There’s no place like home – The Winchester Star

WINCHESTER When her 7-year-old son Isaiah experienced a brain bleed in November 2013, Ruth Truman and her husband Ryan were told that the bleed was caused by a tangle in his veins.

A few months later, in February, it happened again.

(Doctors) ended up doing a scan then, and found that there was a fine layer of brain cancer on his brain and down his spine and in his spinal fluid. It took quite some time about two weeks for labs and they determined 90% that it was called PNET (primitive neuroectodermal tumor), said Truman.

He was going into radiation, and the doctors said if he survives the radiation, theyll give him about a year (to live). If he survived the chemo after that, they thought it would be a year or two. Now were almost at six years, so Im like this kid is a walking miracle.

As she witnessed her son experience 21 days of radiation, five months of chemo and stem cell therapy, Truman was struck by how many other children and families were going through something similar how they were not alone.

I never knew a kid who had cancer before Isaiah. Its like when you buy a new car, and then all of a sudden everybody has that car when you get thrust into the thing, its like wow I had no idea how many kids had cancer or a medical condition... Its just sad that there are so many kids out there dealing with this, said Truman.

That observation is something that has stayed with her since. It seemed like fate, then, that she stumbled upon Savvy Giving By Design last year, a national nonprofit network of professional interior designers who redesign bedrooms of children who are facing a medical crisis. Truman, an interior designer who previously worked in corporate interior design in Ohio and Maryland before starting Ruth Truman Interiors in Winchester, felt she had found her mission.

I thought about it a lot over the year, and you could apply (to start a chapter), but I thought Im in Winchester, a small town, some of these other places are Tampa, Florida... But it just kept gnawing at me and just felt like this was what I was meant to do. So I applied, and they sent back that theyd love to have us start one in Virginia, she said. The Virginia chapter of Savvy Giving By Design was officially launched in October.

Truman said that theres a misconception that children who are facing a medical crisis are always at the hospital. While they are there often, its in their bedroom that they spend the most time.

They do spend a ton of time at the hospital, but most of their hours are at home, because of their immune system, she explained.

They get bored of their space, and so making it somewhere that they want to come back to from the hospital, that is the key. People just dont realize how much time they have to spend there. Some of the kids have had blood disorders, one of the kids who was paralyzed recently, is not able to go out a lot. So many people dont see that, they think theyre at the hospital. But they dont realize they really are at home all of the time.

And its not just an attractive room that the organization gives to its families many practical upgrades are made with the childs specific needs in mind.

Were not just about making some room pretty for a kid, but these kids do really spend such a huge amount of time in their room. How can we make it more functional and meet their medical needs too, said Truman.

Truman said typical changes include replacing carpet for flooring that is waterproof and cleanable, installing dimmers on lighting since parents often check on their child every hour at night, as well as putting in hypo-allergenic mattresses and bedding, and sometimes additional beds.

From one of the other chapters, one family had three siblings sleeping on the floor in the same room together. We want to provide them with good bedding and beds. Some parents sleep on the floor in their childs room on an air mattress, so we could put another bed in there, she said.

For children with disabilities, the designers meet with specialists who can help them to better understand what needs the child may have, which can be incorporated into the room.

Some kids are in wheelchairs, so space layout, how do we maximize the space in their room so they can move around in a wheelchair. That could be adding bunk beds or built-ins, explained Truman.

Not only does the organization create a new bedroom for the child with a medical crisis, they also redo the bedrooms of the siblings. Truman explained that often in these situations, siblings can have feelings jealousy over the attention their sibling is getting, not fully understanding the pain their brother or sister is experiencing.

When your child has cancer, so many people are generous. I cant tell you how many stories where weve been places, people will pay for our ice cream, our meals, I was in the Disney store once and a guy came up and said, can I buy him a stuffed animal? And yet at the same time, the siblings are seeing this and they are kind of feeling left out. Theyre not understanding, she said.

I just think its so great that we do the sibling rooms. They are going through their own issues with this diagnosis of their sibling. We want them to be a part of this.

