Tuesday, October 20, 2009

Pigs in Your Blanket: What to Do When H1N1 is in Your House

Alert! The swine flu has marched its coughing army of viral genetics into your safe haven... it has blown its way into your home.

The porky enemy has infiltrated your territory. The siege is over and the swine have broken through your defenses. Your walls are breached and your pants are down. There are piglet particles everywhere.

Some of your team have been compromised, maybe even your second-in-command (your spouse). What do you do? Are you going to give up? Are you going to throw in the towel and run out screaming, 'the piggies are coming, the piggies are coming'? No! Heck, no!

You are one tough mommy! You don't fall weak at the sight of puke and pustules. You are supermom or superdad. Your motto is: 'Never give up! Never surrender!' Okay, so that's the motto from Galaxy Quest, but you borrowed it and tattooed it on your buttock.

So now that you have built up the resolve to take down the enemy swine, what do you do next? You do what any normal military person would do, you hedge off the areas that have been compromised, tend to the wounded, and do your best to keep from becoming a military casualty yourself.

At this point in the war on H1N1, you know that the time for bellyaching and fear-mongering is over. Now is the time for buckling down, rolling back your sleeves, and heading N95 mask first into the pig pen.

You remember all those old movies about the crusty old army sergeant that forges back into the line of fire to save a fallen comrade: well, that crusty old sergeant is you. This is your moment; you have trained for it and you are going to kick some swine flu butt. You stand in front of your sickly family and shout, "Are you with me?!"

Okay, so your family looks at you as if you are the village fruitcake. Maybe the two-year-old applauds, but they all return to their beds moaning and you are left to tackle the flu on your own.

Well, you're not entirely on your own; the CDC has established some steps to lessen the spread of flu in the home. They have offered you the almighty handbook of "Security Lock-Down 101."

Rule 1: Solitary confinement. The CDC suggests keeping the sick person away from the other members of the household as much as possible, especially those that are high risk for complications from the novel H1N1.

I have to say here, how in the heck is that supposed to work if you have children sharing a room and the only other room in your house is the only last safe haven you have from children, or at least it is until 3 am when your toddler comes jumping into bed with you because the boogie man set up shop in their closet.

But anyway, the CDC suggests that you keep the sick person or persons in a room separate from the common areas of the house. ("For example, a spare bedroom with its own bathroom.") And keep the designated sick room shut at all times.

Oh yeah, a three year old child is going to love the solitary confinement while they feel like crap. How many three-year-olds do you know of that enjoy being absolutely alone when they need comfort from mommy or daddy? And I doubt the six-year-old sick child is going to stay put.

The curious thing about children is that they can and will play up until they are so sick that they can hardly stand. At that time, they begin to shows signs of lethargy and confusion. At that time, they should be visiting ye ol' emergency room, sporting a face mask. While we adults, the first moment we feel ill, we're done playing. (I'll talk about this phenomena more in my posts on hypo- and hyperthermia.)

Rule 2: Careful Transport of the Compromised. The CDC suggests that if the sick person does have to walk through they should wear a mask.

Rule 3: Hedge off the Enemy, Don't Allow it to Compromise Other Bases. Try to keep visitors to a bare minimum. Children when sick can transmit the virus up to two weeks after the last symptoms have gone. So if their friends come over to visit, there is a high likelihood that they can catch the disease and bring it home to their own families. And I'm sorry, misery shouldn't like company.

Rule 4: Keep Yourself From Becoming a Military Casualty. When holding your sick child to comfort them, hold them so that their chin is over your shoulder and turn your head away when they cough. If you come down sick then who cares for your loved ones.

Also, if possible try to wear protective gear to prevent the spread of infection. When leaving the patient's room, remove the protective gear to a designated location and wash your hands.

Rule 5: Clean the Barracks. Laundry should be washed with hot water and bleach if possible. Don't hug laundry to yourself when placing it in the washing machine. Use a laundry basket and gloves. After handling laundry, wash your hands and wipe the area with disinfectant.

In the kitchen, designate a specific set of dishes and utensils for your sick loved one to use. And wash those dishes in hot water in a dishwasher, if possible. Try to keep those dishes separate from the rest of your family's dishes.

Wipe down surfaces, bathrooms, door knobs, etc. with disinfectant sprays constantly.

Rule 6: Call in for Backup When the Enemy Becomes to Powerful. I have listed a series of signs in past blogs of when to go to the ER. Keep in mind that the H1N1 comes on fast. It doesn't wait for a few days to gather its strength, it hits you like a ton of bricks on the fastlane.

A lot of primary care providers are concerned, because of the possibility that patients can come into their offices with seemingly harmless symptoms and within less than 24 hours are in deep distress with full-blown H1N1.

On a single day, a particular hospital reported that there were 50 admissions for H1N1 with 19 of them being transferred to intensive care. The majority of these cases appeared at first looking like they had the common cold.

Recognize when to cut your losses and go to seek professional assistance.

Rule 7: Like all Things, This too Shall Pass. The truth is that I have seen many cases of H1N1 in this last week, where the family has recovered together. Careful planning and attention to warning signs will help you and your family stay safe this flu season.

On a serious note, please keep hydrated. Please get enough rest and vitamins. And for the love of Miss Piggy, please seek medical attention when you start feeling an illness come on quickly.

If you have any more questions concerning H1N1, please utilize the comments section of this blog. I will try to reply to your questions as soon as possible.

Saturday, October 17, 2009

Three Little Swine Flu Pigs: Huff and Puff and Cough Your House Down

There's something to be said about humor in medicine. Some say it's the spice of life. I say it is the anti-nausea drug of the healthcare profession.

Seeing gross things all day, leaves you with two options: You either blow chunks or you laugh... then again, technically you can do both, but I wouldn't advise it.

For instance, when you see the montauk monster of all diseased masses sitting on top of a beating heart, you can easily find yourself heading for the horror flick, "Breakfast Strikes Back." Yet, one good twisted sonnet from the anesthesiologist about his love for the Beatles and your stomach settles.

Then again, it's not like physicians spend all day long laughing at everything to keep themselves upchuck-free. Seriousness has its place. In fact, you can always tell the danger of the case by the amount of humor that passes between the surgeons and hospitalists. If they are singing songs about the names of the new residents, then they are prepared for the case. If they are silent, its bad news and something unexpected of which they weren't completely prepared for, has happened.

The point of these blogs is to utilize humor in preparing now for the serious disasters that can occur later. And there is nothing more serious than witnessing one of your family members suffer from a life-threatening illness. When a loved one starts to suffer, the first response should be to roll back one's sleeves and to take care of them. It shouldn't be 'to panic.'

True, you do have to have the stomach for the work. Not very many people can cleanup puke without dry-heaving. You should have seen how fast my brother's house cleared out of people when his toddler vomited on the couch. Everyone screamed and ran like she was one of the undead coming to feast on their brains. All that remained of her siblings were dust clouds.

Yet, even if you are a little queasy in the face of blood, guts, and gore, if you know beforehand what to do, then you'll quickly adapt.

The ability to laugh during a time of crises is a sign of a well-prepared person. The preparedness I am talking about is not just collecting the temporal materials necessary to survive, but more, the knowledge and training that would keep you from panicking. So, in my blogs, I intend to do my best to help you become mentally ready to face the trials that lie ahead... or at least, the disaster and medicine-related ones.

In this post, I am going to start with the CDC recommendations for taking care of a sick person and in the following blogs, we'll elaborate more. Then that will conclude the H1N1 series and we'll start working on wound care in the wilderness and what to do in the event of an earthquake. (That's my favorite stuff!)

