Tag Healthcare

It’s time to shoot up again

Michael 4 Comments

There’s so much happening in the world, in the country in the state and I can’t do anything about it. Really, I’ve tried and the world/country/state hasn’t budged. But I can do something about me, for me, and help the world/country/etc/etc/etc at the same time. I can see it in your eyes! You know where I’m going!! Yes, you are 100% right. I’m going to get a flu shot. Much more fun than getting the flu. Trust me, I’ve had both. I was going to write a whole new post about flu shots but I’ve already done did that a dozen times or so, so I reached back to 2016 and pulled this one out. It’s still good stuff. Then after you read it, go get your flu shot. It’s about that time again!

Just Shoot Me

(From October 24, 2016, slightly edited to remove unnecessarily big words)

I’ve been shot. I suppose it was about 10 days ago now. I got my flu shot. I can probably count on one hand the number of years I didn’t get a flu shot all the way back to when I can remember doctors keeping lollipops on their desks for the good boys and girls who got their flu shots.

For years I worked in a hospital and getting a flu shot was just something you did every year. It went along with doing annual evaluations, decorating for Halloween, and renewing your parking permit. Everyone grumbled about it but everyone did it.flu

Now that I’m not working I have to remind myself to get a flu shot. And while I was busy reminding myself I thought I’d remind you. Get your flu shot.  If you are a southern hemisphere resident hold that thought for 6 months.

I never understood people who would come up with a dozen different reasons not to get a flu shot when it’s so effective at preventing the flu and when getting the flu can be so devastating. No, you won’t get the flu from the flu shot. You can’t get the flu from a flu shot any more than a zombie will eat your brains. The virus in the flu shot is dead – even more dead than an undead zombie. It can’t come back to life and infect you. What can happen is that you can get a cold or a fall allergy or a seasonal bacterial sinus or respiratory infection at the same time you get the flu shot but it’s not the flu.

You can get the flu in the same year that you get the flu shot if you don’t get it at the right time. Now is the right time. The flu shot doesn’t start working the instant the needle pierces your skin. It takes about two weeks for the vaccine to work its magic on your immune system so it is at its peak in protecting you against a live flu infection. You should schedule your shot about a month before the anticipated beginning of the flu season. If you wait too long to get a flu shot and you are exposed to the flu virus before your body can adequately prepare enough antibodies to repel an assault you can get the flu. The high dose version of the flu shot may provide effective resistance a bit sooner but should not be used as an option to timely inoculation.

You can also get the flu late in the season even if you got a flu shot if the circulating viruses mutate more quickly than expected and if your immune system is weakened by age or compromised by other diseases or conditions. For individuals with compromised immune systems the flu vaccine should be active for about six months. If you have weakened immune system and the active flu season in your area is expected to last past March or April you might consider asking your physician if you should repeat the flu shot six months after your initial vaccination.

Sorry if this post sounded too much like a public service announcement. It’s probably just a result of those years I spent in public service

Be A Hero

Michael 4 Comments

April is half over! In closer to normal years, people throughout the United States would be rushing to get to a post office to have their tax returns postmarked before midnight. It’s not a normal year. For the second April 15 in a row, it’s not been a normal year. For some.

Then there are some 107,000 people who would like today to turn extraordinary before midnight. Those are the people waiting for a transplant. Wait. Make that 107,001. About every 9 minutes another person is added to the list, another person moves another step away from normal. By the end of tonight 17 people will move off the list but not because they got their transplant.

DLAIf the numbers don’t get you – 107,000 waiting for transplant, a new person added every 9 minutes, 17 people dead each day because they did not get their transplant – how about this? April is half over. April is National Donate Life Month. There’s a Presidential proclamation and everything even. How many times did Donate Life Month headline a news report this month? How many people took to the streets to protest the needless loss of life of seventeen people yesterday, and the day before, and before that and before that and the one before that too?  How many times did you even hear about Donate Life Month before today?

Last year, 39,000 transplants were performed. I’ll do the math for you. That’s 106 transplant operations each day. At one added every 9 minutes, that’s 160 new additions to the transplant list. Every day we add 54 more people than we are transplanting.  That’s why the average waiting time for a kidney, which is the most common transplant performed, is 3 to 5 years. (Since I know you’re curious, lung and heart transplant waiting lists are about 6 months, pancreas about a year, and liver close to 5 years. Of course, a patient’s time on a waiting list is a factor of organ needed, blood and tissue type needed, and severity of illness.)

