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N.S. family blames hospital staff for ‘hastened’ death

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The last morning Tracy Gilbert saw her father alive, she walked into his room at the palliative care unit in Truro, N.S., and noticed he was struggling.

He was pulling at the sheets and moving his arms, she says, and it was obvious something was wrong.

At first, Gilbert thought her father was itchy. But two hours later, she realized it was much more severe — the bedside oxygen machine her family had become used to hearing had gone silent.

“There is no way that anybody can look at us and tell us that they didn’t know he needed oxygen to live,” said Gilbert.

Donnie Taylor’s plan was to die at home, looking out at the lake. He ended up in the palliative care unit at the Colchester East Hants Health Centre one month before he died. (Submitted)

Donnie Taylor’s family alleges he went 13 hours without oxygen after he was returned to his hospital room following a family gathering down the hall.

The 69-year-old man died the next day — Aug. 23, 2017.

Taylor had a long battle with chronic obstructive pulmonary disease (COPD) believed to be caused by asbestos exposure on the job. In his final months, he was diagnosed with lung cancer.

But Taylor’s family claims the lack of oxygen “hastened” his death.

Hospital staff doesn’t agree. However, changes were made on the palliative care unit following Taylor’s death. 

“Instead of celebrating a birthday we were at a funeral home for his 70th birthday,” said Kelly Knox, Taylor’s daughter.

Donnie Taylor is remembered by his family as a loving great-grandfather. Despite his illness, he spent as much time with them as possible. (Submitted )

Health records obtained by CBC News confirm Taylor was prescribed five litres per minute of oxygen, but was only getting 10 per cent of that on the morning of his death. When the family notified a nurse about their discovery, the nurse immediately turned Taylor’s oxygen level back up to five litres.

Pushing for answers

Seventeen months later, the Taylor family continues to push for answers. They recently filed a complaint with the College of Registered Nurses of Nova Scotia, hoping it will lead to disciplinary measures.

The Nova Scotia Health Authority (NSHA) conducted its own quality review following Taylor’s death that resulted in several policy changes at Colchester East Hants Health Centre. The Department of Health also completed two investigations after the family filed a complaint.

The family has had several meetings with hospital officials, including at least one with senior management. The health authority has apologized to the family in writing and in person for their loss.

“It tells me that somebody said, ‘Uh oh, something wrong here. We need to check this out,'” said Taylor’s widow, Sandra. 

“And, in the hospital’s mind, they knew they were in trouble.”

Donnie Taylor died a few days before his 70th birthday. He suffered a long battle with COPD and lung cancer, following exposure to asbestos on the job. (Submitted)

As a result of the quality review, staff at Truro’s palliative care unit was ordered to “review documentation practices related to checking oxygen administration levels throughout each shift” and “provide intentional education regarding the role of oxygen on the Palliative Care Unit.” 

Staff were also trained on “development of communication skills.”

Hospital response

The health authority will not comment on the case. Because it was a “serious reportable event” that led to a quality review, the health authority said all details are confidential.

Dr. Dave Henderson, senior medical director of integrated palliative care at the health authority, said a lot of work is happening behind the scenes to improve palliative care in Truro and across the province.

He said more than 1,200 health professionals have received additional training through a program called Learning Essential Approaches to Palliative Care (LEAP) in the last few years.

“Often still in nursing schools and medical schools, we don’t get as much training as we would like in palliative care,” said Henderson. “So we’re working on that both provincially and nationally but also for those people that are out working already.”

Dr. Dave Henderson, senior medical director of integrated palliative care at the Nova Scotia Health Authority, says more training is needed for health care staff. (Robert Short/CBC)

In the last year, the health authority’s northern zone, which covers Colchester, Pictou County and Cumberland, received funding for three part-time palliative care social work positions. A full-time social worker has also been hired to focus on bereavement, grief and wellness counselling for the region.

One of those social workers has been working closely with the Taylor family.

Dying plan

Sandra Taylor said her husband knew he was dying and he had spent months preparing with palliative care staff for a comfortable death.

