In the U.S., our government (federal, state, or local) is often determined to outlaw things for our own good.
Today’s rant is about the Food and Drug Administration (FDA), and the Drug Enforcement Administration (DEA), The FDA is charged with the responsibility of ensuring that food and drugs sold to the public are safe. Good idea. How are they doing? Not so well. My guess is they aren’t funded well enough to do the job right. Nobody even remembers who they are until there is some scare, like contaminated spinach. And then who gets blamed? The FDA! Not the growers. The FDA is in a Catch-22 world.
During the recent 16 day government shutdown, all their inspectors were suspended because their jobs were considered “non-essential”. Really?
In any case, the FDA announced about two weeks ago that they are going to start cracking down on Schedule III drugs. Let’s talk about the schedules. Schedule I drugs are those with a very high potential for abuse, have no accepted medical use in the US, and a lack of accepted safety even under medical supervision. This includes things like heroin and LSD, but also marijuana, which is pretty funny since at the state level, marijuana is legal in many states. So the Feds still consider it illegal, but there seems to be a hands-off policy when it comes to prosecuting people in states where it’s been legalized.
There are five schedules, each of which has a declining level of potential abuse, do have accepted medical uses, and have been tested for safety.
Schedule II includes drugs like cocaine, morphine (which is derived from opium) and various synthetic versions of morphine, including the heavy-duty pain killers Percocet, Oxycontin (considered the really big bad boy of the list), Percodan, Dilaudid and Demerol.
Schedule III includes such things as anabolic steroids and Hydrocodone, as long as it’s combined with an NSAID like ibuprofen or acetaminophen (Lortab, Vicodin, Vicoprofen).
Schedules IV and V aren’t worth mentioning.
So supposedly there’s a new epidemic of abuse of Schedule II drugs. Nonsense. It isn’t new. Thirty-five years ago I worked in a methadone clinic. I never met one person who was addicted to heroin. Apparently, heroin was pretty hard to come by. They were addicted to Dilaudid. How did they get it? In some cases, doctor shopping, going from doctor to doctor with phony complaints and getting prescriptions from each doctor. In some cases, from sympathetic doctors who knew they were addicts but didn’t want them to suffer. In some cases by breaking into or outright robbing pharmacies. And let me tell you, these people led miserable lives. Going from getting high to going into withdrawal. Always worried about where the next pill was coming from. Even if they didn’t rob pharmacies, they burglarized homes and fenced the take, to get the money to buy drugs. I knew a guy who bought a van, had signs painted on the side that said “Acme Movers” or something like that. He would back the van up to a house where he knew the people weren’t home, and clean it out, in broad daylight.
So the “new” epidemic has been around for a while, and the “cracking down” on Schedule II drugs has also been around, to the point where many doctors are afraid to prescribe them at all. Why? Because if you’re determined by the government to be over-prescribing them, they can revoke your medical license. Never mind if you’re an oncologist or an anesthesiologist (who typically run pain clinics for people with chronic pain) or an orthopedist.
The “cracking down” on Schedule III drugs will now remove the last effective alternative for treatment of pain, in my opinion. Pretty soon, if you, say, break your ankle, the doctor will put it in a cast, tell you to take two aspirin and call him or her in the morning. Not because they don’t think you need it, but because they will be scared.
Recently, the Florida Attorney General has been touting her success at closing down “pill mills”. The amount of Oxycontin prescribed in Florida is down by 20%. In a related story, heroin overdoses are up by 20%. What does that tell you? I seriously fear that this approach will not reduce addiction and overdoses, but will make it much more difficult for people who really need pain drugs for legitimate reasons to get them. A woman on NPR (National Public Radio) last week said she got a prescription for a pain drug, but couldn’t find a pharmacy that would fill it.
When will we ever give up on this ineffective “war on drugs”?
NPR also did a story about the issue, here’s a quote. “The US has about 4% of the world’s population, and we’re consuming more than 80% of the world’s oxycodone supply. We’re also consuming more than 99% of the world’s hydrocodone”. What a misleading statistic. What percentage of the world population has no access to medical care of any kind? What other countries have more lenient laws about drugs, and thus less crime associated with it?
You would think we (the US) would have learned when alcohol was banned in 1920 with the 18th Amendment to the Constitution. In 1933, the 18th was repealed by the 21st Amendment. Prohibition did not work then, and it doesn’t work now.
