Strep Throat 2015, or “Hey! I wasn’t done yet!”

I am a 38-year old female who recently got strep throat?!?! My boyfriend’s doctor told him once upon a time that strep only affects children, and it’s pretty common knowledge even among people who like to choose a “natural” approach that strep should be answered with antibiotics. It’s just what you do, right?. I have learned a bunch of things over the last few months and I’d like to get them all out here. Right now it’s just a log of days’ events without much formatting or analysis.


 

October 21 (Monday) — Very slight “something’s not totally normal” feeling in throat

October 22 (Tuesday) — Wake up with legitimately sore throat, but one of those ones that might go away during day. It didn’t go away and by about 2pm I was running a fever. I was at work and turns out judging by what I discovered later — careless mistakes, couldn’t remember talking to customers — that I should have been there at all! Had tickets to pre-season Jets game I had to bail on. That’s how sick I was. Went home, got into bed, and cried. Justin made me check my temp (39C/102F) and urged me to drink fluids and take some Advil.

October 23 (Wednesday) — Had scheduled day off. Throat felt awful, still feverish, laid around and was just sick all day. In afternoon finally decided to look at throat with flashlight and see if it was strep. Throat COVERED in white pustules and very swollen. Realized I was not going to be OK for work and called in.

October 24 (Thursday) — First thing in the morning Justin took me to the walk-in clinic by Polo Park. Only had to wait a little over an hour *groan*. Doc did quick test, diagnosed strep and then prescribed 10 days of penicillin. He actually explained how the antibiotics are to guard against rheumatic fever and how strep is self-limiting and I should just take care of myself with soft foods, OTC pain/anti-inflammatory drugs, etc. That was news to me! Though I started to question whether I should take the antibiotics right away, I was too sick to really analyze things. Filled the prescription and started the dose.

October 25 (Friday) — I believe I took this day off work, too. One more day of laying around and feeling sick. I recall expecting the antibiotics to kick in and make me feel miraculously better, but they really didn’t.

October 26 (Saturday) — Went in to work. Recall feeling better, but not great still.

October 27th (Sunday) — Remember waking up feeling GREAT. Overkill/Symphony X show was that night and I remember being almost fearful of going, as I was worried about overdoing it and all of a sudden feeling sick at the show, but I continued to feel really good. Throat wasn’t sore at all.

…..Continued antibiotic course for allotted days and life went on. Antibiotics totally messed with my gut flora and yeast balance, uh, elsewhere. Life going on included a life that didn’t go on for Justin’s mom, who died on October 3rd pretty unexpectedly. Clearly grieving and stress have been the name of the game lately. Last week (since about Halloween) Justin and I haven’t been eating great and too many nights have involved beers and philosophizing…….

November 5th (Thursday) — Justin had caulked windows downstairs with silicone and the house STUNK. Blamed very minor throaty feeling upon waking up on that. Felt better during the day, didn’t think much of it.

November 6th (Friday) — Think I was fine thru the day, but Justin kept waking me up during the night as apparently my snoring was even worse than usual.

November 7th (Saturday) — Woke up feeling OK, though in the afternoon my throat started to get thick feeling. Did errands, got dressing table thing from Mike’s. Started dinner for Ken/Cecile coming over, even ate dinner. Throat was thick but OK. Had one beer that I started after dinner and suddenly felt like shit and had to admit my throat was actually sore. Checked and saw that right tonsil was covered in white. Read in bed ’til 11pm while Justin hung out with Jason and Derrick. Woke up at 1:30am and had to yell at Justin about the noise which usually doesn’t bother me. Oh yeah — took a dose or two of homeopathic Ferrum Phos. 30CH.

November 8th (Sunday) — Woke up around noon really feeling my throat. Moved to the couch and read for a while, fell asleep, read, and so on ALL DAY and ALL NIGHT. Felt like an ass for squandering what will almost assuredly be one of our last nice days of the year off work just laying around being sick. Checked throat in morning. White moved to left tonsil, and got a bit worse thru most of the day. Started salt-water gargles every couple hours and took a few more rounds of Ferrum Phos. Noticed by around 8pm that white in throat seemed to be waning, not getting worse. Had debate with Autumn about whether or not I was committing myself to a week or more of horrible sickness that would end up at the doctor anyway for not going to the doctor for more antibiotics now.

