The Bishop and the Butterfly: Murder, Politics, and the End of the Jazz Age
    cmaukonen's picture

    My Mom passed away this morning

    By cmaukonen on Thu, 12/06/2012 - 11:43am |

    She did not die of cancer or a heart attack or a stroke. She did not have diabetes or any other disease. Some high BP but that is all. And she did not die of natural causes.

    NO she died from the most likely cause these days after entering a hospital. She died of a hospital acquired infection.

    Most likely CDIFF. She went in for a hip fracture. A common enough situation for an elderly person. But the out come has become far, far too common these days. As you can see from this piece from The Atlantic, you have a 1 in 17 chance of dying from an infection in a hospital.

    The Health and Human Services department's 2009 quality report to Congress found "very little progress" on eliminating hospital-acquired infections and called for "urgent attention" to address the shortcomings — first brought to light a decade ago.

     

    Of five major types of serious hospital-related infections, rates of illnesses increased for three, one showed no progress, and one showed a decline. As many as 98,000 people a year die from medical errors, and preventable infections — along with medication mixups— are a significant part of the problem. MSNBC


    And according to this report in WEBMD, the incidence of CDIFF is reaching epidemic proportions. And hospitals a loath to report this and that this particular bacteria has become more deadly and harder to treat each year.

    C. diff disease can range from mild diarrhea to life-threatening colitis. The bug produces toxins that destroy the mucosal lining of the gut.

     

    There are many different C. diff strains circulating in the U.S. But since 2000, one of these strains has gone from a minor player to become the most frequently isolated C. diff strain. The strain has several names. Referring to its genetic fingerprint, the CDC calls it NAP1. In Europe and Canada, it's often called the 027 or BI strain.

    The NAP1 strain of C. diff took off shortly after it acquired resistance to fluoroquinolone antibiotics. There's some evidence it may also have acquired some resistance to Flagyl, one of the two antimicrobial agents used to treat it (the other is vancomycin).

    Antibiotic resistance isn't the only worrisome thing about NAP1. C. diff normally makes two toxins. The NAP1 strain makes 16 times more toxin A and 23 times more toxin B. And it also makes another toxin, called binary toxin, although it's not yet clear how this toxin affects humans.

    To date, the NAP1 strain has been reported in 37 U.S. states and in the District of Columbia.

    A recent report shows that adult C. diff hospitalizations doubled between 2000 and 2005 to about 300,000 hospitalizations a year. That's more hospitalizations than are seen with MRSA, which sends about 126,000 Americans to the hospital each year.

    The CDC's C. diff expert, L. Clifford McDonald, MD, tells WebMD that if you count pediatric C. diff cases and cases in the community that do not enter the hospital, there are probably half a million U.S. cases of C. diff infection each year.

    And yes, it is an epidemic: The infection rate is going up by about 10% a year. But the death rate is going up even faster, says Marya Zilberberg, MD, adjunct professor at the University of Massachusetts, Amherst, and president of the EviMed Research Group. WEBMD


    And for my mother it was pure torture the entire time.

    14,000 Americans die every year from diarrhea-causing C. difficile (or C. diff for short) infections and 337,000 people are hospitalized, according to a new report by the Centers for Disease Control and Prevention. Unlike other healthcare-associated infections that have been on the decline over the past decade, C. diff infection rates and deaths climbed to historic highs and “pose threat across medical facilities,” adding at least $1 billion in extra costs to the health care system, said the CDC Director.

     

    The people most at risk are those who take antibiotics and also receive medical care in any setting. This could include a nursing home, hospital, doctor’s office, outpatient surgery center, etc. Those most at risk include people who have been in a hospital or other health care facility and have taken antibiotics in the past three months, especially those over age 65. About half of all antibiotics that patients are given are not needed, raising the risk of C. diff infections.

    That’s unacceptable. Everyone receiving medical care should be concerned about C. diff because the effects can be devastating and sudden.