Now, let's roll back our sleeves and get cracking on what to do if someone in your house has contracted the virus. (The following words of advice are derived from the CDC standard of home care in the event that someone has contracted the novel H1N1: http://www.cdc.gov/H1N1flu/guidance_homecare.htm)

First and foremost, if you have children or teenagers, DO NOT give them aspirin (acetylsalicylic acid). Doing so could cause them to acquire Reyes' syndrome. It is an incurable and potentially fatal syndrome that affects all organs, especially the brain and the liver, resulting in severe encephalopathy (swelling of the brain) and a fatty liver. ( For more information on Reye's syndrome: http://www.ninds.nih.gov/disorders/reyes_syndrome/reyes_syndrome.htm)

The over the counter drugs that the CDC recommends are Ibuprofen (Motrin, Advil, Nuprin, PMS-bane, etc.), Acetominophen (Tylenol), and Naproxen (Aleve). You can give children's tylenol to a baby 6 months old or younger (please contact your provider for details) and both ibuprofen and tylenol to children 6 months of age or older. (See also, the American Academy of Pediatrics parenting corner at http://www.aap.org/publiced/BR_Infections.htm)

I do have to mention here that we live in a more is better society. More makeup will hide that zit. More sugar will fix the bad taste of my spouse's cooking. More cartoons will keep my kids from tearing up the house. If it works a little, then more is better, right? Wrong.

Well, let's just put it this way: the only time "more" is better in medicine is when you apply more love to taking care of your patients, and even then, there are times when more is definitely not better. So, please for the sake of all that is good and holy, don't apply the 'more is better' analogy to the above mentioned drugs. Please, just follow your health care provider's advice on dosing or you might end up doing more damage than good. (Image taken from http://www.drugbuyers.com/freeboard/ubbthreads.php/topics/907257/Re_Funny_gifs_post_them_here). For instance, a painful death can result from taking more Tylenol than the maximum dose allowed. [The maximum dose of Tylenol in an adult that is allowed is: 1g/dose(1000mg per dose), and 4g/24h (4000mg per day)].

If you drink more than three alcoholic beverages per day, then one, you really should talk to your doctor before taking it, and two, never use more than 2g (2000mg) per day. Avoid Tylenol, if you have liver disease.

In addition to that, the American Academy of Pediatrics strongly recommends that parents should avoid giving any over the counter cough and cold medications to infants and children under the age of 2 years old, due to the risk of harmful and life threatening side effects. Also, many studies have shown that cold and cough products are not as effective in children younger than 6 years old. (Please see: Common Childhood infections, American Academy of Pediatrics, 2005, updated April 2008.)

So in a nutshell, please seek advice from your primary care physician before taking any pharmaceutical agents, for dosage instructions and any possible contraindications that you or your loved ones may have. (For more information on the side effects of these drugs, refer to: the Food and Drug Administration: http://www.fda.gov/ForConsumers/ConsumerUpdates/default.htm. And also, http://www.tylenol.com/page.jhtml?id=tylenol/children/subchild.inc, and https://online.epocrates.com/u/10a307/acetaminophen)

As for when to seek emergency care, I mentioned in an earlier post about what signs to look for. If the person you are taking care of, or you yourself have any of the following, then please seek medical help immediately:

*Has breathing difficulties

*Has chest pain

*Is vomiting (unable to keep liquids down)

*Has seizures (uncontrolled convulsions)

*Has purple or blue discoloration of the lips

*Acts less responsive than normal or becomes confused

*Shows any signs of dehydration, such as decreased or absence of urination, sunken eyes, dry mucus membranes (inside of mouth is dry), lack of tears when crying (in infants), or dizziness upon standing.

* Has a high output of diarrhea (That is if diarrhea is present. The CDC has indicated that some patients may experience diarrhea from the H1N1.)

In taking care of a sick person, it is important to keep them properly hydrated: 8 to 10 glasses of water a day. More, if they have vomiting and/or diarrhea.

Oral rehydration should be given to the patient in small amounts frequently, such as in small bottles for infants "paced to mimic sipping," and in spoonfuls or small sips for toddlers. (Except avoid giving water to infants under 6 months old, instead refer to your pediatrician for rehydration instructions.)

The WHO suggests replenishing fluids in cases of diarrhea and/or vomiting with rehydration solutions such as Pedialyte (Abbot Laboratories) or Gastrolyte (Aventis Pharmaceuticals). Or you could always go the cheaper route and water-down Gatorade (One part water, One part gatorade).

There is also the WHO solution for developing countries: One liter of pure water, two tablespoons of sugar, and one-half tablespoon of salt. I say add some lemon juice to it. Or you can always switch out the sugar for honey, except in cases of infants under the age of one. The American Academy of Pediatrics has strongly advised that children younger than 1 year of age should not be given honey because of the possibility of food contamination.

Another alternative remedy, you can try is the Apple cider vinegar mix:Two tablespoons of cidar vinegar (not the clear or distilled kind) and one tablespoon of honey combined in one cup of water each morning.

My favorite is mixing one tablespoon of honey, the juice of one lemon, a pinch of salt, a pinch of ginger, and a pinch of cinnamon in one cup of warm water. The mix should be done to taste. If the sick person can't handle the strength of regular ginger, than instead, use gingerale in place of ginger and water.

In the next post, we will discuss what measures should be taken to lessen the spread of flu in the home. Good luck until next time.

So, Ta Ta for now; I have echocardiograms to study.

Thursday, October 15, 2009

Board Exams are Evil Spawned by Satan

If the title of this post doesn't warn you that I'm pausing in the H1N1 series to vent, then could I remind you of that ocean front property in Ohio that I'm selling? :).

Seriously though, earlier today, if you didn't catch it, I posted a list of natural agents that have antiviral properties... so I haven't neglected my blogging duties.

Anyway, I just want to say that the National Board of Medical Examiners are evil! First, they develop these 8 hour exams which we spend months studying for, gaining weight, and eating whatever is close enough to our grasp that doesn't have mold on it, while we become greater zombies with hackers' tans because we haven't seen the light of day for months! And all the time, we are sacrificing our social lives for the will of the Board examiners. (Image taken from www.matt-willard.com)

Okay, that's not true, I do have a social life: I have a very exquisite relationship with Harrison's Internal Medicine book, which I often find myself cheating on by sneaking off with Crush the Step 2. Then to mix it up, I spent a few nights every so often with First Aid for the USMLE and USMLEworld. Believe me, we became very intimate during the last few months. I took them out, we had dinner together. Of course, I paid; it is the 21st century. We slept together: but often I found myself, sneaking off early in the morning pulling a coyote ugly to get to the next board exam review book. I admit that I wasn't very committed to just one.

Then as with any deep relationship, it had to end the day before the exam. I think I found a Dear John note on my pillow, stating, "I can't take the neglect anymore. Signed Harrison's." Therefore, I went cold turkey. No more board review books. My Exam analysts were saying that it was for my own good that I was to part with them for a few days. Believe me, it was hard. I could hear to books calling to me, saying sweet nothings and begging me to take them back. It took all I had to walk away and say no more.

So there I was exam day, getting frisked for possible study materials that I might have sneaked in over the Prometrics center border. It was seriously like Fort Knox. They take your finger prints, your picture, your driver's license, your certificate of exam eligibility, your first born child... it was dreadful. Forget about the fact that you're already nervous from having to take the daunting test that could determine your future, but you also get shaken down like a drug dealer during a meth bust. "Up against the wall. Okay, frisk 'em. If we find any cheat notes, you're going downtown buddy."

So after the airport security picked my pockets, I found myself sitting in front of the ugliest computer screen I had ever seen in my life. The darned PC looked like it was going to croak right in front of me. I was half ready to yell out: "Quick! Call a code and get an AED!"

It makes you think, "All that action and all I get is this is fossil?" Which it only added to my stress because the whole time, I kept thinking that the piece of computer would crash and they would make me take the test over.

