Wednesday, July 18, 2007
By Phillip T. Alden – San Mateo Daily Journal
For publication – July 24, 2007
This part of the article will focus on two people with MRSA and the people who love them. This story has a personal take, as the people I'm going to profile are part of my life, and what I'll share is my personal experience with them. The names of the patients involved are changed out of respect towards their privacy.
My first profile, "Robert," was very dear to me. I stated in part I that MRSA crosses all demographic and economic boundaries. Robert was a very wealthy man and received the best health care anyone could get. He suffered a stroke and was being cared for at home. One day he fell and broke a small bone in his neck. He was taken to Stanford University Medical Center for surgery to repair the break and contracted MRSA during the surgery.
It was hard on those of us who loved Robert. We could not kiss him or even fully embrace him. We had to wear latex gloves any time we touched him or things like his dinner plate, and we had to follow strict protocols on hand-washing after contact.
It was a difficult way to say goodbye to a man I dearly loved, and he passed away shortly before 9-11. MRSA was a factor in his death.
The second person is a young gay man we'll call "Tad." Tad had been rejected by his family because of his sexuality, though they came around when he was exposed to MRSA after trying to help another person.
Tad lost his teaching position. His boyfriend kicked him out of their home and Tad would have ended up on the street had he not been saved by friends and a sympathetic landlord. But Tad lived in near-homelessness and abject poverty for a long time, increasing his stress level and not helping him in his fight against the MRSA.
I met Tad as a journalist and activist, and we became "email friends." I couldn't meet Tad in person because he was infectious, and even though our society had abandoned him, he took pains to avoid infecting those around him. Talking with Tad by phone and email nearly broke my heart. Here was a man who worked very hard to educate the children of San Francisco, and when he needed help, the people in his former life acted as if he had never existed. Tad was rightfully angry, terrified about what might happen to him, and scared that he might die alone in a tiny apartment near Hunters Point.
But Tad did not die. Instead, even with his illness, he started championing for other people with MRSA who, like him, had been pushed to the margins of our society. His family came around and realized they loved their son and they wanted to help him. So Tad became active in an organization called MRSA Watch.
While Robert had enough money to charter planes and pay for multiple hotel rooms for his health care team, he had no more of a survival rate than Tad. There are many more Tads than there are Roberts, and we need to demand health care, stable housing and food for all the Tads out there.
These are our fathers, our brothers and sisters, our sons and daughters. Compassion and humanity are the only things that will drive us to protect these people, and also make the public at large safer.
Tuesday, July 17, 2007
Book Progress Update - July 2007:
(Cross-posted to my book web site and my "public" blog.)
I apologize for not keeping up with this (book web site) journal. I have three at the moment.
I've also been busy writing articles, which you can find posted on my "public" blog.
But back to book news:
Charlie has finished the cover for book one, but we're saving the final image for unveiling when the novel is released.
The current hold-up is my final copy editor. He's been going through some personal stuff, and his father is getting on in years and experiencing all that comes with old age, so we just have to be a little patient. I'm spending this weekend with him in the wine country so I'm sure we'll talk about getting back on track.
I do plan to release this novel this year.
In other news:
Book Two is pretty much written, except for tying up the end of the narrative, and deciding upon a final title. I decided months ago that the current title is a "working title," and I'm going to let the narrative determine the final title.
And I finally conceived of the end of Book Three! It came to me at a birthday party for a friend held at a local Cajun restaurant. I was sitting alone and nursing my Hurricane, (a marvelous alcoholic concoction,) and I was doing what most writers do in idle moments, thinking about writing. There are some people who think that, a person sitting alone must need company, and that's a very wonderful and human thing. But writers often love sitting by themselves, even at a party or similar event. Just observing others interact allows us to think about writing.
But I digress. I'm not going to tell you what Book Three is about for obvious reasons, but when it came to me it was like a bolt out of the blue. I had been contemplating the end of the trilogy for months and it just struck me that night.