Category Archives: Medicine
The Nanny State
In the U.S., our government (federal, state, or local) is often determined to outlaw things for our own good.
Posted in Government, Health, History, Law, Medicine
Orthotics and Prosthetics
Try saying that three times really fast. In fact, try saying it once.
The place I am presently chained to…Tallahassee Orthopedic Clinic…is larger than some hospitals, and has several departments. MRI, Surgery, Physical Therapy, and of course, O and P.
I am for sure getting better. I can tell by the number of devices I need in order to walk. I went from this:
The second photo is a pneumatic boot. Your next step after a cast. Its advantage is, you can (theoretically) take it on and off, which you can’t do with a cast. I’m joking about theoretically. It just isn’t easy. When you put it on, you have all these straps, miles of Velcro which sticks to itself. Which strap goes where? Once you get it on, there is a little port where you inject air to stiffen the rigid sidc supports. Or as one of my friends said, it’s a medieval instrument of torture. And the longer you wear it, the worse it gets. It’s heavy. I started to feel like Frankenstein’s assistant Igor, dragging his leg around.
Two days ago, I graduated to the third photo: an ankle brace. Specifically a Gameday ankle brace. I had to laugh when I looked them up. They claim it’s very easy to wear and adjust. Really? It has a sort of mesh on top, and a lace-up tie that you have to do first. Step One. Then there are two side straps that you have to weave under your foot in a figure 8 pattern and then secure to the top. And finally, a third strap which goes around the top to secure the laces and the other two straps. And I thought the boot was complicated?
The boot was serious Velcro, and when I say Velcro, I mean nuclear Velcro. Not only did it stick to everything, it attracted stuff like it was magnetized. I wore it day and night. It was black. I have a totally white cat, and a red and white dog. I had ditched one of the straps, and another was missing its little plastic thingy that you were supposed to feed the strap through I was embarassed when I saw the O and P guy. He said, it’s okay. It just means you were using it.
Kind of a nice thing to say. Especially since he was trying to get a break to eat his lunch when I walked in.
Nice is not a word I would normally use about TOC. It has a reputation for being like a factory, and the more I’m there, the more I understand that. I have mostly seen a Physican’s Assistant that I love, but he is supervised by a physician I think is an idiot. This physician refused to renew my prescription for pain medication. The PA said, Dr. Borom says he will not prescribe pain medication for more than a month after a fracture.
Seriously? There is a time limit? Every other thing I’ve had a problem with, they asked you to characterize your pain on a scale of 1 to 10 and treated you accordingly.
But the main thing is….I’m better. I can still remember now how awful and desperate and frightening it was in the beginning.
Posted in Medicine
Tagged bone fractures
Blog Stuff, and a Fakename Update
Today I’ve had 97 views on a blog post I wrote in October of 2011. Excuse me? What? And why? It was a post about a TV program I saw, “Fatal Attractions”. And one comment on that same post I would have had to approve. The comment said U should get the whole story before U post this crock.
The commenter said she lived a mile away from the farm where Terry Thompson lived. Thompson was the guy who released about 50 exotic animals and then killed himself. She said I portrayed him as a bad guy, but he wasn’t. First of all, Commenter, you need to take this up with the Animal Planet TV Channel. I just summarized what the program said. Second, don’t ever call me U.
I have such a pet peeve about that. I mean, I don’t care if you’re doing a quick text message (okay, actually I do, but not as much), but in a response to a blog post you can’t spell out “you”?
Meanwhile, peacefully trying to go about my own business, which didn’t require any assistance from Commenter Person, I am much improved. I can walk without assistance in my walking cast. I’m in less pain and can go longer between doses of pain medication. I have new challenges, like pain in my foot, and cramps and muscle spasms in my leg, all the way to my hip. I think because my foot can’t flex, my leg has to take all the punishment, so to speak.
My next appointment is next Tuesday, the 29th. I am so hoping that I’ll be able to go to a less restrictive confinement of my ankle. That will be exactly one month since the injury. I hope, but you would be amazed at the number of people who’ve shared horror stories with me…three months, six months, and so on. To an extent, it amuses me. The same thing happened to them, only it was worse, or they knew someone it happened to, and it was worse. It’s always worse. I should be thanking my lucky stars.
