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Not worth 0500

Holly Doyne Posted on 2022-03-03 by Holly2022-03-03

One of the downsides of living on the US West coast involves time zones. What may seem like a perfectly reasonable time to you, in London, Geneva, or Copenhagen is not all that great from my point of view. Especially this morning,  which is why I am whining. The Global Health Program out of University of Copenhagen has a regular webinar series named the Nordic Global Health Talks. These, in the past, has been both interesting and informative. The topics have ranged over a wide variety of key public health topics and the presentations have been excellent. 

Not so this morning. Ok, from their point of view it was 1400. Early afternoon and no one should be suffering from post-prandial fatigue. But from my point of view – with an alarm sounding off at 0447 so that I was logged on by 0500 – it was dark. And quiet. And a bit on the chilly side.

And yes, I am working my way around to the whine. Last. month the discussion involved the issue of global health and society wellbeing as reflected by the state of migrant health. The speaker was knowledgeable and informative. The topic today was the result of a doctoral dissertation on clinical guidelines for labor and delivery compared to on the ground realities in Tanzania.  What started out as a comparison of actual workload at one location in Zanzibar with clinical guidelines turned into an extended rant about how the guidelines weren’t useful or locally relevant. Ok – but 20 minutes on how poorly the WHO guidelines functioned in practice (low resource settings) was a bit much as she never presented a comparison of those guidelines with the ones locally developed, or how they went about the process of developing guidelines or ….

You get the idea. Not organized, not informative after the first five minutes and didn’t give me much information on what could be done to improve the situation.

I gave up before the end of the hour and went back to bed.

——————– 8- < ——– – – – – – – – – —

Alex is home. He has dogs for company.  His pain meds are working.

And the dogs – they are still trying to dig up that gopher who is too stupid to relocate.

Posted in family, Medicine | Leave a reply

another Saturday, more needles

Holly Doyne Posted on 2022-02-05 by Holly2022-02-06  

I was part of the team at Allen Temple Baptist Church again today. Officially our hours are 1000-1400 which means a good couple hours ahead of time for set up and perhaps time afterwards for tear down. This location is about as far south in Alameda County that I want to drive. Nothing against the other areas, but getting to some of the more southern locations proves to be a nightmare.

Or rather, it isn’t getting there, it is getting home at high traffic. And trust me, the traffic was horrible pre-pandemic and much worse since then. Way too many people who never had cars before are now out on the freeway creating havoc.

Anyway – I went, I stuck needles into people, I came home and stitched. I should’ve done some sewing, or cleaning. Instead – I spent time on Aquarius & the Fox.

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Why am I up

Holly Doyne Posted on 2022-01-26 by Holly2022-01-27  

sometimes I think I am insane, and other times I know it. THis morning was totally and completely a case in point. I enjoy staying educated, up to date, and informed on the public health issues that were part of my job for decades. One of those duties involved dealing with various WHO agencies, committees, and programs.

So, to make an even longer story short, I received an email notice from WHO about a Webinar this morning relating to Neglected Tropical Diseases. It is interesting (for me) to learn the current status of guinea worm, leprosy, and other diseases that I saw in Africa but are not exactly common in the developed countries.  

The Webinar was not what I expected. It was a long, long announcement with bits and bobs from here and there as the opening sally for a Congress and World whatever day. Now, I like singing and people making speeches (not) as well as the next person. But seriously, I would not have gotten on line at 0500 (GMT-7) for a listen. Yes, I understand that 1400 in Geneva is about as good as one is going to get in terms of time zone fairness for the maximum number of people world wide.

But I am going to be a lot more cautious about agreeing to anything that early in the morning. 

Posted in Medicine | Leave a reply

Returning to Our Lady of the Rosary

Holly Doyne Posted on 2021-09-03 by Holly2021-09-12  

POD (point of distribution – thank you very much) which is in Union City – for those of us who have no clue about anything in Alameda County or the East Bay other than Oakland and Berkeley. Trust me, Union City is about as far as one can get from our house and still be in the same county. Driving there is easy since our operations hours are 1500-1900.

Leaving just after lunch lets me skip the traffic, drive calmly and arrive early enough to sit in the car and stitch for an hour or so prior set up.  The days are starting to get shorter and this is an outside set up, so I am really glad we aren’t open later since I detest the East Bay freeways in general and after dark in particular.