Eight hours. Can you believe that they make you take a test for eight hours? Well, at least there were breaks, but still, it starts to wear on you. During the seventh stretch of the exam, I felt like I was ready to throw in the towel. The darned thing had sucked out my brain and was now spitting it back at me in defiance. I couldn't take it. I just wanted the torture to end.

So I looked at the clock running down. Fortunately, I had time to spare. Thank heaven to all those English lit classes that I took just to get out of taking math. I couldn't ask for better lessons on how to read as fast as lightning than trying to get through the evil book of Frankenstein.

So I had two and a half hours left on the clock and only one more block of test questions. So I did what any knowing, burnt out medical student would do. I went bowling. Yep, I signed out of the test in a designated break place, went through security, and went bowling. After a full game of throwing a huge marble ball at some pins to blow off some test anxiety, I came back through the top secret clearance squad and finished the test.

Yeah, but was that it? Oh heck no! I'm a D.O. We osteopaths are gluttons for punishment. I had to take the COMLEX a week later. The COMLEX, for those of you that don't know, is the osteopathic version of the board licensing exam. It's eviler than the USMLE... those twisted National Board of Osteopathic Examiner beastards! And another 400 question test brought me back to the same testing center, through the same frisking process, and back to the same archaic computer.

So here I am now, sweating it a month later, and still my test results for the COMLEX are not back yet. I mean really, how hard is it to grade a test that was taken on a computer?

There must be some logical explanation for them to take so long to report back, because making someone wait several weeks for test results that could determine their future is too cruel and too absurd to be without some severe cause. So, I've been considering a couple of possibilities as to why the NBOME are taking forever to post scores: not even Al-Qaeda would be so intentionally inhumane.

So the following are ten possible reasons as to why they would take so long on such a seemingly easy task:

1. The satanic computer, mad at me for saying a prayer that it would survive the exam, ate my test. Evil, evil computer!

2. An Dark Evil Overlord has infiltrated the NBOME, plotting to take over the world by turning young doctors into mindless zombies that spend their whole day checking online for their test results.

3. Terrorists have abducted the NBOME Chief of Score Reporting, holding him ransom for a pound of pickles.

4. It's the end of the world and they know it. They feel fine... Yeah, they feel fine about not giving us our test scores. Punks! Well, I don't feel fine: I'd still like to see my score... A passing score would put a positive spin on the world ending.

5. The NBOME is an alien organization mothership from the planet Zerthon bent on sucking the hope and life out of the earth's young physicians.

6. It's a government conspiracy to keep us from finding out our scores. I think the alien one is more convincing.

7. An evil artificial intelligence infiltrated the NBOME's computer files, deleting all our test scores to make us humans suffer.

8. Barney the Dinosaur broke in and beat up the NBOME staff so that they wouldn't be able to post our scores. I knew that dinosaur was evil!

9. The NBOME are a cult dedicated to sacrificing our test scores to their unholy gods.

10. A dorky space ranger from the future came back and shot all the NBOME staff with a freeze ray to keep them from posting our scores which would send about a chain of events that may destroy the universe as we know it! I hate that space ranger; I'd rather have my test scores.

See, maybe there are very good reasons for them torturing us poor, unlucky test-takers. At any rate, I feel better now that I vented. :)

Post to you next time.


P.S. I figured out the NBOME motto:

"It's not that we don't care; it's that we don't want to care."

Going Natural: Cocconut Milk Can Kick Swine Flu Backside

I just flew back home from a conference with the International College of Integrative Medicine in Michigan and I have jet lag, so I'm going to try to keep to the bare essentials. Today, I'm just going to mention some natural things that you can use in the event that you or one of your family members catches the H1N1 or any virus for that matter. (Image taken from http://madure.multiply.com/journal)

Now this advice is not meant to replace going to your primary care professional. Far from it. In fact, so far from it that you could travel to Pluto and back before reaching it. If you begin to experience any of the symptoms of the H1N1, the first thing you need to do is get yourself to the hospital or make an appointment with your primary care physician. So basically, let's just put it this way, you avoid going to the doctor when you experience the flu symptoms, then you risk doing what is in the following image:
(Image taken from http://kickbutthumor.blogspot.com)

So, instead of replacing professional medical advice, this post is just meant to provide you with some additional tools by which you can strengthen your immune system to fight off infections. Having said that, let's get down to it:

To begin, I have come across a number of reputable natural products, which deserve acknowledgment here. I must state that I am not in any way trying to promote the sale of these supplements or have any monetary invested interest in them.

I just want to mention that studies have been done that show the efficacy of these agents in helping the body naturally handle viruses. I am sure that there are other products and companies out there with their own versions of these same supplements and are just as reputable. I just haven't heard of them yet. These I discovered, because they were from companies that were screened by physicians at the ICIM conference.

On the other hand, I would like to also provide a word of caution in regards to just going out and buying supplements. Be careful that the companies that you purchase from have been tested in independent studies as to being safe and free of harmful chemicals. For instance, 20% of the Ayurvedic Herbs sold in the Boston area had traces of Arsenic, lead, and mercury in them. (Quig,D. (2004) "Chronic Metal Toxicity: Assessment of Exposure and Retention," In Textbook of Natural Medicine, ed. J.E. Pizzorno, Fr. Elsevier, 3rd ed.)

In addition to that, make sure that the good quality supplements that you use do not have any contraindications that apply to you or your current medications. For instance, those currently taking Warfarin (Coumadin, Jantoven, Marevan, Lawarin, and Waran are some of its brand names) should be aware that over 90% of herbal supplements have adverse reactions with the drug. (See for more details: Lemos, et al. (1999). Herbal Interactions with Warfarin. http://www.vhpharmsci.com/Newsletters/1990s-NEWS/Article21.htm)

The following is a list of supplement categories, their descriptions, and the common products out there.

Lauric acid derivatives:

Lauric acid was first discovered in human breast milk. It is a medium chain, fatty acid that has antibacterial and antiviral properties. It also was discovered within coconut milk. I hear that "phew" of relief when I told you that it wasn't just found in human breast milk.

The most common form of lauric acid is Monolaurin, which is a glycerol ester of lauric acid and is more biologically active than lauric acid itself. Monolaurin is a natural antimicrobial agent that helps protect the immune system from a range of infectious critters.

To be more succinct, Monolaurin has the property of aiding the immune system in destroying envelope-coated viruses. In a study performed by the CDC, Lauric acid/Monolaurin was demonstrated to solubulize the enveloped membrane of 14 human RNA and DNA viruses. These viruses include influenza, Rubeola, RSV, Coronavirus, Newcastle's virus, Epstein-Barr Virus (EBV), Herpes Simplex types 1 & 2, Human Papilloma Virus type 6, and cytomegalovirus, to name a few. (Note: Monolaurin has no effect on naked viruses, such as encephalitis, coxsachie, pox, or polio viruses.)

This product works by disintegrating the envelope coat of the viruses. The bugs take in the fatty acid for use in their own replication, instead the lauric acid derivative destroys their envelopes, paving the way for the body's immune system to attack the virus. (See Hierholzer JC and Kabara JJ. (1982). In vitro effects of Monolaurin compounds on enveloped RNA and DNA viruses. Journal of Food SAfety, 4:1. See also, Lieberman, SC. Antiviral Intervention for Chronic Fatigue Syndrome. www.drshari.net. See also, Fierro, AA. (2007) Antibacterial, antiviral, and antifungal nutritional supplement: a combination of natural or neutraceutical compounds shown to have antibacterial, antiviral, and antifungal properties. US Patent Office. US 2007/0116778. See also, Clarke and May (2000). Effect of antimicrobial factors in human milk on rhinoviruses and milk-borne cytomegalovirus in vitro. J Med Microbiol, 49: 719-23).