Fakesister, the Saint
She might dispute the title of Saint Fakesister, but shouldn’t. When we parted on Saturday, I told her there were not enough words to thank her. She told me just to get well…and there was one more thing I was supposed to do, but I forgot what it is already!
So maybe now I can come up with a few words, which will have a limited (but world-wide) audience.
I called her from St. George Island, and said, You know all those previous times you offered to come down and help me? Well, this time, I really need you. At first I thought I would have to go to Atlanta, but she said no, she would come here. She lined up a hotel room at the Hilton Garden Inn, and my friend Brenda and I were to meet her there around 1:00 P.M. on New Year’s Day. (Happy New Year to us, right?)
When Brenda and I pulled into the parking lot of the Hilton, we were behind an SUV which was towing a trailer. Brenda said, “Could that be your sister? Because I think that thing on the trailer (shrouded in a tarp) is a wheelchair.”
It was my sister, and it was a motorized wheelchair. By a strange coincidence…and hold on here, it’s about to get messy…my sister’s husband’s sister’s husband’s mother had had it. Told you that was messy. The mother had passed away a couple of years ago, and the chair had sat unused in their garage or something. So the chair has its own story
When they turned it on, it wouldn’t work, because the battery was dead, so Fakesister’s mechanically inclined husband, along with, I presume, his brother-in-law rigged it up to two lawnmower batteries, and it worked.
Fakesister also brought me a walker and a cane. She let me stay with her in her hotel room for four days, and fed me. She took my dog Pippin to my vet to board, after the poor little beast had to spend the night in her Dodge Durango. It was New Year’s Day–no place was open, except the Animal Emergency Clinic, and they wouldn’t take him. They said they might have made an exception–normally they don’t do “boarding”–but they didn’t have the kennel space. Holidays are terrible for both animals and people–we eat things we shouldn’t and get sick, or we injure ourselves doing wilder and crazier things than usual in strange environments.
Then my sister took me to the orthopedic clinic, where she watched the process of my cast application with great interest, and offered moral support when I picked “glow in the dark” as my choice of cast color. It was the only white color they had. Black was too gloomy. All the others were colors I was pretty sure I would get sick of after only a week, much less six, which is how long I have to keep the cast on. A little boy two tables down from me got a purple one on his arm. I noticed he was wearing a purple T-shirt, which I guessed is one of his school colors. How cute is that?
Then, my sister rented me a car–for six weeks. She and her husband almost bought a car for me–which I would of course have returned when I no longer needed it–but the logistics of that were too overwhelming. The doctor said I could drive, but not my own car which has a manual transmission. It’s my left leg that’s broken, and I can’t operate a clutch. When I bought this car in 2009, Fakesister said…get an automatic. I hereby apologize for not following that advice–but the manual was $2000 cheaper.
When she got home, her husband had a giant vase of roses for her. Now that is truly fabulous.
If all these things don’t qualify her for sainthood, then I don’t know the meaning of the word. So, Fakesister, thank you.
Posted in Animals, Dogs, Medicine, Tallahassee
Fakename Sees the Orthopedist
I went as soon as I could, on Wednesday January 2nd. The first thing that happened was that I and the receptionist almost had to rumble. To be specific, I was ready to come out of the wheelchair and go to the mat with this witch. Plexiglas screen or not. The issue was whether or not I had sufficient proof of insurance. I said she could call to verify it, and she said she didn’t have time to call, but I could do it if I wanted to. I said, “I won’t be calling, because I don’t think I should have to.” She said, if it isn’t verified, I’ll have to put you in the computer as uninsured. I said, “I don’t care how you put me in your computer. It makes no difference to me.” I was pretty sure that when the time came, SOMEBODY would verify that I had insurance. Like when it was time to send out the bill. I was, in a word, furious. This was not the way to start a new relationship. The receptionists at my veterinary hospital are head and shoulders above this woman.
I grumbled all the way back to where my sister and I parked, and I said, “I am not accustomed to this kind of treatment”. My sister said something along the lines of “What? You expect them to behave like serfs?” I was stung to the core. NO! I’m just accustomed to people being helpful. Which one of us here has the broken leg? I’ve been told no before. Like no, I know it would be more comfortable for you to lie this way on the treatment table, but you can’t. We need you to lie this other way. Sorry. I never had anyone tell me they didn’t have time. If she doesn’t have time, she either needs help, or she needs a different job.
