How does a "Super Bug" like MRSA Develop?

MRSA has been in the news a lot lately. It is unfortunate that the media has caused a small panic over a bacteria that has been around for at least four decades.

What is MRSA? How does a bacteria become a resistant "super bug"?

MRSA stands for methicillin-resistant Staphylococcus aureus, a type of staph infection that is resistant to methicillin and other commonly used antibiotics in the same class, including penicillin, amoxicillin, and oxacillin.

Recently, there was a teenager who was said to have died from MRSA. This is a terrible tragedy especially since it can be treated. I hope to give info regarding this and put to rest the fears that I believe are being fueled by the media.

I. What is MRSA?

Staphylococcus aureus is a species of bacterium commonly found on the skin and/or in the noses of healthy people. Although it is usually harmless at these sites, it may occasionally get into the body through breaks in the skin such as abrasions, cuts, wounds, surgery sites and cause infections. These infections may be mild like pimples or boils or serious when it gets into the blood stream.

It is the staph infection that a lot of antibiotics are useless to treat. However, there are antibiotics that can treat it. For instance, the drug of choice to treat MRSA is Vancomyicin.

- How does one "catch" MRSA?

MRSA is a contact infection. You must touch it to catch it.

-How do you keep from getting MRSA?

Hand washing is the number one way to keep from getting an infection. Whether that infection be the common cold or MRSA. A kindergarten teacher says that a person should wash their hands as long as it takes to sing the ABC song.

If you get a cut or a scratch, wash the site with antibacterial soap, keep it clean, and cover it with a band aid.

Avoid touching other people's personal items. For instance, in Gym class don't use someone elses towel or razor.

- Diagnosis of MRSA

The only way that MRSA can be diagnosed is if your doctor orders a culture to be taken from the area that is suspected of the infection. This is a simple painless test. They take a cotton swab and run it over the area and send it to lab.

Only then, can MRSA be diagnosed for sure.

- Treatment for MRSA

Depending on the location of the MRSA infection, the doctor will prescribe antibiotics. The doctor may have to drain the wound or open it to let it drain naturally. Whatever and which ever, your doctor needs to be involved.

II. How Does a Super Bug like MRSA come about?

-The way that a bacteria becomes resistant to antibiotic treatment and then becomes a "super bug" is actually very simple. Bacteria is very smart. When person is sick and they go to the doctor and the doctor prescribes antibiotics, a person needs to take those antibiotics until they are all gone. If we take antibiotics only until we feel better, some of the bacteria is left in our system. It looks at the antibiotic, sees how it kills the bacteria and it mutates. The way that the antibiotic used to kill that particular bacteria is no longer useful. That bacteria is now resistant to that antibiotic. Every time an antibiotic is given and taken and that bacteria is not wiped out, that bacteria becomes smart and resistant to that antibiotic. You get enough of a mutated bacteria and you get MRSA, the super bug. Fortunately, there are antibiotics to treat MRSA, so it is really not that super.

The hospital which I am employed has a grant to look into people that come into the hospital already infected with MRSA as opposed to those who catch it at the hospital. It is amazing how many people are colonized with MRSA and they have no idea, no symptoms...nothing.

Education is the key to understanding MRSA. Media induced panic is not.

Asthma: When to go to the Doctor

"If I just take one more puff on my inhaler, and if I just sit here, I will feel better...". or "I don't have time for this..."

People don't realize or they don't want to believe that asthma can be a life threatening illness. I have had people come into our Emergency Room in total denial of how serious their condition is at that moment. They have put off coming to the doctor because it really is a bother. Please remember that if you stop breathing, you will not survive.

It is important to educate yourself on asthma if you or your child have asthma. There is a lot of education online, at hospitals, at clinics about asthma. One of the tools that a person can use to see if they need to go to the doctor is their Peak Flow Meter. Every asthmatic should have one. A Peak Flow meter has three levels: A green level...breathing good. A Yellow level...breathing not so good CALL DOCTOR. A Red level...go to the hospital Emergency Room...NOW. I believe that education is key in knowing when to go to the doctor.

One of my favorite e-books is "Asthma Made Simple". It explains asthma in such a simple language so that a person with Asthma can understand exactly what is going on in their lungs. How asthma works, what is that "tight" feeling in the chest? What is wheezing and why do I wheeze during an asthma attack?

http://www.copdmadesimple.com


If you are having tightness in your chest that is not relieved by your rescue inhalers, If you are coughing and wheezing and nothing seems to help, not even your Prednisone, it is time to call the doctor. Do not wait to see if another breathing treatment will help. Do not wait until it gets worse. Do not keep sitting there hoping that you will be able to take the next breathe. The American Lung Association says that when you can't breathe, nothing else matters...believe that.

Know when your inhalers will run out. Educate yourself on which medications you are taking and how each one works in your lungs. If you are using your inhalers more often than what your doctor ordered, you need to call your doctor to let them know this.

If you have asthma, please get yourself a Pulmonologist...a lung doctor. They will be up to date on the newest treatments. They know the lungs and how they work intimately.