November 9th (Monday) — Woke up in time for work with my throat feeling more raw than swollen, but otherwise OK. Check in mirror revealed white on left tonsil back down to almost nothing and right side looking better than day before by quite a bit. Concerned that fever might come up while at work, but I’m fine and writing this, and the day is almost done. If anything I’m feeling the effects of a “hangover” from laying horizontally on the couch or in bed for 36 hours straight. Throat is still a bit swollen. Did a couple salt-water gargles here but can’t check white crap progress because my flashlight is at home. Have plans to take it easy tonight, which probably means more couch and Star Trek TNG episodes.

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End of this round of infection report, thoughts, and analysis coming soon. This will include more about misconception that antibiotics are required to get rid of strep myth, and why I think the course of my own illness followed the path it did as well as my own background to help flesh this out into something that might be useful to others.

Louisiana 2015

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Crystal’s Page

Crystal died on February 24th, 2015. She went into the hospital about a week before, after living with chronic health issues for quite some time. This time was different than times before. This time she didn’t defy the expectations of everyone involved and walk out of the hospital several days later to pick up where she left off. I’m having a hard time believing it’s real.

Quite literally, her and her husband, Danny, made a home in Arizona a bunch of years ago — one of the only things I think she was outwardly fiercely proud of, despite having so much more to be proud of. You might know her as a Philly person, or a traveller, or even the New Jersey native she was. Despite her and myself living in New Orleans at the same time and hanging out a lot, our friendship really grew after the times that we were able to hang out in a living room or at the dog park together — when I moved to Calgary and she moved to Maine. I can only guess at how many hours we spent on the phone. No I can’t. Not even close, I’m sure. I made a trip down to see her, and all that she’d accomplished in Bisbee in 2010. It was her birthday. September. In the photo of us she looks a hell of a lot less impressed than I do to be together in-the-flesh after so many years, but I don’t care. It’s the photo I have (I think possibly the only one of us together) and a photo I’m sharing on this page that I hate having to make.

I feel lucky to have a couple people I consider “best friends”. Each one gives me a unique perspective on life and plays a really important part in helping me navigate this world. I now have a huge gaping hole in the Crystal spot, and I know I’m not going to ever have another like her. I’m going to miss her continuing perspectives more than even I think I know, and I’m still missing her. The only person who will understand my grieving process for her is her, and it sucks that I can’t talk to her right now instead of making this stupid page. Everyone does it differently, but my thoughts go out to Danny, her immediate family, her Bisbee family, and her family of friends who knew her and loved her as much as myself.

Collected here are some photos I took when I visited Crystal and Danny in Bisbee in 2010. I’m sure I have more to share, and will update into the future as I recover stuff. A start for now.

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Gaining Freedom from Fast Food

I know this awesome woman named Shanell who maintains a blog about her efforts to maintain a balanced lifestyle in the face of an incredibly busy schedule as a Creative Communications student. We know each other through roller derby, which is also a commitment-and-a-half. A balanced life includes friends, family, work, and other day-to-day activities, too. In a blog post from October 2013 she expresses her desire to cut down on fast-food. You can check out her post here, and I encourage you to look around her blog while you’re there.

http://shanellsbalancedlifestyle.wordpress.com/2014/10/17/too-much-mcds/

Shanell’s plight is hardly unique. It’s no secret that we live in a society where fast-food fits in with fast-paced life in general. The trouble is that fast-food is more than just convenient for the consumer. By nature of the service, the products are mass produced utilizing fillers, preservatives, and high levels of ingredient and product processing in order to meet the ends of the businesses selling these products. This is hardly different from any other business, but a big problem is inherent in the model when it comes to one aspect: This is food, not a cute pair of shoes or a roll of paper towels. (Not that other products/services should be cheap and outsourced, but that’s a blog for another day.) Food is one of the most basic human needs, the consumption of which directly affects the very functioning of every cell in our bodies. While a person might very well be able to survive on a diet that includes even a lot of fast-food, it’s questionable whether a fast-food lifestyle can allow us to thrive. Evidence is all around us that it can’t, and people (like Shanell) make personal goals and resolutions that include trying to limit their reliance on fast-food all the time.

