Infectious: Stay Away

Are you infected? From Friday April 17th something contagious will be spreading from Science Gallery. Stay away if you wish avoid exposure to infectious agents. If you are brave enough to enter the containment zone on Pearse Street you are advised to wear protective clothing. As soon as you enter the gallery you will be screened for what you might be carrying and will be electronically tagged to monitor your state of infection. Whether you are addicted to brands, obsessed with an idea, coming out with a strange rash or just can’t get that catchy jingle out of your head, you might be infected.

INFECTIOUS is a major new exhibition exploring mechanisms of contagion and strategies of containment through science and art including a live epidemic simulation, an opportunity to have your DNA swabbed from your cheek and analysed and to get up close and intimate with a Petri dish as you cultivate the bacteria from your lips in our Kiss Culture experiment.

INFECTIOUS will start spreading on April 17th and will hopefully be decontaminated by July 17th.

INFECTIOUS is supported by the Wellcome Trust, and curated by Luke O’Neill, Cliona O’Farrelly and Michael John Gorman.

Please note that INFECTIOUS is not suitable for visitors under 15 years of age.

INFECTIOUS EXHIBITION: Science Gallery, Pearse St, Trinity College, Dublin 2.

Tuesday – Friday 12:00-20:00 and Saturday – Sunday 12:00-18:00 Admission Free.

* Much as I’d love to go to this exhibition, I’d be afraid that with my history of resistant bacteria, I might close this exhibition down 😉

Thanks to Roy @ Irish Taxi for reminding me that the exhibition is open.

Rapid MRSA Identification

Ireland is one of only three countries in Europe where antibiotic prescribing outside of hospitals, is on the rise. Antibiotics are frequently taken for viral colds and flu, when in fact they are only effective against bacterial infections. The more frequently antibiotics are used, the more resistant forms of bacteria become to them. The HSE recently launched a national education programme to change prescribing patterns in a bid to curb the use of antibiotics. The level of superbugs like MRSA and C. difficile in our hospitals would fall if antibiotic use was reduced. However, there’s another side to the superbug problem in our hospitals which I believe, has been overlooked.

When I developed serious symptoms of infection some years ago, it took three days for a nasal swab report to come through from the laboratory. In the meantime, I was treated in a ward shared with four other patients, two of whom were recovering from surgery. When my positive MRSA status emerged, I was quickly moved out of the ward and into isolation. You have to wonder at how many patients were cross-infected as a result of this delay in diagnosis. Multiply this by the huge number of MRSA cases passing through our hospitals each year and you get some idea of the scale of cross-infection.

The sad fact is that there is a Rapid MRSA test available which gives same-day results but it appears that the HSE restriction on budgets has ruled out it’s use in Irish hospitals. This decision is short-sighted as rapid MRSA identification can help hospitals make cost savings.

“The 3M BacLite Rapid MRSA test allows fast, affordable screening of patients for MRSA. It also has the potential to improve patient outcomes and decrease treatment costs. Rapidly identifying MRSA colonised patients provides hospitals with another tool to assist in pro-actively managing health care associated infections (HCAI).”

If I’d been rapidly screened, the result would have been available in hours, not days thereby enabling infection control teams to act quickly. My MRSA infection was hospital acquired (HCAI) following surgery and resulted in six weeks of expensive in-patient treatment. The infection recurred a year later and since then I have frequently been screened for MRSA as an out-patient. I always have to wait 2-3 days for a result and as far as I know, a similar delay still applies for in-patient screening.  I’d be very interested to hear if anyone knows different?

Everyone has a role to play in stopping hospital infection, patients and their families included.  However, if the HSE seriously wants to reduce MRSA figures and make reductions in their budgets, then it should address the problem of delayed identification. The rapid MRSA test would ultimately lead to huge cost savings for hospitals and more importantly, save lives.

Need I Say More?

Orla Tinsley suffers from cystic fibrosis. Earlier this year, Orla received a People of The Year award for her campaigning in the Irish Times on behalf of cystic fibrosis sufferers.

Ireland has the highest incidence of CF in the world and to it’s shame, it can also claim to have the highest mortality rate and the lowest life expectancy for CF sufferers. The critical issue here is the limited availability of suitable isolation facilities in Irish hospitals. For optimum management of cystic fibrosis, patients require isolation in individual en-suite rooms to prevent cross-infection occurring but CF patients are being denied this opportunity. Instead, these vulnerable patients must present themselves to A&E where they are exposed to high risk infections while they await admission to a hospital bed. They are then transferred to a mixed ward to be nursed alongside mainly geriatric patients with a variety of illnesses. This practice beggars belief. The high rate of MRSA infection in Ireland has done little to ease the plight of the CF population. Not only is MRSA a constant threat to immuno-compromised CF patients, it’s prevalence has meant that the extremely limited supply of isolation rooms have instead been prioritised for MRSA infected patients.