“He thought, you know, eventually, ‘I would just sleep longer, and one time I just won’t wake up.’ And it should have been that way. That was the whole plan,” she said.

Instead, his loved ones believe he spent his last day in pain.

Taylor’s hospital charts indicate he was not in distress the night before his death. Rather, that he had apnea and appeared “congested.” Sandra Taylor was called by staff around 6 a.m.

A review conducted by the Department of Health determined the family’s claims of neglect were unfounded. Although on the question of how the drastically reduced oxygen levels ultimately affected Taylor’s death, the report is inconclusive.

Donnie Taylor had an early birthday celebration in the palliative care unit with his family. His loved ones say he was no longer verbal but he was aware of his surroundings. (Submitted)

In her report, compliance officer Adele Griffith said: “It was reported by palliative care staff that it cannot be definitively determined that the affected patient did not suffer any discomfort because of the incorrect oxygen flow being administered; however, there is also no evidence to the contrary from staff.”

It was also not confirmed in Griffin’s findings that Taylor required continuous oxygen 24 hours a day.

Birthday party

The family strongly believes Donnie Taylor did require continuous oxygen.

They allege it was never turned back on following an early birthday party for Taylor the day before he died. Taylor was wheeled down the hall to a party room on portable oxygen, where his wife and daughters say he wasn’t verbal but was aware of his surroundings.

Once the party was over, the family left around 8 p.m. Sandra Taylor said when she was walking out the door, nurses were moving him back to his room. 

“When he didn’t get the oxygen turned on [on] the wall, when that happened that may have been a chaotic error, maybe, you know, it’s possible things like that can happen,” she said.

But Taylor said she got angry when no one owned up to the alleged mistake.

“He didn’t have oxygen and somebody didn’t give it to him. And in this case they were special palliative care nurses and doctors.”

Knox believes the “culture of acceptability” within the palliative care unit needs to change.

“It’s because you’re dealing with somebody who isn’t going to remember anyway. You know, they’re pretty much really not going to know, right? And that is not acceptable,” she said.

“Why would you say that about a man who spent his whole life caring about people and their rights. To have that happen to you and to your family … it’s just wrong.”

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Frostbite: What it is and how to identify, treat it

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Manitoba’s temperature has plummeted to its coldest level this season, triggering warnings about the extreme risk of frostbite.

Oh, we know it’s cold. We can feel Jack Frost nipping at our noses. But what about when he gnaws a little harder — what exactly does “frostbite” mean?

People tend to underestimate the potential for severe injuries in the cold, says the Winnipeg Regional Health Authority. We laugh off the sting of the deep freeze, rub our hands back from the brink of numbness and wear our survival proudly like a badge.

That’s because, in most cases, frostbite can be treated fairly easily, with no long-term effects.

But it can also lead to serious injury, including permanent numbness or tingling, joint stiffness, or muscle weakness. In extreme cases, it can lead to amputation.

Bitter cold can cause frostbite in just minutes. Here’s how to recognize the warning signs and treat them. 0:59

Here’s a guide to identifying the first signs, how to treat them, and when to seek medical help.

What is frostbite and frostnip?

Frostbite is defined as bodily injury caused by freezing that results in loss of feeling and colour in affected areas. It most often affects the nose, ears, cheeks, chin, fingers or toes — those areas most often exposed to the air.

Cooling of the body causes a narrowing of the blood vessels, slowing blood flow. In temperatures below –4 C, ice crystals can form in the skin and the tissue just below it.

Frostnip most commonly affects the hands and feet. It initially causes cold, burning pain, with the area affected becoming blanched. It is easy to treat and with rewarming, the area becomes reddened.

Frostbite is the acute version of frostnip, when the soft tissue actually freezes. The risk is particularly dangerous on days with a high wind chill factor. If not quickly and properly treated, it can lead to the loss of tissues or even limbs. 

Signs of frostbite

Health officials call them the four P’s:

  • Pink: Skin appears reddish in colour, and this is usually the first sign.
  • Pain: The cold becomes painful on skin.
  • Patches: White, waxy-feeling patches show when skin is dying.
  • Prickles: Affected areas feel numb or have reduced sensation.