drive_thru

Nutrition aside, I hear all the time that fast-food is “cheap”. I really have to say I think it’s a construct and good marketing that leads people to believe that it’s cheap. Sure, every chain has some ‘value menu’ or little items that cost a dollar or two, but who’s actually eating these things, or just one of them? Going back to Shanell’s blog post, she cites spending an average of $10 on a meal, and figures that at her rate of about twice a week she’s handing over almost $1,000 a year. (For many, it’s a daily thing, not a bi-weekly thing.) Food has become expensive in general. I can’t go to the grocery store even for “a few things” without spending many times what that Big Mac meal costs, but the food goes farther, not to mention the nourishment. There are long-run benefits of real food in terms of dollars and cents, too, but that’s also a topic for a different day.

The success rate of resolutions to eat out less are dependent on a complex set of factors. I think the main failure factors are the inability to actually change one’s routine to accommodate
not hitting the drive-thru, plain old inexperience with preparing food from scratch, and not going from unhealthy to healthier, but shooting for the moon with a switch to a diet that is totally impractical to prepare, doesn’t even taste good, and is just generally uninspiring.

The routine thing is major, and there’s nothing anyone can really do about that but you. Eliminating things can be just as hard as having to add an element to your routine, maybe harder! It’s worth thinking about what the circumstances are that make fast-food fit into your day or week, as it’s probably about more than satisfying hunger. While “it’s fast and convenient” is obvious, that’s probably only part of it, and maybe not even true! The people I’m around most who do the fast food thing seem to use it as a way to take a break and physically remove themselves from what they’re doing. The perceived “speed” of the fast-food experience is a totally socially acceptable way to leave school or the workplace for a much needed break. One has to eat, and fast-food is fast, right? You’re doing the responsible thing by just grabbing something “on the go” so you can get back on the job or back to your studies or whatever. The reality, though, is that isn’t that fast. If you’re making the commitment to eating “real” food in place of fast-food you’ll probably need not only to actually make food at home that is practical to eat at work or school or in the car, you’ll have to make the adjustment to finding a new way to make healthier diversions during the day.

shopping-basket

I feel safe in saying most people do not reach adulthood with a solid set of cooking skills these days. It’s getting to the point where even people’s grandparents very likely didn’t themselves, and a semester of home-ec class at 14 years of age isn’t providing “life skills”, I don’t care what anyone says. Instead of putting in one’s dues with ramen noodles, ramen noodles, and more ramen noodles while learning the ropes that will keep you fed ’til you either learn to cook or can find someone who will cook for you regularly, I see people relying on fast food, and I mean relying. They simply don’t have the skills (and possibly the supplies) to make even simple meals at home. There’s only one way to overcome that:  Learn. You don’t have to become some master chef, but the ability to put together a reasonable meal from whole fresh ingredients (putting a frozen store-bought pizza in the oven doesn’t count) is a skill every person should have. There are plenty of resources for gaining the kitchen skills you want and need. YouTube and the internet in general, of course, have made everything more accessible. Chances are you know someone who works or has worked in a restaurant at some point in their life. Ask them about basics (like proper knife handling and use — a skill that will make all the difference in your enjoyment of food preparation.)

Proficient cooking is all about a few basic skills and then a LOT of experimentation and practice. As with any other skill, it shouldn’t be expected that you get amazing results the first time. Recipes are guidelines. Though our food supply is becoming more globalized every day, ingredients still differ from region to region. For instance, Canadian all-purpose flour has a much higher gluten content than American flour, which means that when a Canadian follows an online recipe for cookies or quick-bread that originated in the States, they get a different result. It took me literally years of frustration after I moved from the U.S. to Canada before I learned that, no, I didn’t just start sucking at making a cookie recipe I’d made 100 times before,  the flour I was using was  different. As you try different dishes and techniques, take notes literally on the recipe you’re following. The margins of print-outs I make for recipes and ideas are filled with notes like, “used chicken thighs instead of breasts”, “batter seemed way too thick but followed recipe and it turned out well”, and “next time add another half cup of broth”.

