Monday, February 28, 2005
EDSA revolution
EDSA is the name of the street where it occured, where people praying and singing hymns blocked Marcos from arresting Corey, and from attacking General Ramos, who backe her...
There is now a shrine there, to Our Lady of Peace, since some of Marcos' soldiers say they didn't shoot at the crowds because a beautiful lady in white appeared to them and implored them not to shoot her children...
And being Philippinos, they also have this joke on the editorial page...
Ninoy call your office...
Medicare alert
So what is the problem? No one knows how to bill correctly...well, almost no one.
A frog picked the right answer more often than the bureaucrat in answering questions about Medicare...
Kermit, call your office, we have a job offer for you...
Sick, sick, sick
This or this?
Of course, if I was going to inherit a couple million dollars instead of being stuck caring for a foul mouthed over the hill brain addled drug addict maybe I'd celebrate his demise too...notice the article says they had a fight before his "suicide"? Easier and cheaper for her than divorce...
Sorry about all the morbid posts, but I picked these up looking for something humerous...
Follow the money
Read the whole thing. You see, most people want to have any treatment that will help. And when it is futile, we encourage hospice.
But if you read the article, they complain hospice is also expensive and might not help.
Their solution?
Introducing gatekeepers, the administrators in health maintenance organizations who choose which procedures patients may undergo, could take the often-emotional decisions about end-of-life care out of doctors' and patients' hands.
Another solution would be to popularize the idea that certain people are better off dead, because their care costs too much.
And you thought "million dollar baby" was just a remake of Rocky, didn't you?
Sunday, February 27, 2005
a quiet day.
Black death
CDC module on the plague is here..
Of course, plague is still found in the USA in rodents in the southwest, and IHS docs see a case or two every year among hunters.
However, this NYCity couple was lucky that their doctors recognized it and treated them with gentamycin instead of the usual "cephalokillitall"...
A good example of plague epidemics is found in the book The Plague...which is an analogy for the breakdown of civilization and the denial of the ordinary Frenchmen under the Nazis...however some chose "to side with the patient, not the disease" and recognized and resisted the "plague"...Camus worked with the resistance of Le Chambon, a small christian enclave that hid Jews...
Some would say these lessons need to be learned by the American people, who ignore the "loss of civil liberties" and fascism of the Bush "regieme", but one suspects when these people are silent on atrocities such as the Manila bombings last weekend, then they are supporting the disease, not the patient...
Albert Camus, call your office...
Saturday, February 26, 2005
Recipe day
recipes and history of cocoa on the Manila Bulletin website.
RECIPES: CHOCOLATE TRUFFLES
Ingredients
240 gm. Dark chocolate finely chopped
1/3 cup heavy cream
2 tbsp. butter
2 tbsp. rum or any liquor of your choice
sifted cocoa powder
Procedure
Heat heavy cream with the butter in the saucepan. Pour scalded mixture over chocolate. Let stand for 2-3 minutes. Stir until smooth mixture. Chill for 3-4 hours or until mixture hardens. Using small ice cream scoop, form the mixture into balls. Roll in cocoa powder.
**For dark chocolate, you may use bittersweet or semisweet chocolate. You may also use chopped nuts instead of cocoa powder.
Bon Appetit!
So much for equality
Rice looked as though she was prepared to talk tough, knock heads and do a freeze-frame "Matrix" jump kick if necessary. Who wouldn't give her ensemble a double take -- all the while hoping not to rub her the wrong way? Rice's coat and boots speak of sex and power -- such a volatile combination, and one that in political circles rarely leads to anything but scandal. When looking at the image of Rice in Wiesbaden, the mind searches for ways to put it all into context. It turns to fiction, to caricature. To shadowy daydreams. Dominatrix!
Tim Blair comments:
THEY NEVER SAID THAT ABOUT LAWRENCE EAGLEBURGER
Gloria Steinum, call your office...
