Louisville Medicine Volume 62, Issue 8 - Page 35

DOCTORS’ LOUNGE virals (which many, including the Cochrane Review, have called into question after years when resistance to them was very high). We are to be on the lookout for pneumonia early on. Nothing fills a primary care doctor or pediatrician with dread like the prospect of offices filled with flu zombies and hospitals too full to admit them quickly and coworkers fainting and then – the fateful shiver, and you realize you, too, are doomed. The fact that the CDC sees fit to warn us is quite terrifying, since I do not recall that they have ever done so with a virus that we have met before. I always ask people, “If you have to get out of bed, do you burst into tears?” I call it the Flat Sign, the inability to be vertical coupled with that unmistakable look in the eyes that comes from having been ambushed by billions of viral assassins. The Spanish Flu genome was reconstructed by the CDC in 2005 and was an H1N1 apparently novel to humans in 1918. It killed more people than the Black Death. It killed 15 million in India alone, and between 50 and 100 million worldwide, by the latest estimate. It was first reported in the West out of a French headquarters camp in 1918. Canadian historian Mark Humphries believes that it arrived from China when 96,000 Chinese laborers were imported to work behind the French and British lines on the Western Front, since an identical illness was decimating the Chinese in November of 1917. It caused a cytokine storm, which we understand as vascular collapse and sepsis. Reading about it will make you reach for the thermometer, I promise, should you even cough once, and make you hug your loved ones tighter to you. As for me, I have declared war on viruses. It’s either them or us, and I vote us. I could use a light saber or two, or a death ray, or the One Ring that rules them all. If you come across these, tell me first: we will attack together. DIVE, we will say, DIVE, DIVE, DIVE and then we will torpedo the flu - we hope. Note: Dr. Barry practices Internal Medicine with Norton Community Medical Associates-Barret. She is a clinical associate professor at the University of Louisville School of Medicine, Department of Medicine. CYCLISTS’ SAFETY 2 Stanley A. Gall, MD A n increasing theme in medical care is the emphasis on prevention of disease or injury. We advise patients to receive vaccines to prevent infectious diseases and for cancer prevention, to have regular mammograms, and have the first colonoscopy at the age of 50. The state mandates automobile seatbelts and motorcycle helmets for beginning riders. a. A bicycle may be operated on the shoulder of a highway; Kentucky statute (KRS 189.030 (1)) provides guidance for cyclists as follows: 7. In all ways bicycles are considered “vehicles” by the State of Kentucky and subject to all rights and regulations of other vehicles including: 1. A front light must be illuminated when riding at night or when it is darker than usual (heavy overcast or dark environment). 2. A red rear reflector or light on the cyclist or bicycle must be functional whenever riding on a highway or shoulder. 3. At night, when overcast, or in a dark environment, a steady or flashing red rear light is mandated. 4. Bicycles shall be operated the same as motor vehicles except on the following: b. If a bicycle lane is provided, it must be used whenever feasible. 5. Not more than two bicycles may ride side-by-side in a single highway lane. an increasing number of cyclists wear dark colored clothing, making themselves perfectly camouflaged to motorists. Most cyclists have forgotten about bicycle etiquette and ride like they own the road (i.e. three or more abreast). b. Signaling with hands, lamps or mechanical devices for at least 50 feet before the turn. To address the prevention of unnecessary cyclists’ deaths, the cyclists must be responsible for their own actions. Firstly, the bicycle should be compliant with state laws by having functioning white and red lights on the front and rear of the bicycle. Secondly, the cyclist is advised not to be camouflaged, but to wear bright colored clothing. Thirdly, the cyclist must remember the laws of physics of the automobile versus the bicycle and adopt an attitude of accommodation rather than confrontation with the motorists. I believe cycling is a great sport for fitness and enjoyment; however, the average cyclist seems to have forgotten the physics of an automobile versus a bicycle. The modern cyclists have also forgotten that the background in Kentucky is green and Note: Dr. Gall is a professor at the University of Louisville School of Medicine, Department of Obstetrics, Gynecology and Women’s Health, Division of Maternal-Fetal Medicine. He practices with UofL Physicians-Maternal-Fetal Medicine. 6. A helmet must be worn if the cyclist is under 18 years of age. a. Stopping at all stop signs and red lights; JANUARY 2015 33