Children with pneumonia face big risks

NOTE: On occasion in this space, adapted excerpts from the EndNotes blog will substitute for the usual question-and-answer format for the column.

In a recent teleconference, organized by the Global Coalition against Child Pneumonia, two experts in pneumonia research and prevention talked about how risky pneumonia is for children in the United States – and throughout the world.

Pneumonia is the biggest killer of children under 5; every 20 seconds a child somewhere in the world dies of it.

Symptoms can escalate quickly. Some danger signs:

• A child is working so hard to breathe that he or she can’t nurse or sip a bottle.

• A child has an apprehensive expression while trying to breathe.

• A child has a cold and then develops a high fever on top of it.

• A child who is blue around the lips.

• A child who is breathing very fast.

• A child whose chest is moving in a way that indicates it’s extremely difficult to breathe.

The researchers also expressed frustration with parents in the United States who resist pneumonia vaccinations for their children. It’s a different story in other countries.

Dr. Orin Levine with the International Vaccine Access Center said: “Every time we go to Africa to film a documentary about pneumonia, we say, ‘Is there a child in this hospital with pneumonia?’

“They show us a child and every time, there is a kid that dies. When we go to those communities and say there’s a new lifesaving pneumonia vaccine, we don’t get the pushback about the adverse reactions. We get 6,000 people in the football stadium wanting the vaccines.”

Grief not so mechanical

If you’ve ever wondered why you, or someone else you know, didn’t grieve in the stages first identified by death-and-dying pioneer Elisabeth Kübler-Ross 40 years ago, wonder no more.

Turns out that grief experts in recent years are rethinking those stages. At a Hospice Foundation of America teleconference held recently at Hospice of Spokane, researchers discussed the new models used to talk about grieving.

With due respect to Kübler-Ross, they said the stages she identified – denial, anger, bargaining, depression and acceptance – made grief seem like a mechanical car wash.

Now, grief experts say grief is much more individualized. One model they mentioned is the “task” process. In other words, what tasks remain undone for the dying person?

They said the term “bucket list” (made famous in the 2007 movie “The Bucket List”) is now used in Hospice. But for dying people, it’s not usually about skydiving before you die.

For instance, a dying person may request a large hamburger, but be able to take just one bite. Or the person might request a Skype call with a child in Europe.

Another great line from the workshop: “People in grief do not need to move on, but carry on.”

Say a Hail Mary

The newspaper only reports a suicide when it is done in a public manner, such as a bridge jump. But the police scanners in our newsroom tell a bigger story. We often hear police called to a home where a person has killed himself or herself – and we hear many calls about people attempting suicide.

The Centers for Disease Control and Prevention recently reported that “suicidal thoughts and behaviors are important public health concerns in the United States. In 2008, a total of 36,035 persons died as a result of suicide, and approximately 666,000 persons visited hospital emergency departments for nonfatal, self-inflicted injuries.”

As children in Catholic school, we were taught to say the “Hail Mary” prayer when we heard fire and ambulance sirens. We wonder now, in this more secular age: What is an appropriate response when you hear about suicide attempts over the police scanner at work?

Hospital bed posts

Sarah Blain Bain is one of those Spokane women everyone seems to know. She has 682 Facebook friends, and she probably knows all of them pretty well.

Recently, she underwent surgery to remove her appendix. She posted her progress on Facebook, writing at one point: “The extrovert in me is so grateful to have FB available for my first surgery.”

Perhaps Bain is at the starting line of a new social media trend. You won’t have to call or visit folks in the hospital anymore, which might be a good thing, because hospital stays are so short now that when patients are in there, they are really quite sick and usually not up to visitors.

Instead, patients and family members can keep everyone posted on Facebook, or for longer hospital stays, one of our favorite sites, CaringBridge.org.

Catherine Johnston, a health care professional from Olympia, and Rebecca Nappi, a Spokesman-Review features writer, welcome your questions. Contact them through their EndNotes blog.

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