New Alzheimer’s Discovery: Using Ultrasound Waves to Improve Memory

Alzheimer’s might be the second most feared disease behind cancer. Most of us, even those outside the medical profession, have come into contact with someone suffering from this illness. Alzheimer’s affects 50 million people worldwide.

Australian researchers have come up with a potential treatment using ultrasound to break down the amyloid plaques that form between neurons.

This ultrasound technique uses sound waves, but alters the frequency that they’re delivered at, to open up the blood brain barrier. This barrier protects the brain against against things that could kill it– like bacteria.

In this case, opening up the blood brain barrier stimulates waste-removal cells, called microglila cells, to begin clearing out these plaques.

Now, this has only been tested in mice but researchers state that 75% of these mice had fully restored memory function and no brain damage to surrounding tissue.

The team hopes to conduct human trials by 2017.

You can read more in-depth about this medical discovery here.

Using Polio to Kill Brain Cancer

Rarely, am I super impressed with medical discoveries.

I can’t say that for this piece I just saw on the news magazine 60 Minutes.

Cancer treatment has gone through various stages. First surgery. Then came the advent of radiation therapy followed by chemotherapy.

But now, the newest frontier in the fight against cancer is your body’s own immune system which makes the most sense, right? If we could train the immune system to seek and destroy cancer cells like it does bacteria and viruses then whole hosts of people wouldn’t have to face death related to this, often times, devastating diagnosis.

I’ve blogged here about the use of the measles virus in treatment of cancer.

Now, researchers at Duke University are using a genetically modified polio virus to kill brain cancer . . . and it’s working.

Glioblastoma is a particularly aggressive, nasty brain tumor. As stated in the piece, it’s usual for this cancer to double its size in 2-4 weeks.

What I learned about cancer cells in this piece that I didn’t know before is that they are smart. I remember learning in my pathophysiology class in college that cancer cells were merely your own cells running amok– dividing uncontrollably and invading normal functioning tissue. Perhaps this is why our own immune systems don’t attack it as the potential killer that it is– because it is our own cells.

The doctors at Duke University are attempting to change this. They took a small group of patients who had glioblastoma for the second time. These patients had already been through standard therapy at it failed.

They surgically implanted a catheter into the center of the tumor and then gave the patient an infusion of modified polio virus directly into the tumor.

What happens is two things. One, the body recognizes the polio and begins to attack it. Second, the virus seems to also strip the protective coating of the cancer cells so the body recognizes it and begins to attack it as well. The body amounts an impressive immune response and MRI’s initially show massive inflammation around the tumor, but then, over a period of 4-8 months, the body’s immune system begins breaking down the tumor.

Two patients who received this treatment first are now cancer free for nearly three years. That is unheard of with this kind of brain tumor. I mean– it is miraculous.

After the researchers had success with the first several patients, they attempted to double the dose to see if they could get a better immune response. In fact, they did get a massive immune response but it proved to be too much for the patients and several of them died.

Now, they are using smaller doses and it remains to be seen if this is a cure but it’s so promising that in a year, the FDA may cut their red tape to make it available to lots more patients.

Truly, truly impressive. I mean for us medical nerds– it is jaw dropping.

Now, of course, there is always worry that modifying viruses could lead to potential breakouts of untreatable illness. That’s definitely fodder for any medical thriller.

But today, let’s bask in the glory of this amazing discovery and what it could mean for patients who receive this deadly diagnosis.

For more information on this study you can view the piece here.

Up and Coming

Hello Redwood’s Fans!

Happy Easter to you! Today, is my second favorite holiday right behind Christmas. It’s the day Christians celebrate the resurrection of Jesus. Have you thought about that? Ever? Really, thought about it?

To me, Easter is mind blowing. There are few people in this world that I would willingly lay my life down for. I mean, I could probably count them on one hand.

Yet, Jesus, willingly gave up his life for everyone. Even evil people– I mean serial killer types.

