I thought I'd take a minute to share a document I recently received in email. It is a dramatic demonstration that shows the amount of bacteria that lives on your fingers and hands. The message is "Wash your hands often and do it right!" The topic is timely with Bird Flu steadily advancing across the globe. During a health crisis, controlling the spread of bacteria becomes a priority for entire populations.

The first two images should grab your attention. If you are still curious, open the web site hosted by the Georgia College of Agriculture and read the entire story.

The test was done by touching finger tips to an agar-filled petri dish then waiting 24 hours. The growth of bacteria is truly astonishing. The test continues by washing the fingers and hands in different ways and repeating the test.

Image 1: Unwashed fingers touching the agar material.

Image2: The resulting bacteria growth after 24 hours.

So when should you wash your hands?

• when hands are visibly soiled
• after using the washroom (includes changing diapers)
• after coughing, sneezing, or blowing your nose
• before and after eating; handling food
• after touching raw meat, poultry or fish
• after handling garbage
• after handling pets, animals, or animal waste
• after shaking hands

But what is the correct way to wash your hands? It's really easy if you follow a few simple rules.

1. get your paper towel ready before your start and keep it dry and clean
2. remove rings or jewelry
3. turn on the water and adjust it to a comfortable but warm temperature
4. rinse your hands then apply soap. one squirt from the soap dispenser is enough.
5. rub the soap onto your hands starting at the wrists and working down
6. rub it vigorously into your fingers and between them for 10 to 15 seconds
7. rinse your hands in the running water and leave it running
8. pat your hands dry with the paper towel
9. use the paper towel to turn off the fawcet so you do not contaminate your clean hands
10. but wait, don't throw the towel away just yet. Use it again to open the restroom door. Hold the door open with your foot and throw the towel away as you leave.

As with every important task, you need to practice these steps several times. Teach your children by showing them how to do it right.

Hand Sanitizer products are good too but do not rely on them exclusively. Wash your hands using soap and water when possible.

DuPont has recently introduced their RelyOn(tm) product line. It is a professional strength antiseptic solution in sprays and handwipes. RelyOn(tm) is a little difficult to find in stores but is avaliable online for about $4 for a 2oz bottle. Click here for one example.

Purell products are also popular.

Now go and wash your hands!

Sunday was a great day. Dad and I went to the Air Show and Open House at the Dover Air Force Base. We watched F-18 Super Hornets, C-5's, C-17's, P-51's, and the Air Force Thunderbirds. Pictures will be coming soon. Check out the short video clips I've uploaded on YouTube.

Watch a C-5 land.

Watch an F18 Super Hornet create a shock cone as it reaches the sound barrier.

Dad's new DART schedule is working out great. He is getting out earlier and even when the bus is late, it's not near as late as before. Traffic is better at 3:30 than at 4:00. He even gets home before Miss V arrives.

He also had his ICD checkup today and received a clean bill of health. In a few weeks, a device will be installed at home to remotely monitor the ICD so he won't need travel to have it checked. Travel was necessary today because they also wanted to check the incision and placement of the ICD under the skin. All is well.

Next week is the cardiologist appointment to check up on his heart.

Tomorrow's dialysis trip will be extended slightly. The team has ordered a test on his fistula (the attachment point for the dialysis needles) just to make sure it is not being constricted above or below the 'business' area.

Time to begin documenting the DART Paratransit service... Friday, Sept. 22, Dad waited until 4:30 at the VA before being picked up and was then driven into downtown Wilmington where the driver picked up a woman. He then drove her into Hockessin to a private home. Dad didn't get home until after 6:00 -- a 1.5 hour ride in a rattle-trap Paratransit bus after sitting in his powerchair for 1.5 hours in the VA entrance way. 4 hours sitting still for dialysis then 3 hours stuck in the powerchair.

Today, he has been waiting at the VA for 1.5 hours. His arrangement is to be picked up at 4:00 and the paratransit has a window of 30 minutes before being considered late. Tomorrow's post will document today's experience.

I called DART dispach and changed the standard pickup time to 3:30. Maybe this will help with traffic and scheduling his trips home from the Elsmere VA.

This entry is just to capture a few events over the past week that I haven't had time to post.

On Friday, September 1st, Dad felt some pressure and pain in the front of his chest just before getting into the dialysis chair. He took a nitro pill but it didn't have much effect so the nurse gave him an antacid. This helped and he began feeling better. The rest of the dialysis went as expected but the nurses were worried and called in the cardiac and kidney specialists to take a look. Dr. Agerwald, the Chief Surgeon asked that Dad be admitted overnight for observation. There was no heart problem this time. It appears to have been indigestion.

Dad stayed Friday night and was very uncomfortable in the hospital bed. He couldn't wait to get home.

I took him home Saturday morning leaving his powerchair in the dialysis area. Monday morning, I took him back in for dialysis using the black wheelchair and he reconnected with his powerchair.

Friday, he had difficulty with the DART Paratransit. The bus did not show at the prescribed time and he had to wait 3.5 hours after a long diaylsis session. Uncle Ray almost jumped into the Chevy to get him but the bus got there just in time.

Second post from Monday... Read the earlier post first, then return to this one.