As it turns out, once again we are offering all three US available vaccines. Since the majority of who are now coming in are school aged, most immunizations are Pfizer. As it turns out, it is mostly young men. Something to do with wanting to play sports. What impresses me is that more than a few are also dragging along older siblings or parents.

And I am the vaccinator. Three vaccines? Three separate immunization stations. We have everything color coded and have the client head to the correct table. Absolutely no way do any of us want a med error. So I bop between tables as required.

I enjoy working with this crew. It is a mix of county employees, contract employees and volunteers. And any day that we provide more vaccines than workers is a great day.

I am home by 2030 and not completely wiped out.

Posted in Medicine | Leave a reply

There are times

Holly Doyne Posted on 2021-08-31 by Holly2021-09-13  

when the truth should be avoided.

remember what I said about fever and chills Saturday? Well, my fun lasted through to yesterday morning. So there I am, checking in at the Oakland Outpatient VA facility. They ask me if I have been exposed to COVID.

No. Ill? No. Fever or chills in the last 2 weeks?

And I mention that I had a normal reaction to my booster.

Stupid, stupid, stupid. The screening person then informs me that I can’t be seen.

Why? I don’t have COVID, I haven’t been exposed. I had a normal reaction to a booster, same reaction as I had last February.

She calls the nurse. Nurse says no.

I very quietly and firmly insist on speaking directly to the nurse. I don’t have a choice about today’s visit. I am out of an essential medication.

After 20 minutes, one of the nurses comes down. I carefully explain, and suggest that they talk to my doctor since I will need medication in any case. He wanders back upstairs. Another 15 minutes pass and he comes back to say that I can be seen after all.

It is now five minutes before my appointment time.

Turns out, this appointment was worth it. This particular physician grew up and trained in NYC. He landed here on the West Coast because of a fellowship at UC Davis. Late 50s, he just shook his head over my hassles with the SFVA staff, reminding me that as a teaching facility, they put more stock in tests and less in patient’s experience. Lab? My lab from July is fine (this is the lab that I thought was ok but was refused as “off” by the teaching staff earlier this month). He isn’t worried. I can have my refills.

I am even willing to drop back in five months. I appreciate consideration and kindness.

Posted in Medicine | Leave a reply

Ouch

Holly Doyne Posted on 2021-08-28 by Holly2021-09-13  

“this post is being released a couple weeks after I wrote it.”

I worked a shift yesterday at one of the Union City PODs. Since we had all three US available vaccines, I went ahead and got my “augmentation” shot as recommended by my Oncologist. Moderna as it happens to be.

Perhaps you might remember my whines last Feb when I received my second shot and felt like cr*p for a couple of days? Well, guess what? Even though the blood tests had come back flat – no immunity here folks – my personal immune system had a different reaction when challenged. I was very glad one of my co-workers had offered to cover my shift at Eden Community Center.  By 2130 last night, I was sure that I didn’t want to work today.

This morning? Ugh. I am with it for the moment, but not sure it is going to last. (Shall we just leave it at fever and chills?) But, as I keep reminding everyone – it is soooo much better than getting SARS-COV2 and landing in the hospital.

Posted in Medicine | Leave a reply

Another stitching day

Holly Doyne Posted on 2021-07-15 by Holly2021-07-16  

Except for an exercise class – can’t forget about self torture – I quietly spent the day listening to an audio book and stitching. I am not sure about my original plan …

Oh, right – it had to do with getting up for an NIH sponsored conference that started at 1000 EDT (which means 0700 for me) on the subject of the Neurological and Psychiatric consequences of COVID-  especially Long Haul COVID. (A side note – CDC and NIH are desperately trying to rename the syndrome/s to something more “official.” It is not working. As one of the speakers said – Long Haul came from the trucking world where heavy loads are hauled over long distances. It really suits, And why shouldn’t those dealing with the subsequent problems get to name their condition? – end digression)

Besides all the usual scientific mumbo-jumbo which all amounted to – we don’t really have a clue – there were some interesting and clear presentations. I will post links for anyone interested once the webinar recordings are placed on line.

