When Bud began to complain to his wife about back pains, Anna assumed it was just the normal aches and pains that come with age. when a painful rash appeared across the left side of Bud’s back, their doctor diagnosed herpes zoster, commonly known as shingles.

Anna and Bud were shocked because most doctors, along with the Centers for Disease Control and Prevention, normally recommend a shingles vaccine to those over 60. Bud is 52.

Shingles usually presents as a blister-like rash on one side of the body and can be accompanied by flu-like symptoms, including fever, headache or nausea.

Chickenpox and shingles are caused by similar viruses and, if you had chickenpox as a child, the virus can remain dormant in your body and be awakened by a triggering factor such as physical or emotional stress — manifesting in shingles. certain drugs can also increase your risk for shingles, such as alpha blockers, which are sometimes prescribed for rheumatoid arthritis.

A case of shingles can last three to five weeks and, although it may be extremely painful, most afflicted people will recover without serious complications and will not get shingles again.

Shingles can spread to someone who has not had chickenpox, but that person will not get shingles — they will develop chickenpox. The frightening statistic is that 1 out of every 3 people in the United States will develop shingles, and there are an estimated 1 million cases each year in this country. Risk for the disease increases with age, which is why the vaccine is sometimes recommended by doctors for older patients.

Bud had chickenpox before age 1, which made him more likely to get shingles at a younger age. Anna does not know if she had chickenpox as a child; she is an only child and her parents are deceased.

Anna’s situation gives rise to a good suggestion for all of us, which is to do the best we can to chronicle our illnesses, vaccines and medications, as well as those of our children. More and more hospitals and doctors are now required to keep medical records digitally stored for their patients, but what if the information is not available? What if you die and have not given information about childhood illnesses and family medical history to your children? Your children could find themselves in Anna’s situation — not sure if she should get a shingles vaccine or be otherwise concerned about exposure to the virus.

take a few minutes to document as much information as you can about your medical history, the childhood illnesses of your children and as much history as you can about your parents, grandparents and siblings. Give a copy of the information to your children and place a copy with your other important legal documents — particularly your advance health care directive — then keep the information current. if you become incapacitated, this written history will need to speak for you.

Liza Horvath has over 25 years experience in the estate planning and trust fields and is the manager of the trust department of a local bank. if you have a question, call 915-0272 or email liza@montereytrust.com.

(Credit:AP Graphics)

(CBS/AP) Hepatitis C deaths are on the rise, according to a new report from the Centers for Disease Control and Prevention. the report found baby boomers are especially at risk because they account for two-thirds of all hepatitis C cases.

The worrisome news has prompted health officials to wonder whether anyone born between 1945 and 1965 should get a blood test for hepatitis C, because many of these boomers may have had the disease for decades without even realizing it.

“One of every 33 baby boomers are living with hepatitis C infection,” says Dr. John Ward, the CDC’s hepatitis chief. “Most people will be surprised, because it’s a silent epidemic.”

Some baby boomers may not think they’re at risk because sharing a needle while injecting illegal drugs is the biggest risk factor for becoming infected with this blood-borne virus. But before 1992, when widespread testing of the blood supply began, hepatitis C commonly was spread through blood transfusions. Plus, a one-time experiment with drugs way back when could have been enough.

“Asking someone about a risk that happened 20 to 30 years ago is a lot to ask,” says Ward. That’s why officials are seeking a new strategy.

About 3.2 million Americans are estimated to have chronic hepatitis C, but at least half of them may not know it. the virus, which affects 170 million people worldwide, can gradually scar the liver and lead to cirrhosis, liver failure, or liver cancer. it is a leading cause of liver transplants.

For the CDC’s study, published in the Feb. 21 issue of the Annals of Internal Medicine, researchers analyzed a decade of death records and found an increase in death rates from hepatitis C. in fact, in 2007 there were 15,000 deaths related to hepatitis C, higher than previous estimates – and surpassing the nearly 13,000 deaths caused by the better-known AIDS virus. perhaps more surprising, three-fourths of the hepatitis deaths occurred in the middle-aged, people 45 to 64-years old.

“Mortality will continue to grow for the next 10 to 15 years at least unless we do something different” to find and treat the silent sufferers, Ward says.

