Respectful Insolence

Mid-week death crud open thread

I just can’t shake it. Try as I might to get rid of it, it just continues to grip my body like a tick that just won’t let go.

I’m talking about the death crud, which I had thought originally to be a nasty cold but is now looking more and more like the flu. It descended upon me Friday night/Saturday morning and intensified over the last couple of days to the point where I did something both yesterday and today that I almost never do: Cancel afternoon meetings and come home early. In fact, I did it two days in a row–unprecedented. Naturally, a sane person might ask why I even went into work at all today. Good question.

I’m a surgeon. The surgical tradition is that you are in the hospital either as a doctor or a patient. If you don’t need to be admitted as a patient, then you should be at work. Such an attitude led me one time to stay on call with a 103° F fever, running trauma codes from the stretcher in the next bay. I didn’t say it was smart; it is the mentality that I’ve been trying to discard as I got older.

Perhaps what contributed is that I didn’t have any patients to see or operations to do. I could hole up in my office and try to get some work done–except that I really couldn’t. I found myself zoning in front of the computer thinking I was looking up references and trying to write, but then I’d look at my clock and note that a couple of hours had gone by without my accomplishing anything. I did find, however, that the course of my plague appears to wane a bit in the evening, allowing me to do the occasional quick blog post. Maybe it even helped my writing style by making me uncharacteristically brief. I also find that a quick blog post temporarily takes my mind off of the misery.

In any case, I had thought of “live-blogging” my disease, but, then, who really wants that? No one. It would have been even more arrogant than my namesake anyway, as everyone’s had the flu like this before, and my recounting the hacking rattle of a cough I’ve had along with the bouts of chills and body aches would just be too depressing. Of course, it’s at times like this that I like to picture the white blood cells of my immune system as an army trying to repulse an invasion that’s made it well past its defenses, and I like to think that tonight the tide may have finally turned, but even in these few days I’ve already been fooled before. One thing I realize is that I’ve been very, very lucky the past several years. It’s been a long time indeed since I’ve caught something like this, so long that I had started to develop the delusion that perhaps I was immune. Certainly, it’s been far longer than the existence of this blog (over three years now).

In any case, when unable to do a more substantive post, what’s a blogger to do?

Open thread, of course! Jump on in. Is there anything you’d like to see Orac write about once he recovers? What has Orac said recently that’s pissed you off? Made you happy? Made you think? Just do me one favor. As you may have noticed, the commenting function here has gotten–shall we say?–quirky. Often Movable Type will chug away for a long time and then return an error message. Before you try to repost your comment, please check and make sure that your comment didn’t already publish. It turns out that often, even with the error message, the comment will have gone through just fine.

Comments

  1. #1 Old Ari
    March 26, 2008

    There’s a thing we do in Canada, it’s called “Flu Shots”, every year, haven’t had Flu in 40 years.

  2. #2 Rev. BigDumbChimp
    March 26, 2008

    We do them here in the U.S. as well.

    Didn’t you know that Orac is anti-shot of any form….

  3. #3 Ruth
    March 26, 2008

    This year’s shot did not work against this particular strain-lots of people who’ve had the flu shot still fell ill. The CDC is looking into improving coverage for next years lot. Despite my best efforts, I still had the worst cough of my life 3 weeks ago.

    So why vaccinate (some will ask)? Most years coverage is good, and the CDC is doing what evidence-based medicine does best. They are aware coverage was poor, and they are seeking rational ways to better predict which strains we will see next fall.

  4. #4 Hans
    March 26, 2008

    Yeah, really. Orac talks a good game about vaccination, but when it comes down to getting the shots, he wimpers like a little girl. And he doesn’t have any arms. He’s an acrylic box, fer cryin’ out loud!

  5. #5 BB
    March 26, 2008

    Tamiflu? amantidine? Ever try them? They do work when flu shots fail or one fails to get the flu shot.