In review on when to go to the doctor with your asthma:


1. When your Peak Flow Meter is in the Yellow
2. You are taking your inhalers more often than ordered by your doctor
3. The tightness and the wheezing is not relieved by your medication

Why & How to educate yourself about Asthma:

1. Know your illness
2. Know why you have asthma attacks and what will make them better.
3. Learn online. Find someone who explains it so that you understand it. Find someone who is not out to impress you with their medical terms. Again the e-book about asthma made simple is a good one.

http://www.copdmadesimple.com

4. Ask your Respiratory Therapist if they have a Certified Asthma Educator at their hospital.

It is imperative that we take Asthma seriously. I have seen a teenager die from an asthma attack because he had the wrong inhaler with him. When they got him to the hospital, we were unable to open up his lungs they were so shut down. Please believe that this is a very serious illness.

Call your doctor, educate yourself, take control of your asthma. You can do it!

More On Congestive Heart Failure

I heard a Doctor explain Congestive Heart Failure to a patient like this: "It is not that the heart fails to pump, it is just that it has been working so hard to pump that it has become thick and unable to deal with the volume of fluid coming to it..."

In CHF the blood moves through the body at a rate that is slower than what the body function needs. So here is all this fluid moving through the body like a line at an escalator. People are waiting to go somewhere, but they just can't get on the escalator just yet...so a line forms. Just like the line forming, the blood backs up into the system and where does it back up to? The lungs. This is why people who have CHF have a difficult time breathing. They have so much fluid backing up into their lungs, that the air can't get through to ventilate the person. Next thing you know, you are rushing that person to the hospital because they cannt breathe.

Causes of CHF include the following:

1. Coronary Artery Disease--Disease of the vessels that provide blood and oxygen to the heart. When they become diseased and clogged, the heart does not get enough oxygen and cannot pump as effectively as it should.

2. Heart Attack -- If a person has a heart attack, part of the heart muscle can become damaged and again, it cannot pump like it should.

3. Hypertension - High Blood Pressure - One of the reasons that it is dangerous to have high blood pressure is that it can damage the veins and the arteries

4. Heart Defect - - This is usually something that a person is born with.

I realize that this is not a complete list, but at least it can give you an idea that any sort of disease that taxes the hearts function can eventually cause CHF.

SYMPTOMS & TREATMENTS of Congestive Heart Failure

1. Irregular Heart Beats. Sometimes a person will say, my heart feels like it is racing or my heart feels like it is jumping in my chest. This rhythm will cause fluid to back up. When you go to the hospital, they will put you on a monitor and do an EKG. This will tell them what your heart is doing. Sometimes they will feel it necessary to change your hearts rhythm. They can give you a medicine that will suddenly stop your heart and then let it beat again in a normal rhythm. Something else they can do is called a cardioversion. They will shock your heart into a lower and more stable heart rhythm.

2. You may feel tired or lightheaded or even experience some weakness.

3. Difficulty breathing. The fluid backs up into the lungs. You come into the hospital, they will give you medication to help you potty out the extra fluid. In some cases they will call for Respiratory Therapy to put a device on you that pushes positive pressure into the lungs.
BiPap causes the positive pressure in the lungs to help push the fluid back into the vascular system where it belongs...and then with the lasix (potty medication) your body will get rid of the extra fluid. Some people require to be put on life support when they also have other conditions such as COPD.

Your Doctor will want to know the extensiveness of your heart failure. In order to do this, he/she will order some tests to be done.


An Echo-cardiogram is an ultrasound of the heart. It will tell the doctor what your ejection fraction (EF) is. That is how well your heart is pumping. This comes in a percentage. For example your EF = 45%.


Your doctor may order some blood tests, and EKG to determine how serious your heart failure might be.

All in all, CHF can be controlled by you and your doctor. Do not try to fix this yourself. Find yourself a fabulous cardiologist who is willing to take the time to explain everything to you so that you can understand it.

I wish you luck and good breathing.

What To Do When Your Child is Having Trouble Breathing

There are few things more intense or frightening as when it appears that your child is having trouble breathing. As a parent, you need to be able to do a quick assessment of the situation and take appropriate and precise action. The first thing you must do is keep your head about you. Secondly, you need to figure out why your child is having trouble breathing. Were they eating something and it went down the wrong pipe? Are they having an allergic reaction, an anaphylactic shock to something? Do they have some sort of lung disease such as asthma or cystic fibrosis? Once you figure out why, you need to go into action.

If the child is choking, are you able to remove the object that they are choking on. (if you have children, it might be a good idea to take CPR) If so, problem solved. If not, you must continue trying to dislodge the item while you are calling 911. The American Heart Association has specific guidelines on how to do this with back blows and chest blows.
If you have a teenager that is choking, you can do the Heimlich maneuver on them. However you do it, it is imperative to restore breathing to that child.

If they are having an allergic reaction and now they are having trouble breathing, you need to dial 911. If you have an epi pen, use it.
Give benedryl to them ONLY if they are able to swallow. Get them to the hospital or wait for the ambulance to arrive..but do it quickly.

Does your child have a lung disease? Asthma is the most common childhood lung illness in the United States.