One of my most favorite blog posts was written about Easter. About substitution. You can read it here and I hope that among the Easter egg hunts and Sunday brunches you can ponder about how Easter came to be and what it means for you.

For you this week it’s a week of amazing medical discoveries. I depend on interesting medical breakthroughs for my novels. I like to think of the next possible step– usually a harrowing step for humanity– and I think we always have to imagine what medical breakthrough could cause potential harm. However, this week we’re celebrating new medical discoveries.

Tuesday: Using polio to kill brain cancer. It’s true. This is amazing.

Thursday. Ultrasound and Alzheimer’s. How could one help the other?

Have a blessed week.

Jordyn

Nine Reasons You’re Waiting in the ER

I thought I’d do a few posts on life in the ER. What’s it really like behind the scenes and provide some explanations on those things we can’t really say to patients but might be an explanation of why things are not moving as expediently as patients, parents and families would like. 
So, exactly why are ER wait times so long in some cases? 
1. Patient Load. Keep in mind there are only so many rooms in the ER and we can’t stop people from walking in. This is unlike EVERY other unit in the hospital that can close their doors and keep patients out. A ward unit or an ICU can say– we can’t take any more patients.

An ER is not like this. Sure, we can stop ambulances from coming. This is called going on diversion (and hospital administrators really hate that because it’s medical dollars going to another facility.) However, the ER must at least address every patient that walks through the door. 

It’s easy for an ER to become overwhelmed. Sometimes, this is seasonal like in the winter when the flu virus hits. When patients outnumber the staff and beds then ER wait times are going to go up.
2. The acuity is high. Acuity is how sick the patients are. The higher the acuity– the more sick. At times, there are few patients but those that are there are quite ill. The sicker the patients are, the more time it takes for the doctor to evaluate them and develop a game plan. The doctor may have to be at the bedside longer than normal to help stabilize the patient. More nurses are likely to be in that patient’s room doing multiple procedures to bring them back from the brink. This will create a back log for the other patients in the department.
3. A slow doctor. In all honesty, some people just don’t work as hard as others. Some doctors are very quick and efficient. Others, not so much. If the department is full, but the nurses are all sitting at the desk– this could likely be the problem. The nurses are waiting for the doctor to write orders, or develop a medical game plan, or give them an idea of how long the patient will be observed for. 
4. A slow nurse. Nurses can be the same. Just slow. Or, they have a heavy assignment and are working the best they can to get through their doctor’s orders.
5. A Code Blue. Most things will come to a halt when there is a code blue. All resources will be needed for that one patient. Radiology. Pharmacy. Lab. All hands on deck. One code blue is going to set the whole department back because that patient takes up a lot of staff and resources. It takes time to recover from those events. Also, the ER is generally responsible for sending a couple of their team members to code events that happen outside the ER which decreases the staff able to help in the ER.
6. Staffing shortages. It’s usual these days to be short staffed. That coupled with a heavy patient load is going to increase wait times. 
7. Emergency care doesn’t mean expedient care. Illness doesn’t cure in an hour. Our true goal is to find the one thing that might kill you in the next 24 hours. I know the goal of all patients, regardless of complaint, is to be out and completely well of their illness in under an hour. This is not a reality, even for the most minor illnesses. It takes time to evaluate a medical condition. Do you have this same expectation when your car is getting fixed? Often times, medical conditions can be kind of dicey to sort out so we’ll hold patients to watch and see how things develop. This is for your safety . . . not to irritate you.

8. Slow specialty response. If your care hinges on hearing back from the expertise of a consulting physician– then everyone is waiting. Us. You. Everyone.

9. Overwhelmed support services. Support services like lab, radiology and pharmacy aren’t just accountable to the ER but to the whole hospital– including outpatient services. So, if they’re overwhelmed, it will cause delays in the ER. There can be other critical patients than those just in the ED.

Hopefully, this gives some insight into why your ER wait time may be more than you’d like it to be. Although the current culture has equated emergency room care with expedient care, our goal is to treat the sickest patients first. 

