Miracles in Review

It’s hard to believe 2009 is coming to a close.  I think back on all the small miracles I’ve witnessed this year – many I could not record here.  Earlier this week, I ran into my patient who became the inspiration for this site (see About).  Unfortunately her hand infection had returned, but this time she knew what she needed to do.  After several days of good treatment, the infection disappeared.  I reminded her of how important it was to take care of oneself, including proper diet, restful sleep and reducing stress levels.  Of course, these are not always easy to do, but she recognized what contributed to her relapse.

Then, I heard from my patient Rose, AIDS survivor, who called me from Florida to wish me a Merry Christmas.  She is on an amazing HIV medication, Isentress, which has helped raise her CD4 count to over 1,000!  It was just fantastic to think how well she is doing, after coming so close to passing away.  It was great Christmas news!

I believe hope is vitally important.  While making rounds in the hospital this week, I did my best to encourage a patient who had a complicated abdominal surgery.  Because her pain level was high and she was feeling miserable, her condition wasn’t improving, even though she was on the right medicines.  I spent time with her, made sure her pain was controlled, and encouraged her to fight through.  Now, several days later, she’s doing really well and should be going home in the next few days.

Today I just received a ‘Happy New Year’ greeting from Dr. Camino, my first rabies mentor.  It was a pleasant reminder about the work we need to do for the rabies patients in the Philippines.  I’m looking forward to increasing our  educational efforts there to try and help.  There is so much to do!

All the best for the New Year!

RW

Rabies dispatch from Malaysia

Just a few days ago, I arrived here in the heart of Malaysia. 

The capital, Kuala Lumpur, is a clean, orderly and modern city. KL, as it is affectionately known, is a thriving gateway to Southeast Asia. 

Shiny sky scrapers are clustered about the city center, motorcycles and cars pulse through the streets, banyan trees and thickets of bamboo offer oases of shade, while thick humid air enshrouds everything in unbearable heat.  At night, the Petronas towers shine like crystal. Wow!

I came here for the 13th annual International Congress on Infectious Diseases.  Doctors and scientists from all of the world met to review the latest drugs, emerging diseases, HIV/AIDS, parasitic infections and tropical medicines – it was an exciting time. 

Luckily, there is no rabies here.  Decades ago, the government resolved to eliminate that threat.  Dog control with vaccination and round-up of street animals was authoritarian but effective.  Rabies had no place to hide.  The WHO officially recognizes Malaysia as rabies-free.   Occasional rabies cases may cross over from border countries, but are quickly stamped out.

Many countries in Asia still struggle with rabies. Depending on resources and commitment, the situation varies. In Thailand, for example, the government curbed human rabies by providing free anti-rabies vaccines to anyone exposed. Expensive, but effective, human rabies cases number only a dozen or so per year. In the Philippines, reductions in rabies suffering are anticipated with the passage of the “Anti-Rabies Act of 2007″ (Republic Act No. 9482).  This law commits to wiping out rabies by 2020 from those islands.  Hopefully it will occur sooner, and with more resources it certainly could. 

RFW is gearing up to support more dog vaccination projects in the Philippines through our click2vaccinate program.  Dispatching rabies from the Philippines remains our primary goal.  We have alot of work ahead of us!

Travelers to Malaysia should check out the CDC website and confer with a travel medicine specialist before their trip.

RW

HIV needlestick!

A good friend of mine who works as a nephrologist was putting in a dialysis catheter. She had done many ‘lines’ before and this one was just routine. The catheter looked like a very large needle with tubing attached. The catheter or dialysis line provides access to the blood stream to provide the patient with life saving hemodialysis. When the kidneys fail, a patient will die in a very short time without dialysis, as toxic levels of metabolites build up.

She accessed the neck veins and got a good flow of blood, indicating the line was in position. She finished up the placement and was preparing to give some fluids to flush the line clean. Now that the ‘hard’ part of placing the line was done, her attention lapsed ever so slightly. While preparing the fluids, she inadvertently stabbed the needle through her glove and into her finger. A lancinating pain ran up her arm – it was a bad ‘stick’ or injury. The needle had penetrated through and through her finger.