My advice to pediatric asthma treatment or cystic fibrosis treatment
is that you find an outstanding Pediatric Pulmonologist. It is also important that this Pulmonologist have excellent Respiratory Therapists on staff to do teaching that your child or you can understand. It is important that a Pulmonologist be involved because of all of the new treatments and medications that have come about just in the last 20 years.

All of these are reasons to get your child to the Emergency Room as soon as possible.

Please remember that your child's breathing is a serious matter. If they complain of being short of breath or if you notice any signs and symptoms of them having any difficulty breathing, you need to get them help immediately.

The American Lung Association says, "When you can't breathe, nothing else matters..." This is very true.

MRSA, the "Super Bug"

MRSA stands for methicillin-resistant Staphylococcus aureus, a type of staph infection that is resistant to methicillin and other commonly used antibiotics in the same class, including penicillin, amoxicillin, and oxacillin.

Recently, there was a teenager who was said to have died from MRSA. This is a terrible tragedy especially since it can be treated. In this blog, I hope to give info regarding this and put to rest the fears that I believe are being fueled by the media.

1. What is MRSA?

Staphylococcus aureus is a species of bacterium commonly found on the skin and/or in the noses of healthy people. Although it is usually harmless at these sites, it may occasionally get into the body through breaks in the skin such as abrasions, cuts, wounds, surgery sites and cause infections. These infections may be mild like pimples or boils or serious when it gets into the blood stream.

It is the staph infection that a lot of antibiotics are useless to treat. However, there are antibiotics that can treat it. For instance, the drug of choice to treat MRSA is Vancomyicin.


2. How does one "catch" MRSA?

MRSA is a contact infection. You must touch it to catch it.

3. How do you keep from getting MRSA?

Handwashing is the number one way to keep from getting an infection. Whether that infection be the common cold or MRSA. A kindergarten teacher says that a person should wash their hands as long as it takes to sing the ABC song.


If you get a cut or a scratch, wash the site with antibacterial soap, keep it clean, and cover it with a band aid.

Avoid touching other people's personal items. For instance, in Gym class don't use someone elses towel or razor.

4. Diagnosis of MRSA

The only way that MRSA can be diagnoised is if your doctor orders a culture to be taken from the area that is suspected of the infection. This is a simple painless test. They take a cotton swab and run it over the area and send it to lab.

Only then, can MRSA be diagnoised for sure.



5. Treatment for MRSA

Depending on the location of the MRSA infection, the doctor will prescribe antibiotics. The doctor may have to drain the wound or open it to let it drain naturally. Whatever and which ever, your doctor needs to be involved.

Like any infection, if your doctor prescribes antibiotics, it is important that you take all the doses that are prescribed.

The lab will run something called a sensitivity test. This will say what antibiotics can be used to treat the infection.



I believe that the Media has stirred up undue panic about MRSA. MRSA was discovered in the 60's and really is nothing new. People are keeping kids home from school because of it. If a person takes the proper precautions they can avoid getting the "super bug". If a person gets MRSA, there are treatments.

Good Luck.

How To Control Your Asthma

You know you did everything by the book and here you are having an asthma attack. What I tell people when they tell me that they are doing everything by the book is that their asthma...well, it has never read the book. It doesn't know that it is supposed to behave a certain way. Controlling ones asthma requires following the doctor's orders and some good common sense.

1. What triggers your asthma?
-If every time you go to the store and walk down the perfume aisle, you have an attack, maybe you should avoid going down that aisle.

-If dust is your trigger then make sure that you change your furnace filter every three months and get something that cleans the air.

Other triggers can be a cold or the flu. At the first sign of these coming on, get in contact with your Pulmonologist to see what you should do to keep your asthma under control.
Irritants such as cigarette smoke, stress, and strong smelling cleaning agents are also things that trigger your asthma.

Avoid those triggers as much as is possible. If you for some reason are not able to avoid it, keep a rescue inhaler on your person at all times. Rescue inhalers can include the following: Proventil, Albuterol, Ventolin, Combivent. These are all fast acting inhalers.

2. What are your doctor's orders?

If your doctor has ordered some long lasting bronchiodilators such as Spiriva, Foradil or Serevent, Continue to take those even if you are feeling good. Likewise, if your doctor has ordered maintenance breathing medications like Advair or Asthmanex, keep taking those every day even if your breathing is fantastic.

One of the biggest myths surrounding asthma is that it is not a serious illness to have. People's airways may be more reactive than other people's airways, but whenever we are speaking of an illness that has to do with breathing, it is a serious illness. The American Lung Association says, "When you cannot breathe, nothing else matters...". Anyone who has ever had to fight for their next breath knows that this is very true. Asthma, no matter how "mild", should be taken seriously.

Another myth of Asthma is that any doctor is qualified to manage one's asthma. This is an illness that requires a specialist. A Pulmonolgist is a lung specialist. They should be aware of the treatments that are new and are working better and longer than the old treatments. Your family doctor is wonderful, but when you have Asthma, you should not trust your breathing to just any doctor.

I wish you luck and good breathing.