So after we get Book One released and I'm selling like mad, I'll edit and change the rough draft of Book Two into final manuscript form. I'll probably start writing Book Three at the same time. More on that as things progress.
To be honest, I've enjoyed this little break from the art. I need to do some research on publication and marketing for Book One, (all options are up in the air at the moment.) I've also been writing my weekly public health column, though that takes very little time really, and dealing with some family issues of my own.
I hope all my friends out there, (including the ones I've yet to meet,) are having a good summer, and I promise to be better about updating this (book site) blog more often. By next week we'll probably be finishing up the final sections of Book One and getting it ready for release.
I'll try to talk about people like Robert Jordan and J.K. Rowling and Philip K. Dick, authors who inspire and influence my work.
Currently Reading: "The Red Badge Of Courage" by Stephen Crane.
Monday, July 16, 2007
Reuters News Service:
A large number of people between the ages of 14 and 39 years have chlamydia, a sexually transmitted disease, a new report indicates, while gonorrhea, another STD, is less prevalent.
Based on 6,632 people ages 14 to 39 tested for chlamydia and gonorrhea between 1999 and 2002, researchers estimate that 2.2 percent of Americans in this age range -- a little more than 2 out of every 100 -- have Chlamydia infection and that 0.24 percent -- fewer than 1 out of every 400 - have gonorrhea infection.
Sexually active adolescents, especially girls, bear the brunt of chlamydia and gonorrhea infection, according to Dr. S. Deblina Datta and colleagues from the Centers for Disease Control and Prevention, Atlanta. Almost half of those found to have gonorrhea also had chlamydia.
Young women, who are targeted for chlamydia screening and are at risk for long-term effects of the infection, had an "unacceptably high burden" of chlamydia infection, Datta and colleagues report in the Annals of Internal Medicine, released today
The data also show roughly equal prevalence of chlamydia and gonorrhea between males and females and disproportionately high rates among non-Hispanic black persons.
Both chlamydia and gonorrhea infection can cause symptoms such as discharge from the vagina or penis, pain with urination, abdominal pain, or no symptoms at all. In women, chlamydia and gonorrhea can lead to infertility. These STDs can also lead to premature birth, low birth weight and serious infections in newborns.
Antibiotic treatment is needed to clear up these STDs, avoid spreading them to partners, and ward off complications.
The current findings, the CDC team concludes, "support current recommendations" to screen sexually active girls and young women age 25 years or younger for chlamydia, to retest those with chlamydia, and to co-treat individuals with gonorrhea for chlamydia.
"Despite the considerable prevalence of chlamydia in males, the value of screening males needs to be better defined," they note.
SOURCE: Annals of Internal Medicine, July 17, 2007.
By Will Dunham, Reuters Newswire:
A particularly serious form of the sexually transmitted bacterial disease syphilis has been detected in gay and bisexual U.S. men infected with the AIDS virus, federal health officials reported on Thursday.
The U.S. Centers for Disease Control and Prevention tracked 49 HIV-infected gay and bisexual men who had "symptomatic early neurosyphilis" from January 2002 to June 2004 in four cities -- Los Angeles, San Diego, Chicago, New York.
The CDC cited the report as further evidence that gay and bisexual men, many also infected with HIV, are the driving force behind increases in U.S. syphilis cases this decade.
The findings also indicate that these men are engaging in the same risky, unprotected sex that can spread the human immunodeficiency virus, which causes AIDS.
"These are primarily infections that people are probably getting because they're not using condoms," Dr. Thomas Peterman of the CDC's Division of STD Prevention, an author of the report.
In some instances, the men involved have the attitude that they do not need safe-sex practices because they already are infected with HIV, Peterman said.
Since dropping to the lowest level on record in 2000, the U.S. rate of syphilis has risen steadily. Gay and bisexual men accounted for 7 percent of syphilis cases in 2000, but more than 60 percent in 2005, CDC officials have said.