Otherwise –

I worked on Part 6 of Owl Forest’s Alice –

se Part 6

which includes the flowers below the table, Alice, mouse, border, the “eat me” cake, and the top of the sock which leads into a shoe (remaining to be stitched). Some of this was actually completed yesterday.

Then I moved on to Claire Bray’s Solar System – The Sun is actually from May but I decided the 3k+ stitches would be easier to follow in Pattern Keeper and got around to loading it this morning. I have two planets on the list for tomorrow…

the start

end of the day

which amounted to about 1700 stitches. That is a lot of oranges….. and I still have 600+ to go…

Mindless cozy mysteries make for good audiobook listening. Of course, Audible is having yet another sale…

Posted in Cross-Stitch, Medicine | Leave a reply

Home Early

Holly Doyne Posted on 2021-07-14 by Holly2021-07-16  

For the last several years (several being defined as a couple of months after finishing R-CHOP in summer of 2017) I ventured across the Bay Bridge to the SFVA for follow up every couple of months. That follow up consisted of a check-up with my wonderful oncologist, a boat load of lab tests, and maintenance infusion (with assorted medicines accompanied by pre&post chasers).

The study information (you have to love those involved in academic medicine) supported a regime of 12 doses (q2months) of maintenance meds which resulted in an average of 48 months of disease free existence. The jury is still out as to whether or not going beyond that made any difference. [side note – for anyone paying for medical care out of their pocket, this would be a considerable expense just to get the first 24 months of extended treatment. HMOs don’t normally offer the option of continuing after those 24 moths. The VA, stupid on somethings, doesn’t have those limits on its physicians. While not anywhere near as expensive as George’s stem cell transplant, the cost would be a consideration for many].

Anyway – I have made it to my 48 months without any sign of recurrence. I could continue on the therapy but SARS-COV2 is impacting my decisions. Nothing like an infusion to kill off all CD-20 related white cells every two months. CD-20 is on the B cell lymphocyte line. The line that, among other things leads to plasma cells (which produce antibodies). See where I am going? Nothing like wiping out my immune system every couple of months. With COVID-19 expressing new and more infectious variants.

Right.

I have done fine so far through the last year +, but I don’t have a problem wearing a mask and staying away from crowds. But with Delta, plus all those who don’t want to be immunized to protect themselves and everyone else much less wear masks – I don’t think the risk is going to be worth it.

The end result? Rather than get home at 1600 or later, I was home before 1100, complete with a stop at the bakery for fresh peach turnovers… yummm

Posted in Medicine | Leave a reply

Herd Immunity

Holly Doyne Posted on 2020-10-15 by Holly2020-10-15 3

This is a rant – delete at will.

Before I even go down the trail of why this new plan of the US White House is immoral, obscene, and not even remotely ethical – let us talk about herds.

Herds are groups of bovine or related species.  There is absolutely no question in the herd that all are not equal, not all members have equal chance at survival, that there is limited ability to protect the most vulnerable members of the herd. It is Darwin at the finest. The weakest members can and are left behind. They are brought down by predators while the rest of the herd escapes. A balance of nature – so to speak. If a member of a wild herd gets a serious infection – it dies. A newly born member of the herd, if physically “defective” dies. The elderly members, especially those past reproductive age, who can’t keep up with the herd – die.

As humans – we like to pretend that we are not herd animals. We care for our young, long past the point in most societies where children born with defects are left outside for the elements. We have antibiotics and treat all those infections that we can. We don’t routinely discard members of society who are past childbearing age so that there is enough food for those who are perpetuating the species (not going down this rabbit hole at the present – as there are way too may locations in the world where grandparents are raising their grandchildren). We pride ourselves on care and respect for our elderly, elders, and aged.

Or, I thought we did. That we were not a herd.

So why would we pretend that it is perfectly all right for us to say that “let the disease spread while those who are vulnerable are protected”?

Is this idea finding root now because one person has survived his episode of COVID-19 with a level of medical support that is not available to the vast majority of the US -especially those of us who live in areas where the hospital infrastructure is old, crumbling, inadequate, and lacks even remotely current ventilation standards?

Is it because the vast majority of deaths thus far have been in aged care facilities, nursing homes, residential homes, poor neighborhoods, essential workers of color? Do those in certain places assume that their whiteness, their economic status, their privilege will protect them? Their families.