I’ve written about Orla before to document the appalling hospital conditions which she and many other cystic fibrosis patients must endure.  CF patients have been waiting for more than a decade to have a dedicated CF unit built at St. Vincent’s Hospital in Dublin and they are quite literally sick waiting.

Here is her account of her recent visit to hospital as published in today’s Irish Times.

“Dear diary: It’s Tuesday and I’m back in hospital for another blast of treatment for my cystic fibrosis, writes Orla Tinsley

I … ENTER St Vincent’s hospital in Dublin as I need treatment for an exacerbation of my cystic fibrosis. I have two options. I can go to A&E and wait on a trolley for a bed, or I can go home and wait on a waiting list.

Although my home is safer, I choose the A&E. I can’t continue in college or do the things I want to do if I am unwell, so I wait on a trolley.

A special type of needle, called a gripper, is used by most CF patients who have frequent infections. I need one now, but no one in A&E is qualified to put it in. A nurse from the designated CF eight-bed ward is called and comes down to put it in for me.

I am on a trolley in A&E and this procedure requires a certain amount of exposure. The porters are nice, the nurses are nice – they are both busy.

We ask if there is somewhere private for me to get my needle put in. There is nowhere. The specialised nurse and I think of what to do, she decides to take me out of A&E to try and find a room in the main hospital.

The A&E nurse stops us.

For a procedure that requires the utmost cleanliness, she says we can use the bathroom. The toilet in a busy, infection-ridden A&E is open to us.

We leave the department for the main hospital. It is after hours, treatment rooms are closed and wards pose a cross-infection risk. We eventually find an open door in a room that we know is clean and use it.

I go back to my trolley in A&E wishing I could have slept in that room. In A&E a nurse comes to give me my nebuliser through an O2 cylinder. I tell her that there are nebulising sets on the CF ward; if she could just ring them up she could get one. I’m sorry I didn’t bring my own, but she doesn’t understand what I’m saying. I explain twice more, then a porter who had been listening steps in. He tells her to leave it and goes up to the ward to get it.

There is no plug near the trolley I am on and so I have to wait before I can have it. I get moved to another square of the wall so that I can take my nebuliser. I then get moved into a curtained area for the night, and I am relieved.

The next day I am moved out to another curtained area. The nurse minding me is nice but busy, and late giving me one of my drugs. I ask her three times over the next few hours. Being on this drug long-term can affect kidney function, so the morning time is the best time to have it.

I use my mobile to call my CF nurse, who calls the A&E department and asks them to give me the drug. I still do not get it. I try calling my CF nurse again, but then my battery dies.

I walk up to their office and they call again, frustrated for me. They should not have to sort this out. I go back to A&E and get it.

Late that night I get a bed on the semi-private ward. It’s Wednesday night. I am in a room with a young girl, a lady with cancer and two elderly patients.

I am aware from the time my aunt was dying with cancer that I am not allowed to be around immune-suppressed cancer patients. Over the next few days I find out that the lady is in fact immune suppressed.

I am a danger to her, and I don’t think it’s a good thing to tell her.

One night the breathing of the elderly lady in the bed beside me gets worse. The next day her family are by her bedside and they keep apologising to me that it’s happening in my room. They are so, so sorry.

I tell them please, it’s not your fault. And I feel guilty that they feel so bad about it as they watch their mother die.

Another woman comes in, a new patient replacing the young girl. She is coughing violently, but seems pretty happy. She makes a phone call to a friend to tell her that at least she doesn’t have double pneumonia, like her neighbour, she only has pneumonia.

I feel the room shrinking.

She tells her friend on the end of the line: “Don’t get the sliced melon from Marks and Spencer . . . It’s right inside the door, I want the diced one,” she giggles down the line.

At that same moment a relative behind the curtain of the lady beside me says: “Is she gone? Yeah? Oh God.”

The other woman continues to talk on her phone. After the lady passes away her body stays in the room for three hours.

That night, another lady with cancer moves into the bed beside me. Her temperature has gone up so she had to come in. Both ladies with cancer are so much fun to be in a room with.

The lady who had just moved in is only starting to lose her hair, the other lady had already lost hers. She wants a “Posh Becks” hairstyle, like Victoria and David Beckham when her hair grows back. We giggle at the thought.

