Project Runway: MRSA, HIV and Jack

If you're a Project Runway fan, you're no doubt wondering how Jack Mackenroth is doing. And you probably have a lot of questions about his MRSA and his health living with HIV.

The good news is that he's fully recovered from his MRSA infection. But like many other people with MRSA, he had to spend 5 days in the hospital getting strong antibiotics in his veins.

Jack left the show not only to get treatment for his MRSA but also because MRSA is contagious. He didn't want to risk any of the other designers catching it from him.

MRSA is methicillin-resistant staphylococcus aureus. It's basically a variant of the very common staph bacteria. But it's a potentially very dangerous variant. It's resistant to many antibiotics, including methicillin - hence the name.

MRSA is estimated to kill about 19,000 people a year - most commonly among people with weakened immune systems. Most of these people also appeared to acquire their MRSA in the hospital (more on this later).

Thankfully it's not resistant to all antibiotics. MRSA can sometimes even be treated with oral antibiotics. However, when the infection is severe, as in Jack's case, IV (intravenous) antibiotics are needed to knock it out. And in even rarer instances, also as in Jack's case, surgery is needed to clean out the infection.

Jack's infection was in his nose and surgeons had to go in and clean out the infected tissue. This is a very important part of treatment when antibiotics alone are not be able to wipe out the infection.

MRSA most commonly affects the skin and mucous membranes - the tissues that line the nose, for example. Wondering what an MRSA infection looks like? Check out WebMD's new MRSA slideshow.

The question that seems to be on a lot of people's minds is whether or not Jack being HIV-positive had anything to do with his MRSA. The answer is probably not -- definitely not, according to Jack.

While HIV can suppress the immune system and make someone more susceptible to infections like MRSA, Jack is apparently very healthy and has no signs that his immune system has taken a hit.

It's an important point and something that most people don't understand. What's the difference between HIV and AIDS?

HIV is the virus that causes AIDS. Someone with HIV can have a very healthy immune system. AIDS occurs when HIV kills enough of the person's immune cells and they fall to dangerously low levels. This can lead to unusual and dangerous infections that most of us never have to think about.

But today, people can live years and years with HIV - without having AIDS. Jack has apparently been HIV positive for 17 years and as you can tell looking at him, he's doing quite well.

That's the miracle of science at work. In just the 20+ years that we've known about HIV and AIDS, the disease has gone from a very quick death sentence to a chronic illness. It's still a very serious illness and people still die from it every day - yes, even people in the U.S. But with modern drug treatments, people can strive to live a long, healthy, and happy life. And we'll all keep our fingers crossed that some time in the next 20 years (hopefully sooner), researchers will find a way to wipe it out completely.

So back to MRSA ...

Most MRSA infections still occur in the hospital, particularly among people in the intensive care unit or after surgery. But we're now seeing increasing numbers of MRSA infections in the community - even in schools. Recently, a 17-year old high school football player in Bedford, VA died from MRSA.

I don't know where Jack got his MRSA from but the point is that it's out in the community. That said, most community MRSA infections are mild and can be treated fairly easily. And you can take steps to help avoid it.

It's something we all need to be aware of and know how to avoid. You can learn what you need to know, including how to avoid MRSA, in WebMD's MRSA: Experts Answer Your Questions.
Related Topics:

• 5 MRSA 'Hot Spots'
• WebMD Video: Preventing Staph Infections

Technorati Tags: Project Runway, MRSA, HIV, Jack, staph, drug resistant staph

Kid Nation: The Verdict

Last night marked the end of the first season of Kid Nation. And what a season it was! If you've been reading our blog, then you know we're not exactly fans. OK, actually, we think it's pretty awful.

But in reflecting on the series, and trying to get a little perspective on these kids and what they've been through, we have come to this conclusion: it's a pretty awful show. But by and large, these are good kids trying to make something work.

