Docs battle ice storm to save preemie

We had quite a winter storm come through here over the weekend. Tough for a doc like me being on call trying to get to and from work - although I'm less than 5 miles from the hospital. As I was scanning the medical news, I saw this story from ABCNews from last week.

Tuesday morning, a 2-pound baby named Dorotea Orgovanyi was born at 6:10 a.m. in Mount Pleasant, Iowa — three months premature and about 50 miles away from desperately needed treatment at University of Iowa Hospitals. Studies show that risk of death increases significantly when a preterm baby is born in a small hospital that does not have the specialized facilities for the tiny patients.

Under normal conditions, an ambulance or helicopter would have transported a special response unit to pick up Dorotea. But an ice storm made it difficult for the University of Iowa's Air Care helicopter and the ambulance to attempt such a dangerous trip. Travel advisories broadcast across the state warned people to stay off the dangerous roads.

Knowing the small community hospital in Henry County didn't have the facilities to treat the preemie, Mike Acarregui and John Dagle, neonatal doctors at the University of Iowa, took action.

Acarregui grabbed a rescue pack and the two doctors drove Acarregui's Audi four-wheel-drive sedan to pick up Dorotea and bring her to Iowa City. Meanwhile, doctors in Mount Pleasant improvised their own resources, rebuilding a warming bed in an ambulance for the baby to use on the trip back to Iowa City.

Our hospital here is a small community hospital. And, I take care of newborns. Although I cannot exactly relate to this situation, I can definitely imagine what this small hospital was going through. We don't routinely take care of preemies. We stabilize them until an ambulance with neonatal specialists can get there and take over care. As for this case, great job docs!

MexicoMedStudent: Runnin Down A Dream

I so remember this video. This is when MTV actually played videos on their channel. This was seen as "groundbreaking" at the time with animation. Plus, still enjoy Tom Petty and The Heartbreakers. My favorite songs include this one and Free Falling. Ah, yes, high school memories.

Last night's show was definitely different than any of the previous shows in that you can hear the emotion in the voice of MexicoMedStudent. The way that he described his experience with his medical school giving him the runaround on procedural and paperwork issues - the frustration is palpable.

He has his wife and daughter with him close to the medical school and hospital campus - just bought a house. His wife had surgery in the past few months. And, now, he was charged tuition for classes he did not attend. On top of all that, his status as a continuing medical student is even in question.

I cannot even imagine being in another country, with my family, recently buying a home, and being told that your medical school career is over. What are the options here? Pick up and go home to Texas? Transfer to another medical school? What about all the debt that you have already accumulated?

This story has also moved some bloggers out there so much that they are talking about this today. I encourage you to read the thoughs of Fat Doctor, Scan Man, and AbelPharmBoy. If you listened to the show live or on the archives, how do you feel about the situation? Something like this probably happens more than we know.

So, MexicoMedStudent, my thoughts and prayers are with you and your family. I hope you get good news from "that committee" that you referred to on the show last night. Keep "Runnin Down Your Dream" of becoming a doctor. We're all pulling for you!

Update: Enrico writes a very poignant and reflective epilogue to yesterday's show. I encourage you to check it out. Also, there's a great picture of his wife and daughter.

NHS Blog Doctor: What's happened?

I just got a distressing e-mail from my blog friend and colleague The Angry Medic. The last post on the NHS Blog Doctor's blog is on October 17th, 2007. As I scrolled down, I see 129 comments (as of this posting). The most disturbing is the following:

Hello to you all.

This is not an easy comment to write, and I apologise for the lack of a full post, but 'John' was more than a little security conscious when it came to passwords, I have contacted "blogger" to explain circumstances but as yet have not had a reply.

Getting to the point, so to speak, I am a senior partner at 'John's practice, I have only become aware of this 'weblog' after accessing his email account through our internal system. Other partners have read this website, but none of us knew who the author was - although in retrospect there are a number of clues we could have picked up on!

There is no easy way to say this, but the doctor known as 'John' or 'Crippen' passed away in a road traffic accident mid-October. Although I appreciate the esteem in which many of you obviously held him, I must ask that the emails cease as of now - they are all redirected to our mail server and this is causing some difficulty.

Dr. Crippen's identity may no longer need to be secret for his own purposes, but out of respect for his family and remaining colleagues I shall not be sharing this here, neither will I post another message or reply to any left. This webblog will be removed once I can circumnavigate the security protocols for obvious reasons of confidentiality.

This said, I thank all who visit here for their support of our dear, and much missed colleague.

Kind regards, Dr.P.

Wednesday, December 12, 2007 11:20:00 PM

I'm not one to spread rumors, but this comment, although sounding genuine, was very disturbing to me. Has anyone heard anything? Does anyone out there know anything? I hope this is not true. This is a true pioneer and legend in the medical blogging community. I hope this rumor is not true...