Current CDC guidelines recommend testing people known to be at high risk, and until last summer there wasn’t much enthusiasm even for that step: the reasons are the year-long, two-drug treatment promised to cure only 40 percent of people; treatment was so grueling that many patients refused to try it and treatment could cost up to $30,000.

Two new drugs – Vertex Pharmaceuticals’ telaprevir and Merck & Co.’s boceprevir – are starting to change that pessimism. Research suggests adding one of them to standard therapy can boost cure rates as high as 75 percent. While still full of side effects, they can allow some people to finish treatment in just six months. they add to the price, however, another $1,000 to $4,000 a week. Drugs that promise to work even better are also being tested.

Those advances are fueling CDC deliberations of whether to change testing guidelines to recommend that anyone born between 1945 and 1965 get a one-time screening. A second CDC-funded study, also published in the Feb. 21 Annals, analyzed models of that option, and concluded it had the potential to save 82,000 lives.

A third study published Monday from Stanford University looked more closely at the price tag, and concluded the new triple-therapy would be cost-effective for people with advanced disease. It’s still cheaper than a transplant costing well over $100,000. But not everyone with hepatitis C will go on to suffer serious liver damage. for those with mild disease, that analysis concluded some gene testing to predict who might really need the costlier triple therapy rather than the older drugs would be a good next step.

It’s not clear how quickly the CDC will settle the boomer-screening question. But doctors at Montefiore Medical Center in New York City have started raising the issue. Montefiore internist Dr. Gary Rogg also says a number of patients have sought testing after seeing hepatitis-awareness ads from the drugs’ manufacturers.

“Now it’s considered a curable disease, that makes all the difference,” says Rogg, who was surprised at some longtime patients’ test results. Even a nurse he knows learned she had it, and the only risk she could recall was a blood transfusion during surgery when she was 10 years old.

According to WebMD, symptoms of hepatitis C include feeling very tired, joint and belly pain, itchy skin, sore muscles, yellowish eyes and skin, and dark urine. since many people with the disease don’t show symptoms, it is common for people to have hepatitis C for 15 years or longer, before it’s diagnosed as chronic hepatitis C.

The CDC has more on hepatitis C.

The cause of a mysterious condition that haunts its sufferers with sensations of crawling bugs and fibrous material embedded in the skin may be one step closer to being found, a new study suggests.

The condition, commonly referred to as Morgellons, does not appear to be contagious, according to a new report from the Centers for Disease Control and Prevention.

“This alleviates concerns about the condition being contagious between family members and others,” said mark Eberhard, Director of CDC’s Division of Parasitic Diseases and Malaria.

People with Morgellons report having symptoms manifesting on their skin. These include non-healing skin lesions, the emergence of fibers or solid material from the skin, and disturbing sensations, such as crawling, stinging or biting. Some patients report fatigue, memory loss and a substantial decline in quality of life, according to the study.

The study was undertaken after the CDC received a number of calls over the last 10 years with reports of the condition, Eberhard said.

“We had no idea what it was or might be,” Eberhard told MyHealthNewsDaily. “We felt very compelled to do something. it was quite clear that people were suffering.”

The report still does not identify a cause of the condition, and Morgellons is not recognized as a distinct medical disorder. however, by ruling out an infectious cause, researchers have begun to narrow down what health care providers need to look for when patients report signs of the condition, Eberhard said. And it’s likely that different factors contribute to individual cases.

“I don’t think there’s going to be a single diagnosis that will fit across the spectrum of it,” Eberhard said.

Unexplained disease

Eberhard and colleagues identified 109 patients with this condition by searching the electronic medical record database of Kaiser Permanente of Northern California. The researchers estimate the condition is rare, found in about four out of every 100,000 people.

Patients were put through a battery of tests to identify possible causes, including a medical exam, skin biopsies and psychiatric and blood testing. Fibers and solid material was extracted from the patients’ wounds, and their composition was examined.

“There’s been a great deal of fixation, on everybody’s part, with those fibers,” Eberhard said. Previous reports included patients bringing fibers they said had emerged from their skin to their doctors, but “there was no way to validate, scientifically, where the fibers came from,” Eberhard said.

The researchers concluded the fibers were coming from external sources, mostly from cotton. Fibers from clothing or carpet may become stuck in an open wound before it clots over, and appear to be coming from the wound, Eberhard said.