Friday, February 25, 2005
tracheostomy take two...
Usually for respiratory failure, you place an endotracheal tube...which makes me wonder why they didn't do that for the pope.
However, I have done several while in Africa.
One of the complications of post measles was a severe tracheobronchitis.
Usually these kids were malnourished to begin with, and often didn't survive...and if you did the tracheostomy and they lived, you would be blamed for the death. Again, usually we didn't do the procedure.
But I did two. One was a fat two year old, and he made it.
Another was a girl with epiglottitis..about 10 years old. We didn't have blood gas measurements, but it was obvious she was going into respiratory failure and arrest. So we got permission and took her to the operating theatre.
The head nurse/anesthetist put her into a light anesthesia, but couldn't get the tracheostomy tube down. I tried, and again we couldn't get past the large swollen epiglottis..
So with the patient crashing on us, I did an emergency crycothyroid incision, stuck in a pair of scissors, and the patient turned pink, thank the Lord. (one usually doesn't do it at this level because of the danger of stenosis down the line).
Tracheostomies are not easy, nor is intubation in emergency rooms...when in training, we lost a child on the table (not my case) from a problem quite similar to the one I describe above... and an adult from bleeding--the carotid arteries, the jugular vein, and the vascular thyroid is very close to where you make your incision...nor are intubations easy. A think neck, neck injury, small airway, or recent trauma can lead to losing the patient...alas. Nor is this malpractice, merely a recognition that some things are difficult technically, even in the best of hands.
tracheostomy
The previous two posts are about swallowing difficulties and the pope, and how are they related.
The latest news is an "elective" tracheostomy.
Hello: Tracheostomies can be "elective", but that doesn't mean we believe Vaticanese, which puts the word "clintonesque" to shame.
Some people with neuromuscular diseases can have problems with secretions. Normally, you cough up your phelgm/sputum okay. Most of us have had episodes where we had problems getting up the phegm...I had mycoplasm pneumonia where this happened, and used to take an inhaler, then inhale steam for relief.
So many elderly, even those at home, might need help in coughing. Often, I suggest they buy or rent a nebulizing machine to help them loosen the phlegm, and chest percussion used to be used quite a lot for this problem.
In severe cases, however, you need to put a tube down to suck out the secretions. In the days before cheap nebulizers, we did this a lot. Some of our people with chronic emphysema/black lung/COPD even had tracheostomies routinely put in "electively" to help suck them out. Not done as much nowadays as twenty years ago.
Now, it is not clear with the pope. Did he need help with secretions due to poor muscles from Parkinson's? Is he having "laryngospasm" or other thoat problems and needs it to breath? Or did he have it placed (as the most recent CNN suggested) in order to be placed on a respirator.
It happened so quickly, I suspect he was in danger of respiratory failure, and they did an emergency tracheostomy because the Parkinson's was making it hard for him to breathe and swallow.
Now, once he's over the pneumonia, he can go back to normal, since a lot of times the Parkinson's medicine merely is readjusted.
But if he's on a respirator, as the latest reports say, we have another ethical problem.
You see, neither respirators nor feeding tubes are required by Catholic law, since they are extraordinary treatment.
Recently, with the spate of pulling feeding tubes from the disabled as a means of euthanasia, the pope pointed this was a no- no.
However, in terminal Parkinson's disease, usually by the time the feeding tube comes into play, the person is near terminal, so it is still optional.
Ditto for respirators. In neuromuscular disease, they are optional even for pneumonia.
Remember, Paul VI refused ICU care and dialysis at the end of his life. This pope has used all types of sophisticated care in the past for not only his parkinson's but for his colon cancer.
So my question: If the tube was for respiratory failure, he will probably die. If it is merely for upper airway spasm causing problems with secretions, he'll be back to normal in two weeks.
Anyone want to take bets?
I place my three cents on Cardinal Arinze as next pope...