Very shortly I was called into the treatment room, which is a huge open area where many patients are in various stages of cast application or removal. Fakesister said, “Oh my. It’s an assembly line.” Gulp. I had heard this about Tallahassee Orthopedic Clinic before, that it was an assembly line. Impersonal.
But it turned out, it was merely efficient, and not at all impersonal. I saw a physician’s assistant and dutifully handed over my X-rays from the Apalachicola ER. I had to have one more X-ray–a gravity X-ray. You hang your foot over the end of a cushion. If it droops more than it should, it means one of the ligaments is damaged too. I was fine.
Now let me count the ways I was lucky. The fibula fractured right between two ligaments which hold the bone together. No matter what I did, I could not make the bone break “worse”. I did not also break the tibia, which often happens when the break is that far down toward the ankle where the tibia and fibula are connected. Not breaking the tibia is a major perk. It’s the weight-bearing bone for your entire leg.
Small anatomy lesson here…and thanks to Fakesister for it. You know your ankle has two “bumps” on either side? The one on the inside of your ankle is the end of the tibia. The one on the outside is the end of the fibula.
But thanks to my good fortune, I got a walking cast right away. The PA said I could put as much weight on it as I could stand, which would not be much for the next several days.
I got to pick the color of my cast, so I picked the only shade of white they had, which also glows in the dark. I almost lost my nerve when this resulted in grins from nearby patients and virtual smirks from the technicians. Fakesister said to the techs, “I’ll bet you’re used to this choice from 11-year old boys, right?” But she also said she loved it, so I pressed on.
Later that evening, Fakesister tried to take a picture of it with her iPad Mini, but it doesn’t give off enough light to take a picture of it in the dark. She describes it as a “ghostly greenish glow”. It’s pretty cool 🙂 I’m glad I stuck with it.
The guy who put the cast on said I might scare my pets with it. Now that I’m back home with my cat (the dog is at the vet’s), she hasn’t been alarmed by the cast at all. But she is ultra-scared of the walker. As far as she’s concerned, it’s a WMD.
Posted in Medicine, Tallahassee
The ER In Apalachicola
The ER is at Weems Memorial Hospital. Chief Jay of the St.George Island Volunteer Fire Department advised me not to go there. It’s possible he had some prior bad experience. But I guess it depends on your expectations. I was not expecting it to be the Mayo Clinic. I needed only two things: X-rays and a prescription for pain. I got both, so I considered it a success.
The X-rays were no fun. They kept wanting me to turn my ankle in directions it didn’t want to go. There was another woman in there with me, who had a back fracture. She kept screaming things like “Please, God, help me.” They had done a portable X-ray and would not let her lie back down until they checked to see if the X-rays were okay. If that had been me, I would have laid back down anyway and pardon my language, but fuck what they told me to do. I thought the X-ray tech was extraordinarily insensitive.
Needless to say, I wasn’t feeling that great myself, but I had resisted crying except for one almost-crying episode. But this situation had me in tears. I wanted out of there, so I did not have to hear her screams any more. This sounds selfish, but I couldn’t help her. If I could have, I would have done anything in my power, screams or not.
You could hear her screaming all the way out into the waiting room, and my friends Brenda and Pat thought it was me. They should have known better. For one thing, I would not have been calling on God.
When we first pulled up to the ER entrance, I got what I now consider the greatest invention of mankind–the wheelchair. I could have kissed its foot rests.
It turns out that wheeled chairs have been depicted in both Greek and Chinese art since the 6th century BCE. But the first modern, lightweight, collapsible wheelchair was invented in 1932 by Harry Jennings, an engineer who built it for his friend Herbert Everest. Everest had sustained a back fracture in a mining accident. I could kiss them too.
After being wheeled back to my exam room from X-ray, the doctor came in and said, “I have some bad news and some good news. The bad news is, you fractured your fibula, but…” I said, “Wait! Are you saying I broke my LEG? By falling down one step?” He said, “Well, yes. But the good news is, it isn’t fractured all the way through.” I guessed that must be good news, if he said so. He told me to go ASAP to an orthopedist–they didn’t have one there. And he gave me a prescription for Lortab–a hydrocodone/acetominophen combination that goes by many brand names, such as Vicodin, which Dr. House was addicted to on the TV show “House”.
