Influenza: check your pulse!

This year influenza is bad. My key test in influenza is not a chest x-ray. It is taking a resting pulse and a walking pulse.

Why? Influenza can cause a walking pneumonia. Walking pneumonia is where the lungs are infected throughout and there is tissue swelling. It is different from a lobar pneumonia. In lobar pneumonia people run a higher fever, look sicker, and on the chest x-ray, that part of the lung is white: infection, not air.

In walking pneumonia, the chest x-ray may be read as normal. This is because all the lung tissue is equally swollen. The swelling means that there is less air space. The person may feel ok at rest. They feel exhausted when they walk because the heart must take up the slack for the missing air space, the swollen lungs. At rest this week one person’s heart rate is 84. After walking it is 124. Normal is 60-100, so 124 is like running a marathon: exhausting and hard on your heart and body.

I have patients saying “I was sick two weeks ago and I am still exhausted.” If their pulse is much over 100 after they walk, they cannot work until it comes down. If they work and wear themselves out, the lungs can’t heal. The treatment is rest. If they are at work with a pulse of 114 or 124, then they risk getting a secondary infection in already damaged lungs. They could die.

Check your pulse at home. Count the number of heartbeats in 60 seconds. That is your pulse. Walk around, sit down, and check again. That is the walking pulse. Over 100 is not normal.

This is a bad influenza. The tamiflu (oseltamivir) helps but works best in the first three days of flu. Check your pulse, be seen, rest and get well.

http://www.peninsuladailynews.com/news/three-die-of-flu-on-peninsula-public-helath-officals-say-a-fourth-death-said-to-have-been-in-seattle/

cracks

For the Ragtag Daily Prompt: fault.

I realized last night that I had not put up the prompt, and got back up to do it. My daughter called while I was thinking and told me about segmentation faults. I wrote the poem this morning.

cracks

people talk about me

whisper gossip
social skills aren’t right

they only see now

I had to grow in cracks
hold on tightly
find nourishment where I could
not fall
survive

if they could see my roots
if they could see
where I had to grow
no choice

maybe they would be kinder

yep, yep, yep

My daughter and two friends and schoolmates at Mount Saint Helens at the end of eighth grade. And what do you think is happening? Present, facing the speaker, yep, it’s a teacher going over the rules. Let’s get on with it. We know the rules. Face forward, mind might be elsewhere.

Setting up camp.

picnic table in the woods with containers to set up camp
Group camp at St. Helen’s
shelters tied over tents for rain protection.
rain preparation
Teachers and annoying parent chaperones with cameras
Teachers and annoying parent chaperones with cameras
8th grade audience at park
audience for each other
Seven 8th grade girls performing a song they made up.
group song

All taken in 2012 on the end of the year 8th grade trip to Mount St. Helens, to get the students together before starting high school. Huge thanks again to the teachers, the parents and the teens too.

Mount St Helen's
Mount St Helens

mother and child

I have a collection of parent and children pictures and sculptures. This is one. A mother ox and her baby. I was born in the Chinese Year of the Ox and so was my daughter. This little sculpture is about 3 by 2 inches, but both my daughter and I love it.

I am so proud of everyone who stood up for children yesterday, and for everyone who is saying, if it was MY child, I would want someone to stand up for them and for me.

Blessing and bring the children back to their parents.

teens high risk for addiction

What teens are at high risk for addiction?

Would you say inner city, poor, abused, homeless?

This study : Adolescents from upper middle class communities: Substance misuse and addiction across early adulthood. which I first saw in WebMd, says that the privileged upper middle and rich children are at higher risk  for addiction than many of their peers.

350+ teens in New England were studied.

Drug and alcohol use was higher than across country norms, including inner city.

Rates of addiction diagnosis by age 26 were
19%-24% for girls
23%-40% for boys
These rates are two to three times the norms across the country.

Rates for addiction diagnosis by age 22 were
11%-16% for girls
19%-27% for boys
These rates are close to the same in girls, but twice as high in boys as peers across the country.

The teens were often popular high achievers who are A students. Parents tended to drink more in those cohorts than the norms.

Also: “Findings also showed the protective power of parents’ containment (anticipated stringency of repercussions for substance use) at age 18; this was inversely associated with frequency of drunkenness and marijuana and stimulant use in adulthood.” That is, parents who sent a clear message that consequences for illegal and underage substance use including alcohol and marijuana would be serious, provided protection for their teens.

A second article: Children of the Affluent: Challenges to Well-Being says this:

“Results also revealed the surprising unique significance of children’s eating dinner with at least one parent on most nights. Even after the other six parenting dimensions (including emotional closeness both to mothers and to fathers) were taken into account, this simple family routine was linked not only to children’s self-reported adjustment, but also to their performance at school. Striking, too, were the similarities of links involving family dining among families ostensibly easily able to arrange for shared leisure time and those who had to cope with the sundry exigencies of everyday life in poverty.”

Other children’s perception of parenting examined included:

felt closeness to mothers
felt closeness to fathers
parental values emphasizing integrity
regularity of eating dinner with parents
parental criticism
lack of after-school supervision
parental expectations

This aligns with my observations both in my town and with patients. I see parents “check out” sometimes when their children are in their teens. “I can’t control him/her. They are going to use drugs and alcohol.” I told my children that if they partied I would NOT be the parent who says, “Oh, he needs to play football anyhow.” I would be the parent who would be yelling “Throw the book at him/her. Bench them.” And I saw parents of teens going out to the parking lot to smoke marijuana at a church fundraiser when it was still illegal. And saying “Oh, our kids don’t know.” I thought, “Your kids are not that dumb.” They invited me along. I said, “No.” And I really lost respect for that group of parents. What example and message are they sending to their teens? Yeah, cool, do illegal things in the parking lot, nod, nod, wink, wink.

Meanwhile, my children keep me honest. “You are speeding, mom.”

“Yeah,” I say. “You are right. Sometimes I do.” And I slow down.

burnt

This is for photrablogger’s Mundane Monday #129.

We were two of the three first responders to a house fire across the street and two doors down two weekends ago. The house was an inferno when we got there. Both the resident and two cats got out. The fire was in the morning. We returned in the evening and walked around. It is terrifying to see what melts, what explodes, how fast the destruction can happen.

And sending love to the injured and lost in Las Vegas and still thinking of all of the hurricane victims.

I wish today were mundane.