On the low end, Truman estimates that it can cost $3,000 or more to renovate a childs room if the organization has to pay in cash for all supplies and labor. Each chapter must raise 100% of the funding themselves, which can be done through donations of products like flooring, lighting, furniture, labor by tradesmen, as well as financial donations to purchase materials and supplies for the room. Work would be completed in four to six weeks.

So far, Ferguson Lighting has agreed to provide the lighting for the Virginia chapters first two bedroom renovations, and Prosource Wholesale Flooring has agreed to provide the flooring. Truman hopes to find local licensed and insured tradesmen who can donate their time to install flooring and electrical, painters and wallpaper installers, as well as businesses that may donate furniture and bedding, dcor, paint, and other necessities. Financial donations are also welcome and can be made online at http://www.savvygivingbydesignva.org or by check.

Once a child has been selected and the room has been designed, Truman said they will post specific items that are needed like pillows from Target, with a link to purchase on the organizations Facebook page, and donors can purchase the item for the room. The Virginia chapters Facebook page is http://www.facebook.com/groups/2105182686449144.

Truman said they already have two applicants, a child in Winchester and another child in nearby Aldie; both children have cancer. Truman said she expects to announce the Virginia chapters first bedroom makeover within the next month.

Ive been in their shoes. I think about me and Isaiah going through that time, if we had gotten something like this how special it would have been, she said.

So much good can come out of a bad situation if you can use it for the good. I think that were thrown things in life that are hard and how can we make them into something good. For me, this is one way that everything he has been through, I feel Im able to give back to people who are going through the same thing.

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There's no place like home - The Winchester Star

This World Cancer Week, let’s separate the myth and reality surrounding it – The New Indian Express

Fake, fun and fantastic, myths usually tell us something about why the world is the way it is. But believing myths about cancer can be outright dangerous. Consider this: cancer is contagious and you need dollops of positivity to beat the dreaded C-word. Or this: cancer is caused by a fungus and its actually your bodys attempt to protect itself from the infection. From coffee to carbonates to cannabis, millions of pages on the internet tell us every day about miracle cures for cancer. And it is hard to distinguish fact from fiction, because few illnesses cause as much terror or have as many misconceptions that refuse to die. Here, some of the countrys leading oncologists bust old myths and bring new hope, as an explosion of new research changes the way cancer is perceived, understood and treated.

Dealing with cancer means making some tough choices. How you decide to seek medical help will determine your chances of cure. Hence, education is vital. The most common concerns patients come to me with are often some of the biggest myths. I find it painful that the myths are very much alive even among the educated classes. I make time to engage with my patients to dispel the misconceptions and to create awareness about the bad effects of these myths. Remember, you have a far better chance of beating the disease if you can dispel the fallacies and false notions.

Myth Biopsy can disturb cancer cells and cause them to spread to otherparts of the body.

Reality

It disturbs me that people still come to me and say, I dont want to do a biopsy. The truth is: there is little reason to worry that a biopsy allows cancer cells to spread within the body. Medical evidence shows that this is unlikely. In fact, patients who have biopsy procedures to confirm their diagnosis and determine the cancers stage have a better outcome and longer survival than patients who do not have a biopsy.

The point is, how can you diagnose a cancer without biopsy? Cancer treatment starts only after biopsy. It is the first landmark event in the definitive diagnosis of a cancer. That is crucial in determining and planning the correct treatment for a patient. If a biopsy indicates a benign disease, the patient is spared unnecessary treatments.

Biopsy may involve discomfort and bleeding, but the gain far outweighs the risks. I ask my patients if biopsy is responsible for cancer spreading, then all the people coming to me should have initial stage cancers, since they havent done biopsy as yet. I bring in their own examples: how come your own cancer has spread, as all the imaging, MRI, CT and PET scans show, although you have not done biopsy? Yet faith in this myth continues. It is a key reason why treatment gets delayed in our country. We have to understand that cancer does not wait for any procedure to spread.