It took 45 minutes for the only open pharmacy in Apalachicola to fill it, during which time we took a little scenic tour around the town. It truly is a quaint and beautiful little fishing village with a lot of history. Its name, translated from the Native American, means something like “people from the other side (of the river)”. In this case, the Apalachicola River. Subject of major lawsuits and countersuits by the states of Georgia, Alabama, and Florida. The issue, in a nutshell, is Georgia hoarding all the water it can get into Lake Lanier, to support the population of Atlanta. Meanwhile, the Apalachicola River needs a certain amount of fresh water to pour into the Gulf at Apalachicola Bay, to support the briny environment oysters need to live. They can’t live in fresh water, but they can’t live in sea water either–it has to be a combination.
I can tell you that the beauty and history of Apalachicola are best appreciated when your ankle isn’t screaming. But it was a good distraction. I opened the bottle with trembling hands and promptly swallowed half a tab. The ride back across the three bridges to get back to the island was therefore somewhat more bearable.
Next episode: Fakename visits the orthopedist.
Posted in Medicine
Tagged accidents, bone fractures, fractured fibula
Happy New Year…Or Not!
Saturday, December 29th (my birthday, by the way!), I traveled to St. George Island for the New Year’s holiday with my two friends Brenda and Pat. We were there for fun in general, with the high point being the bonfire on the beach on New Year’s Eve. The first order of business on the first evening was to go to the Blue Parrot for oysters. We set out at about 7:00 P.M., when it’s quite dark this time of year.
Like almost every house on the island except the very old ones, the house is on stilts to protect it from flooding during hurricanes or tropical storms, so it has to be accessed via stairs. From the door, there is one set of steps leading to a landing. From the landing, the steps split into two “wings” leading to one side of the house or the other. While descending that first set of steps from the door, I missed the last step. Just. One. Step. I fell in a heap onto the landing, twisting as I went. This all happened so fast I wasn’t even sure, really, what had happened. It was like, one minute I was walking down the stairs, the next minute I was sitting on the landing holding my ankle, going Ow! Ow! Ow!
If I’d had any sense (which clearly, I don’t), I would have turned right around and gone back into the house. But I proceeded down the steps, with Pat’s help, and went for oysters. It’s the perfect time of year and the perfect temperature for the world-famous Apalachicola Bay oysters. Eating those dozen raw oysters was my last happy moment of 2012.
Again with Pat’s help, or maybe Brenda’s, I had to climb back up the whole set of stairs into the house. At least at that point, I did the right thing. I elevated my leg and put ice on it. My ankle, by that time, was swollen like a balloon.
I’ve never broken a bone before so I didn’t really know what to look for. But by the next morning, which was Sunday, I had a very strong feeling that my ankle was broken rather than just sprained. The pain was excruciating and I couldn’t walk at all. I could barely stand up. I knew I had to go to the Emergency Room. The question was, how to get out of the house?
So we did the only thing possible…we called 911. The St. George Island Volunteer Fire Department came and carried me down the steps in a special chair built for that purpose. I have a picture, but WordPress does not seem to want me to share it for some reason. I’ll have to investigate that later.
The only person on duty that morning was the Fire Chief, Jay, and he called in another volunteer to help–primarily because the chair was in her vehicle. Jay came again two more times, once to get me back into the house after visiting the ER, and a final time to get me out of the house to come back to Tallahassee. Unfortunately, these last two times, he came alone, so that poor Pat had to do rescue duty without having volunteered for it.
So after being carried from the house, Brenda, Pat, and I piled into Brenda’s SUV, or well, I didn’t exactly pile. Can I tell you how hard it is to get into a Ford Expedition with an injured leg? I’m short, so it’s a challenge for me even normally. We headed to the nearest town with an ER, namely, Apalachicola itself. The county seat of Franklin County, Florida. Population as of 2000–2,234. This was not going to be high tech medical treatment. But the only alternative was to go back to Tallahassee, which I refused to do. And not just for stubborn reasons.
Apalachicola is about 9 miles from St. George Island. Tallahassee is 80. If I had gone back to Tallahassee I would have been alone, without Pat and Brenda and the Volunteer Fire Department to help me. Worse, if Brenda took me back she would likely have gone on to return home herself to Jacksonville. Therefore missing the main purpose of our visit–the bonfire. I didn’t see why their vacation should be ruined too. It would have made me feel worse than I already did.