  6. #6 SLC
    March 26, 2008

    Dr. Orac might be interested in a thread over at a blog hosted by the Atlantic Monthly, the subject of which was originally a book written by Pat Buchanan. However, the comment section of that thread has brought out the Holocaust deniers in full force. Arguing with these clowns is about as fruitful as arguing with any of the other deniers who pollute the internet.

    http://matthewyglesias.theatlantic.com/archives/2008/03/buchanans_provocation.php#comments

  7. #7 Catherina
    March 26, 2008

    get well soon ~~~

    As for your work ethics: rethink them, too. I have been attended by sick doctors and that left me livid every time. Extremely angry, because the doctors in question were too sick to be functioning in the first place and livid, because in one case, the doctor was attending the birth of my child and whatever she had she could have given my baby (just as you could give something to a cancer patient).

    As for the flu: isn’t the flu something that comes and knocks you off your feet within 12 hours of the first sniffle rather than something that creeps up over days?

  8. #8 Dianne
    March 26, 2008

    Orac, what the hell are you thinking? You’re a surgical oncologist! A substantial proportion of your patients are immunosuppressed. Go home and stay there until you are no longer infectious. And stay in bed until you feel better, unless you want to end up as an admission yourself.

  9. #9 Bob O'H
    March 26, 2008

    To follow up comments on a previous thread, “Mid-week Death Crud” is an even better name for a death metal band. If Orac doesn’t get well soon, we’ll have a full festival line-up.

  10. #10 Orac
    March 26, 2008

    Actually, I’ve been nowhere near patients, the clinic, or the OR during the last couple of days. Trust me on that one; I have lab days where it’s easy to hole up in my office and see not another human being if I so choose. It’s not an issue, fortunately. As for flu shots, usually I get them but for whatever reason this year I didn’t. I won’t make that mistake again.

  11. #11 PalMD
    March 26, 2008

    Tamiflu? amantidine? Ever try them? They do work when flu shots fail or one fails to get the flu shot

    Worst flu season I’ve ever seen. Unfortunately, amantidine resistance is pretty much the rule these days. In the first day or two you can do Tamiflu, but after that, your just fucked.

    Good luck. When they put the lucite box in the pine box, I’ll bring, well, flowers or something.

  12. #12 Dianne
    March 26, 2008

    Actually, I’ve been nowhere near patients, the clinic, or the OR during the last couple of days.

    Ah, um, my apologies for the unjustified assumption and attack. I’m afraid I have seen a number of people, including oncologists, pull the “work with patients while sick” stunt and am rather sensitized. No one likes calling in sick and burdening their colleagues with their work or making their patients reschedule, but it’s better than giving a person with a WBC of 0.1 influenza. And I still think you should go home and rest. Or feed your cells/mice and then go home. Let yourself recover from the crud before the secondary pneumonia sets in.

    As for flu shots, usually I get them but for whatever reason this year I didn’t. I won’t make that mistake again.

    Yeah, I did that last year. Just stupid procrastination. And got the flu–probably the first time I’ve had true influenza since childhood. I got my flu shot in October this round.

  13. #13 Dr Aust
    March 26, 2008

    Yes… As you get older you get past the “I am indestructible and MUST work through this piffling illness” phase. I used to take this line. I think it is reinforced in the professions (especially) and in academia by “If I don’t show then my friend/colleague X will have to cover my work for me, so I will be dumping him/her in it”.

    Anyway, after a couple of decades of struggling in with various seasonal aliments to teach my med student and other classes, this year when I got the norovirus dose I admitted to myself I was powerless etc etc and called up to cancel all the lectures, classes, meetings over a couple of days.

    Amazingly (not), everything was promptly rearranged, re-routed or cancelled, all involved coped fine without me and the med students told me they got more done in their case-based scenario discussion without me interrupting them every 5 minutes.

    So kind of a lesson there.

    As to a topic… I can think of a few. Coenzyme Q10 has been getting a big new sales push in the UK for “all you people who feel you don’t have enough energy” (!). Or what about that hardy perennial “Why do people find Woo so attractive?”, or on a similar theme “How and why has Woo made such strides into the mainstream in the last 30 years, over which time our scientific understanding of disease has increased so much?”

    I suspect part of the answer to these last two has been that – with exceptions such as childhood leukemias – the advances in scientific understanding have not been matched by concomitant advances in medicine’s ability to treat the killer diseases. But would be interested to hear the Orac take. Apologies if you’ve done these topics before.

