INSOMNIACS place to talk in the wee hours
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Rose, yes, all plans can fail when not followed. So many unknowns about Texas Health Resourses. They have been caught in so many lies the first week with Duncan, now no one will believe them.A ways back I said I was very happy about not being a nurse right now. There are only two places in the country prepared. Emory and Nebraska. Their Bio-containment units are so far superior to what is available elsewhere. it's not just the units --it's the training. it's the difference between a Lexus and an Escort
On CNN, they showed a hospital going through a drill. The PPE Personal protective equipment wasn't even close to the CDC recommendation. Duh. I sat there in disbelief.
I'll link an article that tabulates healthcare workers deaths in Africa. Not good. Of course they are different than here. But eventually healthcare workers are going to catch on to the risk. I'm so pissed that all the big wigs are laying problems off on the Dallas Nurse and Teresa Nursing assistant in Spain for not following protocol. Chit.
One on the centers in Africa that the USA is building is for healthcare workers. Which will avoid taking them off the continent.
The commonality of survival is ---early recognition, receiving a plasma transfusion having antibodies from a survivor which kick starts the immune response, and one of the experimental vaccines. My opinion.
The positive outcome of this is that infection control training and understanding of the transmission of disease has been sorely lacking for a very long time. If someone believes that statement isn't true. Wrong. Medicare has come down on hospitals very strongly in the last few years. If an infection is traced to a hospital, they don't get paid for an entire admission. Plus, the hospital is not allowed to bill the patient. Money regretfully, has been a driving force for hospitals to improve. Hospitals have been attempting to beef up controls. This is a horrific way for naysayers--hospital managers to allow proper training to occur, but it will improve all care in the USA.
And just maybe another STUPID government offical won't decide to kill the dog.
Excalibur will go down in history.
I predict that the existing Spanish Government will fail because of the way Teresa Rameros and Excalibur have been treated. The Spanish people are pissed. Seriously pissed. There are many dynamics in the fray, Teresa and Excalibur are now the fuse for the populace. So, when the government falls, don't think it was just because of the two. Much more will have caused it.
Hmmm well, anyone for tea?
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Oops here's the link. numbers are off the charts
http://time.com/3453429/ebola-healthcare-workers-fatality-rate/
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I agree with what you have said. I just remember being suited up for work with TB patients and jeez it's so hot and claustrophobic in all the gear. The mask steamed up my glasses... Crazy hard to work in all that PPE. Methodically taking it all off so you don't contaminate yourself is tough. Then add to the misery the heat of West Africa and the lack of AC in the buildings. Miserable. Resistant TB is every dang bit as terrifying and deadly as Ebola... just kills you slower. Some of the strains they can't offer any treatment. I mean I have stage 4 cancer and HIV looks better than that. Can't believe I said that, but you can live longer. People's perceptions are often goofy and based on hearsay. Fear is irrational.
I have worked in hospitals for years and while they do much good and save many, my mantra is get in and out as fast as you can. There are so many bugs and things to catch it isn't funny. My Dad ended up with MRSA & VRE and particularly nasty strains and even had some experimental drug with just numbers from the CDC. He got that somewhere between the local hospital and the VA.. pitiful. Complicated everything. Life has risks and there is no way to be completely safe in everything. Not possible. Human error will always be there. As some one pointed out just seasonal flu kills more folks world wide every year than ebola.
The only way anything will improve is by being completely transparent about any and all mistakes so they can be avoided the next time. There will be a learning curve with treating Ebola. Covering up mistakes up is deadly stupid. Better to learn from them. Our culture doesn't appreciate learning from mistakes and penalizes folks/medical facilities when mistakes occur. It will be most interesting to see how things play out. It was insane to have killed the dog. They should have learned from it and kept it in isolation. Another lost opportunity to learn about this disease based on fear not science. I worry about the troops sent to help because they don't have the back ground to protect themselves. I hope they are training and drilling them. I will say when they write a book about this out break it will be a stellar read - rival Dan Brown's novels.
Good night owlettes.
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Sleep well Owlettes...
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Okay it's official. I am now an insomniac. Last night was just up, and down.... and dreaming in between times! I dreamed of the craziest scenario's you could ever imagine! Glad I'm awake and drinking coffee, and complaining to you guys.
And I'm worried about Theresa.... Her DIL answered my email, and sort of let her hair down...and she is frustrated, because of running out of things to help her feel better. I don't think she can be "fixed"..... and she is thinking that too...
It's all that has happened to her this past year.... Trying so hard to take care of their house, AND Eddie, and then him having to go to Assisted Living, and then her stress over that and the up and down BP, dizziness, and just being afraid. Then SHE moved to the same place, and her eyes.....she is almost blind. That Macular Degeneration is just not slowing doen... Her Son and DIL and I have tried to get her "new" glasses, like Binoculars that are supposed to help, but they don't.... Now this NEW type, she saw on TV.... Her DIL ordered them, but we don't think they will be any different than the last 2 pair...
