Athlete’s Foot (and what to do about it)

16 02 2012

Dr. Mary Beth Koslap-Petraco, awesome nurse practitioner, explains what it is, how to prevent it, and, if that fails, how to treat it!

Listen now!

Right-click here to download podcast (5 min/2.5 mb)

Cryptococcus: One Scary Microbe

28 04 2010
NIOSH N95 mask

NIOSH N95 mask, courtesy Gruscana on Flickr

Cryptococcus gattii is all over the news. This dangerous fungus is making its way down the coast from British Columbia, through Washington and Oregon, and soon into California.

Now comes the really scary part.  When that fungus hit Oregon, it changed. There’s now a new strain of this fungus that’s even more deadly to humans and animals than the one that originated in B.C.

The fungus doesn’t spread person to person—you breathe it in while outdoors.  Symptoms may not start for months, it’s hard to diagnose, and if not caught in time, it’s difficult to treat.

There’s no vaccine and there’s little one can do to prevent infection.

Not much good news, but the scientists are working on it.

We talked with a man from the state of Washington who’s still recovering from his infection. This is his story, as he shared it with us:

Around August 2008, I was doing some work on my house, and I started coughing and feeling short of breath. I went to urgent care at Group Health where they took an X-ray and said I had pneumonia. They put me on IV antibiotics. Each treatment lasted about an hour and a half, and I had 11 treatments over about two and a half weeks’ time, but I wasn’t getting better.

The doctors did more X-rays and could see that my left lung was clouded. They gave me a test for gastroesophageal reflux and did a scan with dye, and finally said they thought I had cancer. I was then admitted to the hospital where I had a bronchoscopy. The pulmonologist said my lung had nodules, like cancer, but the samples they took came back negative. The doctors really couldn’t figure out what was wrong with me!

I then saw an infectious disease doctor, who was more familiar with symptoms like mine because of his work with AIDS patients. He asked what I’d been doing lately, and I said I thought maybe I’d inhaled some dust from mowing my yard, which has bird feeders in it, or from cutting limbs off trees. I’ve never worn a mask for any work I’ve done around my place.

They sent my tissue samples to the University of Washington and that is when they determined I had Cryptococcus. I was in the hospital nine days total. They also did a spinal tap to be sure the Cryptococcus was not causing meningitis.

I started on fluconazale, 400mg daily, but it wasn’t working so they increased it to 600mg. I have to take it for three years—this summer, I’ll complete my second year of it. I’m now down to about 200mg/day. At first, I had to go in every month so they could do X-rays and blood tests.

My lungs are pretty clear now, but the Cryptococcus is still in my blood. Fortunately, the amount of it drops by half about every time I get tested. I only have to go in about every 6 months now.

They told me if I had not started treatments when I did, I would have lived only another six to nine  days.

When you have Cryptococcus, the coughing is terrible—you just can’t stop. I couldn’t have conversations with people, it was so bad at times. I’d wake up in the night a lot and cough stuff up. The first month was especially bad this way—you gag a lot. Drinking orange juice helped me—I’m not sure why, but I’d carry it with me everywhere so that I could at least carry on a conversation.

I’ve had to build my stamina back up slowly. I feel I’m at about 90 percent now. My lungs have some scarring that will always be there, but they do expect that the Cryptococcus will clear my system.

My advice to others is to wear a mask! If you have any doubts at all, wear one. Whenever I mow, or do anything around the bird feeders, or go into the barn area, I wear a mask. This also helps protect against other diseases transmitted in bat and rodent droppings. You have to get the kind with a filter. I use NIOSH N95, and after I use a mask, I throw it out.

I feel very cautious now. We recently had a friend in the hospital with MRSA, and I didn’t visit her because of that. I wonder about people working in the poultry or forestry industries. I hope they are wearing masks.