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Dr. Manoj Jain: H1N1 toll is great, and still many don't heed warnings
By Dr. Manoj Jain. Manoj Jain By Dr. Manoj Jain Manoj Jain
Posted February 22, 2010 at 12:03 a.m.
It was before Thanksgiving when Teresa Heberling of Southaven first went to her doctor with a cough, fever and body aches. Her brother had died of lung cancer a week earlier and hundreds of people had attended the funeral.
"That's where I think I picked it up," she told me a month ago from her hospital bed, where she lay too weak to even transfer from bed to chair.
Heberling is a manager of sales for Screenvision, a movie theater advertisement company, and assigns daily work to about 20 sales staff members. But the two-month hospital ordeal nearly cost Heberling her job and her life.
The cough, fever and body aches were relentless. When she developed shortness of breath, she returned to her doctor, who sent her by ambulance to the emergency room.
Within a day, she was in intensive care with one end of a garden-hose-size tube in her throat and the other end attached to a ventilator. The lung washings showed she had H1N1 swine flu, and my partners and I were asked to see her for infectious disease management.
Exceptionally poor health did not predispose Heberling to become so ill with H1N1. But her health wasn't problem-free. At age 53, she is overweight and has borderline diabetes and takes medicine for high blood pressure and high cholesterol. Before she became ill, she was attending Weight Watchers and had been working out with a personal trainer. She had lost 25 pounds in the past year.
The H1N1 virus caused Heberling to develop acute respiratory distress syndrome. Her lungs became so stiff they needed pressured air from the ventilator to open them up. A normal lung inflates and deflates like a latex balloon, but an ARDS lung is like a balloon made of cardboard.
During Thanksgiving weekend, she was thrashing in bed, bound in soft restraints, confused and agitated while on the ventilator. Her ARDS became complicated by a staph infection in the lung. The hose-size tube was now replaced by a tracheotomy, a hole in her windpipe, to ease the burden of pumping air to her lungs.
When her pneumonia cleared a few days later, we transferred her to a long-term-care hospital. The next day, her temperature spiked and her blood pressure dropped. She had developed sepsis, possibly due to another pneumonia, a line infection or a urine infection. She was soon back in the ICU.
Before Christmas, I spoke with her son, who kept vigil in the ICU along with his fianc?e, often holding his mother's hand. "I am not sure if she will make it," I told him outside the room. "But we are going to keep trying."
Studies show that nearly one in three patients with H1N1 who are admitted to the ICU do not survive.
Finally, over the New Year's weekend, Heberling turned the corner. The ARDS resolved, the pneumonia cleared, she became more lucid and we began to wean her off the ventilator.
After 67 hospital days and hundreds of thousands of dollars in medical charges, Heberling was transferred to a rehabilitation hospital.
"She still has a long way to go" to recovery, said my wife, who was the rehabilitation doctor caring for her. "Months in bed have left her muscles wasted."
Then, the night before I was to visit Heberling to discuss more about this article with her, my wife received a call at 4 in the morning. Heberling had again become acutely short of breath and was transferred to intensive care. This time, bleeding in her injured lungs had caused her to be placed on the ventilator.
She is now recovering and going to the rehabilitation hospital again.
The human toll of H1N1 has flashed on the TV screen too often.
The U.S. Centers for Disease Control and Prevention estimate that of the 50 million people who have become ill with the virus, 200,000 have been hospitalized and 10,000 have died.
But what I will never forget is my first conversation with Heberling a few days after her windpipe was closed with a plastic cork and we were all certain that the worst was over. "You know, Dr. Jain, I never get the flu shot -- but next year I will," she said.
I told her that her harrowing experience was not her fault: "Back in early November, we did not have the H1N1 vaccine readily available."
But now we do, and still most Americans have chosen to remain unvaccinated.