kraft_pizza_sauce_ingredients

Another roadblock I see with the transition from overly processed fast-food and prepared meals is that homemade food just really doesn’t taste the same. I swear that eventually this will turn into a good thing, but it’s hard at first, I know it. Case in point: My boyfriend. Just like so many people, he grew up eating processed food and fast-food (not exclusively — his mom’s a great cook and he ate real meals a lot), and as a young person out on his own ate plenty of it. He has a taste for it. At some point he realized that he should probably consciously cut highly processed food out of his diet. I came along and feel I’ve probably nudged him along, what with my insufferable food snobbery and honest dislike of fast-food. (I didn’t grow up eating a lot of it, and fast food burgers and stuff have never been more than a couple-times-a-year thing for me.) This has been a challenge for me as someone who likes to cook, and likes to eat whole grains, weird vegetables, and explore interesting taste combos like fruit with meat. (Note that I also didn’t grow up this way: I was a horribly picky eater as a child with a very limited tolerance for all but a few vegetables.) We’re coming along together, though, and though I’ll admit to frustration — “No, celery root doesn’t taste like “dirt”, it has an “earthy flavor” — I’m learning new techniques in the kitchen all the time while we come up with our own set of tried-and-true dishes that are healthy and that we enjoy. His dislike for “eating wicker” — as he calls anything whole-grain — was one factor in my learning more about sourdough bread and long fermentation times with refined flour.

The very process of creating fast-food creates very specific tastes and textures. This has as much to do with the items being mass-produced in one facility and trucked to restaurants for final preparation as it does psychology and the science of what tastes good and how to engineer products that are literally irresistible. A whole universe of food is reduced to the experience of a mere handful of ingredients, textures, and flavors. “About 7,000 species of plants have been cultivated for consumption in human history. Presently, only about 30 crops provide 95% of human food energy needs, four of which (rice, wheat, maize and potato) are responsible for more than 60% of our energy intake.”* Once one is accustomed to a limited combination of highly processed food, it’s difficult to climb out of that box and really truly enjoy variety again. (Or for the first time.) I think the key here is taking the journey slow and easy.

The way I see it, the first step is simply creating (and re-creating) dishes that are familiar with “real” ingredients at home. When it comes to health, cutting out the preservatives and processed (then processed again) ingredients that end up as final fast-food products is a huge step. You don’t have to go from Big Mac to quinoa and tempeh. You don’t have to buy organic foods or switch to brown rice. Like burgers? Make your own. Making a batch of patties ahead and keeping them in the freezer makes it easy to come home and prepare a burger that’s a million times healthier and much less expensive than hitting the drive-thru on the way home, even if you’re worn out from a busy day. Do you usually opt for the sub sandwich or turkey club at popular non-burger fast food places? Those are still loaded with undesirables. Finding a good bakery where you can buy really truly tasty breads and selecting fresh veggies and better deli meats will take you farther financially and nutritionally than fast-food. Make really tempting dishes at home that you actually look forward to eating during the day, or select ingredients that will still be desirable by lunch time even if, say, you don’t have access to a refrigerator or microwave. Opting out of fast-food will be much easier when you’ve got an awesome slice of casserole that you know will be filling and satisfying rather than a bag of dried up carrot sticks with warm dip and a squished soggy sandwich. You gotta set yourself up for success.

Well, that’s my get away from fast food pep-talk. Plans for the RRR blog future are tips for the inexperienced cook, and the secret cooking technique for almost every sauce type imaginable that will help expand your kitchen horizons and help with the setting yourself up for homemade food success.  (Both in the works now.)

Your new problem soon will be trying to convince co-workers that you really truly don’t want to put in an order on their fast-food lunch runs but without sounding like an elitist snob. For me it usually goes something like this:

Co-Worker: Hey, Joe’s driving to McDonalds. Want anything?

Me: No thanks, I brought my lunch. I do appreciate you thinking of me, though.

Co-Worker: Are you sure? I’ll get you something.

Me: Oh wow, thanks, but I’m good with what I have.

Co-Worker: No, really, what do you want? Do you want some fries or something?