Update: People have been e-mailing me over the past 9-10 hours saying this is not true. I don't want to "out" my sources here. I really feel bad if I'm spreading an inaccurate statement. But, I guess there really is no way to confirm or not confirm this, unless someone in the UK can help clarify this. If someone wants to go "on the record," put it on your blog and I'll link to it.

Update: Someone commented on KevinMD that this report is false. The Holford Watch states "unequivocally that there is no truth to this cruel story."

Tonight's Show Changed

The good news is that I'm not going to cancel The Doctor Anonymous Show tonight. The bad news (and it's not really bad news) is that something has come up to make me change topics for the show tonight.

First of all, Dr. Val contacted me saying that she was feeling ill and was not able to be on the show tonight. Everyone send Dr. Val a "Get Well" e-mail! I have three words for her - "Physician, Heal Thy Self.' HA! Hope you're feeling better.

Next, MexicoMedStudent (pictured above) contacted me and told me about what his medical school is doing to him. Here's just the beginning of his post called "School Beating Me Down Once Again", but I encourage you to read the whole thing...

This post is way late in coming, but I can’t hold it in anymore. As many of you might remember, I took a voluntary leave from school this semester to focus on personal matters. I said that the worst of all possibilities was that I’d look back on this time, now drawing nearer to a close, and feel that I wasted 6 months of my life, having gotten no further in my personal goals.

Well, UAG doesn’t disappoint, and they’ve trumped themselves in the sodomizing students department. While I do have some regrets about things I didn’t get to accomplish during my break (which, as I remind myself, is not over), the reality is UAG has given me the biggest stressor of all: creating an untenable situation which would force me to leave school altogether, the last two years of my life wasted and over 120k of debt for my troubles.

Wow! You can feel the emotion just come through the screen. So, naturally, he's not really in the holiday spirit.

One of the reasons I started a radio show was to talk with people and have them share their stories - and this is a compelling one. This is a show that you need to listen to. There's a lot of crap on television that is called "reality TV." But, boys and girls, this is real life.

This is a story of a guy who has a dream of being a doctor. From reading his blog and talking with him a little bit in the last hour, someone who has went through some personal and professional trials and tribulations. And, just TODAY, learned that his dream may be delayed, or even destroyed by the medical school that he his attending.

This is a story that needs to be told. This is a story that you have to listen to. This is a story that you need to listen to. Tune in Tonight at 9pm Eastern Standard Time on The Doctor Anonymous Show.

Listen LIVE tonight!

Thursday, December 13th, 2007 at 9:00pm Eastern Time

Join us tonight for The Doctor Anonymous Holiday Show. Our distinguished group of panelists include Dr. Val, MexicoMedStudent, and Dr. Blogstein. You can join us as well by calling the show and/or being in the chat room. 

Need any help getting your thoughts going on this topic? Well, I have the perfect show-prep material for you. The Mo Show last night also talked holiday stuff, so you can check that out. See you tonight!

For first time Blog Talk Radio listeners:

*Although it is not required to listen to the show, I encourage you to register on the BlogTalkRadio site prior to the show. I think it will make the process easier.

*After registering, don't forget to make me you BlogTalkRadio "friend" and "favorite show." You can even give me 5 stars if you like the show. These will help my stature as a BTR host (hehe). Thanks in advance for considering this!

*To get to my show site, click here. You can even ask the BTR site to send you an e-mail reminder so you don't miss the show! As show time gets closer, keep hitting "refresh" on your browser until you see the "Click to Listen" button. Then, of course, press the "Click to Listen" button.

*You can also participate in the live chat room before, during, and after the show. Look for the "Chat Available" button in the upper right hand corner of my show site. If you are registered with the BTR site, your registered name and picture will appear in the chat room. (If not, you will be designated as "guest")

*You can also call into the show. The number is on my show site. I'll be taking calls beginning at around the bottom of the hour. Hope these tips are helpful!

Checkpoint Vodka

So, you get all the way to the airport. You wait in line to find a parking spot. You wait in line at your airline check in desk. You wait in line to drop off your checked bags at the security station. You wait in line at the next security check point before getting to your gate. Your patience is wearing thin, because you just want to get to your gate.

As you're waiting in line with the other million people who are waiting to get through, you see a sign that says this: "The following liquid materials are prohibited and cannot pass through this checkpoint." What? Who made up all these silly rules? What else am I not allowed to bring on the plane?

"Let's see," you tell yourself. "Let's see what's in my carry-on bag that may get me in trouble." Hmmmm.... Vodka? In my bag? Who put it there? Did I actually put that in there in my rush to get out of the house this morning? Well, I can't bring it on the plane. What to do? Here's an Associated Press story about a guy did at a Berlin airport.....

Berlin - A man nearly died from alcohol poisoning after quaffing two pints of vodka at an airport security check instead of handing it over to comply with new rules about carrying liquids aboard a plane, police said Wednesday. The incident occurred Tuesday at the Nuremberg airport, where the 64-year-old man was switching planes on his way home to Dresden from a vacation in Egypt.

