TB Today

24 03 2014

Tuberculosis. Sounds old-timey to me, a disease not of this century.

My 87-year-old uncle had TB when he was a teenager. He was sent to a sanatorium and came back about a year later, more or less healthy.

In those days, TB was the leading cause of death for teens and young adults. He was lucky to survive it.

Today, TB hasn’t dropped down the list much. It’s still a killer, and holds the number two spot in the world for leading cause of death from infectious disease.

One million kids get sick from TB each year. The World Health Organization says that in 2012, about 8.6 million people developed TB and 1.3 million died from the disease.

We talked about the details of TB on this blog last June. Today, let’s watch a story unfold. This is Chapter One of EXPOSED – four short films by Aeras TB.

 

 

 

By Trish Parnell

 





Flu – You Have a Choice

20 03 2014

Kristi was a beautiful, intelligent elementary school teacher, and my only sibling. She was healthy, and ran or walked several miles many times a week.

She was active in the community, supporting anything for children. And she made sure her own two children were given lots of experiences by visiting zoos and national parks, camping, playing sports, and doing lots of other activities.

She was always on the go somewhere to do something.

She encouraged all of us to spend time with family, and to put aside our daily chores so that we wouldn’t miss out on opportunities to make memories.

She was an avid photographer and literally had thousands of photos stored on memory cards.

Sisters

Sisters

She was always the one to pick up on someone being left out, and took time to show them kindness and love. Kristi developed many strong relationships because of this positive attitude. She was very strong-willed, fighting for what she believed was the right thing in life.

My sister was someone special.

Since Kristi taught first grade, she was frequently exposed to colds and illnesses. Even though she was healthy, on December 12th, 2013, she began to develop symptoms of influenza. She had a headache, extreme fatigue, nausea and vomiting, and a hacking cough.

She went to her physician, who prescribed Tamiflu® and told her to take some over-the-counter flu relief medications.

She made a choice to not purchase the Tamiflu because, even with insurance, the cost was $65, and she had Christmas presents left to buy. Kristi didn’t want anyone to do without a precious gift, particularly her children.

The next two days she began to worsen, to the point she couldn’t get out of bed to get herself fluids. Friends came by to help her and brought her Gatorade®. My mother took her chicken noodle broth, and she was able to get out of bed on Sunday, December 15th.

She still complained of a headache, but drank lots of fluids to try to build up her strength. Kristi’s fever continued, and she started noticing some chest pain Sunday evening while in the shower. Once out, she said it went away. Urgent care had already closed, so she told us she would return to her doctor’s office on Monday morning just to make sure she wasn’t developing any complications.

My mother asked her if she had gotten a flu vaccine this year and she said, “No, but I will definitely get one next year!” She was so scared of needles that she opted to not get a vaccine, thinking lots of people get the flu and suffer through it a few days and get better.

She was not this lucky.

On December 16th, at 1:13pm, only four days into her illness, I got a call from my dad saying an ambulance had been called to her house and it didn’t sound good.

Hearing those words from my dad, who was an EMT, made me know it was serious. As I rushed to the hospital, I picked up my mom from her work and tried to reassure her to stay calm. I tried to prepare Mom for Kristi maybe being on a ventilator or unconscious, just in case.

As we approached the hospital ER doors, my father came out with tears rolling down his cheeks, and my mother instantly knew without him speaking. She desperately asked, “She didn’t make it?” He quietly shook his head. And as I stood there clinging to my parents as they mourned the death of their child I thought of my mother’s words I had so quickly brushed off, “People die from the flu, Sharon.”

As a registered nurse, I have taken care of many patients with influenza and they have recovered. I brushed it off when my mom had been worrying over the weekend because my sister was healthy! She was active. She was an adult with no complications.

Kristi was so healthy, she gave my dad a kidney 10 years ago. At her regular check-ups, her physician always said things looked great and she was doing well.

Healthy adults don’t die from the flu!

She was a fighter, she was so strong-willed. People like that don’t succumb to the flu.

But, I was wrong. Healthy adults and children die every year from the flu because they do not get vaccinated—the number one way to prevent infection.

Losing a sister, and having to see my parents mourn the loss of their first-born, was the hardest thing I have ever faced in my life.

