THE INTERNET IS NOT A DOCTOR

Do you grab your phone and head for Google, Bing, or one of dozens of other search engines the moment a question on any subject pops up? If you’re looking for driving directions or good rate on a motel, that’s usually not a problem.

On the other hand, maybe you’re concerned about a rash on your baby’s bottom or a sudden increase in her drooling or crying. You call your mother, who says it’s just diaper rash, or the drooling and crying is just teething. That’s only comforting if your mom is a doctor. If not, you want to be sure she’s right, but it is ten o’clock on a Saturday night, and your doctor’s office is closed. Do you call her answering service or make a trip to the Emergency Room?

Or do you go to your phone or computer to look up your baby’s symptoms? If you do that, proceed with caution. The Internet is not a doctor!

Your search engine cannot guarantee that the sites you visit will give you the medical advice you need. What you find online may be unreliable at best, or dangerous at worst. Consider recent false news of a cannabis cancer cure. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6426557/

To avoid those pitfalls, you might try visiting the National Institute of Health’s U.S. National Library of Medicine. https://www.nlm.nih.gov/

Let’s get back to that mother with the unhappy baby. The most helpful of the US NLM options for laypersons seeking information would likely be MedlinePlus.

After reading through causes, symptoms, exams, tests and treatment, let’s look at their advice about when to call the doctor for diaper rash.

Call your child’s provider if:
The rash gets worse or does not go away in 2 to 3 days
The rash spreads to the abdomen, back, arms, or face
You notice pimples, blisters, ulcers, large bumps, or sores filled with pus
Your baby also has a fever
Your baby develops a rash during the first 6 weeks after birth

What about the drooling and crying? Let’s see what advice the NIH site offers:

MedlinePlus indicates the signs of teething are:
Acting cranky or irritable
Biting or chewing on hard objects
Drooling, which may often begin before teething starts
Gum swelling and tenderness
Refusing food
Sleeping problems
Teething does NOT cause fever or diarrhea. If your child develops a fever or diarrhea and you are worried about it, talk to your health care provider.

Notice in both cases, the warnings about calling your health care provider. No matter how well you do your research, or how certain you feel that your mother’s diagnoses are correct, the NIH reminds you that consulting your doctor is your best choice when it comes to keeping your baby, or yourself, healthy and happy.

For more information about the U.S. National Library of Medicine, go to: https://www.nlm.nih.gov/


Aimee Machado, hospital librarian with a specialty in forensic collections, finds herself investigating a sordid crime involving medical procedures performed on undocumented immigrants in private prisons
. Primary Source is book five in the Aimee Machado Mystery series published by Camel Press and Harlequin Worldwide Mysteries.

 

DEATH IS IN THE AIR: Cadaver Dogs Pick Up the Scent

While writing Primary Source, the fifth book in the Aimee Machado Mystery series, I was surprised to discover that many cadaver dogs and their handlers are volunteers. This fascinating topic led to further research and another chance to share facts I’ve learned by writing fiction.

Here’s what I’ve learned about Human Remains Detection Dogs, more commonly referred to as cadaver dogs.

Why does law enforcement rely so heavily on volunteer cadaver dogs? It’s usually a matter of cost. Human remains detection dogs are specialists and are not needed on a daily basis the same way a regular K9 patrol dog is used. Many smaller law enforcement agencies do not have the funding to train and maintain a cadaver dog that may be used only a few times a year.

That brings up another fact. Dogs trained for search and rescue, or to sniff out drugs, are not usually cross-trained as cadaver dogs because of the differences in the types of scents. Drug dogs are trained to recognize drugs, cadaver dogs are trained to recognize human remains.

And just how are those cadaver dogs trained? Most canines take around 18 months to two years to be fully trained. While they are often Labrador retrievers or German shepherds, the breed is not as important as a dog with the requisite traits: good energy, ability to focus, obedience and a good nose. Depending on the breed, a dog’s sense of smell is around 100 to 1,000 times greater than a human’s, but the dog still needs direction and training.

Here’s a term I had not heard until I began this research: pseudo corpse scent. Yep. It’s just what you think: an ersatz odor created to mimic the scent of death. It comes in three different formulas: recently dead, decomposed, and drowned.

However, some expert trainers recommend using the real thing, because human blood has unique organic compounds. Sometimes searches involve dangerous areas like collapsed buildings. Before risking injury to themselves or their dogs, handlers want to be certain the dog is hitting on human remains rather than a dead stray animal, or even a pet. It is legal in the U.S. to obtain bodily components like human placenta and blood, but that is not always easy, so some handlers resort to using their own blood for training purposes.

The dog is often trained to associate the smell of death with its favorite toy, and when ready, it should be trained to search night or day, in various kinds of terrain, from wilderness to rural farmlands to the concrete environment of urban settings. The scent of death could be old dry bones or even a death as recent as one hour before the search began. When the canine discovers the source of the scent, it should sit or lie down calmly. Digging, jumping around, or even urinating could destroy evidence.