Swallowing problems
The reason this is newsworthy is that the courts are trying to starve a brain injured non comatose woman in Florida, and she has NOT had the rehab to swallow.
Too often, feeding tubes are placed because they are easier than slowly feeding a person. And it decreases aspiration pneumonia. Indeed, one institution where I worked was sued by the Federal government who claimed we needed to place MORE feeding tubes to prevent pneumonia.
But the dirty little secret is that if you have severe dysphagia, you aspirate anyway: You vomit and aspirate, or you aspirate saliva. The lady in Florida hasn't died of pneumonia so I suspect she would be able to eat (and she should have died of pneumonia, since her husband's DNR orders forbids antibiotic treatment...of course, he has a live in girlfriend and two kids by her, and stands to inherit the malpractice money settlement, but that doesn't mean he has a reason to starve his wife to death...but that's another story).
The second dirty little secret is that many neurologists will declare brain damaged people as "persistant vegetative state" after a quick look, when their caretakers (like those caring for the Florida lady) know these people are alert.
When I worked with the Indian health service, one of our patients had frontal lobe damage. She was alert, but hyper emotional. We asked a neurologist to suggest treatment:we asked: Should we use haldol, or would Propranolol or anti convulsants work better?
So the neurologist took one look at the lady, and spent 40 minutes telling the family why they should pull her feeding tube.
The family, like most traditional Chippewa, stayed quiet in respect and slowly got angrier and angrier. Finally, the neice, who was a nurses' aide, spoke up:
Yes, you would have us starve her to death. But that's the difference between you white people and we Indians. We respect our elders".
And they walked out.
The Chipewa considered such people as partly on the other side...which reminds one of the Pope's comment that when he was sick he was almost on the other side,,.
blessed Kateri pray for us...
CNN Clueless as usual
They are visiting St. Patricks in NYC reporting that there are a lot of people praying there, then claim most aren't actually praying, they are tourists...(Hint: Lots of locals go there for mass...and many tourists say a prayer).
Most Catholics know this pope is on his last leg, and the PC have been salivating for ten years that he needs to resign or insisting that when he dies the church will improve.
But seeing how the Asian and African bishops are opposing "reforms" in the Anglican church, one suspects that the ultimate result of a new pope will be a schism between the Christian catholics and the modernists.
CNN yesterday was reporting on the pope's new book...two of the four interviewees were ladies, one with wrinkles and long blond tresses suggesting she thought she was still 20, the other an ugly fat lady with a hat...(reminds me of Limbaughs' law of feminism: feminism is a way for ugly women to have power...of course, one could say conservatism is a way for fat druggies to get fame...because all the liberal druggies, unlike Limbaugh, are slim and attractive but never mind)...
So anyway, there are two feminist critics, who said something I didn't quite understand. Then someone from the modernist "catholic" newspaper from the UK (their equivalent of the national catholic reporter, a modernist anti traditional newspaper)....and the laments that the pope opposes gay marriage and abortion (so what else is new).
The impression is that he's old and should go and let a modern reformer in...but as I pointed out in a letter to the London times, the pope is like one's father, not a CEO, and a holy pope who prays and sets the example of holiness in infirmity is more valuable than an efficient CEO, at least if you believe in God.
Thursday, February 24, 2005
the seeds of change?
Genocide?
Not much in the news about Zimbabwe, where the government is planning a rigged election while starving it's opponents...
Ah well...neither group is politically correct...
Ward Churchill, call your office. Your certiciate certifying you as a 100% twinkie have arrived...
Wednesday, February 23, 2005
The end of the 1960's
Link
his life reminds me of a description of a bureaucrat...(I paraphrase)...no woman would mourn him, no child remember his loving care. No sick person would bless him for his compassion, no poor person give him thanks for his help. He would die alone and unmourned...
In the book, the bureaucrat became involved with life and was mourned at the end, because he opened himself to others...