At every opportunity I leave the room to talk to the nurse about trying to get moved. Bed management are aware of the situation, but there is nowhere to move any of us.

I talk to the ladies about it and tell them I might write about it. They are meant to be in isolation, but they are not. I am a risk to them, and then there is the lady with pneumonia in the corner, who poses a risk to us all.

I try to sleep with a mask to protect myself and the people in the room, but it is sweaty and a bit restricting for breathing.

On Monday I am given the option of moving to a two-bedded room on the same ward. I accept and find myself in a room with one the kindest, most vivacious elderly ladies I have ever met. She is chatty, but knows when to leave me alone. She is a pleasure to share with, but even our camaraderie can’t disguise our different needs.

As she is unable to leave her bed, she needs the commode two or three times during the night. She is the nicest woman in the universe, but my cough is already making it difficult for me to sleep.

The rattle of the commode at 12.30am, 4.00am and 6.30am rips into my ability to rest. There is a smell too. It is not her fault, but I cannot sleep properly.

One day she is complaining of discomfort and extra swelling in her legs. I only become aware of it because this woman is not a typical patient.

She never complains, even though she has a chest drain in, which makes it impossible for her to walk around. That morning she complains a lot about her feet.

It is three hours at least since someone has been at her chest drain and I notice that it is clamped. I tell the nurse, he comes in straight away and deals with it. I ask a medical person about it later – chest drains should never be clamped unless they are about to be removed.

She feels better, we’re getting on well, but I’m still not sleeping well. We keep in good spirits chatting, and she tells me about how her handbag was taken while she was in hospital. Luckily her daughter was with her to cancel her cards and keep her afloat.

It wasn’t her bank card so much, but being without her reading glasses really upset her. She was told a member of security would come back to investigate the situation, but they didn’t.

There are 28 cystic fibrosis patients in as I write this, and there are eight single en-suite beds. The beds are allocated on the advice of the microbiologist. There is a long list to get into them. The eight single en-suite beds are on a new ward, but there are also general beds on that ward too for patients who do not have cystic fibrosis.

In February this year former junior minister for health Pat Gallagher said 14 single en-suite rooms would be available by the end of the summer for CF patients. I remember being told early this year that there would be six more, in another area in the hospital.

I ask a person in officialdom what is going to happen with the six other beds we desperately need until our unit comes at the end of 2010. This person tells me that there are no plans for six beds, that they have heard nothing about it. They have no funding; they have other things to sort out first. They want to see how the eight single rooms work.

Meanwhile, the winter months are coming, the number of cystic fibrosis patients needing inpatient treatment will rise. Some will refuse to go into hospital and risk damaging themselves, some will come to A&E, and risk damaging themselves.

Others can be treated at home, but if that doesn’t work they will have to come in anyway. Those who are not in the eight beds will continue enduring cross-infection, exhaustion and fear every time they are in hospital.

We will all think of the recession and what that means for us. We will comment to one another that 2010 seems like a lifetime away, and feel sick to our stomach that some of the 1,100 people in Ireland with cystic fibrosis will not see it.”

This article is published courtesy of the Irish Times online.

A Happy Bunny

I’m back and in more ways than one!

My heart sank when we arrived at Rome airport in the lashing rain but within a few hours, the skies had turned blue and that’s the way it stayed for our 10 glorious days in Tuscany.  We’d been lent a little house in a tiny hillside village in southern Tuscany where nobody spoke a word of English.  It was like a dream come true.

Our house was part of a terrace of houses where the few neighbours were all elderly Italians who I imagine, had lived in this little community all their lives.  It was located down a narrow alleyway, only a few steps away from the village square.  We were within easy reach of the bakery, the grocer and more importantly, the local pizzeria where we spent many a happy hour. The house was perfect for all our needs. It was owned by an elderly artist and every available inch of wall space was covered by her beautiful paintings.  The house had it’s own private little garden at the back and beyond that, there was nothing but rolling hills.  We woke each morning to the sound of the local cock-a-doodle-do!

The olives groves are harvested in October. Our little back garden contained one olive tree as well as a beautiful fig tree, a lemon and an orange tree, all of which bore fruit.  We ate breakfast in the garden every morning in the company of numerous lizards and on one occasion, a grass snake.

Surrounding countryside.

The warm mineral-rich water of the volcanic sulphur springs was only a few kilometres from the town. And yes, I did try it but once was enough as the smell of rotten eggs was overpowering.