The majority of patients were middle-age white women. about half had evidence of other medical conditions, mostly psychiatric illnesses. Also, about half of patients were found to have been using drugs, including amphetamines, opiates and cocaine, according to the study.

Most of the lesions had the appearance of wounds caused by scratching, Eberhard said. Other potential causes for some of the cases include eczema and bug bites.

Seeking help

Eberhard emphasized that the study cannot say whether certain factors, including drug use and scratching, are a cause or an effect of the condition.

People who suspect they have Morgellons should speak with their health care provider, Eberhard said. Eberhard recommends that both the patient and doctor keep an open mind about the diagnosis.

However, “we would propose that they not focus on an infectious cause, or an environmental link,” Eberhard said.

Although no treatment for Morgellons is available, patients should be given standard therapies for any co-occurring conditions they may have, the researchers say. in addition, patients may benefit from therapies used to treat psychiatric conditions with similar symptoms.

The study is published today (Jan. 25) in the online journal PLoS ONE.

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A Johns Hopkins Children’s Center study shows that air cleaners can significantly reduce household air pollution and lower rates of asthma symptoms among kids living in homes with smokers.

The improvements are similar to those achieved by using anti-inflammatory asthma drugs.

However, the level of air nicotine remained, leaving kids at risk of some effects of secondhand smoke.

So, the study researchers concluded in the Aug. 1 issue of the Archives of Pediatrics & Adolescent Medicine that air cleaners should only be used as a temporary measure as smokers seeks to quit.

“Air cleaners appear to be an excellent partial solution to improving air quality in homes of children living with a smoker but should not be viewed as a substitute for a smoke-free environment,” lead investigator Arlene Butz, an asthma specialist at the Children’s Center and professor of pediatrics at the Hopkins University School of Medicine, said in a statement.

The researchers followed 115 children for six months. Asthma is the most common chronic illness among children, with some 6.5 million affected in the United States, according to the Centers for Disease Control and Prevention.

About a third of U.S. kids live with a smoker.

A Disease Control Department vaccine specialist yesterday called on the Public Health Ministry to introduce a free-of-charge vaccination programme for cervical cancer so all girls who need the drug will have access to it.

Renowned virologist Prasert Thongcharoen, a vaccine adviser at the DCD, said the Public Health Ministry told a vaccinology course held by the National Vaccine Institute that 5,000-6,000 women per year die from cervical cancer – or about 18 women per day.

Dr Prasert suggested the ministry conduct a review of the effectiveness and efficiency of the current anti-cervical cancer vaccination programme, saying at present only girls from well-to-do families were able to afford the vaccine.

The cervical cancer vaccine is recommended for girls aged 11 to 12, although it may be given to girls as young as age 9. It’s important for girls to receive the vaccine before sexual contact and possible exposure to human papillomavirus, which causes cervical cancer.

If girls in that age bracket are not vaccinated, the US Centers for Disease Control and Prevention recommends catch-up immunisation for girls and women ages 13 to 26. the vaccine isn’t recommended, however, for women older than age 26.

In Thailand, some 400,000 teenagers are in need of vaccinations.

Dr Prasert’s call for free vaccinations echoes recommendations by the Royal College of Gynaecology of Thailand, the Royal College of Paediatrians of Thailand and the Thai Gynecologic Cancer Society. Those organisations say free vaccinations would help prevent up to 3,500 deaths a year and save billions of baht in annual treatment costs.

Dr Prasert said he was certain that if the government moved ahead with a free vaccination programme that it would be able to negotiate with vaccine producers for lower prices by ordering in quantity.

The Health Intervention and Technology Assessment Programme suggests that women who have not had the vaccine should submit to regular screenings or pap smear tests, considered the most effective method for checking for cervical cancer symptoms.

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Gonorrhea is becoming more difficult to treat with readily available antibiotics, and it may be just a matter of time before a case shows up in California that doesn’t respond to any of the drugs currently in use.

This week, the world’s first case of drug-resistant gonorrhea – in a sex worker in Japan – was reported during a conference on sexually transmitted disease research. And last week the U.S. Centers for Disease Control and Prevention reported increased rates of gonorrhea cases that, while not quite resistant to antibiotics, are requiring larger doses to treat effectively.

Gonorrhea is still relatively easy to cure, and in the United States there has yet to be a patient who wasn’t successfully treated with antibiotics. but it’s likely that a strain of gonorrhea that doesn’t respond to the current treatments will begin circulating worldwide at some point – and doctors have run out of new antibiotics to replace the old ones.