Examples of Monolaurin products are:

Lauricidin (3-monolaurin) which can be found at http://www.lauricidin.com/. Refer to the company for correct dosing. I'm too lazy to include that information today. But if you're really interested, leave a question in the comments section below this post and I will send you the dosing instructions.

Monolaurin from Ecological Formulas. Which can be found on any natural supplement site.

Viraclear EPs 7630:

This is not a lauric acid derivative, but this is a homeopathic remedy for viruses that has been proven in more than 20 clinical trials as being effective in enveloped viruses. (refer to Chucalin, AG, et al. (2005) Treatment of acute bronchitis in adults with a Pelargonium sidoides preparation (EPs 7630): a randomized, double-blind, placebo-controlled trial. Explore,1:437-445. And also, Kamin, W. (2007). Pelargonium sidoides extract EPs 7630 in the treatment of respiratory tract infections in children and adults--an overview of recent results. Planta Med, 73:822.) No studies have been performed testing the effects of EPs 7630 on the novel H1N1, so the Integrative Therapeutics company, being a largely research based organization, makes no claims that it can help in treating the swine flu.

Yet, this product has been shown to the shorten duration of and reduce the severity of symptoms of upper respiratory infections, including the common cold, bronchitis, and sinusitis. I'm not saying that this agent is perfect for dealing with the H1N1, but it is something to consider. You can find this product at www.integrativeinc.com.

Herbs and Spices:

Origanum is a genus of about 20 species of herbal plants from the family of Lamiaceae, particularly the culinary herbs of Marjoram and Oregano. The most important of this group is Oregano, especially Oregano Oil. This oil has been shown to be effective in boosting the immune system against viruses, bacteria, and parasites. (Image taken from www.cure-nailfungus.com/Natures-Home-Remedy.html)

In fact, Preuss, et al. (2005) demonstrated that the essential oil Organum had bacteriocidal effects against microbials such as Staphylococcus aureus, Mycobacterium terrae, Helicobacter pylori, Klebsiella pneumoniae, and Escherichia coli. They compared it to monolaurin, which was also found to have bacteriocidal effects, but only on bacteria such as S. aureus, H.pylori, and M. terrae. Both fatty acids were also bacteriostatic to Bacillus Anthracis Sterne. (Preuss, H., et al (2005) "Minimum inhibitory concentrations of herbal essential oils and monolaurin for gram-positive and gram-negative bacteria." Molecular and Cellular Biochemistry, 272, 29-34. http://www.springerlink.com/content/r4141k0583264m7l/. See also, Batovska, et al. (2009). Antibacterial study of the medium chain fatty acids and their 1-monoglycerides: individual effects and synergistic relationships. Pol J Microbiol, 58: 43-7. And also, Soekmen, et al. (2004). In Vitro antioxidant, antimicrobial, and antiviral activities of the essential oil and various extracts from herbal parts and callus cultures of Origanum acutidens. J. Agric. Food Chem, 52:3309-3312.)

Elderberries: Why we love them

Professor Zakay-Rones, et al. (1995) demonstrated that Elderberry extract called Sambucol (SAM) reduced the hemagglutination of and inhibited the replication of several strains of influenza virus and reduced the associated symptoms. (Please refer to: Zakay-Rones, Z., et al. (2005) Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B in Panama. Journal of Alternative and Complementary Medicine, 4:361-369.) (Image taken from thriftyliving.net/?p=7)

PharmaCare Europe produces the Sambucol product and can be found at http://wwcol.comw.sambu/.

Pure Compounding Pharmacy (www.purecompounding.com) also offers a nice elderberry extract with dosing instructions as well as a Immune support package which includes it.

Peppermint Oil: It doesn't just smell good

In a study, Shuhmacher demonstrated that peppermint oil, the essential oil of Mentha piperita, was active against even the acyclovir resistant strains of enveloped viruses. "Considering the lipophilic nature of the oil which enables it to penetrate the skin, peppermint oil might be suitable for topical therapeutic use as virucidal agent in recurrent herpes infection." (See Schuhmacher, A. (2009). Virucidal effect of peppermint oil on the enveloped viruses herpes simplex virus type 1 and type 2. Phytomedicine, 10:504-510.) (Image taken from www.puremints.com/peppermint.htm)

Olive Leaf Extract: A few words

Well, I hadn't intended to include this extract, but I recently discovered research that shows its antiviral properties against viruses, such as HIV and VHSV. So, I decided to give the olive leaf extract an honorable mention in this list. (Lee-Huang, et al. (2003). Anti-HIV activity of olive leaf extract (OLE) and modulation of host cell gene expression by HIV-1 infection and OLE treatment. Biochemical and Biophysical Research Communications, 307, 4:1029-1037. And also, Micol, V., et al. (2005). The olive leaf extract exhibits antiviral activity against viral haemorrhagic septicemia rhabdovirus (VHSV). Antiviral Research, 66:129-136.)

So there you have it: a small list of natural items that you can add to your armory to prepare for the battle against the H1N1. Man, I'm tired.

Link of the day on Herbal Safety: http://www.peacefulmind.com/safety.htm This site gives a listing of the current herbs, their indications, contraindications, and side effects.(Image taken from www.seniorsworldchronicle.com/2009_05_01_archive)

Sunday, September 27, 2009

A New War Cry: The Power of the Pig Stops Here!

Working in the health care industry, you become indoctrinated in the way of the acronym. It's like being trapped in a world of IM speak, where teenagers across the globe are texting their friends as fast as you are talking. (Image taken from http://www.lamblion.us/2009_05_01_archive.html)

"He's in V-fib: Get the AED and give him 360J, STAT! Place 2 bore IVs: 16 gage. Ready 1cc of epi, ASAP! What's his BP and HR?!"

Okay, so that is not how it really goes. I had to add in some normal words so that anyone reading this wouldn't think that I was trying to send an SOS to the planet Plutekion.

Now that I prefaced this acronym style of medical talk, you won't be surprised when I say that the theme of this post is BSI. I think since we're taking a war strategy attitude in handling the Novel H1N1 that "BSI", should be our war cry. So let's practice together: BSI! BSI! BSI!

It feels great, doesn't it? Wait, I forgot: you don't speak medical geek. So, I will happily translate the acronymese. BSI means.... No, it's not Big Squishy Inkerdinks. I know what you're thinking; you saw this post and thought "Holy inkerdink! That's a lot of swine flu crapola."

Instead, BSI stands for: Body Substance Isolation.

Normally, the term BSI is used when you arrive on a scene of an accident and you see a Moby of blood, guts, and gore that would make Stephen King blow chunks. Either that, or the need to wear gloves to keep from touching anything that could be construed as bodily fluids. (Note: if you saw half of the slimy stuff that we see in the medical field, you'd realize that goo does glow in the dark. Somethings are just too scary for words.)

In this case, I'm going to take BSI interchangeably with the idea of how you can protect yourself and your family from contracting the H1N1 from seemingly innocent places. But first, I want to stand on my soap box and state something that is bothering me. I was searching on the net as all we bloggers do when looking for awesome pics to spice up the fruits of our labors.

And first, I found this picture of a health care worker getting prepared to screen patients for the swine flu. This is BSI to the extreme, all this person needs is some goggles and you have total body coverage, non-HAZMAT style. Even look at the two face masks the worker is sporting; now, that's some serious BSI right there.

I've had to don on this stuff myself before. It was prior to walking into an infected patient's room. Then immediately, upon walking out of their room, I had to strip the gear off and dispose of it in a bio-hazard bin that was right next to the door. The bin had signs above it warning anyone that happened to be crazy enough to look inside a big red, bio-hazard garbage bag in a hospital that it was not a wise thing to do. Then, after all that I had to seriously wash my hands and alcohol my stethoscope. That was hospital protocol.