The end of the culture of death is death. One of the early "right to die" cases was a woman with cerebral palsy...who was given the "right" to starve herself, but changed her mind and was still living the last I heard...but her lawyer has since committed suicide...
The difference was made by physicians who treated her medical problems, arranged for her to live independently, and encouraged her.
But this didn't stop Ed Bradley of 60 minutes from telling her that her "care" cost the taxpayers $50 000 a year, and then asking aggressively to justify why she changed her mind.
The mercy of God covers all tormented souls, so God have mercy on Mr. Thompson...but one feels a long healing in Purgatory to atone the damage he did to all the lives of those influenced by his writings to take drugs, eschew responsibility, and live "free"...
Matthew Talbot, call your office...
Birthday present ideas
http://www.gizmodo.com/gadgets/gadgets/household/index.php#gizmodo-japan-idee-remotecontrolled-table-033792
and if you scroll down, it shows the latest electronic stethescope.
Dr. Casey, call your office...
Monday, February 21, 2005
Firsthand knowledge versus pc
One reason is that the MSM assumes you think they are the experts, but often they merely show their naivity...it's like when I read Chomsky...sounded very persuasive, until I compared his claims versus what I had actually seen, and they didn't fit.
And even the Herald article shows another reason: You can't just jot off a note telling the writer your opinion, you have to "REGISTER" and then get a password before putting your opinion down. Last time I tried that was a NYT board, and I found it full of anti Christian bigotry worse than anything one finds on places like Free Republic, which unlike the sophisticated NYT, has a nice "report abuse" link which is easy to use...
Here is an example of what I mean, about the war against the murderous FARC in Colombia...in the past, I wouldn't have access to such a rebuttal of pc ness...
And here is another: Did diet and lifestyle increase this lady's risk of cancer?
Yup. promiscuity increases greatly your rate of cancer of the uterus, and having children decrease the rate of breast cancer. Now, I'm not convinced that abortion increases the rate of breast cancer, but I suspect that birth control pills and increased estrogen in the environment and pseudoestrogens from pollution do. But don't mention such things...
Then there are these articles on the NYTimes...after loud broo haha about the "dangers" of Vioxx, they finally report that the FDA says ok but with caution, that every drug has risks, and they then "balance" that out with a bunch of "experts" who say these drugs should be removed because they are "risky"...Hello. You want to hurt, fine. Maybe a tiny risk is worth not hurting...and if you are worried about the small increase of blood coagulability it causes, take a bayer aspirin...
And in an earlier post, I mentioned non embryonic stem cells for regeneration of breast tissue...here is research on regenerating limbs...nope, I don't understand it, but it's interesting...
Sunday, February 20, 2005
Nagging women live longer.
The original article requires registration, but this right wing web site has the article and a lot of non polically correct humor commenting on it...and here is the take from the London Times...
Pravda reports it by saying that hot tempered men die sooner, but hot tempered women live longer.
No comments about if the reason they live longer is because making up is so much fun...
Lawsuit humor take two
Koko has been sued for sexual harassment....
(also via boingboing)...
Anita Hill, call your office...
Important scientific breakthrough...
Ironically, they got the cells from bone marrow, although other similar researchers got stem cells from human fat.
The dirty little secret about stem cells is the continued success of using non embryonic stem cells for treating diseases...
Payne Webber, call your office...
Saturday, February 19, 2005
When doctors are wrong....thank God
Go read it.
Doctors think they are God, but sometimes they are wrong, thank God.
Arsenic and deep wells
However, usually I don't use it for my "Blog" because I don't read it on line, and don't have links.
One of the good things is that in the culture wars, it tries to be fair. It is "liberal" in the old fashioned sense, seeing the good in all peoples, and allowing a wide range of comments. I've written several letters criticizing a point of view, and had them either published or twice had the writer answer my criticisms. Since I tend to be a bigmouth, it was both glad and humiliating to m e, since I don't really expect to be listened to.
In today's paper on 2-17, there is a long article about well water and arsenic.