When we go, I love to see her, and I sit on the floor in front of her recliner, and talk to her, and just want to make her laugh... She jokes, and says "I feel so bad sometimes, I must be dead!" And I tell her.... "No, I think you have to get better before you can die" and she laughs..... She doesn't move around hardly at all.... And she doesn't want to go down for her meals now.... It's like I'm trying to help her, just like her DIL is...!
All I can do is be there for her.... and call her, and just listen. I don't think there is one cause, that is taking her down like this... She is 92, and things are just going hay-wire. But what else can you do? She has to just hang in there... and we have to just listen, and help when we can, I guess.
Last night, she called, and I said "Well thank God you ain't dead yet!" And she just laughed.!
That's all I can do.... just listen, and make her laugh.0 -
Wow, I slept til almost 7 this morning! Its rare when I get to do that!
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Chevy, sorry, you and Theresa are in such pain, You have been such a good friend to her.Rose, I agree, the media is hyping to healthcare workers being ill in Texas and Spain. Negating info on all the others. Troublesome. Slanted reporting. Supposedly, our soldiers are setting up treatment facilities. They aren't suppose to be involved with patients. So, hope nothing happens.
The repatriation of Ill HC workers, while humane is shortsighted overall. May sound farfetched, but I believe they should have a bio-containment center on an island someplace that is equivalent to Emory and Nebraska. All facets could be contained. Meets the need to take care of he ill HC workers. Yet limited literally by the surrounding waters. And a separate place on the island that each person has to go through a 21 day quarantine before disembarking. A tiered movement system.
Sorry about your Dad. Awful. Sounds like he survived?
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Morning Paws and MommyEveryone have a good week
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Mornin' sas!
Gonna have a good one!
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Sas-shatzi- no my Dad died 2006. He was kind of a train wreck at 74. So it was a blessing. I do very much enjoy the coverage of this ebola illness. Not because I enjoy seeing folks suffer (no we see/ feel enough of that here in cancerland) but because learning how to contain and protect patients and staff from things like this helps us all.
Momyof2- lucky duck you slept until 7AM! I am jealous.
Chevy - Join the insomniacs - I got to bed at 11:30pm up at 3AM - the cat walked across me. Then wide awake at 5am... 10 mg melatonin at 11pm and another 10mg at 3am... what a joke. My eyes hurt I am so tired.
Cold this morning... Fall is here! Have a good day ya'll!
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Earthquake woke me at 7:30... But I did get a four hour nap yesterday. Steroids today.
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Mag-earthquake??We had bad storms last night, wind gust shook the house and blew the fence down. Woke me up and scared me!
This morning was nuts!! Oldes dd brought home 2 kittens, munchkin kittens and she did it w/o asking...she knew I would melt when I saw them. Anyway this morning, one of them got their little heads caught in the recliner and little dd thought it was her fault. Big dd was panicking and we finally got the cat out. omg....i'm ready for a do-over!!
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oh no! Earthquakes, fences blowing down, kittens getting caught, not a good way way to start the day or the week!
I think I got a bug at the hospitals last week feeling icky.
Looked at Yahoo and look what I found:
https://www.yahoo.com/travel/breast-cancer-road-tr...
Knew it had to be Vinnie when I read the title. Something a little cheery to start the week.
Have a great week!
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and coffee!
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Local media has released the identity of the 2nd Ebola pt. 2010 graduate of TCU Harris College of Nursing. Where I graduated. Local media totally saturated so much with that news that severe storm news is only 2nd fiddle today. Stayed up till 3 am as storm blew thru. Nasty heavy misty morning. 58 degrees. It was 100 here last Tuesday.
I saw that story on Vinnie. Knew it had to be him from the opening lines.
Mags - Today's Earthquakes is one of the tabs I open daily. N Texas had it last year but OK has had a bunch more than we had. Per the earthquake specialist hired locally they continue here but just below level of what is reported.
I totally agree that the more isolation equipment you put on the harder it is to get it off correctly. Local media reports using resp. isolation procedure too. I had an oddball flu pt in respiratory isolation. We had a reverse flow room - the unit I worked on was totally revamped to open as a palliative care unit and I think it was added then. It had been a step down ICU but I had not been in that part of the hospital in prob. 20 years since I wasn't working. Since we worked 7 on (yes 7 on- 7 off 10 hours shifts) I had this same pt for nearly the 7 days. She had the heat in the room cranked up too. Talk about sweaty pie that was me.
2TA - love the smack up the head Bam Bam (I think that's who - not up on my Flintstone char.).
I copied this from somewhere yesterday. Might have been on BCO but I think from elsewhere. Quote from St. Therese of Lisieux:
"Today, may there be peace within. May you trust that you are exactly where you are meant to be. May you not forget the possibilities that are born in yourself and other. May you use the gifts that you have received and pass on the love that has been given to you. May you be content with yourself just the way you are. Let this knowledge settle into your bones, and allow your soul the freedom to sing, dance, praise and love. It is there for each and every one of us."
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Was so busy this morning getting ready for my appt. I forgot to have my coffee!
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LMG, it was a 4.3, about 6.5 mil north of our suburb. We are having a veritable monsoon here, pouring rain, wind, and just general nastiness. DH came home to get some work done (at his office it's endless meetings). I'm thinking a good day to curl up in the recliner with a bowl of soup. Chemo tomorrow, last one. DH is coming for the bell ring, I asked him if he was taking me out to dinner. He didn't think I'd feel up to it, and I might not. But he could offer, right?