Symptoms can also include:

  • Reduced body temperature.
  • Swelling.
  • Blisters.
  • Areas that are initially cold, hard to the touch.

Take quick action

If you do get frostbite, it is important to take quick action.

  • Most cases of frostbite can be treated by heating the exposed area in warm (not hot) water.
  • Immersion in warm water should continue for 20-30 minutes until the exposed area starts to turn pink, indicating the return of blood circulation.
  • Use a warm, wet washcloth on frostbitten nose or earlobes.
  • If you don’t have access to warm water, underarms are a good place to warm frostbitten fingers. For feet, put them against a warm person’s skin.
  • Drink hot fluids such as hot chocolate, coffee or tea when warming.
  • Rest affected limbs and avoid irritation to the skin.
  • E​levate the affected limb once it is rewarmed.

Rewarming can take up to an hour and can be painful, especially near the end of the process as circulation returns. Acetaminophen or ibuprofen may help with the discomfort.

Do not …

There are a number of things you should avoid:

  • Do not warm the area with dry heat, such as a heating pad, heat lamp or electric heater, because frostbitten skin is easily burned.
  • Do not rub or massage affected areas. This can cause more damage.
  • Do not drink alcohol.
  • Do not walk on your feet or toes if they are frozen.
  • Do not break blisters.

Seek immediate medical attention

While you can treat frostbite yourself if the symptoms are minor — the skin is red, there is tingling — you should seek immediate medical attention at an emergency department if:

  • The exposed skin is blackened.
  • You see white-coloured or grey-coloured patches.
  • There is severe pain or the area is completely numb.
  • The skin feels unusually firm and is not sensitive to touch after one hour of rewarming.
  • There are large areas of blistering.
  • There is a bluish discolouration that does not resolve with rewarming.

Be prepared

The best way to avoid frostbite is to be prepared for the weather in the first place.

Wear several loose layers of clothing rather than a single, thick layer to provide good insulation and keep moisture away from your skin.

The outer garment should breathe but be waterproof and windproof, with an inner thermal layer. Retain body heat with a hat and scarf. Mittens are warmer than gloves because they keep the fingers together.

Be sure your clothing protects your head, ears, nose, hands and feet, especially for children.

Wind chill and frostbite rates

Wind chill: 0 to –9.
Frostbite risk: Low.

Wind chill: –28 to –39.
Frostbite risk: Moderate.

Exposed skin can freeze in 10-30 minutes

Wind chill: –40 to –47.
Frostbite risk: High.

Exposed skin can freeze in five to 10 minutes.

Wind chill: –48 to –54.
Frostbite risk: Very High.

Exposed skin can freeze in two to five minutes.

Wind chill: –55 and lower.
Frostbite risk: Extremely High.

Exposed skin can freeze in less than two minutes.
 

NOTE: In sustained winds over 50 km/h, frostbite can occur faster than indicated.

Source: Environment Canada

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Awkward Flu Jabs Attempted at Golden Globes

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In what can only be described as a new level of propaganda, hosts Andy Samberg and Sandra Oh featured a flu shot stunt during the 76th Golden Globe Awards ceremony. They told the audience to roll up their sleeves, as they would all be getting flu shots, while people in white coats stormed down the aisles, syringes in hand.

Most of the audience looked thoroughly uneasy at the prospect of having a stranger stick them with a needle in the middle of an awards show. But perhaps the worst part of the scene was when Samberg added that anti-vaxxers could put a napkin over their head if they wanted to be skipped, basically suggesting that anyone opposed to a flu shot deserved to be branded with a proverbial scarlet letter.

The flu shots, for the record, were reportedly fake,1 nothing more than a bizarre gag that left many people stunned by the Globe’s poor taste in turning a serious medical choice into a publicity gimmick.