“We’re not seeing any untreatable cases in the United States, but we’re seeing proof that what we’ve been worrying about for a while has actually happened” in Japan, said Dr. Susan Philip, director of STD prevention for the San Francisco Public Health Department. “If previous patterns hold true, drug resistance should slowly move its way toward us.”

S.F. has high rate

Gonorrhea is the second most common sexually transmitted infection after chlamydia, and San Francisco has among the highest rates of disease in the state and country. The city reported nearly 2,000 cases of gonorrhea in 2010, for a rate of 253 cases per 100,000 people; statewide, the rate is roughly 70 cases per 100,000 people.

While gonorrhea cases had been declining in recent years, San Francisco reported a 10 percent increase last year. there are several possible explanations for that increase – better and faster testing of STDs, for example – but epidemiologists say drug resistance could be a factor, too.

Gonorrhea is a bacterium that typically infects the male and female reproductive tracts, the rectum or the mouth. Symptoms can include a burning sensation when urinating and a discharge from the penis or vagina. but half of women, and a small percentage of men, have no symptoms, and if the infection is in the rectum or mouth, most people won’t know it.

Untreated gonorrhea can cause pelvic inflammatory disease and infertility in women, and people infected with gonorrhea are more susceptible to contracting HIV.

Antibiotics fading

For decades, gonorrhea was treated with penicillin but, like many other bacteria, gonorrhea mutates quickly and often, and eventually strains that didn’t respond to penicillin were circulating widely around the world.

Now that antibiotic isn’t working as well as it once did. Cephalosporin is still an effective treatment for gonorrhea, but over the past decade, public health labs have found more cases that require higher doses of the antibiotic to kill the bacteria.

In California, 4.5 percent of cases needed higher doses in 2010; there were no such cases in 2000. Higher doses are usually the first sign that the bacteria is building resistance to a drug.

“We’re down to our last class of antibiotics that we use to treat gonorrhea,” said Dr. Heidi Bauer, chief of program development and evaluation in the California public health department’s STD Control Branch. “One by one we’ve had to eliminate these other classes because this bacteria is so good at resistance.”

WASHINGTON (Reuters) – The number of U.S. teenagers and young adults who say they are abstaining from sex is on the rise, even as more young women report having sexual contact with each other, U.S. government researchers said on Thursday.

The U.S. Centers for Disease Control and Prevention (CDC) said in 2006-2008, 29 percent of women and 27 percent of men ages 15 to 24 reported not having any sexual contact compared with 22 percent in 2002.

At the same time, the CDC's National Center for Health Statistics found a growing number of young women who said they have had some form of sex with another woman, rising to 13 percent in the latest survey, from about 12 percent in the 2002 survey.

The number of young men reporting same-sex encounters fell from 5 percent to 4 percent over the same time period.

It also showed an overall increase in reports of the sexually transmitted disease Chlamydia, especially among 15 to 19-year-olds. The bacterial infection is the most common STD in the United States and can lead to complications if untreated. Some people have no symptoms, making it easier to spread.

The CDC report aims to provide data to help health officials prevent the spread of sexually transmitted diseases and unplanned pregnancies nationwide.

Its findings for 2006 to 2008 are based on interviews with about 13,500 men and women ages 15 to 44. overall, it found few changes in the nation's sexual patterns compared to CDC's last survey in 2002.

Among teens, however, the center this time tried to take a closer look at certain, specific sexual behaviors that youth may not typically report as sex because it is not traditional vaginal intercourse.

"This focused look at oral and anal sex among teens and young adults is prompted by concerns that some young people may engage in other types of sexual contact before they have vaginal intercourse, to avoid the risk of pregnancy," researchers said.

"in addition to placing themselves at risk of STIs (sexually transmitted infections), some studies have documented that engaging in these other types of sexual contact may hasten young people's initiation of vaginal intercourse," they added.

Of youth aged 15 to 24 who said they have had sex, nearly 63 percent of women and 64 percent of men had oral sex compared to nearly 69 percent in 2002.

About 21 percent of young men said they have had anal sex, compared to nearly 22 percent in 2002, while the number of young women having anal sex was unchanged at about 20 percent.

Little 8-year-old Eden Perry wants to be a rock star when she grows up, although she’s not a fan of being the center of attention.