Saving lives is rarely a trending topic of Twitter, there are not many infographics on giving life on Facebook, and I haven’t seen one of those “How You Can Help” Instagram posts on alleviating the pain and suffering of up to 8 people with one act. More actually, and some even while you’re still alive! 

The number that gets thrown around a lot is that every organ donor can save 8 lives. One heart, two lungs, a liver, a pancreas, two kidneys, and the intestines. You can add to that two cornea, a lot of skin and a handful of other non-categorized tissues like the abdominal wall. That’s from a deceased donor.  Want to be a hero and still be around to feel good about it after the transplant. Living donations aren’t restricted to kidneys although they are the most common living donor organs transplanted. In addition to giving a kidney to transplant you can also donate a portion of your liver, pancreas and intestines, and one lung, For the most recent period, March of this year, the Organ Procurement and Transportation Network of the U.S. Department of Health and Human Services, reported 9,878 transplant surgeries of all types performed for March 2021 from 4,740 donations.* But that’s just solid organ donations. You can also donate bone marrow for transplant. And if all of that seems too icky for you, there’s still blood donation.

Don’t let the second half of Donate Life Month go by as innocuously as the first. Do something. At the very least register to be an organ donor after life when you renew your drivers license.  For more information on solid organ donation and transplant in the United States go to https://www.organdonor.gov/. You won’t make the news, nobody will say you name, and there will not be parade in your honor. Do it anyway.

* How can you perform more surgeries than you had donations? From living donors you can’t, but from deceased donors you can transplant multiple organs. In March there were 1,463 living donors responsible for 1,478 transplants (multiple living organ donations are rare but possible with kidney/pancreas transplants) and 4,740 deceased donors contributed to 9,878 transplants.

 

You’ve Got a Friend in the Pharmacy

Michael 4 Comments

Tomorrow is a special day for me. Almost as special as Groundhog Day (and if you read this blog for any of the last 8 Groundhog Days you know how special that day is). January 12 is National Pharmacists Day. It’s special to me because even though you might think I could make a decent living on the goofy blog circuit I actually have a professional side to me and for over 40 years have hung a hunk of paper from the state’s board of pharmacy declaring me to be one of them. Pharmacists not groundhogs.

National Pharmacists Day is an opportunity to recognize all pharmacists for their contributions to the nation’s health and health care systems throughout the country regardless of their practice settings or specialties. Yes pharmacists work in a variety of health care settings and do sit for specialty boards in a variety of conversations from psychopharmacology to eldercare.

Pharmacists trace the root of the profession to ancient Egyptian, Greek, and Roman civilizations. Recipes for remedies have been found on papyri dating to the 15th century BC. In the 1st century AD, the Greek physician Dioscorides wrote his five volume textbook on the practice of medicine and the use of medical substances and remedies. Pharmacy and medical students may more readily recognize its Latin translation De Materia Medica. It would another 700 year though until individuals took on specific roles of preparation and dispensing of medicaments that we associate with the specialty of pharmacy when the Taihō Code defined this role in 701 at the end of Japan’s Asuka Period. The roles of pharmacists and physicians would sometimes separate and sometimes blur through the first half of the second millennium. In 1683 the city council of Bruges formally separated the practices and passed an ordinance forbidding physicians from filling medication orders for their patients.

MortarBeforeIn the United States, Benjamin Franklin is credited for creating an autonomous apothecary within the Pennsylvania Hospital which opened in 1754 in Philadelphia. Although apothecaries were operating in the North American colonies, the pharmacist physician separation was not the standard practice as it was becoming common in Europe and England. Franklin’s insistence on the establishment of a separate service for the hospital was seen as an opportunity for drug research and development as well as to manage and dispense a fragile inventory.

Since 1754 pharmacists have taken more diverse roles, formally specialized, led development, and revolutionized education. Still the pharmacist is a dispenser. Whether of medications or information, whether to ambulatory patients, hospital staff, nursing home residents, fledgling students, or even to the International Space Station, pharmacists’ role is to give. Pharmacists embrace that role regardless of where they practice and continue to hone their skills and define their roles.

If you should happen to cross paths with a pharmacist tomorrow, join the dozens of people who even know this special day exists and wish him or her a Happy National Pharmacist Day!

Those Who Should Know Better

Michael 14 Comments

Ok, you’re going to need a little background for this. At times I’ve written about having kidney disease and going through dialysis. You might recall other times I’ve mentioned some unspecified rare disease. And then once or twice I talked about cancer. So if you sometimes get confused I can understand that. Some of my best friends get confused regarding what’s going on with me. Apparently so are some “experts.”