MythChemotherapy means the cancer is terminal. Hence,avoid chemo.

Reality

The second set of cancer myths I come across revolves round chemotherapy. My patients ask a lot of questions about it: they want to know if chemotherapy means the illness is terminal, if the side-effects of chemo will completely disrupt their life completely, and if chemo is really worth it. A lot of patients do not wish to go through it.

The truth is: chemotherapy certainly does not mean a cancer is terminal. It is essential for many cancer patients. The more advanced cancer you have the more you need chemotherapy. In fact, chemotherapy is often a preventive measure to prevent recurrence and to improve the odds of cure. It also ensures faster recovery. Chemotherapy has evolved considerably over the decades. The drastic side effects are not as prevalent today. It does not disrupt a patients everyday life the way it used to once. With the advances in chemotherapy, more and more people are surviving and doing well after cancer treatment.

We need to understand that cancer is something that happens in all multicellular organismsfrom the smallest hydra to the biggest whales. Cancer is more common in animals that are domesticated or in the zoo, because they live longer than those in the wild. Studies from India have analysed fossils of dinosaurs that suffered from cancer. Cancer is a disease of cell regulation. In multicellular organisms there are many cells, some of which become bones, some tissues, some the brain. In that process of evolution, things can go wrong. And sometimes they can become uncontrollable. Cancer is such unchecked cell growth.

More recent studies show cancers are caused by three broad groups of cell alterations: the smallest group is that of people born with some genetic alteration that runs in the family. It makes up about 5 percent of all cancers. Of the environmental factors, the biggest is tobacco, which causes damage to the DNAcigarettes and passive smoking, chewed tobacco, hookah, dant manjanmaking up 25 percent of cancers. The next big group is infection, which is coming down now as hygiene is improving. The big ones are papilloma virusa sexually transmitted disease, from the male to the femaleit takes about 30 years to manifest, from pre-cancer to cancer and then to metastatic cancer. In the liver you get Hepatitis B and C, from mother to child.

Hep C comes through transfusion, tattooing. Then there is the Helicobacter pylori, a waterborne bacterium that is usually acquired in early life. If one is exposed to other carcinogens, like salted meat, cigarette smoke and so on, it triggers the cancer. Infections are responsible for 15-25 percent of cancers in India.The rest of the cancers are now thought to be random occurrences. Our body is a continuous workshop of cell regulation, replacement, regeneration: when cells get damaged, old cells are removed and new cells grow. The skin, the bone marrow, the linings of the gut, bladders and the kidneyare changing continuously. Stem cells provide new cells to the body as it grows and replace those that are damaged or lost. They can divide over and over again to produce new cells. As they divide, they can change into the other types of cell that make up the body. And just sometimes, things go wrongat randomthat have carcinogenic potential. That means, anyone can get cancer. Call it plain bad luck.

MythCancer is fast turninginto an epidemicin India.

Reality

That to me is the biggest myth. You may see a large number of cancer patients in hospitals. You may know a lot of people with cancer. But the epidemic is more apparent than real. Cancer is a disease of older age. It usually picks up from about age 40-50 and reaches a peak at about 7080. What has happened in India is that our population has exploded and we have a substantial number of older people. There are a 100 million people above age 60.

The number of cancer patients is also increased. This is typical of what we call an epidemiological transition. That means, once people died of infectious diseasestyphoid, malaria, dengue, choleraand so life expectancy was very low. In 1947, life expectancy was about 30-35 years. Now it is almost 70 years. So you dont just have more people, you have more older people.

Most importantly, we have started doing lab testsendoscopies, scans, screens, biopsiesso deep-seated cancers are being picked up. Even 30 years ago, there was no opportunity for this. This is why you are suddenly seeing so many people with cancer. The proof for this lies in some very beautiful studies done 100 years ago by British doctors in India. They had done autopsies on a lot of unclaimed bodies. And the autopsies showed a high rate of cancersalmost as high as it is today. The Mumbai Cancer Registry, which was started in 1962, has been monitoring cancers in the city continuously for nearly 60 years. You will be pleased to know that the rates have not really increased. The actual numbers have gone up, as the population of Mumbai has gone up enormously, but if you standardise the number of cancers in corresponding age groups and compare, there is no increase at all. On the contrary it has decreased a little bit, which is very reassuring.