Me: No really, honestly, I don’t actually even really like the food from McDonalds.

Co-Worker: Oh. Well, we don’t have to get McDonalds, there’s Wendy’s and Subway right there, too.

Me: No, it’s OK, I don’t really like those places, either. You guys go ahead and enjoy yours. I’m actually really looking forward to the lunch I brought. Thanks for trying to include me, though.

Co-Worker: You don’t like Subway?

Me: No, even Subway I think is kinda gross.

Co-Worker: So you don’t eat fast-food at all?

Me: I really don’t.

Can Food Not Fear!

I have been wanting to take the next step in food preservation for years: Pressure canning. Freezers are great, in fact, I can’t imagine ever not having a chest freezer. Freezing has limitations, though. Those are notably space, time, and reliance on uninterrupted electricity. I used to dream about a situation where I could spend a chunk of money buying up the fresh seasonal produce, a chunk of time preparing it, and at the end have a shelf-stable product. This year I learned that pressure canners are not actually as expensive as I thought. Given a boyfriend who was fishing for birthday gift ideas I started to do some (more) research in anticipation of realizing my dream. It almost convinced me that it wouldn’t be a viable thing to do. Almost.

Botulism? Eeeek! BOTULISM!!!!

If you read any online article or book about home canning the first order of business is always to warn you about the connection between botulism and home canning. Everywhere the message is the same: Home canning is an affordable and satisfying way to preserve the taste and nutrition of food, and it’s even fun! …BUT if you don’t do it just right you’ll kill your whole family. No biggie. Just don’t mess up. OR ELSE. *insert scary music*

Can Food Not Fear -- C. botulinum, he's one bad bacteria.
C. botulinum, he’s one bad bacteria

Who in their right mind would undertake such a risky endeavour?! I’m about the farthest thing from a germophobe and all this botulism talk had me pretty uneasy. Whenever I’m up against something like this I tend to read. And read. And read some more.

Here’s some of what I learned: According to the CDC an average of 145 cases of botulism are reported in the U.S. each year. There are three kinds of botulism infection: food-borne, wound, and infant. The “wound” type almost solely affects intravenous heroin users (of a particular type of heroin even) and accounts for 20% of all botulism cases. Another 65% of all the botulism cases are babies who are infected by the bacteria and then become ill or even die more or less because they’re babies. That’s way overly simple, but the point is that the majority of cases linked to the same bacteria that frightens the desire right out of potential home canners is actually a different scenario. Then there’s other 15% of cases, which are the food-borne botulism. (1)

The CDC says those 15% of cases are almost always caused by home-canned food, but as you’ll see, that’s only part of the story. An average of 22 cases of food-borne botulism in the U.S. are reported to the CDC every year. That’s practically nothing when you consider your likelihood of getting into a car accident or getting maimed by one of many statistically common household accidents. It’s still scary when you consider that one of those 22 could be you or a member of your family, though, and just because you wanted to eat veggies from your garden in December.

You know what’s cool? The CDC makes reports available online. Want to see for yourself who made themselves sick with home-canned food each year and what they were doing to some extent? Find the records for 2001-2012 here: http://www.cdc.gov/nationalsurveillance/botulism-surveillance.html

Pie chart: The only time it's OK for botulism and pie to mix
Pie chart: The only time it’s OK for botulism and pie to mix

222 total cases of botulism were reported to the CDC between 2001 and 2012…….

In those 12 years there were 11 confirmed deaths. If you look closer at the cases resulting in death, you’ll see that in many cases there were very likely extenuating circumstances.

16 of the total cases were officially caused by a commercially prepared product straight from the store. I don’t suppose I need to point out that this is not a home canning problem!

An additional 26 cases were people in prison making and drinking batches of “pruno“, a alcoholic drink made with things from the cafeteria. I’m going to venture a guess that in the cases listed the brew was kept hidden in airtight containers where the bacteria responsible for botulism had a chance to become active. Not really home-canning.

70 of the cases occurred in Alaska with native food items, which is over 30% of the total. The traditional diet of Alaskan native peoples includes fermented meat and fish. There is a bigger issue than simply home-canning with this one. For more please see the footnote at the bottom of the page for a few related links.