    That was the case for Peggy Lillis, a public schoolteacher in Brooklyn. In April 2010, Peggy had routine dental surgery and took a common antibiotic to aid healing. Soon, however, she developed painful diarrhea. Peggy died of C. diff within just six days. Safe Patient Project.


    A horrendous way to die. And totally preventable. That anyone would have to undergo such mal-treatment and suffering is unconscionable. That an elderly person would wind up dying under such horrible conditions is outrageous ! Far too many doctors and specialist are completely incompetent, inexperienced and concerned only about their own fiscal bottom lines.

    A corrupt and uncaring health care system that is the very epitome of this corrupt and uncaring country.  !

    And the hospitals say nothing about this. Not one word. They do not tell you "Hey...you have a 1 in 17 chance of getting sicker here. And it could just kill you." The media will not touch it but it needs toi be shouted from the roof tops.

    I have myself experienced being sicker after a hospital stay of only 3 days. With all the symptoms of a mild (in comparison) CDIFF for at least a week after being discharge. And I was only there for some tests !

    People our heath care system is killing us ! In a most brutal and tortuous manner as well. We constantly harp about the insurance aspect while our for profit heath care is committing negligent homicide with complete impunity.

    This reason above all is why we need to completely nationalize it and make all health care professionals and facilities totally accountable for their actions and lack there of.

    http://www.news-medical.net/news/20100223/Hospital-acquired-infections-increase-mortality-rate-and-healthcare-costs.aspx

    http://www.hospitalcompare.hhs.gov/hospital-search.aspx

    http://news.consumerreports.org/health/2012/10/hospital-infections-among-medicare-patients-remain-unchanged.html

    Comments

    Cmaukonen, this a terrible tragedy. I'm so sorry for the loss of your mother. 

    -- Michael


    by Michael Wolraich on Thu, 12/06/2012 - 11:49am

    Total condolences; tho I lost my mom decades ago it still hurts.  


    by Ivan Ivanovich Renko (not verified) on Thu, 12/06/2012 - 12:01pm

    Chris, there are no words/platitudes I know that can truly ease your pain.  I am sorry for your loss and know to lose your Mother is devastating.  But, especially so I'm sure because of the circumstances/reason.

    I, as I'm sure others, do appreciate the information you have shared and hopefully, will serve to alert many and hopefully motivate us to become pro-active in addressing the horrific facts/conditions you cited. 

    My thoughts are with you and yours.  Take good care and if you feel it would help to talk just email. 


    by Aunt Sam on Thu, 12/06/2012 - 12:22pm

    I am real sorry for your loss.

    It is more than clear that you cared very much for your mother and that you feel powerless.

    Your research is flawless.

    And it is important that truth gets out!


    by Richard Day on Thu, 12/06/2012 - 1:17pm

    We all wish you the best, Cmaukonen.  Terrible that this happened.


    by Michael Maiello on Thu, 12/06/2012 - 1:20pm

    Very sorry for your loss. You're right to be angry at a medical system that has created and is perpetuating this plague. I understand that doctors and medical staff are under pressure and time constraints, but two simple practices could slash the number of C. diff cases:

    One, stop prescribing antibiotics every time a patient asks you to or you don't know what they've caught. You are just breeding better and more deadly bugs.

    Two, wash your damn hands every time you go from one patient or room to another. If you're a hospital administrator, don't pinch pennies by cutting back on cleaning staff. You may get away with it, but that is murder. 

    Right now in Quebec, we're having a debate over whether annual flu shots should be mandatory for hospital staff. People who don't see why they should are in the wrong line of work.

     


    by acanuck on Thu, 12/06/2012 - 1:57pm

    I just now noticed this story:

    http://www.cbc.ca/news/health/story/2012/12/06/hospital-outbreak-ndm1.html


    by acanuck on Thu, 12/06/2012 - 2:03pm

    Sincerest sympathy, Chris.  I understand your anger.  I lost both parents, a brother and a grandmother way too soon as a result of either medical errors or complete incompetence.  Not sure when they stopped practicing "First, do no harm" oath, if they ever actually did.  