Maybe consider waiting a gift. It means you’re likely not going to die today. 

Miracle or Experience?

I can’t tell you how many times a day I run into parents at the hospital who don’t believe what I tell them in triage. Now, as a nurse I can’t diagnose an illness but when I try to relay their fears– I often get the quizzical one eyebrow raise.

This happens a lot with abdominal pain. Abdominal pain in kids is most often constipation and it fits a pretty consistent pattern. Most parents who present with their children to the ER for abdominal pain think their child has appendicitis. That also fits a fairly consistent pain pattern. This is not to say you can put ALL kids into one of these two camps (because sometimes kids actually have both or one presenting like the other) but you can reassure parents who feel like the next step for their child is the OR by saying something like:

“This could be appendicitis but based on my experience, your child’s symptoms fit more into a constipation issue. You’ll get a doctor’s exam and they’ll diagnose you but you will not be going to the OR in say . . . the next ten minutes.”

And then I get that knowing eye roll that says . . . “Well, why believe her. She’s just the nurse.”

And nine times out of ten do you know what the discharge diagnosis is? Constipation.

It’s not rocket science. I don’t have a crystal ball. But what I have is nearly twenty-two years in nursing . . . almost twenty years in pediatric ER and critical care. What that says is I’ve seen, literally, thousands of kids present with abdominal pain. I know the classic signs of constipation. I also know the classic signs of appendicitis. They do present differently. I can educate (this is a nurse’s job) on the signs and symptoms of these two illnesses and what the doctor will likely choose to do– to prepare the family for what they face.

After an ER shift, I got home and the first thing my husband says is, “Harley let out the weirdest yelp when he was just lying down. We have no idea what it was about.”

Harley is our dog. Harley has pretty bad hip dysplasia so it’s not unusual for him to tweak a hip if he’s been moving but in this instance he hadn’t which raised my husband’s suspicion.

I call Harley over and immediately notice blood in his fur near his neck. Now, it wasn’t a lot of blood and my husband hadn’t noticed it. Why did I? Because I see blood every day and am in tune to noticing even the smallest amounts of it.

I comb through his coat with my fingers and there isn’t a cut underneath. How else would a dog get blood on his coat in that area? We’re used to asking ourselves this with kids– because kids may not always be developmentally able or willing to tell us.

Which led me to think that he’d scratched himself and the blood came from a paw. Then I see droplets of blood on the floor– like when we accidentally cut his toenail too close. Yes, I had done this myself.

I see one of his toes looks bloody.

“Where was he laying?”

My husband points to the spot and I see a full-length toe nail on the carpet. He’d been scratching himself and caught the nail in his chain collar which ripped it fully off.

Mystery solved in under five minutes. My husband was somewhat baffled.

Not me. It’s not a miracle. It’s my experience in injury mechanism that I practice every day.

This is how it can be for your medical characters. Have them use their experience in other situations to make them come to life in your novels. They don’t just have to stay in the hospital.

Winner!!

A quick note to announce the winner of Bethany Macnanus’s e-book Nerve . . .

Congratulations Mattie P!

Hope you enjoy the novel and thanks so much to Bethany for your insight into genetic analysis and how it inspired your story. Can’t wait to read it myself.

Up and Coming

Hello Redwood’s Fans!

How has your week been? Mine? Feeling a little overwhelmed lately. My writing life is gearing up in a good way but trying to fit all that in with working part-time is anxiety producing. Any other author in that boat with me?

Colorado is in what a good friend of mine calls “the teasin’ season” when she can’t really decide if it’s still winter or spring. One day this week, we had a few inches of snow and then by evening it was sunny and all melted. Anyone else live in a state like this?

For you this week I thought I’d give you a glimpse into what really happens behind the scenes in the ER.

Tuesday: Are ER nurses smart about medical things?

Thursday: Just why can ER wait times be sooo long?

Tune in and find out.