Seeing the pain in their eyes, the thousands of tears shed, was crushing to me. I not only lost my sister but had to watch my parents’ pain, knowing I could not fix this.

But one thing I know is it could have been prevented. It only takes a minute. The pain of a needle doesn’t compare to the pain of watching your family suffer through grief, trust me! Influenza can be prevented with a simple vaccine taken yearly.

It’s your choice. Please make the decision to vaccinate yourself against this deadly illness.

by Sharon Hicks





A Brother’s Love

14 03 2014

My older brother, Evan, and I were 12 1/2 months apart.  We were the “twins” who weren’t really twins, but who shared a bond so close, that I still can’t believe he is gone.

I never needed to worry about having friends around, because I always had Evan.  We both loved sports, and I have the greatest memories of growing up playing baseball, soccer, and basketball together.  It was a great family time, and one I hope to impart to my children.

Evan wanted to be a pitcher on a college baseball team, and my dad took him around to different colleges in Georgia.  After tryouts at Georgia Southwestern University, Evan was asked to join the team as a walk-on player.

Me and Evan

Me and Evan

He was at a small university, but he loved it and loved his team.  I was attending the University of Georgia, and I was so proud of my brother for following his dream.  Both of us had plans to become orthopedic sports physicians and practice medicine together.  We would get married, our children would not only be cousins but best friends—everything was planned out, everything was in motion.

Then, Evan came down with a violent migraine, so we thought.

The ER physicians diagnosed him as having a “little virus,” but it wasn’t a “little virus.”  It was bacterial meningitis, or more specifically, “meningococcal disease.” My parents were told he had a 5% chance of survival.

I can only imagine, now that I am a parent myself, what horror they must have felt hearing that their son might die.  I was on spring break with some friends in Florida, and my parents couldn’t reach me until much later that night.  I immediately left to drive to the hospital where Evan was being treated.

In a spirit of youthful optimism, I felt that if Evan knew I was by his bedside, he would rally, just as each of us could always get the other one to rally.

But this horrible disease was stronger than all of the prayers and love being sent to Evan.  My parents and I watched the disease ravage Evan’s body,  as gangrene set in on his arms and legs.  We watched the machines monitoring Evan, willing the numbers to be stable, for some sign of improvement.

As Evan was transferred to a third hospital, a burn unit, we were told that Evan had a 1% chance of survival.  I remember asking my mom about life after death.  I didn’t understand how my brother could be so sick.  Evan went in for surgery to try to save his life, and both arms and legs were amputated.

That still wasn’t enough.

I watched my brother, in a medically induced coma, lie in bed with stumps, his face and body bloated from kidney failure.  I cried, I prayed, I begged.  I would go listen to music in my car, to try to escape from the reality of what was happening.

Then, Evan suffered 10 hours of grand mal seizures, and that caused irreversible brain swelling, and a herniated brain stem.

My brother, who I loved so much, was brain dead.

We all watched as Evan was disconnected from life support, flat-lined, and carried away in a body bag.  Those are my last images of my brother.

I missed that quarter of school, because Evan had been in the hospital almost a month.  When I went back, it was with a renewed determination to be a doctor.  I did get admitted to medical school, and when I graduated, I fist-pumped my arm, and said to myself, “Evan, I did this for both of us.”

I still talk to Evan, I still miss him so much, and I carry his memory with me everywhere.  My daughter’s middle name is Evan. When I got married, I did not have a best man, because that spot was reserved for Evan.

When my parents and I found out that Evan’s death could have been prevented with a vaccine, that was being routinely used in the military, it just made no sense.  Why hadn’t any of us been told about the vaccine?

Needless to say, I am a staunch vaccine advocate, and as a primary care physician, I make sure that all of my patients are up-to-date on all CDC-recommended vaccinations.

It really is your choice, and your life. Take control and protect yourself against infections by getting immunized.

by Ryan Bozof





Baby Armor

6 03 2014

And now, a timely reminder from CDC:PSA-superbaby

It’s easy for parents to think of vaccine-preventable diseases like measles or whooping cough as issues of the past, but we know that most of these diseases still persist around the world.

