Fungal Fright: Killer Spores

In preparation for Thursday's post-- I did a quick Google University search for "deadly fungus" and up came Cryptococcus-- again. I first blogged about this fungus here.

The interesting thing about fungal infections is that they are like the unwanted orphans of pathogens. Their infections can take a while to manifest and be equally as difficult to treat-- often requiring months of anti-fungal therapy.

I first blogged about Cryptococcus two years ago but have you even heard of it? The reason bacteria and viral infections get much more press is that they tend to spread and manifest much more quickly-- thereby meeting our need for instant gratification. We'll know, likely within a few weeks, whether you're going to live or die.

Not so much with a fungal infection.

A person gets infected by cryptococcus by directly inhaling the spores. There are two species that are responsible for MOST human infections. C. neoformans, found in the soil, generally infects people with weakened immune systems like those with the HIV virus. The other, C. gattii, affects more healthy populations.

What's interesting is that these fungus spores are continuing to spread along the western sea board. Compared to when I first wrote about this infection, the death rate has risen to about 33% from 25%. What's more interesting is that the same fungal infection for Canadians only has a death rate of about 10%.

It makes me wonder if the difference in geography plays into the host, the fungus, and/or the ability to fight the infection. All good plot points for a medical thriller.

Treatment is antifungal medications for many months but if these prove inneffective then surgery may be required.

What about you? Have you heard of this deadly spore?

You can check out the following links if you want to read more about Cryptococcus and these links are also where I got the information for this post.

http://www.realclearscience.com/articles/2013/05/28/cryptococcus_spread_of_a_deadly_fungus_106543.html

http://www.cdc.gov/fungal/cryptococcosis-gattii/

http://www.ncbi.nlm.nih.gov/pubmed/20570552

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2669189/

Winner!!

Just a quick post on this happy Monday to announce the winner of the Who Will Survive The Zombie Apocalypse Contest-- or at least have fun trying whilst reading a copy of either Proof or Poison.

The winner is: Audrey Allyn Reilly!!

Audrey-- e-mail me at jredwood1(at)gmail(dot)com and I'll tell you how to claim your prize.

Thanks for playing everyone. It was fun to see your percentages. I'm not sure I'll be hanging with those of you who scored under 65%-- you might have to fight those zombies off on your own. Now-- as Crystal said-- time to stock up on canned foods and weapons.

Up and Coming

Hello Redwood's Fans!

Our group hitting a rock.

How has your summer been? Ours-- very busy. For the first time since living in Colorado for almost seven years we finally braved the wilderness and took our two daughters camping-- twice. I know some of you may not think this is a major miracle-- but it is.

It's not that I don't enjoy camping-- I really do. Nighttime-- not so much. It just gets too cold. Of late, I've resorted to boiling hot water and putting it into water bottles and lining my sleeping bag with four or five of them. Even with that and wearing three layers it is hard to stay warm.

If anyone knows of an electric sleeping bag-- let me know.

Then going backwards!

One of my favorite activities is to go white water rafting and this year we decided to torture-- I mean-- let our children experience this fun adventure.

And yes-- I am in this boat!

For you this week:

All is right again!

Monday: Winner announced. Have you taken the Zombie Apocalypse Quiz yet? Check out this post for a chance to win Proof or Poison for details.

Tuesday: Fungal Fright: What is cryptococcus and just how deadly is it?

Thursday: Fungal Fright: The medical thriller Spiral by Paul McEuen.

Hope you have a great week!

Author Question: Fever Reduction in Unconscious Patient

Alyssa Asks:

One of my characters has a high fever. I know that there are several different herbs that can help to reduce fevers, but he is unconscious. What might the healer do to help him?

Jordyn Says:

Obviously it's hard to get an unconscious person to ingest something.

You're writing medieval times?

If a person can't swallow but you want to reduce a fever-- you can strip their clothing off and put them in tepid to cool water. This should help bring down their body temperature.


Depending on your time era-- medications can also be given rectally or intravenously. For instance, acetaminophen (commonly known as Tylenol) can be give rectally.


NSAIDS (non-steroidal anti-inflammatory drugs) can be given IV and are fever reducers though this is not the primary reason to give an NSAID IV. Most common reason if for pain.

