Thursday, July 4, 2019

Happy Independence Day to All



  Sending wishes to the readers of our blogs and our books, and their families, for a safe, peaceful, and memorable Independence Day.  Please stay safe and vigilant.





Sunday, March 31, 2019

Information on the Asian Longhorned Tick

             Since 2017, the Asian longhorned tick has been found within the United States. This is concerning information. Ten U.S. states are presently impacted. New York, New Jersey, Virginia, and Tennessee and East Coast states are impacted.  This tick is known to carry a number of diseases including a thrombocytopenic fever that is normally seen in Asia.  Because this tick is new here, it is suspected that it may carry, in time, the diseases the other ticks carry such as Lyme Disease, Erlichiosis, and others. It also represents significant risk to deer, dogs, cats and other animals, except perhaps mice.  This is authoritative information


https://www.youtube.com/watch?v=1myb4fNLUO4




Thursday, March 14, 2019

What is Tranexamic Acid ?

                A recent article intended for civilian and military physicians in the journal of the British Royal Army Medical Corps discussed the use of something called TXA in  major trauma cases. I have never administered TXA or Tranexamic Acid, so I was interested as to what this was, and the mechanism of why it works in improving patient outcomes.

               Tranexamic Acid is a synthetic analog of the amino acid lycine. It was discovered in 1962 by Utako Okomoto, a female medical doctor who died in 2016 when she was 98 years old. This drug, which comes in a glass vial, when administered correctly can help to prevent post-partum hemorrhage, deadly episodes of bleeding in those with hemophilia who are having dental procedures, and prevent a fatality due to simple hemorrhage on the battle field or in civilian sourced trauma. It also can be helpful for epistaxis, that severe dripping nosebleed that prior to this needed to be treated by tightly packing the nose and sinus area behind it, by an ER physician or an ENT.  There are also some cases of hemorrhagic menses that can be treated with TXA.

              Those with acquired bleeding disorders which have occurred as a result of ingestion of an anticoagulant of some type may also benefit from this drug. (Heparin or coumadin overdosage patients, for example.)

                There are some side effects, and a potential for seizures, but since 2009, this drug has been on the listing of the World Health Organization's listing of Essential Medicines.  It is also available in oral form.


This is additional information for physicians, nurses, EMTs or anyone who would like to read more about this interesting and exciting drug.

              https://jramc.bmj.com/content/164/3/170?fbclid=IwAR2WMivWOXHyNcLDHwlGApw5BMowx_Mb_U3CdjAkzoyHpd56jAOKGgMPBXg

https://en.wikipedia.org/wiki/Tranexamic_acid

Thursday, January 3, 2019

What is Blastomycosis ?

This patient has ARDS, and is waiting for a diagnosis.



               Not everything you get that causes a respiratory infection is a virus or a bacteria.  Today, I have chosen to pass along some information about Blastomycosis.

               Blastomycosis, also known as Gilchrist's Disease, is a fungal disease, that is found in dirt and wet decaying organic matter. It is also known as "North American Blastomycosis".  It can infect the skin, and can affect the skin of dogs and cats also, but most often, we hear about Blastomycosis after it is inhaled, and then within a number of days it creates a pneumonia.  I worry about this kind of thing rather a lot because I am allergic to molds, and when I provide hay to alpacas, horses, sheep or others, I worry that there are varietal molds in the hay, and sometimes, there are.

              In North America, it is most often found in :

      Southern Canada, Upstate, New York, The Ohio and Mississippi River Valleys, the US Mid-Atlantic and Southeast, and the Northern Mid-west.  There is also a version which afflicts Africa and the Middle East.

              The subject inhales the buds of this fungus, and then it grows and may spread.  It is an opportunistic infection, which means that most often we expect the patient to have something else going on that allowed them to become infected with this fungus.  It is possible for this infection to spread throughout the body including the spine, the brain,  and the bone marrow.  It can cause a brain abscess and meningitis.  It is diagnosed through chest x-ray and then lab confirmation of the fungus through samples. There are some very specific hospital lab tests for it now also. It can also create some rather impressive and frightening looking skin lesions.