  14. #14 Uncle Dave
    March 26, 2008

    YEP! That’s actually the “National Death Crud”
    My wife has upper respitory issues and has been trying to get it out of here lungs now for over a month, won’t let go. Started out as a fever and chills yadda yadda yadda then mitigates to this agonizing annoying thing that seems to linger on.

  15. #15 Phoenix Woman
    March 26, 2008

    I take it you’ve tried saltwater nasal lavage, gargling chicken soup, and the rest? (Along with getting some rest!)

    Get better, Orac!

  16. #16 Death Crud Survivor
    March 26, 2008

    I got the flu vaccine this year and I got the worst flu I’ve ever had. You roll the dice and sometimes you come up snake-eyes… Orac, If you have what I had, then I stand in awe of your ability to drag your infectious butt to work, however pathological such behavior might be. I had to concentrate to get out of bed to use the bathroom. I ended up missing over a week of work, I lost 10 pounds, and I went to the ER once. Not fun. Hope you shake it soon.

  17. #17 Yttrai
    March 26, 2008

    I have nothing but sympathy for you as well, Orac. I don’t normally get the flu shot since this is the first time in my life i’ve gotten the flu in actual flu season. There are people out there who need the shot much more than i do.

    I had it twice in a month, this year, however. The first one was 5 days of fever with 18 hours of sleep per day, and the second my fever was so high my skin hurt. I wouldn’t wish this flu on anyone.

  18. #18 Kapitano
    March 26, 2008

    Is there anything you’d like to see Orac write about once he recovers?

    Fond as I am of seeing woomeisters taken down, I’d like to see more blogging on science, rather than pseudoscience.

    Homeopathy, IDiocy, Chopra and all that dreck is kind of sparkly and glamorous in a fairground sideshow kind of way, but surely they are just a side show.

    Real science is, well, real. And important, and interesting in its own right, and useful.

    In the meantime, get well soon, and let’s hope the crud isn’t an alien being from another dimension invading your circuits, like it was last time ;-).

  19. #19 Mustafa Mond, FCD
    March 26, 2008
  20. #20 DonZilla
    March 26, 2008

    Mustafa beat me to it! Stories like these really confuse me sometimes, since as a student of the American Revolution I’ve been following the wonderful “John Adams” series on HBO and woo confuses me as to which century I’m in.

    Thank you Dr. Orac and keep on “fighting the power that be.”

  21. #21 IAMB
    March 26, 2008

    You could always try the trick my brother and I learned from a bunch of Russian gymnasts: they weren’t allowed to take any of the cold and flu medications (because the pseudoephedrine won’t pass muster with the Olympic committee) so their trick involved nearly killing yourself with vodka. Sure, you feel like hell the next morning but by early afternoon things are usually much better.

  22. #22 AtheistAcolyte
    March 26, 2008

    What’s your address? I’ll send you a case of Airborne.

    (yuk yuk yuk)

  23. #23 Sandy
    March 26, 2008

    I’d certainly like to read your comments regarding the news item you can read here:

    http://www.foxnews.com/story/0,2933,341574,00.html

    As the father of a daughter with type 1, this story saddens me and at the same time I feel immense rage at her parents.

  24. #24 daedalus2u
    March 26, 2008

    Actually there are very good reasons for not trying to do to much when you are feeling like crap. The feeling like crap is a “feature” to tell your body to not do stuff.

    The reason for this is complicated but it has to do with nitric oxide physiology. When you are sick, your immune system causes the expression of iNOS via the transcription factor NFkB. The NO level from iNOS can get very high, and can even reach 1 nM/L.

    It is this NO that can lead to mitochondrial failure under conditions of immune system activation. At high NO levels NO blocks cytochrome c oxidase and mitochondria are shut down. That is ok, so long as enough ATP can be supplied by glycolysis. But glycolysis supplies only 1/20 the ATP of oxidative phosphorylation. If you try to do “too much”, and exceed the ATP that can be supplied by glycolysis, then the mitochondria “turn on” and to do so they generate superoxide to pull the NO level down. If the NO level is modest (as under non-septic conditions), everything works ok. If the NO level is too high, then the mitochondria get shut off long term. If enough mitochondria get shut off, then you get multiple organ failure and you die. This shut off can occur pretty rapidly because once mitochondria start to shut themselves down, the fewer that are left get pushed to higher potentials where they get shut down faster.