Author Question: Speech Therapy after Traumatic Brain Injury

Karen Asks:

I’m writing a story about a man who is shot in the head in a way that impacts his ability to speak.  Long months of rehab restore his speech but leave him with a stutter.  Is this feasible?  Which part of the head would he need to be shot in?  What else could be impacted by such a wound?  Can you recommend any websites or resources about gunshot wounds or speech therapy?

Jordyn Says:

Karen-- thanks so much for sending me your question.

Generally, the left side of the head is considered to contain the speech centers of the brain--in most cases. It might depend on whether or not your character is right or left handed.

97% of right handed people have their speech centers on the left hemisphere.

19% of left handed people have their speech centers on the right hemisphere-- which may be where the phrase "left-handed people are the only ones in their right mind" come from. I LOVE this phrase speaking as a left-handed person.

68% of people have language abilities in BOTH hemisphere.

To read more on these areas-- check out this link: http://webspace.ship.edu/cgboer/speechbrain.html

A good case to look into would be former Arizona Congresswoman Gabrielle Gifford's. She received a serious gunshot wound to the head and had extensive rehab-- over many many months. It might give you an idea of how long the road to recover is for some of these victims. It can be years.

http://www1.uabhealth.org/BoneandJoint/victims-gunshot-head-daunting-road-ahead

http://www.aans.org/en/Patient%20Information/Conditions%20and%20Treatments/Gunshot%20Wound%20Head%20Trauma.aspx

http://www.everydayhealth.com/blog/dr-black-brain-health/the-outlook-for-recovery-from-a-gunshot-wound-to-the-brain/

I think you have a lot of leeway as an author to decide what you want to do after brain injury because we don't understand as much about the brain as we do other organs. It might be hard to pinpoint sources of "speech therapy after gunshot wound to the head" (which is how I first started to Google your inquiry) but a gunshot wound would be considered a traumatic brain injury so I started to Google that and came up with several other resources as well. Here's a great You Tube Video that demonstrated a speech therapy session that could be great for a fiction novel.

What else could be impacted? Anything really. Again-- you have a lot of leeway here. There could be motor issues as well. Difficulty walking. Difficulty with fine motor skills. To the other extreme which would be coma.

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After creating Christian education curriculum for 25 years and writing over 250 published articles, Karen Wingate has turned her attention toward historical and contemporary fiction.  She lives with her husband and Welsh Corgi in Western Illinois.

Up and Coming

Hello Redwood's Fans!

Did you enjoy learning about the creepy crawlies on my pathogen posts last week? Hopefully, you haven't been scratching at your skin.

We have been camping! Last time for this summer. Hopefully, I'll have some pictures to post next week.

For you this week.

It's author questions. You know I love these. Hope you'll tune in.

Are you enjoying your summer.

Jordyn

Primer on Pathogens: Part 3/3

Sometimes you need to take a silly quiz to learn a point.

That's why I like The Ultimate Zombie Apocalypse Survival Quiz. Now, of course, the quiz is in jest but it brings up several important points when we talk about pathogens and your susceptibility to them. How are zombies often made-- by an infectious disease process-- at least in books and movies.

But it also examines survival techniques. Have you thought through aspects of survival in your mind? The more you rehearse emergencies-- the more apt you are to act. This is one reason why we practice "mock codes" in the hospital setting. Thinking through your response on a mannequin several times makes it less scary when a real person is involved. 

Let's look at several of these factors.

Your age. Typically the ends of the spectrum are more susceptible to illness. The very old and young for instance. This is why we are super cautious in pediatrics during an infant's first 30 days of life. A very low temp (anything 100.4 or greater) is concerning and will likely buy the infant a septic work-up. You can read a post I did about newborn septic work-ups here and why babies in their first two months of life should be sheltered in-- particularly in the winter.

Where you live. People living more close together have the opportunity to spread disease more easily. This is why when school season starts we see an increase in illness-- things like strep throat and meningitis. Because you're lumping 20-30 (or more) kids in a classroom. Close contact=ease of transmission.

Your general state of health: Obviously, someone who has a healthy immune system and good general health will be able to fight off infection more easily.

Your occupation: When I first started working in pediatrics they warned me about the "Children's Crud." It's not unusual for healthcare workers (those working taking care of people with infectious disease) to get sick a lot in their first couple of months. Suddenly, their immune system is exposed to LOTS of new bugs it hasn't seen before. Now, I don't get sick very often because my immune system has been primed for several different types of pathogens. However, my husband came down with a very common pediatric infectious illness from one of our daughters. "Why didn't you get sick?" he asked. It's simple-- my immune system has seen this bug literally hundreds of times and it laughs it off now.