Another notable aspect of these statistics is that a “case” is a person. 222 people. 118 out of the 222 we’ve been looking at (over half) are not isolated incidences, but part of what the CDC considers an “outbreak” (four or more people poisoned by the same source). In fact 33 “outbreaks” were responsible for the 118 cases. That’s 33 things making over 100 people sick (keep in mind this is going back to all the cases — pruno and fermented fish included).

Here’s a case study of one of these outbreaks for which there is a lot of information. I think it’s revealing and really helpful in understanding this issue better. In 2001 an outbreak in Texas resulted in 16 illnesses. This was due to someone buying improperly handled cans of commercially prepared chilli at a “salvage store” and serving it to their church congregation (2). This was not home-canning! I haven’t cross referenced all the cases in the CDC reports, but I’m willing to bet more of the cases are like this.

From a report in the Oxford Journals, Clinical Infectious Diseases about the Texas chilli outbreak, “The correct diagnosis was delayed by 1–7 days in 4 patients who had classic symptoms of botulism.” This brings up another important aspect of botulism and food borne illness. If you seek care as soon as you identify symptoms and you’re up-front with your doctor about what might have landed you there — e.g., “I ate a jar of beans I canned last summer. The seal was kind of iffy, but I ate them anyway. I’ve read that my symptoms could mean botulism.” — you’re much more likely to receive the care you need. Just by virtue of reading this, you’re aware of the itty-bitty potential for becoming sick with botulism. If you display symptoms it’s not the time to prove how tough your immune system is. Not putting off a visit to the ER and then not just shrugging your shoulders and saying “I dunno” when asked (or not asked) about what might have happened should help get you the timely treatment you need.

In other words, don’t be this guy (also from the Oxford Journals article on the Texas chilli outbreak): One day before the onset of his symptoms, the 17-year-old outlier ate frozen brand X chili, which he had heated but not boiled. The patient reported to his mother that the chili appeared to be spoiled, with a fungus-like appearance in one section of the container. He proceeded to eat the chili despite the indication of spoilage and his mother’s advice against consumption.

The big take-away from this is that these numbers (even if limited to the USA) include everyone who home-cans just like you and I might — that being with a bit of research under our belts and an iota of common sense — as well as those who don’t. Obviously your risk of food borne illness goes up exponentially if you aren’t even aware of food safety issues.

Can Food Not Fear: Botulism needs boundaries
C. botulinum may be one bad bacterium, but fortunately he’s one that respects boundaries. Good fences make C. botulinum a perfectly good neighbor. (If you don’t mind neighbors who sit on the other side of the fence plotting to kill you if you make it easy enough.)

A friend showed me this post from a food blogger recently:

How Not To Die From Botulism: What Home Canners Need To Know About The World’s Most Deadly Toxin. It explains so much about botulism, and in a simple fun way. Make sure to click on the news link about the guy who contracted botulism from his home-canned elk meat, and make sure to note his process. Not a canning role model, and surely a CDC statistic for the year.

Am I saying you don’t have to be careful? Absolutely not. Of course you should be conscientious and practice home-canning according to established safety guidelines. What I’m trying to put out there with this blog post is that as long as you are practicing safe canning protocols there’s no reason to be preoccupied with worry. No reason to worry at all, really. While botulism may be a super nasty critter, it’s one that respects boundaries. You just have to set them.

Update August 2015: Botulism does happen! Here’s an article that covers a recent outbreak from Food Safety News: Rapid Response Kept April’s Ohio Botulism Outbreak in Check. Notice something? The cases were tied to a single incidence of improperly canned potatoes — someone using waterbath canning, which is not adequate for canning potatoes.


REFERENCES:

(1) http://www.cdc.gov/nczved/divisions/dfbmd/diseases/botulism/

(2) http://cid.oxfordjournals.org/content/37/11/1490.full

FOOTNOTE:

Native Inuit and aboriginal North American diet links:

http://blogs.discovermagazine.com/bodyhorrors/2011/08/14/this-aint-yo-mommas-muktuk-or-fermented-seal-flipper-botulism-being-cold-other-joys-of-artic-living/#.VAEiaEvoZDM