Usually all we read about arsenic is that Bush is poisoning us by increasing the legal level of arsenic. Bad bush good environmentalists. Case closed.
However, this article is about arsenic in wells dug in order to give clean water to people in the third world. Alas, although they now don't have to worry about typhoid and various types of dysentary, they now have to worry about the long term consequences of arsenic poisoning.
The answer?
Maybe coaldust...bottom ash (NOT the more toxic Fly ash)...
Or maybe a one dollar plastic bucket of crushed bricks, gravel, sand, and iron nails
Like most stories "under the radar", it affects people quietly. And since it's not Bush's fault, and since the people involved are not politically correct poor people, you won't read about it in the MSM or hear about it on Fox (Athough CNN might cover it in one of their "special reports).
Another proposal is using surface water instead of dep wells...covering them tightly "to prevent biological contamination"...which would cost one thousand dollars per well...
When I worked in Africa, our hospital well was a deep well. I don't know if it was arsenic contaminated or not...but the locals used pond water. The streams were used, but in the dry season the streams might dry up, and women would have to walk for several miles to get their water. They might bathe themselves and the children at the pond, but for daily needs, it meant carrying a jug of water on their heads.
The streams had snails and bilharzia in them (Schistosomiasis). So if you bathed in them, you would have these parasites dig into your leg skin, travel up into the pelvic veins, and attach. If there was a major infection, you would pee blood. (Men called this male menstuation, using the same word as they use for female periods to describe this common phenomenum).
But there was more danger in using such rivers and ponds.
Often they were used by animals, and contained contamination from animal and human waste.
(In our area of Africa, the phrase for "go to the bathroom" was "to to the forest"...in the forest, you had privacy--something lacking in villages where everyone lived close together, the "living room" was the space in front of the sleeping hut, and garbage and waste attracted unwanted flies and insects. Forests also had leaves to use to clean oneself, and one could bury the feces; this not only kept the village clean of human waste, but prevented an enemy from getting your spore to cast a spell on you).
Alas, just like rain run off from farms and golf courses contain fertilizer and pesticide that contaminates nearby rivers, so too we see the local streams contaminated with run off from the forest.
Of course, you could build latrines, but the cultural taboo against such smelly fly filled places were strong...
So you might say, build a well.
When we were in Africa, we did just that.
Most of the locals knew where the ground water was not too deep (usually where trees and bushes remained green during the dry season). But digging is only step one.
You need to know how to line the well when dug. This prevents collapse, and allows the water to settle clear. Traditional wells are lined with stone.
Now, remember, the nearest Home Depot is 200 miles away, in the city. So you just get rocks, right? But rocks are round. How about flat rocks?
In our area, the ruins of Zimbabwe stand tall. Early settlers insisted they were built by the queen of Sheba or some other Mediterranean culture (the terraces of Umtali might indeed have Mediterranean influence, so this is not too far fetched). However, locals know how to make the bricklike rocks that were used for the Zimbabwe ruines.
First, you find a flat rock. They are all over, and indeed, many villages are built on such flat rocks, so as not to wash away in rain storms (remember the bible parable of the house built on a rock and a house built on sand? Same idea here.).
Once you find the rock, you make a fire...and let it burn for one to three days--let the coals heat the rock. Then you get water and remove the coals and pour on lots of water. Voila, the top layer of rock cracks. And since the rocks are layered, it often cracks down to a layer of 2-4 inches. You then take these irregular slabs, and hammar them into the right size for what you need.
So one of our "brothers" ( a man with vows but not a priest) gave well digging classes to the villages who wanted to participate. And then these villages dug the wells, got the rocks, and lined them.
Now you have a pit with water in the bottom.
Problem. Animals in the dry season will smell the water and try to drink...and fall in.
If this happens, the well is contaminated.
Indeed, not only animals but small children can die this way.