So, I will nominate the above as Example A: The medical profession's idea of protecting oneself from the swine flu and the other random viruses that have appeared on the scene over the last week. (Image taken from http://www.paraswadher.com/2009/08/swine-flu-nagpur/)

Then, when I came across the image to the right. The first thought that came to mind was: "What the Fahrvergnuegen!? Who's sick and twisted idea of BSI is this?!"

This picture was pulled from a site, discussing individuals that had been known to contract the H1N1 and I believe it was being the areas where they lived. (Image found on http://blogs.poz.com/shawn/archives/2009/05/swine_flus_patient_z.html)

I hope they have some seriously giant bottles of hand sanitizer to go with those bathing suits.

At any rate, I will nominate this as Example B: The "what the heck were they thinking?" version of BSI.

Please compare: Example A, we have Health Care Worker style of preparing for the H1N1. And Example B, we have Malibu Barbie and Ken style of preparation. Which version are you in support of: A or B? I should open a voting link or something.

Anyway, this is not to say that we should go over board and break out the surgeons' gowns, gloves, boufont caps, and N95 masks every time we go outside.

But there is an interesting dichotomy of the understanding of the H1N1 presented in the above two pictures.

Okay, to be fair to bikini Barbie, face masks are great, especially if they are N95 face masks that are designed specifically to filter out bio particles. Yet, most viruses we catch, are contracted from the things that we touch.

And if the bikini couple were near individuals infected the swine flu or infected items with all that skin? ... Well, you do the math.

Enough of my little soap box, let's talk about the places and things where can possibly acquire the swine flu.

The grocery store: Shopping carts (not just the handles), grocery bags, canned foods, produce, money, key pads, Pharmacy counters, etc. Anything you touch, someone else can touch.
-Now most grocery stores provide sanitation wipes for the cart and hand sanitizer at the cashiers.
-Also, any other type of stores: Dressing room handles, toys on display, dvd packages, rack clothing, etc.

Gas station: I know everyone fears the germs that could arise from the gas station bathroom. But the gas pumps and squeegees can be H1N1 perpetrators as well.
-Here's a scenario for you: You take your keys from the ignition and get out to pump some gas into your poor hungry car. You grab the pump handle and set it to automatic, so you can squeegee your windows. After you're done with all that, you get back into your car, use your keys to start her up, and then steer out of there.
If that handle or squeegee was carrying H1N1, then you have just infected your hands, your car keys, your car door handles (inside and out), and your steering wheel.

Moral of the story: Hand sanitizer and disinfectant spray are our friends.

Public and home restrooms: Commode seats, handles, fixtures, and bathroom doors.

Banks: Bank counters, bank pens, money, credit card and ATM keypads, the teller window canisters and buttons, the free candy they give you for letting them do wonders with your life savings, etc.

Church: (This is a sad one, and I am definitely not promoting the avoidance of Church, or any of the places listed here for that matter. So those of you that get the "Sunday flu" don't go to your family saying that Christine told you that you had to stay home from Church to watch Football in order to stay healthy.) Hymn books, offering plates or trays, pews, Church nursery toys, pamphlets, podiums, etc.

Work or School: (This is an area where you or your child should stay home if you exhibit any of the symptoms. Also, if there is a child that has come down with the swine flu in your child's class, it is best to have your child stay home for a little while. Keep in mind that children can have the flu for up to a few weeks before exhibiting symptoms as well as stay contagious longer after the signs and symptoms disappear. I will discuss this in further detail later.)
-Copy and fax machines, pencils, pens, shared keyboards and mouses, coffee makers, chairs, couches, desks, backpacks, lockers and locker rooms, passing notes (Hah! Got you kids! Try texting instead.), etc.

The Mall: Self-explanatory. But I will add here arcades and game handles, video game controllers in electronic stores where people sample games, elevator buttons and escalator handles, etc.

Other: Doctors' office waiting rooms, ER waiting rooms, any waiting room especially pediatric ones, Hotel room surfaces, restaurant menus and surfaces, etc. In a nutshell, I can't say all the places that you can pick up some viral hitchhikers from. (Please refer to the CDC for more information on this subject.)

Also, I am not intending to turn all of us into Howard-Hughes-germ-a-phobes, where we go around for the rest of our existences worried that we'll catch anything off of everything. But instead, I am hoping that we all acquire an extra sense of caution and try to practice the BSI protocols of washing of hands or wearing disposable gloves after touching things in public places during this flu season. And then, cleaning surfaces with disinfectant sprays.

All in all , the bare minimum suggestion that I am going to make when you are in situations where you will come in contact with people that ma have H1N1 is that you avoid taking the Malibu Barbie style of BSI and at least wear: gloves, an N95, eye protection (such as goggles), and carry sanitizer wipes, and/or hand sanitizer. Then take a really nice shower after wards.

Also, I suggest getting one gianormous can of disinfectant spray that is labeled kill viruses, if you haven't already purchased one.

(Image taken from http://www.who.int/en. Please refer to the site http://www.mumbaikar.com/en/media/get/20090806_h1n1-poster-1.jpg for a better viewing of the above image. No matter how hard I tried, I still couldn't get it to stop being blurry.)

Until the next post.

This is Christine the Medical Student wishing you a happy BSI filled night!

Link of the day: This cheesy yet fun link is of the H1N1 educational rap found on youtube,

(The H1N1 rap was written, produced and performed by Dr. John D. Clarke, MD, FAAFP.)

Saturday, September 26, 2009

Preparing for the Flu Season: Waging War on H1N1 One Step at a Time

Now that I have finished subjecting myself to the horrible torture of the Medical Board Licensing Exams, I finally have time to dedicate to writing tid bits about bacon... that is writing blogs about preparing for the Swine Flu a.k.a. the Novel H1N1. (Image is a T-shirt logo, go figure, taken from http://shop.neatorama.com/product-info.php?swine-flu-bacon-revenge-pid411.html)

The information covering H1N1 precautions and preparedness will come in a series of posts. There isn't a snowball's chance in heck that I could cover all the material in just one shot... well, I could, if you like reading a novel about the Novel H1N1. But at least, I will be able to guide you step by step on how to start paddling though the loads of manure out there on the subject.

So together, we will handle the threat of the H1N1 like any normal and rational people of the 21st century: we will wage war on it. We're talking full-on military strategy! Bring on the missiles of disinfectant and the trenches of hand sanitizer: nothing is getting through our defenses. So bring on the rain, you piggy fiend from the underworld!

In the words of the great military strategist, Sun Tzu (The Art of War), "It is a matter of life and death, a road either to safety or to ruin. Hence, it is a subject of inquiry which can on no account be neglected."

The last post I wrote laid the foundation for understanding the nature of the bacon beast and what we are up against, focusing on debunking the myths surrounding our viral pork product. One of the first steps in engaging in the art of war is lay plans based on the characteristics of your enemy, while eliminating any misconstrued beliefs of their weakness or false strength.

In this post, I will attempt to finish that premise, by describing how to recognize the bacon bandit. So, to start off, I will explain what the signs and symptoms are of the H1N1 as compared to the regular seasonal flu.

The New York Health department gives a nice list of the similarities and differences between the two viruses. I will begin with the general influenza symptoms: these symptoms are evident in both the seasonal flu and the H1N1, which include fever, cough, runny nose, sore throat, body aches, headache, chills and fatigue.

The novel H1N1 goes further (it likes to inflict punishment) and includes symptoms such as diarrhea and vomiting. Worse cases of it can also result in difficulty breathing, pain or pressure in the chest or stomach, bluish discoloration of the skin, dizziness or confusion, and fever that is higher than 101.4 degrees Farenheit. (http://www.health.state.ny.us/diseases/communicable/influenza/h1n1/) (Image derived from: http://findmeacure.com/2009/04/29/swine-flu/.)(Strange, this image is supposed to be a picture of a man infected by the H1N1 and look at him, he's smirking pleasantly : I just want to know what's up with that.)

