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My Classmate died of MRSA

May 15th, 2012 3 comments

The 1967 graduating High School Class of Stearns High School, Millinocket, ME  was a very close bunch.  Like all young people, we  each moved on with our lives. Most of us moved “away”, but part of our hearts stayed in Millinocket.  We sometimes lost touch, but a lot of us tried to go to the reunions as often as possible.  I saw my friend Mike Simone just a couple of years ago for the first time in years.  It was like those interim  years never happened. He was such a sweet guy and he loved his hometown and classmates.   We talked about life, his diabetes and old friends.

It was with great sadness I read my classmate’s obituary today.  I just visited with him a little over a month ago.  I was contacted and told by a co- classmate that Mike had MRSA.  This was not good news.  Mike was a big man with a big heart and he had problems with diabetes.  He was considered “high risk” for infections, although it is my belief that infections can be prevented for ALL patients in Hospitals.  It is their job!

Mike had a cardiac valve replacement done last fall. His preoperative MRSA screening test was negative.  He had the heart surgery because he needed a knee replacement and the heart  problem  was fixed to prepare and bolster  him for the second surgery. He told me he never felt right after the heart surgery.   Then several weeks later, when he took off his shoe and sock, there was a tremendous odor. He hadn’t felt pain because he had neuropathy and decreased sensation in his feet.   He  found pus in his sock.  His toe was infected with MRSA.  He was seen by his local doc and Hospital and then transferred to EMMC here in Bangor for further treatment.  He had to get his toe amputated, and the pervasive MRSA infection was also in his blood and in his heart….his newly repaired heart.  This was very serious business for Mike.  His appetite disappeared, he was unable to get out of bed and his strength was gone. The damage to Mike’s body caused by MRSA, and the high powered antibiotics needed to treat it  was much worse than what years of diabetes had done to him.   His treatment at EMMC lasted a few weeks and then he was told “there is nothing more we can do”.  According to his wife Carolyn, his liver and kidneys had begun to fail.  I advised them that perhaps the Joslin Clinic, with their cutting edge diabetes interventions, could help.  Mike just wanted to go home.  He missed his family and  his lifelong community of friends.  His wife said that he already had his finger on the pulse of all ‘goings on’ at his hometown hospital just a day after his transfer back ‘home’.  He saw everyone who roamed the Hospital halls and talked to a lot of them.   He was where he wanted to be. 

I visited Mike just a little over a month ago in our hometown hospital.  I carefully washed my hands and donned gloves and sat with him. We talked again.    His once large arms were skinny and  had wrinkled  sagging skin on them.He couldn’t get out of bed and he was very weak.  He had become a shadow of the Mike I knew.  But,   he was comfortable, and content and glad to be home.  When I asked if there was anything I could do for him, he said  “I don’t think there is much anyone can do for me”.   He had accepted what was coming.  The following was in this morning’s newspaper.

Michael J. Simone, 67, passed away May 13, 2012. A complete obituary will be published in a later edition of the Bangor Daily News. Arrangements are by Lamson Funeral Home, Millinocket. Messages of condolence may be expressed at www.lamsonfh.com.

Published in BDN Maine on May 15, 2012

Mike died on Mother’s Day, May 13.   I am so saddened by this news and for his family.  He died in the same Hospital where my father contracted MRSA.  Today, I grieve Michael Simone and my father, both victims of preventable Healthcare Associated MRSA infections.

My renewed passion to STOP THE INFECTIONS NOW has pulled me back to my blog and other places where I will share Mikes story (with both his permission and his wife’s).  I became part of a 10 member panel to help determine the gaps in MRSA Screening Research.  I will tell about Mike and Dad to the  other 9 members, all with impressive MD resumes and who manage insurance companies, influence  CDC recommendations and teach at medical schools.   I will share these tragedies anywhere, and with whomever I think  can make a difference.  At the end of the month,  I will attend a national conference on the reporting and data of these infections.   Mike’s  infection and my father’s will not be buried  in data. They will be reported in person.

When I visited Mike, I told him that I was sorry this was happening to him.  My heartfelt apology was on my behalf and that of others who really care about stopping infections.   We hadn’t done enough yet to prevent Mike’s infection…it’s time to stop metering out prevention in fits and spurts.  We need to go “ full court press”  to eliminate HAIs.

Addendum.  A few days ago, I spoke with Mike’s widow Carolyn.  She is doing well and taking stock of Mike’s life and healthcare journey.  Like most of us who have had similar experinces,  she is still seeking answers about Mike’s debacle.  She believes that patients are not warned enough about the possibilities of MRSA when they are asked to give consent for the surgery.  She also had great concerns about the lack of education for the patient and their families and visitors about MRSA.  She made a plea to me to get the word out on these concerns.  I made a promise to Carolyn that I would do my best, and spread the word on her requests and concerns.