I now see that this post must be done in installments. Next epis0de: the Emergency Room.
Not A Good Day to be Claritin-Free
When I was a little girl, one of the things I wanted most was a cat. I wanted a cat like some little girls want a horse (say, for example, my sister). She at least had the sense not to beg. A horse truly would have been beyond our means, but I thought a cat was quite reasonable. They are certainly cheaper. But my mother flatly refused, without ever really giving an explanation. I thought she just didn’t like them. That does happen. But as it turns out, maybe she knew something I didn’t.
When we left home, my sister and I both eventually made our dreams come true. I got a cat, she got a horse. That’s when I found out I’m allergic to cats. And so is my sister. She is wildly allergic, I’m less so, but I think that’s due to exposure. I eventually got to the point where I could tolerate my own cats, but I couldn’t be in the same room with someone else’s cat. Then that got better and I could be in the same room, but I just couldn’t touch them. That’s very hard to do with cats, who are twining themselves around your ankles and purring, and looking generally very cute and begging to be petted. But if I succumbed, I would be rewarded with my eyes swelling almost shut and itching, and finding it hard to breathe. So it wasn’t hard to exercise some discipline there.
Eventually that got better too. The experts call this “immunomodulation”. I just learned that word today, and what a good word it is. Sixteen letters, even. That would be a great Jeopardy clue. Normally that has to be accomplished with drugs, but it can also be done by exposure, which leads to greater tolerance. Most of the time.
As an aside, I have to say that I once saw an allergist after an unfortunate encounter with fire ants, and I got the standard test for all sorts of allergens, including cats. The test showed that I am not allergic to cats, so I promptly dismissed the test. Now that I know more than I did then about medical tests of all kinds, I know that I was right. Tests are inadequate. Period. They are an aid, but they are not infallible. I also tend to have what are undoubtedly allergy symptoms every spring and fall, but the test did not show any allergy to pollen, the likely cause. In spite of that, I’m pretty sure I’m allergic to oak pollen. The tests did show that I am seriously allergic to fire ant stings Duh. This reminds me of my former car, which had a “low traction” light. You could be sliding across ice and spinning around three times before the light came on. Duh. Thanks for telling me. Lucky for me, the allergist was very smart. I’ve been lucky that way–to find doctors who are very smart. He said, I know you’re allergic to something–I just don’t know what it is.
So the exposure thing has worked well for me, except some times. Because immunomodulation (I just had to say that again) does not mean you’re cured. One of those times was last night, when I suddenly couldn’t breathe. Normally I buy Claritin in packs of 10 tabs, which is not cheap, but I don’t need them that often. Maybe once every three months. So here I am, pawing through my handbag in the middle of the night, and I can’t find any. Arrgh! This is like trying to use the copier in my office, and it’s out of paper. Who!!!! I scream,was the last person to use this copier without replacing the paper? In this case, that would be me. So, I had three choices. Go to the pharmacy. Go to the ER. Lie down and concentrate only on breathing. Breathe in. Breathe out. I picked Option 3. In between screaming at the cat to get away. Get Away Now! Get Away or You Die! That kind of thing.
So I must end with a story about Fakesister. Sorry FS, you will now become the unwitting star of this post. If I have as much trouble as I do, you can imagine what it must be like for Fakesister. So one day, I accompanied Fakesister to her horse barn. Where there are horse barns, there is horse food. Where there is horse food, there are rodents. Where there are rodents, there are cats. Ergo, horse barns equal barn cats. QED.
So her horse Hoover has the condo of stalls, and it’s large enough for Fakesister to keep her own tack cabinet in it. It contains all the minor accessories needed for horse care–brushes, hoof picks, bridles, and bags of baby carrots, etc. On this day, she is preparing to open the cabinet when out of nowhere, a tiny black barn cat appears. (Barn cats all seem to be small and stunted.) The cat is weaving itself through her ankles and I’m like…Alarm! Alarm! But she’s wearing leather riding boots, so no harm done. The cat isn’t actually touching her.
So Fakesister opens the cabinet, and what to my wondering eyes should appear? A bag of cat treats. I thought, Are you crazy?! But here is what I think the deal is. My sister loves all creatures, as do I. It isn’t just allergies that are genetic.