In addition to the extra symptoms, the H1N1 has a habit of profiling its victims. It is more prone to attacking younger people than it is the elderly. In fact, people aged 25 or younger, or are pregnant are more likely to contract the H1N1 than the elderly population that are more prone to being effected by the seasonal influenza. (http://www.cdc.gov/h1n1flu/qa.htm) Now, that is not to say that the older folks are safe from contracting this virus, but for some reason, the H1N1 prefers to focus on younger victims. Maybe, its looking for dates. (Image taken from http://www.paraswadher.com/2009/08/swine-flu-nagpur/)

Or maybe, the internet dating sites just didn't work out for it, so it is seeking revenge on all the youthful people that spurned it.
As in, some dumb internet date says to it, "You're a lot fatter than your picture." I mean really, the swine flu has feelings too.

We don't know. We may never know. Maybe we'll get lucky and the swine flu will go on TV, in front of a dirty green cloth painted with squirlies, to make an announcement of why it launched an attack on young people across the world as some sort of symbolic Jihad, while all the true viruses shake their heads at its blatant stupidity and rash behavior.

But at any rate, we still need to be prepared to counter the viral onslaught this coming flu season. Which leads us to the next step in the art of war, preparing defenses against and preventing the advancement of your enemy's forces.

The first thing we can do is get the seasonal flu shot. No, it won't protect you from the H1N1, but it will make you feel better about it. No really, it is important that we still protect ourselves from the seasonal influenza as well as the H1N1. Remember the 36,000 that the seasonal flu kills each year, well that number isn't going to just go away just because the Novel H1N1 has made its debut. Every prima donna has to have its understudy. (Image of Miss piggy taken from http://muppet.wikia.com/wiki/Miss_Piggy)

Second, we can remember that perfect hygiene is the best means of preventing the transmission of the disease. Covering one's mouth and nose with a tissue when coughing or sneezing has been shown by researchers to greatly reduce the spread of the H1N1.

If a tissue isn't available, coughing or sneezing into the crook of one's elbow and not his or her hands has been shown to be a good alternative in preventing the spread of infection. Just don't let your date grab your arm after you sneezed into it; because, ewe! It doesn't make for a good first impression. (http://www.cdc.gov)

Holy pork rinds, Batman! Can you believe size of that spit spray in the above picture?! It's like sputnik exploded in his mouth, or like he swallowed an angry fire hydrant! Or maybe, he wanted to do an impression of Old Faithful?

Actually, that picture is a good depiction of the spray of respiratory droplets that happens when anyone coughs or sneezes without covering their mouth and nose. Influenza viruses, especially the H1N1, are transmitted by water droplets sprayed into the air by coughing or sneezing. One 'achoo' and there we have the world being spritzed down with a personal shower of germs. And who said that it isn't in human nature to share? (Image taken from http://www.morethanmedicine.us.gsk.com/cgi-bin/mt/mt-search.cgi?blog_id=8&tag=CDC&limit=20)

There are two main ways that the flu can be spread:
1. Either the influenza is dispersed into the air to land on surfaces through respiratory droplets, as demonstrated in the human geyser picture above or...
2. The virus is transferred to an object or surface from an infected person's hands.

Then an unsuspecting victim, minding their own business all healthy and happy, touches one of the infected surfaces unknowing of the viral-loaded presents that lay thereon, and then touches his or her eyes, nose, or mouth... Wham! They are inoculated with H1N1 and the cycle of transmission continues.

So, if you haven't guessed it already, the next line of defense, and perhaps the single best method of prevention, is vigorous hand washing with soap and water. (Other ways of prevention will be discussed in greater detail in a later post.) [Image of washing hands was taken from http://hubpages.com/hub/Ways-to-Prevent-H1N1-Flu-or-Swine-Flu]

In addition to washing with soap and water, it is also a good idea to carry hand sanitizer gel with you. Hand sanitizers are a fast and effective way of eliminating germs from your hands and your children's hands when you are out and on the go.

Ah, darn! Look at the time. I guess that is all I am going to have time to discuss today. But my next post will give a deeper look into understanding where one can catch the H1N1 and how to prevent the monster pig from attaching itself to you and entering your homes.

Later posts will discuss what to do in case the virus does manage to enter your household, what to do if you are infected yourself, how to take care of sick children, what to do in the event of a quarantine, and the things that you may need on hand in the event of these things do occur.

Have a safe and fun pig-free day. Until next time, please try to keep yourself from ending up like this guy.

The caption read, "Kermit the frog dies of the Swine Flu. And we all know who gave it to him! Don't we?" Be afraid. Be very afraid. (Image of Kermit the frog dead from the Swine Flu taken from http://timwadesblog.com/tag/kermit-the-frog/).

Wednesday, August 26, 2009

H1N1 (Swine Flu): Putting Porky the Pig Myths in Their Place

I know it has been a over a month since I posted last, but I have been trapped in the ritual of preparing for the medical licensing exams.

I figure since there has been great interest in the upcoming flu season that I should take a break from my studies and talk about some pork. Not necessarily the other white meat, but the swine flu, or rather H1N1, that presents a problem to this year's fall festivities. (picture from http://www.ktis.fm/blogs/lisa/2009/04/29/where-swine-flu-comes-from/)

But, before I write a post about how to cope with the H1N1, I have to do some myth busting. Sorry, it's not that I don't love you mythophiles and legend lovers, but I have to do this; it's for your own good. We must accept that some myths no matter how fascinating, are a bunch of .... well, hogwash. :)

Myth 1: Eating pig meat causes the swine flu

I personally love this myth. Can you imagine how many calories we would save if pork actually caused the virus? No wait, how many scary pork-flavored meals we could avoid!

"Ahem, I'm sorry Aunt Bertha; I'd love to eat your pork belly chop stew, but I'm cutting back on the swine flu. Doctor's orders. No more bacon butts for me." (picture from soda.com)

So truth be told: you can't get H1N1 from eating porkchops.

Dr. Ed Hsu, an associate professor of health informatics at the University of Texas Health Science Center indicated that "There is no scientific evidence or literature or any studies that suggest that one contracts H1N1 virus through eating pork or handling pork products." (abcnews.go.com)

In addition, the Food and Agriculture Organization (FAO) of the United Nations has stated concerning the virus, "Given current facts and scientific understanding, consumption of pig meat does not bring any increased risk to the consumer." (http://english.peopledaily.com.cn/90001/90777/90856/6649432.html)

Too bad the FAO forgot about the increased risks of hypertension and obesity from eating buckets of bacon, but that's another subject entirely.

Furthermore, Agriculture Secretary Tom Vilsack (www.foxnews.com) has made a general statement to Americans that the H1N1 is not a food-borne illness an that it has absolutely nothing to do with eating pork products. So you can pig out on all the sausages and hot dogs you want. You're more likely to get the H1N1 from the package the dogs come in, than the little pork guts themselves.

The real reason why H1N1 began to be known as the 'Swine Flu' was that it manifested like the Asian and European swine influenzas that were contracted first by hog herders.

Yet, it is true that pigs are intermediate hosts for a number of influenza strains.

Our little piggy friends first mutate the strains within themselves, and then are so obliging as to share the new human-loving strains with us. And who said that pigs were selfish animals?
(picture from National Institutes of Health http://www3.niaid.nih.gov/NR/rdonlyres/3D377A8B-747F-480A-832E-02A8ED9D1B3C/0/AntigenicShift_HiRes.jpg)

In reality, the H1N1 is like the Frankenstein of influenza viruses. After analyzing its genes, scientists have discovered that it is a never-before-seen mutated combo of the genetic components of at least four different classes of flu viruses.

