Yellowland

February 11, 2012

The colour yellow tends to have negative connotations. Traditionally, it’s been associated with cowardice and deceit. In hospitals, the colour yellow is used to indicate an infection control risk. Last week, Steph’s hospital chart was awarded another bright yellow sticker.

Yes, you guessed right… I’m infected with MRSA again! 

I’ve been fighting a constant battle with recurrent infections in my head since Christmas. Antibiotics gave temporary relief but the infection repeatedly recurred, accompanied by nasty headaches. Two weeks ago, I requested a hospital appointment to get nasal swabs taken and analysed. Shortly afterwards, I was informed that I was indeed MRSA positive. The prosthetic implant which was inserted into my nasal septum last November, was thought to be the source of the infection.

Pacemakers, artificial heart valves, catheters and many other surgical implants commonly become contaminated with bacterial biofilms. The longer a contaminated device remains in the body, the greater the risk of antimicrobial resistance developing. As my infection had been confirmed MRSA positive, I was advised to have the implant removed as soon as possible. Following consultation with my surgeon in Notts, the decision was taken to remove the prosthetic implant.

Sign on door to Steph’s room at the hospital

Last Tuesday, I was admitted to hospital as a day case and nursed in isolation while the prosthetic implant was removed under sedation. This involved another trip to the operating theatre but on this occasion, I remained conscious throughout. When you are MRSA positive, you’re last in the line for everything so as to minimise the risk of cross infection.

When the call finally came, I was whisked directly into an operating theatre, transferred onto the operating table and attached to the various monitors before being given intravenous sedation. I expected to be knocked out by the sedation but far from it. I was able to continue a conversation with the surgeon and anaesthetist while the implant was being yanked from my head. It felt a bit like having a wisdom tooth removed except that it was from my nose rather than my jaw. I was then wheeled straight back to my isolation room to sleep off the effects of the sedation before being discharged home.

It was hoped that the prosthetic implant would remain in place for at least two years to maintain healing of my septum. Instead, less than three months later, the implant now sits in a specimen container while I await further assessment. My head feels a great deal more comfortable now that the source of infection has been removed. What happens next, is anyone’s guess.

I may be labelled yellow… but I ain’t no coward. MRSA watch out!


Super Pillow

November 23, 2011

I’ve always had a ‘thing’ about bringing my own pillow (if possible) whenever I overnight away from home. And, that includes when I’m admitted to hospital… my non-allergenic, frequently washed pillow comes too plus a supply of my own pillowslips.

Why? There are lots of reasons why but chief amongst them is hygiene. I’ve never liked the idea of burying my head in someone else’s pillow. The crisp, white pillowslips found on hospital/hotel pillows, do not reassure me. According to an article in yesterday’s paper, my reservations are well-justified…

A recent clinical trial carried out by Bart’s Hospital and the London NHS Trust, concluded that the risk of infection from bedding is “grossly underestimated”. “Dead skin, bodily fluids and dandruff found on hospital pillows made them a potential source of more than 30 types of infection”. Read on… if you dare!

Pillow aims to halt the spread of superbugs

Carol Ryan

AN IRISH company has invented a pillow that may help to reduce the risk of picking up a hospital-acquired infection (HAI) such as MRSA from lying on contaminated bedding.

Gabriel Scientific’s “SleepAngel” pillow was the subject of a clinical trial by Barts and the London NHS Trust, which found its product to be more hygienic than regular hospital pillows.

Several international studies have found that hospital bedding can harbour bacteria if they become contaminated with the bodily fluids of a patient who has an infection.

While regular washing is a standard infection-control measure in all Irish hospitals, the Barts study concluded that the risk of infection from bedding is “grossly underestimated in clinical practice”, and that regular cleaning may not be enough.

The inventors of the SleepAngel pillow, Billy Navan and David Woolfsen, both worked in the health industry and saw the problems caused by superbugs in Irish hospitals. They thought the risk of infection from pillows was being overlooked in hospital hygiene policies and spent nine years creating their infection-control pillow.

Most of that time was spent searching for a material that could keep germs out of the interior stuffing while still allowing the pillow to “breathe”. A membrane normally used in heart stents was incorporated into a specially designed filter.