So this is where the missions helped. We got money for simple pumps. And we petitioned a government office for concrete for slabs. And when the wells were done, Brother Charles and his boys (i.e. teenagers who were learning how to fix things as his apprentices) went out, and placed the slabs with the pumps.
Our well digging was the first step: Water closer to the villages, so that hands and utensils would be washed more often, washing could be done without risking schistosomiasis, and major contamination from dead animals and fecal material was decreased.
But you still had the problem of run off.However, these were not ideal, since the run off from the forests still contaminated the wells. But it was better than nothing.
Now, in this article, it mentions how DEEP wells were dug to prevent disease.
Like water filtration devices, by the time the water perculates down to the deep aquaphors, it is cleared of fecal material.
Alas, it also picks up minerals from the rocks.
This water was essentially disease free...so deep well water is a great improvement over our 20 foot deep wells...but now, twenty years later, the slow injestion of arsenic is starting to cause problems (arsenic accumulates in the body).
So instead of dying of cholera you have a low grade but increasing problem.
Water treatment plants will be the future, but for now various people are trying to find ways to remove the arsenic.
Sand, brick dust and iron nails is one. And coal ash is another. Like charcoal, they leach the poison to their surface area.
And those who thirty years ago would be dying of cholera but now are alive will now get improved water.
But of course, you won't hear about it in the MSM...
Michael Jackson's case is much more important.
Johnny Cochrane, call your office..
Friday, February 18, 2005
Killer presidents
Ah, how wonderful it would be to have a president with guts, one who would not be afraid to risk his life doing something like visiting troops in a warzone.
But Lucianne links to a post from the past, when we really had macho presidents who fought personally against their foes and won....
Mel Blanc, call your office....
Thursday, February 17, 2005
Rabies
I didn't know rabies still existed in the pristine utopia of the European Union...
The reason I bring it up is that last year several people from Texas also were transplanted with rabies infected organs...
We sometimes use Texan organs in our Okie patients, and had a patient die after receiving a heart a couple months earlier, so it got my attention, but not much press...
Rabies still exists in the wilds of the USA.
When I lived in the pristine utopia of Massachusetts thirty years ago, one of our patients, a sweet little seven year old girl, opened a door and was bit by a bat, which flew off.
Alas, bats rarely bite people, and bats in rural Massachusetts have been tested positive for rabies.
So we got her the vaccine: Back then, it was 26 doses, subcutaneous, two or three times a week.
By the twentieth dose, she was getting severe local allergic reactions...poor child. Luckily now we only need three shots...
But there was another story...the series of vaccines cost about 600 dollars, a lot of money back then. Our office bought it, but the patient had no insurance, so we billed her county public health office...the office said the bill used most of their yearly budget.
Puts things into perspective...
Cows and cats and racoons also carry rabies.
And in Africa, a dog bit also is a major danger.
In our area, they would go thru every three years or so, vaccinate and paint the domestic dogs, then put out meat and shoot any unpainted dog.
After independence, some countries had resurgence of rabies, because they could not afford bullets and paying a sharpshooter...
Again puts things into perspective....
Luckily, I have never seen a case...
Louis Pasteur, call your office....
Attention Art Bell listeners
Healthy skepticism, it seems, has curdled into paranoia. Wild conspiracy tales are peddled daily on the Internet, talk radio and in other media. Blurry photos, quotes taken out of context and sketchy eyewitness accounts have inspired a slew of elaborate theories: The Pentagon was struck by a missile; the World Trade Center was razed by demolition-style bombs; Flight 93 was shot down by a mysterious white jet. As outlandish as these claims may sound, they are increasingly accepted abroad and among extremists here in the United States.
To investigate 16 of the most prevalent claims made by conspiracy theorists, POPULAR MECHANICS assembled a team of nine researchers and reporters who, together with PM editors, consulted more than 70 professionals in fields that form the core content of this magazine, including aviation, engineering and the military.