Just last year a higher than normal number of measles cases were reported in the U.S., including an outbreak of 58 cases in New York City that was the largest reported outbreak of measles in the U.S. since 1996.

Making sure children get all of their vaccines is the most important thing parents can do to protect them from 14 serious childhood diseases before their second birthday. And CDC has created a series of print PSAs encouraging just that (including an adorable  super baby version).

CDC also has immunization schedules available for all ages and a handy scheduling tool that allows you to enter your child’s birth date and print out a custom copy of his or her personal immunization schedule.

As winter begins to fade and a new spring season starts creeping up, don’t forget to schedule your pediatrician’s visits and discuss vaccinations with your doctor. Let’s give our little super heroes the best protection we can.





Pneumo – It’s All About the Numbers

3 03 2014

DDWhen we are immunized, we usually have to get several shots, or doses, before we’re protected against a disease.

Nearly all vaccine-preventable diseases require more than one dose of vaccine to provide us with a strong immune response. It’s not fun, but it’s better than fighting all those infections.

Last summer, an article in Pediatrics described a study which looked at the cost-effectiveness of removing a primary dose of 13-valent pneumococcal conjugate vaccine (PCV13).

This vaccine helps to prevent pneumococcal infections, which can mean anything from an ear infection to pneumonia to meningitis. It can be a dangerous and deadly infection.

Right now, this vaccine is a four-dose series. The first three doses are primary doses, and the fourth dose is a booster.

A primary dose “primes” the immune system, allowing our bodies to develop stronger immunity with each primary dose we receive. The booster dose is the last shove to get us over the top, helping our bodies to develop long-lasting immunity against a particular disease.

The study in Pediatrics was the topic of conversation at PKIDs for several weeks, and, while we were surprised that removing a dose was up for consideration (and you’ll see why in a minute), we thought it was probably more of an intellectual exercise than a course of action that our public health leaders in the US would take.

After all, our tradition in the US is to use all of the tools we have to protect our citizens and prevent infections.

Come to find out, this is more than an exercise in “what if.”

In February, I attended the Advisory Committee on Immunization Practices (ACIP) meeting in Atlanta.

(As noted on their website, the ACIP “is a group of medical and public health experts that develops recommendations on how to use vaccines to control diseases in the United States. The recommendations stand as public health advice that will lead to a reduction in the incidence of vaccine preventable diseases and an increase in the safe use of vaccines and related biological products.”)

Based on that meeting, it sounds like they’re looking at removing a primary dose as a real option.

This may give us an opportunity to save money—$400 to $500 million—but it’s not a risk-free deal. In order to save that money, we have to be willing to see harm come to a lot of people.

This flies in the face of what we, as health advocates, say every day to the folks we meet, which is: Get immunized! Use the safe and effective prevention tools available to protect yourself and your family from unnecessary infections.

It’s easier to make this kind of money-saving decision if the conversation is all about the numbers: the dollar amount saved, the numbers of increased cases of disease, the numbers of hospitalizations and deaths.

Numbers are easy to talk about because they’re not personal.

But this decision to remove a primary dose of vaccine is personal. The consequences will be felt by our people, our loved ones, our friends, and our neighbors. We can’t dehumanize this process by just talking about the numbers.

If the third primary dose is removed, an average of 2.5 more people will die each year. Who are those people? One could be my niece, Millie, who’s just learning to crawl. Another could be your grandson, who loves cheerios and bananas.

Forty-four more people will get invasive pneumococcal disease. My daughter could get meningitis, and your son could get a bloodstream infection.

Fifteen hundred more people will be hospitalized for pneumonia. When my oldest was a toddler, she was hospitalized for pneumonia. It’s a terrifying experience and one that I would not have anyone else go through, if possible.

An additional 10,000 of our friends and neighbors and loved ones will have to be treated for pneumonia as outpatients.

Twenty-three hundred more ear tubes will have to be inserted into the tiny ears of children that we know.

A staggering 261,000 more children will get earaches, fevers, and possibly ruptured eardrums.

All of this happens if we decide to save money and remove a primary dose of PCV13.

It’s all about the numbers. We just have to decide which numbers are more important to us as a nation—the dollar amounts or our people?

by Trish Parnell