She’s shy around people she doesn’t know and speaks softly with an Australian accent. When she gets nervous, she’ll bury her head into her dad, Mike Perry. sometimes she gets unwanted attention in public, like when her family eats at a restaurant and she pulls a syringe out of the kit she carries with her everywhere she goes.

“When I tell people that I have diabetes, they look at me weird,” Eden says.

But the second grader at Dry Creek Elementary School has not shied away from using her story to bring awareness to juvenile diabetes — a chronic, autoimmune disease with no cure. With the help of her graphic designer dad, Eden launched a website called “Eden’s Effort” to raise funds for Juvenile Diabetes Research Fund International.

About 25.8 million kids and adults in the United States have diabetes, including type 1 and — the far more common — type 2, according to the U.S. Centers for Disease Control and Prevention. That’s 8.3 percent of the population. each year, about 15,000 children are diagnosed with type 1 diabetes, or roughly 40 children every day.

Eden’s website has raised $7,000 since launching in January, with a last-minute anonymous $900 donation that helped her reach this goal. Her classmates also helped, giving her $51.86. both sets of grandparents donated $1,000.

Eden finished the fundraiser Feb. 5 with a flourish, by chopping off 12 inches of her wavy brown hair for Locks of Love, a nonprofit organization that provides hairpieces to financially disadvantaged children under age 18 suffering from long-term medical hair loss.

But Eden’s Effort will keep accepting money to go toward finding a cure for diabetes.

The idea for the website stemmed from a family movie night in November when the Perrys watched “Pay it forward,” which chronicles a young boy’s attempt to make the world a better place by passing on good deeds.

Eden’s good deeds have already helped at least one family who, through her website, recognized the warning signs for diabetes and had their daughter tested — the results returned positive.

Jaedyn Jurtensen, 9, is best friends with Eden’s 10-year-old sister Alyssa, and has checked out the website.

“When you go on her website and read her story, it’s so sad,” Jaedyn says. “you feel really bad.”

The Perry family had lived in Australia for eight years before moving to Roseville in January 2010 to be closer to relatives. During a camping trip in Napa over the summer, to celebrate Alyssa’s birthday, Eden drank water nonstop and kept using the toilet. Then, as Heather Perry applied sunscreen to her daughter, she noticed she felt skinny.

Back in Australia the Perrys had a friend whose child had diabetes, so they knew the warning signs, which include extreme thirst, frequent urination and sudden weight loss.

If undetected, diabetes can pose serious health threats to sufferers. Type 1 diabetes can easily be mistaken for more common illnesses, such as influenza, which is why recognizing symptoms can save a life.

Eden’s parents took her to a medical clinic but doctors there didn’t have the ability to test for diabetes. So they went to an emergency room where doctors diagnosed her with diabetes. she spent three days in a hospital. Her pancreas had stopped working and her body could no longer produce insulin.

“I was really scared for her,” Alyssa says, during a break from running around the house with Jaedyn.

A healthy pancreas produces insulin, a hormone that changes glucose in the blood into energy. this glucose comes from the food and drink a person consumes. a person with type 1 diabetes doesn’t produce insulin. Without insulin, glucose builds up in the blood, causing high blood sugar, or hyperglycemia, which can lead to ketoacidosis, coma and death.

People with diabetes control the disease through diet, exercise and insulin. Eden needs at least four shots of insulin injected into her blood stream each day to stay alive.

“When we found out she had diabetes, we were devastated,” Mike Perry says. “but she’s been fantastic.”

His daughter must carry a medical kit everywhere she goes — school, grocery stores, playgrounds — that includes a bottle of insulin, syringes and other equipment. For instance, if Eden passes out from low blood glucose levels, someone can administer a shot of sugar using a tool in the kit.

Eden’s levels have to be tested five times a day — at breakfast, lunch, when she gets home from school, dinner and before bed. at school, the nurse tests her and then calls her dad with the results and together they decide what insulin amount Eden needs. There’s no perfect equation for this.

The Perrys monitor the food their daughter eats to make sure she avoids carbohydrates, such as breads, cereals, pasta and items with lots of sugar, such as juice. she snacks a lot throughout the day, munching on cheese sticks, Slim Jims, Pringles Stix and Jelly Belly fruit snacks. The hardest thing, says her dad, is when a kid brings cupcakes to school and she can’t have one.