Dad's emergency room episode was determined to have been a ventricular fibrillation... where the heart just vibrates and can't get back into a normal rhythm. The standard protocol in this case calls for the implanting of an ICD, or Implantable Cardioverter Defibrillator. The ICD also has a pacemaker feature so it's a combination of the two devices.

He was brought to the prep room at 12:30 where his monitor leads were switched from the portable monitor used on the 2nd floor step-down unit (a step down from the intensive care unit) to a more sophisticated monitor. Although keeping a steady 55 - 57 beats per minute, the monitor graph was rising and falling (?). (I'm not sure what this signifies but after the procedure, the graph maintained a steady horizontal line.)

At 1:00 the anesthetist discussed his role and what Dad should expect from today's procedure. Dad's only question was "When do I get to eat?" He was grumpy most of the day. He hadn't eaten or had a thing to drink since midnight Sunday and to make things worse, he was given a three hour dialysis treatment in the morning.

At 1:20, I wished him good luck and went to the waiting room and registered with the receptionist. She handed me an LED pager... it wasn't really necessary but I carried it around until the doctor appeared at 3:45. All had gone as expected. The ICD was implanted on the right side instead of the usual left side because of the dialysis port in his left arm. They wanted to stay clear of the left side so the leads into the heart are a little longer than they would like but it is not a major concern. He said there would be someone prior to discharge (later in the week) to go over detailed instructions about the care and management of the ICD.

I called Bob, Chad, Wilda and Ray to relay the news then went into the recovery room where Dad was already awake. He saw me coming from about 125 feet away and waved as if to say "All is well". He was wearing an oxygen mask and was very thirsty. He had to endure another 30 minute wait before being released to go back to his room where he ate and drank continuously for almost 90 minutes...

This is the first post to my renewed blog. Events of the past several months could have been documented easily if only I had thought to re-awaken such a useful tool.

Dad's been the family focus of late, just a few weeks following Mom's passing on July 2nd. He was complaining of a pain in the middle of his back between the shoulder blades. At his regular dialysis visit Monday, August 21st, he told the dialysis technician that he needed a nitro pill because he thought his angina was flaring up. One small pill and the pain subsided. Fast forward to the same evening -- His Bayada aid, Virgina, became worried because he had no appetite and went into the bedroom to lay down... totally out of character. Virgina called me and I stopped at the house after work.

When I arrived, Dad was lying on the bed restless. He couldn't get comfortable and didn't feel as though he could fall asleep so he got up and came out to the kitchen table. He ate a little salad and went in on the couch where he stayed until about 9:00. He said the pain had subsided and he was feeling much better. I told him to take it easy and get some sleep and I left for home.

At 2:30AM, the phone rang. It was Dad. The pain had returned and it was intense enough that he felt he should call 911.... I told him to call then I hung up and called Bob. Bob lives closer to Dad's place now and it would take me 35 minutes to get there. He managed to get to the house in about 5 minutes where he found the paramedics already had Dad loaded and were ready to take him to Christiana. He called me with the destination.

I met them at the emergency room entrance where Dad was awake and feeling fine except for the pain between his shoulder blades. He was joking with the paramedics and the admitting staff. We were escorted to ER 9 where Dad was hooked up to a small monitor with about six leads. We were there approximately 30 minutes while the nurses did basic checks and a paper work-up. At that point, only the three of us were in the room. Bob was sitting on a chair and I walked over to the counter to put down my phone and keys. Dad was extremely uncomfortable on the gurney and had tried to sit up straight with his back off of the mattress. I had moved over to the starboard side of the gurney when I glanced at Dad and saw him stiffen and begin to shudder. He stiffened his entire body and his arms went straight with his palms down. His mouth opened and his eyes rolled up and to the right and he went grey immediately. I put both hands on his face and yelled "DAD!". He went limp.

I called for help just as our nurse was coming around the corner. Her expression immediately went to a sad "oh no" look. She called for assistance and from that moment on, people just kept arriving until there was no room for me or Bob. The first male nurse to come into the room began to pound Dad's chest with his fist. One, two, three thumps but the monitor didn't change. He started chest compressions while another nurse started using a mask and air pump. They continued this for at least two minutes. Bob and I were asked to stand outside so we did. I had propped the door open about an inch with my foot so I could watch Dad. I couldn't see anything except his left ear and neck but I could tell he was in serious trouble. This was the moment that I realized I was shaking noticeably. I watched as they used the defibrillator and with a single hit, Dad's heart found its rhythm and began beating on its own. I could hear the nurses calling out various things then Dad tried to sit up or get out of the gurney. He let out several growls and loud groans pulling himself up off of the mattress. One of the nurses called his name a few times and told him to lay back down... "Mr. Davis, Mr. Davis, Don't try to get up..." As he was lying down again, someone pushed the door closed.

About that time, this huge guy came around the hallway and said we should wait in the ER waiting room. I looked at him in disbelief, shook my head and said I wasn't leaving. He didn't say another word and walked back the way he had come. A few moments later, a nurse appeared and said we could watch from the inner entrance to the trama room. We were escorted to the area just past the inside nurses station where we could see the crowd around Dad. They were winding down... moving away giving a few remaining staff more room to work but none of them were leaving. We all stayed between the small trama room and the nurses station watching the monitors. The worst was over.

For more information on Ventricular fibrillation (VF):

http://www.hrsonline.org/

http://www.hrspatients.org/patients/treatments/cardiac_defibrillators/default.asp