MRSA Awareness

August 2, 2010

Everyone has heard of the hospital superbug MRSA and many have a view on how to stop it. I recently came across the results of a survey carried out in Ireland*, to assess the knowledge and perception of methicillin-resistant Staphylococcus aureus (MRSA) among the general public.

The study concluded…

“The public are generally knowledgeable about MRSA but most agreed that they would feel angry and afraid by its diagnosis. Future public education campaigns on MRSA should be aware of this response.”

MRSA infection can be very serious or even fatal so it’s easy to understand why people would be afraid of a diagnosis. I was pretty scared when first diagnosed with MRSA but I can honestly say that I did not feel angry about it. The only time I felt any anger was when I was exposed to the stigma attached to MRSA, by hospital staff who had not been properly trained in infection control. Why is it then that most people in the above survey, agreed that they would feel angry if diagnosed with MRSA?

I can’t help but feel that the media coverage of MRSA has a lot to do with the opinion of the general public. The newspaper coverage tends to be alarmist in nature and is centered around individual’s stories. MRSA is a problem and should be reported but the media should reflect the whole story about MRSA.

Hospital cleaning is part of the answer but so is the reduction of antibiotic use, which is regarded as one of the most effective ways of reducing MRSA. More microbiologists are needed as well as more infection control nurses. Increasing the number of isolation units so those with MRSA can be treated without the fear of infecting others, is also part of the answer as well as reducing bed occupancy rates in hospitals.

And always remember… the most important thing you can do to reduce the spread of MRSA, is to wash your hands thoroughly and often. If soap or water isn’t available, use alcohol-based hand sanitizers.

How do you think you would feel if you, or someone close to you, was diagnosed with an MRSA infection? Would you feel angry?

* This survey was published in the British Journal of Infection Prevention.


Bowel Talk

May 11, 2010

This time last year, I was diagnosed with a type of inflammatory bowel disease called Microscopic Colitis (MC). The condition gets it’s name because the large bowel (colon) lining looks normal during colonoscopy (a test to look inside your large bowel) and can only be seen when tissue samples are taken from the colon and examined under the microscope. The exact cause of microscopic colitis is unknown and treatment depends on the severity of symptoms which can range from mild to very severe. Some people recover spontaneously and continue to keep well, while for others the condition comes and goes. There is no cure at present.

Microscopic colitis is the term used to cover two types of bowel inflammation that affect the colon, called Collagenous Colitis and Lymphocytic Colitis. The main symptom of both these conditions is chronic (ongoing), watery diarrhoea without blood. Urgency and fatigue are also common. Nocturnal diarrhoea differentiates this condition from irritable bowel syndrome.

At first, my GP thought that I was suffering from an antibiotic-associated colitis (Clostridium difficile) as the severe colitis followed prolonged antibiotic treatment but repeat laboratory tests ruled this infection out. I was subsequently referred to a gastroenterologist who scoped my entire digestive tract and took biopsies for analysis. Two weeks later, the biopsy results confirmed a diagnosis of collagenous colitis and treatment was immediately commenced. As anti-diarrhoeal drugs had already proved ineffective in my case, I was prescribed the same anti-inflammatory drugs used to treat ulcerative colitis and Crohn’s, with good effect.

Microscopic colitis is classified as a type of inflammatory bowel disease (IBD), but is different from and not usually as severe as the better known types of IBD, Crohn’s Disease and Ulcerative Colitis (UC). However, this condition is still commonly overlooked or misdiagnosed.

One year on from diagnosis, my colitis is well-controlled with an anti-inflammatory drug called mesalazine (Asacol). However, antibiotic use will still trigger a nasty flare-up and corticosteroids, in particular budesonide (Entocort), are required to bring it back under control.
As the saying goes, “What can’t be cured, must be endured!”
Now if you’ll excuse me, I’m off to powder my nose.

Information Source:  The National Association for Colitis and Crohn’s Disease (NACC).


24 Little Hours

April 9, 2010

I was feeling a little sorry for myself yesterday when an email arrived from a blogging friend. Her supportive email was just the tonic needed. You see, this friend knows only too well what it’s like to deal with a long term illness. It felt so good to be understood.