This episode began in much the way they all began, with some contrived circumstance in which our fateful "pioneers" would have to rally strength, energy, interest or all of the above. In this instance, Mike, one of the kids who figured prominently in the show, was unable to sleep, reflecting on the good times (?!) and pondering the notion that he might never again see his new friends. But Mike soon discovered that the "job board" was on fire. In his characteristic cut-to-the-chase style, Mike exclaimed, "That's insane." (We often agreed with Mike.)

Mike ran through Bonanza City, waking up all the kids and bringing them to the job board to see for themselves. Pails of water were thrown at the flames, but the job board burned to the ground. And lo and behold, who shows up...Jonathan of course...always the bearer of strange news intoned in a particularly cloying manner. This time was no different; in fact, we felt, a little worse.

Jonathan informed the pioneers that the fire was "no accident." No kidding. He went on to tell the kids that for the rest of their stay, there would be no jobs, no Journal to guide them--just time to do with as they please. So what do you think 37 kids who have been fairly deprived of almost every kind of treat did with this news? They ransacked their own town, carting away massive amounts of candy and dry goods, hoarding everything they could get their hands on, and gorging themselves on sweets.

Kids running the candy store? You bet. In their own words, "We've all decided to go mad!" But perhaps the most telling comment of all came from Taylor's cohort, Leila, who expressed the majority opinion:

"We need to be kids for once!"

There was, thankfully, a group of kids who did not partake of the looting--kids who have already emerged as leaders. Zack, DK, Sophia and a few others were thoroughly disgusted by this utter disregard for property and propriety, and began to clean up the town themselves. The next morning, perhaps seeing the error of their ways, the kids rallied and cleaned up Bonanza City. They seemed to feel ashamed of their behavior and were ready to make amends.

Once the town was in better order, Jonathan showed up to announce that there would be no "showdown" but that the Council had to decide, right then and there, to whom the final $20,000 gold star would go. After brief deliberations, the star was awarded to Zack, deserving, humble, and grateful. He wept and expressed his overwhelming emotion at the prize. We like Zack and were pleased.

It wouldn't be Bonanza City without the requisite side stories that have characterized much of this series. Taylor and her chicken-obsession--this time she brought all her favorite chickens (you remember, the pretty ones?!) to her bunkhouse; the same Taylor-lead group asked Emilie, a sensitive young girl, to leave for the final night so the original core clique of yellow district girls could bond...with their chickens...causing Emilie great distress. Migle, who lately has emerged as a big-sister-calming-influence, settled the screaming girls and everyone went back to their corners.

One of the things we will miss the least about Kid Nation is Jonathan's voice screaming, "Pioneers, Gather Up!" But gather they did, for their final day. Jonathan informed the kids that while the Council had given out their last $20,000 gold star, they now would have the difficult task of awarding three HUGE gold stars, each worth $50,000. The awards would be made at the final town hall meeting.

The final task was laid out for them: they would have to work together, as a town, as a community, as a cohesive group, to complete the last challenge and win the prize--a party! There were three obstacles to overcome, involving cleaning, cooking and erecting picnic tables for the event. They did it, without incident. In the words of the ever-wise Laurel, "It was nice to see this town finally coming together."

Jonathan announced that special guests would be attending the party, known, oddly as "The Bonanza City Bonanza." And in a special, heartfelt moment, all of the parents came running over the hill toward their children. The kids went wild, there were tears and hugs and leaping into waiting arms. (We were trying to catch a good glimpse of Taylor's folks, but there wasn't much singling out.)

The kids gave their folks a tour of the town. The parents got to see highlights such as "the chicken feet from the chickens we chopped up", (Seriously, CBS could get a call from the chicken lobby), experience the living conditions, and yes, use the outhouse. They also got to have some of that tasty food. All in all, it was a successful visit.