New airport rules prohibit passengers from carrying larger quantities of liquid onto planes, and he was told at a security check he would have to either throw out the bottle of vodka or pay a fee to have his carry-on bag checked. Instead, he chugged the vodka — and was quickly unable to stand or otherwise function, police said.

A doctor called to the scene determined he had possibly life-threatening alcohol poisoning, and he was sent to a Nuremberg clinic for treatment. The man, whose name was not released, is expected to be able to go home in a few days.

The Dr. A Holiday Show

Join us this week for the long awaited Doctor Anonymous Holiday Show! Even though there will be very little medicine discussed, but there will be a lot of fun!

We will be talking about everything to do with the holidays including Christmas, Hanukkah, New Year's, and any other holidays that come at this time of year. We will be "debating" the very controversial topics as the following: Favorite Holiday Cartoon, Best/Worst Holiday song, Favorite Holiday Movie, and any other topics that come up.

I know I've been discouraging people from sending me e-mail and leaving comments about their faves, but Kb sent me her favorite holiday song and favorite holiday movie. I encourage the rest of my faithful Doctor Anonymous listeners to call into the show on Thursday night to share your thoughts.

We have a distinguished panel who will be talking about these and other holiday issues. They are Dr. Val, MexicoMedStudent, and BlogTalkRadio personality Dr. Blogstein. So, write it down! Thursday, December 13th, 2007 at 9pm Eastern Standard Time. Advertise it on your blog. The Doctor Anonymous Holiday Show on Blog Talk Radio. Be there!

Need sleep? Forget the hospital

Anyone who has been admitted to the hospital or whose family member has been admitted to the hospital or works in the hospital knows this fact - The hospital is the worst place to get some sleep - Even though I "prescribe" adequate sleep to everyone who comes into my clinic.

Well, now, there is research that was just released which supports this. According to this article from Reuters, researchers at the University of Texas Southwestern found that the healing process may be interrupted because of inadequate sleep (restorative sleep) in the hospital.

[Dr. Randall Friese, lead researcher] monitored the sleep patterns of 16 patients in the ICU who had suffered traumatic injuries or had abdominal surgery. Although it appeared the patients were getting enough sleep, Friese said their brain wave patterns showed their sleep was fragmented and superficial.

"There are two major things contributing to abnormal sleep in these patients -- the pathophysiology of the disease process itself and the stressful environment of the ICU," Friese said. "If we can neutralize the stressful environment, maybe we can shorten the hospital stay, lower infection risks and increase patient wound healing."

Now, don't get me wrong, I'm not saying totally ignore the intensive care patient while in the hospital. But, there may be something to this sleep/healing connection. And, if there is some way to increase restorative sleep and accelerate healing and shorten the hospital stay, I'm all for looking into it more. I know our patients would appreciate this.

Gasoline price drop

Here's something that the majority of the press will not report on - an actual price drop in gasoline - at least in Ohio. According to the Associated Press, Ohio gasoline prices have dropped 12 cents in one week. Yipee!

The statewide price is now $2.91 according to the American Automobile Association. A week ago, prices were just above three dollars a gallon.

Now, compared to a year ago, the price is up about 70 cents. That will probably spark some remarks in the comments section. But, any kind of price drop, I'm happy to report. So there....

Pro-biotics

Now, everyone has heard about anti-biotics. But, look out, because the latest craze in the health food world is the area of "pro-biotics." What are these? Well, as you can probably figure out, these are "friendly" bacteria - and they are found in the digestive tract. A recent article from the Associated Press discusses this further.

Experts say probiotics are generally safe, and in some cases might be helpful. More research is needed, and it's a hot new area, reflecting a growing understanding of the role that naturally occurring intestinal bacteria play in health. This week, the National Institutes of Health is hosting a conference where top scientists will discuss recent advances.

From a business standpoint, this is a fast growing sector. According to the article, over 150 food products that have probiotics have been introduced in the market this year - compared to about 100 last year and just 40 the year before that. But, do they actually work?

Small studies have suggested that certain probiotics might help treat or prevent some types of gastroenteritis, diarrhea and allergic skin reactions, and the bugs are being investigated for many other ailments.

The NIH has declared the study of gastrointestinal bacteria and probiotics a major research initiative. The agency's upcoming meeting will highlight current science so it can identify research gaps and determine the direction of future research, said Crystal McDade-Ngutter, who heads an NIH working group on the topic.

It's still too early to say whether these probiotics deliver substantial health benefits. The research still has to be done. Pro-biotic detractors say that without a gastrointestinal condition, probiotics just exhibit a placebo effect.

In my clinical experience, in talking with some of the specialists around here, feelings are mixed as well. Some put all their patients on probiotics, and others say it's just a waste of money and give patients false hope of symptom relief. Me? I'm cautiously optimistic. I have read and I am intrigued from some of the early studies. But, I'm not completely sold - yet.