First Tamiflu resistant H1N1 influenza cases in US reported in Washington state

2 Tamiflu-resistant swine flu cases in WA | Top Stories | Seattle News, Local News, Breaking News, Weather | KING5.com

Posted using ShareThis

Bear in mind, these patients are immunocompromised and thus represent a subset of patients who may be more likely to harbor resistant organisms due to recent and/or repeated hospitalization or other health care environment exposure due to an underlying condition or disease state. There are other antiviral options, but not very many. It is especially important to refrain from self-treatment with left-over prescription medications in these circumstances. It's never a good idea, but it could prove fatal to you or a loved one down the line.

The harvest to come

The raised beds; how they've grown!














Jalapenos















Serranos























Roma tomatoes
















Better Boy tomatoes




Next year's vegetable garden being prepped for tilling. It looks small as pictured, but that's a trick of the camera. I assure you, it's a fair-sized piece of dirt.

And I've included a gratuitous shot of part of the serpentine border. The rudbeckia take over after the firecracker lilies have all bloomed out, and the lilies bloom after the penstemmon and alium behind them have faded. One of these days I'll get some shots up to show the succession in that one corner. It was a happy accident, but that doesn't keep me from taking props for it.

Pico de gallo!

We are not exactly drowning in Roma tomatoes, but we have quite an abundant harvest which promises to get more bountiful as the season progresses. The jalapeno bushes have been very prolific as well, so what am I to do except make pounds and pounds of pico?

Maply sweetness

Nana's little maple nugget.

Some reasons I'm glad to be a hospital pharmacist

Early in my pharmacy career, before I graduated and sat for my boards, I decided I would follow the hospital practice track. I had worked in a very successful independent pharmacy while a student, but institutional practice beckoned to me. Now, just about twenty-five years after getting my degree and license, I am contemplating why I feel I made the right choice.


1) I don't have to worry about getting robbed at gunpoint.
2) No one asks me where the motor oil, sunglasses, Christmas cards or Sham-Wows are.
3) I'm not asked to fix electric razors or sell lottery tickets.
4) My workplace doesn't sell tobacco products or liquor. No conflict of interest.
5) I get to sit down.
6) My lunches are covered, and I can take timely bathroom breaks.
7) I have many knowledgeable pharmacist colleagues on site and at my disposal if I need to kick something around.
8) I am generally viewed as a learned member of a team of health professionals, not a speed bump in someone's discount palace pilgrimage or an unappreciated arbiter of prescription benefits.
9) I won't be inundated by waves of middle-aged, unemployed men armed with coupons for free Viagra.
10) I don't have to find a relief pharmacist so I can take a day off or a *gasp* vacation.
11) No smarmy drug reps dropping in. Well, they still drop in, they just can't get to me without going through our front office people. Good luck with that, Buffy.
12) No aisles full of sketchy herbal remedies and weight loss products.
13) No Muzak.
14) No Muzak.
15) Still no Muzak.
16) That was snarky. I'll try to be better. OK, I enjoy the kind of dialogue you can have with a physician after years of working side by side and carefully building a professional relationship based on mutual respect and deference. I imagine some of my retail comrades experience this if their store is inside a clinic or in a medical building. I hope so.
17) No cash registers.
18) No contact with damp/dirty/blood-stained/altered/forged prescriptions.
19) Daily opportunities to directly improve patient outcome by making major clinical interventions.
20) And last but probably the best: No screaming, snot-nosed children.

The downside? The fact there is a third shift and I am required to cover it once in a while. And there are the times the pneumatic tube system delivers blood, urine or stool samples to the pharmacy instead of the lab. I sure do dislike those steamers.

Pandemic, schmandemic

Thank you, major media outlets. No, really, thank you.

Hospital emergency departments were already overtaxed and bulging at the seams with patients, now we're dealing with what CNN has referred to as "the worried well." Who the hell got them so damned worried, huh? Who has them convinced that a little sniffle and a slightly funny scratchy feeling in their throat means they have the piggy plague? Who oversold this panic-demic?

It would be laughable except these anxious souls are truly frightened. Worse, they are filling up beds in the ER, thereby potentially delaying treatment for more seriously ill people. Ambulances get diverted down the road to the next available facility, and maybe further if that ER is backed up.

I give it two weeks before the panic peddlers pick up on this and start inundating us with touching stories about the patients that couldn't be seen in a timely fashion and are forever diminished, or dead, because of it. Forget the Tamiflu, I want a supply of Zofran so I don't turn myself inside out puking in disgust once the sob sisters get revved up.

It's just possible the real danger has yet to present itself. As it seems the H1N1 novel virus of 2009 is so far turning out to be a pig in a poke, the masses who have been taken in by the unrelenting media hype will become skeptical. That skepticism may indeed cost them their health, if not their lives, if this new virus follows the pattern of its pandemic predecessors that emerged as mild bumps in an epidemiological curve and returned months later as merciless and efficient killers.

As it stands now, I'm not sick. No one I know is sick. And statistics say you're probably not sick, either. Now wash your hands, stay well and stop the madness.

"We all gon' die!"