     


    by EmmaZahn on Thu, 12/06/2012 - 2:36pm

    I'm so sorry, Chris.  What a terrible loss and how horrible to know it didn't have to happen.  Hospital cleanliness and individual hand-washing is such an easy remedy, it's infuriating to keep hearing that it's not being done.

    When I was in the hospital for a couple of days last month, I don't remember seeing anyone coming in to clean--not even to sweep the floor.  Nobody ever even made my bed, let alone change the sheets.  And this is a brand shiny new hospital proud of their state-of-the-art equipment.

    In some circles I might be considered elderly, but in that hospital it didn't seem to matter.  I hope you raise holy hell.  This has got to stop.  Again, I'm so, so sorry for your loss.

    Mona

     


    by Ramona on Thu, 12/06/2012 - 2:58pm

    My condolences on the passing of your mother.  My thoughts and prayers go out to you and your family.

    I know about infections and hospital caused infections too.   I came close to dying from an infection about a dozen years ago and since then have fought a number of times against recurring infections. It's an outrage that going to a hospital can make you sick or even kill you. 

     

     

     

     

     

     

     


    by MrSmith1 on Thu, 12/06/2012 - 2:59pm

    I'm really sorry for your loss.  Last year, my mother went in for a cosmetic laser treatment.  This was a superficial skin treatment - an outpatient procedure.  Somehow during the procedure, she contracted a bad staph infection.  This infection followed her for months and through numerous courses of antibiotics.  For a time she was only getting worse despite these treatments.  Thankfully, she eventually recovered, but the danger you describe here is very real.

    Again, I am so sorry for your loss.  Thank you for sharing this personal experience.


    by DF on Thu, 12/06/2012 - 3:19pm

    I'm so sorry, Chris. What a terrible loss.


    by Doctor Cleveland on Thu, 12/06/2012 - 3:20pm

    Condolences. I had an elderly Aunt die after months of (words cannot describe the details)....... after an elective operation. Another time, a Catholic Hospital seriously tried to gain family permission to operate on our late 80's Gram for a small 'breast tumor/lump' picked up at routine exam. Having some experience in hospitals, I weighed in on it, asking if they are nuts or just need business, watch it, she is more likely to die of the operation. It was never noted again. She lived past 100.

    USA Today had a good article on a new resistance, which can apparently be passed among different types od bacteria, Carbapenem-Resistant Enterobacteriaceae, or CRE:

    ...The bacteria, known as Carbapenem-Resistant Enterobacteriaceae, or CRE, are named for their ability to fight off carbapenem antibiotics -- the last line of defense in the medical toolbox. And so far, they've emerged almost exclusively in health care facilities, picking off the weakest of patients.

    The bacteria made headlines this summer after a CRE strain of Klebsiella pneumoniae battered the National Institutes of Health Clinical Center outside Washington, D.C. Seven died, including a 16-year-old boy. (Hospitals don't reveal victims' names in keeping with medical privacy rules.) But that case was neither the first nor the worst of the CRE attacks....

    The spread of CRE threatens to change the face of health care, crippling hospital units that specialize in treatments such as organ transplants and chemotherapy, which rely on the ability to control infections in patients with weak immune systems.

    If unchecked, "these (bacteria) are going to greatly impact the kind of surgeries (and) treatments we can have," Perencevich says. "We're entering the post-antibiotic era; that's a very big problem."...

    For 'elective' operations, get 2nd and 3rd opinions, and when possible delay treatment or try other therapy. If surgery is necessary, check the hospital's record if possible, and have someone else stay with you as much as you can, to ask questions about hand washing, infection control to all providers.