The final drama came when Jonathan called everyone to the last Town Hall Meeting, where the $50,000 gold stars would be awarded. The Council conferred and we witnessed their deliberations, as they tried to remember the kids who contributed the most, and in the ways that were not always obvious. We were rooting for Laurel, who in our estimation, was the most consistent contributing pioneer.

Drum roll please. The first $50,000 star was awarded to Sophia, very deserving indeed. She said she was flattered and appreciative and described Kid Nation as, "the best times of my life and the worst times of my life."

The second star went to Morgan, in honor of what Greg described as her ability to bring the town together. In a very sweet moment, Morgan's dad rose to his feet and thanked the Council for honoring his daughter and expressed his great pride.

The final star was awarded to Migle, for being the pioneer who constantly improved and who "contributed kindness" to the town.

A few parents spoke and told the kids that they felt more hopeful about the future as a result of their efforts. No comment.

The final full statement came from Jonathan: "We will miss you. Keep building a better world."

Where do we begin? Perhaps with a few of the lessons that Kid Nation has taught us all:

• Kids, left to their own devices, will actually behave like kids.
• Not unlike life in camp bunks, kids find ways to get along, weed out the dissenters, acknowledge those who make a positive contribution, and make friends in the process.
• Natural leaders rise to the top; survival of the fittest is alive and well.
• The system of checks and balances is also at work; kids put up with Greg and Taylor only so long, before they were both taken to task and encouraged to change their ways.

Kid Nation would be a better show without the contrived appearances and obvious influences of adults. It's just not good television. Sure the kids survived. And it appears they are relatively unscathed, though the interesting show would be ten years from now with the same kids.

One last note: All of the final $50,000 winners were female. Three girls chosen by four boys. Perhaps that's the most important way these kids really did make change in the world.

Moral of the story: GIRLS RULE!

(c) CBS. All rights reserved.


Related Topics:

• Young Kids See the Good in Others
• Project Good Heart: Teach Your Kids to Give

Technorati Tags: Kid Nation, season finale, CBS

Alex Trebek: Hearts in Jeopardy

I understand that Alex Trebek, the host of the television show Jeopardy, had a heart attack last night and that he apparently had no risk factors for Coronary Artery Disease.

Is it true that he did not have any of the 5 major risk factors for heart disease? The major risk factors for Coronary Heart Disease are Smoking, Diabetes, Hypertension(high blood pressure), Age, and High Cholesterol. I believe that he did not have the first three, but we all age so that is indeed a risk factor.

Most importantly, did he really have normal cholesterol levels? On his regular lipid panel done by his doctor, I am sure it was "normal" but there is so much more to the story. I will give you something to think about. Last year there were 125 million lipid panels done in the US but the number of patients with Coronary Heart Disease continues to rise.

Also, the CDC states that 50% of people who have heart attacks have "normal" cholesterol at the time of their heart attack. Was Alex Trebek one of the 50% ? My guess was that he was in that group.

Although I am a heart surgeon, I have dedicated my practice to preventing Cardiovascular Disease by opening up The Center for Cholesterol Management in Los Angeles where I perform advanced lipid testing on all my patients. There is more to lipid management than measuring "good" and "bad" cholesterol. Most of today's tests do NOT tell the whole story. In fact many times heart attacks can occur without any warning signs. I will try and describe advanced cholesterol testing in simple terms.

We all know that oil and water do not mix. Well, blood is like water and cholesterol is an oily substance. When too much cholesterol is deposited in one of the Coronary Arteries, a narrowing results which can lead to a heart attack.

Since blood and cholesterol do not mix, the cholesterol has to be transported through the body by particles and these particles include HDL(the good cholesterol) and LDL( the bad cholesterol). Think of these lipoprotein particles as cars on a highway and ask yourself, is it the number of cars that cause a traffic jam or the number of passengers in the cars? We all know that it is the number of cars.

Unfortunately, the cholesterol testing that is done by 99.9% of the physicians in the US measures the numbers of passengers in the cars when it has been show that it is the number of LDL particles(the cars) that cause Atherosclerosis. I perform LDL particle testing on all my patients and measure the number of LDL particles in the blood stream.