When I first took the Zombie Survival quiz-- I answered fairly honestly with my current state of health. My chances of surviving a zombie apocalypse was 78.8%. 

When I took it a second time-- making my health and survival knowledge much worse my score was 35.7%

How about you? How well is your body at fighting off infection? How well do you think you'd survive a Zombie Apocalypse?

If you take the quiz and post your score-- there will be a chance to win one copy of either Proof or Poison-- your choice. Winner announced Monday, July 29th! Must live in the USA.

Primer on Pathogens: Part 2/3

I remember a few years back when H1N1 (the swine flu) hit. Our ED volumes were through the roof. H1N1 affected middle and high school aged kids more than older populations. It was one time that perhaps the elderly were not as affected (perhaps because of years and years of flu shots and being exposed to other viruses.)

I was working with a PICU intensivist who was moonlighting in the ER. These are doctors who work in the Pediatric ICU. He was wicked smart, managed ED volumes well, had an awesome bedside personality and was great with the nursing staff. If you work in healthcare you'd realize these things ALL together in one physician are rare.

H1N1 Influenza Virus

There was becoming a concern about resources. If H1N1 hit as bad as was thought-- this is what he said, "There won't be enough ventilators to take care of everyone."

That's not funny.

Have you heard of coronavirus or the one that's in the news a lot lately: MERS-CoV that's affecting people near and around Saudi Arabia.

So far there has been 81 confirmed cases and 45 deaths-- that's about a 56% death rate.

That's high. In medical terms, this would be considered a highly virulent bug. Imagine you're told you have this virus and you have more than a 50% chance of dying.

MERS-CoV is a member of the coronavirus family. If you remember SARS from a few years back that affected South China and Hong Kong -- this is a member of the same family. Consider it a cousin. Death rate from SARS was around 10%.

See what I mean?

Transmission of MERS is from close contact. This generally means you have to be within six feet of someone for prolonged periods of time to contract the bug-- like living in the same household or being a medical person caring for a patient.

People present with symptoms of a URI (upper respiratory infection) which would be fever, cough and shortness of breath.

Thus far-- there have been no cases in the US.

However, coronaviruses are common but usually not fatal. In fact, the CDC website says most people will be infected at some point in their life.  They were first identified in the 1960s.

Interestingly, the SARS virus mentioned above hasn't been seen since 2004. Where is it hiding? Will it come back?

The coronavirus family is a good example of the gamut viruses can run that are related. From mild infection to death.

Have you heard of the Saudi Arabian MERS virus? Did you know it had such a high death rate?

To read more about MERS: check out this post.

Here is Part I of the series.

Primer on Pathogens: Part 1/3

There's nothing like a good pathogen story line for medical thriller authors. It might be considered a mandatory novel requirement if you're in the genre. Hmm . . . guess I better start developing a virus-run-amok story line.

Great examples would be Robin Cook's Outbreak and the unrelated movie Outbreak that starred Dustin Hoffman. Recent film examples would be Contagion.

I was talking with a physician co-worker of mine after the movie Contagion was released and she said she'd applied for work at the CDC but they were overwhelmed by applications as a result of the movie. Personally, that movie would have quelled my desire to study virulent pathogens up close and personal but I guess if you like to hang over the edge of the cliff like that go right ahead . . . I'd rather write books.

When picking a pathogen there're a couple of principles to keep in mind when you choose your microorganism of destruction.

First-- what is a pathogen? A pathogen is a microorganism that causes disease. It can be one of four things: bacteria, virus, fungus or prion. Each has a different level of virulence.

Virulence is how deadly a pathogen is. Generally-- medical thrillers pick bugs that have high virulence (hence the dramatic part.) This is the concern with the new SARS like virus (MERS-CoV) in Saudi Arabia that has a death rate of 60%. That's scary. I'll blog about that later this week.

Next thing to consider is how will the pathogen spread or what is its route of transmission? If you're talking medical thriller-- airborne transmission is generally preferred because of it's ease and spread of transmission.

Pathogens can be spread person to person through touch (common cold), contaminated blood (HIV, Hepatitis C), saliva (rabies), and air (measles.)

Pathogens can also be spread through food, water, insects and fomites (non-living objects such counter tops).