    Of course there are different degrees of this depending on the “details” of which tissue compartment, how much NO, and a lot of other different things. Your body will “let” you do what ever you can get it to do, regardless of the damage you may be causing. Your body can’t tell if you are pushing because you need to run from a bear, or because you

  25. #25 BB
    March 26, 2008

    Sandy- read the story, thank you for the link. The police chief didn’t see a reason to remove any of the other 3 siblings? HELLO??!!!!

  26. #26 genewitch
    March 26, 2008

    Daedalus! you’re alive!

    Orac, get better. I like you haven’t had the flu in years, i dodged it this year mostly because i wasn’t in calfornia to get the worst of it. the flu makes me want to die in a fire. >.<

    Orac you should write about daedalus. He’s my favorite commenter.

  27. #27 Interrobang
    March 26, 2008

    Hi, Orac and friends, I had the Death Crud too, except in my case it wasn’t la grippe, it was something on the order of sleeping sickness crossed with a charming “total-body migraine.” I couldn’t wake up, and didn’t want to be awake when I was. I think I slept sixty hours in four days. Even for me, that’s the somnolent equivalent of a marathon.

    My doctor informs me that it was probably a virus, because there are “lots of weird things going around this year, and all of them make you feel like garbage.”

    If I could ask you a favour, could you please do something about ColdFX? I’ve been having people left, right, and centre pushing it on me, and I am pretty sure it’s expensive woo, but I don’t know why and I don’t have any ammo to use on people who are essentially blaming me for getting sick because I don’t take it… (Yeah, and if garlic prevented colds like you folks say, I’d never be sick a day in my life.)

  28. #28 Blake Stacey
    March 26, 2008

    After an interesting Q&A session, Richard Dawkins is reconsidering the use of the word Darwinism, as it might sound too much like a cult of personality.

  29. #29 Ben Wraith
    March 26, 2008

    I’d love to see more deconstruction of 9/11 Truthers or maybe even UFOs, if it’s not too off topic. I rarely come a good skeptical summary of UFOs.

  30. #30 Dianne
    March 26, 2008

    Not quite you’re usual thing, but this unique explanation of global warming might amuse you.

  31. #31 blf
    March 26, 2008

    Orac’s death crud is a not very subtle hint from the Big Pharma Lizard Overlords. They are not happy with you Orac!

    And it looks like Ian McKellen will again be playing Gandalf in the forthcoming The Hobbit movie.

  32. #32 Robert W. Donnell
    March 26, 2008

    Last time I had a bad and drawn out case of the crud I got so desparate I even considered trying woo. The thought passed.

    When you’re feeling better check out all the links on AMSA’s new naturopathic medicine page.

    http://www.amsa.org/naturopath/

    You may find something worthy of a post.

  33. #33 deenaclaire
    March 26, 2008

    I’d like to have your comments on the like of Dr. William Rader, who claims to be giving embryonic stem cell transplants down in (I think) the Dominican Republic.

    And I’d really like more information about Abraham Starchild Cherrix. Haven’t seen anything recently in the news.

    Hope you feel better.

  34. #34 Alan Kellogg
    March 26, 2008

    Orac, the first step is to stay home and rest. You have cable tv, put on one of the cartoon channels and put your mind on hold. Right now you need something mindless to occupy your time.

    Chicken soup. Every day chicken soup. Nutrients and liquids in one convenient package. Tastes good and is easy to keep down. There is a reason why they call it Jewish Penicillin. Otherwise eat light. Small salads and fruit. Nothing heavy.

    Last, but most important, don’t fret. Stress screws with the immune response. I know this because my disability leads to stress with screws with my immune system.

    BTW, you can get all sorts of disgusting gunk out of your sinuses with nasal rinsing. But for hardcore sinusal cleansing only a nose vacuum can do the trick. Ask the ear, nose, and throat guy at your hospital the next time you see him.