Dog owners interested in volunteering to train their animals for this work might benefit by forming relationships with their local law enforcement agencies. Handlers should be physically fit and able to pass background checks. Other important skills include working with maps and GPS. They must also have the disposition to remain composed no matter what their dog might uncover.

Visit the links below or use the keywords “human remains detection dogs” or “cadaver dogs” to search for more information on this topic.

https://www.nytimes.com/2015/06/21/magazine/how-to-train-a-cadaver-dog.html

https://www.theguardian.com/lifeandstyle/2015/sep/08/cadaver-dogs-trained-to-smell-death

https://news.nationalgeographic.com/news/2013/10/1310xx-working-dog-dead-body-cat-warren-science/

In Primary Source, the fifth book in the Aimee Machado Mystery series, Aimee and Nick are assisted in their search for evidence by Ginger, their Chesapeake Bay retriever recently trained as a volunteer Human Remains Detection Dog.

All of the books in the series are available online in paperback and eBook formats from Amazon and Barnes & Noble, and by order from your local bookstore. The series is published by Camel Press, an imprint of Epicenter Press in Kenmore, Washington

You Gotta Have Heart-And Other Vital Organs

Many of our hearts are touched when we see a human-interest story about organ donation. We feel grateful that there are donors among us who have made a second chance at life possible for another human being. But how much do we really know about this amazing gift?

While writing Primary Source, book five in my Aimee Machado Mystery series, I discovered many details about organ donation that otherwise I might never have known. One more example of facts I’ve learned while writing fiction.

The search term “Organ Donation” on Google produces 64,400,000 hits, which tells us there is a lot of information available. But despite continuing efforts at public education, there are many myths, misconceptions and inaccuracies about donation.

One fact that is easily understood is that there are 115,000 people in the U.S. waiting for a transplant. Another fact, perhaps not so well understood, is that it is not necessary to die to become a donor. There are two categories of organ donation: living donors and deceased donors.

Living Donors

Living-donor transplantation offers an alternative to waiting for a deceased-donor organ to become available.

The Mayo Clinic, one of the largest living-donor kidney transplant programs in the United States, estimates that in the U.S., about 6,000 living-organ donations are reported each year. Kidney donation is the most common living-donor procedure. After one kidney is donated, the donor’s remaining kidney performs the necessary functions for life. More than 45 percent of kidney transplants at Mayo Clinic come from living donors.

Living donors can also donate a portion of their liver, and the remaining liver will regenerate, grow back to nearly its original size, and perform its normal function. Though kidney and liver are the most common types of living-donor organ procedures, living people may also donate tissues for transplantation, such as blood, skin and bone marrow.

Deceased Donors

There are 8 organs that can be donated by a deceased donor: the liver, lungs, heart, kidneys, pancreas and small intestine. Donor tissues can also improve the quality of life for many ill people. They include skin, corneas, bone tissue including tendons and cartilage, heart valves and blood vessels.

The current model for deceased donors in the U.S. presumes that organs and tissues belong to the individual and cannot be appropriated without some kind of permission or authorization from that individual or a surrogate. This is referred to as “the donation model.”

Some other countries follow the model of “presumed consent,” otherwise described as “deceased organ recovery without explicit consent or authorization.” In that model, the individual who does not want his or her organs donated after death, must take steps before death to “opt out” as a donor.

Whether choosing to be a living donor or a deceased donor, it is important to know that of the more than 145 million people registered as organ donors, only about 3 in 1,000 can actually become donors when they die.

Qualifications as a donor

All people may consider themselves potential organ and tissue donors—regardless of age, health, race, or ethnicity. No one is too old or too young to be a deceased donor and most major religions support donation.

Even those with an illness or a health condition may be able to donate organs and/or tissues upon death. If the situation arises, doctors will examine the organs and determine whether they are suitable for donation. Only a few conditions would absolutely prevent a person from becoming a donor—such as active cancer or a systemic infection.

In the U.S. all people age 18 and older can register to be an organ, eye, and tissue donor. You can choose what you wish to donate, and you can change your status at any time. In many states, people younger than 18 can also register, although their families will have the final say if the occasion arises for donation before they turn 18.

Visit these websites and more to learn the facts about organ donation:
United Network for Organ Sharing https://unos.org/
Organ Procurement and Transplantation Network https://optn.transplant.hrsa.gov/
Mayo Clinic https://www.mayoclinic.org/healthy-lifestyle/consumer-health/in-depth/organ-donation/art-20047529

Primary Source is book 5 in the Aimee Machado Mystery series published by Camel Press (an imprint of Epicenter Press) and Harlequin Worldwide Mysteries.