This type of testing misses no one with high cholesterol, which can lead to Atherosclerosis, heart attack, and death while conventional lipid testing can miss up to 50-60% of people with high cholesterol but their test shows it to be "normal".

Simply put, the more LDL particles one has, the greater the risk of Cardiovascular disease. An example would be this: Let's say on your cholesterol test at your doctor's office your LDL cholesterol is 120mg/dl. This is considered normal in a low-risk patient. How do I know if you have two big cars(LDL particles) carrying 60 people in each one or 120 small cars (LDL particles) with one person?

It is impossible to know without doing LDL particle testing. The first person has a LDL cholesterol level of 120mg/dl and this is transported through the blood in two big particles. This person is not going to get Atherosclerosis. The second person has exactly the same "normal" LDL cholesterol of 120mg/dl, but it is transported through the blood in 120 small LDL particles. There is no doubt that the second person has had untreated high cholesterol for years because the patient and the physician thought it was "normal".

Years of untreated high cholesterol (high LDL particle number) leads to Atherosclerosis and ultimately Cardiovascular Disease and maybe even death. For a more in depth discussion, you can go to my website at http://www.lipidcenter.com/ and click on the power point presentation titled Advanced Cholesterol Testing - A Basic Understanding.

Dr. Richman also writes about issues related to cholesterol management and testing on his Cholesterol Management 101 blog.

Related Topics:

• WebMD Video: Tryglycerides and Heart Attack Risk
• Interactive Tool: Are You at Risk for a Heart Attack?

Technorati Tags: Alex Trebek, Jeopardy, heart attack, high cholesterol, health, wellness, heart disease

Kid Nation: The End is Near

The two most beautiful words in the world: Season Finale! Yes, the long awaited end to our collective misery is next week. We made it. Almost.

But even we have to admit that this week had a moral to the story. Honest. More about that later.

As you may recall, or perhaps you just try to block it like we do, the Council of Bonanza City had appointed Sophia its first sheriff. Sophia's been a fairly consistent, helpful, opinionated, productive citizen. And by and large, well-liked.

So naturally, in keeping with the contrived pattern of this show, as soon as someone is identified for their good qualities, they are forced into a situation where they are shown to be nuts! Sophia, in her first act as sheriff, "roped off" a tiny square of...well...dirt, in the center of town. She announced, from her perch inside the square, that anyone crossing the borders of "her" property, would be charged a fee. The response from the others was pretty much a universal cry: "Sophia's gone off the deep end." They accused her of being power hungry and selfish. This was an odd thing, even for Bonanza City. Sophia seemed to want to prove that people can be manipulated into doing anything. If she still needs proof, she ought to watch herself in reruns.

This odd storyline never got resolved. Once the scene took place, the show went to a commercial break, and when it returned, we were back to Sophia, the wise and benevolent leader. (One more episode, one more episode.)

The Council, upon reading the Journal, decided to take a hike. If only. To their utter amazement (cue amazement soundtrack) they discovered a tribal society, living well, just over the hill, beyond sight of Bonanza City. They were welcomed with customary dance, song and campfires, and hoped to learn about leadership from the tribal chief. The chief offered wise counsel: "Lead by example". Wow. There's a revelation. "The young ones will look up to you. Take care of them. And remember the smart ones. They are the future." The Council members looked genuinely rapt, which leads us to this question: How did they get to this age and not know these basic concepts? But perhaps the producers finally felt that adults should make an appearance, and offer the only sound advice all season.