Another thing to consider is the incubation period which is the time between exposure and development of symptoms and surprisingly they vary widely depending on what agent is involved. For instance, Mad Cow disease could have up to a 30 year incubation period whereas a staph infection can have an incubation period as short as one hour.

Here a list to peruse of different pathogens and some of these principles.   

Up and Coming

Hello Redwood's Fans!

How has your week been? Mine-- relaxing. It's weird not operating on a book deadline. Hopefully my new fiction proposal will get picked up and I'll be a writer under a deadline again.

We. Shall. See.

Writing downtime usually leads to trolling on social media. Someone posted this picture of uber-scary children and of course I think-- "Stephen King obviously saw this picture and it inspired him to write Children of the Corn."

What do you think? What book would you write based on this picture? A scary one? Whimsical? A psychological thriller?

This week-- I thought I'd focus on pathogens. Those microscopic instruments of death. Good news is that most of the time-- people do survive infectious disease.

However this is not always the case.

So enjoy my "Primer on Pathogens" series as well as a chance to win either Proof or Poison (you'll have to check Friday's post for details.)

Have a great week!

A Gentlewoman's Guide to Opium Addiction

I'm pleased to host author and friend, Michelle Griep, this week as she blogs about historical medicine.

Welcome back, Michelle!

What comes to mind when I say Jane Austen? Hold on. Let me guess…

-         --Swirling ballroom scenes

-         --Dinner parties galore

-         --The dashing Mr. Darcy

Any of these answers would be right, of course, but you’d also be correct if you’d shouted out opium usage. Austen’s mother used opium to help her sleep, and her father was an agent in the trade. Elizabeth Barrett Browning took opiates every day from the age of fourteen, Sir Walter Scott consumed 6 grams a day, and Samuel Coleridge was a regular user.

Yes, indeed. I hate to burst your bubble of the romantic days of yore, but opium addiction was an issue to be reckoned with.

The first written account of the non-medicinal virtues of this drug is in De Quincey’s Confessions of an English Opium Eater, published in 1821. He advocates opium usage not as a pharmaceutical pain reliever but as a trip into “an inner world of secret self-consciousness.” Sounds positively hippyish, eh?

Had Mr. Darcy been hanging out in a nearby opium den, these are the symptoms Elizabeth Bennett should’ve looked for:

·         Red or glazed eyes

·         Confusion

·         Slurred or rapid speech

·         Loss of appetite

·         Apathy or depression

·         Frequent headaches

·         Insomnia

While Jane Austen preferred to write of dances and dinners, I dove into the seamier side of things and made the hero in A Heart Deceived a recovering opium addict. Why?

Because addiction is a contemporary problem with historical roots.

It’s just as hard for my fictional character Ethan to turn down a bottle of laudanum as it is for a real person today to pass on a hit of meth. With God’s help, it can be done—which is exactly what Ethan discovers.

So take care, gentlewomen, when searching out your Mr. Right. Opiates have been around since the days of Pharaoh, and are likely here to stay.

Interested in Ethan’s story? Check out A Heart Deceived.

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A Heart Deceived is available by David C. Cook and at Amazon, Barnes & Noble, and ChristianBook. Keep up with the exploits of Michelle Griep at Writer Off the Leash, Facebook, Twitter, and Pinterest.
 

Avoiding the Fellas in White Jackets

I'm pleased to host author and friend, Michelle Griep, this week as she blogs about historical medicine.

Welcome back, Michelle!

My mother took me to a pediatrician when I was five because I spent an excessive amount of time beneath the dining room table talking to my best buddy…Daniel Boone. Yeah, I know. He’s dead. I knew it at the time as well, but that didn’t stop me from having heart-to-hearts with him. In my mind, he was as real as the old cat lady who lived next door, only he didn’t smell as funky.

The doctor vindicated me by telling my mom there was nothing to worry about. I simply had a bad case of a vivid imagination. I don’t dare tell her (or the good doctor) that my gray matter now devises horrific murder scenes in cinemagraphic color—and that I actually make money doing it. 

All this to say that writers are a quirky lot. They have to be, or they won’t get paid, which is really interesting because a few hundred years ago, the same twitchy behavior might’ve landed one in the loony bin. It didn’t take much...

Attitude

Husbands committed wives for being “melancholy”. Translation: the fella took a fancy to the hot babe down the lane and wanted to ditch his wife.

Physical Glitch

Yo, mom and dad…got too many mouths to feed and one of them has a slight deformation? Maybe a cleft palate, perhaps? No worries. Pack that kid off to the asylum and voila; one less plate to serve at dinnertime.