Our lunches invariably consisted of a variety of salami’s, cheeses, fresh plums and nectarines and lots of the local grape.

The local vines were ready for harvesting. When my hubby returned to this spot a few days later to take some more pictures, these grapes had all been picked. September is a busy time in Tuscany.

The elaborate façade of the Gothic Duomo at the Piazza del Campo in Siena.  We spent a lovely day roaming the medieval streets of the city but sadly, our visit did not coincide with the Palio, the famous horse race through the streets of Siena.

Our day trip to Rome included…

The Colosseum…

The beautiful roof of the Basilica in the Vatican City…

And a passing tourist kindly took this shot of us in St. Peter’s Square. Somehow she managed to make it look as if we had the place to ourselves but in reality, it was absolutely milling with tourists.

So that’s it!  Hope you enjoyed the pics (courtesy of my hubby, Jaimie). All in all, we had an absolutely brilliant time except for one little set-back. A day or two before the end of the holiday, I developed an infection in my forehead. I flew home on strong painkillers, foolishly believing that the infection would clear of it’s own accord.  It didn’t and I’ve been struggling with severe headaches ever since I got home. I finally got sense on Friday and started a powerful antibiotic and today Hey Presto! the headache has lifted.  Now I really am a happy bunny!

Hole in the Head

When it comes to medical emergencies, it could be said that I’m a bit of an old-timer. You see, I have a long history of emergency admissions to hospital and friends and family tend to joke me about it. I never quite know what lies around the next corner but as the saying goes, “if you’ve gotta do it, at least do it in style.” I do my best.

No one pays much attention to their sinuses until they start to hurt. I’ve suffered from sinusitis all my life so headaches are commonplace but pregnancy really exacerbated the problem. The hormones of pregnancy can have a direct effect on the lining of the sinuses and in my case, it left behind a real legacy. Having successfully delivered my second child after a pregnancy fraught with difficulties, I continued to have severe sinus headaches. A CT scan revealed that an abscess had developed in the frontal sinus, very close to the base of my brain. Endoscopic surgery was carried out to drain the abscess and the relief was instantaneous. However some months later, the pain began to slowly return again until one day I awoke in so much pain, I knew I was in real trouble. On calling our family GP to the house, he immediately decided that emergency treatment was required and contacted the surgeon who had previously operated on my head. The surgeon was in the operating theatre at the time but the hospital he was in, did not have the surgical instruments he required for my head. He recommended that I should be transferred to another larger hospital by ambulance to await his arrival. I was duly rushed to hospital and taken straight to theatre to be prepared for emergency surgery on my skull. Despite being in severe pain, I have a vivid memory of lying on the operating table while one of the theatre nurses took a call detailing the ETA of the surgeon and his anaesthetist as they both rushed across the city to come to my rescue. The drama of the occasion resembled a scene from Casualty except that there was nothing fictional about this episode.  It was all too real.

I awoke several hours later feeling decidedly frail having had several holes drilled in my skull to relieve the pressure. The surgeon appeared looking totally exhausted and announced that he’d needed my emergency operation about as much as “a hole in the head.” I knew exactly how that felt. It hurt to laugh but it was hard not too.

Battle of the Bugs

Steph’s back! And so is Staph. I had a bit of blip with my health last week but I’m back on form again. At first, there was concern that it might be the unwelcome return of the superbug, MRSA. As it turns out, I have a nasty Staphylococcus aureus (Staph A) infection in my head but luckily, I have a non-resistant version of this bacterium which is very treatable. The problem I now face is finding a way to effectively eradicate this bug from my system.

It’s just over a year since I had surgery to stamp out a chronic osteomyelitis in my skull which had resulted from an MRSA wound infection following previous surgery. A few months later, I started to develop minor sinus infections and was reassured when laboratory tests showed that I was only positive for the more common form of the Staph aureus bug rather than it’s resistant form, MRSA. This bacterium is commonly found on the skin and in the nose of healthy people but it is not harmful unless it gets into the bloodstream. Approximately 20–30% of the general population are ‘Staph carriers’. I was treated with an sensitive antibiotic but the minor infections still continued to occur. Last November, I developed a nasty infection in my hand which turned out to be another Staph A infection. I was treated aggressively with oral antibiotics for 3 weeks and commenced a 6-month decontamination programme with the application of a topical antibiotic ointment to the inside of my nose. This process would appear to have failed as last week, nasal swabs and blood tests showed that the infection in my head is due to a heavy growth of Staph aureus. This latest development is worrying as it confirms that I am again systemically infected with this bacterium. I have responded well to a tetracycline antibiotic so there is no immediate cause for concern.