Flu Shot Stunt Reeks of Desperation

Whoever came up with the idea to turn the Golden Globes into a platform for a public health message probably thought it was ingenious, but the stunt only serves as a seemingly desperate attempt to make flu shots relevant and in vogue. During the 2017 to 2018 flu season, only 37 percent of U.S. adults received a flu shot, a 6 percent drop from the prior season.2

“To improve flu vaccination coverage for the 2018-19 flu season, health care providers are encouraged to strongly recommend and offer flu vaccination to all of their patients,” the U.S. Centers for Disease Control and Prevention (CDC) wrote. “People not visiting a provider during the flu season have many convenient places they can go for a flu vaccination.”3

Yet, perhaps the decline in people choosing to get vaccinated has nothing to do with convenience and everything to do with their dismal rates of efficacy. In the decade between 2005 and 2015, the influenza vaccine was less than 50 percent effective more than half of the time.4

The 2017/2018 flu vaccine was a perfect example of this trend. The overall adjusted vaccine effectiveness against influenza A and B virus infection was just 36 percent.5

Health officials blamed the flu season’s severity on the dip in vaccination rates, but as Dr. Paul Auwaerter, clinical director of the division of infectious diseases at Johns Hopkins University School of Medicine, told USA Today, “[I]t is also true that the vaccine was not as well matched against the strains that circulated.”6

But bringing flu shots to the Golden Globes, and calling out “anti-vaxxers,” is nothing more than “medical care, by shame,” noted Dr. Don Harte, a chiropractic activist in California. “But it was entertaining, in a very weird way, including the shock and disgust of some of the intended victims, notably [Willem Dafoe],” he said, adding:7

“This Hollywood publicity stunt for the flu vaccine is one of the stupidest things I’ve ever seen from celebrities. But it does go with the flu shot itself, which is, perhaps, the stupidest of all the vaccines available.”

Did 80,000 People Really Die From the Flu Last Year?

The CDC reported that 79,400 people died from influenza during the 2017/2018 season, which they said “serves as a reminder of how severe seasonal influenza can be.”8 It’s important to remember, however, that the 80,000 deaths figure being widely reported in the media is not actually all “flu deaths.”

According to the CDC, “We look at death certificates that have pneumonia or influenza causes (P&I), other respiratory and circulatory causes (R&C), or other nonrespiratory, noncirculatory causes of death, because deaths related to flu may not have influenza listed as a cause of death.”9

As for why the CDC doesn’t base flu mortality estimates only on death certificates that list influenza, they noted, “Seasonal influenza may lead to death from other causes, such as pneumonia, congestive heart failure or chronic obstructive pulmonary disease … Additionally, some deaths — particularly among the elderly — are associated with secondary complications of seasonal influenza (including bacterial pneumonias).”10

In other words, “flu deaths” are not just deaths directly caused by the influenza virus, but also secondary infections such as pneumonia and other respiratory diseases, as well as sepsis.11

According to the CDC, most of the deaths occurred among those aged 65 years and over, a population that may already have preexisting conditions that makes them more susceptible to infectious diseases. As Harte said of annual flu deaths, “[M]ost if not all, I would assume, are of people who are already in very bad shape.12

CDC Claims Flu Vaccine Reduces Flu Deaths in the Elderly — But Does It?

Since people aged 65 and over are those most at risk from flu complications and death, the CDC has been vocal in their claims that the flu shot significantly reduces flu-related deaths among this population. The research, however, says otherwise.

Research published in 2005 found no correlation between increased vaccination rates among the elderly and reduced mortality. According to the authors, “Because fewer than 10 percent of all winter deaths were attributable to influenza in any season, we conclude that observational studies substantially overestimate vaccination benefit.”13

A 2006 study also showed that even though seniors vaccinated against influenza had a 44 percent reduced risk of dying during flu season than unvaccinated seniors, those who were vaccinated were also 61 percent less like to die before the flu season ever started.14

This finding has since been attributed to a “healthy user effect,” which suggests that older people who get vaccinated against influenza are already healthier and, therefore, less likely to die anyway, whereas those who do not get the shot have suffered a decline in health in recent months.