Have a GREAT week.

Jordyn

Can Peanut Allergies Be Cured?

There are few things that make me nervous in the ER anymore. After spending twenty plus years in nursing, I’ve seen and handled most everything.

One exception is peanut allergies. When a patient signs in with that complaint it is emergent because of the concern of anaphylaxis which I posted about here. There is a point of no return when it comes to an allergic reaction where the patient will die despite all efforts. 
The other question becomes just how do we protect these children? An Epi-pen should be kept with these children at all times. For one, some parents won’t do this. Also, parents are uncomfortable giving these injections. 
Another reaction is to create a peanut-free environment. In reality, I don’t know how feasible this is. Peanuts and peanut products are prolific and I feel like this gives parents a false sense of security. 
Recently, researchers developed a study to see if they could inhibit the body’s response in a peanut allergy. They gave small but increasing amounts of peanut protein along with a probiotic every day for eighteen months. The test group was split in half with half of the participants receiving a placebo that looked and smelled like the treatment. On the last day of the study, the participants were given a double dose of peanut protein with the probiotic. Twenty-six of the twenty-nine children didn’t have an allergic reaction whereas only two of twenty-eight in the placebo group demonstrated the same.
Of this group on non-reactors, after a two-five week period of being peanut free, they were retested and twenty-three of twenty-five still had no reaction.
Over time, it is possible for the body to build up tolerance but this method has been found to be twenty-times more effective.
The next step is to see how long this effect will last. Will it be a cure?
It might be too early to tell but it might well be a very good step in the right direction. 
Would you try this for your child if they had a peanut allergy?

Allergic Reaction: Dianna Benson

I always love it when friend and author Dianna Benson stops by! Dianna is a talented writer and has two treats for you today– a new novel, Persephone’s Fugitive, is releasing. I was blessed to have the opportunity to read and endorse this novel. Two, she is giving a factually based fictional account of an EMS call dealing with a severe allergic reaction called anaphylaxis.

Welcome back, Dianna!

“EMS 6, allergic reaction, at 123 Main Street.”

At 7:40 Christmas night, my partner and I flip on the lights and sirens and race our ambulance toward 123 Main Street. En route, my partner reads off details of our dispatched call on our dashboard laptop.

“Twenty-year-old female. Respiratory arrest.”

I grab the radio. “This is EMS 6, requesting assistance on our anaphylaxis call. Copy?”

“Copy EMS 6. FD 14 is en route.”
    
Once we roll up on scene, several people wave us into the two-story home, their faces contorted in panic. As we hear sirens from an approaching fire truck, we rush our loaded stretcher inside the front door and toward the young lifeless body lying on the tiled kitchen floor, cyanosis around her lips.

I notice our patient’s chest is motionless, and I don’t feel or hear any air moving out of her mouth or nose.

“What is her name?” I ask no one in particular in the crowd of about a dozen surrounding us.

“Ally,” several voices answer.

“Ally?” I rub my knuckles over her sternum.

“Unresponsive,” I inform my partner, who’s yanking out a BVM (bag-valve mask), other airway equipment, and the med box.

I feel for a carotid pulse on her flushed neck. “Rapid and weak,” I say to my partner. We share a look of understanding—our patient is headed for cardiac arrest. Our interventions must be quick and efficient.

“What happened here?” I again ask the room full of people as I press the mask over my patient’s mouth and nose with my left hand in the E/C formation. With my right, I squeeze the football-sized bag every five seconds to oxygenate the young woman’s system. Her chest rises and falls with every squeeze, indicating her airway isn’t blocked by swelling or any foreign object.

“She was eating and started coughing, and said her chest is all tight,” a hysterical woman answered, suddenly kneeling next to me. “She was itchy all over, had trouble breathing, hives on her back.” 

I face the middle-aged woman, tears flowing out of her eyes and down her cheeks. “Are you her mother?”    

“Yes. She was severely allergic to peanuts when she was little but out grew it or whatever.”

