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Ebola: For Those Who Want to DO Something [Oct. 19th, 2014|11:49 pm]
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[Current Mood |awake]

Thanks to a Twitter post by @kejames, a scientist I follow,  who posted this link to information for those who wanted to help with the Ebola situation in West Africa:

It includes a link to this list of known, reliable, already-working-in-the-area organizations who have Ebola-related relief efforts ongoing in West Africa.  Links for online or mailed-in donations are given for each.   The website links explain each organization's range of activity.

This is not an attempt to guilt anyone into donating, merely information offered if you've been wondering how to help.   Everyone has their own priorities for giving and their own economic situation to consider.
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Ebola: When the Lightbulb Doesn't Want to Change [Oct. 15th, 2014|05:04 pm]
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[Current Mood |angry]

Texas Health Presbyterian Hospital--the hospital that misdiagnosed Mr. Duncan in the Emergency Room and sent him home, and then--once he came back with Ebola diagnosed by a family member--not only did not save his life, but managed to allow two nurses to become infected with Ebola while treating him--is a member of a group of hospitals run by Texas Health Resources.

"I don't think we have a systematic institutional problem," Dr. Daniel Varga, chief clinical officer of Texas Health Resources, told reporters, facing questions about the hospital's actions.

Medical staff "may have done some things differently with the benefit of what we know today," he said, adding, "no one wants to get this right more than our hospital."

Dr. Varga is wrong.  He is wrong factually (just the ER visit alone shows that THPH has an institutional problem in its Emergency Department--which other previous complaints and ratings also showed, previous to Mr. Duncan's visit.)   He is wrong in implying that medical staff acted properly with the knowledge they had at the time: they did not.  He is wrong administratively and politically, in not facing the reality and accepting responsibility.    Yes, there is an institutional problem.  His name is Dr. Varga.   He is the reason--or one of them--that Texas Health Resources has an institutional problem, and every other hospital in that group probably has the SAME institutional problems as THPH.

Dr. Varga just screwed the pooch.

So when the lightbulb doesn't want to change, and the lightbulb should be giving the light needed to see and fix a reach up and yank that sucker out of there and put in a new one.  A different one.  Both the CEO (to whom Dr. Varga presumably reports, and whom, presumably, he's shielding here) need to be replaced, and the replacements need to be informed upfront that they will be held accountable for lapses in quality care.

And in the meantime, the relevant hospital accreditation board should take a long hard look at not just THPH, but every other hospital within the Texas Health Resources group.  At the least, these hospitals should be audited for quality in every kind of case they accept, and put on probation to ensure they meet all standards in all areas.  I wouldn't close them all...but patients deserve better--all their patients deserve better.

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Ebola: Lessons Learned the Hard Way [Oct. 14th, 2014|12:36 pm]
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[Current Mood |determined]

We could start with the worst: those who rouse panic largely for their own gain: to make money, to get elected to or stay in public office, to get their faces on the front pages or a chance at being a talking head on TV, to raise the ratings of their network, TV station, radio station, blogsite, Twitter feed, etc, etc, etc.  But that bunch don't learn lessons--they simply take any problem, magnify it, and declare that it's someone else's fault (for the past six years, Obama's fault) and add it to their repertoire to bring up when they move on to the next problem they can get a little publicity out of.   So I restrain myself from adding my personal "Worst of the Panic-Raisers" list and move on to the lessons.   They're more important, and so are the reasons we're learning them the hard way instead of easier ways.

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And....More Socks [Oct. 11th, 2014|11:52 pm]
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[Current Mood |accomplished]

The last time I put up a picture of the Mountain Colors Indian Paintbrush socks, they looked like this:

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What's Blooming [Oct. 10th, 2014|04:51 pm]
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[Current Mood |accomplished]

While the skin cancer's being treated, I'm supposed to protect the treated skin from sun exposure (and yeah, all skin should be somewhat protected from skin exposure.)  This means that since through today it's been up in the mid-high 90s, I can't really get out on the land or ride the bike, because it's too hot to wear dense long sleeves while exercising.   Sweat is one thing, but heat exhaustion is another and I no longer have the heat resistance I had as a kid.  Funny thing about that.  Anyway--I can stand to wear a denim shirt over a T-shirt while walking briefly out to the grass garden.   Which now looks like this:

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Things Going Right [Oct. 7th, 2014|11:45 pm]
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I just watched a video prepared by the Dallas ambulance service.   They have (as I would have done, if I'd been in charge) designated units that will be used for transport of any future possible-Ebola patients in the Dallas area--three of them--and given the crews of those units extra training.  The video also covered how the units are decontaminated after transporting any high-risk patient (who might might have  TB or MERS instead  of Ebola.

Three of the top Dallas hospitals have designated where in their hospitals an Ebola patient would be isolated and how that area would be staffed.  They're ready if any of Mr. Duncan's contacts develop it or if someone else arrives sick from West Africa.

And then there's the judge I mentioned before: Dallas County Judge Clay Jenkins, who has shown courage, intelligence, and compassion.

