Wednesday, April 29, 2009

swine sensation

i suppose it needs to be addressed
so first: why swine, rather than pig or hog flu? the cute porky creatures from charlotte's web or babe were never referred to as swine, so i don't know why that ugly word had to be brought back. anyway.
current case count as of yesterday from

so right, the whole pandemic thing. yesterday we had a joint peds/medicine conference on the current situation. at this point, the overall assessment was that it is very hard to tell which direction things will go.

the recommendations given by our hospital infectious disease team were fairly simple, but confusing at the same time. here are some highlights:

✔ any suspected swine flu case should be treated just like any other flu case, with isolation using an N95 mask*, gown, gloves, and handwashing precautions

✔ patients with suspected swine flu (symptoms + positive flu A) should be treated with oseltamivir (tamiflu) which may provide some help with symptoms and decrease shedding (thus helping prevent further spread) of the virus

✔ patients should not come to the hospital seeking care for swine flu unless they are at a level of illness that would otherwise require hospital care

✔ the ID attendings also reassured us that at least so far, the confirmed US cases have been mild, with the vast majority not requiring a hospital level of care, although they did acknowledge that it was poorly understood why some seemingly robust patients in their 20s-30s in mexico were affected so severely.

selfish fears for myself and family aside, i am already having visions of same day clinic (where i was pulled to work next week!) and the ER (despite the guideline above) swarming with mobs of sniffling children and their parents, all demanding a rapid flu test. and the truth is, with recommendations to treat those with suspected virus, this would be completely warranted. i am also having apocalytpic thoughts about pharmacy lootings for tamiflu.

but maybe -- just MAYBE -- it will fizzle. i'm hoping that in 3 years, we will be able to mention swine flu and chuckle, likening it to SARS or anthrax panic. ha ha, we were nearly wiped out by a virus! i suppose we laugh because otherwise we'd have to cry. life -- really, it's just so fragile.

* too bad i was never fitted for one. uh oh.

i was disappointed to find out that in ACLS, you don't actually get to ask for an amp of anything. instead, all the medicines are in sensible milligrams (not mg/kg like i am used to!). today is day 2 of the training, where we practice and run a giant megacode. the instructors love to say megacode (often with an air of malicious glee) and have been building it up since the start of class, so it will either be very challenging and exciting, or a big letdown (much more likely).

i'm still resisting the urge to say "find a medicine resident?" when asked how to proceed if i find a 70 year old man DOWN in the cafeteria or radiology suite. heart attacks and strokes are just so not my bag, baby. but the instructors were nice and spirited and i actually did think it was useful to learn some of the protocols. as i mentioned yesterday, it would come in handy to have a bit of this knowledge in case of emergency on a plane or at the mall.



workout: 6 mile run after work in 82 degree heat. this was only bearable because:
a) the humidity was only 36%!
b) there was a breeze
c) parts of the run were in the shade.

i still had to take it much slower than usual and ended up with a 9:26/mi overall pace, which i was very happy with given the conditions.

doin' time: last night i made martha's cod with leeks and tomatoes along with some white bean/carrot/pepper salad. it was a light and refreshing counterpoint to the previous night's restaurant feast. i will admit that it wasn't the world's most exciting dish, but it was extremely easy, the tomatoes tasted great, and the health-factor was top notch. so i probably would make it again.

reading: 45 minutes studying the ACLS meds/protocols and taking the pre-test.

flossing/biting: success.


da said...Best Blogger Tips[Reply to comment]Best Blogger Templates

pharmacy lootings for tamiflu--now THERE'S a scary thought!
L, da

Run Sarah said...Best Blogger Tips[Reply to comment]Best Blogger Templates

great post! I'm glad I didn't book my trip to Mexico yet...

rebecca said...Best Blogger Tips[Reply to comment]Best Blogger Templates

uh oh, news just in... 1st US swine flu death reported =/

Jess said...Best Blogger Tips[Reply to comment]Best Blogger Templates

Please keep a count of how many freaked out parents come in and ask you to test for swine flu.

First US death in Houston, where I was over the weekend. Gah!

sarah said...Best Blogger Tips[Reply to comment]Best Blogger Templates

the death was a mexican patient brought to houston for treatment . . .

i hope the hospital isolated that case hard-core!

jess: this week i'm still on an elective but next week i'm on acute care and it might be crazy. i don't blame the parents, though -- in this case i would be worried and want my kid tested, too.

Susan said...Best Blogger Tips[Reply to comment]Best Blogger Templates

A customer at work today informed our manager that the bus boys (who are Mexican...) need to practice better hand hygiene. (It's not like they walk around with dirt on their hands? And they LIVE here, they're don't commute from Mexico City.) He was worried about them touching the silverware and transmitting swine flu to other customers. He was also a jerk to me, but for other reasons.

Re: "Find a medicine resident." In nursing school, my instructors liked to ask fun questions like, "When would you intubate?" To which I always wanted to respond, "When the doctor says to?" Yes yes, I can be a forward thinker, but the guy with the medical degree makes these decisions!

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