So much to do, but where do we start?

I've already let you in on our plans for a new flower garden in the back yard. I got most of the outline dug out yesterday, and though the actual digging was easier than I imagined it would be, the bed itself has taken on a much larger footprint than I originally planned on paper. We are going to have to hire someone to do the heavy work, or it will be years before we get this done. I'm not kidding. At least two years. Any of our neighbors can back me up on this. Once I get the outline completed, we'll call in our landscaping guy. It's nice to have a landscaping guy. He'll probably want his trailer back, though, so there's another chore to finish. Half a trailer load of topsoil has to be relocated, and soon.

Our raised bed kits absolutely must be in place by May 7 so we can get the tomato plants purchased and planted before all the good ones are gone. I probably shouldn't have picked this week to work night shift. It's going to rain all week, though, so nothing would get done outside anyway.

We also have to finalize our plans for an extension of our existing deck across the back of the garage. We know what we want to do, but there's an awkwardly placed retaining wall that has to be worked into the design. At least we have a reputable contractor, so that's one less worry. Oh, and we need to replace our garage door as well.

So. Raised beds need to take priority. Then the new flower bed. Then the deck. Well, the flower bed and the deck can be done simultaneously, since we'll use different contractors. But before the deck goes on, we may need to address the new rain garden location, so we can bury the drain pipe from the garage downspout first. Geez, it shouldn't be this hard. But it's going to be great when it's all finished. And whatever we decide, it's not going to be a catastrophe if we're wrong. I have enough of that kind of pressure at work, thank you very much.

Hurry, Friday

I need to garden.
I desperately need to get outside amidst the maple helicopters and grass clippings and get busy cleaning up winter's detritus. I have yet to clear the dried skeletons of last year's perennials to make way for the season's new growth. Old leaves are still blanketing the rain gardens and native plant borders, though they are no longer needed to protect tender shoots from cold winds and serve only to deaden the subtle colors of the newly bloomed columbines and native iris. The birdbaths and feeders need to be scrubbed and filled again. The new beds I so blithely drew on grid paper last week have to be dug, turned and amended with compost before I can even think about buying the new peonies, lavender, coneflowers, salvia and sedum that will provide summer blooms against the backdrop of the existing drifts of blue iris.
But, I dread the digging. The ground here is insanely rocky. There is no simple way to turn the earth; a shovel is a poor weapon against such stubborn, stony land. This job will require pry bars, pickaxes, rakes and maybe a backhoe to finish. Oh, and I forgot the hatchet and bow saw to cut the tree roots.
Maybe I'll just sleep on Saturday.

Ruby-crowned Kinglet

Any other avian action shots snapped in the garden this week would be pornographic. The birdies are very, very randy right now.

The changing of the guard

Last week, we lost a good neighbor. He was a retired Lutheran minister, a ham radio operator, a former Air Force Reserve chaplain, a french horn player, a radio operator on a B-26 Marauder. He flew 40 missions over France and Germany as a young man in the Army Air Corps. He was 60 years old when we moved in next door nearly 25 years ago, and became a good, although not close friend. I grew to love him like an uncle, and I am sad that he has passed.

Now, my husband is almost 60 and I am not far behind. It seems to have fallen to us to assume the questionable privilege of being the oldest couple on the block. I'm not absolutely certain of it, because I have never seen the people that live in the house on the farthest southwest corner, but I think it's a safe bet. This is indeed uncharted territory for me. I really wish my wise old neighbor were here to give me guidance. I wish I could have had one more chat with him about nothing in particular, and everything in the world. I wish I could have said, "Goodbye."

Another update on Oscar and other things

Relations have improved immensely among the feline residents here at Casa Nana. Oscar no longer hangs in the library, but has become an integral part of the pride, although somewhat low in the pecking order. Willow and Lily still have no use for him, but then Lily really doesn't care much for any of the other cats, sometimes even her own offspring. Longshanks and Oscar are pretty tight, and are often found sleeping in close proximity on couches, chairs and beds. Those two share a common history of living rough, so really not surprising that they bonded after all. Group grooming sessions are not rare. Peace reigns at feeding time, litter box visits are respected as the private moments they are, and toys are (for the most part) shared. All the cats have a bad case of Spring Fever, though, and the sound of a window opening brings most of them galloping faster than you can say, "SQUIRREL!" Soon it will be too hot for them to do much more than lie around like half-baked rolls of cookie dough, so we'll enjoy their antics while we can. Good kitties.

We're off in a couple days to sunny San Antonio to make the acquaintance of our little grandson. We met him over the Holidays, but he was pretty fresh off the showroom floor, so to speak, and not much of a person yet. He's got an actual personality now, so much fun will be had.

Looks like we picked a good week to get out of the Ozarks. Chilly nights and gloomy days predicted until next weekend. I really must get the gardens dressed and the raised vegetable beds started very soon, or I'll miss the boat. The growing season is long here, but I'd like to get the kitchen garden established before the heat of late Spring comes on. So far I'm planning tomatoes, cilantro, salad greens, bell peppers both green and red, jalapenos, poblanos, marigolds for insect control, and basil. I can't wait!