Thursday, December 22, 2011
Modern day miracles...they really do happen.
Miracles...here's one in this modern day...
Sam Schmid, an Arizona college student believed to be brain dead and poised to be an organ donor, miraculously recovered just hours before doctors were considering taking him off life support.
Schmid, a junior and business major at the University of Arizona, was critically wounded in an Barrow Neurological Institute at St. Joseph's Medical Center in Phoenix, where specialists performed surgery for a life-threatening aneurysm.
As hospital officials began palliative care and broached the subject of organ donation with his family, Schmid began to respond, holding up two fingers on command. Today he is walking with the aid of a walker, and his speech, although slow, has improved.
Doctors say he will likely have a complete recovery. He even hopes to get a day pass from the hospital to celebrate the holidays with his large extended family.
"Nobody could ever give me a better Christmas present than this -- ever, ever, ever," said his mother, Susan Regan, who is vice-president of the insurance company Lovitt-Touche.
"I tell everyone, if they want to call it a modern-day miracle, this is a miracle," said Regan, 59, and a Catholic. "I have friends who are atheists who have called me and said, 'I am going back to church.'"
Schmid's doctor, renowned neurosurgeon Dr. Robert Spetzler, agreed that his recovery was miraculous.
"I am dumb-founded with his incredible recovery in such a short time," said Spetzler. "His recovery was really remarkable considering the extent of his lethal injuries."
Hospital officials are crediting Spetzler with having a "hunch" that despite an initially dire prognosis, the young man would make it. But he said it was "reasonable" for others to consider withdrawing the patient from life support.
"It looked like all the odds were stacked against him," said Spetzler, who has performed more than 6,000 such surgeries and trained the doctor who operated on Congressman Gabrielle Giffords after she was shot at the beginning of this year.
During surgery, Spetzler clipped the balloonlike aneurysm in the blood vessel -- "as if I were patching a tire," a procedure that eventually worked.
For days Schmid didn't seem to be responding, but what puzzled his doctor was that he did not see fatal injuries on the MRI scan. So he decided to keep Schmid on life support longer.
"There was plenty wrong -- he had a hemorrhage, an aneurysm and a stroke from the part of the aneurysm," Spetzler said. "But he didn't have a blood clot in the most vital part of his brain, which we know he can't recover from. And he didn't have a massive stroke that would predict no chance of a useful existence."
So while the family was given a realistic picture of Schmid's poor chances for survival, Spetzler ordered one more MRI to see if the critical areas of the brain had turned dark, indicating brain death.
"If not, we would hang on and keep him on support," he said. "But I didn't want to give the family false hope."
Schmid's mother said no one "specifically" asked if her son would be a donor, but they "subtly talk to you about quality of life."
"At some point, I knew we had to make some sort of decision, and I kept praying," said Regan.
The MRI came back with encouraging news during the day and by evening Schmid "inexplicably" followed the doctors' commands, holding up two fingers.
"It was like fireworks all going off at the same time," said Spetzler.
Today, Schmid -- his speech clear and sounding upbeat -- told ABCNews.com, "I feel fine. I'm in a wheelchair, but I am getting lots of help."
Sam Schmid Has No Memory of the Accident
He said he remembers nothing of the accident nor coming around after being in an induced coma. "It wasn't until I woke up in rehab," he said. "But they told me about afterwards."
Schmid was returning from coaching basketball at his former Catholic school when a van swerved into his lane. The Jeep in which he was riding went airborne, hit a light pole and landed on its side.
Schmid's left hand and both of his femurs broke and required surgery. But the worst were the traumatic head injuries, which were complex and nearly always fatal.
All those involved say the support that Schmid got from family and friends -- and especially the care at Barrow -- may have made the difference. His brother John, a 24-year-old IT specialist, took a leave of absence from his job in Chicago to be at his brother's bedside.
Family flew in from around the country, and Delta Chi fraternity brothers made regular visits, even creating a mural for their friend.
"It seems like we were being led down a path to plan for the worst and that things were not going to work out," said John Schmid. "The miracle, to put it bluntly, was that in a matter of seven days, we went from organ donation to rehab. What a roller coaster it was."
He said his brother's speech is slow, but he understands what others are saying. Sam Schmid's athleticism -- as a basketball coach and snowboard instructor -- probably helped, he said.