Revenge

If someone higher up the food chain has an issue with you, watch your back, buddy. Dueling is against the law, but getting you committed sure isn’t. All it takes is a lie or two whispered into the right ears and you’ll be packing your bags for Bedlam.

Traitorous Tendencies

One of the most famous nutjobs in Bethlehem Royal Hospital was James Tilly Matthews, who was little more than a verbal threat to the crown. Well, to be fair, there was the rumor that he was a double agent, and he did think there was a conspiracy to place bad thoughts into his head by use of an “airloom”, but other than that, he was relatively harmless…unless you happened to be one of the politicians he spoke against and were worried he might froth up the rabble against you.

Getting packed off to a late eighteenth century asylum was about as much fun as stint in a Poorhouse. Many were understaffed, over populated, and the mental health industry itself was in need of reformation—which would and did come, but not in time to help out the heroine in my latest release, A Heart Deceived.

Today, writers, daydreamers and silly hearts don’t need to be as fearful about the men in white jackets coming to haul them away. Still, it wouldn’t hurt if you kept all your talk about airlooms to yourself.

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 A Heart Deceived is available by David C. Cook and at Amazon, Barnes & Noble, and ChristianBook. Keep up with the exploits of Michelle Griep at Writer Off the Leash, Facebook, Twitter, and Pinterest.
 

Welcome to the Asylum: Horrific Politically Incorrect Practices of Yesteryear

I'm honored to host author and friend, Michelle Griep, as she blogs about aspects of historical medicine this week. Check out her wonderful new novel, A Heart Deceived.

Welcome, Michelle!

In the eighteenth century, medical care for the mentally ill was both a remedy and a punishment. What went on behind the ivy-covered walls of most mental institutions makes One Flew Over the Cuckoo’s Nest seem like a five-star hotel stay.

Granted, the majority of doctors really were trying their best to help their patients, but a many of their practices only made things worse. Here’s a sampling of what might happen to you…

Spinning

Think of riding a crazed merry-go-round on steroids. Feeling queasy? This was worse. The “Swinging Chair” is a contraption designed to spin the patient at high speed, which would induce vomiting, bladder evacuation, and eventually lull the poor little buddy into a tranquilized state of mind.

Trephining

Ever had a really bad headache? Just thinking about this course of treatment makes my brain hurt. Trephining is an early form of lobotomy and was actually the first psychosurgery procedure to change socially unacceptable behaviors. Without getting too gory, just picture a huge drill bit hovering a breath away from your skull—only it doesn’t hover for long, if you know what I mean.

Shock Treatment

There’s nothing electrical about this kind of shocking treatment. The patient was left blindfolded on a platform, waiting, and waiting, and then bam! Suddenly the platform falls and he plunges into a tub of icy water, which was intended to shock the brain back into normalcy. Noise shock treatment was used as well, wherein an individual was again blindfolded and then without warning, a cannon behind them was shot off.

Besides these three, there was the usual bloodletting, purging, binding, and the attempt at good ol’ hypnosis. All this to say, an asylum was best avoided if at all possible—which is exactly what the heroine in my latest release, A Heart Deceived, is trying to do…

Miri Brayden teeters on a razor's edge between placating and enraging her brother, whom she depends upon for support. Yet if his anger is unleashed, so is his madness. Miri must keep his descent into lunacy a secret, or he'll be committed to an asylum—and she'll be sent to the poorhouse. 

Ethan Goodwin has been on the run all of his life—from family, from the law ... from God. After a heart-changing encounter with the gritty Reverend John Newton, Ethan would like nothing more than to become a man of integrity—an impossible feat for an opium addict charged with murder. 

When Ethan shows up on Miri's doorstep, her balancing act falls to pieces. Both Ethan and Miri are caught in a web of lies and deceit—fallacies that land Ethan in prison and Miri in the asylum with her brother. Only the truth will set them free.

Fortunately, the mental health industry has come a long way since then, but if you’d like a glimpse into the roots of present day psychiatric care, pick up a copy of A Heart Deceived, a timeless tale of love, lies and redemption. 

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A Heart Deceived is available by David C. Cook and at Amazon, Barnes & Noble, and ChristianBook. Keep up with the exploits of Michelle Griep at Writer Off the Leash, Facebook, Twitter, and Pinterest.