Is it because it is easy to assume that SARS-COV2 is a one and done? How easy is it to ignore the reality of long-haul COVID and the thousands upon thousands who will be living with the consequences for years.

Does someone, somewhere think that we can identify who is vulnerable? That we have enough trained personnel to staff our hospitals and care facilities to take care of that 60% of the population getting infected that it will take?

Are we willing to accept that – with our current best medical care available to all – that the death rate is about 4%? That, my friends, translates to 12 MILLION people dying in the US. Our current US death count is just past 220,000.  Look around you – that means that 1/25 of those you know would be sacrificed to herd immunity. Does your family – including partners, parents, off-spring, siblings – number 25?  Who are you willing to let die for the cause? How about your friends, colleagues? How about you? Are you willing to die to promote herd immunity?

This disease is real. It is deadly.   All those scientist who signed the Barrington? All I can think of is that they don’t view themselves at risk. That they are sure they can protect themselves. I can play with numbers. But as a physician – those numbers have human faces; dreams, families, futures. Do I, sitting behind a computer and playing with numbers have a right to say – you get to die so that others can have a “normal” life?

The long term consequences of this disease are ugly in human life, in disability, in economic cost. No one who survives an intensive care unit stay ever returns to full normalcy. The idea that political leaders could advocate sacrificing a portion of the US population to death so that they don’t have to wear a mask is ludicrous.

Excuse me – but I think we have been here before in history. When a particular movement decided that cleaning house would be advantageous to themselves, their beliefs, and their economy. The result?

We call it the Holocaust.

And now? Will we go down the same path using a disease rather than ovens?

Think about it.

 

 

 

 

Posted in Medicine, Prose | 3 Replies

New light

Holly Doyne Posted on 2020-10-07 by Holly2020-10-07

is being shed on me.

Ok, I decided to not get too far into the puns. Just to relate that I purchased (thank you Amazon) a new small lamp to sit next to my chair in the living room.

simple, useful…



Oh, of course it was on sale. But it has several important features – like a long cord, two outlets and 4 USB plugs besides having a lovely and bright light which I can direct toward my computer, reading, or stitching.

Otherwise, it has been a Webinar day – starting at 0600 which is too early for any reasonable human being (but corresponds to a reasonable time for the speakers in the Philippines and South Africa). I guess I should just be glad that I am not living in Hawaii… 

Tomorrow will be more of the same. The great thing about virtual meetings? Among others of course, is that I can listen, learn, and stitch or knit at the same time. Multi-tasking!

Speaking of which – 

Baba Yaga
Oct 7 – Trick or Treat
Day 7 – magic potions

 

Posted in Cross-Stitch, Home, Medicine | 2 Replies

UCSF Medical Grand Rounds

Holly Doyne Posted on 2020-10-06 by Holly2020-10-06 2

Since the start of the SARS-COV2 Pandemic, the regular Medicine Grand Rounds have been co-opted by COVID-19 epidemiology, research, medications, treatments, and the like. Thursdays at noon saw hundreds of us linked in by Zoom to hear the latest which was not always the greatest or good news. 

UCSF stands for University of California – San Francisco and is comprised of a hospital system, dental, research, and the affiliated professional schools. Where I did my undergraduate and medical education – University of Minnesota – everything was more or less located on the same campus. As a result, there was a lot of cross-course work between basic sciences, public health, and the medical/dental/nursing schools. Not so here in the Bay Area where much of the basic science graduated programs and the School of Public Health are at UCBerkeley (aka CAL) across the bay and about an hour + by public transportation. 

Prior to the pandemic, there was little participation from my side of the Bay in UCSF weekly educational activities – the travel time just made it prohibitive. Now? Zoom, my friends, ZOOM.

Anyway – the usual Tues Grand Rounds were preempted today by a discussion of current status of COVID-19 as it relates to certain events of this past week and weekend. It was a moderated, good, free wheeling discussion of actions, testing, current treatments, and how you manage all of those. 

The link is here

If, for any reason you happen to think that wandering around (at least anywhere there is ongoing transmission) without a mask – you might want to watch and see a discussion of what happens when people blatantly disregard common sense and medical recommendations.  

