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20.12.2014
Life Flight nurse Geralyn Martinez; Life Flight nurse David Bevin checks equipment on board. Thirty years and thousands of flights later, Life Flight launches its helicopter and crew — a pilot and two nurses — up to three times a day and averages about 700 flights annually, ranging as far south as Santa Barbara and as far north as the Oregon border. Most of the nurses have advanced certifications in flight nursing and critical care specialties, and several have graduate degrees.
The program now has a faster, larger helicopter than its first model with medical equipment that is compact, lightweight and rugged.
It’s the only flight program in Northern California able to transport critically ill cardiac patients who need advanced equipment such as an intra-aortic balloon pump.
It’s one of just a few such programs with professionals qualified to insert a catheter into an artery to monitor blood pressure in critically ill patients, Baulch says. Beneath all the technology and specialized training, however, remains the power of a calming voice.
Until his daughter was born, he wasn’t aware that what were popularly called hermaphrodites even existed beyond the realm of mythology. Cult leaders: What makes people like David Koresh so successful at getting people to follow them? Erin keeps a photo of herself playing soccer in the living room of her tidy cottage near San Francisco Bay. Thus began her seven-year journey battling a devastating illness with no known cause or cure. That same year a door opened on the other end of San Francisco Bay, in a windowless basement of a clinical research building at Stanford University.
Davis, director of Stanford’s Institute for Immunology, Transplantation and Infection, is in the right place at the right time for this quest, swimming in the primordial soup of creative disruption, Silicon Valley. The CyTOF enables researchers to detect 40 different components within a single cell at the rate of 1,000 cells per second.
When it’s all done, the team hopes to create a map of what a healthy person’s immune system should look like and a flow chart depicting how immune-system signaling pathways work.
The ultimate goal of Davis’ “Human Immunome Project” is to develop better tools to answer immunological questions no one can answer now. During this time, she had lost some of her most active and athletic friends, who grew impatient with the waxing and waning symptoms that prevented her from the leaving the house on most days. None of them could settle on a definitive diagnosis, so the physicians tagged her with the insurance code for chronic fatigue syndrome, a controversial diagnosis for a set of symptoms also sometimes labeled as CFIDS — for chronic fatigue and immune dysfunction syndrome — and ME — for myalgic encephalomyelitis. It’s a syndrome that gets little respect in the medical community because, with no tangible cause and an ever-changing constellation of symptoms, patients often get labeled as hypochondriacs, malingerers or seekers of addictive pain medications. As Erin went from specialist to specialist, well-meaning doctors grew frustrated with their inability to help her. Finally, in 2009 Erin was diagnosed with postural orthostatic tachycardia syndrome — which accounted for her fainting spells.
Montoya’s ethos to reduce patient suffering was shaped by a hardworking, single mother and the iron-fisted priests at his Catholic school in Cali, Colombia. Montoya conducted a detailed medical history and physical exam on Erin, then ordered a battery of tests for viruses, bacteria and fungi. Though Montoya wasn’t sure if these viruses were at the root of Erin’s illness or merely collateral infections, he started her on a high dose of the antiviral drug famciclovir. One factor is that the NIH funding process favors well-defined diseases that fit neatly into medical specialties like cardiology, cancer and neurology. But none of this deterred Montoya, who was driven to do something for the suffering patients queuing up for appointments. Montoya’s game plan was to use a big-picture, big-data strategy to find out what was wrong with patients like Erin. Montoya convinced experts in immunology, rheumatology, genetics, bioengineering, anesthesiology, neuroradiology, cardiology, psychiatry, infectious diseases and bioinformatics to all work together. Davis, in well-worn jeans and running shoes, leans back in his chair, surrounded by pillar-piles of scientific papers. But looks can be deceiving, because Davis, who discovered how T cells help a body fight off infections, is all about the fight. As if to prove this point, Davis reaches into a random stack of paper and pulls out a black-and-white photo of a collegiate fencing match. He also chides many of his colleagues for spending too much time on mouse studies and not enough on human studies. Just in case getting your limbs blown off isn't bad enough, you need to worry about how much all the medical intervention to keep you alive is going to cost you? Because the injuries suffered in Boston are so varied and the patients’ information is mostly unknown, Miller said he couldn't come up with an exact figure. Imagine, having your basic life-or-death medicine funded by a corporation? But, thankfully, there is a fundraiser backed by the city's mayor that has been set up to help the victims and some of the families of victims.