In the end, we were able to debunk each of these assertions with hard evidence and a healthy dose of common sense.Ah, but conspiracy theories are more fun...
Michael Moore call your office...
Wednesday, February 16, 2005
Attention Mullahs
(Via Dave Barry)
Of course, the best defense is being fat, ugly and mean...works for me ;-)
Typhoon Annie
Back in the 1990's, the Abu S. Bombed some planes when I was here and now this.
Lucky for us it's not nearby...and no bombs so far at the airport.
This might be considered the reply of Osama, who threatened blood on Valentine's day, but actually it is probably because there was a major battle with Moro rebels a week or two ago.
No volcanos or monsoons yet, however..
And the main news headline in Oklahoma is the Michael Jackson case...
Bill O'Reilley, call your office.
Tuesday, February 15, 2005
Pain pills? I don't need no stinkin pain pills
But they don't mention the alternative, which is to hurt...tylenol doesn't help much. NSAIDS have more ulcer side effects, and narcotic use may lead to your records being confiscated by an aggressive DA.
Oh well...why don't we just take our vioxx and rinse it down with some Dago Red?
(AKA home made Red wine. Dago Red, of course, was the chaplain in M*A*S*H)
Father Mulcahey, call your office...
Let's keep things into perspective
Lady of Leisure
Nothing to do but eat sleep and read.
Lovely place. As globalization gets stronger here, it does get cleaner. Fifteen years ago, the water buffalo and goats grazed in the vacant lots across the sleep, which were full of garbage. I used to joke that the only clean place in town was the LDS church...
Now, however, there is more air pollution from cars, but less from burning garbage.
Monday, February 14, 2005
hello from Nueva Ecija
Our small town is growing. And our son is turning the small house and compound into a mansion with meeting rooms etc. for guests and visitors for his work in human development/character cities.
And so I go around singing nostalgically: I wanna go back to my little grass shack (yes I know, it was a shack in Hawaii)...and our house was never a grass shack, although my husband's original home is still intact, with the traditional raised flooring to protect it from monsoons.
Ah, modern globalization. No near by mcdonalds, but a Jolibee and mall nearby, and when we "jog" every morning, a dozen other people are doing the same thing around the city square.
When things get more efficient, I will post photos.
No broadband yet here, but they do have DSL and I'm trying to get us connected...
Thursday, February 10, 2005
BBC: TB Killed off Leprosy.
Now, I don't know much about leprosy, but if you scroll down about the way the body attacks TB, a similar T cell (if I remember correctly) hits the infection in leprosy.
Now, ancient leprosy may or may not have been Hanson's disease-- there is an ongoing argument that it may have been a disease called Yaws, which causes bubos and is a spirochete related to Syphillis. (There is another argument if Syphillis came back with Colombus, or if sailors caught yaws going around the horn of Africa and the disease changed---and syphillis changed after arriving in Europe, from "the great pox" to a slow disease that took years to kill).
Now, most cases of Hansen's disease is caused by being very dirty-- Father Damian caught it because there was no good water supply when he arrived in Molakai, and he was in close contact. However, few modern nurses have ever caught the disease, and indeed, the suspicion is that most cases are "caught" by infants or children who have thin skin and immature immune sytems, and smolder awhile before showing up in young aduts.
So although the TB causing cross immunity theory is nice, I posit two other explanations: One, a gradual increase in cleanliness and the standard of living. Two: People whose immune system was weak from Hanson's disease quickly died of TB, and never spread the disease to new cases.
BTW: Hanson's disease is fairly easily treated in villages, but leprosariums still exist because many cases are thrown out of families when discovered.
James Carville, call your office...
Leaving home
The neighbor had a doctor's appointment, so it was easier this way.
We closed an agreement to sell the house, and all the furniture and appliances have been sold or arranged to be auctioned.
This is not the first time I have sold/given away/stored all my belongings to work overseas. It is the third time--twice I went to Africa.