(FYI – the rounds are posted on YouTube that evening if you are interested in a bit of pandemic history as it developed in the US).

In more fun stuff – stitching progress –

Day 6 – proper caldron
Day 6 – will probably do over

More on the house
Spooky Sampler 3/9 finished

Posted in Cross-Stitch, Medicine | 2 Replies

CISTM16-P

Holly Doyne Posted on 2019-06-05 by Holly2019-06-06  

Ok, title coding first. This is the Conference, International Society of Travel Medicine, #16. This afternoon was dedicated to the pre-conference workshops. Those included to take examinations could have spent the morning on the Certification Exam. I decided that I didn’t want to do years ago. I enjoy the meetings and I have a network now of fabulous people. But another exam? Done with those, thank you very much. And if I had, had even the smallest temptation, UCHastings and legal exams have thoroughly cured me.

I successfully made it from the airport to the Metro to the meeting hotel. I am still contemplating whether it is better to walk 4 blocks up hill from Dupont Circle, or 8 blocks downhill from Woodley Park. Such hard decisions are the bedrock of life.

The pre-course, mostly organized by my French colleague ran smoothly, so that is one critical item checked off my list. After thinking carefully, I bagged the opening ceremonies and reception in favor of heading to my hotel (the cheaper one a few stops up the Red Line Train to ….

 

Posted in Medicine, Military, Travel | Leave a reply

back in the lounge chair

Holly Doyne Posted on 2018-03-07 by Holly2018-03-16  

in this case it was both dental and the infusion center chairs. Not the most thrilling way to spend the day mind you but my port was functional.

Then I went home and got some sleep….

Posted in Medicine | Leave a reply

CISTM15 – Day 3

Holly Doyne Posted on 2017-05-17 by Holly2017-05-17  

Both the education and the entertainment continued today. Takeda (Pharma) was kind enough to provide both wifi and an app for the program. As a result figuring out where to go and what to do has been extremely simple. It has also made the evaluation of each presentation and panel easy as the usual questions can all be answered on line.

The highlight of the day was a presentation by Jay Keystone (Canada) who has an extremely dry sense of humor as well as a breadth of knowledge in infectious disease. For this conference he was tagged to discuss STIs (sexually transmitted infections in CA/UK parlance often referred to as STD – diseases in American English) as they relate to the travel population. The issues of human trafficking, sex tourism (which includes both men and women on the travel side – men, women and children on the host country side) and disease spread aren’t particularly funny. But confirmation of sexual activity in the younger set (hey – alcohol, drugs, opportunity with fellow travelers and rarely planned) is not the same as the business traveler (older, money, often planned) still leads to consequences in both groups. As a side note – the CDC’s condom information includes the reminder to “open the package.”  Most of us assume a slightly higher level of intelligence in our patients. Our issue is reminding them to take condoms along on the trip.

The business meeting at the end of the day was just about as boring as one would expect. The money is being handled responsibly, awards were given out, the outgoing and incoming executives shook hands and gave speeches (yada, yada, yada).  I stayed through about 15 minutes of the reception then headed to the Tram. My flight is early in the morning (looking at an 0430 cab ride) and grabbing coffee at the airport. It is going to be a really, really long day…..

Posted in Medicine, Travel | Leave a reply

CISTM15 – Day 2

Holly Doyne Posted on 2017-05-16 by Holly2017-05-17  

There wasn’t anything in the 0800 offerings that thrilled my heart which gave me more time to wander from the hotel to the conference center. It also meant being on a slightly more crowded Tram which wasn’t all that exciting.

Today’s sessions covered the range from effects from climate change through public health emergencies in the morning to special groups of travelers, new vaccines and the usual discussions on malaria.  What I didn’t do was attend the Gala Dinner thinking an early bedtime was much more interesting

The cross stitch is now going more slowly. Not surprising as the sections are smaller, starting to curve. This results in ending the fun of long runs of a single color mostly in straight lines which translates to mindless stitching while listening to an audio book. I’m on the last Daisy Dalyrumple (Carola Dunn, author) that is available on Hoopla. But this way I don’t wind up with another half dozen audio books in my “collection.”