On another note, I'm wondering if this is really pneumonia that I have. I finished the Zpack, on the 4th day of Avelox with no change, not coughing up anything, and more than being out of breath after any exertion, it's more like my heart is just racing. And nothing grew in the cultures. Any thoughts? Sassy? LMG?
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Mags - Could be viral. Not sure what blood cultures show for pneumonia. Might not grow even if bacterial (actually would hope it wouldn't grow so then it's not systemic). Have you taken your pulse to see if it is racing? Mention that tomorrow at chemo - well more than mention it - chew on them a bit about it. How's your RBC (red blood cell) count? Again I've never done oncology nursing - just throwing some ideas out. Try to give some specific example - it takes this long in minutes to recover when I just get up to pee. When I shower I have to ---- . And what has changed from when you were feeling mod. well (as good as you can with chemo) a couple of weeks ago. Can't remember how it was diagnosed - simple chest Xray? Easy to repeat. Yes more radiation exposure but if you're not getting any better might be needed.
Gosh I don't think we ever got one that big. I only felt one just a sharp jolt. DH and I joke about people incinerating aerosol cans but this was about 9:30 at night. Mid afternoon on a weekend I would prob. have thought nothing of it. If you keep your tablet/laptop open all the time this reports down to 1.5 magnitude I think.
http://earthquaketrack.com/recent
US Geological Survey has a good one too but only starts at 2.5 mag.
Mommyof2 - DH has coffee on timer. No way to forget. May need to make some fresh. I have one of those Melitta cones. Make boiling water in micro, pour over grounds. Yup sounds like what I need. But AC has not been on all weekend. Little break in the elec. bill.
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What time was the earthquake...wondering now if that was wind or an earthquake that made my house shake!!0 -
Tang - I don't think around here. Up in Oklahoma. I think the last one we had was around Irving maybe several weeks ago.
Sorry about the fence going down. I saw lots of damage on Twitter. We had only a brief hard wind and I've seen much worse.
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It was 7:24am actually. DH didn't feel it at work, so you probably didn't either. It was 6.5 miles n or Edmond, OK.
My counts have been good, even what they took at ER, all counts normal. Probably not the best day to check my pulse with the steroids. Just did, and I've been sitting in the recliner, absolutely no exertion, pulse is 108. I will take it after walk to bathroom just for comparison though. Dx was done with CT/dye. ER doc said he couldn't see it on X-ray, but saw "scattered" pockets on CT. MO said he could see it on X-ray, and they will do another at cancer clinic tomorrow for comparison. I have no wheezing, just takes an effort to breathe deeply. ER doc said my lungs sounded clear. Tis a mystery, eh?
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Walk to bathroom & back, pulse is 128.
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DING DING DING
MAGS!!!!!!!!!
I had what I thought was bronchitis. Was at docs a few times, different ab's each time. Hard, non productive cough. Got winded going to bathroom. Sound familiar?
Wasn't till my 3rd visit, complaint about my leg being hot, swollen, painful his light bulb went on.
He said, go on down to the hospital, we'll call & tell them you're coming.
Pulmonary embolism. Blood clot in lungs and legs.
Please go to ER and get checked out. I spent 3 unhappy days in hospital.
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Spookiesmom, no swelling at all, or pain. I'll be at clinic tomorrow so will see. Omd. Sure hope it's not.
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no the pain was in leg. Thought I had bronchitis was blood clot in lungs.
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P L E A S E!!!!!!!
If it is a clot, and it moves, could go to heart, no more Mags
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Mags, I'll take a shot here. Not a PE.pulmonary embolism. You don't fit the profile.Your symptoms difiiculty breathing after exertion, tachycardia(fast heart rate) resting 108 increasing to 128 with exertion. Not coughing anything up. (you don't define cough--constant , intermittent, paroxysmal--sudden without control).
CT test showed scattered findings in the lungs. Counts good. Physical exam by ER doc lung sounds clear. No complaints of leg pain.
Peripheral blood cultures were actually not indicated because you didn't have a fever. A fever would have indicated systemic symptoms and blood cultures are used to dx bacteria in the blood. Viral cultures take a long time.
Doc likely did them because you were a chemo patient and the temperature regulating mechanism can be faulty in the young, the aged, and the immuno-comprimised.
When I said it was cool they did cultures , I thought it was sputum---sorry, assumed because they were evaluating respiratory problem, it was sputum. That would have been logical. Love sputum cultures b/c they define what you are dealing with. If a bacteria were present and it was a valid sputum(gunk from the lungs--not spit), it would have cultured up. If a sputum culture is done after antibx's have been started a bacteria may not culture up.
Recommendation: get the radiologist reading of the CT and the Chest xray. ER docs and in your case your Mo may do a reading. BUT that is considering a preliminary reading. The radiologist is the definitive. Mo's are Mo's unless they are also board certified in radiology
Once you have Radiologist report then the next step can be taken.
Changes in heart rate and breathing have to be put into context of all the other findings and the treatments.
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