Today, I received a text message from another dear friend who lives locally and it really made me stop and think.

Her text message read…“Hi, just to say thanks. I’ve seen and learned so much from you about managing your health responsibly and with a cool mind. From what I’ve observed over the years, I always knew that you had courage and now I’m experiencing how vital that is!

This old friend of mine has recently been diagnosed with a nasty autoimmune syndrome and is slowly coming to terms with the fact that she now has to learn how to live with a long term illness. I’ve been so tied up with my own woes of late that I’m guilty of not giving her the level of support she needs and deserves. I suspected from the nature of her text that she must have been reading my blog on the quiet as I rarely dwell on my health problems in ‘real’ life. When I enquired if this was the case, to my surprise she replied “not yet but I will.”

I’m aware from the supportive comments received on this blog from people I’ve never met that I give the impression of being ‘level headed’ when it comes to dealing with illness. I think this is because the blog gives me free rein to talk about coping with illness in a way that is rarely facilitated elsewhere. I’ve often wondered how my coping strategies are perceived by people who I meet in everyday life.  I would hate to think I was known as a moaning minnie.

I’m now mightily relieved. What a difference a day makes!


Catch-22

August 7, 2009

home sweet home

It’s true what they say. There ain’t no place like home. After four long weeks spent in shared hospital wards, it’s heaven to be back in my own bedroom, in my own bed. No more doctors’ rounds, no more observations taken and no more drips to endure. Peace and quiet at last. I owe a lot of people, a lot of thanks.

Firstly, to the surgical team whom I could not fault. They saw me every day, usually twice a day, throughout those many weeks and my respect for them grew with each passing day. These non-consultant hospital doctors (NCHDs) work incredibly hard and frankly, I don’t know how they stick the conditions they endure. The consultant surgeon is fantastic but he’s just the icing on the cake. The NCHDs are the ones who should really take a bow.

My final diagnosis was osteomyelitis of the frontal bone plus orbital cellulitis following complex surgery on my skull last June. Both conditions had the potential to be life threatening. Prevention and treatment is heavily dependent on antibiotics. I suffer from a form of microscopic colitis called collagenous colitis (CC) which has developed in response to antibiotic treatment for my head over many years. It’s a catch-22 situation. Antibiotics are needed to keep me alive but they also produce side effects which limit treatment. Treatment over the last four weeks, has been a delicate balance of IV drugs and I owe big thanks to the microbiology team at the hospital who devised (and revised) a treatment plan to suit my personal needs. I also owe thanks to the gastroenterology team who came to my rescue when the bottom fell out of my world, quite literally. My overall condition has now stabilised and I’ve been able to return home on oral treatments.

The last few weeks have really made me realise how much my family and friends, and especially my blogging friends, mean to me. It’s been a real privilege to turn on my laptop and know that there is always companionship available. Grannymar was there for me every day on instant messenger and I can’t thank her enough. Lily sent a beautiful bouquet of flowers to brighten up my world. Such a kind gesture! Baino kept me entertained with funny emails and Annb sent gorgeous pics of the West of Ireland, my favourite place. It’s been really fantastic to receive so many supportive emails and comments on my blog. Thank you to one and all :D

Lastly, but not least, to my husband Jaimie who has stuck by me through thick and thin. I owe him a definite holiday.


Look on the bright side

July 31, 2009

I’ve read two newspaper articles in the past week which have totally resonated with me. Life can be a bitch at times. I’m going through a difficult time with my health at the moment. I’ve been in hospital for weeks undergoing treatment following a complex operation on my skull.  Following the surgery I developed a complication known as osteomyelitis. In layman’s terms, this is infection of the bone and it’s a bugger to stamp out. I have also developed a fairly severe form of colitis which has complicated the treatment for the osteomyelitis. In order to stay sane, I really need to look on the bright side.

smiley face sticker

Last weekend, I read a case study in one of the Sunday mags about a woman who’d suffered a severe facial injury in a car accident.  She says “I began to see that it was an accident, that I couldn’t change it, that I had no control over it but that I could control how I would learn to live with it.”  I like her attitude. I can’t change what’s happened to me but I can control how I cope with the conseqences.