As I continue bagging, my partner pushes epinephrine IM (intermuscular) then inserts an IV into our patient’s left arm for med access and fluid replacement. A fire crew of four men darts into the house.

Without an exchange of words, I hand one of the firefighters the BVM, and two of them take over bagging. One presses a tight seal over the mouth and nose, the other squeezes the bag.
   

“Hand me our monitor,” I ask the firefighter closest to our cardiac monitor. He and the fourth guy assist me in hooking up a twelve led ECG to our patient’s four limbs and chest.

I study the monitor for our patient’s vital signs, looking for indications of imminent anaphylactic shock and cardiac arrest. “BP 80/52. Pulse 134. SPO2 86%. Normal sinus heart rhythm.”

“Uh-huh,” my partner says, letting me know he heard my report of the grave vital signs.

I hand him diphenhydramine and methylprednisolone to administer into the IV line.

“Does Ally have any medical conditions or take any medications for anything?” I ask the mother.

“No. Nothing.” 

We add Benadryl to the line then attach a little bag of Pepcid to the IV set up. Following up with those meds, we add Solu-medrol.

In scanning the kitchen, I spot several whole pies ready to be served, remnants of T-Bone steaks and empty lobster tails on multiple dirty plates. “Did she eat any nuts tonight?” I ask the mother to keep her occupied.  

“Nothing any of us ate tonight contains nuts.” The mother points over her shoulder. “We haven’t eaten any pie yet, but none of them has nuts.”
     
“Has she ever eaten lobster before tonight?” I ask while digging into our airway bag.
 
“Once. Couple of months ago and loved it.”

“It was probably the lobster. The second encounter with an allergen is when an allergic reaction occurs.” I turn to my partner. “Let’s intubate.”

“Uh-huh.”

I’m readying the intubation equipment when Ally jerks to a conscious state, coughing and rolling on to her side, shoving the mask away from her face.

“Guess she didn’t want to be intubated,” one firefighter whispers near my ear, not out of humor but relief, a feeling I share. 

“Ally? Hi.” I grab a non-rebreather mask. “You suffered a severe allergic reaction. You need oxygen.”

She nods, rolling to lie on her back again. Her mother squeezes her hand, pats her forearm.

“Bummer, I know, but we gotta take you to the hospital to be monitored overnight.” After turning the portable O2 tank on to 15 liters per minute, I strap the non-rebreather to Ally’s face. “Just breathe normally and relax. You’re doing fine. We’ve got you, Ally.” I smile at her.

The firefighters lift her weak body onto our stretcher; I study the monitor. “BP 96/60. Pulse 118. SPO2 92%,” I say to my partner.

“That’s what I want to hear,” he responds in a relief matching my wide smile.

You can read more posts done on allergic reactions/anaphylaxis here, here, and here.


*********************************************************************

Dianna T. Benson is the award-winning and international bestselling author of The Hidden Son and Final Trimester. Persephone’s Fugitive is her third release. An EMT and a HazMat and FEMA Operative since 2005, Dianna authentically implements her medical and rescue experience and knowledge into all her suspense novels. She lives in North Carolina with her husband and their three children. www.diannatbenson.com


Up and Coming

Hello Redwood’s Fans!

Are you enjoying the warmer weather? I must say, it is nice to be out of the bitter cold but I’m one in the minority that is a little sad to see winter leave. I’m not a big fan of bright sun and hot days so you can find me holed up inside in a dark, air conditioned room.

But I’m happy for the rest of you!

For you this week we’re focusing on allergic reactions.

Tuesday: Friend and author Dianna Benson stops by with a factually based fictional account on how to treat the most severe form of allergic reaction called anaphylaxis. Dianna’s new book, Persephone’s Fugitive, is releasing so I hope you’ll check it out!

Thursday: Can peanut allergies be cured? Some interesting research in this area that could prove to eliminate this dreaded allergy.

Have a great week!

Jordyn