But why is this necessary in the world's most prosperous country (or so it is always said)?


Kenneth Feinberg, the Boston-area born lawyer who oversaw the September 11th Victim Compensation Fund, will administer the One Boston Fund, a large chunk of which is expected to help with hospital bills. However, the bad news is that people disabled by the twin blasts may face short-term financial pain, especially if they lose their job. I find the very idea of a hospital charging an individual for critical medical care after they've had a couple of limbs blown off by a terrorist to be morally repugnant.
And what about all those individuals who get their limbs amputated by, say,  a thresher and don't have mayors putting together fundraisers for them?
There is a big difference between Canada, which has socialized medicine, albeit far from perfect, and the United States. OK, I’ll probably get blasted for this, but do the victims of the Boston bombing need $20 million? I think it is absolutely terrific that Americans can show their support by giving financially to the needs of the victims of the terrorist bombings in Boston! Speaking of crisis, if this is how healthcare works in the States then it looks like things are in crisis mode pretty much all the time. In contrast to my American brothers and sisters down south, here are some Canadian reactions to the story I linked to above.
As much as I think we have great neighbours to the South, this is what is greviously wrong with the USA. I really am just baffled and confused by how things can apparently work so badly in the word's leading country.
A 70-year-old woman critically injured in a car accident in Santa Cruz County became Stanford Life Flight’s inaugural patient. Between 30 and 40 percent of those flights carry children to the neonatal intensive care unit of Lucile Packard Children’s Hospital Stanford. To be considered for the crew requires years of experience, as well as extensive clinical qualifications and exceptional interpersonal skills. Flight nurses also assist when needed with trauma alerts in the emergency department and help in the intensive care units with advanced procedures, such as arterial lines and intubations. Its helicopter is equipped with instrument-aided flight technology that makes transport in inclement weather safer. It thinks and dreams, it loves and hates, it recollects and predicts, it directs our moods and our movements. It captures her image frozen in time and space, hurtling like a comet between two opponents, her white-blond ponytail fanned out like flames.
As a little girl, her favorite toy was a soccer ball, a present from a cousin living in Rome. Here Mark Davis, PhD, an immunologist with a computer hacker’s mindset, was launching a center that aimed to break open the black box called the human immune system. At long Stanford cafeteria tables frequented by geneticists, bioengineers, math geniuses, computer programmers, surgeons and cancer biologists, ideas just happen. It not only measures static levels of proteins, useful in identifying different types of immune cells, but it also detects minute changes in signaling proteins within cells in response to various stimuli.
One of the first: What is wrong with the immune systems of patients like Erin, and how can we help them get better?
On any given day, she would cycle through a laundry list of symptoms: brain fog, dizziness, light sensitivity, a sore throat, nausea, swollen lymph nodes, crushing fatigue, a racing heart, ear ringing, drenching sweats and fainting. The primary diagnostic criterion for this condition is infuriatingly vague — “six or more consecutive months of severe fatigue” — virtually unchanged since 1994. For treatment, her cardiologist sent her to Stanford Hospital’s cardiology clinic to see one of the nation’s few POTS specialists, cardiac electrophysiologist Karen Friday, MD. The mechanism is unknown, but some people develop it after contracting viral or bacterial infections like mononucleosis, pneumonia or Lyme disease. He was accepted into medical school at age 18, after receiving the third-highest qualifying exam score in his native country that year. His wide-net diagnostic approach paid off; he found two blood-borne microbes — Human Herpesvirus-4 and the coxsackie virus — known to cause chronic disease and POTS. Erin was relieved to finally have a physician who wasn’t going to punt her case to another specialist.
Most of these medical societies have organized lobbying efforts, sometimes backed by pharmaceutical or medical technology companies. Traditionally, NIH funding is awarded through medical specialty groups that tend to favor research that tests one narrow hypothesis about a disease.
His first step in launching the Stanford Initiative on Infection-Associated Chronic Diseases was to convince a dozen or so academic investigators to venture out of their comfort zones to research a wildly unpopular disease using technologies yet to be developed. The team members would be searching blood samples for infectious microbes, inflammation-related molecules and genetic flaws. Even worrying about whether the insurance company would pay for it would likely give me an ulcer. And while he’s not worried about the initial cost of treating the patients, he said it will be an expensive proposition down the road.


