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MRSA kills Virginia teen


It used to be that MRSA, or methicillin resistant staph aureus, a bacteria, was the rarely even seen. It was talked about as a hospital acquired illness and patients were usually elderly with many complicating medical problems. Unfortunately, now, it's being seen more and more commonly. (image credit)

The Associated Press is reporting that Ashton Bonds, a 17 year old Virginia high school student, died yesterday after being diagnosed with MRSA last week. Officials closed down 21 schools for cleaning to prevent spread of the bacteria.

Many of the infections are being spread in gyms and locker rooms, where athletes — perhaps suffering from cuts or abrasions — share sports equipment. Ashton Bonds played football last year but was not playing this season.

Ashton went to Bedford Memorial Hospital on Oct. 4 after complaining of pain in his side, his mother said. He was sent home after doctors ruled out appendicitis, but was readmitted three days later and transported to Carilion Roanoke Memorial Hospital.

Last week doctors diagnosed Ashton with a MRSA infection that had spread to his kidneys, liver, lungs and the muscles around his heart.

Early Thursday morning, Ashton had to be sedated and put on a ventilator. He was about to undergo surgery to drain the infection from his lungs when doctors detected a blood clot near his heart. Bonds said the clot was inoperable.

In my community, of course, we're not having tragic outcomes like this one. But, when looking at emergency room visits, community acquired MRSA infections are becoming more and more common. Almost every patient coming from a nursing home to the ER with an infection is assumed to have MRSA until proven otherwise.

This is becoming a major problem. MRSA is no longer a problem of the big cities and big university hospitals. It's occurring more and more in grassroots America. So, next time you have an infection that's not going away, don't ignore it - Have it checked out...

500th Post: Halloween Meme


According to the friendly Blogger ticker, this is my 500th post. Yay me! This is merely 485 days since my first day of blogging. So, what I'm going to do is go back into the Dr. A archives and dig up a post from last year.

Hm. Since this is a recycled post, would that mean this is not the 500th post? I guess we'll need to rules officials for that one. Anyway, for those of you who are wondering - YES - I used to participate in memes. And this one from last year was a good one. Enjoy this flash from the past all the way from October 5, 2006! (Don't forget to check out the comments from back then as well.)
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I was tagged my Morgan (gee, thanks) who started his own meme. What is it that I'm always the first person picked when a meme gets started? (Was that whiney enough for you?) Anyway, this is a 13 question theme that goes like this...

1. What's the scariest movie you've ever seen?
Howard the Duck. Just kidding. Ever see this movie? Nope, not many people did -- I think in grade school, they showed a dracula movie around this time of year. I couldn't sleep for days. I think it scarred me for life - really. *smile*

2. What was your favorite Halloween Costume from childhood?
I was a superhero guy. My fave was Superman. Had the cape, had the big "S" on my chest, had the tights. I was 18 years old - just kidding. But, my mom has pictures somewhere of me. Don't worry she has them carefully hidden and will only reveal them at the worst possible time for me, like when I make my long awaited guest appearance on Gray's Anatomy (playing myself of course).

3. If you had an unlimited budget, what would your Fantasy Costume be for this Halloween?
Without a doubt, I would be giving some love to Pluto. I mean the planet, and not the dog. It'll be part of my "Save Pluto" campaign.

4. When was the last time you went Trick Or Treating?
Last year, did you know, I went to a neighborhood and they were giving out iPods? Yeah right. The last time I remember was probably junior high. I remember because my friend went as Michael Jackson. That explains a lot about where he's at now in life.

5. What's your favorite Halloween Candy?
Any time of year, my fave candy is M&Ms. This time of year, of course, the Halloween colors. And, for giving out candy, the M&M minis. Is that too much information?

6. Tell us about a scary nightmare you had.
I was out of town without internet access. Oh yeah, that really happened. Read here.

7. What is your Supernatural Fear?
That slimy ghost from the Ghostbusters movies is going to get me some day. Who you gonna call?

8. What is your Creepy-Crawlie Fear?
Everyone who comes to my office stating they have a spider bite is always fearful of the brown recluse spider. Why? Because the bite injects a venom that literally eats away at your skin and has the potential (although rare) of causing a fatality. Scared yet?