For the record, it all started about 15 years ago when I was diagnosed with Wegener’s Granulomatosis. Wegener’s is an autoimmune vasculitis that affects the smallest of blood vessels and the organs they occupy – most notably the kidneys, lungs, liver, and sinuses, in my case the kidneys. There is no cure but it can sometimes be controlled with combinations of chemotherapy, immunosuppressant, and steroid medications.

After 10 years of treatment with methotrexate and prednisone, the working parts of my body decided they wanted some attention and got together to vote on who would revolt. My bladder either won or lost depending on your point of view and grew cancer.  One year and four operations later I was pronounced cancer, and bladder, free and the proud owner of rebuilt body parts fashioned from other body parts that to this point had done not much more than the jobs they were originally intended.

In the process of trying to create a recoverable environment for my post-operatively rebuilt body I had to replace the drug therapy that was so far managing to keep the ravages of the Wegener’s at bay but now not such a good choice in a body now equally desperate to keep other cancers at the same bay. While that search was underway the dastardly disease took advantage of the temporary unprotected kidneys and put them into a (hopefully but who are we kidding) temporary shut down and put me in a chair at the local dialysis clinic.

And that’s how I came to be an unplanned early retiree with a handicap placard hanging from my rear view mirror. But “who are those who should know better?” you asked. Good question.  Why, the health care “experts” of course. I’m allowed to speak of them with disdain because I was a health care expert for close to 40 years before my unplanned early retirement. And those years included years when experts in health care were the ones educated in and actually providing health care.

Recently I had to complete some paperwork for the government’s end stage kidney disease program including what led me to be on dialysis. As in the past I check “other” after not finding in among the pages of pre-selected options and entered Wegener’s. It was rejected because there is no such condition in their database of diseases. Since I have it know for sure there is but I also know for sure it’s also known by another name, Granulomatosis with Polyangiitis, I questioned the explanation. Even if you’re being paid by the letter you have to agree that Wegener’s is an easier fit for a government form. And that’s why I had always fit it. So I called the help number for some help and asked what I had done wrong. I was told we’re not allowed to call it Wegener’s anymore because that doctor who discovered it “was a Nazi you know.” So all traces of his name have been removed and it is disallowed from official use. I wouldn’t have minded if at least they would have matched the funds it took to rename everything for “official use” with perhaps some official research.

But those are government people who are used to doing stupid things. Or things stupidly. But…there actually are others who should know even better even. Those are ones who bring me my tri-weekly adventures in artificial kidney function replacement. Or dialysis if you prefer,although personally I don’t prefer dialysis.

At the corner kidney clinic they posted a new “let’s raise everyone’s spirit” poster. On it is a classic pie chart with the legend, “ONLY 7%!” It goes on to explain that “You spend only 7% of your week in dialysis. The other 148 hours are yours to do the things you like!” Really. That sounds like something that someone who doesn’t know what dialysis does to a body wrote. Not a national organization responsible for 290,000 dialysis patients. (Source: that company’s website). That 7 percent might account for the time that you are actually having your blood circulate through the machine taking up the 10 square feet next to your chair. Not the time it takes for a nurse to do a pre-dialysis assessment and then physically connect you to the machine by way of two needles about the size and diameter of a Bic pen stuck into your arm. Not the time for a nurse to physically remove you from the machine by withdrawing the Bic pen like needles from your arm, for the bleeding one would expect for two holes the size of Bic pens in your arm to stop bleeding, and then to go through a post-dialysis assessment (all about another hour). Not the time it takes to get to and from the dialysis clinic (roughly another hour for me). Not the time it takes to physically recover from the actual process (in my case 10 to 12 hours).

So if we consider the time to get on dialysis, get off dialysis, go to dialysis, and recover from dialysis I actually have 10 hours a week to do what I like. I like to sleep about 8 hours a night and I like to eat at least 2 meals a day so I’m down to around 33 hours a week I can call my own. Almost a whole day and a half! I wonder if they would notice if I would “edit” their poster at the clinic.

PieChartHD

My revised pie chart

Well now you know who those are who should know better. A government who is more concerned with what to call diseases than what to do with the people who actually have the disease and the people who are supposed to be minimizing the effect of a disease on the body but are clueless about how to minimize the effect of the disease on the person.

Boy I feel bad for the poor soul who I might run in to today and says “Hey, how ya doing?” I might actually tell him.