Up and Coming

Hello Redwood's Fans!

Hope you are well and enjoying some beautiful autumn weather where you live.

I am busily trying to wrap up book #3 of my Bloodline Trilogy now officially titled, Peril. Must keep typing!!

For you this week:

Monday: JoAnn Spears continues her wonderful series on Queen Ann's obstetrical history. JoAnn always offers great insight and I know you'll enjoy her post.

Wednesday: Author and friend, Michael King, stops by. Is there a purpose in suffering? Mike is a husband, father, author and cancer survivor so I think he brings unique perspective to this question. Mike is giving away a copy of his new book, A Thousand Sleepless Nights, to one commenter on his Wednesday post so be sure to stop in for details.

Friday: New blogger and anesthesiologist, Kate O'Reilly, MD, stops in to discuss the inhaled substances given by anesthesiologists. It'll be a gas (yes, yes, yes-- pun intended).

Have a GREAT week.

Jordyn

Combat Medicine in Today's Army

I'm so pleased to have Nelda Copas return for a look inside military medical operations.

Welcome back, Nelda!

From surgical care to physical therapy to blood supplies, the military medical system is moving its assets closer to the front lines to be more responsive to patient needs and, when possible, to return wounded troops to duty faster.

At the same time, the military is boosting know-how about treating combat casualties so everyone on the battlefield, regardless of job specialty, knows the most basic steps to take to help save a life.

Operations in Iraq and Afghanistan represent the first time these concepts, which the Army started introducing about eight years ago, are being applied in combat. A commander of the U.S. Army Medical Department Center and School at Fort Sam Houston, TX, said the trend reflects research about injuries, particularly trauma injuries. "What we have found is that the sooner you get to people after they have been wounded, the better your chances of saving them," he said.

That's particularly true of injuries involving extensive blood loss, because that's what kills people on the battlefield if they don't die instantly. So the sooner we can get the medical people to them, the better the outcome. Recognizing the importance of quick care for wounded troops, the Army started beefing up its training programs — introducing a three-day combat lifesaver course taught to all soldiers in their units and creating a whole new job description for combat medics, who receive their training at Fort Sam Houston.

In addition, the Defense Medical Readiness Training Institute here prepares doctors, nurses, physician assistants and other medical service corps professionals from all military services for the rigors of combat and the challenges of providing patient care on the front lines. Even more important as increasing expertise about combat lifesaving is, getting it as close as possible to the patient.

In response, each Army company typically includes four to five combat medics, who operate "right there where the action is happening." In addition, forward surgical teams, 20-person units that include three surgeons and an orthopedic surgeon are being assigned at the battalion or brigade level. These teams move alongside the combat forces during the early, "maneuver" phase of operations in Afghanistan, cutting medical evacuations, when necessary, to less than 20 minutes.

These teams offer not just trauma care, but also a full spectrum of services ranging from physical therapy to preventive medicine. So not only can we treat them far forward, we can prevent them from getting sick and needing to get evacuated.

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Nelda Copas graduated with a BS in Psychology/Criminology and a Master's degree in Mental Health Counseling both from Western Kentucky University. She has worked extensively with law enforcement and is frequently a workshop presenter on the topic of Serial Killers. Nelda retired from the United States Army, where she worked as a nurse and combat medic. Twisted Desires was her debut novel, which was followed by it's sequel Twisted Revenge. She lives with her husband near Fort Knox, Kentucky. Nelda is currently working on the third installment of the Detective Delsey MacKay series, a true crime novel, and a young adult zombie apocalypse novel. www.neldacopas.com

TV Show Once Upon A Time: Why it Rakes my Nerves

First off, I am a fan of this show where fairy tale characters have been thrust into real life in current times. The show centers around the actions of Snow White's step-mother the Evil Queen. She is the head meanie on the show and her curse thrust them all into our realm of existence.

Of course, the red apple comes into play. Said evil queen wants to get rid of the one chracter who can lift her curse-- but instead her son takes a bite of the poisoned apply turnover and falls ill.

One thing I love to hate about television shows is their one lined-medical-declaritive statement. In this episode, when the child who consumed the poisoned pastry was rushed to the hospital-- unconscious-- the physician takes one look into his pupils and says. "Well, there doesn't appear to be any signs that he ingested a neurotoxin."

Wow! Really?!? Just one look at his pupils told you that.

