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Wednesday, October 31, 2012
In Consideration of the Unanticipated Varieties of Disaster
I spend a fair amount of my time describing and passing along specific actions families can take in order to prepare for, and cope with natural and man-made disasters. There is certainly a lot that families and individuals can do in order to plan for such events. We can have emergency kits assembled and ready. We can have Evacuation Notebooks structured and assembled so that when we are overwhelmed, we have quick access to a plan we custom made for ourselves when we had a calmer, cooler head and carefully considered our strategy. We can prepare our children for possibilities, and tell them the truth, which is that whatever happens, you have a plan, and you will move Heaven and Earth to keep them safe. I will even go as far to say that we can make MOST disasters safer for us, and we can go a long way through advance planning to keep those with medical issues alive through a true disaster.
However, I feel the need here to address the "No Win Situation" or the "Worst Case Scenario". Most of the time when disasters occur, there is some warning. There often IS time to grab your Evacuation Notebook, skim your personalized plan, make a decision as to whether you should shelter-in-place or evacuate your home. Then, grab your Evacuation Medical Kit adding any prescription meds, nebulizers or any other equipment your family uses medically, grab your pets and their bag, and then flee. Your document bag should also be ready to go. Many people find locking all of these things in one closet is helpful and allows them to be updated quickly periodically.
Sometimes though, there is not time for adequate preparation. Sometimes an aspect of a certain disaster occurs in a manner that we did not anticipate. Sometimes, something we never dreamed would happen, actually does. Sometimes, there is the true, "Worst Case Scenario" where we are lucky to escape with our lives. Last week, I was visiting an area in which a large reservoir sat above a region of homes below. I was not pleased with the engineering of such a thing. It seemed unwise to me to build homes below such a vast water reserve. If this reservoir ever ruptures as a result of unprecedented rains, a direct tornado hit, or even seismic activity, the people below will die, as there will likely be insufficient time to evacuate, at least close to the reservoir itself. There are predictable potential no win situations. Living below the reservoir is one of those. There are others which could not easily be anticipated. The death of my twelve year old son when I could do CPR, but had no AED was one of those. We had no reason to know we needed to have an AED in our home. His first spontaneous heart rhythm disturbance, was simply his last. He had no prior medical history of any kind which suggested such a problem.
So, the take away from this post should be, a commitment to do whatever we can to anticipate reasonable natural and man-made disasters which could befall us in whatever location we choose to live. There is much we can do in terms of risk management, and meeting those risks head on. However, when we do reach the event for which we could not fully plan, or when we meet someone who has, lets provide to them understanding and assistance when we can, rather than judgement for a failure to anticipate such a thing. Even bright people can linger in normalcy bias long enough to waste critical moments in advance of an evacuation. Lets keep calm heads, and provide understanding to those survivors who for whatever reason were caught in a cosmic surprise.
Tuesday, October 30, 2012
Reflections on Sandy
Note nurse in gurney. She is holding a sick neonate. |
Lets pray that all the sick newborns, newborn babies, children, and sick adults who must be relocated during their illnesses fare safely and well. |
Here in my own rural area of Virginia, despite heavy rains, winds, and some snow from this peculiar storm, we are fine, and so are our animals. Thank you to people from Russia, Belgium, the UAE, and Nova Scotia who have inquired as to how we are faring.
This morning I have been watching television and noticing so many things with regard to evacuation and disaster preparedness. New York and New Jersey have been badly hit, and the infrastructure there is likely not to recovery for weeks. I saw something this morning which interested me there. New York University Medical Center had a situation where the level of the hospital which housed their back up generators during the outage had flooded. This necessitated an evacuation of the hospital including the Neonatal Intensive Care Unit. In my youth, when I rotated through the NICU, if we evacuated, we did so with all babies in incubators. The news program I saw yesterday showed NICU nurses in scrubs being removed from the hospital in a gurney, clutching tightly a small baby with nasogastric tubes and oxygen masks intact. This was interesting to me because this is not how we would have performed an evacuation. The more I thought about this, the better idea this sounded. Holding an infant tightly will decrease stress, stabilize blood pressure and pulse and contribute to security. Holding the infant will also help to naturally absorb bumps which could occur as an incubator or gurney navigated streets or curbs during the evacuation. I have been thinking and breathing disaster preparedness and evacuation for twenty-five years, and still each day, I learn or are exposed to something else.
The second thing I heard annoyed me. Good Morning America had a child psychiatrist on to help urban parents deal with "unstructured time" due to mass cancellations in the storm.Have we, as a culture, fallen so far that we need a professional to tell us how to deal with our own children when school is cancelled? It's one thing to deal with a child's feelings of anxiety when a disaster occurs. It's quite another to be at one's wits end because you have no idea how to redirect the attention of the child you brought into the world. Perhaps the answer is not to overbook your child every spare minute, and learn to talk to him about his hopes, his fears, and his wishes for the future. Not everything about a disaster is entirely bad.
Lastly, I never tell anyone what they should believe or to whom they should pray. However, I would be less than honest and less than who I am if I were not honest about the fact that I pray unceasingly to Jesus Christ, and that the honor and glory for everything that I do that's any good in the world, goes to Him. Therefore, I am sending this prayer out for everyone, Christian, Muslim, Jew, or Agnostic who is adversely impacted by this rare and complex storm.
Heavenly Father,
Please help those displaced and effected by Hurricane Sandy to find support, encouragement and safety in this confusing and frightening time. May they feel supernatural caring and support from you and from those on Earth who are entrusted with Earthly help here. May they have their medical problems addressed, and find their fears addressed as they realize that they have been granted a continued opportunity to learn and laugh and play in this schoolyard of a world you created for us. Please address the practical, as well as the loss, and the bewilderment and sorrow. For those who have lost a loved one, please be with them, and provide to them the love and solace you so graciously provided to me, following the loss of my young son and of my father. Thank you for the blessings that we know to thank you for, and for those of which we are so blissfully unaware. In Jesus name I pray.
Amen.
Monday, October 29, 2012
Hurricane Sandy: An Impressive Storm
This is rainfall probability from NOAA for Hurricane Sandy on DAY ONE alone. |
This is Wind Speed Probabilities of Hurricane Sandy from NOAA. Note the widespread nature of this storm. This does not include the Noreaster which will join it from the West. |
By now you likely know that Hurricane Sandy is a rare hybrid storm. A number of conditions have converged which make this an interesting and challenging storm. It is estimated that more than fifty thousand Americans who reside in the Eastern US will be impacted by this storm. Eight states have declared a State of Emergency.
