feeling.
Dutch, Phylliswhoishealing, Mags, LMG, Cami, Blondie, Susan, Rose, Jwoo, Blessings, Mommyof2 (who am I missing?) -great to see you all.
Chevy, thanks for all the smiles and laughs. You make my days!
Sassy, thanks for keeping me updated on the Ebola issue, certainly not keeping up on TV.
All this talk of Ebola is making me sick, well not really. But I think 5 days visiting DM and DH in both hospitals did. A day and an evening in ER, I picked up something. Tossing my cookies, chills/sweats, achy, sleeping/napping all the time (so not me), what does a temp of 97.7 mean? Weather was 91* the other day! high 70's today, maybe this adds to it?
Hi Pawprint, hope you're doing well. Nice we have cooler weather, huh?
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Well I just heard from my mom a bit ago. They couldn't set the broken fingers, instead Monday she has to start the process of setting them through surgery! They did confirm that the one that the one finger that they thought had a hairline fracture does indeed have one. The surgeon thinks that it might heal on its own, but he is going to monitor it in case it doesn't. Mom is feeling a bit down over it and I told her to tackle one obstacle at a time. The only saving grace about this whole things is at least it wasn't the hand that she writes with.
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lol
Chevy that picked me up out of my depressed mood about my mom's upcoming hand surgery!
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Okay Momom.... here's another one! Don't worry.... we're all with you....!
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i think this should be shared with everyone, regardless of the situation, it is good advice
http://articles.latimes.com/2013/apr/07/opinion/la-oe-0407-silk-ring-theory-20130407
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