     


    by NCD on Thu, 12/06/2012 - 3:31pm

    These are really good points.  As I mentioned above, my mother's predicament was the result of elective, cosmetic surgery.  Her infection proved to be highly resistant to several of the most potent antibiotics.  She essentially lucked out with their last resort.

    The "post-antibiotic era" sounds scary because it is.  A truly post-antibiotic era would be like turning the clock back 100 years on medical treatment.  All effort would have to be poured into simply avoiding infection at all costs.  Many would die regardless of such efforts.


    by DF on Thu, 12/06/2012 - 4:50pm

    Very, very sorry this happened to your mother.

    It is all-too common and a real problem. Not just infections, but "simple" errors like giving patients the wrong medicine or not giving them the meds they need, even the ones they take regularly. A friend's father died from that error.

    Peter


    by Peter Schwartz on Thu, 12/06/2012 - 4:07pm

    Very sorry about your Mum. Go well, Chris.

     

    Q


    by Q (not verified) on Thu, 12/06/2012 - 4:44pm

    All condolences, CMAUKONEN.


    by A Guy Called LULU on Thu, 12/06/2012 - 5:08pm

    Thank you all for commenting.  And for the links that I was not aware of.

    This is a huge deal. Even among those I know who are not all that news and politically savvy, they are all aware of this situation. Even having personal experience.

    And yet it remains an elephant in the room that nobody wants to talk about.  But I fear this particular elephant will turn out to be a mastodon with a very bad attitude that will bite us in the ass.

    My mother was an RN for many years and worked public health. Of the many conversations I had with her I would bring up the subject of over population as one of the problems we had.

    She would then tell me not to worry about that. That nature would come up with a pathogen/disease that would wipe out half the population.

    I wonder if she was aware just how prophetic this may turn out to be.

    We keep expecting to have some magic bullet to fix these kinds of things. What happens when we run out of ammunition ?

     


    by cmaukonen on Thu, 12/06/2012 - 5:32pm

    Tragic. Sorry for your loss.


    by rmrd0000 on Thu, 12/06/2012 - 11:25pm

    Oh Chris,

    I am truly, truly saddened by this news of your loss.  My heart goes out to you and your family.  

    I have known you for quite a few years now through conversation on the net.  Your wit and wisdom is something I have come to value as part of my life.  Although I didn't know your mother in any other way I sort of did know her by knowing you. Such is the way it is with mothers and their sons.  You are a living tribute to your mother's good work in her lifetime.  With you she gave us all a lot and I for one am grateful and will hold her in fond memory.


    by LarryH on Fri, 12/07/2012 - 12:41am

    My sympathies Chris xoxo.

    Thank you for sharing this.

     

    A few years ago my mother was hospitalized.  She passed out in a store.  As it turned out the only thing wrong was that she was taking high blood pressure prescribed by her doctor but she did not have high blood pressure.  So her blood pressure became dangerously low.  It did not happen immediately.  She had been taking the medication for about 8 months and it put her in the hospital.  She had been diagnosed with a heart problem and the doctor automatically put her on high blood pressure medication.  I remember asking her why at the time and she told me 'he said I needed it'...


    by synchronicity on Fri, 12/07/2012 - 2:09am

    So very sorry, Chris.  What a tragedy.


    by AmericanDreamer on Fri, 12/07/2012 - 7:39am

    Sorry Cm, may her memory be a blessing.


    by Bruce Levine on Fri, 12/07/2012 - 8:15am

    My deepest sympathies for your loss.


    by William K. Wolfrum on Fri, 12/07/2012 - 9:10am

    A corrupt and uncaring health care system that is the very epitome of this corrupt and uncaring country.  !

    And the hospitals say nothing about this. Not one word. They do not tell you "Hey...you have a 1 in 17 chance of getting sicker here. And it could just kill you." The media will not touch it but it needs toi be shouted from the roof tops.

    The thing here is that these people have no sense of responsibility. If responsibility is ever mentioned, it's a projection on to the patient.