On Tuesday, the Irish Times Healthplus supplement featured an article titled “Look on the bright side”. Again, the words jumped off the page at me. “If you’re looking for what’s going to go wrong, you will always find it. If you’re looking for what works, life just gets a lot easier.”

I like this philosophy. It definitely helps to look on the bright side :D


Rapid MRSA Identification

February 5, 2009

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.

mrsa2“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.


Psoriasis Uncovered

January 14, 2009

At the beginning of last year, I developed an itchy, dry scalp. Shortly afterwards, my skin started to breakdown with small patches of intensely inflamed skin appearing in the strangest of places. This was subsequently diagnosed by a dermatologist, as being part of a condition called inverse psoriasis.

One weird aspect to having psoriasis is that nobody ever enquires about it except of course, your prescribing doctor. People would rather not know about difficult and embarrassing conditions so it’s rarely discussed. Many people think of psoriasis simply as an unpleasant skin condition but it’s much more than that. Psoriasis is a chronic immune system disorder, it’s non-contagious and it affects about 100,000 people in Ireland. There are many different types of psoriasis. Eight out of 10 sufferers will develop plaque psoriasis, which involves red scaly and often itchy plaques. Other types include guttate psoriasis, pustular psoriasis, inverse psoriasis, erythrodermic psoriasis, nail psoriasis, scalp psoriasis and psoriatic arthritis.

itchy4I wrote about my own situation shortly after diagnosis when I was literally itching for a solution and I received a great response from readers. It’s now exactly a year since I first started to itch and I’m no closer to finding a lasting treatment. I had hoped to be able to identify a contributing factor but other than finding out that I’m in the high risk bracket, I’m none the wiser. I recently weaned myself off using the prescribed treatment for my scalp and and lo and behold, my scalp is showing signs of improvement. My skin, alas, continues to break out in patches of intense inflammation no matter what I do or try, and it’s continuous battle to keep it under control. However, I know that things could be a lot worse especially when you consider some of the other forms of psoriasis but I still long for normal skin again.

The Psoriasis Association of Ireland in collaboration with Abbott, are running a campaign called Psoriasis Uncovered. The campaign aims to increase the understanding of psoriasis, the impact it can have on quality of life for people with the condition and the need for effective treatment. A new survey has been launched which is designed to find out the effect psoriasis has on people. If you suffer from psoriasis and would like to take part in this survey (it runs until March 2009), click here to complete a questionnaire. It only takes a few minutes to answer the questions and your answers are totally anonymous.

So, the next time you hear mention of psoriasis, please don’t drop the subject like a hot potato. Living with this condition is difficult enough. Your understanding would help a lot.

Information Source:  Psoriasis Association of Ireland; Psoriasis Uncovered.


Keep Taking The Pills

December 9, 2008

AD8B2D

One afternoon, a man went to his doctor and told him that he hadn’t been feeling well lately.

The doctor examined the man, left the room, and came back with three different bottles of pills. The doctor said,

Take the green pill with a big glass of water when you wake up.

Take the blue pill with a big glass of water after you eat lunch.

Then just before going to bed, take the red pill with another big glass of water.”

Startled to be put on so much medicine, the man stammered, 

“Doc, exactly what is my problem?

The doctor replied, “You’re not drinking enough water.”


Some Day…

August 25, 2008

Do you have health insurance or is this something you’ve put off until another day? If you’re young, fit and healthy, the chances are you’ve never really given your health much thought. Why would you worry when you haven’t had to face huge medical bills? With the rapid privatisation of our health service, health care in Ireland is becoming more like the 2-tier system in the States. Those with insurance will get top dollar care while those without, will suffer.