"Honestly, I am at a loss for words," said John Schmid. "I am just so proud of Sam. He's got a strong constitution and he's very determined. But it's been quite an eye-opener for me -- a real learning curve. You can't take anything for granted."
Sam Schmid's surgeon agrees.
"You get incredible highs when you save someone facing neurological devastation or death," said Spetzler. "That is counter-pointed by the incredible lows when you fail to help someone."
"In a way, his recovery was truly miraculous," he said. "It's a great Christmas story."
Ever the scientist, Spetzler wasn't willing to speculate what a comatose patient hears. But he admits, "There are so many things we don't understand about the brain and what happens at the time someone is near death."
"The whole family was at his side during the day and at night hovering over him, then to see there was a chance after being ready to let go," he said. "But I am very much a big believer that positive thoughts and positive energy in a room can only help."
Monday, November 28, 2011
The Holiday "giving" season
Well, I love it and hate it.
Just to blow off some steam, it really hacks me off to hear sob stories about people not being able to pay for the basic things in life. Just to name a few: Formula/milk, piano lessons for kids, tires for their car, insurance. We all feel bad for these people because they can't "afford", these things we feel are basic necessities. Rightly so! I feel bad and want to help. But on the other hand, I'm sick and tired of donating my own personal money to those who claim these things, and yet as it turns out, make more money than I do!
And then there are those families who are probably in the same "lower income" bracket as myself, complain, then on black Friday come home with 50 inch TVs.
Fiscal responsibility people! If you can't afford it, then DON'T BUY IT! Stupidity breeds stupidity. Save your child from this curse and be a good example by being responsible with the funds.
Freedom of speech! What do you think?
God Bless the United states...
Here's an article found on yahoo news... does she deserve 20 years in prison for this? ;)
A Kansas City teenager is receiving backlash for a comment she made against her state's governor on Twitter. Emma Sullivan was attending a Youth in Government event with her classmates listening as Governor Sam Brownback spoke, when she tweeted, "Just made mean comments at gov. brownback and told him he sucked, in person #heblowsalot." The 18-year-old Shawnee Mission East senior is now declining her school principal's request for her to write a formal letter of apology to Governor Brownback saying she "isn't sorry and doesn't think such a letter would be sincere." In reality, Sullivan did not actually make the comment she tweeted, and said she was "just joking with friends." However Governor Brownback's office, which monitors social media for any posting with the governor's name, saw Sullivan's tweet and contacted the Youth in Government program. What followed was a verbal scolding from Sullivan's principal, Karl R. Krawitz, who instructed Sullivan to write a letter of apology and also offered talking points for how the letter should be written. Sullivan has refused, and people on Twitter are responding. Before the incident, Sullivan had 65 followers, currently her following has increased to more than 6,500. She said that she feels her tweet has helped to "open up dialogue" about free speech in social media. Sullivan has not heard from Governor Brownback or his staff, but says she is not opposed to conversing with the governor directly.  Sullivan has also said, "it would be interesting to have a dialogue with him. I don't know if he would do it or not though. And I don't know that he would listen to what I have to say." Sullivan also admits that she disagrees with Brownback politically, partly because he vetoed the Kansas Arts Commission's entire budget--making Kansas the only state to eliminate its art funding. So what does Emma's mother have to say about this Twitter controversy? Julie Sullivan said she is not angry with her daughter, but she could have, "chosen different words." She also notes that "[Emma] was talking to 65 friends. And also it's the speech they use today. It's more attention grabbing. I raised my kids to be independent, to be strong, to be free thinkers. If she wants to tweet her opinion about Gov. Brownback, I say for her to go for it and I stand totally behind her." As for Emma, she's still waiting to see if there will be further action against her since she has refused to apologize.
On the other side of the world, Ampon Tangnoppakul, a 61-year-old truck driver from Thailand, was sentenced to 20 years in prison for sending cell phone text messages that were deemed insulting to the country's monarchy. The law imposes seemingly severe penalties for publicly or privately making insults or threats directed at King Bhumibol Adulyadej, 83, and his family.
Monday, October 24, 2011
Ostentatious
I once had an incident when I showed up for a Wednesday meeting in my scrubs because I had come directly from work and didn't want to take the extra time. Time included, driving home, changing, pulling the kids off me then driving back to the church. So, I came in scrubs. One of the quorum members pointed out in a joking manner how ostentatious I was being by coming in my scrubs. Both he and I know why it must be this way, especially for the time being (residency), where every ounce of time is very very precious. Precious because I only have a limited amount of it during each day, and every single minute of it is demanded in one way or another. Lest I go off on another tangent on how people abuse the time I give them, I will stere back.