16 May 2017

Posted in Cross-Stitch, Medicine, Travel | Leave a reply

CISTM15 – Day 1

Holly Doyne Posted on 2017-05-15 by Holly2017-05-15  

Picking up where I left off yesterday, this is the official first full day of the conference. As professional organizations go, it isn’t all that large. Even with membership from 120 countries, the vast majority still belong to the major four English Speaking (UK, US, Canada, Australia) which makes sense in terms of the founder group and the original focus on medical care for tourists.

The first plenary session addressed the issues of migration from the EU perspective. From the US side of the Atlantic, we read about immigration from Afghanistan, Iraq, Syria but don’t always have a good idea of the actual impact on the towns, cities, villages and countries that are the receiving side. It is startling to realize that there are now countries where 1:4 or 1:7 total population is refugees. Few, if any countries are stable enough or wealthy enough to absorb that kind of population increase. From the medical side, infectious diseases aren’t really the issue; it is trauma along the way and chronic disease that put a significant burden on the receiving country.

I spent a fair amount of the rest of the day listening to vaccine updates or conversing with various other members of the Responsible Travel group.  I also ran into an old French Military Colleague and may just have gotten suckered into working on the establishment of a new interest group.

Taking the tram back was easy but used up the last of the change in my pocket….

 

Fractal

15 Mary 2017

Posted in Cross-Stitch, Medicine | Leave a reply

Travelers, Immigrants & Refugees

Holly Doyne Posted on 2017-05-14 by Holly2017-05-14  

From it’s inception in 1991 the emphasis of ISTM has been the traveler. Usually in fact the tourist. Over the years the membership has expanded both beyond Western travelers and health care providers into areas of travel and those who worked there.  Over the last ten years both regional meetings and involvement in issues of population movements has spread. No longer just oriented on the tourist experience, the organization has been active in environmental impact, expedition, altitude, wilderness medicine in addition to increasing involvement in travel by and problems of refugees.  It has taken a lot of work over the years to reorient even a little from a primary concern with infectious diseases. Face it, we all like malaria. It has a clear path from infection to treatment, lending itself well to Western concepts of curative medicine.

And so, the emphasis of this year’s ISTM conference is on travelers of all kinds, not just tourists.  The young Japanese doctor who is the chair of the Refugee & Migrant Interest group had put together an extremely interesting and educational recourse for those of us who want to maximize our learning for the number of hours spent in Barcelona.

 

Completely aside, this is probably about the 9th or 10th time I have been in Barcelona.  There is always something to explore; a museum, a gallery, an old neighborhood .  I am finally conversant with the Metro and tram system; leaving me to wonder why I had not made much use of it in the past. Getting from the airport to the Congress turned out to be easy and 4.50€ (compared to taxi or private transfer fees).  As an aside another participant asked me in all honesty if a day would be enough to see the city after the conference.  Hum, would you expect to be able to do that in Berlin, St Petersburg, London, Paris, NYC? Perhaps five days might be a good start….

So I attended the afternoon course following my early flight from Munich before going to my hotel.  I had stayed for the opening remarks but bagged the reception on the grounds of being tired.  I’ve free wifi at both conference and hotel resulting in my sparing of our phone budget

 

 

 

Posted in Medicine, Travel | Leave a reply

Last flight out

Holly Doyne Posted on 2017-05-06 by Holly2017-05-06

All of us who fly to Europe are used to the “leave in the evening and arrive the next morning” method of travel. For years when traveling from the East Coast, this meant a flight leaving somewhere after 2000 and sometimes as late as 2230. After moving to the West Coast things changed a lot. If you are stuck (schedule or expense) changing planes in the US it normally means a morning departure. You have to account for 4-5 hours of flight plus three hours of time change. And, if you are smart, at least 2 hours at the change airport just to have 1/2 a chance of making your flight.

Even the direct flights from SFO seem to leave early afternoon. But then, my most recent flights have involved Frankfurt, a plane change in Frankfurt or Copenhagen. Imagine my surprise when informed that the flight to Munich (why wouldn’t I fly direct?) didn’t leave till 2055! Of course, it doesn’t exactly arrive in the morning, now does it? This is not a flight for someone who needs to be able to work the same day they arrive. But it is totally and completely perfect for someone who needs to get there, have a light supper and crash for the night.