During the Barts study, their product was put to work alongside standard NHS pillows in UK hospital wards. Both were used on cardiac, vascular and respiratory wards and tested after three months.

The results showed high levels of contamination in the standard pillows. Some had bacteria levels which were described by Dr Arthur Tucker, who led the study, as a “bio-hazard”. Dead skin, bodily fluids and dandruff found on the pillows made them a potential source of more than 30 types of infection ranging from flu to leprosy. The SleepAngel pillows tested negative for interior contamination and were much less likely to have bacteria on the outside.

There was also some unpleasant news about domestic pillows – apparently you are never alone in bed because after two years of use, one-third of a pillow’s weight is made up of dust mites, dead skin and bacteria.

Infection control has become a big challenge for hospitals in recent decades. Dr Brian O’Connell, medical director at the National MRSA Reference Laboratory in St James’s Hospital, explained that the superbug problem first surfaced in Ireland during the 1980s and quickly became “endemic” in some hospitals. Rates of infection have declined in the past few years but cross-infection still creates a huge extra workload for hospital staff and puts patients at risk.

Of real concern is stopping the spread of MRSA, a strain of the common Staphlococcus aureus bacteria that has developed resistance to antibiotics, making it difficult to treat. If the bacteria gets into the system through a break in the skin it can cause infections but, in more serious cases, can lead to life-threatening diseases.

The HSE Infection Control Action Plan estimates that about 25,000 in- patients develop a HAI every year in Ireland.

The cost of treating and preventing HAIs is €23 million per year and about one-third of infections are thought to be preventable.

Source: HEALTHplus – The Irish Times


Six Feet Tall

November 17, 2011

I’m heading over to Nottingham today to have the nasal prosthesis fitted under general anaesthetic tomorrow.

I just hope I don’t end up looking like this…

Apologies for the lack of communication. Life is far from easy at the moment but I’m determined to stay standing… roughly six feet tall!

 


Having a nose job

August 8, 2011

No… I’m not a celebrity. There’ll be no before and after pics although somewhere in the annals of medical literature, Steph’s skull will be recorded in 3D. Many people choose to undergo “a nose job” to enhance their looks. I’m about to have a nose job with a difference! 

The nasal septum is the vertical wall in the middle of the nose that separates the right and left nasal cavities. This wall extends back to the end of the nasal cavity and is made up of cartilage at the front and thin bone at the back. The main functions of the nasal septum are structural support for the nose and regulation of air flow in the nasal passages.

When I had the graft surgery in Nottingham last year, one side of my nasal septum was harvested and used to cover an area of bone within my skull which had been left exposed following previous surgery. The graft tissue healed well in it’s new location but unfortunately, the donor site (my septum) has failed to heal properly and continues to be symptomatic. This failure to heal is rarely seen and is thought to be due to the fact that I’ve an underlying connective tissue disorder, called Ehlers-Danlos syndrome (EDS). My surgeon in Notts has been scratching his head to find a solution to the problem.

Nasal splinting has already been tried and failed. Topical antibiotic ointment has failed. Daily hypertonic sinus rinse-outs (with the addition of baby shampoo) have failed. We even tried occluding the air flow on that side of my nose, using a prosthetic ‘bung’ but nothing has succeeded in getting my septum to heal. I travelled over to Notts recently to discuss what options are left… if any.

At the consultation, it was quickly spelt out to me that we are now in ground-breaking territory in terms of finding a solution. The first surgical option proposed by my surgeon, sounded too invasive for my liking so I asked him to think again. We discussed various other options all of which were ruled out because of my failure to heal. It was then that my surgeon had the brainwave to adapt another tried and tested surgical procedure, to suit my needs.

There is a condition known as a perforated nasal septum. This is basically a hole in the nasal septum which can be caused by nasal surgery, cautery, physical injury or cocaine use. Now, I’m not a cocaine snorter but I do have a large perforation (surgical opening) in the bony posterior area of my septum as a result of previous surgery to improve the drainage from my frontal sinuses. Sometimes, a nasal septal button is used to close an anterior septal perforation. While my perforation is asymptomatic, my surgeon has come up with the novel idea of adapting the button procedure to suit my unique anatomy and thereby solve the problem with my anterior septum.