It certainly is unusual to have one storm engulf both our farm and also our "Bug Out Location" and our "Tertiary Bug Out Location" as well.
Rather than focusing on how things are going here, I would like everyone to look at their own situations and do whatever you can to remain safe, whether it is sheltering-in-place in your homes, or whether it is rapid Evacuation with your pets, which has been ordered in some locations.
This is the Hurricane Sandy Situation Page:
http://www.vuetoo.com/sandy/Situationpagenews.asp?sit=6512
Stay safe !
Sunday, October 28, 2012
Hurricane Sandy: The Long List of Things Done and Yet to Do
Virginia in Autumn |
In the interest of jogging your own memories as to what you might need to do before a hurricane or major storm, I am going to share what we did yesterday, here on the farm.
1. The dogs who reside primarily in the main kennel have been upset as they sense barometric pressure changes and wind. I visited each of them, checked them and made sure everyone was ok. I tried to be reassuring.
2. Then, I visited the two dogs which will be on patrol through the farm throughout the storm itself. (They have safe houses and a way to get into a secure building if they choose.) Ben, a large golden retriever, and Skye, a Collie, are on duty in the early part of this week, before they rotate back to the kennel for two others to patrol and "go out to work."
3. All the alpacas have been visited and assessed. We keep a large separate water tank for them which is pumped using a marine battery with a tiny pump house. This was filled to the brim should there be any interruptions in electricity which could complicate water for animals.
4. Duck homes were rebuilt about eight weeks ago. They should weather this storm well, and they tend to love storms anyway.
5. Yesterday, my husband removed the camouflage tops to each of the five chicken enclosures. Our thinking is that the tops tend to catch the wind and topple even the heavier chicken structures during severe storms.
6. All tractors, riding lawn mowers, ladders, and other structures have been placed in the equipment barn.
7. The windows on the second story of the alpaca barn which are normally kept open because they have screens were closed to prevent water from entering.
8. Adequate feed for nine dogs, 100 chickens, 10 ducks, 8 alpacas, 2 cats, and 7 people was obtained and put away here yesterday. We also have fresh hay for the animals who use it.
9. We spent some time with and spoiled our pretty barn cat. She does not like storms. Our indoor cat is semi-consciously sleeping.
10. Secured outdoor white iron furniture on back deck, along with gas grill. (These were already covered for winter) Secured all outdoor iron furniture on front porch. Removed house flag from front. Removed light furniture from porch including outdoor cushions.
11. Removed large number of porch hanging plants. Will relocate them to garden shed with big windows. (Like a greenhouse with fewer windows.) We watered them before putting them away because I may not get down there all that quickly if the storm is large and the power is out for awhile.
12. Husband completed survey of alpaca outpost roof, Reinforced a couple of areas.
13. Filled all cars with diesel or gasoline as appropriate. Collected diesel fuel in containers for generator. Collected gasoline for reserve generator and lawnmowers.
14. Husband started all generators, just to make sure all is well. He also located oil for their oil changes, and new oil filters for maintenance which must be done after use. I put out another piece of older wood to go on top of the canopy over the generator.
15. Newest car will be garaged through worst part of the storm.
16. Bought extra bottled water in the event that the power goes out and the weather is so bad we don't feel like going outside to pump any. This will be the first major outage where we can actually pump our well water and pressurize our houses water system using the Simple Pump. (www,simplepump.com)
17. This week I ran a quick check on prescription medications making sure there is enough for at least the next two weeks. There is enough of all items for at least a month.
18. I went to Lowes this morning to get extra buckets. Not sure why, but I can't find mine.
19. Our daughter pulled everything out of her refrigerator and freezer and placed it in ours. We have a generator and will continue to keep food cold or frozen. She could be without power for 7-10 days.
This is all I believe I have done and recall. I hope something here reminds you of something you could do.
This is the Hurricane Sandy Situation Page:
http://www.vuetoo.com/vue1/SituationPageNews.asp?sit=8118&ref=anm
Stay safe !
Saturday, October 27, 2012
Sandy, a Dangerous Hybrid Storm
In the next few days, the East Coast of the United States is about to have an encounter with Hurricane Sandy. Sandy is virtually a unique storm in that it is a hurricane which will be combined with a Noreaster, a significant snowstorm, with an additional weather front. This storm is going to leave the East quite cold afterward. Incidentally, this is also occurring over a full moon, which may contribute to a higher storm swell. Tens of millions of Americans off the East Coast are likely to be impacted by this storm. Many locations along the East Coast are under mandatory evacuations. This storm will then move on to Canada.
I know that if you are a follower of this blog then I am preaching to the choir, however, it is important to prepare.
1. Make sure you have bottled water. Even if you are like me, and have a hand pump feature on your well, severe flooding could adversely impact your well in some places.
2. Obtain bread, peanut butter and non-perishable foods for perhaps a week. Power outage estimates in some places could be one or two weeks depending upon your location.
3. Fill up your car and get some cash from the ATM. Grab whatever you need for the next week from the pharmacy. If there is a protracted outage, then none of these things will be possible soon. Get cyalume lightsticks, or flashlights, batteries, etc. Get diapers if you use them. Charge ALL of your phone and chargeable devices right now.
4. Secure or being in your lawn furniture. This storm is also unusual in that you should also keep shovels near your doors because at the end of this peculiar hurricane, you may be shovelling snow.
5. Make whatever arrangements you can to cancel your activities in the early part of next week. Very little that we do is worth risking our lives over.
6. If you are ordered to evacuate, then please do so, and take your animals.
This is a Sandy google map which is updated regularly:
http://google.org/crisismap/sandy-2012
This is one of the things we prepare for. I am praying for each of you. Stay safe, stay home if you can, and help whomever you can.