Oh, I didn’t say? It doesn’t arrive till 1715 in the late afternoon. For me, this is perfect. I need to be at the SanAK the next day for registration and my conference is Tue-Thurs. Makes complete sense; within the week travel for everyone in Europe and in country.

My studio is almost clean. There are several hundred books and a dozen or so audio books ready to go to the used bookstore. I passed along a couple dozen weaving books to a new weaver and 500 gm of beads to a friend of the Eldest. Between College Guy and myself, there are three bags of clothing to go to the Charity Shop and three baskets of craft supplies are going to be rehoused on my just emptied shelves in the garage.

I’ll have phone and wifi while gone. I will miss the family (no, not you dogs) but not the construction noise. The Eldest is documenting the whole process for me.  Meanwhile, there has to be something interesting to snack on here in the United Lounge (no, I’m on Lufthansa).

Ah!, cookies….

Posted in Home, Medicine, Military, Travel | Leave a reply

International Society of Surgeons

Holly Doyne Posted on 2015-06-05 by Proseknitic2015-06-05

Every once in a while I will still wander to a museum. At least if it is one in which I might have half an interest. In this case, it was the above named societies’ Museum of  Surgical Science. Located at 1524 N Lake Shore Drive, I really didn’t have a clear idea of the length of my hike when I started out.

IMG_0793

It was a bit further than I expected.

The Museum itself is well organized with sections on modern surgical and forensic science, and historical exhibits on dentistry

IMG_0797

 
and pharmacy, even if they were carefully and safely ensconced behind glass.
IMG_0796
but the most fun exhibit of all was the following:
IMG_0798
If you are under 55, I don’t expect you to recognize it. But for the rest of us? Think shoe store….

Posted in Medicine, Travel, Uncategorized | Leave a reply

Being High

Holly Doyne Posted on 2015-05-27 by Proseknitic2015-05-27

Trekking isn’t just about altitude it is also about Attitude.

Of all the seminars today – the one on altitude medicine was the most interesting. When you think about it – a lot of the real fascinating places in the world are not exactly at sea level.

There are the low mountains – NE US, the Alps, Northern Scandinavia, Southern Argentina and Chile. Then there are those higher places which are jumping off points – Nepal for the Himalayas , Cuzco (Peru), Quito (Ecuador), La Paz (Bolivia). Places that large numbers of people live and work which leaves tourists (not just Western but Korean, Chinese and Japanese) with the idea that altitude really isn’t a big deal.

Wrong.

For example – in a mountain climbing population in Nepal the incidence of AMS (acute mountain sickness) was 42%. And these were those who hiked up the mountain, not those who were delivered there by air. On the Lukla to Pheriche the incidence increased to 60%. If there are no rest days and as the rate of ascent increases – the incidence goes up…. Including extra time at 3450 meters, and 14000 feet – decrease to 35-43%. Mt Everest is the highest point, 8380 meters that people walk to. It can be done without oxygen.

Definitions:

AMS – acute mountain sickness – just your basic headache nausea, tired and weakness
HACE – High Altitude Cerebral Edema (think the worst hangover – ever)
HAPE – High Altitude Pulmonary Edema

Dealing with these extremely likely and potentially fatal diseases is like pre-medicating for seasickness. It is not the same as malaria. Taking medication is mostly for comfort, to stave off symptoms and not have one’s trip wrecked. The critical information includes – an honest evaluation (been at altitude before, and what happened, what is the itinerary & what are the options for descending rapidly). The second two above are fatal diseases and death without descent.

Factiods: 15/100000 died trekking in the 1980s. 1/40 who have attempted the Everest Climg died (2900/100,000). In contrast – the Sherpas die not from climbing but from accidents. Westerners die from altitude and injury. 40% of trekkers are organized groups but 80% of deaths occur are in organized groups.

Itinerary Truths – published schedules are averages, and will not prevent all AMS. its ok to get altitude illness – its just not ok to die from it!

    #1 – learn to recognize the early sx and be willing to admit that you have them
    #2 – never ascend to sleep with any sx of altitude
    #3 – descend if symptons are worse while resting at the same altitude.

and now you know as much as the rest of us…

Posted in Medicine, Travel, Uncategorized | 2 Replies

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