About five years ago, my GP sent me urgently to the A&E department of our local public hospital as I had developed acute abdominal pain. I was processed by the triage nurse and allocated a trolley in a cubicle so that the doctors could assess my condition. Once my blood tests had come back from the lab, the decision was made to admit me overnight in case I needed to go to theatre. I was put on a drip (nil by mouth) and lined up on a trolley in the centre of the department along with scores of others, in a queue for a bed. I hit lucky on that particular occasion and was transferred to a ward in the middle of the night. By the following day, my abdominal pain was severe (my intestine was blocked by an abscess) and it was decided that a CT scan should be performed to ascertain if surgery should be performed. I was started on intravenous antibiotics while I awaited the scan but kept fasting in case surgery was required. This was bearable until a harassed looking junior doctor appeared at my bedside to announce that the CT scanner had broken down and was awaiting repair. By the following morning (day 3), the scanner was still out of action and my situation was beginning to look very bleak. Around lunchtime, the same doctor rushed in and asked me to confirm that I had private health insurance. I did, thankfully, so the decision was made to transfer me to the private hospital, to avail of their scanner. The scan confirmed a diagnosis of acute diverticulitis with obstruction of the bowel but it was seen to be resolving so I could finally be taken off the emergency list. Had I not had health insurance, I hate to think that I may have ended up having investigative surgery as no scanner was available to make the diagnosis. Please don’t get me wrong here, I received excellent medical care during my 10-day stay in this public hospital and was very grateful for it. However, the system was clearly in overload and patients were suffering as a result. My insurance was worth every penny to get the care I needed when I needed it most.

Health insurance is a complicated business. It’s designed this way so that the insurers are protected against excessive charges by private doctors and also to restrict patient benefits. There are three main insurance groups in Ireland and they each purposely have slightly different health plans so that it’s almost impossible to compare like with like. I have spent vast amounts of time over the years, trying to work out which plan offers the best deal for my family. It was years before I realised that each member of the family can hold a different policy to meet their individual needs but don’t expect your insurance company to tell you stuff like this, ‘cos they won’t. I review our policies every year to see how we can reduce costs yet still retain adequate cover for both emergencies and day to day care. There are all sorts of clauses to catch you out, so be careful what you change. And remember, it’s too late to look for insurance when you’ve already become ill because penalties will abound. You have to put in the work yourself if you want to see improved benefits. I long ago gave up hoping that an apple a day would keep the doctor away.


One size fits all?

August 12, 2008

Have you ever been a medical mystery? I’m talking about those patients whose symptoms fail to fall neatly into the diagnostic criteria for a particular illness. You go to your doctor feeling really ill, your doctor listens carefully to your woes and recommends a battery of tests to help with the diagnosis. Several days later, your doctor rings to tell you that all your tests have come back normal. You’re still feeling lousy and you’re meant to be pleased with this news?

I’ve found an interesting new blog written by A Country Doctor (based in the USA) which provides a refreshing look at illness. Today he discusses how the labelling of a patient can affect a patient’s response to an illness.

“Labels are good if they help you understand what’s going on, and bad if they lock you into some sort of fixed category where you either don’t believe you can get out or, perhaps worse, start to feel comfortable and liberated from your own responsibility for your life and health.

Receiving a diagnosis is never any fun but sometimes it’s almost preferable to not knowing what’s wrong. There’s little to recommend about being a medical mystery. The patient is suffering from very real symptoms yet nobody seems to be able to explain why and it’s not unusual for them to get to a stage where they begin to doubt their own sanity. Doctors these days have a large array of tests available to them to assist with a diagnosis. It seems that the days are gone when doctors rely on their own diagnostic skills to make a judgement. Today, tests are often ordered before an opinion is given. If the tests fail to show any abnormality, doctors generally take great pride in reassuring the patient that all is normal. However, from the patient’s perspective all is not normal if they continue to suffer from the original symptoms and are no closer to receiving help with the problem.

As the Country Doctor says “Somehow in the last generation of doctors, we seem to have lost our ability, or perhaps our perceived right, to give patients advice about their health; only if we diagnose them with a disease, or pre-disease, do we have something to tell them.”

Having been a medical puzzle myself for many years, I can assure you that it was a huge relief to finally receive a diagnosis. The missing piece of the jigsaw was found and suddenly my medical history made sense. My ‘label’ has not caused me to become fixated with illness, rather it has helped me to understand my condition more fully and to take responsibility for my own health. When I consult a medical doctor, it’s because I want to find out what it is wrong and receive advice on how best to deal with the symptoms. I think that doctors would do well to remember that not all patients have symptoms that fit the label and very often, these are the patients who most need their help.


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