Why do people need to hold fundraisers so citizens can get critically needed medical and psychological care? A Boston Public Health official said it’s difficult to tell how much the city has spent on counselling at this time. I love to see people moved by a spirit of generosity, and God knows there are plenty of great uses to which their money can be put. That's the problem with having to hold a fundraiser every time you need to pay for an expensive medical bill. Who will care for the third child, a little boy while his dad is in the hospital with the mom and sister? You get injured by a bomb blast, and then have to pay hundreds of thousands out of your own pocket for medical? It is the duty of a state to ensure that its citizens have the basic necessities of life: food, shelter, health and a basic education. With that flight, Life Flight became the first helicopter emergency services program in the San Francisco Bay Area, and Stanford Hospital became the first medical center in the region to have its own helicopter and air medical transport team. Adult patients are most often transported to Stanford Medicine for stroke, cardiac or trauma care. The crew also wears night vision goggles for all nighttime flights to aid visibility and improve safety. This dynamic network of biological sensors, cells, secretions and genes is like a sixth sense, able to detect microbial friend from foe in the food we eat, the things we touch and the air we breathe. Friday prescribed fludrocortisone to manage Erin’s low blood pressure, but to explore the possibility of an underlying microbial trigger, she sent Erin to see Stanford professor of infectious diseases Jose Montoya, MD.
After medical school he went on to Tulane University School of Medicine for his residency, then joined the infectious disease division at Stanford. For example, a researcher might get funded to screen blood samples for one virus, or treat patients with one drug. They can be bred with specific diseases, such as diabetes or Parkinson’s, and then dissected to evaluate the effectiveness of experimental treatments. But I wonder if we shouldn’t first determine where our resources are most needed, then commit them based on that. I may moan about owing at the end of the year, but goof grief - I think it's my duty as a human being to help provide some base level of medical care for my fellow countrymen, countrywomen and children both in times of crisis and not. Such is the case with Davis’ Human Immune Monitoring Center, which before long had enough funding to acquire a CyTOF, a time-of-flight mass spectrometer for high-speed acquisition of multiparametric single-cell data. And armed with big-data analytical methods developed during the Human Genome Project, Davis’ multidisciplinary team is trying to bring order and meaning to the output.
A rheumatologist evaluated her for systemic lupus erythematosus and other inflammatory diseases. At Stanford he became a world-recognized authority on infections affecting heart transplant recipients and on toxoplasmosis, a common parasitic disease. This approach takes a long time, and researchers typically aren’t able to share and build on discoveries for years. They also fear that any government assistance, or mandated healthcare would mean poorer healthcare, that is we'd get crappy-quality care.
An endocrinologist agreed that the origin of her fatigue was not the thyroid, the adrenals or any other gland.
He emphasizes that lab mice live in isolated, disease-free, temperature-controlled environments, far different from the crowded, germ-ridden urban habitats of your typical Homo sapiens.
What are the steps involved in launching an army of white blood cells to attack a microbial invader? Next, he launched a Bay Area recruitment campaign for 200 patients who met the Centers for Disease Control’s definition for chronic fatigue syndrome, including Erin, and 400 age- and sex-matched healthy volunteers, all of whom agreed to donate eight tubes of blood and be poked, scanned and surveyed over the next decade. Half the country feel otherwise, but if you've been watching our Congress lately, you may have noticed we are a nation divided in ideology and we have the largest wealth divide ever with 400 people controlling more wealth the the bottom 150 million combined. How do our traitorous cells — the cancers — make themselves invisible to our immune system? In fact, last time I was in the emergency room I asked them when I got there how much the visit was going to cost me and they couldn't tell me anything. The whole time I was there I was hoping it would be a $20 copay and fearing it would be a $10,000 bill. So they buy politicians and entire news stations to lie to the American public- especially the very people universal healthcare would benefit.
That being said, many Americans hope for and actively work towards change, even if the power lies with those that oppose healthcare reform. I also think that your plutocracy down there likes to spread the fear around about socialized anything.




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Comments The secret life of the brain ptsd

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