Meanwhile, back at the ranch, Sophia, in a contrived parallel to the tribal wisdom, had whipped Bonanza City into shape. She was clear and respectful with the kids - do your chores, quickly and well, and we'll all have fun together in the arcade. She went around town encouraging people, even sharing a hug with Taylor, the resident pageant-queen-brat-dishwasher-chicken-lover-problem child. When the town completed their regular chores, Sophia gathered them in the town square, stood on a balcony and delivered her heartfelt thanks. "I'm so proud of all of you," she said, "Thank you. You've earned your arcade." The town went wild, felt genuinely respected and rewarded for their hard work, and Sophia was once again lauded for her extraordinary leadership abilities.

Sophia herself observed the transformation among the kids this way: "I'm not getting any crap because I'm not giving any crap." She could be the tribal chief!

Taylor, of course, had the line that only Taylor could have - her own special brand of compliment: "Sophia is doing such a good job I hope that Greg is eaten by coyotes." (One more episode, one more episode.)

The Council was meanwhile ruminating on the way in which gold stars are rewarded, remembering the words of the Chief, and decided this week to honor and acknowledge intelligence over brute strength. So they turned their focus to thoughts of Alex and Jared, the two kids who seem to embody that geeky kind of "smarts" that gets noticed.

Cut to Alex and Jared, discussing the carbon dating process by which they might determine the age of a cow skeleton conveniently found near Bonanza City. And the subsequent conversation about molecular structure and the ability to convey humans without formal modes of transportation, through the atmosphere, by developing bio-transporters and other related inventions. Beam me up, Scotty.

The Council was conspicuously and thankfully absent from the Showdown, where districts had to un-build, then re-build, a small wooden house, and move it in the process from one location to another. A task that, without the strongest boys in Bonanza, the Council, would prove challenging. They all completed the task, thus garnering the coveted big reward. This time the choice was between a carved monument to the first (and hopefully last) Kid Nation, commemorating their forty days in Bonanza City, or hot air balloon rides for all. Sophia, charged with making the decision herself, wisely chose the balloon rides and off they went. While airborne, the Council returned, and found the town had...well...risen above them. OK, we couldn't resist.

But actually, that was the moral of the story. The kids did far better without the Council, at least this particular Council. And respect begets respect. Bonanza City ran smoothly this week for the first time. There were no hysterics over chores, because no one was being bossed into doing things. No one was belittled and bewildered. They just did what they had to do and got appropriately rewarded for their efforts. And we extend our sincere congratulations to Sophia, often a kind of moral compass in Bonanza City, who pulled the town together and demonstrated what was possible when you treat people the way you'd like to be treated yourself.

It's too bad that it took the series almost being over for one of the kids to rise to that level of leadership and clarity, but it certainly got the attention of the pioneers. They might have even learned the most valuable lesson yet on this show.

Back to the Council and their award deliberations. Greg, quickly forgetting what he learned from the Chief and reverting to his disrespectful nature, laughed at Zack when he came to plead his case about why he deserved the gold star himself. This caused Zack great anxiety and tears of frustration. And it was in sharp contrast to the environment of mutual respect Sophia had spent time creating, demonstrating once again that a lack of respect creates pain and heartache. DK called Greg on his behavior and it was clear that the Council was back - and the party was over.

The gold star was awarded to Alex, the oddly-toothed but adorable little boy, who described feeling "bubbly inside" about his good fortune. He called his parents; his mother didn't recognize his voice, but he got past that. We didn't, but he did.

So here we are, one week from the finale...did we mention one more episode...?!...and we wonder what all of this is about. Perhaps the best way to describe how we feel is to borrow the words of this week's gold star pioneer, Alex. He was describing to the kids that while he was overjoyed about the star, he realized that its intrinsic value was relative to fluctuating market conditions, and that the investment in his future, while valuable on some level, nonetheless would prove a drop in the bucket of a long term investment strategy. He concluded that his win was something of a paradox. And as the pioneers squirmed, not knowing what the heck he was talking about, we felt he summed up the whole shebang:

"A paradox is something that is, and not is."

One more episode, one more episode.

(c) Scott Rothstein. Image from BigStockPhoto.com

Related Topics:

• Survival of the Smartest
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