Dr. Manoj Jain is an infectious disease physician and member of the Healthy Memphis Common Table Council.
http://www.commercialappeal.com/news/2010/feb/22/h1n1-toll-is-great-and-still-many-dont-heed/
By Dr. Manoj Jain. Manoj Jain By Dr. Manoj Jain Manoj Jain
Posted February 22, 2010 at 12:03 a.m.
It was before Thanksgiving when Teresa Heberling of Southaven first went to her doctor with a cough, fever and body aches. Her brother had died of lung cancer a week earlier and hundreds of people had attended the funeral.
"That's where I think I picked it up," she told me a month ago from her hospital bed, where she lay too weak to even transfer from bed to chair.
Heberling is a manager of sales for Screenvision, a movie theater advertisement company, and assigns daily work to about 20 sales staff members. But the two-month hospital ordeal nearly cost Heberling her job and her life.
The cough, fever and body aches were relentless. When she developed shortness of breath, she returned to her doctor, who sent her by ambulance to the emergency room.
Within a day, she was in intensive care with one end of a garden-hose-size tube in her throat and the other end attached to a ventilator. The lung washings showed she had H1N1 swine flu, and my partners and I were asked to see her for infectious disease management.
Exceptionally poor health did not predispose Heberling to become so ill with H1N1. But her health wasn't problem-free. At age 53, she is overweight and has borderline diabetes and takes medicine for high blood pressure and high cholesterol. Before she became ill, she was attending Weight Watchers and had been working out with a personal trainer. She had lost 25 pounds in the past year.
The H1N1 virus caused Heberling to develop acute respiratory distress syndrome. Her lungs became so stiff they needed pressured air from the ventilator to open them up. A normal lung inflates and deflates like a latex balloon, but an ARDS lung is like a balloon made of cardboard.
During Thanksgiving weekend, she was thrashing in bed, bound in soft restraints, confused and agitated while on the ventilator. Her ARDS became complicated by a staph infection in the lung. The hose-size tube was now replaced by a tracheotomy, a hole in her windpipe, to ease the burden of pumping air to her lungs.
When her pneumonia cleared a few days later, we transferred her to a long-term-care hospital. The next day, her temperature spiked and her blood pressure dropped. She had developed sepsis, possibly due to another pneumonia, a line infection or a urine infection. She was soon back in the ICU.
Before Christmas, I spoke with her son, who kept vigil in the ICU along with his fianc?e, often holding his mother's hand. "I am not sure if she will make it," I told him outside the room. "But we are going to keep trying."
Studies show that nearly one in three patients with H1N1 who are admitted to the ICU do not survive.
Finally, over the New Year's weekend, Heberling turned the corner. The ARDS resolved, the pneumonia cleared, she became more lucid and we began to wean her off the ventilator.
After 67 hospital days and hundreds of thousands of dollars in medical charges, Heberling was transferred to a rehabilitation hospital.
"She still has a long way to go" to recovery, said my wife, who was the rehabilitation doctor caring for her. "Months in bed have left her muscles wasted."
Then, the night before I was to visit Heberling to discuss more about this article with her, my wife received a call at 4 in the morning. Heberling had again become acutely short of breath and was transferred to intensive care. This time, bleeding in her injured lungs had caused her to be placed on the ventilator.
She is now recovering and going to the rehabilitation hospital again.
The human toll of H1N1 has flashed on the TV screen too often.
The U.S. Centers for Disease Control and Prevention estimate that of the 50 million people who have become ill with the virus, 200,000 have been hospitalized and 10,000 have died.
But what I will never forget is my first conversation with Heberling a few days after her windpipe was closed with a plastic cork and we were all certain that the worst was over. "You know, Dr. Jain, I never get the flu shot -- but next year I will," she said.
I told her that her harrowing experience was not her fault: "Back in early November, we did not have the H1N1 vaccine readily available."
But now we do, and still most Americans have chosen to remain unvaccinated.
Dr. Manoj Jain is an infectious disease physician and member of the Healthy Memphis Common Table Council.
http://www.commercialappeal.com/news/2010/feb/22/h1n1-toll-is-great-and-still-many-dont-heed/