Journalist Jeremy Hammond summed up the CDC’s continued spreading of misinformation regarding the flu vaccine’s effectiveness in the elderly, as they continue to claim it’s the best way to prevent the flu:15

[T]here is no good scientific evidence to support the CDC’s claim that the influenza vaccine reduces hospitalizations or deaths among the elderly.

The types of studies the CDC has relied on to support this claim have been thoroughly discredited due to their systemic ‘healthy user’ selection bias, and the mortality rate has observably increased along with the increase in vaccine uptake — which the CDC has encouraged with its unevidenced claims about the vaccine’s benefits, downplaying of its risks, and a marketing strategy of trying to frighten people into getting the flu shot for themselves and their family.”

Death of Vaccinated Child Blamed on Not Getting Second Dose

In January 2019, the state of Colorado reported the first child flu death of the 2018/2019 flu season — a child who had received influenza vaccination. But instead of highlighting the vaccine’s failure and clear limitations, the Colorado Department of Public Health and Environment blamed the death on the child being only “partially vaccinated.”

“It’s an unfortunate but important reminder of the importance of two doses of influenza vaccine for young children who are receiving influenza vaccine for the first time,” Dr. Rachel Herlihy, who is the state communicable disease epidemiologist, said in a news release.16 For those who aren’t aware, the CDC notes that one dose of flu shot may not be enough to protect against the flu. Instead, they state:17

“Children 6 months through 8 years getting vaccinated for the first time, and those who have only previously gotten one dose of vaccine, should get two doses of vaccine this season …

The first dose ‘primes’ the immune system; the second dose provides immune protection. Children who only get one dose but need two doses can have reduced or no protection from a single dose of flu vaccine.”

Not only may the flu vaccine fail to provide protection against the flu, but many people are not aware that other types of viruses are responsible for about 80 percent of all respiratory infections during any given flu season.18 The flu vaccine does not protect against or prevent any of these other types of respiratory infections causing influenza-like illness (ILI) symptoms.

The chance of contracting actual type A or B influenza, caused by one of the three or four influenza virus strains included in the vaccine, is much lower compared to getting sick with another type of viral or bacterial infection during the flu season.

Does Flu Vaccine Increase the Risk of Influenza Infection, Contribute to Vaccine Shedding?

There are serious adverse effects that can come along with annual flu vaccination, including potentially lifelong side effects such as Guillain Barré syndrome and chronic shoulder injury related to vaccine administration (SIRVA). They may also increase your risk of contracting more serious flu infections, as research suggests those who have been vaccinated annually may be less protected than those with no prior flu vaccination history.19

Research presented at the 105th International Conference of the American Thoracic Society in San Diego also revealed that children who get seasonal flu shots are more at risk of hospitalization than children who do not. Children who had received the flu vaccine had three times the risk of hospitalization as children who had not. Among children with asthma, the risk was even higher.20

There’s also the potential for vaccine shedding, which has taken on renewed importance with the reintroduction of the live virus vaccine FluMist during the 2018/2019 season. While the CDC states that the live flu virus in FluMist is too weak to actually give recipients the flu, research has raised some serious doubts that this is the case.

One recent study revealed not only that influenza virus may be spread via simple breathing (i.e., no sneezing or coughing required) but also that repeated vaccination increases the amount of virus released into the air.21

MedImmune, the company that developed FluMist, is aware that the vaccine sheds vaccine-strain virus. In its prescribing information, they describe a study on the transmission of vaccine-strain viruses from vaccinated children to nonvaccinated children in a day care setting.

In 80 percent of the FluMist recipients, at least one vaccine-strain virus was isolated anywhere from one to 21 days following vaccination. They further noted, “One placebo subject had mild symptomatic Type B virus infection confirmed as a transmitted vaccine virus by a FluMist recipient in the same playgroup.”22

Are There Other Ways to Stay Healthy During Flu Season?