    Remember, flu bugs don’t hate you, they just see you as a convenient source of material and manufacturing centers for making more flu bugs. :)

  35. #35 Jennifer Ouellette
    March 26, 2008

    I had the selfsame death crud at the beginning of February. It’s horrible. You have my sincerest empathy. And you’ve got another few days of it. Damn virus knocked me down for a full week…

  36. #36 Regan
    March 26, 2008

    I’d like to see your wise discussion of things that might look close to woo, but are not woo, vs. that which is completely woo, and the distinctions. I think one issue is that of subtle discrimination…outright fall down and laugh woo is pretty discernible to many.

    Sorry you are whacked with the flu; it’s one that hangs on; be careful of pushing yourself too hard–I did and ended up sick for a month.

    As for going in to work–what is this construct where we drag ourselves in to work or school if only slightly ambulatory but completely fuzz-headed and possibly contagious? I figure it’s my civic duty (if I have enough vacation or sick time accrued) to not “share the wealth” with those around me. The school has been sending frantic emails asking parents to “Please, don’t send your child with the flu to school” and a list of indicators of illness.

  37. #37 khan
    March 26, 2008

    When I was in college (68-72) there was a bug referred to as “Potsdam Plague” “Creepy Crawly Crud” “Potato Blight”

  38. #38 steppen wolf
    March 26, 2008

    Hi guys,

    sorry to intrude, but I would like to ask you to 1) spread the news about this carnival and 2) submit a post yourselves if you are interested!

    The all-spanking-new Cancer Research Blog Carnival #8 is coming up, and I would love to get some submissions from you by April 3. You can use the form here to submit your cancer-research-related post.

    Discussion of cancer-related woo and peer-review articles is welcome!

  39. #39 HCN
    March 27, 2008

    Alan Kellogg said “Chicken soup. Every day chicken soup. Nutrients and liquids in one convenient package. Tastes good and is easy to keep down. There is a reason why they call it Jewish Penicillin. Otherwise eat light. Small salads and fruit. Nothing heavy.”

    When we get sick, we go down the block to our neighborhood Chinese restaurant and get Hot and Sour Soup. Yummy, warm with a nice bit of heat to help clear the sinuses. We call it Chinese Penicillin.

    Orac, you should ask Mrs. Orac to bring some home on the way back from work.

    We also do chicken soup. Last night I made a nice batch from the roasted chicken that was dinner the other night. Threw in carrots, celery, onion, herbs from the yard, and for some extra kick I put in pepper corns, a couple of cloves and some coriander seed. Extra tasty, and good for what ails you.

  40. #40 Marilyn
    March 27, 2008

    Only a guy would whine and moan like you’re doing. I pity your wife/s.o. for having to put up with you.

  41. #41 Jud
    March 27, 2008

    There’s not only flu, there’s something called “adult whooping cough” going around. My doctor offered me a combined vaccine for it and tetanus, and I jumped at the chance. Got the flu vaccine too, $10 at my workplace. Whoo!

    Then I came down with strep throat and pinkeye. (‘Struth.)

  42. #42 Monado, FCD
    March 28, 2008

    Sorry to hear you’re down with the lurgy. It’s been years since I had flu but find Vitamin C is excellent for colds. It’s consistent, too. I take it, about a gram an hour, until it suppresses the symptoms. If I take 2 or 3 grams at the first sniffle, that usually stops it. If I miss the first couple of days, I can only suppress the symptoms. I have to take more Vitamin C and if I stop the symptoms come back. I don’t know if that’s a placebo effect but it works fine for me. I’d like to see some such regime actually tested on a large sample group.

    I read somewhere that a preliminary scientific study showed that chicken soup stimulates the production of antibodies, but you know preliminary studies — they’ll say anything to get attention.

    Hot & sour soup sounds like a great idea. Fluids, warmth, steam, and nutrition.

    Then there’s hot water. lemon juice, sugar & rum concoctions.

    I’ve been getting flu shots pretty regularly — missed it last year but came up lucky and didn’t catch anything. When it came out you could pay extra for it, then children and seniors got it free, and now the Ontario government covers it for everyone because it saves so much work time.
    My son, who thinks vaccinations are bad, had the flu for at least a week. Sigh.

    Finally, there are some statistical indications that people who get flu shots are less likely to get Alzheimer’s.

  43. #43 katrina
    March 28, 2008

    please take on the indoor tanning association and their add in the new York times saying that tanning is good for you and doesn’t cause cancer, but actually prevents it.

    Get well soon.