Reading With Fakename: Rabid
Subitled, A Cultural History of the World’s Most Diabolical Virus. It remains the “most fatal virus in the world, which kills nearly 100% of its hosts in most species, including humans”. By nearly 100%, they mean a handful of people have survived, and I do mean literally a handful. For practical purposes, don’t count on being the next survivor.
It’s diabolical in more ways than one. The symptoms are not apparent until it has wormed its way into the brain, by which time it’s too late. Its delivery system is also diabolical and unique. It both infects the saliva of its victims AND drives them to bite others.
The only way to tell for sure if an animal is rabid (although its behavior is a big clue), is to kill it and examine its brain. The authors, in a gallows humor sort of way, point out that this is like Schrodinger’s cat.
The animal is literally decapitated, and its entire head is sent to a lab. Assuming this happens quickly, there will still be time to administer the post-infection vaccine, which exists thanks to Louis Pasteur. Of course, it often is impossible to catch the animal responsible for the bite, unless it’s a domestic animal instead of a wild one. And even then–capturing an infected domestic animal with rabies is risky, to engage in extreme understatement here. So the authorities don’t try. They just shoot it. And be glad. It’s the kindest thing they can do for the animal.
In my neck of the woods, any time someone is bitten by a normally shy and reclusive wild animal, rabies treatment is started whether the animal can be captured or not. In fact, there is no question when the animal cannot be captured. Normally this would be a bat, a fox, a raccoon, or a bobcat. If a vaccinated domestic animal is bitten by one of the above, it’s quarantined. If it isn’t vaccinated, say goodbye to Fluffy or Fido. It will still be quarantined, but the outcome is…not promising.
Which brings me to Pasteur. The people in his lab went out and captured dogs who clearly had rabies and brought them back to the lab for study. Inside the lab, they kept a loaded pistol. If any one of them had been bitten, one of the others would have shot him.
Another sort of side story is that Pasteur had satisfied himelf that he had created a post-infection vaccine that would work in animals, but was still reluctant to test it on humans. When at last he did so it was on a nine-year old boy named Joseph Meister. As a man, Meister became the concierge of the Insitut Pasteur. I now quote: “When the Nazis, on occupying Paris, attempted to visit the Pasteur crypt [located in the Institute] in 1940, Meister bravely refused to unlock the gate for them. Soon after this discouraging event, he took his own life”.
Pasteur was not a doctor, and had to enlist the aid of one to actually administer the injections to Meister. At that time it was a series of something like 13 injections over ten days or so, that would be very painful. Today it’s four injections in the arm.
I could never write a post long enough to cover the wealth of information in this book. As usual, I have only hit the highlights as I see them. But I’ve omitted the sad and almost amusing explanations people had for the cause of rabies, pre-Pasteur. And rabies has been around as long as (if not longer) than there have been mammals.
But a final few words about bats. Bats are one of my favorite animals. Before the construction of Walmart in my neighborhood, which drove them away, I used to love sitting at my backyard picnic table at dusk and watching the bats. They would often fly so close to me I could hear their wings whirr. You have to steel yourself to an extent, not to flinch. You have this irrational fear that one will become entangled in your hair. Of course that never happened. That sonar thing really does work. Bats have the extra added attraction of eating mosquitos. Anything that eats mosquitos is on my side (“The enemy of my enemy is my friend”.)
I’ve always known that bats carry rabies, and if one ever did become tangled in my hair, it would mean it was sick and I should carry myself to the nearest Emergency Room forthwith, hopefully with (dead) bat in hand.
Still I was saddened to read this: “Bat bites are now the cause of nearly all human rabies infections in the United States, accounting for 32 out of 33 deaths from domestic exposure since 1990”. And, “Bat bites are so subtle that people can be unaware of it, especially in the night, when a bat bite is sometimes not even painful enough to wake a sleeping human. The U.S. Centers for Disease Control and Prevention recommend that anyone who awakens with a bat in his or room seek out vaccination for rabies. Likewise, any unattended child or mentally incapacitated person found in the presence of a bat should be treated as if he or she were exposed”.
The book is a great blend of science, human and natural history, and amusing anecdotes despite the gravity of the subject.
Posted in Animals, Books, Dogs, History, Medicine
Tagged bats, Louis Pasteur, rabies, rabies treatment, rabies vaccination, viruses