Contrary to the CDC’s and Golden Globe’s claims that flu vaccinations are a great way to prevent flu, other methods exist to help you stay healthy during the flu season and all year, and they’re far safer than annual flu vaccination. Vitamin D testing and optimization have been shown to cut your risk of respiratory infections, including colds and flu, in half if you are vitamin D deficient, for instance.23,24

In my view, optimizing your vitamin D levels is one of the absolute best respiratory illness prevention and optimal health strategies available. Influenza has also been treated with high-dose vitamin C,25 and taking zinc lozenges at the first sign of respiratory illness can also be helpful.

Following other basic tenets of health, like eating right, getting sound sleep, exercising and addressing stress are also important, as is regularly washing your hands.

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Homemade Miso Soup With Vegetables

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homemade miso soup

Sometimes when the weather is chilly or you’re simply feeling under the weather, there is nothing better than a warm brothy soup. This miso soup combines nutrient-rich bone broth with the probiotic benefits of miso. And you get the benefits of vitamins and minerals from vegetables too. Make a big batch for the whole family or just one bowl for you!

What Is Miso?

Miso is a potent paste made out of fermented soybeans. But isn’t soy bad for you, you ask? Yes and no. Soy beans, like any legume, contain a large amount of phytic acid which interferes with nutrient absorption. They also contain phytoestrogens, which have their own negative side effects.

However, miso is fermented soy. Fermented foods contain bacteria which has eaten the sugars and starches present in the food. This process preserves the food and also gives it probiotics, enzymes, and additional vitamins. It makes the food more easily digested and the nutrients easier for the body to use.

There are several different colors of miso available, and all of them are just fine for soup making. Generally, the darker colored the miso, the stronger the flavor. I can usually find miso in the ethnic food section of my grocery store, but there are also some good organic options available online.

How to Make a Quick Miso Soup

To make miso soup, add a few teaspoons of miso paste is to a broth with spices and vegetables. Traditionally, dashi, the broth used for miso soup, is made with dried bonito (a type of fish) flakes and kelp. While you are welcome to do it this way, you can also use a good chicken bone broth like the one sold at Kettle and Fire.

Then, just top with additional seasonings, some vegetables, the miso, and sometimes a hard-boiled egg.

One note on adding the miso — it works best if you remove about ¼ cup of the warm broth from the pan and whisk in the miso paste with a fork before returning it to the rest of the soup. Once you add the miso, just warm the soup gently. Don’t boil it or you’ll destroy all the gut healthy bacteria in the miso!

If you’d like to try your hand at making dashi, the traditional fish and kelp broth for miso soup, this video is a good one.

No Time to Make From Scratch?

If you want to make life even simpler, Kettle and Fire also sells a delicious miso soup that’s all ready to go. Just heat it up and add any vegetables you like.

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Homemade Miso Soup Recipe

It’s easy to make miso soup at home using a good chicken bone broth, miso paste, and vegetables.

Ingredients

  • cup chicken broth
  • 1 clove garlic (minced)
  • ¼ tsp onion powder
  • ½ tsp ginger (grated)
  • 3 mushrooms (sliced)
  • 1 TBSP miso paste
  • ½ cup fresh spinach
  • 1 green onion (chopped)
  • 1 egg (optional)

Instructions

  • In a small saucepan, combine the broth, minced garlic, onion powder, grated ginger, and sliced mushrooms.

  • Bring it to a boil, then reduce the heat and simmer 5 minutes.

  • Allow the broth to cool slightly.

  • Remove ¼ cup of the warm broth to a small bowl and whisk in the miso paste.

  • Return the broth/miso mixture to the pan with the rest of the broth.

  • Turn the heat on low and add the spinach, heating just until warmed.

  • Top with the green onion and hard boiled egg if desired.

Notes

Other vegetables you can add: baby bok choy, daikon, cabbage, kale, chard

Nutrition

Serving: 1.5cups | Calories: 181kcal | Carbohydrates: 14g | Protein: 17g | Fat: 7g | Saturated Fat: 2g | Cholesterol: 163mg | Sodium: 820mg | Potassium: 675mg | Fiber: 2g | Sugar: 3g | Vitamin A: 35.3% | Vitamin C: 10.5% | Calcium: 5.4% | Iron: 14.7%

Have you ever used miso? What do you do with it?

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