So, I hate going out in the public in scrubs. You might as well pin a sign on me that says, "Here stands a mighty surgeon...or dentist". Though thoughts of putting on a jacket and stripping off my pants has crossed my mind, I think this idea (especially the latter) may pose a worse outcome.
It is the reality in which I live. There is only so much I can do. However, there are things which can be done. So, you doctors out there...take note on a few suggestions I have, off the top of my head...
1. Don't go to church in scrubs! This just gives the wives extra "I'm above all the other ladies becuase I married a super doctor-dude" (see #2). If you do wear them, then be ready to bust out the pen and prescription pad.
No one else comes in their overalls from the machine shop. Show some decency and go to work in a shirt and tie on the weekend, change in the hospital, then change back before going to church. Show some respect to the Lord. Put some effort into showing Him that you care enough to put some thought and effort into Sunday worship. You're there to worship Him, and not for people to worship you. Show the people at work where your heart is on the Sabbath day.
2. Write/Tell your wives a prescription of humility which strips them of their haughtiness and pride. They must think outside of their superiority "clicks". Ask more questions of others and not just be ready to talk about "themselves, and their latest up-do, fingernails, future ginormous home, etc." Challenge them to ask 5 questions to another woman who is not married to a doctor. Amazing how interesting people are other than YOU!
3. Doctors recieve a lot of respect and attention. Rightly so! They sacrifice heavily, and spend a lot of time to become such. However, they put their pants on one leg at a time just like everyone else. Where they are superior in some ways, they still lack in others. You can be the smartest man alive, and yet a fool at the same time.
Tuesday, July 26, 2011
The great Mayo Clinic...
Even the great Mayo clinic is not an exception when it comes to misinformation screw ups.http://www.mayoclinic.com/health/tinnitus/DS00365/DSECTION=causes
Here they have listed the anti-cancer agent called Bleomycin listed under "Antibiotics that cause Tinnitus (ringing in ears).
Dang! thats one potent "antibiotic". Please don't give that one to me!
Monday, July 11, 2011
Woman shot...probably republican fault :)
San Diego Woman Shot in Head
Linda Burnett, 23, a resident of San Diego, was visiting her in-laws and while there went to a nearby supermarket to pick up some groceries.
Later, her husband noticed her sitting in her car in the driveway with the windows rolled up and with her eyes closed,
with both hands behind the back of her head. He became concerned and walked over to the car.
He noticed that Linda's eyes were now open and she looked very strange. He asked her if she was okay, and Linda replied that she had been
shot in the back of the head and had been holding her brains in for over an hour.
The husband called the paramedics, who broke into the car because the doors were locked and Linda refused to remove her hands from her head.
When they finally got in, they found that Linda had a wad of bread dough on the back of her head.
A Pillsbury biscuit canister had exploded from the heat, making a loud noise that sounded like a gunshot, and the wad of dough hit her in
the back of her head. When she reached back to find out what it was, she felt the dough and thought it was her brains.
She initially passed out, but quickly recovered.
Linda is blonde, a Democrat and an Obama supporter, but that could all be a coincidence.
The defective biscuit canister was analyzed and it was determined to be Bush's fault.
Of course it was Bush's fault! Dang capitalism! If she hadn't gone to the grocery store to buy the biscuits, and instead only had one loaf of bread to choose from like every other decent socialized country, she wouldn't have this terrible and emotionally disturbing incident! Plus, she probably pumped tons of CO2 into the environment from hyperventilation! How awful! Poor woman, she should be given social security, medicaid, medicare, food stamps, government housing and whatever else she needs for the emotional damages she has received from living in this horrible and corrupted capitalized country! Hmm, was it hot enough to bake the dough? I'll have some. ;) RKH |
Sunday, June 19, 2011
First account of an ER physician at St John's... the Joplin tornado disaster
So, word has it that he graduated from the same hospital which I am training under. I live less than 2 hours away from Joplin. I know their Ear Nose and Throat residents and physicians well. I went down two saturdays ago to help with the clean up. It will take years for any normalcy to take shape in the EF 5' s wake. Anyway, pretty powerful account of what went on...