The series is available in print and e-Book format from Amazon, Barnes & Noble, and by request from your local bookstore. Visit again soon when I’ll share more facts I’ve learned by writing fiction. 

IED HAS TWO MEANINGS – BOTH ARE EXPLOSIVE

You might think you know what an IED is. I thought I did, but I was only half right. Most of us who have followed the various military conflicts in the Middle East are familiar with the term. It’s an abbreviation for a deadly roadside weapon called an Improvised Explosive Device.

There is another IED, however, which is often described as a “temper tantrum,”  or “flying off the handle,” but it is more than that. It is a psychological diagnosis found in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5 for short), and it’s called Intermittent Explosive Disorder. Coincidentally, it can also be set off on a roadside, as seen in cases of road rage. This diagnosis is another fact I’ve learned by writing fiction.

In Breach of Ethics, book three of my Aimee Machado Mystery series, an angry outburst occurs in a most unlikely setting—a hospital conference room during a meeting of the Ethics Committee. Until I wrote the scene, I had never heard of this other IED. Taking on the persona of my protagonist, a hospital-based health sciences librarian, I decided to research impulsive rage, and in doing so, I discovered Intermittent Explosive Disorder.

In some cases, as in extreme road rage incidents, this lesser-known IED does turn deadly. As defined by the Mayo Clinic, “Intermittent Explosive Disorder involves repeated, sudden episodes of impulsive, aggressive, violent behavior or angry verbal outbursts . . . grossly out of proportion to the situation. Road rage, domestic abuse, throwing or breaking objects, or other temper tantrums may be signs of intermittent explosive disorder.” Simply put, this explosive disorder brings out the beast in some of us in a terrifying manner.

Once diagnosed, treatment might include a combination of cognitive behavioral therapy and medications, including antidepressants, anticonvulsants, antianxiety and mood regulators.

For more detailed information on diagnosis and treatment of this disorder, visit the sites shown below.

https://www.mayoclinic.org/diseases-conditions/intermittent-explosive-disorder/symptoms-causes/syc-20373921
https://www.psychologytoday.com/us/conditions/intermittent-explosive-disorder
https://www.health.harvard.edu/newsletter_article/treating-intermittent-explosive-disorder
https://my.clevelandclinic.org/health/diseases/17786-intermittent-explosive-disorder

The Aimee Machado Mystery series, published by Camel Press and Harlequin Worldwide Mysteries, is available in print and e-Book format from Amazon, Barnes & Noble, and by request from your local bookstore. Visit again soon to learn more facts I’ve learned by writing fiction. Primary Source, book 5 in the series, is due for release in mid-February.

(Bear photo by Andre Tan on Unsplash)

 

Get Hip to HIPAA: Hackers Want Your Health Data

I have a question for you. What do hackers want more—your Social Security number or your health information?

If you guessed Social Security, you’re wrong. Here’s another fact I learned by writing fiction. The answer is health data, and criminal hackers are busy stealing it every chance they get.

Despite this alarming trend, there is some protection in place for patient privacy. In 1996, the United States legislature passed the Health Insurance Portability and Accountability Act  known as HIPAA. This act provides for data privacy and security provisions for safeguarding medical information.

The passage of this act was meant to protect patients’ privacy, but it means nothing to a criminal hacker whose day job is stealing your health data. The law has emerged into greater prominence in recent years with the proliferation of health data breaches caused by cyberattacks and ransomware attacks on health insurers and providers.

Hackers can fetch only around $15 a pop on the web for a Social Security number, but a medical record with personal information attached can go for $60 or more. 

Criminals can use health data to create fake identities that allow them to buy and resell medical equipment or drugs, to file fake claims with insurers, or to file fake tax returns. Hackers will use stolen hospital records for extortion—the patient must pay to keep from having their records sold on the dark web.

One reason health data fetches more dollars is that medical identity theft can go undetected for years. The modern practice of electronically storing medical records rather than using paper charts has resulted in a bonanza for criminal hackers. They can sneak in with a few taps on a keyboard, grab the data, and sneak out without being detected.,

How is this possible? One explanation is that medical facilities and private practices tend to put patient care items first when considering expenditures. If the budget is tight, money is not spent to replace aging computer systems, hire IT consultants, and upgrade security infrastructure. These cost-cutting practices make hackers’ work remarkably easy.

Visit these sites for more complete information on this topic:

https://www.dhcs.ca.gov/formsandpubs/laws/hipaa/Pages/1.00WhatisHIPAA.aspx

https://www.healthit.gov/sites/default/files/YourHealthInformationYourRights_Infographic-Web.pdf\

https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html

The security of health data is a recurring theme in the hospital-based Aimee Machado Mystery series published by Camel Press, an imprint of Epicenter Press. Available in print and eBook formats from Amazon, Barnes & Noble and by request at your local bookstore. http://camelpress.com/