Hmmm--- how about the fact that he is unconscious. That could be sign #1.

LOC or level of consciousness is considered by some to be the most sensitive indicator of how good or how bad your brain is working. So, a patient that is unconscious-- well, something is affecting the brain. It may not be stemming from the brain itself but it is making the patient ill enough that they're "lights out".

And yes, a neurotoxin can do that.

Next-- there are lots of different types of neurotoxins and how they effect the body.

Here's one short list.

http://toxipedia.org/display/toxipedia/Neurotoxins

So, quick lesson. Try not to make declaritive statement. They are likely to get you into trouble.

And really, Once Upon a Time-- nurses DO NOT wear caps anymore.

Sheesh...

A Sad Story of Royal Obstetrics: Part 2/4

 

JoAnn Spears is doing a four part series on Queen Anne's obstetrical history. It's very fascinating. You can find Part I here. Part III here.

Part Two:  What happened to Queen Anne?

A health history marked by seventeen or eighteen pregnancies and no surviving children staggers the modern mind, but it is only one part of the medical history of Queen Anne the Good.

In terms of childhood health, Anne was probably like she was in so many other ways–middling. She survived smallpox. She suffered from some sort of eye ailment, described as a defluxation, or preponderance of tears. It sounds like a fairly minor problem, but apparently was concerning enough for the child to be sent to France for treatment at a time when travel could be dangerous.

The young adult Anne was healthy enough to marry at the usual age, and by all accounts thoroughly enjoyed conjugal relations. Married in 1683, she was pregnant pretty much annually until 1700.

Anne’s obstetrical history is variously reported. It appears her first child, a girl, was stillborn. Her next two children, daughters, were born healthy. Unfortunately, smallpox claimed both daughters within days of each other when they were tots.

Three unsuccessful pregnancies followed. Then, in 1689, William, Duke of Gloucester, was born, and survived.

Baby William, according to medical report and portraiture, had a large head. Possibly, he had hydrocephalus, or fluid in the skull. Nowadays, hydrocephalus can be effectively treated with surgical shunting, but that was not the case in Queen Anne’s day. Brain damage of some kind would be expected.

Some sources describe young William as delicate and backward; others describe him as quite a clever child. He clearly had difficulty with balance, walking, falling down, and getting up. This was attributed by his caregivers to his disproportionate head size. It is worth noting, however, that Anne’s grandfather, Charles I, walked at a very late age, and only after his weak and rickety legs had been braced.

William’s birth was followed by at least ten pregnancies (one with twins), all resulting in miscarriages or stillbirths. Sadly, William of Gloucester eventually died in adolescence of pneumonia, leaving Anne childless.

Around the time Anne’s pregnancies ceased, other physical infirmities began. Gout was one of them. Nowadays gout refers to a specific metabolic problem that affects particular joints. In Anne’s day, it was a catch-all term for pain. Her ‘gout’ sounds more to modern medicine like migratory arthritis or arthralgia, pain making its way all around the body, caused by an autoimmune condition such Systemic Lupus Erythematous (SLE). Anne is reported to have had the facial redness or rash associated with such disorders.

Anne’s was also morbidly obese. She liked her food and drink, and was aided and abetted in overindulgence by her like-minded husband. Her being nicknamed ‘Brandy Nan’ at a time when a degree of abstemiousness was expected in women hints at the possibility of actual alcohol abuse or alcoholism.

Anne’s weight and debility necessitated her being toted to her coronation in a litter in 1702. She was unable to walk much on her own.

Anne died in 1714, a martyr to her ill health. She had become so overweight that her coffin was described as almost square; it required fourteen men to carry it. A contemporary commented that no sufferer would covet their rest as much as Anne would.

Surely, Anne’s phantom children–possibly as many as twenty of them–were on her mind at the very end. What was it that had made her reproductive history go so very tragic?

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JoAnn Spears is a registered nurse with Master’s Degrees in Nursing and Public Administration. Her first novel, Six of One, JoAnn brings a nurse’s gallows sense of humor to an unlikely place: the story of the six wives of Henry VIII. Six of One was begun in JoAnn’s native New Jersey. It was wrapped up in the Smoky Mountains of Northeast Tennessee, where she is pursuing a second career as a writer. She has, however, obtained a Tennessee nursing license because a) you never stop being a nurse and b) her son Bill says “don’t quit your day job”.