45 Seconds: Memoirs of an ER Doctor from May 22, 2011
At 5:42 pm a security guard yelled to everyone, “Take cover! We are about to get hit by a tornado!” I ran with a pregnant RN, Shilo Cook, while others scattered to various places, to the only place that I was familiar with in the hospital without windows, a small doctor’s office in the ED. Together, Shilo and I tremored and huddled under a desk. We heard a loud horrifying sound like a large locomotive ripping through the hospital. The whole hospital shook and vibrated as we heard glass shattering, light bulbs popping, walls collapsing, people screaming, the ceiling caving in above us, and water pipes breaking, showering water down on everything. We suffered this in complete darkness, unaware of anyone else’s status, worried, scared. We could feel a tight pressure in our heads as the tornado annihilated the hospital and the surrounding area. The whole process took about 45 seconds, but seemed like eternity. The hospital had just taken a direct hit from a category EF5 tornado.
Then it was over. Just 45 seconds. 45 long seconds. We looked at each other, terrified, and thanked God that we were alive. We didn’t know, but hoped that it was safe enough to go back out to the ED, find the rest of the staff and patients, and assess our losses.
“Like a bomb went off. ” That’s the only way that I can describe what we saw next. Patients were coming into the ED in droves. It was absolute, utter chaos. They were limping, bleeding, crying, terrified, with debris and glass sticking out of them, just thankful to be alive. The floor was covered with about 3 inches of water, there was no power, not even backup generators, rendering it completely dark and eerie in the ED. The frightening aroma of methane gas leaking from the broken gas lines permeated the air; we knew, but did not dare mention aloud, what that meant. I redoubled my pace.
We had to use flashlights to direct ourselves to the crying and wounded. Where did all the flashlights come from? I’ll never know, but immediately, and thankfully, my years of training in emergency procedures kicked in. There was no power, but our mental generators were up and running, and on high test adrenaline. We had no cell phone service in the first hour, so we were not even able to call for help and backup in the ED.I remember a patient in his early 20’s gasping for breath, telling me that he was going to die. After a quick exam, I removed the large shard of glass from his back, made the clinical diagnosis of apneumothorax (collapsed lung) and gathered supplies from wherever I could locate them to insert a thoracostomy tube in him. He was a trooper; I’ll never forget his courage. He allowed me to do this without any local anesthetic since none could be found. With his life threatening injuries I knew he was running out of time, and it had to be done. Quickly. Imagine my relief when I heard a big rush of air, and breath sounds again; fortunately, I was able to get him transported out. I immediately moved on to the next patient, an asthmatic in status asthmaticus. We didn’t even have the option of trying a nebulizer treatment or steroids, but I was able to get him intubated using a flashlight that I held in my mouth. A small child of approximately 3-4 years of age was crying; he had a large avulsion of skin to his neck and spine. The gaping wound revealed his cervical spine and upper thoracic spine bones. I could actually count his vertebrae with my fingers. This was a child, his whole life ahead of him, suffering life threatening wounds in front of me, his eyes pleading me to help him.. We could not find any pediatric C collars in the darkness, and water from the shattered main pipes was once again showering down upon all of us. Fortunately, we were able to get him immobilized with towels, and start an IV with fluids and pain meds before shipping him out. We felt paralyzed and helpless ourselves. I didn’t even know a lot of the RN’s I was working with. They were from departments scattered all over the hospital. It didn’t matter. We worked as a team, determined to save lives. There were no specialists available -- my orthopedist was trapped in the OR. We were it, and we knew we had to get patients out of the hospital as quickly as possible. As we were shuffling them out, the fire department showed up and helped us to evacuate. Together we worked furiously, motivated by the knowledge and fear that the methane leaks could cause the hospital could blow up at any minute.
Things were no better outside of the ED. I saw a man crushed under a large SUV, still alive, begging for help; another one was dead, impaled by a street sign through his chest. Wounded people were walking, staggering, all over, dazed and shocked. All around us was chaos, reminding me of scenes in a war movie, or newsreels from bombings in Bagdad. Except this was right in front of me and it had happened in just 45 seconds. My own car was blown away. Gone. Seemingly evaporated. We searched within a half mile radius later that night, but never found the car, only the littered, crumpled remains of former cars. And a John Deere tractor that had blown in from miles away.