Otherwise, Eden is like any other precocious and fun-loving kid.

“It hasn’t really stopped me from doing things,” Eden says.

She still draws and paints — she loves art — and plays basketball, baseball and tetherball. plus, her dad says she’s “really good at watching TV,” especially episodes of “Hannah Montana” and “Good Luck Charlie.”

“She’s been so strong, you can’t help but be strong,” Mike Perry says. “She’s just awesome. she just goes with the flow.”

Sena Christian can be reached at senac@goldcountrymedia.com.———-Warning signs of type 1 diabetes· Extreme thirst · Frequent urination · Sudden vision changes · Sugar in urine · Fruity, sweet, or wine-like odor on breath· Increased appetite · Sudden weight loss · Drowsiness, lethargy · Heavy, labored breathing · Stupor, unconsciousnessSource: Juvenile Diabetes Research Fund International

On Friday, sheet metal worker Garth Wise of Plum celebrates two significant milestones: His 50th birthday and the second anniversary of his diagnosis with necrotizing fasciitis.

For a while, it appeared he might not make them.

Although rare — the Centers for Disease Control and Prevention estimated in 2008 there are no more than 800 cases a year — as many as 25 percent of those patients die of the excruciatingly painful disease also called “flesh-eating bacteria.”

It kills flesh and other soft tissue, which must be removed, sometimes with amputations, to save the life of the patient. Still, those procedures can be insufficient. at one point during the first of multiple debridements, or flesh removals, an infectious disease physician told his sister-in-law that mr. Wise had a 25 percent chance of survival.

Two factors are cited for his victory over the disease: the quick diagnosis and response of James McCormick, vice chairman of surgery and a colorectal specialist at Forbes Regional Hospital, and mr. Wise’s will to live.

“In my opinion, I think Dr. McCormick saved his life,” said Robert Kang, the plastic surgeon who later would graft skin over gaping, muscle-deep wounds that covered both sides of mr. Wise’s lower abdomen and groin. “He quickly picked up on the life-threatening illness and did a great job of keeping Garth alive.”

Dr. McCormick shrugs off the role of hero, although he acknowledges he recognized the disease as the variety of necrotizing fasciitis called Fournier’s gangrene, which affects the groin.

“I just happened to be the guy around that day, and I don’t consider myself an expert on this,” although he described himself as “happy to take care” of mr. Wise.

At the time he was taking mr. Wise in and out of the operating room for debridements — he had three surgeries total plus at least seven dressing changes under anesthesia — Dr. McCormick told the family, “I cannot believe how strong that man is.” about 20 percent of his flesh was removed.

His return to a normal and productive life is “a testimony to his will,” Dr. McCormick said.

“I figured as long as I’m breathing I’ll be able to keep fighting,” mr. Wise said recently. “I knew I was dying. … There was a look in everybody’s eyes.”

If he hadn’t trusted Dr. McCormick, he added, “I probably wouldn’t have survived. … I thought, ‘I’m not going to let the guy down.’ ” He said he had the same faith in Dr. Kang.

“Every time I went in [for surgery] I came back with a little more missing,” mr. Wise said. Meanwhile the pain was relentless. He remembers watching morphine drip through an intravenous line and telling himself with every drop, ” ‘That makes me feel a little better’ even though I didn’t feel a thing.”

Mr. Wise and his wife, Sandra, 49, a vice president for Dollar Bank, never really had time to absorb what had hit them. In fact, when the infectious disease doctor talked to Sharon Stover about her brother-in-law, the Plum nurse waited a while to tell her sister.

The illness had started with generalized but increasing discomfort when the Wises began driving home Feb. 22, 2009, from a trip to South Carolina.

Whether he was getting necrotizing fasciitis or feeling the side effects of a bad hamstring injury sustained in a fall on ice that Feb. 3 is still unclear. The bacteria can enter the body through an opening as small as a pin prick or through weakened skin such as a blister, an abrasion or a bruise, according to the National Necrotizing Fasciitis Federation. Commonly, the bacteria at fault is group a Streptococcal, the same germ that causes strep throat, the NNFF said, but the disease also can be caused by other bacteria or a mixture of bacteria.

All the Wises do know is that by the time they got home the next day and mr. Wise went to physical therapy for his hamstring injury he felt worse, “like I had the flu. Achy. There was a lot of pressure in my hip,” he said. “It was so general [but] I knew I was getting sicker and sicker.”

