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,
http://www.youtube.com/watch?v=_gwUdmPl0bU

(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/).