Tragedy has a way of revealing human goodness. As I worked, surrounded by devastation and suffering, I realized I was not alone. The people of the community of Joplin were absolutely incredible. Within minutes of the horrific event, local residents showed up in pickups and sport utility vehicles, all offering to help transport the wounded to other facilities, including Freeman, the trauma center literally across the street. Ironically, it had sustained only minimal damage and was functioning (although I’m sure overwhelmed). I carried on, grateful for the help of the community.
Within hours I estimated that over 100 EMS units showed up from various towns, counties and four different states. Considering the circumstances, their response time was miraculous. Roads were blocked with downed utility lines, smashed up cars in piles, and they still made it through. We continued to carry patients out of the hospital on anything that we could find: sheets, stretchers, broken doors, mattresses, wheelchairs—anything that could be used as a transport mechanism.
As I finished up what I could do at St John’s, I walked with two RN’s, Shilo Cook and Julie Vandorn, to a makeshift MASH center that was being set up miles away at Memorial Hall. We walked where flourishing neighborhoods once stood, astonished to see only the disastrous remains of flattened homes, body parts, and dead people everywhere. I saw a small dog just wimpering in circles over his master who was dead, unaware that his master would not ever play with him again. At one point we tended to a young woman who just stood crying over her dead mother who was crushed by her own home. The young woman covered her mother up with a blanket and then asked all of us, “What should I do?” We had no answer for her, but silence and tears.
By this time news crews and photographers were starting to swarm around, and we were able to get a ride to Memorial Hall from another RN. The chaos was slightly more controlled at Memorial Hall. I was relieved to see many of my colleagues, doctors from every specialty, helping out. It was amazing to be able to see life again. It was also amazing to see how fast workers mobilized to set up this MASH unit under the circumstances. Supplies, food, drink, generators, exam tables, all were there—except pharmaceutical pain meds. I sutured multiple lacerations, and splinted many fractures, including some open with bone exposed, and then intubated another patient with severe COPD, slightly better controlled conditions this time, but still less than optimal.
But we really needed pain meds. I managed to go back to the St John’s with another physician, pharmacist, and a sheriff’s officer. Luckily, security let us in to a highly guarded pharmacy to bring back a garbage bucket sized supply of pain meds.
At about midnight I walked around the parking lot of St. John’s with local law enforcement officers looking for anyone who might be alive or trapped in crushed cars. They spray-painted “X”s on the fortunate vehicles that had been searched without finding anyone inside. The unfortunate vehicles wore “X’s” and sprayed-on numerals, indicating the number of dead inside, crushed in their cars, cars which now resembled flattened recycled aluminum cans the tornado had crumpled in her iron hands, an EF5 tornado, one of the worst in history, whipping through this quiet town with demonic strength. I continued back to Memorial hall into the early morning hours until my ER colleagues told me it was time for me to go home. I was completely exhausted. I had seen enough of my first tornado.
How can one describe these indescribable scenes of destruction? The next day I saw news coverage of this horrible, deadly tornado. It was excellent coverage, and Mike Bettes from the Weather Channel did a great job, but there is nothing that pictures and video can depict compared to seeing it in person. That video will play forever in my mind.
I would like to express my sincerest gratitude to everyone involved in helping during this nightmarish disaster. My fellow doctors, RN’s, techs, and all of the staff from St. John’s. I have worked at St John’s for approximately 2 years, and I have always been proud to say that I was a physician at St John’s in Joplin, MO. The smart, selfless and immediate response of the professionals and the community during this catastrophe proves to me that St John’s and the surrounding community are special. I am beyond proud.
To the members of this community, the health care workers from states away, and especially Freeman Medical Center, I commend everyone on unselfishly coming together and giving 110% the way that you all did, even in your own time of need. St John’s Regional Medical Center is gone, but her spirit and goodness lives on in each of you.
EMS, you should be proud of yourselves. You were all excellent, and did a great job despite incredible difficulties and against all odds
For all of the injured who I treated, although I do not remember your names (nor would I expect you to remember mine) I will never forget your faces. I’m glad that I was able to make a difference and help in the best way that I knew how, and hopefully give some of you a chance at rebuilding your lives again. For those whom I was not able to get to or treat, I apologize whole heartedly.
Last, but not least, thank you, and God bless you, Mercy/St John’s for providing incredible care in good times and even more so, in times of the unthinkable, and for all the training that enabled us to be a team and treat the people and save lives.
Sincerely,
Kevin J. Kikta, DO
Department of Emergency Medicine
Mercy/St John’s Regional Medical Center, Joplin, MO
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