The first African trip, we couldn't ship stuff, so only had suitcases. Ditto for the second time I went there.
Things don't always work out, however...the first African assignment went fine for three years, then the war got bad and we went home in a hurry.
The second time, I was barely there six months when I got shipped home to fix a visa, just in time for a war to break out two days later (most of my friends were worried sick, and I had to call them to say I was okay).
We will see how long this lasts. But of course, this time I am not going as a missionary, but as a wife of a retired physician who is returning home in his retirement.
I have just enough government "pension" to cover health insurance under an early retirement...but not enough to live on (no way I am going without decent health insurance, although except for "female problems" I have always been in good health).
The interesting thing about hotels now is that they have wireless. The last hotel was free, but this one is about 8 dollars for 24 hours. A bit expensive, but no more than a movie or room service...(I LOVE ROOMSERVICE...but that's another story).
Luckily, the new downloads for Windows was available, so I could download it fast...
In the Philippines, we have telephone connections, and it's expensive. No broad band yet...nor satellites in the area.
My husband the doctor is reading his newspaper...happy as a clam. He knows more about the world than I do, and his secret vice is the National Enquirer...
Monday, February 07, 2005
We often see soldiers coming and going at the Tulsa airport, and often people greet them and congratulate them...
And before you joke about whitebread Red states, you should know that we often see Muslims--Iranians, Pakistanis, Iraqis, Lebanese-- welcoming relatives at the airport also. Indeed, many people don't know that the writer of "Reading Lolita in Tehran" studied here, or that a lot of Iraqi refugees settled here after GWI...
Immigrants are all over...one person who came to inspect our house for his brother who is thinking of buying it came with his wife. She is part Osage, part Filippina...
Bobby Jindal, call your office...
Diabetes transplant
There are technical problems with getting islet cells to transplant (which is why the holy grail of embryonic stem cells are being pushed by childhood diabetic groups).
You see, insulin is produced in the pancreas. The pancreas is a huge gland that produces digestive juices (think of it as a ten inch spit gland, that spits out fluid when food starts draining out of the stomach).
In the middle of this big gland are tiny islands of different cells, cells that produce insulin. They are aptly called the Islets of Langerhans...(remember an earlier post where I discussed language showing history? Well, Paul Langerhans the physician who discovered them, has an interesting history..did a lot more than discover these cells.)
So the first problem is that, in brain dead people, often other organs are partly injured by the poor circulation or the lack of oxygen that caused the brain damage. So if you try to get the cells, they are often partially digested by damaged pancreas juices from nearby.
The second problem is that the pancreas is plastered against the backbone.
So surgically, to get donor cells, you can't go from the back--the spine and four inches of muscle is in the way. But if you go from the front, you have to move the liver, stomach, and duodenum out of the way.
Needle biopsy--sticking a needle into the islets-- is an option, but what if you get the wrong cells?
Sounds promising, but one wonders about risk to the donor...because there is a big danger if the pancreas is injured, you get a nasty disease called pancreatitis.
All sorts of research in this area is being done, and although pancreas transplants have been successful, the technical aspects make it still experimental...
Dr. Banning, call your office...
An untold story of rescue
The brothers from Cincinnati had taken turns going to Manila for two-year periods during the 1920s and '30s to run the Helena Cigar Factory, started by their father in 1918.
While they were there, they established a Jewish Refugee Committee and worked with highly placed friends - U.S. High Commissioner of the Philippines Paul V. McNutt and Manuel L. Quezon, the first Philippine president - to help the mostly German and Austrian refugees get passports and visas, then find employment and homes in Manila.
"We were welcomed in the Philippines at a time when the gates to Jews were closed all over the world," said refugee Lotte Hershfield, 74, of West Hartford, Conn.
The rescue was little known until a recent book by Ephraim, "Escape to Manila: From Nazi Tyranny to Japanese Terror," led to efforts in the United States and the Philippines to honor the humanitarian effort before the aging refugees die off.