And this church:

Then there's Youngor Jallah, a member of the extended family: if not for her, Duncan might not have been back at the hospital on Sunday.  Not only did she take his temperature and notice the redness in his eye, where bleeding had started, but she insisted that he go back to the hospital, called 911, and warned the EMS personnel to put on protective gear--telling them she thought it was Ebola.
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Anniversaries [Oct. 5th, 2014|06:44 pm]
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[Current Mood |contemplative]

Life provides us with the opportunity to mark time by personal events--birthdays, graduations, marriages, and deaths.   Every October 5 since 1990 has been an anniversary for me--my mother died on October 5, 1990.   Over the years since, the stark memories of her final decline, and the first months of grieving, have softened, overlain by other events, other anniversaries--births, graduations, marriages, and deaths.  But the day itself still hits like a baseball bat.  My mind refuses to ignore it, to treat it as an ordinary day.   It is split, constantly comparing, hour to hour, that day and this day--the October 5 in which I'm living.  The memory of that day--from waking up, from walking across the yard to her house, not knowing if she'd lived through the night, of finding her alive--awake--clearly waiting for me, the last word she said clearly, "Finally!"  through the next two hours before her last breath, as I sat with her, sang to her, fought my EMT/Paramedic urge to intervene, to try to bring life back to someone whose body was worn out, unable to sustain life, to allow her the peaceful, natural death she wanted--that memory is still vivid, still sharp enough to cut.  Every year it reminds me of her talents, her vivid wide-ranging intelligence, her humor, her kindness and service to others.   Reminds me that I saw there beside her, hand in hand, aware of the questions I hadn't asked, the complements I hadn't given.
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Adventures With Ultraviolet Rays [Oct. 5th, 2014|06:02 pm]
[Current Mood |confident]

I grew up in South Texas, and moved back to Texas after a few years in Virginia in the military.  Texas had powerful sun when I was a kid, and the ozone hole made its sun even more likely to burn than tan.  Though I wasn't one to lie out in the sun trying to get brown, I've always spent time outdoors: riding a bike, hiking, riding horses, just walking around, etc.  I tanned well, never burned (well, I wasn't spending hours in the sun trying to tan.   Back then, we considered suntan lotion to be what you used in order to tan or keep skin from drying out--not protection from sunburn.   I hated the greasy, gummy feel and the cloying smell, so used it only rarely, when I knew I'd be outside a long time.   I wasn't getting sunburned, so why bother?   So...despite using more care (once I knew to, which was sometime after 25)  I was browner than my natural skin tone on face, arms, lower legs for much of my life.   Less, as I got older, because of the aforementioned caution, but also because I was raising a kid and writing books.

You probably see where this is going.

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High Tech Vulture Roosts [Oct. 5th, 2014|04:15 pm]
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[Current Mood |awake]


Although not all the cellphone towers around here have a steady population of vultures--and I can't quite figure out why--some are often crowded with them in early morning and late afternoon/evening.   Sometimes only one species inhabits a given tower (this tower "favors" turkey vultures; another about 5-6 miles south-east has a large population of black vultures.)    Occasionally a hawk will rest on a tower during the day.   Cellphone towers give vultures a "lift" on  by giving them clear height to take off from, plenty of room to build up airspeed.
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One Failure Point--One Low-Tech Solution [Oct. 4th, 2014|03:34 pm]
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So it seems that other hospitals in oither states using the same software have, potentially, the same problem that Texas Health Presbyterian Hospital found in its software: there is no way to put a big whopping flag on the intake chart to indicate a known serious risk.   Programmers are no doubt downing coffee and chocolate and trying to modify the software without crashing everybody's system (which would not be good.)

But there's a fast, cheap, effective way to deal with this, says the writer who lives on both sides of the high tech/low-tech divide.  (No dishwasher, no smartphone, but computers and high-speed internet.)

Bright-colored (I suggest yellow, the color of the traditional plague flag--bright, easily noticed if it falls to the floor, etc.)  3x5 cards easily obtained in any office supply store, plus a stamp that says "Priority", an indelible marker (probably already at the ER intake desk) .  

Step one:  Hospital prints out a sheet to be taped to the staff side of the intake desk.   It reminds staff to ask specifically about travel  or residence in Guinea, Sierra Leone, or Liberia within the past 21 days.  Staff doesn't have to remember which countries--it's right there in front of them.   At the foot of the sheet is the in-hospital number they're to call if they "card" someone.

Step two:  Upon getting a positive answer to the question,  staff person writes patient's name on one card and hands it to the patient, asking the patient to wait right there.  Staff person clips second card to clipboard; if patient used that clipboard to fill out information, use the same clipboard.. 

Step three: Staff person 1 calls the contact number that will immediately initiate response to possible Ebola patient.   Upon arrival of team to ER waiting area, staff person 1 hands off clipboard to nurse or doctor, followed by immediate handwashing while another staff person, gloved, swabs down everything the patient touched.

Advantages, besides cheap, fast, and simple:  no physical contact between patient and staff is required in the ER.  Contact with other parts of the hospital is minimized--transport to an isolation area is controlled by a trained team, who will have with them, both protective garments and containment for any bodily fluids that emerge between the ER and isolation.  ER staff beyond the admitting office are not contaminated and will not need even brief isolation (allowing the ER to continue to function) and anyone in the ER when the possible Ebola patient arrives can be identified immediately for follow-up.
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