Friday, October 26, 2012
Avoiding Buying a Home Which Was Used in the Drug Trade
ANY home may have been used in the drug trade, and it may not be immediately obvious. |
Even the title is amusing. Who would buy a house that was involved in any way, in the illicit drug trade ? The fact is that many people do, and they have absolutely no idea until something disastrous happens there. It used to be that it was easy to avoid buying a "drug den". Such places were always in bad neighborhoods and were dirty or obvious. In fact, a realtor might not even accompany you to a dangerous location. This is no longer true. Some very lovely and gracious homes have been part and parcel of the drug trade. In addition, some very nice rural homes in serene areas have also been involved in the illicit drug trade. It's also true that there are many different ways in which the drug trade might use a home. Some homes might be used to grow tree sized marijuana, or to start plants indoors or in windowed outbuildings. Other homes might be used as a place to stock drugs as the owner may be involved in illicit drug distribution. Some people stock the drugs and allow another dealer to pick it up at his location. Others actually sell drugs from their home. In some of these locations marijuana is the only drug involved. In others, methamphetamines are being cooked on stove tops. This is a particularly dangerous practice and has damaged the people who move into such homes afterward, as these noxious chemicals are in carpets, walls, and everywhere else. Young children are particularly sensitive to these remaining chemicals and at least one recent death has been attributed to moving in to an unknown former meth lab, and breathing in the environment. Of course crack cocaine, and cocaine and even heroin dealers also have homes and may distribute from them.
According to law enforcement, as the economy has worsened, both inner city and rural clandestine drug labs and distributors have appeared. Police call these "clan labs". Some of the people who run such operations from their homes don't pay their mortgages, and a number of these clan labs become homes in foreclosure. Pay close attention to this article before you buy a US foreclosure. It may well be anything from a low level "pot farm" to a "meth lab" to a source for multiple types of drugs. You may not simply be endangered by the fumes of such a place, but by those who may return to look for drugs, cash, or to eliminate their own competition whom they assume may still live there.
These are some things which may indicate that your "dream home" has a checkered past in this regard:
1. Use caution any time you are considering buying a repossession where you are told "the owners defaulted because they are in jail for drug abuse/sales."
2. Pay attention when the neighbors of the repossessed home you are considering says that they thought there was drug activity there.
3. Be alert to soil in peculiar places like kitchen cabinets. Marijuana grow houses often spill soils and vermiculite and this can cause unseen mold in a house, so this can be a telltale sign. Some references say that marijuana grow houses may have bad wiring as a result of frequent irrigation.
4. When purchasing, write a Contract contingent upon a whole house inspection. Then, have a good inspection done and ASK them to look for signs of drug activity.
5. In the US, Call the DEA. Ask them Most of their offices will send a couple of agents to sweep and test your home.
6. Consider the possibility of the prior owners or tenants "meth cooking" when the house is being sold with the stove gone.
7. Do not move infants or children especially into a former meth. house. Although the residual contaminants are dangerous to everyone, they are especially dangerous to young children.
8. When you do buy a home, change the locks and pay a reputable handyman or builder to reinforce your exterior door frames. This would make it much harder to kick the door in, particularly at night. If this is done correctly, the door won't be kicked in very easily and a metal door would be destroyed but would not allow entry. Attempted entry would not only be very time consuming for someone, but would be very noisy, as well.
In addition to the potential environmental hazards of former drug selling or manufacturing homes, there is another hazard of which you should be aware. One of my firearms trainers told me of a man who bought a new house and then have several people attempting to enter it through the master bedroom window in the middle of the night. The new owner shot one of them. It seems that sometimes former drug partners, original owners or buyers will try to enter to either look for residual hidden cash or perhaps even hidden drugs. Many people have bought lovely repossessions and have had a version of this scenario occur. Make sure you do your best to anticipate such a possibility.
Keep in mind that the very same things which make a home attractive to someone interested in preparedness or survival, are things a drug dealer might seek also. Both may be drawn to a solid home, with privacy, without neighbors too close, with plenty of storage, particularly hidden storage. Notice rooms with hidden closets or where there is a dropped ceiling, or hidden attic storage. Note hidden storage below wood floors. Both groups might like some acreage and lots of parking. Both may seek a place a distance from town, but of course, for very different reasons. So when a person who is interested in preparedness finally finds the perfect home, and it is a foreclosure, for example, they may well have selected a former drug haven of some kind..
Remember that when a bank or governmental agency sells a house they provide lots of documents which hold them blameless from the activities of the prior owners. If they have sold you a home which is eventually found to need fifty thousand dollars worth of remediation, then this is your problem. Some families have had to bulldoze such a home and start again, with no accountability whatsoever from the bank or government agency who sold them the home.
More information on this topic:
http://methlabhomes.com/about-us/my-meth-lab-home-story/
http://realestate.msn.com/article.aspx?cp-documentid=26924092
http://realestate.aol.com/blog/2012/06/28/family-forced-to-tear-down-home-because-it-was-meth-lab/
Sunday, October 21, 2012
Regarding Pain Management Departments
spinedockc.com |
There have always been physicians or medical professionals of one type or another who devote a portion of their practice to managing pain. Some chiropractors focus on pain abatement, and some of them have received training and certifications in order to become physician acupuncturists. Physical Therapists and Massage Therapists also do a great deal in order to manage chronic pain of many causes also. There are also acupuncturists who are non physicians but who also have loyal followings of patients who have been at least somewhat delivered from chronic pain.
I was aware that some hospital systems and medical centers have a Pain Management Department. I imagined this to be designed for the terminally ill, or those with multiple spinal fractures or trauima. I have never sent a family member, or accompanied one to a Pain Management Center at a major medical center which has a medical school.
My eldest son, who is in his twenties has been experiencing some pretty severe symptoms following a lightning strike for a bit more than a year. His primary physician is a highly regarded and well educated physician who has completed a couple of different residencies, including a fellowship in sports medicine. He has been unable however to do much about our son's continued leg pain which began to occur within a week or two of being struck by lightning while in a steel roofed building here on the farm. Eventually, our son was sent for an EMG which seemed normal. However, our son was still bothered by significant leg pain and something called fasiculations, which are intermittent episodes of twitching in skin and muscles of both legs. He had tried a TENS unit, and even narcotic medication, neither of which were terribly effective. Eventually, he was referred to the "Pain Management Department".