9. Tell us about a time when you saw a ghost, or heard something go Bump in the night.
The first house I lived in following residency was in the woods. Beautiful landscape, although it was hard to maintain. Anyway, one night, I think it was in October I heard something on the roof. I was definitely freaked out. The wind was swirling and you could hear the leaves outside the window. What happened? Just some squirrels on the roof. Funny now, but not that night.

10. Would you ever stay in a real Haunted House overnight?
No. Let me think about that - No. Wait a sec --> Still no!

11. Are you a traditionalist (just a face) Jack O'Lantern Carver, or do you get really creative with your pumpkins?
Just a face. I'm not much more creative than that.

12. How much do you decorate your home for Halloween?
Decorate? What's that? I'm lucky to "celebrate the season" by wearing a Halloween tie to work. I'm kind of a minimalist that way.

13. What do you want on your Tombstone?
That's easy: I'm Dr. A, and I'm a blogaholic...

Cleveland school shooting update


I briefly discussed this last week. In the aftermath of this tragedy, the Associated Press released a story talking about a teacher from SuccessTech Academy in Cleveland -- Michael Grassie. The student he was talking about was Asa Coon, 14, who wounded two teachers and two students before taking his own life.

Grassie, sitting in a wheelchair, said Coon was doing poorly in his class at SuccessTech Academy and risked failing.

"I know that made him really mad," he said. "He just seemed really troubled, really troubled."

Grassie said Coon came into his classroom Wednesday holding two revolvers and said something Grassie didn't understand, and then Coon said, "Now what have you got to say to me?"

"He just shot me," Grassie said.

"I remember the expression on Asa's face," he said. "Anger, total anger. Real hatred. It's something I haven't seen on a 14-year-old's face before."

Now the title of this article is this: Cleveland School Shooter Upset About Failing History. That's what drew me into this story initially. I was asking myself, "How can just failing a class drive a student to take shots at others and then take his own life?"

It's clear that there was more going on in this student's mind. And, this teacher, unfortunately, said what is commonly said in tragedies like this one, "All the warning signs were there. No one picked up on them." There will be a lot of finger pointing and blame passed around. Hopefully, a definite solution can be developed to prevent something like this in the future.

Grand Rounds


Grand Rounds 4.04 is now up and running over at the NY Emergency Medicine blog. The theme this week is everything to do with emergency medicine. I wasn't able to write anything for GR this week (how can I get more time in my week?).

If you don't know what Grand Rounds is, it is a weekly compilation of the best posts from the medical blogosphere that moves to different sites each week. And, who doesn't like reading about medicine and science?

Be sure to check out the new Blogborygmi template, and the ability to put future GR hosts into your Google calendar (it's cool). Next week, Grand Rounds moves over to PalliMed.

Dentist breast massages


You're probably going to think that I'm making this up, but you be the judge. Now, I'm no dentist, but I don't recall any kind of gynecology classes in that curriculum. This article from the Associated Press should speak for itself. (image credit)

Woodland, Calif. — A dentist accused of fondling the breasts of 27 female patients is trying to keep his dental license by arguing that chest massages are an appropriate procedure in certain cases. Mark Anderson's lawyer says dental journals discuss the need to massage the pectoral muscles to treat a common jaw problem.

Police say Anderson said during recorded phone calls that he routinely massaged patients' chests to treat temporo-mandibular joint disorder, or TMJ, which causes neck and head pain.

In a related story, SmileWright's Office and Massage Parlor is announcing the grand opening of a new branch in Woodland, California. For all new patients, with your teeth cleaning, you get a coupon for [insert joke here].... HA!

By the way, who knew there was a movie called "Dentist Visit" with the picture above? How weird is that? Is this art imitating life, or life imitating art? You be the judge.....

Update: A judge has ruled that he cannot practice while his case is pending. Duh!

Filipino Mob found me


For those who tuned into The Dr. A Show on Friday night and on Sunday night - you heard that I was having technical problems. On Friday, my internet connection totally dropped. And, my connection did not come back until Sunday. So, Sunday, I tried to have another show, and more technical problems happened.