The reality is that Staph aureus is everywhere. It may well be that I have just been unlucky to have been contaminated/infected on several different occasions. My own theory is that my immune system has been weakened following intensive antibiotic treatment for MRSA and it has become a breeding ground for opportune bacteria like Staph aureus. The problem now is how to find a way to shake off this damned bug before it gets an even greater hold on my system. I cannot afford to let things go wrong with my head again. My GP has gone away to think about the options over the weekend. If anyone reading this has any knowledge on how best to proceed, I would be eternally grateful for your advice. I intend to win this battle.

When I became generally unwell last week and my head started to hurt, I lost all enthusiasm for blogging. I deserted the blogosphere but it didn’t desert me. My new-found blogging friends reached out and gave me the support and encouragement needed to get back on track. Thanks guys! I’m really, really grateful. Blogging – Yes! it’s the way to go!

All Tagged Out

I’ve been tagged by Mousie. Now Mousie’s not someone you mess about with as one day you may end up on a trolley in her A&E Dept and that’s when you’ll be glad you did as she asked! Having said that, I’ve never been good at obeying rules so I’m going to do my own thing with this meme. If you want to see how it should have been done, pop on over to Mousethinks and, be impressed.

I’ve been asked to share some facts about myself, some random, some weird. As the theme of this blog is medical/health-related, I’m going to stick with my medical misadventures. Here goes!

I am a twin. My mother spent the final month of her pregnancy in a small nursing home, on strict bed rest. My twin brother arrived into this world 20 minutes ahead of me but he arrived so quickly, my mother never made it to the delivery room. They tried to transfer my mother immediately afterwards but I decided to arrive while she was on the stairs. She was rushed back to her bed just in time for my delivery. In all the excitement, my brother got forgotten and was later rescued from under the bedclothes. That all happened 50 years ago last May.

I once smashed my big toe when my ‘hot jar’ landed on it. When I was a little girl, we didn’t have the luxury of rubber hot water bottles. I had a heavy ceramic jar filled with hot water, with a large ceramic screw lid on top and it was used to take the chill off the bed as our house had no central heating at that stage. Anyway I managed to drop this thing on my foot one day causing my toe to bleed profusely. I can recall having my foot immersed in a basin of hot water (with Dettol) and watching the water turn bright red. I also remember my Dad giving me a piggy back every day into school. A few week’s later I felt something peculiar in my sock and found a discarded toe nail.

During my college days, I was the proud owner of a gold Yamaha 50cc motorbike having worked for a whole summer in a German canning factory, to fund it. One dark wet winter’s evening on driving home, an oncoming car suddenly turned across my path without warning, at a road junction. In that split second, I had a clear choice. 1) to crash into the side of the car or 2) to take evasive action and swerve into the path of oncoming traffic. I chose to hit the car and I can still recall the ‘thump’ and the sensation of being catapulted through the air, over the roof of the car. I was lucky in that I survived and was carted off to hospital by ambulance but I lost my dear bike that night. It took many years before I rid myself of the nickname, Evel Knievel.

Those of you who have read this blog before will know that I have an inherited connective tissue disorder (EDS) which leaves me prone to joint laxity. I’m right-handed and so my right shoulder takes the brunt if/when I have a fall. After several dislocations it eventually got to the stage where I needed surgery to stabilise my right shoulder joint. The surgeon carried out a ‘Putti-Platt’ procedure to shorten the ligaments and prevent further dislocation. Now no matter how hard I try, I cannot rotate my right arm outwards (no external rotation) to reach things on my right side. Think about this, the next time you reach for your driver’s seat belt.

And that’s as far as I got last night before I became all tagged out and went to bed feeling rotten. I’ve not been feeling well since last Friday having woken with marked congestion in my nasopharynx (area behind nose and above soft palate) but with no sign of a cold or sore throat. The congestion continued over the weekend and I began to feel like I was fighting a viral infection. My husband had to abandon the bed by Sunday night as loud snoring prevented him from getting any decent sleep. Yesterday, the congestion moved on up into my forehead and overnight it turned into a fulminating infection with pus literally bubbling over in my head. With my past history, I cannot afford to take risks so I headed to the doctor first thing this morning to get nasal swabs taken before starting on an antibiotic. So my medical misadventures are ongoing. I’m going to call it a day now as my head feels like it’s been taken over by aliens. I’m not going to tag anyone with this meme for fear it may be infectious. Enjoy the lucky escape!