At 2 a.m. Feb. 24 he headed to Forbes’ emergency room, where prostatitis, inflammation of the prostate gland, was diagnosed and antibiotics were prescribed. “I’d had prostatitis before,” he said, “so I didn’t really panic.”

But the symptoms started to go beyond prostatitis, so at 3 p.m. that day the Wises went to see urologist Stuart Feldman. He ruled out prostatitis but couldn’t diagnose the illness and advised them to go to the hospital.

Mr. Wise was admitted and started on IV antibiotics and pain medications, both of which would flow through his veins for days and days to come.

The next morning, Feb. 25, Mrs. Wise and Mrs. Stover went to see him and found him still in severe pain, sweating profusely from fever and with a rash on his abdomen. He had undergone test after test, but the cause of his illness remained elusive. The rash was spreading.

Dr. McCormick was called in, and Mrs. Stover told him her brother-in-law’s symptoms. He diagnosed the disease and took mr. Wise in for surgery to see the extent of the problem.

Mrs. Stover, who stayed in the intensive care unit with her sister during the operation, said she got a pretty good idea of just how bad things were when the infectious disease doctor, whose name she can’t remember, came out of the OR and told her mr. Wise had necrotizing fasciitis.

“That’s when the bottom dropped out of my life because I knew exactly what it was,” said Mrs. Stover, who at just 10 months younger than her sister is extremely close to the Wises. her voice broke.

Although Mrs. Wise learned “early in the process” her husband had flesh-eating bacteria, she delayed for months doing any research to learn how serious it is.

“I don’t think I ever allowed myself to believe he could die because somehow believing he would live was more helpful to me and him,” she said.

“I told [Dr. McCormick] I would keep his head in the game if they would keep his body in the game.”

“[Mrs. Wise and Mrs. Stover] wouldn’t let me give up,” mr. Wise said.

Along with the debridements and the pain — “dressing changes would sometimes take me right over the edge” — there were other complications:

His intestines stopped working and a nasogastric, or NG, tube had to be inserted to bring liquid up out of his stomach, the family said. a colostomy was performed to keep the area clean. He started to suffer from psychosis from being in the intensive care unit for so long.

But clinically speaking, he already had turned the corner and was on his way back to health, Dr. McCormick said.

“When you do a surgery for any kind of severe infection you typically give 72 hours in which you hope the patient responds to what you’ve done,” he said. “And after about two or three days, he started to show signs of improvement.”

Mr. Wise definitely felt improved March 9 when the sun came out and Mrs. Stover got permission to wheel his gurney and lines outside for a couple of minutes.

“It was so nice,” he said, adding that the sunshine and his sense of humor — he would describe his clear liquid meals as tasting “pink” or “yellow” — helped to keep him going. “It was like getting a second wind.”

And 24 hours later he got an even bigger breather when he was moved to the West Penn Burn Center, where Dr. Kang would do the skin grafts and carefully trained nurses would do gentle wound care praised by doctor and patient alike.

The plastic surgeon told him that day there would be no more surgeries until he had some time to boost his immune system with rest and nutrition. The first skin graft, Dr. Kang said, was March 14. mr. Wise also learned at West Penn he would not lose his more wounded left leg.

“I wouldn’t have bet my life I was going to be keeping my leg,” mr. Wise said. “It was fileted up. Knowing I was going to walk again was really a boost.”

The grafts came from healthy leg skin, which is meshed like fishnet stockings over wounds. mr. Wise had a total of four grafts and plastic surgeries, the surgeon said.

He was sent home March 25. Visiting nurses did the dressing changes at first, but the family learned to do them and took over.

The ordeal didn’t end there. Dr. Kang did an outpatient surgery April 3; then the next day mr. Wise returned to Forbes with back pain. The diagnosis: Blood clots in both lungs that kept him hospitalized until April 9.

Dressing changes that caused enough pain to require he wear transdermal medication patches continued until late summer 2009. Physical therapy started July 21, about the same time he happily resumed golfing.

The colostomy was reversed Nov. 19, 2009, leading to more blood clots that sent him to the hospital on New Year’s Eve.

Meanwhile, he suffers from and undergoes therapy for post-traumatic stress disorder. His wife said his symptoms show up when he’s sleeping.