               A systemic infection with blastomycosis can be treated by an inpatient hospitalization, and with a number of treatments with a drug called Amphotericin-B.   This can become a life threatening disease, leading to adult respiratory distress syndrome (ARDS) especially by virtue of the fact that it can become quite advanced before the diagnosis is made, and because this may not be the first thing your physician was considering.

             It is wise to own facial masks which one should use when working with hay, dirt, near rivers, or anywhere where you are likely to inhale spores of any kind.  Change your disposable mask fairly often and wash and dry your cloth masks regularly.  I wear one whenever I am cleaning or sweeping in the barn or any enclosed space.

             It is possible to get a milder version of this illness which can be treated on an outpatient basis with oral anti-fungals.

              I wanted to make my readership aware of this, because although this does not occur frequently, it does occur, and certainly treatment with antibiotics will not improve it, in fact, it may well worsen it.

This is additional information for those who wish to read more:


https://www.cdc.gov/fungal/diseases/blastomycosis/health-professionals.html

https://www.cdc.gov/fungal/diseases/blastomycosis/index.html

https://www.merckmanuals.com/professional/infectious-diseases/fungi/blastomycosis

https://rarediseases.org/rare-diseases/blastomycosis/



Tuesday, October 16, 2018

The Murder of Jamal Khashoggi

       
Crown Prince Mohammed Bin Salman



             When I was in college, I was lucky enough to meet a Saudi Arabian prince who was attending Princeton at a party. We had friends in common.  When my two eldest children were at university, they met, spoke to, and befriended a number of Saudi princes who were attending their university for a year or so.  I also had a chance to meet them all a couple of times.  I have been fortunate enough to know some Saudis, and to consider them friends. I don't need everyone I speak to to share every view I have.  Because my father was a world explorer, we sometimes had visitors to the house who were from the Middle East, and so I tend to take each person as they come, rather than group them and make decisions about groups of people.

                 I did not know and I have never conversed with Jamal Khashoggi. What I know is that Khashoggi tried to get official copies of his divorce decree from the Saudi Embassy in Washington DC, then tried in London, and that he was told he would have to get the from the Saudi Arabian Embassy in Istanbul Turkey. He had planned to remarry a Turkish woman shortly. He made the trip to the Saudi Embassy and they told him they would have his documents that afternoon, and that he should come back.  Then, the Saudi Embassy sent its employees home and waited for Jamal Khashoggi to return.  When he did, he was accosted by what European news anchors have called a "Hit Squad".  He is alleged to have been drugged, murdered and dismembered within a brief period of time following his return to the embassy.  This story has been told again and again by everyone from Turkish Police to British intelligence. What we know is that Jamal Khashoggi has not been seen anywhere since his entry into the Saudi Embassy. This week, the Turkish police in a "joint Saudi operation" have entered both the embassy and the home of the Saudi Ambassador. Evidence has been located indicating that Khashoggi was murdered and dismembered there.

                 This is incredibly disturbing. Traditionally, the US and Saudi Arabia have been strong allies. We sell them defensive weapons and weapons systems. They support us in a number of ways in the Middle East and world wide.   The US has an important strategic air base there, in a place in the world where we now have few friends. The Saudis have also had the most moderate stance toward Israel, our ally.
   
                Crown Prince Mohammed bin Salman is the de facto leader in Saudi Arabia. He is a young man who has many visions as he diversifies his nations economy and brings both women and men into this century as contributors to it.  However, there is a darker side to the man more commonly referred to as MBS.    In the past, MBS placed royal family members under house arrest and did the same to the elite in his nation. He has had more than one hundred journalists jailed.  Khashoggi's fate should make us wonder if they are actually alive.  MBS does not tolerate opposition. After all, Saudi Arabia is a kingdom and not a democracy. I am not aware of voting there at present.   Many of us have tried to focus on the positive things MBS has been doing.   For the first time, women may drive. Movie theatres are back, and there are attempts to weave women into a more modern world.  He also seeks to diversify his nation's economy from an oil dependent one, to a financial and business hub.  Many nations in the world had joined the Saudis with the intent to make the MBS vision a reality.   Saudi Arabia is also at war with Yemen. Eight million people, mostly children are starving because the area where their food is being sent in, is repeatedly being hit with Saudi air strikes.  An entire generation of children has died or has been damaged enough that they will never reach their intellectual potential.