He’s going to have a nasal septal prosthesis custom-made to fit through the surgical opening at the top of my septum and which will completely encase both sides of my septum with silicone. A 3D model of my skull will first be made from recent scans so that the prosthesis can be made-to-measure in advance of surgery. All that’s required of me, is to turn up and have the thing fitted under general anaesthetic.

I told you I was having a nose job!


Let Patients Help

August 1, 2011

Are you an e-Patient? The most under-utilised resource in all of healthcare, is the patient. Patients need to be allowed to take part in their own healthcare. e-Patients are equipped, engaged empowered and enabled.

Some of you may be familiar with TED.com. TED is a non-profit organisation devoted to “ideas worth spreading”. It started as a conference bringing together people from the worlds of technology, entertainment and design. As well as running conferences, it delivers riveting talks by remarkable people, free to the world. These talks are well worth dipping into for inspiration and thought-provoking perspectives.

Here’s one I really enjoyed… Meet e-Patient Dave.

Thanks to Ann @ Transplant News for alerting me to the above talk.

Tune in next week for an update on e-Patient Steph! ;-)


Take the MRSA Test

June 8, 2011

How much do you know about MRSA?

I challenge you to take the quiz here and test your knowledge of this resistant bacteria.

The quiz only takes a few minutes to complete.

I’d love to hear how you got on.

Source: MedicineNet.com


I’m fine, how are you?

April 10, 2011

Tonight is census night in Ireland when an estimated 2 million census forms – one for every household in the country – will be filled in. Two new questions have been added to this year’s form from the previous census carried out in 2006. One of the new questions deals with how healthy you feel you are. Most of the questions are multiple choice and in the section on health, you are asked “How is your health in general?” with an option of five boxes to tick, ranging from… very good to very bad. This question poses a dilemma for me…

I was out to dinner with a group of friends last night and during the evening, the topic of the census form came up. When I mentioned that we would all be faced with a new question about our health, one of my closest friends leaned over and said, “Steph, I hope you tell them how bad your health really is”. I was quite taken aback by this remark as despite living with a chronic illness and being an ‘expert by experience’ patient, I’ve never really thought of myself as having bad health. I’ve always regarded episodes of illness/injury simply as obstacles to be overcome so that ‘normal’ life can be resumed. Admittedly, I’ve had rather a lot of so-called “episodes” but even so, it’s still come as a bit of a shock to realize that others may regard my health as being bad.

Over the years, whenever someone has asked me how I am, I much prefer to reply that “I’m fine” rather than have to watch their eyes glaze over with boredom while I detail my latest woe. Those who want to hear more, will usually dig a bit deeper for it and then I’m perfectly happy to oblige. After last night’s conversation, I’m now wondering… am I right to be so positive about my health or am I actually in denial?

I came across this rhyme recently and loved it so much, I want to share it with you today…

There’s nothing the matter with me,
I’m just as healthy as can be.
I have arthritis in both knees,
And when I talk, I talk with a wheeze.
My pulse is weak, my blood is thin,
But I’m awfully well for the shape I’m in.

All my teeth have had to come out,
And my diet I hate to think about.
I’m overweight and I can’t get thin,
But I’m awfully well for the shape I’m in.

Sleep is denied me night after night,
But every morning I find I’m all right.
My memory’s failing, my head’s in a spin,
But I’m awfully well for the shape I’m in.

Old age is golden I’ve heard it said,
But sometimes I wonder, as I go to bed.
With my ears in a drawer, my teeth in a cup,
And my glasses on a shelf, until I get up.
And when sleep dims my eyes, I say to myself,
Is there anything else I should lay on the shelf?

The reason I know my youth has been spent,
Is my ‘get-up and go’ has got-up and went!
But really I don’t mind when I think with a grin,
Of all the grand places my get-up has been.

I get up each morning and dust off my wits,
Pick up the paper and read the ‘obits’.
If my name is missing, I know I’m not dead,
So I eat a good breakfast and go back to bed.