This department was not at all what I expected. It is a multi-disciplinary team which meets with each patient, pulls their medical records and formulates a plan for management. The director of the program is a board certified physician who is an anesthesiologist who has furthur specialized in the management of pain. She is also responsible for physicians who are also board certified physician anesthesiologists who are doing a fellowship in pain management. Their patients include those who have had terrible accidents, workmen's comp injuries, burns, and those who have been left with phantom pain in a limb which has been long since amputated. They do see cancer patients, and on occasion, they also see those who have sustained injury and who have protracted pain which is the result of lightning strikes. They are not restricted to the practice of handing out medications for pain willy nilly. They focus on ascertaining the cause for pain and formulating a team approach to managing pain. They were very clear that narcotic pain management only ever works in the short term and that other strategies for pain must be planned for patients. Such plans must allow the patient to reach his maximum level of function.
In my son's case, they were quite clear that the twitching in his legs constituted mild myoclonic seizures which could easily be attributed to lightning strike. They also did a neurological exam. They prescribed a drug which would stop the switching in his legs, which is normally used for seizures. They also prescribed a skeletal muscle relaxant that he could take if the pain became more severe. With these issues managed, they wish him to begin to wean the narcotic tablets he had been taking. They also obtained lab work in order to make sure that his calcium, magnesium and other levels obtained in a blood chemistry level are at levels which are optimal for his recovery. They believe that his supplemental magnesium given by prescription will need to be increased. They also have referred him to another physician member of their team who teaches both pain management meditation and self hypnosis which he can use as his recovery takes place.They did not do this in my son's case, but they frequently refer patients to physical therapy as well. They were careful to tell him that his nerves in his legs will likely never be as they were prior to being struck. They also said that if the twitching of his legs could be made to stop for a period of time, and that if he could finally sleep a full eight hours a night, (which is not happening now), that he could begin to repair even the nerve damage he had sustained, and had potential to recover from this particular issue.
So far, a fairly low level of the drug being taken to diminish the leg twitching is being taken, yet he is better. They have left directions for it to be gradually and carefully increased, and we will remain in touch via e-mail. In just a few days he has markedly decreased the amount and frequency of narcotic he had been using for leg pain. He has not yet used the skeletal muscle relaxant which was prescribed as needed, because he feels that he is doing well and doesn't need it presently. He has not yet seen the physician who will use biofeedback, hypnosis and meditation.
I must say, that a challenge which has kept other physicians thinking and reading was short work for a multi-disciplinary pain management team. A neurologist will see him tomorrow to see that we are covering all the bases. I am incredibly impressed and grateful for the expertise of this team of physicians. This is the way the team approach is supposed to work !
Artists conception of pain : nuhopecare.com |
If you or a loved one have a pain management issue, please don't hesitate to explore the possibilities of seeing a hospital based Pain Management Group run by an anesthesiologist. An incredible number of different modalities are available depending upon the type and source of pain the patient is experiencing. Imagine the number of suicides that will likely be prevented by the simple management of severe or chronic pain of many different types. Imagine the improved quality of life for these patients.
Wednesday, October 17, 2012
Post Lightning Injuries
When I was in high school, one of the students a year or two younger than I was, was struck by lightning. He had been on an open field during a ball practice when a storm appeared to be in the distance. It appeared not to have arrived yet, and final directions were being given to the team before they were being sent inside. Then, a bolt of lightning which prefaced the storm came out of nowhere, and knocked down eight students on the open field. Seven arose and ran inside, and one remained unconscious in the field, steaming. The school nurse began CPR while the coach ran in, in those pre-cellphone days to call an ambulance. The student was picked up by Emergency Services, taken to an excellent hospital a distance from there, and survived. He did however, not remain on the honor roll, as he had been. At the time, from the perspective of a teen-ager, I thought the only hurdle was keeping him alive that day. I thought that survival was the only challenge. Although I did appreciate the miracle of my classmate's survival, I had no appreciation of how hard his road to recovery might be.
Now, many years later, I am afraid that I know more about lightning injury than I ever cared to consider. In medicine, the specialty of treating those who have been injured by direct or indirect lightning strike is called keraunomedicine. The focus of this post will not be the immediate emergent care of lightning strike victims. Those who are struck and who are pulseless and breathless will require immediate CPR and ambulance transport to a competent hospital with a good Emergency Room and an Intensive Care Unit. This post will focus on what is not mentioned very much in literature for the general public, and that is the devastating and sometimes permanent damage sustained by those who received a glancing or direct lightning strike.
Scientists estimate that worldwide there are 24,000 human deaths from lightning strikes each year. It is estimated that 240,000 people sustain lightning injuries worldwide, but since not all strikes occur in places where they will be reported to any one central body, this is likely to be an artificially low figure. Some unlucky individuals have been struck by lightning repeatedly. There is truly no safe location out of doors to avoid lightning strike. People may be struck directly or indirectly while out of doors. Direct lightning strikes are almost always fatal. Indirect strikes occur when something else takes the brunt of the strike and some of the overwhelming and powerful energy travels through objects to ground, and one of the items on the way to doing so, is a human being. This is why people are advised not to shelter underneath a tree during a lightning storm. If the tree is struck, then some of the energy dissipating toward ground will pass through the human being sheltered under the tree. There are a number of different indirect strikes that a person can receive, and what type of strike they receive will impact the level of damage they receive. The victim can also receive many different types of injuries from lightning. These can be splash injuries, grounding injuries, or even blast or concussive injuries. There can be very wide ranging injuries in those struck by lightning. Some have no evidence of injury other than a cardiac arrest. Others have clear injuries where skin injury where skin injury and significant burns are evident, or where the lightning strike entered the body is clearly seen, and where it exits is clearly seen also. Most have injuries which may be temporary or permanent, to their eyes and to their ears.75%-80% of people who are struck by lightning, sustain permanent injuries. Also interesting is that a person who is struck by lightning and seems fairly well today, can have serious medical results from it which develop over the following weeks as the body tries to heal damage which is not immediately seen. True injuries and the full extent of neurologic injuries cannot be fully assessed for days or weeks beyond the strike itself. A majority of those struck by lightning experience serious depression afterward.
Most surprisingly to many is that we may not always be safe from lightning injury inside our homes or inside buildings. Some people are struck by lightning while using a landline telephone. Although these people only comprise 1% of lightning injuries, their ear and neurologic damage can be significant. People have also been struck while using a toilet or shower,(primarily connected to copper or other metal pipes), or by standing near a window. People have been struck while working the drive up window of fast food restaurants. Some have been struck inside metal structures or simply metal framed structures. People have been struck while working on agricultural fencing. My eldest son was struck inside a very solid post and beam style wooden building which happened to have a steel roof. and posts with beams that were treated with copper arsenate, which seem to be quite conductive when struck.