“He thrashes about, talks in his sleep and otherwise appears to be quite restless,” she said. “For the most part, however, Garth does not know that he is so restless at night unless I tell him about it or he finds the alarm clock and night stand on the floor.”

“The body heals pretty rapidly,” mr. Wise said, “but the mind, it takes longer.”

Still, he was ready to party when Sharon and Ed Stover held a celebration of his life for 80 people on Feb. 27, 2010, and he returned to his job at supportive McCamish inc. in Lawrenceville on March 23.

Pain, however, continues in shifting parts of his trunk. “I think his body is still adjusting to the loss of mass in his hip area,” Mrs. Wise said. “Again, it’s hard to say what is related to necrotizing fasciitis and what is related to normal wear and tear on a man that works in the construction industry in the winter [and] who has had a series of invasive surgeries.”

He is scheduled for March 1 surgery to repair a hernia caused by the colostomy, the family said. He also has a fistula, or opening, in his flesh that requires treatment.

Still, when asked how he feels overall, he quickly answered: “Considering where I was, I feel phenomenal. really. obviously, I’m grateful to so many people. If I tried to thank them all, I’d miss some. And I’m grateful for the support they gave to my family.”

His wife echoes his emotions.

“We celebrated our daughter’s graduation from college in May. We got to go to my son’s graduation from high school [in 2009],” she said. “I’m thankful every day.”

First published on February 21, 2011 at 12:00 am

A new trial finds that the Gardasil vaccine protects men against human papillomavirus (HPV) as effectively as it does women. the question is: is widespread vaccination necessary?

Gardasil became available in 2006 and is now recommended by the Centers for Disease Control and Prevention (CDC) for all girls and young women between the ages of 9 and 26. it protects against four strains of HPV: 6 and 11, which cause 90% of genital warts cases, and 16 and 18, which cause 75% of all cervical cancers. Cervical cancer affects some 12,000 women per year.

However, vaccination rates remain low: according to a study presented in 2010 by researchers at the University of Maryland, only about one-third of teen girls and young women who start the three-dose series actually finish, and nearly three-quarters don’t start it at all. Part of the problem may be the drug’s cost, which approaches $400 for all three doses.

In 2009, Gardasil was approved for use among boys and men aged 9 to 26, but, lacking key data on the effectiveness of the vaccine in boys, official CDC guidelines don’t recommend routine vaccination in this group.

The new study, funded by Gardasil’s maker, Merck, involved 4,065 sexually active young men ages 16 to 26, from 18 countries, who were HPV-free at the time of trial. the participants were followed for two to three years. Overall, the study found that those in the Gardasil group was 65.5% less likely to develop genital warts caused by the four HPV strains that Gardasil inoculates against, compared with the placebo group. among study participants who completed the entire three-dose regimen, the vaccine was 90.4% effective at preventing genital warts (and 85.6% effective at preventing persistent HPV infection), compared with the placebo group — similar to its effectiveness in the female population.

Preventing persistent HPV infection and genital warts in men may also protect them from related cancers of the anus and penis. But given that rates of both genital warts and anal and penile cancers are so low in men, experts question whether the costs of vaccination are worth its benefits. Still, last week, the American Academy of Pediatrics included HPV vaccines for the first time in its list of recommended vaccines for children and teens. In December, Merck received permission from the FDA to market Gardasil as prevention for anal cancer.

Some advocates of routine HPV vaccination say that inoculating men contributes to herd immunity, and helps protect women. CNN reports:

“Men are such a vital component of the whole prevention cycle when looking at HPV or any sexually transmitted infection,” says Demetrius Porche, a professor of nursing research and evaluation at the Louisiana State University School of Public Health in new Orleans.

Vaccinating men provides a “double benefit” in that fewer men with HPV will also mean that fewer women are exposed, adds Porche, who was not involved in the current study but has researched HPV in men.

HPV is the most common sexually transmitted infection and affects 50% of sexually active adults over their lifetimes. the CDC estimates that 20 million Americans currently have a strain of HPV, with 6 million new cases each year. the virus has 40 different strains and is unusual in that its symptoms and outcomes can vary wildly; most people who have the virus have no symptoms and no lasting health problems. About 90% of HPV cases clear up on their own, though it can take up to two years for that to happen, which affords plenty of time to spread the disease.