It is true that health officials have seen conglomerates of virus strains before, but "never such an intercontinental combination with more than one pig virus in the mix." (http://centurean2.wordpress.com/2009/04/29/why-call-it-swine-flu-when-its-a-mixture-of-avian-human-and-swine-viruses/)

The viruses mixed within it include: the Asian, Europian, and North American swine flu strains (no shocker there); the Human Influenza(no shocker there either, considering that humans have now contracted it); the North American Mexican influenza; and the North American avian influenza (Surprise!).

Yep, there it is our old buddy the Bird flu, back to bite us in the pork belly. And you thought the Avian flu had gone without even saying, 'hello.'

And in a nutshell: a pidgeon fell in love with three little pigs, and now we have the H1N1, formally the artist called Swine flu.

Myth 2: Swine flu parties are fun!

I just have to say in response to this myth, "What the heck?!"

One question: who came up with the idea that going to a party with a bunch of people infected with the H1N1 is a good thing?

For those of you who haven't heard of this myth: Swine flu parties are gatherings of non-infected people with infected people for the purpose of catching the swine flu early in the season.

Okay, I don't know who out there is propagating the fantasy that people are better off if they catch the flu "before it mutates in the fall." But... wow! I'm impressed at their creativity. That is about as good as the cultural belief in some parts of Africa where if a man sleeps with a pure virgin, he'll be cured of AIDS. (Sorry, to all those that follow the virgin-AIDS-cure belief, but it's entirely and deadly false. But if you still want to believe that, I've got some Ocean front property in Ohio that you might be interested in.)

Back to the subject at hand: Yes, there are some people out there in la la land who somehow believe that if they inoculate themselves now with the virus that they will be protected from a worse and more mutated strain in the fall.

Well, I hate to burst their bubble, but the H1N1 has already mutated. It's the mutated freak of mutations. All mutants shun it. If Magneto's wife had this mutated virus as a child, he would divorce her for cheating on him with the monster from the deep lagoon. (Note: Magneto is a Marvel comic book character that is a mutant-rights activist to a major extreme...[picture from photobucket.com])

It probably is best to avoid the H1N1 altogether.

Myth 3: H1N1 is more benign than the seasonal flu

Basically, this is another pipe dream. Dr. William Schaffner of Vanderbelt University and expert on influenza strains explained that the H1N1 is "not a harmless infection. We anticipate that whatever it does this summer, it's likely to be a major player in the fall, and when something this new and unpredictable shows up, we are all well-advised to do our best to prepare for it." (http://abcnews.go.com/Health/SwineFluNews/Story?id=7691400&page=1)

While the seasonal flu kills nearly 36,000 per year, the H1N1 is estimated to kill up to 90,000. That's nearly three times as many people. Can you see now why Swine Flu Parties are a bad idea?

The President's Advisory Council (PCAST) has released a report indicating that the worse case scenario for the United States could be as many as 30,000 to 90,000 deaths from the H1N1 this fall, with 40% of the population contracting the virus. (http://www.examiner.com/x-12837-US-Headlines-Examiner~y2009m8d25-H1N1-or-Swine-flu-deaths-could-reach-90000-this-fall) Keep in mind that these projected numbers are considered to be in addition to the 36,000 that die from the seasonal flu each year.

While somewhere in between 5-20% of Americans catch the seasonal influenza, H1N1 is projected to affect nearly 30-50% of the population.

Not that I want to end on such an unhappy note, but I have licensing exams to attend to. I do fully intend to get to the good stuff of H1N1 preparations in my next post. So stay watching.

The link of the day is: http://www.cdc.gov/h1n1flu/


Friday, July 3, 2009

Indoor Air Quality: Plants That Can Save Us

Assuming that your house is still standing after a disaster and the authorities haven't attempted to evacuate you, the best thing for you to do is to stay indoors with your air vents sealed.

For instance, in the event of an earthquake, a good amount of dust is stirred up into the air, bringing with it a number of soil fungi that have been shown to cause lung infections in earthquake survivors, such as coccidioidomycosis immitis which is the cause of San Joaquin Valley Fever. (Refer to Jacobs, A.V. and Leaf, H. (2007). Fungal infections of the lung. Current Infectious Disease Reports, vol. 1, pp. 89-98 and Torre, J. and Richard, A.J. (2008). Coccidioidomycosis, emedicine, http://emedicine.medscape.com/article/781632-overview).

In the event of a nuclear fallout, there is the radiation factor. No biggy, right? Well, that's because you already know that it is best to go into your basement and seal off any openings to the outside in your home and stay down there for at least 3 weeks. (Note: Earthquake and Nuclear preparedness and disaster response will be discussed in more detail in a later post.)

So how do you survive in an air tight environment for a few weeks? Yep, you guessed it: Plants!

Not only do plants convert carbon dioxide to oxygen, they also filter harmful substances from the air such as formaldehyde (man, plants would've been great to have around when I was in Cadaver class), benzene, and trichloroethylene. So in a nutshell, plants function as amazing air pumps and humidifiers. (Aglaonema modestum picture taken from florists.ftd.com)

In 1989, NASA scientists Dr. B.C. Wolverton, Anne Johnson, and Keith Bounds conducted a study to find an economical way to purify air for the extended stays that astronauts made in space stations. (http://www.ssc.nasa.gov/environmental/docforms/water_research/water_research.html)

This study found that a particular fifteen houseplants performed better at air filtration than was ever expected.

Wolverton stated that, "Plants take substances out of the air through the tiny openings in their leaves (stoma). But research in our laboratories has determined that plant leaves, roots and soil bacteria are all important in removing trace levels of toxic vapors. Combining nature with technology can increase the effectiveness of plants in removing air pollutants. A living air cleaner is created by combining activated carbon and a fan with a potted plant. The roots of the plant grow right in the carbon and slowly degrade the chemicals absorbed there."

The plants were also found to be helpful to air-tight office buildings. For instance, in most office buildings, trapped pollutants produce what is often referred to as Sick Building Syndrome. (http://en.wikipedia.org/wiki/Sick_building_syndrome)

The signs and symptoms of this syndrome include: fatigue, nausea, confusion, flu-like symptoms, sinusitis, anxiety, pneumonia, headache, lack of concentration, edema, allergies, and insomnia, irritation of the eyes, nose and mouth.

Now if you're wondering how formaldehyde, benzene, and trichloroethylene get into your house, they do it like every other criminal, they pick the locks. No really, they are more like vampires, you invite them in... by bringing paper, cardboard, particle board, insulation, paints, oil solvents, adhesives, inks, varnishes, perfumes, deodorants, body lotions, cleaning products, smoke, pesticides, synthetic fabrics, carpets, detergents, etc. into your home. Darn, there goes the good things in life.

So here you are stuck in your house, trying to avoid the nuclear fallout like every other normal, non-mutant person, and all you have is books to read and walls to paint. Then you get that cleaning urge because you've got nothing to do except stare at the dust collecting on all the DVDs you can't use because the power is out. So, you clean and of course you have to varnish what remains of your furniture... and now you need to apply three layers of deodorant because you stink from all that work.

But then, suddenly, one of the radiation mutated cockroaches from the underworld just ate your dog and you have to whip out two cans of industrial strength bug spray because there is no way in Tartarus that your shoe is big enough to kill that thing. What do you do?