Symptomatic early neurosyphilis is a rare manifestation of syphilis usually occurring within the first year of infection.
Ordinary syphilis is readily curable with antibiotics in its early stages. Neurosyphilis can lead to blindness or stroke, Peterman said.
"There are a number of studies that continue to show that there are some HIV-infected and some uninfected men who have sex with men who continue to have large numbers of (sexual) partners and anonymous sex. This is one of the consequences of that," Peterman said.
Of the 49 HIV-positive gay and bisexual men with symptomatic early neurosyphilis, 63 percent were non-Hispanic whites, 18 were non-Hispanic blacks and 14 percent were Hispanic. Their average age was 38.
"I think the bigger message is that we need to get control of syphilis. And control of syphilis would require safe-sex behavior, reducing the number of partners, and using condoms with those partners," Peterman said.
"And for men who have sex with men, it means getting tested for HIV and other STDs at least once a year," Peterman added.
Syphilis, like many other sexually transmitted diseases, raises the likelihood of infection by or transmission of HIV.
Friday, July 13, 2007
By Phillip T. Alden
San Mateo Daily Journal
For publication – July 17, 2007
MRSA is an acronym for a highly infectious bacteria, Methicillin-resistant Staphylococcus aureus, commonly known as Staph. This form is resistant to the first line antibiotic used to combat the illness in humans, but MRSA is often resistant to most of the drugs used to treat it, not just the Methicillin for which it's named. People infected with MRSA are highly contagious and potentially dangerous to interact with on an intimate basis.
And MRSA can happen to anyone hospitalized under certain conditions, the most dangerous being invasive surgery. But close contact with an MRSA patient can also spread the disease and there are people in the population who are infectious. Sadly, some of them live in near-homelessness or live on the street. I'm not suggesting that we get hysterical around the homeless as most are not carrying any infectious illnesses. People from all walks of life and all income levels are infected with MRSA.
Most MRSA patients are told how contagious they are and at what periods, (when they have a certain number of active symptoms,) and told how they must limit their contact with others. Most MRSA patients simply take themselves out of circulation for the most part. But the world is not all that cut-and-dried, where we all have someone to shop for us and do all those other things necessary for living. When MRSA hits a person living paycheck-to-paycheck it can be devastating. They are too sick to work, and the $900 a month the federal government gives to a wage slave who becomes disabled is hardly enough to live on under the best of conditions. Imagine trying to live in San Mateo County or San Francisco on $900 a month, then add the isolation, and you have an impossible situation.
For a long time MRSA was a "dirty little secret" in the medical community because the bacteria can become endemic in a clinical setting, and nearly impossible to remove. Stanford University Medical Center is infected with MRSA, (among other infectious organisms,) but there are few better places in this country, (if not the world,) to have specialized surgery. Most medical facilities have this problem, the older the facility, the more likely it's infected with MRSA. All hospitals and large health care facilities where invasive procedures are performed have an Infection Control Team, usually headed by a doctor with special training in infectious diseases. The only way to remove the MRSA is to build a new facility and tear the old one down, destroying a lot of very expensive medical equipment in the process.
So we see already that MRSA is a complicated problem, and one that we should all understand fully. Once a patient has MRSA there is very little chance of clearing it from the body and it is considered a factor in mortality, (death.) Both CA-MRSA (community-associated MRSA) and HA-MRSA (hospital-associated MRSA) are on the rise. And MRSA keeps becoming resistant to the arsenal of drugs used to treat it. So both the problem and the disease itself are getting worse.
One obvious aspect to successfully combating this disease is better health care for everyone, and a stronger and more robust public health system run by doctors and not politicians. A CDC whose scientists and physicians are strongly supported by the public is a good start. A hard look at the abysmal treatment disabled Americans get is another.
(Part II will cover the personal experience of two MRSA patients and the people who love them.)