Horses, dogs and other animals are also killed by occasional lightning strikes.
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(from "Lightning Injuries to Humans in France" by Dr. Elisabeth Gourbière of the Electricité de France, Service des Etudes Médicales)
-Asystole/Ventricular fibrillation
-Inhibition of brainstem respiratory centers
-Multi-system failure (delayed death)
Cardio-pulmonary injuries
-Arrhythmias - Arterial pressure changes
-Electrocardiographic changes
-Myocardial damages (infarction)
-Cardiac dysfunction
-Pulmonary edema - Respiratory distress syndrome
Neurologic/psychiatric injuries
-Loss of consciousness/coma
-Amnesia/Anxiety/Confusion/Aphasia/Seizures
-Electroencephalographic abnormalities
-Brain/Cerebellum damages
-Numbness/Weakness in limbs/Partial or complete (but temporary) paralysis Tremors
-Neuropathy/Pain syndromes
-Spinal cord injury/Parkinsonism
-Sleep and memory disorders/Concentration
disturbances/Irritability/Depression/Various other disturbances such as headaches, tiring easily, lightning storm phobia, etc.
-Post traumatic Stress Disorder
Burns and Cutaneous marking
-Small, deep entry/exit points (typical)
-Contact, metal chain heating (typical)
-Superficial linear
-Flash
-Lichtenberg figures (arborescent, fern-like markings):pathognomonic(on trunk, arms, shoulders)
Clothing, shoes
-Exploded off, torn off, shredded, singed
Blunt traumas (explosion)
-Contusion, internal hemorrhage (brain, lungs, liver, intestine )
-(rarely) Fractures (skull, cervical spinal column, extremities )
Auditory and ocular injuries
-Tympanic membrane ruptured (typical)
-Deafness/Tinnitus/Vertigo
-Transient blindness/Photophobia-Conjunctivitis - Corneal damage
-Retinal abnormalities (macular hole) - optic neuritis
-Cataract
"Lightning injuries are varied and take many different forms. The most dangerous (and possibly fatal) immediate complications are cardiovascular and neurologic. It must be kept in mind that only immediate and effective cardiorespiratory resuscitation (started by rescuers), followed as soon as possible by emergency medical treatment, can save victims who are in cardiopulmonary arrest, or avert the serious consequences of cerebral hypoxia. Some victims remain in a coma despite intensive resuscitation and die of secondary causes including hemorrhages and multiple lesions (encephalic, cardiac, pulmonary, intra-abdominal)."
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Following our son's lightning strike one year ago, we have met two people locally who have also been treated for similar injuries. One has permanent eye and ear damage from answering a phone during a storm. The other has experienced what seems like a complete recovery following a direct witnessed strike through his head ! Although it's good to know that a complete recovery is possible, most people are not so lucky. The best strategy remains avoidance of being struck.
Other posts in the Rational Preparedness series concerning lightning, and lightning abatement can be found here:
http://rationalpreparedness.blogspot.com/2012/02/exploring-possibility-of-adding.html
http://rationalpreparedness.blogspot.com/2012/02/protection-from-lightning-hazards.html
http://rationalpreparedness.blogspot.com/2012/04/professional-lightning-protection.html
http://rationalpreparedness.blogspot.com/2012/05/lightning-protection-for-trees.html
http://rationalpreparedness.blogspot.com/2012/10/on-resiliency-and-hope.html
More articles concerning this phenomena and on lightning abatement etc. :
http://science.nasa.gov/science-news/science-at-nasa/1999/essd18jun99_1/
http://blog.lightning.org/
Sunday, October 14, 2012
On Resiliency and Hope
My son's graduation from the university came and went. The cactus sat there, unchanged, and still silent. Its scrapes and injuries from its time in the trash can did not heal. They remained in silent witness to the abuse it had sustained. After his graduation from the university, he tried in vain to find a job. It took our daughter more than two years to find a job following her university graduation, the year before our son's. Our son networked and tried and tried, but about the only thing that went his way is that the Federal Student Loan people placed his large loan in forbearance until he finds a job.
Last September, our son, who is also a sculptor was working in one of our buildings which is arranged as a artists studio and as a woodworkers shop. He was there to unplug heavy equipment there in anticipated of a big storm that was rolling in. Unfortunately, the storm hit before he could get back to the house. The steel roofed building was struck by lightning and apparently so was my son. He was fortunate that the glancing strike did not cause a cardiac arrest or arrhythmia. It did take his hearing for a period of about a week. It also placed what looked like a sunburn on both of his arms. Within a couple of weeks when the peripheral nerves in his legs began to come back on line, he was in episodically severe pain. He is being treated by several physicians for this chronic pain issue, and of course, this interferes with his job search.
This of course, is the reason we called a Lighting Protection contractor this year and had lightning rods, arrestors, and copper grounding wires placed deep in trenches around buildings. Interestingly, we have since met two other men in our general area who were struck by lightning. One was on a telephone and has eye and ear damage. Another was outside and also had chronic pain issues for a bit more than a year. The man is fine now. Our family is quite concerned about this and hopes that my son finds a better management strategy to the pain from this lightning strike, now more than a year ago. A TENS unit actually worsened the pain. I am trying really hard to have faith that he will recover, and soon.
Wouldn't you know it ? The poor large cactus that he rescued and that was silent for so long has sprouted two large and tall arms which are heading up to the light. You would not know that this was the same bedraggled and scratched cactus pulled out of a trash can so long ago. It stands as a reminder that we should think hard before discarding anything that could be given away or used in some other way. In also reminds us of the innate resiliency and potential of anything that God has made. Prayers for our son are always appreciated !