Going into hospital? Protect yourself from MRSA.

March 31st, 2010 No comments

For about a year, I worked toward safer and more effective MRSA prevention in Maine Hospitals.  I proposed the very things that I learned of from MRSA prevention experts (Infectious disease doctors who have written recommendations, nurses, microbiologists, advocates and activists) , and hospitals who have practiced Active Detection and Isolation to stop the MRSA growth in their facilities.  But, Maine hospitals and  infection control  practitioners obstructed ADI.  It was even a struggle to get them to comply with the new State Law to screen high risk populations.   The entire process was contentious and arduous.  It was also controlled by people who do not do direct care of infected patients.

Not all of the populations who are at risk for acquiring MRSA when hospitalized were included in the current MRSA “prevalence test” in Maine.  The populations that are included are 1) patients who have been in the hospital or nursing home within the past 6 months, including transfer patients, 2) all ICU patients 3) Prisoners, 4) dialysis patients. 

The ones who were not included are  1) Immunocompromised patients, ie patients with diabetes, Cancer, HIV/AIDS,  and those on medications that render them immunocompromised, 2) Patients who are facing surgery involving implants, ie. Orthopedic joint replacement surgery, Cardiac valve replacement, Neurosurgical shunt placement, 3) Patients who are IV drug users, 4) Patients with open infectious appearing wounds.  Other populations are more susceptible to MRSA too, including the elderly, who are more prone to Hospital Acquired MRSA, and the young who are more prone to Community Acquired MRSA (those in contact sports, day care centers, close living quarters like dormatories).  All of the patients in this paragraph are known to be at  increased risk for getting MRSA, yet, Maine hospitals and their representatives fought against screening for them.

So, since only a part of the effective approach of ADI (and that part was severely diminished)  was accepted as law in Maine, what can you do to protect yourself from MRSA if you must go into a Maine hospital?

Ask your doctor for a simple nasal and/or wound culture.  This simple cheap test may save your life.  If you know you are scheduled for a hospital admission, do this test about 10 days prior to admission.  This allows time for the culture to come back and for decolonization treatment if necessary. After the culture is done, be sure to follow up on results because not all lab results are reported back in a timely way. This simple test, and treatment if necessary could save you from unnecessary suffering and/or death.

Why won’t your hospital just do this for you without you having to request it?  That is such an excellent question. Actually, during this current prevalence test, some hospitals are screening all new admissions.  But, for the ones who are not,  I have my own theories about why they just won’t do it without a request, none of them flattering.  The problem of MRSA and many other  hospital acquired infections has been brewing and growing in our hospitals for years.  The multidrug resistant infections have come front and center and increased mostly for the past 10 to 15 years.  There has been a complacency and helplessness attached to these infections and not a whole lot was done until very recently to STOP THE INFECTIONS.   I believe that the reason hospitals do not want to screen you for MRSA unless forced to by law or after a hospital has had a significant or deadly outbreak of the infections, is they are afraid of liability

They  do not want to be liable for proper rooming of patients to avoid spread of disease.  They want to continue to room colonized or infected patients with other patients, and not tell either one of their infection status.  This way they can fill beds, wash hands,  and hope for the best…..meaning…perhaps the infection won’t spread.  But, if it does, they can tell the patient that they probably brought the infection into the hospital with them. Without a screening culture, I guess they could actually say that and get away with it.  With a negative screening, will it would be less easy to blame the patient for his own infection.  This sounds negative and cruel, but I have spoken with enough victims to know that these things do happen, and they happen often.  I do not believe that hospitals intentionally infect patients, but they do not use all of the necessary steps available to STOP INFECTIONS NOW!  And when somebody becomes infected they are not entirely honest about the name of the infection or the origin of it.

So, go get that screening before you are admitted to the hospital.  If your admission is planned, get it early enough to have results and treatment if necessary BEFORE your admission.  Have family members bring in hand sanitizer for you and for your visitors and bring in disinfecting wipes for frequently touched surfaces.  Don’t share things, with your roommate.  Be sure anyone who touches you does so with clean hands.  Nobody should have to ask for clean hands, but it is a fact of life.  Just ask and don’t be bashful.  If you are too ill, have a patient advocate with you to ask and do these things  for you.These are some things that keep you in control of your own well being while hospitalized.

And finally, don’t linger.  The sooner you go home, the less your risk for infection.