During my show, I criticized the "Filipino Mob" for totally overreacting (image credit). So, during both my radio shows, I was feeling totally paranoid that "someone" or "someones" were either gaining access to my computer or cutting off my internet connection. Could they really do that? Can't the Mob do anything?

After the paranoia passed, I checked out my system to see if there were any problems on my end. After a cursory check, I didn't find anything obvious. My next step was looking at the site of my internet service provider. Interestingly enough, I found the following message on their site.

Red 10/12/2007 4:38:03 PM
TW-NEO Road Runner is currently experiencing issues with the cable network. Subscribers in the affected area(s) may experience a loss of connectivity, usually indicated by flashing modem lights and/or a loss of video service. Our engineers are working quickly to resolve this issue. We apologize for any inconvenience this may cause.

Now looking back, this was about four hours prior to my Friday night show time. So, this was probably the culprit. I feel a little better (kind of). On Sunday night, I was having problems with calling in via Skype, so I had to use my landline.

Hopefully, these tech problems can be worked out. I really didn't believe that the mob found me - well, kind of. They really can't find me, can they? What's that? Oh yeah, it's the paranoia that's coming back. hehe

Cancer rates falling


It's not very often that the press reports good news. So, I'm giving credit where credit is due. Reuters is reporting today that death rates from cancer (in the United States) are continuing to fall compared to previous studies.

They found important declines in deaths from lung, prostate and colorectal cancers in men, as well as in breast and colon cancer among women. Lung cancer deaths were still on the rise among women but this increase slowed, according to the report.

The annual decline in cancer death rates from 2002 to 2004 was nearly twice the decrease of 1.1 percent per year from 1993 through 2002.

This is definitely great news. A lot of work from a lot of different people and a variety of different organizations helped make this possible.

What will be interesting to watch now is these different organizations - whether they be government agencies, private sector research firms, patient advocate organizations, or others - take credit for this work (which they should) and fight for government budget dollars, private foundation dollars, and your public donation dollars (you can already see this at the end of this Reuters article). Let the games begin!

Chocoholic metabotype


Some people may think this sounds like the latest album from that youtube guy who sang chocolate rain, but this is real science I'm talking about here -- hehe -- Anyway, the Boston Globe describes a study was recently published in the American Chemical Society's Journal of Proteome Research (is that really the name of the journal?). Of all places, the study was conducted by Sunil Kochhar at the Nestle Research Center in Switzerland.

Kochhar and colleagues enlisted 22 men of approximately the same age and weight - 11 claimed to be "chocolate lovers," and 11 said they were indifferent to chocolate. The subjects were all put on the same diet for five days, and all ate chocolate or bread for the duration of the study. Researchers found that the "chocolate lovers" had lower LDL-cholesterol and higher albumin levels in their urine and blood, even on days when they didn't consume chocolate.
Let me get this straight. So, when asked to take part in a study at the chocolate research center and asked if you enjoy eating chocolate, they then give you either chocolate or bread? I'm no researcher, but if I'm not receiving chocolate and getting bread - I pretty much know that I'm in the placebo group. Research bias?

What this study concluded was that if you have the favorable metabolic type (metabotype) for chocolate, then basically you can eat as much chocolate as you want and it will not affect your LDL (bad) cholesterol. Finally! A study which justifies the amount of chocolate I consume.

Close to the bottom of the article, it says that the research was limited by the fact that only males were used. The next step was doing the same study using female subjects. Any takers?

Dr. A: Guest Blogger


I was contacted last week by Dominic Carone, Ph.D. from MedFriendly to write a guest post for them. Naturally, I was flattered. I don't think I've been asked before to write a guest post. In checking out the MedFriendly blog, I was that Kim Emergiblog herself wrote a guest post about ED visits. So, hey, this site is probably ok.

If you get a chance, I encourage you to check out the site and their blog. It looks like the site has been around for a number of years and has won some awards. Thanks again for the opportunity to write a guest post. I talk about Family Medicine physicians on my post over there.