    Perhaps if hospitals were more regulated and accountable to the public, we would have better results. Maybe. There is something seriously wrong right now - it's as if this isn't even being discussed very much. I was surprised to see this post here. It may be that people don't really talk about this until it's too late.


    by Orion on Fri, 12/07/2012 - 12:01pm

    Oh, Chris! I am so sorry-and so angry- at this news. I missed this thread until I got the chat room email. Couldn't log in there ( and will seek guidance momentarily from LisB, chatroom guru) but I did not want this news to go unremarked. C.Diff has become a monster. It is so susceptible of prevention yet so ubiquitous! That your mother was an RN and still fell victim is blood chilling in its implications. I am so sad for you and your family...

    by jollyroger on Fri, 12/07/2012 - 9:48pm

    This is a terrible story.  I am so very sorry for you.  


    by anna am on Fri, 12/07/2012 - 11:22pm

    Such sad news and just before Christmas.  I am so sorry.  I know you will miss her.


    by trkingmomoe on Sat, 12/08/2012 - 8:00am

    Yes I will and already do.

     

    Thanks momoe.


    by cmaukonen on Sat, 12/08/2012 - 11:49pm

    Oh Chris, what sad news. You and yours have all my sympathy.

    When this issue has been studied, hospital after hospital has discovered that vigilant handwashing solves many of these problems. (Surprise!) It's not rocket science. So sad. 

    Thinking of you at this difficult time.

    When you recover from the shock and sadness, there is work to be done on this issue. I suppose the good news is that as the "boomers" continue to age and realize that each hospital visit is a game of infection roulette, hospitals will get more serious about infection control and antibiotic conservation.

     

     


    by erica20 on Sat, 12/08/2012 - 12:45pm

    Well I sincerely hope so but I ain't holden my breath. wink

     

    I do intend to keep bringing this issue up however. Especially when ever any new information come out. Though I am sure the Hospital Association and the AMA would prefer it didn't.


    by cmaukonen on Sat, 12/08/2012 - 10:28pm

    There are forces at work in the medical system to effect change. Dr Mark Makary, a pancreatic transplant surgeon at Johns Hopkins, has written “Unaccountable: What Hospitals Won’t Tell You and How Transparency can Revolutionize Health Care”. Makary notes that approximately 30% of medical procedures are unnecessary. Publication of procedure rates and complication rates result in decreases in procedure rates without an adverse effect on patient outcomes. Some hospitals are publishing their outcomes already.

    Physicians are being reimbursed based on volume rather than quality. This has to change. Obama care has provisions that require reporting of quality outcomes to receive full reimbursement.  These are baby steps, but some progress is happening.

    Unfortunately, this did not help your mother. Again, you have my deepest sympathy.

     


    by rmrd0000 on Sun, 12/09/2012 - 12:31am

    I'm sorry for your loss.  As you said, C difficile and other hospital acquired infections are highly preventable and extremely unfortunate. 

     

    As a previously healthy 23 year old victim of C difficile who battled against this nasty bacteria for 6 months following antibiotic treatment for a dental infection, I can understand the frustration you face.  Although the increased rates of C difficile in North America can be attributed to a new and more virulent and highly resistant strain, it is evident that infection control in some areas is underfunded.  This along with the fact that many hospitals have outsourced their janitorial services, has resulted in increased and record high rates of nosocomial infections.  It is reported that Ontario has out-sourced approximately one third of their hospitals janitorial services and in British Columbia, the number is much higher.  Interestingly, the spike in C difficle infections correlates with the privatization of the cleaning services and I have read several testimonials of health care workers and janitorial staff who claim they have less materials to work with and more space to cover.  As a citizen who pays taxes, and as a victim, it angers me that a poor decision made by someone, probably based on cost-savings, to outsource an essential service may have resulted in lengthy life-threatning infections and many deaths that affects us all.

     


    by Anonymous (not verified) on Fri, 01/04/2013 - 6:32pm