               However, it is naive and unrealistic to pretend that MBS was not completely aware of the plan to entrap Khashoggi who had spoken against him in the past.  Hit squads don't fly in to other nations because they think their leader might approve of a forced rendition or a murder. They aren't known for their independent thinking. Many experts think the theory of a Saudi"rogue general" is absurd.

              I understand that the US and many other nations have invested heavily in Saudi Arabia. I understand that many young people like the vision of MBS very much for their future, but I urge all of you to think again.  A man who sends a squad to entrap, drug, murder, and dismember so that, in their faith, the subject person cannot reach Heaven, is not someone you should be investing in, or leaving as a guardian of anyone's future.

               I urge President Trump, the US Congress and Senate, and all nations and companies of the world to reconsider your dealings with Saudi Arabia until another leader is managing the kingdom.  I commend Sir Richard Branson for being one of the first to say that, in good conscience, that he would not presently serve on the board of Saudi companies at this time.  Others should follow him. I commend those who are shocked by these revelations and who believe sanctions must be leveled against Saudi Arabia.

             It would be foolish to make a dangerous man, more powerful on the world stage than he already is.  I also believe that as long as MBS is in power there that we should rethink our own dealings with him.

            Please pray for the family of Jamal Khashoggi, for his fiancee, and for his many friends.




Friday, September 7, 2018

"Westward: The Novel" Has Arrived !

"Westward: The Novel is a 6x9 inch paperbound book with 322 pages. It is also available electronically.

                  For those of you who gather paper bound books for your collection in order to read during the day during power outages or in other emergencies, may I make a suggestion.   "Westward: The Novel" is my fifth book, and second novel.   This time, it's not about disaster preparedness, the true story of a family dealing with the death of a child, a novel about an intelligence analyst and his family making a go of life on a large acreage during an economic collapse, or the true story of the life of an American world explorer.  This time, it's a novel that traces the life of a young woman with small children who must return to work after the death of her husband. She not only finds work and builds a new career for herself while parenting her children, but she finds the second great love of her life.  This is a story of overcoming obstacles and then taking chances. It also follows her through the process of blending a new husband who has never been married or had children to a family with four of them.  This book was designed to be read by either men or women.

             Today, it is available at this website   https://assets.booklocker.com/pdfs/9981s.pdf 

It should shortly be available on Amazon.    In the weeks that follow, it will ultimately be available worldwide and will be available at any bookstore and also eventually at libraries.   I will update as I learn of its availability.

            It's ISBN # is:   978-1-59113-643-9


            If you do purchase this book, particularly on Amazon, if you could write even a brief review that helps to get more people interested in the book and in reading in general.  Thank you !


           This is the first time that "practical Jane" has written what is, in part, a love story so it covers new ground in that respect.  I hope you enjoy it.





Wednesday, August 29, 2018

Stan Brock, Founder and President of Remote Area Medical, Dies

Stan Brock, and his assistant Sherri Elizabeth, taken recently.

             


                     It is with great sorrow that I report that today, while at work, Stan Brock, the founder and president of Remote Area Medical, died.  Brock was a television star who hosted Mutual of Omaha's Wild Kingdom in 1968.  In 1985, he founded Remote Area Medical which provides medical care and dental care to those without access, both internationally and in the United States. They have treated more than a million people.

                     Today, I send sincere condolences to his family, his friends, his co-workers, and especially to a dear friend of mine, Sherri Elizabeth, who was his assistant.

                     Stan Brock leaves an incredible legacy for those of us who remain on Earth.  He also ensured that the important work of RAM both internationally and domestically will continue.