The moral of this as the tale unfolds,
Is that for you and me, who are growing old.
It is better to say “I’m fine” with a grin,
Than to let people know the shape we are in.

(Source unknown)


Gone Surfing

April 8, 2011

I was busily rinsing out my hair sinuses with shampoo this morning (please don’t ask why) when I heard the doorbell ring. Quickly wiping away any telltale bubbles from my face, I rushed downstairs to answer the door only to be greeted by our cheery postman who was waiting patiently to thrust a parcel into my hands. Thinking it was probably another parcel for yer man, I accepted the package, thanked the postman and shut the door. To my surprise and delight, I then discovered that the parcel was actually addressed to me! Hoping there might be some chocolates inside, I ripped it open only to find that it contained a box of this. Darn! :-(

I’ve no idea who sent me this present* as there was no enclosed note – the only clue is a Royal Mail sticker?

So… if you are the mystery benefactor and you happen to read this…. damn you! THANK YOU VERY MUCH! I’m off to practice surfing now.

* SinuSurf surfactant is an easy to use water soluble product that facilitates deeper cleansing and helps remove excess mucus and dried crusts out of nasal passages when mixed with a buffered isotonic saline solution.


Blowing Bubbles

March 23, 2011

Just home from Nottingham following another trip to see the surgeon. The outcome wasn’t quite what I’d expected but if it results in the avoidance of further surgery, I welcome it with open arms…

Those of you who follow this blog will remember that I underwent a graft procedure last year having developed post-operative complications following previous surgery on my head. The graft healed well but the donor site for the graft (upper part of nasal septum) has failed to heal and despite regular medical supervision over the past year, using conventional treatment options, I’m still in trouble. Hence I was referred back to the specialist unit in Nottingham for further assessment.

The surgeon had a good look around the inside of my head yesterday using a flexible endoscope and local anaesthetic. Once nasal debridement had been achieved on the affected side, pictures were taken for comparison with previous records. I was then shown the recording with a step-by-step commentary from the surgeon, outlining the nature of the problem.

While my underlying connective tissue disorder (EDS) is a contributory factor, the surgeon suspects that resistant bacteria are the main cause of my failure to heal. Apparently, with a long history of chronic sinus infection, surgery, MRSA, osteomyelitis and long-term antibiotic use, I’m a prime candidate for bacterial biofilm formation… huh?

In other words… the mucosal lining of my head is banjaxed and I can’t shift thickened mucus (snot!) without some extra help. The solution to this problem… wait for it… is to use baby shampoo to rinse out my head!

I thought the surgeon was having me on but no, he was absolutely serious. Baby shampoo when used in nasal irrigations, has been shown to serve as an antimicrobial agent and works to affect mucus properties and promote secretion clearance. I bet you never thought you’d hear that about a baby product!

I’ve been prescribed a 6-week course of twice daily sinus rinse-outs using a well-known baby shampoo at 1% dilution in a commercial saline solution, as an adjuvant therapy to a combination of other conventional medications.

And so… if you see me frothing at the mouth, with bubbles emanating from my nose and ears… you know why!



A good day?

March 10, 2011

I like it…

On Tuesday, Olivia O’Leary shared some thoughts on International Women’s Day.

Then yesterday, our new Taoiseach, Enda Kenny revealed his new Cabinet.

And, guess what?…

The Labour deputy leader, Moan Joan Burton, the party’s Finance spokesperson for the past nine years, did not get the portfolio with responsibility for public sector reform, for which she had been widely tipped. Instead, she was given Social Protection.

Also… two prominent female Labour TD’s, Roisín Shortall and Jan O’Sullivan were not promoted.

Add to that… there are fewer women in this new Cabinet than in the outgoing government.

Progress… eh?

As far as I can see, the only concession made was that a woman was appointed to the position of Attorney General…

Labour’s Máire Whelan, is the first woman to occupy the post of legal adviser to the government. Hur…ray!

Apart from all that, the good news is… this new coalition government has promised major health reform. The new Minister for Health, Dr James Reilly, is committed to developing a new universal health insurance (UHI) system which aims to end 2-tier healthcare and give everyone equal access to GP and hospital treatment based solely on medical need.

Bring it on!


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