Saturday, October 13, 2012
The Abyssmal US Public Educational System
A US high school science class. |
When I was a child I attended a US public school until my teens when I spent some time attending what was a British school in Harrow. Both the American and the British schools did some things extremely well. The American school fueled by that days consummation of math and science, did an exceptional job teaching young students fundamentals of scientific principles, including physics, biology and chemistry. They tried very hard in mathematics as well, even though I think my mind at the time could not always grasp as fast as their honors classes could move. The curriculum of my American school was deficient in history and in geography at that time, and most students there knew almost nothing of the world outside the United States. The US educational system in the 1960s and 1970s bears at least some responsibility for the insular views of many Americans. The British school was rated as one of the best of its kind. It was exceptional in teaching history and geography, and top drawer in English. Although their math curriculum was much slower paced, I probably came away having learned more from them in mathematics, through endless repetition. They were deficient in science in comparison to my other school. The British system of the day, also made broad reaching decisions about student's futures and the training which will be offered to them. This means that "late bloomers" will not reach their potential in the British system, as these decisions as to their future are made between about eleven and twelve years of age.
As I grew many things changed. I realized as a young adult that the American school system I had attended was better than most. In the US, depending upon your school system, it is possible to graduate from high school reading and writing poorly. This is particularly cruel because a student who comes through thinking that he is a graduate, and that there will be work for him will find that there is little beyond a very basic or low level job he can do with such reading, reading comprehension skills, and basic skills in writing. Some also have very rudimentary math skills as high school graduates. This is also quite a blow to companies who might seek to train entry level workers. Workers who can't read the Orientation Manual to your business, or the guidebook to the office equipment aren't going to be useful to you. This began to fuel a desire to hire people of higher and higher education. In my youth, after I went on to college, many people from my original high school went on to entry level jobs after graduation. They went on to buy homes, buy cars, raise children, and to gradually move up in their careers. Of course, they could read and write.
Today in the US we have some rather complex problems. Some school systems are quite good. This is less because large amounts of funds are allocated for certain districts, and more that some neighborhoods have parents who send their children to school knowing the alphabet, their colors, basic communication, how to sit still, etc. The parents have spent time readying their child for school, and will continue to show concern and guide them in this endeavor. In school systems where the parents have not readied their children, these systems must spend a great deal more, and they lose time in having to bring these students up to basic school entry skills. We also have some racial issues in US schools. In some US schools Hispanic students remain socializing with other Hispanics. African Americans remain socializing with other African Americans, and caucasians socialize with all of them. In practice, school administration often does not enforce basic standards of education for the minority students because this will often bring charges of racism or preferential treatment from the students and from the minority parents as well. The result is that depending upon the area, minority students often receive a substandard education. This is in stark contrast to both the Canadian and the British system where most often, the foreign or minority student is fairly strictly held to the same standard as any other student. The result is that minority students are faring better in those nations, than some of them are here. The perception that a minority student should be slid through because the normal standard is too high for him is actually the most damaging form of racism I think you can have. The student himself will fall into setting a lower standard for himself.
The US public school system's embrace of computers has also done some damage. I love computers, and I think you would be hard pressed not to find a profession or college major which does not require their use in some manner or another now, but you need to be able to think and to write in order to use one, program one, load software, or reasonably trouble shoot one. The use of the computer has obscured those students who have no writing or spelling skills whatsoever. They will graduate without these skills, and it may only be detected in college that their skills are not yet developed enough to attend an institution of higher learning. Some of these issues are why home education is flourishing in the US, and why homeschooled students in general, do well when they hit the work world or colleges.
At the university that one of my sons attended before his graduation, the professor was telling the students one day that "They are the smartest generation which has ever existed.". This is incredibly misleading. Yes, it is true that the internet has provided unprecedented access to information within a brief period of time. However, a huge amount of information on the internet is incorrect or misleading. It is a tool, not an oracle. One also needs to have a certain amount of education in order to know where to look and what material to thin or to disregard. Many students of today do not know geography, history, mathematics, English, the foreign language they took in high school. They do not have good critical thinking skills. They do not write or spell well. Most of all, their educations have not prepared them to think. They can't listen to a debate and ask good questions. We pile more and more requirements on students, and a few of them get more and more degrees, but the reasoning skills and question formulating skills still aren't there.
I realize that the British system has also taken a tumble since I attended there. I realize that the result of a small island's taking on of many refugees from different nations has provided them with everything from cultural clashes to a growing crime problem, as well as challenges as to how to educate everyone from Romas to Bosnians to Russians. However, we must do better than this. Both Jay Leno and Glenn Beck have segments on their programs where they ask questions of Americans as to things most third or fifth graders should know. The number of people in the US who cannot answer as to who takes over should the American president resign, is frightening. So many people function without very basic information that it's no wonder they have little or no understanding of politics, the electoral system, or anything being discussed in any depth.
Sunday, October 7, 2012
On Hypothyroidism
This is the location of the thyroid gland. |
The general public, and many physicians think of hypothyroidism as a disorder simply characterized by weight gain. Although this is often a long term feature of the disorder, this is not necessarily so. In the interest of detecting and seeking proper diagnosis of this very common disorder, I have decided to post about this today. Some patients have an enlarged thyroid gland in their necks, known as a goiter, but many do not, or did not notice they had. (A goiter can occur when there is inadequate thyroid production, or sometimes when there is excessive thyroid hormone production, and rarely in the euthroid, or normal thyroid state) Some patients develop an enlarged thyroid with inadequate thyroid hormone production as the result of inadequate iodine in their salt, or in their water or soil in their region, which impacts the foods they eat. Fish can also be a good source of dietary iodine. Some hypothyroidism can be positively impacted by iodine supplementation, but not all. For some it is too late, and for others, this was not the cause of their thyroid dysfunction in the first place.
There are a couple of basic types of Hypothyroidismm which can be best described as low thyroid hormone output. Often, this disorder afflicts women, but this also is not always the case. I have known male physicians who also developed it. One variety of the disorder is a temporary condition where someone, perhaps just following childbirth or an illness, has a low thyroid output for a time. In this instance, they receive thyroid supplementation of a type of thyroid hormone for a temporary period until thyroid gland recovery occurs. Sometimes, a patient has had their thyroid removed when it became diseased, ir when its output became excessive, and the end result becomes hypothyroidism. Since the removal is permanent, additional supplementation of hormone would be also. Another type which should receive lifelong thyroid hormone supplementation is Hashimoto's thyroiditis. Hashimoto's thyroiditis was thought to be rare within my own lifetime, but with the advent of very quick and effective radioimmunoassay testing, endocrinologists have discovered that the disorder is far more common than was realized. In Hashimoto's thyroiditis, an autoimmune thyroid disorder, patients make antibodies against their own thyroid gland as if it were a foreign organ. These attacks on the thyroid are episodic. The disorder can start in many with too much thyroid output alternating with too little. The patient may enjoy months of anxious productivity followed with a few months of a letdown and difficulty completing tasks and thinking clearly. Some patients wonder if they have a lesser child of bipolar disorder, and this is one reason that psychiatrists diagnose a fair amount of hypothyroidism and send these patients off to endocrinologists for treatment. Often those with hypothyroidism report symptoms which are consistent with Depression.
When thyroid hormone input is too low, the speed at which all body functions occur is decreased. What most people notice, if their diet remains stable throughout thyroid failure, is a slow and steady weight gain, as metabolism slows, but as I mentioned earlier, this does not always occur. Some patients, in the midst of hypothyroidism experience a decreased appetite and gradually adjust their food intake downward. The result is a stable weight, and a physician who might not make the diagnosis if this is all he is seeking, or if he erroneously thinks this symptom alone must be present, in all cases. The effects of hypothyroidism are much more insidious, and potentially very damaging in the long term. Remember that in longer term hypothyroidism, that the speed at which every body function occurs is decreased. Over time, the patient's colon does not absorb nutrients at the speed at which it should. Peristalsis of food occurs too slowly. Most patients complain of constipation which often resists conventional treatment. A few experience diarrhea, because their colon can't heal itself and becomes irritated. Some complain of alternating constipation and diarrhea or an irritable bowel. Women usually find that their menstrual periods become farther apart and longer and heavier. A woman who menstruated every 28 days for five days, may find she has a period every forty days for seven days, and that it's heavier. Sometimes, there is decreased libido. Some women have difficulty becoming pregnant as a result of hypothyroidism. Others conceive easily but miscarry on a regular basis because pregnancy quickly requires the thyroid to double its total hormone output. A thyroid gland which fails during pregnancy can cause an early or a late miscarriage. This is one of the reasons for a pre-pregnancy check up. Because iron may not be absorbed with a sluggish colon, and excessive loss occurs through menstruation, anemia may occur in hypothyroidism. This can be worsened as in longer term hypothyroidism, patients will not make adequate numbers of red blood cells, leading to a critical anemia.
Most patients notice dry skin, and a decrease in either the amount of hair they have, or they notice that their hair may not grow as quickly as it once did. Since the liver is also not getting adequate thyroid, and the liver determines blood cholesterol level, a hypothyroid patient may present with a high cholesterol level when he/she never has before. A few patients, because their pancreas and beta cells are not receiving thyroid hormone in adequate amounts may exhibit either hypoglycemia, low blood sugar, or sometimes a higher than normal fasting blood sugar. People with hypothyroidism often experience frequent infections. They are no longer making enough white blood cells on the bone marrow level and so, they tend to catch everything which comes down the pike and take longer to reach resolution of infections. Many times, they experience chronic sinusitis. Since the kidneys are not being told how fast to function, the patient may tend to retain fluid. Hands, feet, faces, and legs, and even our brains may carry more fluid than is optimal or desirable. Hypothyroidism does not simply impact our metabolism and weight gain and prevention of weight loss. It adversely impacts every body system. Almost all patients who have had hypothyroidism describe a "brain fog" or mental sluggishness or slowing. Some complain they have difficulty with math calculations when they never did. Others find they cannot pull the right word for something, even though it may be prominent in their work lexicon. Others are emotionally overwhelmed. Some, as they are retaining fluid in their hands, and possibly their brains as well, complain of migraine headaches. Hypothyroid patients may also have hypertension, and a few have a bradycardic or very low heart rate, as a symptom of low metabolism. Most complain of feeling cold rather easily, but then, they don't seem to tolerate heat all that well either.
The long term effects of hypothyrodism can be damage to the heart and cardiovascular system, or even cancer, the result of a hamstrung immune system.
If you notice an enlargement of your thyroid gland, you must see a physician. |
One would think a disorder with so many wide ranging symptoms would be detected by physicians very quickly, especially since their are symptoms which present themselves in every organ system. This is not always the case. Many times, family practitioners or obstetrician gynecologists attribute a few of these symptoms to anything from "early menopause" to "anxiety" or even "psychoneurosis". Sometimes the patient himself or herself really knows this is a problem, but the physician has obtained only one lab, and feels that the TSH is within normal limits, and does not refer to an endocrinologist to perhaps look a bit harder or follow the patient for another few months when labs might clearly indicate thyroid issues.
We know that thyroid disorders tend to run in families. We know also that some patients with Hashimoto's, an autoimmune disorder, do go on to develop other autoimmune disorders in later life, such as Crohn's Disease, Ulcerative Colitis, Type I autoimmune diabetes, Lupus (SLE), Rheumatoid Arthritis, etc. We could do a much better job of putting off these additional disorders if we did not pat patients on the head and tell them they are fine. Long term undiagnosed hypothyroidism can and sometimes will eventually lead to something called Myxedema Madness, where the patient develops a full blown madness with paranoia, as the disorder has impacted brain function. These patients eventually lapse into coma and die in Myxedema, the most severe form of hypothyrodism. I often wonder how many people, particularly elderly women who die in Nursing Homes, the supposed victims of an Alzheimer's-like dementia, when a full and more careful assessment would yield the treatable condition of severe hypothyroidism, "Myxedema Madness", myxedema, or Hashimoto's encephalopathy. This diagnosis is too frequently missed or not fully considered in patients of all ages.
If you have a thyroid disorder your management is likely best if you are followed by a board certified endocrinologist. They tend to replace the amount of missing thyroid hormone more readily than a family practice physician who may be more uncomfortable replacing hormone at higher rates. This is a highly complex disorder and will best be managed by someone for whom this is a consuming interest and passion. They may also be more alert to subtle changes as they relate to hypothyroidism. This is a life long disorder and will require periodic blood testing and prescription thyroid medication for a lifetime. One followed for this disorder, most patients do very well. Singer/Songwriter Linda Ronstadt was eventually diagnosed with Hashimoto's thyroiditis and is now treated.
If this is a concern for you, ask for the labs necessary to rule this out. They are a T3, a T4, a TSH and an antithyroid antibody test. Get copies of these results and if you are not satisfied with your physician's answers as to whether you have a thyroid disorder or not, take them to a board certified endocrinologist. They will sometimes pick up cases which might take much longer by a family practce physician.
Lately, patients early in the course of the Hashimoto's continuum have found that going on a gluten free diet has improved their symptoms. This may be an interesting avenue for study in future.
Wednesday, October 3, 2012
I Wish It Weren't This Bad
Please forgive some of the more colorful language used by the bears as they become frustrated in talking to one another.
We Haven't Been a "Free Country" In Quite Some Time
(Photo by: dreamstime.com) |
Even before 9-11 fundamentally changed the way government viewed it's citizens and their rights, an erosion of these rights began in the US. I am in my late forties, but when I was a child, and a teen, a large amount of citizenship, civics, and national history was required in school prior to graduation. This wasn't intended to force us into national pride, but to very carefully inform us of our Constitutional rights, in a bid to ensure that no successive governmental regime embarked on a plan to dilute or subvert them. We received a good overview of the American legal system so that we could navigate it, should this become necessary. Two of my children were born in my twenties, and then two more in my thirties. When my two eldest children reached public school a lot had changed. They were taught the pledge of allegiance in kindergarten, but it was no longer said on a daily basis, as it had been They were not taught patriotic songs. No one taught them much about US History except that Christopher Columbus brought syphilis to "The New World" and that his trip across the ocean brought conquest and destruction to the original denizens of the areas in which he landed. Our kids were not taught that who we are voting for is a private matter of conscience which is not to be shared anywhere but the polls.
Because of our frugal nature we were lucky enough to be able homeschool all of our children, including the four biological and the one we adopted. This gave us a chance to make sure that they understood a balanced history of the United States. As with all of the countries on Earth, sad and unjust things happened here, especially at the beginning of our nation. However, many good and just things have happened here as well.
9-11 brought changes to American law of which most people were unaware. Warrantless wiretapping began. Certainly the times dictated a reassessment, and perhaps a streamlining of a Federal Judges ability to permit a law enforcement agencies ability to monitor potential terrorist activity was in order, but this is not what was done. The "Patriot Act" brought in a large number of nebulous abilities on the part of the government. It also began the process of extreme rendition. People in the US and outside it disappeared and were held without due process. No one was really sure about what might constitute terrorism, or treason, for that matter. No fly lists came in, and what I consider legal molestation of children, the elderly and everyone else became possible legally by the TSA whenever we fly.
Our government also now censors educational material provided to the masses. Make no mistake. We have more mediocre employees and more mediocre minds because our sub-standard educational system has taught them to be this way. The government was less comfortable with Patrick Henry type people, and more comfortable with Homer Simpsons.
All of these erosions of our freedom trickle down to the local level as well. The Homeschool Legal Defense Association has its hands full in terms of defending the rights of families to legally homeschool their children. A few years ago, I was repeated followed by a truant officer from another county as I made a short trip to buy animal feed in their county. Apparently, the large African American truant officer was unable to differentiate me, an almost fifty year old long haired college professor from a high school student. I of course, filed a complaint only to find that other mothers my age had been followed and had filed complaints for stalking.
All over the country there are complaints that law enforcement are writing tickets in order to generate revenue. This is very bad. When the core citizenry no longer believe that law enforcement is out to do good in the land, then we stop helping them. Without the assistance of the citizenry, true policework is almost impossible.
I am not saying that the US is bad and that Europe is good. I am saying that different nations in Europe are harassing their citizens as well. A number of European nations harass and prosecute homeschooling families, when independent studies indicate that homeschooling almost always benefits the students, the families and the societies in which they live. Even England and Canada have civil rights violations sometimes. What I am saying is that the US which makes such a song and dance of "The Land of the Free and the Home of the Brave" is struggling to be such, and is missing the mark. This year, former marine Brandon Raub was detained and placed in a psychiatric facility a great distance from friends and family based on things he said on his privately managed social media page. Eventually, Mr. Raub was released, but it is an egregious case of FBI, and other law enforcement agencies mis-steps if not gross incompetence.
We need to get back to educating the masses in what the Constitution is, and what it stands for. Then, we need to have the masses read the large number of Executive Orders which have come from the Obama Regime. These are dark days for the United States. Thomas Jefferson would be sick.
Read more about the Brandon Raub case at our prior post:
http://rationalpreparedness.blogspot.com/2012/08/are-these-soviet-tactics-here-in.html
Monday, October 1, 2012
Near Miss Days
Living on a secluded farm, we tend to lump our trips together. We do whatever we can to work from home, and then head out to meetings or to work. Then, on the way home we stop for groceries and place them in a cooler in the car or truck and head for home. We did this long before fuel went from $1.80 a gallon to the four dollars a gallon it is now. We also tend to "car pool" with our large family. When our eldest kids were at the university, they and my husband would arise at four am, and the three of them would head for the city. My husband would drop them off and they would take buses around the city to classes, and my husband would head to work. At night, they would do the same thing again. Occasionally, one of them would drop my husband off, and keep the car for the day. With the three of them sharing commuting and car maintenance costs, this was far more affordable and a more responsible way of commuting. I tend to do the same thing. I keep lists of things we need, and when I go out I will take care of a doctor's visit, banking, the pharmacy, picking up animal vitamins and sometimes feed, and then some frozen foods before heading for home.
Because we drive fairly long distances and have driven for years, we are careful and we are careful drivers. Most days we can get in or out of the three cities which are within a days drive, and get home again without incident. Some days are what I have come to call "Near Miss Days". Some days just seem as if everyone insane, senile, blind, drunk, high on antihistamines, suicidal, evading police capture, or just plain crazy decided to drive. Today was one of those days. At a rural flashing red light I stopped, and proceeded ahead, only to have a woman in a brown SUV decide to tear across the road in front of me. My son gasped. As I drive carefully, I was able to stop. I was a little shaky after that, but there were two more close calls on the way home. One woman lost control of her own SUV when she turned on her lights. I avoided her crazy weaving, and she wound up in the ditch. Another woman was doing such a rate of speed she appeared from nowhere behind me, and almost hit us. I pulled over, and she disappeared in the dust.
When we got home, my daughter drove up only to tell us that she had had three near misses today on the highway. Why some days are filled with crazy drivers and others are not, I will never know !
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