You get out your Mother-in-law's tongue. No, you don't have your mother-in-law to lick the roach to death; Mother-in-law's tongue is actually a plant called Snake Plant or Sansevieria trifasciata that filters all the chemicals from the above scenario. Please see the adjoining picture. (picture from dkimages.com)

In other words, you prepare with plants. The following is a list of the top 15 plants that NASA found were helpful in filtering indoor air:

1. Philodendron scandens 'oxycardium,' or heartleaf philodendron (This is that plant that never seems to die, no matter how much you lack a green thumb. Picture is to the left. plantoftheweek.org)

2. Phildendron domesticum, elephant ear philodendron

3. Dracaena fragrans, 'Massangeana', cornstalk dracaena

4.Hedera helix, English Ivy

5. Chlorophytum comosum, Spider plant. (I love this plant; you only have to water it once every two weeks! Perfect for times of disaster. www.webmaster-forums.net)

6. Dracaena deremenesis 'Janet Craig', Janet Craig dracaena (medium light)

7. Dracaena deremenesis 'Warneckii', Warneckii dracaena (medium light)

8. Ficus benjamina, weeping fig (intense light)

9. Epipiremnum aureum, golden pathos

10. Spathiphyllum 'Mauna Loa,' peace lily (in low light, this plant works the best)

11. Philodendron selloum, selloum philodendron

12. Aglaonema modestum, Chinese evergreen

13. Chamaedorea sefritzii, bamboo or reed palm

14. Sansevieria trifasciata, snake plant, mother-in-law's tongue

15. Dracaena marginata, red-edged dracaena

NASA suggested that there should be at least two plants per 100 square feet, or two plants per a small room/office. The results recommended 15 to 18 houseplants, grown in 15cm containers or larger, to filter an average home of less than 2,000 square feet. My grandma seems to apply the more is better rule: her kitchen looks like the rain forest.

For those of you whom are interested in which plants filter what chemicals....

Filters of Formaldehyde:
Green Spider plant, Peace lily, Bamboo palm, Mother-in-law's tongue, draecena marginate, golden paths, and dracaena warneckei.

Beaters of Benzene:
Peace lily, Bamboo palm, Gerbera daisies, Mother-in-law's tongue, English Ivy, and Pot mums (my grandma loves these).

Tricklers of Trichloroethylene:
Peace lily, Bamboo palm, and Gerbera daisy.

Well, again, I better sign off for today. Again, i must hit the books.

May you enjoy your time with your Mother-in-law's tongue.


Here is a list of resources for more information on NASA's study, including the pdfs for the day:




Tuesday, June 30, 2009

Around the House...

There are three things that I would consider essential to any wilderness or disaster medicine kit: Duct tape, plastic bags, and a pocket knife.

And no, I'm not trying to teach people how to kill their neighbors' annoying wiener dogs, even though at 3 am when the dogs are still howling like banshees-being-beat-by-super-monkeys, you did wish that you had some duct tape, plastic bags, and a pocket knife.

Actually, like duct tape, plastic bags, and pocket knives, the most versatile items in a good medical kit are the ones that you would find ordinarily around the house.

For instance, duct tape can be used to seal off sucking chest wounds (please cover the wound with plastic before applying duct tape... Duct tape plus torn flesh equals bad situation), stabilizing splints, and creating things such as stretchers out of jackets and ski poles, slings out of T-shirts (safety pins can do this as well), and a water catcher from a tarp, etc.

Here's one of my personal favorite uses for duct tape:

For knocked-out tooth (or avulsed tooth), rinse the tooth off with milk or water (don't scrub it) and replace it in the socket. Then cut a small piece of duct tape, and use it to splint the tooth to its neighbor. Be careful not to move the tooth too much out of its normal position when doing this. Then get to a dentist, if possible.

(Note: When treating an avulsed tooth, Dentists clean out the socket with water, then splint the tooth to its neighbor with resin and orthodontic wire. Can take months to heal. More dental treatments will be discussed in later posts. )

Also, in cases of earthquake or nuclear disaster and your house is still intact, it is in your best interest to duct tape plastic coverings over your windows and air vents. I'll explain this in more detail when I post about earthquakes or nuclear disasters.

As for plastic bags, especially the ones from the grocery store, they can be twisted into strong ropes. Okay, not so strong as to go bungee cord jumping, but you get the idea.

They can be cut to produce rain proof ponchos as well as be used to cover wound dressings or be bandages themselves.

They can be used as plastic gloves (check for holes first). Or for plastic boot covers to keep your shoes dry or to cover casts when you take a shower... again, holes could be a problem. ;)

They can also be used as pillow and mattress stuffing, when you run out of beds and pillows for your wounded and/or infirmed.

The big use for plastic bags is for sanitation purposes: use as barf bags, for disposing of dirty diapers or for use as diapers, use them as a port-potty liner, or even as a porta-potty themselves.

They can be used for emergency toilet paper (personally, I would prefer to stock up on the real stuff, but some people may prefer that glossy, crinkly feeling).

Here's my favorite plastic bag tip:

In cases of severe pandemics, if anyone has to go outside the home, it would be wise to have a decontamination area (garages are great for this or a mud room would work).

Everytime a person comes home, they go into the decontamination area to strip off their exterior clothes and get a good spray down with the hose and lather with antiseptic soap. Long-handled scrubbing brushes work. Think car wash for a person.

Any items taken off a person should be handled only with plastic gloves and placed into plastic bags. The contaminated clothes should be placed immediately into the washing machine with one part bleach and 10 parts water...Okay, maybe you can add more bleach. Hope you like tie-dyed clothing.

Pocket knives: You'd be surprised at how many people actually don't know how to use one of these things. So here is a link to more information on the use and characteristics of pocket knives.


Duct tape, plastic bags, and pocket knives aside, everyone of us has things that are just around the house that can be used in situations of disaster or in the wilderness setting.

The following is a list of some of the items that you could have that have great medical uses:

Meat tenderizer (the seasoning, not the mallet): Make into a paste with a few drops of water or spittle for bee or hornet stings. (In case of bee sting, please remove the stinger with a credit card first.)
The meat tenderizer must have chymopapin or papain in it in order to be effective. Chymopapin is a derivative of the proteolytic enzyme papain that comes from the papya tree (Carica papaya). So papaya works as well under the same principles. The meat tenderizer or papaya needs to be applied immediately to the stung area. They proteolytic enyme breaks down the proteins in the sting, neutralizing it.

Altoids: Not only are they good for bad breath, but they also help clear your sinuses as well. Herbal tea, especially peppermint or a handful of peppermint tic tacs (notice the peppermint theme) can also help clear up congestion.

Alka-Seltzer: In addition to helping you with your upset stomach, it also can help relieve urinary tract infections (UTI)s. Lemon also helps in eliminating UTIs. Both work on the property of changing the pH of your urine, making it difficult for bacteria to cling to the bladder wall.

Johnson and Johnson baby shampoo: (or other brand of baby shampoo). Treats cradle cap and can be used to clean wounds.

White sugar: Place inside superficial wounds and cover with bandages. It acts like an antibacterial and wound debriding agent. Clean the sugar dressing every day.

Honey: Can help heal skin blemishes and wounds. More acidic than table sugar, honey therefore has greater antiseptic properties. Honey should be used only inside the superficial wound and not on the skin surrounding it. Also, it works better on drier wounds, while sugar works better for more moist wounds. Cover with bandages and change dressings every two days.

Did you know that King Herod stored his dead wife, Mariamne in a barrel of honey to preserve her, for 7 years? That gives a whole new meaning to the term, 'she's my honey.'

Listerine: Created as a surgical antiseptic in 1879, listerine has more uses than just keeping you cavity-free and minty-fresh. It actually can kill toe fungus and be used as a balm for broken blisters. Basically, it is a good wound antiseptic, if you can handle the stinging nature of it.

Tomato paste: Boils beware. Cover a boil with tomato paste and a compress. It soothes the pain and brings the boil to a head.

Make a pinhole in cardboard: Believe it or not, but this can be used to help replace missing or broken glasses in times of disaster. Looking through a pinhole actually helps increase vision in people suffering from far-sightedness, astigmatism, and eyestrain. Also can reduce heart rate, tension, and headaches.

Well, that is all for today. It's time that I hit the books to study for my board licensing exams. Have a great day getting prepared.


Information link of the day:

The following is a pdf published by the United States Military for handling first aid and battle wounds created for public use: