Tuesday, December 30, 2014

Important News Concerning "The Bourbon Virus"

               
Would you like to bet that Bourbon Virus isn't just in Kansas anymore ?



                  I remember when Lyme Disease was new.  I remember when HIV-AIDS was newly described.  Now, we have all lived long enough to hear of a new virus.  The Bourbon Virus is a tick borne virus so named because it afflicted its first known victim in Bourbon County, Kansas.   The first known victim, a male farmer, died of this illness, despite being in good health prior to this. For those of you who have an interest in epidemiology, this is one of the thogotoviruses which is a member of the orthomyxoviridae viruses, which is an RNA virus.  This is the first disease causing virus of this type which has been identified and located in the Western Hemisphere.   It is similar to some of the viruses in Africa, Asia and Europe.

                  The description of this virus and what the implications of its presence here are in its infancy.  We have no idea, as yet, whether this will afflict people annually, or whether only a few cases will occur, and most of them will be deaths attributed to something else, and not identified as "Bourbon virus".  We also don't know whether some people will recover from the illness, or whether everyone clinically afflicted will die.    So far, what we know is that the one person afflicted suffered a loss of appetite, body and muscle aches, headache, fever, and ultimately cascading multiple organ failure. (Primarily lung and kidney failure with elevated AST and ALT, which are liver enzymes.)   I am reminded of erlichiosis which is an increasing problem in both human beings and animals where I am.

                 There are many tick borne illnesses in both the United States and the world.  You may wish to read the following links to prior posts here as a refresher for next season.



http://rationalpreparedness.blogspot.com/2012/04/avoidance-of-tick-borne-illnesses.html

http://rationalpreparedness.blogspot.com/2012/04/learn-something-about-your-areas-tick.html

http://rationalpreparedness.blogspot.com/2012/08/the-advent-of-new-tick-borne-illness.html



http://rationalpreparedness.blogspot.com/2013/03/what-is-ipm-or-integrated-pest.html


http://rationalpreparedness.blogspot.com/2012/07/other-types-of-envenomation-injuries.html


Other references:

http://www.medscape.com/viewarticle/837229

http://www.huffingtonpost.com/2014/12/24/bourbon-virus-tick-kansas_n_6377932.html

Sunday, December 28, 2014

Interesting Products in Freeze Dried Food of Which You Might Not Be Aware

       





       Many of us who have a long term interest in preparedness, have an interest particularly in the #10 industrial sized cans of freeze dried foods.   One of the questions I am asked quite often is the difference between freeze dried food and dehydrated food for long term storage.    Dehydrated foods are heated and water is removed.  However 20-50% of the water remains. As a result, the food can only be stored for between 1-8 years depending upon the product. In addition, as a result of the water which remains in the product, either salt, sugar or a preservative mist be added to permit the 1-8 year shelf life. Dehydrated foods are generally cheaper than freeze dried.

                  Whenever I can I try to stock the industrial sized cans of freeze dried food.  Freeze dried food is produced by a different process entirely. The product is frozen and then placed in a vacuum, and then about 98% of the water is removed. This is a more expensive process and requires specialized equipment, but as a result the food itself can be freeze dried without added sugar, salt, or chemical preservatives. This makes it much more desirable for diabetics, or those on special diets. The most significant reason I prefer freeze dried is that generally depending upon product, the can will remain edible for 25-30 years.  Also, a number of references indicate that freeze dried food will retain all the vitamins whereas dehydrated foods may not because they have been superheated.  Of course, many of you have noticed that freeze dried cans are much more expensive than the dehydrated variety.

                  There are also some important things to note.  My own preferences toward #10 industrial sized cans of freeze dried food are motivated by the fact that I have a very large family and a lot of hungry young adult sons.  I also have a daughter who is a Type I diabetic (since early childhood) and so the "no sugar added" feature is very important to us..  In an emergency I would likely need to feed a number of my kids despite the fact that some of them might no longer live here..  Lots of vegetables and fruits would be necessary as well as rice, pasta, potatoes and other carbohydrates, . Since I don't know when such an emergency would occur the long shelf life would be desirable to me.  Of course, if you are one person or perhaps three, you might wish to invest in smaller or "everyday" cans of freeze dried food.  Once opened, the #10 cans of freeze dried food need to be consumed within a year. This could be hard for two or three people.as some of the #10 industrial cans contain as many as 42 servings.   There are plenty of families who stock both dehydrated foods and freeze dried food and then just pay attention to food reserve supply rotation.

                 How do we afford #10 cans of freeze dried food when they have increased in price so sharply in the past year ?   I never buy anything when I need it.  A number of great supplier sells #10 industrial cans of freeze dried emergency food.  I only buy during sales and then I stock up on the items with a good price. We do open and consume some products so that we can learn to use them properly, however the bulk of them remain for emergency storage in a cool dry heated enclosure.  When one of our kids bought a home, our house warming gift was an emergency food supply of #10 freeze dried food cans They established emergency supplies before the furniture entered !.

                 Many people have no idea how many different types of food are available between the different brands. There are also companies who offer an entirely gluten free line.  Probably the smartest prepping strategy is to buy some dehydrated canned foods and some freeze dried canned foods and to know which is which.  Today I wanted to introduce some of you to some of the more unusual products you might not know are available.

  http://www.nitro-pak.com


Gourmet Reserves Blueberry Honey Granola With Milk

This is a nice change if you and your family had been eating cooked rolled oats with brown sugar for a time.
It's about eighteen dollars and well worth having in the supplies.


Rocky Mountain Instant Pudding in Banana

Most of us know that we can buy this in chocolate and vanilla, but banana could be a boost and a welcome change for many of our family members. It's a bit more than thirty dollars but for a year, you and your family could have banana pudding when you want it.

Gourmet Reserves Split Pea Soup

This is a hearty and unusual soup which is only about $21.00
For those of you who are allergic to cottonseed oil, it does contain this.

Many other great tasting freeze dried and dehydrated foods for families can be found at:

 http://www.nitro-pak.com



Over the years the largest supply of #10 canned foods our family has purchased has been through Augason Farms.


Dried eggs

These are seventy-one eggs, dried for future use and great in cooking.

Non-Fat Dry Milk
This is not your mother's putrid non-fat dry milk.  First of all, it doesn't sour or spoil the way hers did in a year to twenty-four months.  When reconstituted in warm water, whipped with an ordinary mixer, and then chilled, many of the freeze dried milks taste as good as conventional milks.   They also sell freeze dried chocolate milks which are quite good and can boost the caloric intake of children.

Cheese Blend Powder
There is no end as to how this can be used.    Make your own fondue, macaroni and cheese, casseroles, or make a bubbling rice and spinach dish with cheese. Reconstitute what you need and save the rest for another time.

The Perishables Starter Kit
Great to have at home if there is any possibility of being snowed in.

Note:   Although Augason Farms themselves have the far broader selection, Sam's Club does sell the more common items via their online store.  Take a look as sometimes the postage is cheaper.    Also, in some localities, particularly in the West and Midwestern US, Wal-Mart sells some of the #10 cans of Augason Farms staples, in their Super Wal-Mart grocery stores.  Check what is available in your own community.


The items below come from Emergency Essentials

Quick Oats

These quick oats will last 25-30 years in their can. When you do open them, you can add anything from honey or brown sugar to fruit, or even the freeze dried or dehydrated types.  These are inexpensive. We keep some of these in our RV also. They are also a great gift for someone going to college. Oatmeal is an underrated, nutritious and filling breakfast.

Pilot Crackers

Most suppliers sell freeze dried pilot crackers.  These are very helpful when serving soups or used crumbled as a chief ingredient as a crust for either meat or fruit pie, or a pie with an instant pudding inside.   Conventional crackers won't keep for more than six to nine months.  These are fine after 20 years or more.

Freeze Dried Orange Pieces

This is a wonderful way of supplementing Vitamin C and roughage while your family thinks they are enjoying a treat in an emergency.  Buy extra, because your children could fight over these !

Freeze Dried Banana Slices

Many companies sell freeze dried bananas, but many of them are additionally sweetened or "honey dipped".  This brand is simply bananas which makes it especially helpful for those with Type I or Type II diabetes or for those with gastrointestinal issues.    They are an excellent source of potassium and should be stocked for anyone on diuretics or other blood pressure medications which could cause potassium levels to drop. You may reconstitute them and add them to oatmeal or cereals, or chew them as freeze dried.

Sour Cream Powder

An excellent addition to baking, casseroles, or soups. This is available in a smaller can, or a large one if you use a fair amount of sour cream or have a large family.


                   There are many companies who sell freeze dried food, either as individual items as I have chosen to show here, or in entree form.  These are the three companies that I buy from predominantly.  Please take a look at all the freeze dried foods which are available and make a decision as to whether the small cans or the #10 cans suit your family best.  Then, it isn't necessary to drop thousands of dollars at one time. Simply discipline yourself to buy a few less expensive items and find a cool, dry heated place in which to store them. A regular contribution to your freeze dried stockpile will yield an important emergency collection in no time.  Certainly, pay attention to, and make use of the frequent regular sales offered by these, and other companies.   This is an absolutely excellent time of year to make use of all of these stores special reductions.  There are many other freeze dried surprises !


(Photo: www.preparedplanet.com )





             I receive absolutely no benefits whatsoever in recommending these brands.  These are simply brands and items I have used and stored and companies from which  I have purchased      Many other companies do exist.   Readers are encouraged to do their own research and to pay careful attention to postage costs.









   
      

Thursday, December 25, 2014

Christmas 2014

               




        We live in challenging times and for many of us, the holidays don't have the meaning they once did.  This is evidenced by many things.  The lack of Christmas parties and gatherings this year coupled with the few Christmas cards sent are just a couple of them.    Perhaps this is a good thing.  Perhaps we should be focused on more Christmas truth and fewer Christmas trappings anyway.


                   I send Merry Christmas wishes and blessings to everyone who reads this blog.   Whether you are in Finland, Russia, Ecuador, Hawaii, or Tristan da Cunha, I send you wishes for a comfortable and safe Christmas and a positive and safe New Year.


                    Please remember that for all the differences we perceive we have from one another over the Earth, our faiths, our differences in how we believe we should practice even the same faith, or where we live or what our challenges are, and our economic challenges, that we all have more in common than we have differences.

                   Stay safe and be blessed on this day when we remember the birth of Jesus Christ.




Wednesday, December 24, 2014

Greetings to the People of France

                     
Yes, this is France.   (Photo: www.francehomestyle.com )




                There are many consequences, both good and bad, to agreeing to have your blog translated into various languages, and therefore available to many of the world's people.  First of all, the automatic translation of such is not exact and many times the intent is unclear or perhaps even slightly offensive to those who don't completely understand the post.   Imagine my posts on the importance of gun rights and women being read by a housewife who speaks Urdu.   Apparently, the automatic translation for French is better than most and this has resulted in a slow and steady climb in the number of regular visitors to this blog from France.   The increase in French readers is also likely to an increase in world tensions and concerns for French citizens both domestically and abroad. For some reason, French people are very interested in the topics we discuss here, such as family preparedness, disaster preparedness, civil unrest, economy,  and self sufficiency. The French are also subject to a deteriorating health car system in some sectors.  I am happy to have these new readers.
  
                       I have visited both La Havre and Cherbourg in France.  I was to have made it to Paris when I attended school in England. It was our school trip, but I returned to the US before the trip.  I remember the British school contacting my mother and asking if I could return with my class simply for the trip to Paris, but by then it would have caused upheaval with my American school schedule, if it didn't generate truancy problems with my American school !    So, as an adult, I have never been to Paris.   My mother's closest friend while in the US was a frenchwoman who was an artist.  Much of what I learned about France and of Paris came from her and her recollections of her days at the Sorbonne.

                      I learned to speak French in both British school and then took four years of French in American school.  Of course, my experience and immersion in French was in Quebec and Montreal and so the accent Quebecois and specific words used there are more comfortable to me.








                       Since French laws with regard to firearms are considerably different than in the state in which I reside, my comments on firearms and self defense with firearms will not apply to our French readers.  However, a lot of the medical posts, those which apply to self defense mindset, and posts on moving toward self sufficiency, certainly will.   I welcome our French readers and invite you to indicate which topics are of concern to you just now.  Merry Christmas and Happy New Year.  We are all on the pretty blue ball together !

                    

Saturday, December 20, 2014

Please See A Tribute to "Noche Buena"

                  

 


       We become very close to the animals who accompany us in this life, most especially when they are animals who joined us even before our present farm was built.  Animals are not simply pets and many of them on a farm actually help to ensure the survival of the human inhabitants.   This is the victorious story of our Noche Buena as posted on another one of my blogs.

 A Tribute to Noche Buena




Monday, December 1, 2014

Wisdom from "Mausers and Muffins"

        
Of course, this photo is from the Sig Sauer website at http://www.sigsauer.com/CatalogProductDetails/p220-x-six.aspx


       If I had to write a post on the Second Amendment, or if my very life depended upon it, I am afraid I could not even approach the clarity or eloquence found in my dear friend's post.   Please take a look at this and while you're there, take a look around her incredible longstanding blog.

http://mausersandmuffins.blogspot.com/2014/11/most-civilization-is-based-on-cowardice.html





Saturday, November 29, 2014

Remembering Our Veterans Who Still Live

                 





                 If you listen to American news, they proudly report that an upswing in available jobs and hiring,  is occurring. "The recession is over !" they hail.   Of course, none of the long term unemployed with whom we are acquainted, have been hired.   They are getting a few more interviews from time to time though. There is another phenomenon we are seeing in Virginia which I find particularly disturbing.  About twice a week or so, I make a run by car to one of two cities within a days drive from here. Consistent with having good situational awareness, there are lot of things I notice on these trips.  I also dress as "the grey woman" so I can come and go quickly, unnoticed, and a lot of people talk to me, and I respond. I learn a lot of things by simply speaking to people in my travels.  There is, a decided uptick in the number of veterans who are panhandling within my state.  There is a veteran from the  Vietnam conflict  panhandling on one corner who has listed his numerous medical diagnoses, on a giant cardboard placard, many of these diagnoses are likely correct, but misspelled. One of them is metastatic bone cancer.  He is standing on the corner, and from the gentle sway, he is obviously in pain. I had seen him and spoken to him several times to make sure that the staggering was pain and not drunkenness, before I gave him money. He is homeless and waiting for some type of disability. to come through  He stays at the mission whenever they are open or they have room.  I accept that there are people out there who won't take help sometimes, and who fall through the cracks in even the best systems. However, I am seeing an increase in the number of veterans in really serious situations who aren't getting what they need, and as an American citizen, I am both embarrassed and  ashamed.  I have done a little research on this, and the US Department of Veterans Affairs claims that there is help, housing, vocational rehabilitation, and medical care for these people.  If this is so, then why would so many veterans of so many different conflicts, and of both sexes, with differing issues not make use of the available help ?  Certainly, the social workers at the missions and homeless shelters have internet access and can help these souls who gave so much to us some direction to such programs, if such programs exist.  Why is this system not working ?   The VA says that homeless veterans are usually of African American or Hispanic ancestry and I don't know how they could even know this, because so many don't wish to be counted.  So many wish to be completely off grid.  The ones I mention in this particular post have all been caucasian.  I don't actually care what their ethnicity is identified as. Someone who served our country and was damaged or injured in the course of doing so, should have our support in both the short and the long term until they once again can take an important role in our mainstream.

                        There is a young woman who is a veteran of one of our recent wars. She has an amputation, and panhandles about one day a week  She has a dog who is protective of her.  She doesn't say much other than she "doesn't have anywhere to go".      I have met a number of fairly able bodied looking former soldiers in the community in the past six months.  Most are trying to adapt, and trying to fit in, even those without continuing medical issues from injuries. Goodwill has provided a job to a few of them.   It is quite difficult for many of them.  Some of them find a willing ear in the preparedness or survivalist communities.  Some of them over time are able to calm themselves enough to begin to piece together a life.  What bothers me is how many of these former soldiers claim that there are no resources allocated to help them reintegrate into their communities.  I know only one who found a job and is doing fairly well there.  Some of them don't trust the systems in which they once worked enough to confide in them to get the help they need. For a few, the Department of Defense has become a secondary untrustworthy enemy.  Many of them know what happened to Brandon Raub and they are acutely aware of NSA gathering of information, of Edward Snowden, and of the progressive erosion of the US Constitution under the Obama regime.

                       Yesterday, as I picked up fruit at a Wal-Mart in a distant town, I noticed a warmly dressed man in a beard in the line in the express line in back of me.  He had a bottled water and an inexpensive compilation video of an action series. "Sir, why don't you go ahead of me ?" I asked.   He looked surprised, but he silently went ahead and thanked me.  I commented that the compilation for five dollars is a very good buy.  At that point the female clerk in at the checkout said that he often finds the best priced videos.  As we headed out to the cold, he told me that he is a former marine, homeless and  living in a tent in nearby woods and watching compilation videos from a small portable battery operated player, whenever it's time to hunker down, like on the holidays.  I thanked him for his service to our country. For a moment he stood a bit taller and straighter, and didn't seem quite so cold.  How sad our country didn't find a better way to help those who have sacrificed so much of themselves to run operations which were said, at least at the time, to benefit America and her security.   As I shivered my way back to my car and thought about how when I finally got home,  I would have to spend a couple of hours once again today outdoors in snow and rain caring for horses and other livestock, caring for them, and placing them in the barn. I thought about the lives of so many who are simply living out in the cold all the time.  I said a prayer for the men and women like the marine.I met today. Please do the same.



Thursday, November 27, 2014

Revisiting "Why There is Thanksgiving Sadness"

Every Thanksgiving is a snapshot in time which may not come again.  (dvd-ppt-slideshow.com)
     


                      This post was first written and posted on November 21, 2012.  I don't think I have anything more profound to say at Thanksgiving, other than please have a safe and good one.
 

    I am a little reticent about Thanksgiving.   In the 90s, my mother in law died in her fifties before Thanksgiving.   Then in 2006, my beloved golden retriever Susan, who had helped to raise all our children, passed of old age, early in the morning the day after Thanksgiving.  She passed at 5 am on a pillow on our bedroom floor. Despite her old age, this was a great loss, and I knew even then, it was the beginning of a trail of losses.   The following year, my mother passed in the hospital the day after Thanksgiving.  I was eating some leftover turkey with some stuffing and gravy when I got the phone call. I still remember how I felt as I sat down in the dining room to compose myself.  The following year, my father passed before Thanksgiving, and I had the great honor to sit with him for five days beforehand.  He was quite lucid and this gave us both a chance to tell each other some things and for me to confirm some final life directions.  Just after Thanksgiving in 2008, our youngest son passed at 12 1/2.   There was a clean autopsy, and physician think he may have had a spontaneous heart rhythm disturbance.  We were supposed to be comforted by the fact that this is happening more and more to children who play sports and to professional athletes also.  I don't think misery really loves company.  I don't think I want anyone to lose a loved one, on a holiday, just after, or any other time.
             I suppose it's probably normal for me to approach Thanksgiving with a little trepidation.  "Whose turn is it this year ?"  is a thought which sneaks in sometimes.  With my new onset atrial fibrillation experienced seven times this year, I think the likelihood is there that it will be me.
             Still, with all this holiday baggage, it doesn't matter.  We ARE here, and we ARE going to celebrate because no one is every promised or guaranteed any day, let alone another Thanksgiving, or another Christmas.  We are here, until we aren't.  The crime would be squandering that time in which we are.
              I could look at our trail of Thanksgiving losses as very bad luck.  Or I could see it as it is.  God has orchestrated for us that He calls us when he is ready, and is demonstrating to our family that there is a plan.  Our family members will be well until they are called, and then they will be lovingly called to go home.  I try really hard not to be sad in the holiday season.  Most of the time, it works.

   Happy Thanksgiving Everyone.  Give a hug to everyone because sometimes it IS their last year with us.

                                                             ~~~~~~~~~~~

UPDATE:    Thanksgiving Day, 2013        So many people are reading this post this year, that I thought I owed all of you an update.   My health has improved greatly from a year ago.  I am no longer having atrial fibrillation since I supplemented magnesium glycinate, and changed from omeprazole which decreases needed magnesium levels over time, to ranitidine, for GERD.
   There is a book called "Beat Your A-Fib" which you can see at http://www.beatyoura-fib.com/     If atrial fibrillation is a problem for you, read this book and then discuss whether implementing its recommendations are right for you, with your doctor.
                  I am still dealing with animal health issues this year.   My son's thirteen year old Siberian Husky is requiring pretty intensive care as a result of probable Addison's Disease with fluid and electrolyte imbalances.  This Thanksgiving, I will be working hard with him on his appetite, until the vet reopens after Thanksgiving for more definitive treatment.    It is my hope that we will avoid a Thanksgiving season loss this year.


 UPDATE:  Thanksgiving Day, 2014
              Our Siberian Husky is still with us and will be sixteen years old in January.  He requires a lot of care but still enjoys his life, and we very much enjoy having him with us.
                                                            ~~~~~~~~~~~

Tuesday, November 18, 2014

Introducing "Ash Fall"

                    

                        My friend, Deborah D. Moore is the author of The Journal: Cracked Earth which found its rightful place on the best seller's list last year after only six weeks.    The Journal: Ash Fall is the second book in the trilogy which is now available as a kindle edition.

           Buy Ash Fall as a Kindle edition


                       Deborah is not only an expert in family and regional preparedness in her area of the US but she has also been on television in both the US and in Canada.   Her unraveling of the story of Moose Creek is not only very instructive from a standpoint of disaster preparedness, but is entertaining as well.

                     The e-book and printed version of Ash Fall will be available within two weeks and is probably most easily obtained through Amazon.com .





Saturday, November 15, 2014

A Piece of Perspective at "Black Friday, Indeed"

               


 
  When you have a chance, please visit one of my other blogs at:



http://learnedfromdaniel.blogspot.com/2014/11/black-friday-indeed.html


                This post concerns long term survival of self and of family in loss and in layered losses.

The Disc-O-Bed Cam-O-Cot

                


This is the Disc o bed Cam O Cot shown with organizers attached.




  I have promised that from time to time when I see a product that I think could be helpful to some of you, to call your attention to it.  As always, other than my very own books, I have no financial interests whatsoever in the products which I mention here.   Make sure you do your own due diligence. Ask good questions and see that you understand everything about any product you see here before investing your hard earned ever shrinking dollars on them.

      If you have a home sized even slightly larger than you need for daily needs, or if you have a dry basement, you could be called upon to be an emergency shelter for relatives or close friends.  Even a simple snowstorm on Thanksgiving could cause you to need to provide emergency dwelling for friends or family. I keep a number of sleeping bags, but many people can't sleep on them, or on a concrete floor, as would often be in most basements.  The Disc O bed Cam O Cot comes in easily stored bags.  It assembles fairly easily, or you could assemble them and leave them up if you have the space.  You can configure them, as above, as bunks, or you can configure them as separate beds.  These are particularly helpful for your own cabins too should you plan to use those in emergencies and lack the space or money for genuine beds.  These beds can be ordered either in 28 inch or 35 inch wide sizes.


These are the largest beds unassembled in their storage bags.

This is inside one of those bags.  These are easily transported.
                 

  These beds are used by the US military and are especially helpful in tough-to-bunk places.  The organizers as seen in the picture at the top of the page come with the package.  Each bed can be converted to a bench should you need a bench with a back later the next day.  No tools are required for the assembly of these bunks.

       Please let me know how you like them.



One Source of these beds starting at $299.95 per set

Cabela's Page for this Product







Friday, November 7, 2014

The Onus is On the Republicans

                     
( Rendering: fabiusmaximus.com  )



                   So, it seems that the discontent which is so pervasive with regard to the Obama Regime manifest itself yesterday by the loss of a number of Congressional and Senate seats.  People are tired of knowing lots of people who have been out of work for years.  They are tired of their adult kids looking for jobs all week, and remaining in their home for another year.  They are unhappy with a thousand dollar a month rise in their health insurance deduction from their salaries (as was the case this month for us.)  The Republicans control more than they did and I wish I believed that this was a wholly good thing. Already, the new Speaker of the House has said he doesn't know how practical it will be to repeal Obamacare.


                          When I vote, I generally vote for the individual I believe is best suited for the job, and whose ideas best approximate my own.  I am an issue driven voter, which increasingly seems to be unusual.   In much of the past, I have voted Republican, particularly during the presidential elections.  However, I must also say that I have friends who are politicians who consider themselves to be Democrats and although we might agree on some things, we often don't agree on how we might get there.   I have never voted Libertarian although more and more, I find myself agreeing with some of the things they are saying also.  I believe in federal government only for the things which are essential for them.  They need to consider national defense, national security, securing borders etc.  They do not need to be tinkering with education or health care.  States do a marvelous job of addressing the issues in their location. What is right for Texas or Louisiana might not be needed in Rhode Island, New Jersey or Alaska.  Let's let the states manage their own issues starting with education, and environmental issues.  Why are we paying for redundant agencies ?  Why does every federal agency have its very own SWAT team ?   Why does the CDC have one ?    Is the US Postal Service getting one next ?  Are they going to break down the doors of those who are late on postage due fees or post  box fees ?


                         The point is that America has spoken. They are not embracing Mr. Obama's grand transformation of America.  It hasn't worked and we are awakening to a much higher national deficit than we had prior to his presidency coupled with infringements or the dilution of many, many of our rights, often by weekend or holiday executive order.   The Republicans have a narrow window in which to begin repealing the madness gently and deliberately.   If they do not, then the infringements of our rights continue as does the economic death spiral of our nation.



                    So, please excuse that I am not dancing for joy that a party which in theory should oppose everything Barack Obama stands for now has more control.  Their election will be meaningless if they cannot grow a spine sufficient to make hard decisions which repeal tinkerings the Obama regime made which are strangling the economic machine of our once great nation.




Saturday, October 25, 2014

Ebola ? Worry About This Instead




                 As regular readers know, my daughter has been a juvenile diabetic since age 9. (Which was 1993)    No, she is not overweight. She will never outgrow this, and losing weight or any such life change or magic will never impact the fact that she will never make insulin herself again.  She does not have Type II diabetes, the current scourge of the United States, she has the rarer autoimmune variety which afflicts about 10% of diabetics, and is actually a different illness than the Diabetes Mellitus Type II which is so common now.        How did she get it ?    We do not know how all cases of Type I autoimmune diabetes mellitus start, but we do know this information, in her particular case.

                   When my daughter was 9, my father-in-law caught a virus in his office.  (He was in his fifties and worked as a engineer in a large office in the city.)   Within several days he became ill enough to be hospitalized with pneumonia, cardiac arrhythmia, and  generally was miserable with a flu-like illness.   The doctors thought he would be released by Monday, but he thought he was dying.  It turned out,  he was correct.  Despite being in a cardiac monitored intensive care stepdown unit,, he coded and died as the physician in charge was actually watching the monitor, and could therefore start attempts at resuscitation immediately.  Since this was an unexpected death, the hospital paid for a full autopsy and the results were surprising.   The causative organism to his flu was Coxsackie B4, which among other things, can invade the heart's conduction system and cause death, just as it did in this case.   We were all in shock as we made funeral arrangements, and many of the people where he worked came to the funeral although I noted many of them were sick or recovering from a viral illness also.   None of our physicians indicated that there may be implications for our family, and no one asked us about the health of the rest of our family or our kids.  They had the sniffles, but nothing more.

                 During the viewing, a room was set up in another part of the funeral home for the family and especially the kids. There was a television  and food was set up there.   In a very brief period of time, our daughter who had the sniffles downed quite a bit of soda,  and ate quite a bit.   Each time we checked on her, she seemed to be in the bathroom a great deal. This was quite uncharacteristic for her.and so I called the pediatrician to report rapid onset   polydipsia, polyuria and polyphagia,** all things that indicated that new onset Type I Diabetes Mellitus needed to be ruled out.  The pediatrician thought this was a grief reaction and tried to discourage our coming in.  When I called later to report a flushed face with a fever, she agreed to "let us be reassured" by the pediatric endocrinologist.  The endocrinologist thought she looked great and took blood for thyroid testing, but declined to get even a blood sugar. He proclaimed that she was simply in a growth spurt.  I was not okay with this. I wanted diabetes ruled out even though no one in my family had ever had it   So, on the way back from the endocrinologists office, I bought an inexpensive screening test kit at the CVS Pharmacy for glucose and sugar in urine. We didn't have to wait long on our return home to check it.  It was highly positive for glucose and ketones.  I took the time to explain to my daughter that there was no other reason this could be true that I knew of, other than a new case of juvenile diabetes.  I also told her that blood glucose monitoring devices and that teeny insulin syringes and improvements in technology have made this a much easier disease to control than it was even a few years prior.  I also told her that between the two of us, we could control it, and that after a brief hospitalization, she would give all her own insulin.  She accepted this, and while she went to pack and get her teddy bear, I called the endocrinologist and the pediatrician to arrange the inpatient emergency hospitalization.

                 The endocrinologist was flabbergasted that a parent who called his attention to something was actually correct.  "I should have listened to you, because you are a nurse !"  he said.  " That's not why you should have listened to me", I said.   When any parent tells you that something is really wrong with their child, then you should listen, because the parent is the expert historian on their child."    When my daughter was admitted to the hospital with a glucose level of 547,  (70-120 being the desirable range.)   we were told that she likely escaped death in her sleep because we had acted so quickly.   When I brought up whether this could have anything to do with the virus that had killed my father-in-law just a few days before, initially I was pooh-poohed.   My daughter's fever made it harder for them to brush me off.    Eventually the labs were done which indicated that my daughter too, had Coxsackie B4, and that it had likely activated the autoimmune chain of events which wiped out her ability to make insulin on the beta cell level.     I did not know of Coxsackie B4 virus at the time, but I learned that it can both invade the conduction systems of hearts and cause lethal arrhythmias, or it can cause a cascading effect which can cause the patient to attack and destroy their own beta cells, the functional unit in the Islets of Langerhans in the pancreas.  Both my father-in-law and my daughter were severely impacted by the same virus !  The link between viral exposure and Type I diabetes has been known for 40 years, yet is seldom discussed, even by nurses or physicians.

              This leads me to my concern in the present day.   While many are obsessing about Ebola, they are ignoring Enterovirus, which is much more common and much more easily transmissible.  A large nationwide study in Taiwan, published recently, indicates that children with enterovirus have a whopping 48% increased likelihood of developing Type I (autoimmune, juvenile) diabetes mellitus !    This is the first such study of its kind and the implications to the world are staggering.  No antiviral strategies are yet effective against it.   The article postulates that perhaps we can develop a vaccine for Enterovirus to try to head off some of these cases of Type I diabetes mellitus that will be heading down the pike. We are already seeing an increase in the incidence of the Type I variety of diabetes mellitus.   Learning to control this chronic illness is time consuming, expensive, and it can be life limiting. Not all of the children who develop it, survive. This needs to be a major focus of public health.


    So, think a bit about taking your baby or young child out to crowded places.   The old strategy of masks on visitors to babies, and frequent handwashing is a good one.  Perhaps a smaller daycare is a better idea than a large one.Perhaps having someone who does good daycare for only two children in her home has merit. Perhaps you are one of the lucky ones who can sidestep all the germs and viruses in daycare altogether.  Can you or your wife work from home ? Can one of you stay home with your young child ?

             Before you bet the farm on bugging out due to Ebola, please realize that there are far more common and more likely infections out there, which can be physically and financially devastating, and can change your child's life and your own forever.

                As for my daughter, it was hard work for us all controlling her blood sugars, even with the insulin pump she eventually received.   She grew up, went to college, graduated with honors,  drives a car, and has a life partner and a new home.  She has survived the birth and  the first month of her own new baby's life.   She realizes how layered viral exposures can adversely impact her child's life and is taking steps to limit those exposures.  I don't think my daughter will be taking her baby to the Coliseum to watch Sesame Street on Ice, as I did when the kids were toddlers.   She uses a pediatrician where sick children are segregated from those who are ill as they all wait.   Please think about doing the same. We need to do more to keep our children from layered viral infections.


**  Polydipsia means drinking liquids a great deal, polyuria means urinating frequently and in larger amounts, and polyphagia means eating a great deal.  These are earmarks of new onset diabetes, especially Type I.


More information:


http://www.healthline.com/health-news/could-enteroviruses-be-behind-type-1-diabetes-rising-rates-102214

http://www.medscape.com/viewarticle/833474?nlid=68107_3042&src=wnl_edit_medp_diab&uac=49270BG&spon=22



Friday, October 24, 2014

A Tribute to Gerald Frantz


Gerald and Jane Frantz       Photo courtesy of John Wesley Smith


                             
I have been away from the computer for several weeks as I have stayed with my daughter helping her with her new baby, her juvenile diabetes, shopping, and care of her animals.  I am home long enough to take care of my horses and other animals and then I flit back again until she is better able to manage.  There is progress, but she needs rest and routine sufficient to control her blood sugars during a time of hormonal turmoil. I will also be starting my new job teaching college again soon.

       Yesterday afternoon, while I scrubbed out horse water buckets, mucked stalls, and measured out their grain, Gerald passed from this Earth to the next life.   I had the incredible good fortune to have phoned him two days ago, and we had a very lengthy conversation, which I will always cherish.

         Some years ago, I became acquainted with Gerald when he appeared on a friend's blogroll.   He penned a blog called "The Last Robin" which were both musings of his life, and observations.   He was clearly an incredibly gifted writer, and quite a Biblical scholar, and teacher.   His eloquent writings however, were not the reason we became friends.  He periodically commented here on this blog, and was a good friend to me, and I know to others as well.   Who was Gerald Frantz ?     To most observers he might have appeared as a widowed older man who spent the last couple of years in a nursing home while writing a poignant blog.   However, I don't think that's who he was.   I think Gerald was a true creature of light.   Most of us come to Earth in infancy as a creature of light who is all at once encased in a small human flesh suit.   Our knowledge of light and all that we know becomes deflected by the complexities of maintaining that suit.  We must eat, then we must endure other functions, and then we must sleep. As we move through life and we grow, we learn to manage sleeping and eating, but by then, the trappings of the world have seduced us.  In youth, our friends, our schools, our families all take us farther from being the creatures of light we were meant to be.  Our worlds give way to anxieties and for thoughts of perhaps not being good enough to stand beside the other "flesh suits".  Then as we venture into adulthood, where there may be losses and events we perceive as failures, we may fall farther and farther from the people we were meant to be on our journey, which is egregiously short.     Gerald did not let a stroke, the loss of his beloved wife, or his leukemia interfere with his being a creature of light.   He had an uncanny memory for the things you had told him.  Even though he recalled scripture better than almost anyone I've known, this did not motivate him to be judgmental.   He was wholly supportive.  He was also bright enough to follow what you were saying and anticipate the extension of what you were saying, along with its implications.

         He chose not to fight his leukemia, but to go home when the time came.  This always leaves nurses in a difficult position.  On the one hand, we must honor the wishes of human beings and be supportive, and on the other, we must wonder whether we have done a good enough job of explaining how far cancer treatments and treatments for leukemia have come, in order that each patient can make the most informed decision for themselves.   I remember Gerald telling me about one of his physicians who some time ago visited him and spent a great deal of time explaining the treatment options for Gerald's cancer.  Gerald listened and no doubt left an indelible print on the doctor.  When Gerald eloquently explained why he was choosing to take the natural course with regard to the illness, the doctor hugged him, no doubt impacted by Gerald's eloquence, bravery, and most of all, his golden faith.

         Gerald believed different things about Heaven than I do, and yet he never corrected my perceptions.  He knew that I am a child on a journey, and also that I might need to believe what I do, in order to make sense of what happened when I lost my youngest son at 12. Perhaps he thought there is still some time for me to grow and learn more.

          Gerald passed at 5:25pm Central Time yesterday, and did not wish a funeral. Today he was buried  with the least amount of fuss, as was consistent with his wishes.

         Should you wish to memorialize this wonderful man, you may consider a gift to his last stop while on Earth, which was:

        Hospice Compassus, 3050 I-70 Drive SE, Columbia, MO 65201.

He conveyed what a wonderful job they did for him, especially with regard to controlling his pain with sufficient skill to allow him to still be clear enough to continue to communicate via phone with his many friends.  I will always be most grateful for the conversation we had, just two days ago.
 
         My favorite recollection of Gerald's was the story of the "Library Cat".  It so epitomized his personality and generous spirit, and it also reminded me of something my own father might have done.


          I will remember this remarkable man and creature of light for many things, for the funny anecdotes, for the sad ones, and for a golden faith.  Gerald believed that those who accepted God would meet again but only upon the resurrection.    Once again, I need to be comforted by knowing that today, he will see God and his beloved bride Janie.  In the time which follows I imagine, or perhaps I hope that my beloved father and my son can meet with Gerald and share stellar conversations.  It comforts me to think this.

If you wish to read some of the writings of a creature of light, then these are links to specific posts:


http://thelastrobin.blogspot.com/2012/12/the-library-cat.html

http://thelastrobin.blogspot.com/2012/12/who-do-you-work-for.html

http://thelastrobin.blogspot.com/2014/10/degrees-instead-of-knowledge.html

http://thelastrobin.blogspot.com/2014/10/will-you-please-shine-light-over-here-i.html

http://thelastrobin.blogspot.com/2009/12/no-more-death.html



The entire anthology of this great man can be found at:

http://thelastrobin.blogspot.com


Godspeed, Gerald

Saturday, October 18, 2014

Interesting Updates in US Hospital Managed Childbearing

          




        My last child was born eighteen years ago in an excellent hospital in Richmond, Virginia.   Just recently, I attended my daughter during her labor, her delivery  and in her week of hospitalization afterward, in a major university medical center.  Both of our pregnancies and labor and deliveries were high risk, but for very different reasons. The evolution as to how childbearing women are managed since then has been quite interesting.

                 Often in medicine, something that is done as custom, completely reverses in a few years in response to the latest and greatest new study on the subject.  Sometimes, change is for very good reason, and sometimes, well, not so much.  Sometimes, the studies which change the tides of practice are not that large, and perhaps should not be taken quite as seriously.   Often I think that rather than embracing the other side of the pendulum's swing that we should simply approach childbirth, child rearing and general medical care using a more flexible mindset in the beginning. Each patient, each family, and each baby is an individual, and one size fits all, is rarely a healthy medical treatment strategy.

                   In 1996, only those families who had attended the full Prepared Childbirth classes (often Lamaze styled training given in hospitals by specially certified nurses) were permitted in the delivery room.  This helped to ensure that the participants knew where to stand and when to stay out of the way in an emergency. It also meant that they understood enough about the process to accept an emergency cesarean section if rapidly necessary.    In 2014, this was not even a point of inquiry.  Whomever the woman wished to have with her in the delivery room was just fine.  In 1996, the hospital also provided scrubs to the individual who would remain in the delivery room with the laboring woman.  This time, there were no scrubs offered.

                    In 1996, there was a paper medical record and everyone caring for us knew the prior medical history and the plan of care.  In 2014, there was a wholly electronic medical record. However, it would only update periodically (leaving prior medical history out, upon admission, until the software update occurred) and as a result, my daughter was in labor several days without a number of members of the team knowing her entire medical history.   Since only one screen of data is available at a time, many health care workers are unaware of the entire picture, and know only the snippet they need for each task.  In a complex case, this can be a problem.  The function or dysfunction of the electronic medical record resulted in a Type I diabetic who requires insulin on a real time continuous basis, to experience seven hours after labor and delivery without any form of insulin whatsoever, when she was assumed to be a "gestational diabetic" who might not require continuous insulin reordered immediately. (Go ahead, and tell me again how much safer we are with an electronic medical record !)

                    In 1996,  I saw a regular obstetrician, a high risk obstetrician for my thyroid issues, and an endocrinologist.  These were on different days and in different locations in the same city. Non-stress tests, labwork, other tests were done in different locations. It was hard work getting a pregnant and hypertensive woman (me) to all those appointments safely, and I was driving and had small children with me for most of the appointments.    In 2014, high risk pregnancies came to one hospital location where my daughter saw an obstetrician, a high risk obstetrician, an endocrinologist, the lab for labwork, an ultrasonographer and a technician for a non-stress test in about the same location, and  often on the same day.  This meant that she did not become exhausted simply in the course of getting intensive medical care during pregnancy.  The prenatal high risk health care system was a vast improvement over the experience in 1996.

                   In 1996, in labor, we were allowed nothing to eat or drink for the duration of labor, except for a few lemon barley lollipops which our prepared childbirth classes told us to buy and bring to the hospital.  This was done because digestion of food does not occur during labor anyway, and anesthesiologists in particular, if they must attend a patient having an emergency cesarean section, prefer to be working on a patient who has an empty stomach and cannot aspirate stomach contents while under a general anesthesia.      In 2014,  my daughter was allowed to have clear fluids through the course of her labor, even if she were vomiting. This is done now to keep the woman comfortable and aid in hydration. It also permitted her labor to go on longer and was part of how she was able to endure such a long trip and avoid a cesarean section.

                    In 1996, most women still received an episiotomy.  Toward the end of labor, the obstetrician cuts an incision on the posterior vaginal wall at a 90 degree angle with scissors, thus widening the opening and preventing potential deep vaginal tissue tears during delivery. (These are quickly sutured closed after delivery and the straight clean incision usually heals quite quickly.)  Although this is still practiced as a method of preventing serious tearing in a great deal of the world, it is no longer routinely practiced in the US.   Now, a first degree vaginal laceration itself,  which occurs during childbirth is stitched up afterward.   I had several episiotomies which healed quite quickly.  I am noting, that my daughter is still quite uncomfortable without one, three weeks past delivery.
    
                    In 1996, the nursery filled with lots of babies, where families could visit and compare still existed.    Since I was breastfeeding, my baby was brought to me fairly frequently after delivery, and then he returned to the newborn nursery with nurses in attendance.  As I recovered, he spent more time with me in the room, and less in the newborn nursery.  I remember being a few doors from the elevator and in my slight post partum anxiety, I was afraid to go to sleep with the baby in the room.  I feared someone coming up the elevator and taking the baby while I slept.     In 2014, my daughter was moved from labor and delivery where she also completed her recovery to a Mother Baby Unit.    Both she and her baby remained in the room 24/7 to facilitate breast feeding.   The Mother Baby Unit is high security and is a locked unit, a bit like a modern day psychiatric unit.  Family members with a pass must be buzzed in each time they wish to enter.  To prevent babies being kidnapped, each baby is not only double labelled, but is fitted with an RFID tag.   The baby remains in the room with the mother and cannot ambulate outside her room with her, as I so often did, in 1996.   The RFID tag causes a loud alarm to go off in the unit anytime a baby leaves the desired area, and there are sensors throughout the unit and on the elevators outside.

                   In 1996, the emphasis was on having new mothers ambulate as much as possible on the hallways of the post partum unit to avoid blood clots, to hasten recovery and in order to get to the small kitchen on the unit to get tea or milk.   (Probably also a way of helping to transition a woman going home from the hospital who will take on the tasks of caring for other children as well as her new baby, on arriving at home.)   In 2014,  my daughter was discouraged from leaving her room or interacting with any other patients.  There was no on unit kitchen, and she had difficulty getting hot tea when she wanted it, which she actually needed for diuresis. In addition, being confined to the room meant that when she was discharged after a week, she required an evaluation for deep vein thrombosis and pulmonary embolism. (medical speak for blood clot which can travel to the lung and potentially cause death)

                  In 1996, if you were discharged and your baby needed to stay, then you were thrown to the wolves sitting in a rocking chair until your baby was discharged, and this was not helpful to milk production.  In 2014, my daughter was discharged a day ahead of her son, but she was allowed to remain in their room as a "boarder" with him with her own bed, breastpump, and meals provided, as it is now understood that this is best for both of them.  This new strategy was very much appreciated.

                 In 1996, there were no specific directions about positioning newborns (other than avoiding suffocation with blankets, softtoys or crib bumpers) but now, the American Academy of Pediatrics is very clear that studies indicate that a baby should be put down on his back to avoid SIDS.   I am not sure what they do with newborns who turn their heads or bodies to the side after you place them on their backs.

               The last and most interesting difference is the stance on breast feeding.  In 1996, I was a curiosity. I was a nurse who had chosen to breast feed, and I was indulged as this was considered "quaint".   How could a working woman keep up with breast feeding ?  Why, it's so difficult !!    Now, the pendulum has swung and the attitudes are quite different.  Now, there is a "take no prisoners" attitude toward breast feeding.  The Obama administration now requires health insurers to pay for at least some types of breast pumps via insurance.  There are no more formula samples given to families.  There are no pacifiers permitted.  Babies are to be breast feeding !   Even mothers who endure daily visits by 74 medical students, interns, residents, fellows, attendings, attending physicians undertaking studies of childbearing women etc.,  and a bevy of registered nurse lactation consultants are to be either breast feeding their baby, or using the rolling breast pump.  No one seemed to know though, that Type I diabetics, or those with hypothyroidism or other endocrine issues tend to get a lactation response a bit later than other women, and so my daughter was guilted by some of those on the pediatric service.    I am actually a proponent of breast feeding, but again, a forced inflexible response to any situation generally does not work well for most patients.

              In conclusion, some of the approaches and procedures in 2014 at a major world class medical center were far better than those in 1996.  However, some were not.  In future, I think my daughter will chose to be a "non-teaching patient" and will sidestep all the extra physicians.   Consistency can be a wonderful thing.




Tuesday, October 14, 2014

About Friends

          




            When I look back, I have always been fortunate to have had really good friends, whatever the challenges we have endured.  However, with difficult and challenging times to come, there are a few things I would like you to consider with regard to friends. Consequently, I have run the mile for them, and then been the recipient of some really herculean aid and sometimes wonderful gestures when events turned dark in my own life. I will always be grateful to those people, and I think they likely already know who they are.

                True friends are rare.  Most of us have neighbors who aren't really friends but are acquaintances.  They may seem to have your back and to be available to you, but they aren't really friends. If you were to move out of state, would they still be your friend ?  Would you still rate as more than a Christmas card ?  Would you rate as a Christmas e-card ?    Would they extend themselves or inconvenience themselves in an emergency ?  If not, then they are neighbors on which you are on good terms, they are not friends.

                 Most of us have some "work friends".  These are people with whom we have worked, often for many years, and we are often on very good terms with them and have developed trusting relationships with them in the workplace.  However, if you changed jobs, would you see them again ?  In six months, would they remain in your life ?  If not, then they are more correctly "workplace acquaintances" or professional collegues.    It's important to have good solid relationships within the workplace, but it's also important not to mistake these connections as friendships, because often they are not.

                My accountant, my financial advisors, my doctors and our insurance agent have all been with us for many years.  I know some of them socially, and when our youngest son died, most of them dropped everything to attend his funeral.   However, these may still be people to whom you are a valued client, they still may not really be your friend.

                 Friends are people in which you can confide, and in whom such confidence is not misplaced.  They are people who would endure inconvenience and discomfort if you had troubles.   Relatives can sometimes be friends, but often they are not really your friends. We can't choose our relatives, but we can choose our friends.

                  When I was in high school, we all recognized the syndrome of the friend who pretended to be, but when the going got tough, sold us out for one reason or another.  This was the friend who dated your boyfriend after you and he took a break.    We called these people false friends, but my kids call them frenemies.   These are not just restricted to high school.  They exist in all walks of life, in all occupations,  and in all age groups.  Sometimes people inadvertently betray us, and sometimes, they do it deliberately.

                We can have many acquaintances in life, but most of us have few true friends.  With difficult times ahead it is very important to know which is which.    Remember that friends know your political affiliations.  They know where you bank.  They usually know what you have and what your weak points are.  They know that your town requires a septic tank be pumped every five years and that you haven't had your pumped in seven.   They probably know enough to effectively perpetrate identity theft.  They certainly could inadvertently mention personal information of yours to someone who could betray you.   Most of them would never do such a thing, but do they know enough not to mention your new car to another friend ?   Do they know enough not to mention where you keep your safe and that you have one ?  Something said quite innocently to another could be devastating to you.  Good friends can be a godsend whereas you can be left destroyed by a bad friend whom you have misjudged.    A male friend of ours found that his wife had been having an affair with his best friend, for years !   Another friend of ours found that the friend who was supposedly giving his son a great job reference, was actually providing a bad one.  We are vulnerable when opening ourselves to friends.

               If the world became even more frightening than it is just now, would your friends keep you safe ?
Would your friends who have the room,  let you stay with them following a flood or an earthquake ?    When food or incentives are given by government for turning in those with a food stockpile, would your friends or neighbors turn you in ?   How much do they know about your stores and supplies?  How much do they know about your legal firearms and where they are ?  Have you ever unwisely said to them that you "would never turn in your firearms to the federal government" if they ever called for them ?  This would be an unwise comment to make.

                One of my friends once told me that she is a good friend to us because I have always been a good friend to her.  I think this is indeed part of it.  I have always tried to be a good friend.  Like most people on Earth, I have fallen short from time to time, mostly through errors of omission or by being too busy to be present enough during their trials of life.  However, at times, I have indeed been a good friend.

               Keep in mind that no matter how close you believe your friend to be, and how honorable you think he/she is, that once private information is provided to them, it can't simply be called back. Once private information is out there, it's out of the box and can't be put back.  This means that you should be much more careful about what type of information you reveal to friends or on the internet and especially in social media.  Keep in mind that in a couple of hours, a person searching us with only a name can amass quite a little dossier on all of us.  Make sure that this is very little information, for many reasons.



This is an uplifting song to help counter the somber tone of this post


Casting Crowns                                                             "Thrive"