MythAYUSH cancure cancer.

Reality

Every day in my chamber, I see patients who have been sitting on their symptoms for months, sometimes years, thinking it would not be cancer. Their doctors have not told them it could be cancer and treated them for dysentery or piles, instead. And when things get out of order, they come to oncologists. But by then, its often too late. There is a serious lack of awareness among people and among AYUSH practitioners. The bottomline is, if you have symptoms that continue for weeks, do not go to doctors who cannot do biopsy. You cant diagnose cancer without doing biopsy.

MythCancer is adeath sentence.

Reality

People panic once cancer is diagnosed. They seek out immediate treatment, go to people who are not experts, do not understand the upsides or downsides and end up getting treatments that harm them more. One reason could be that they are driven by the messages they hear. So the first thing to remember is that cancer is not a death sentence. Dont panic. You must do your research and find out people who are doing the right treatment and go to the right place. Cancer cells grow slowly, dividing every three to four weeks. It is not that scary. You have four to six weeks time to find the right place. The best treatments are inevitably found in places that have multidisciplinary teams.

Myth Cancers spread with intervention.

Reality

The biological nature of cancer is to spread. Thats why cancer kills. All cancers will spread depending on its tumour biology. Some fast and some slow. The reason why there is an apparent spread after an intervention via biopsy or surgery is because those procedures can reveal the spread more accurately, and not because cancers spread after the intervention. As the cancer cells divide in geometric proportions, it will take more or less time to double its size from 1 mm to 2 mm and from 5cm to 10 cm. In other words, the growth of cancer will appear to be faster in more advanced stages.

Myth Dont tell the patient the bad news.

Reality

If you tell the patient the bad news (diagnosis of cancer etc) they will not be able to take it. As a result, often half-truths or white lies are told by doctors to patients. Studies done in India on patients with cancer, however, reveal that 90 per cent of them want to know the correct diagnosis and likelihood of survival, as it helps to plan the treatment and plan their lives as well.

There are a whole range of rumours and myths about cancer that makes it hard for people to know what is true about this widely misunderstood disease. Every day, new myths arise and old ones reappear, leaving patients and family members confused and vulnerable. Many turn to dangerous remedies, others get trapped into believing fallacies that harm them immensely. Here are some of the most persistent and pernicious myths surrounding cancer and its treatment that we face every day.

MythNo, this cannotbe cancer.

Reality

We come across hundreds of patients who show signs and symptoms indicating the possibility of cancer, yet they will not accept it. The first reaction in India, typically, is: No, this cannot be cancer. Somebody gets a lump, a hard mass on any part of the body, a coughing spell that lasts for over four weeks. And the first thought is to blame it on infections or pollutionsomething that will settle down within a week or two. Who will tell them that cancer coughs will not settle down? The first presenting symptom for lung cancer will be cough. We get patients with telltale signs of cancerblood or discharge through urine, stool, mouth, female genital organsyet by the time they seek medical opinion, often the cancer has already spread to other parts of the body. This denial mode and not letting treatment start on time, is a very Indian attitude.

MythLifestyle tendencies that lead to heart disease, hypertension or stroke are notrelated to cancer.

Reality

Think of physical inactivity, of stress, of eating a lot of preserved and processed food. And the first reaction we find among patients is: Surely, those are not linked to cancer. They seem to be convinced that the lifestyle tendencies that are linked to heart disease, hypertension or stroke have nothing to do with cancer. Thats just not true. Now we have sufficient literature and scientific evidence to show that patients having more junk food, leading more sedentary lives, living in more stressful environments are more prone to cancer than those who are not under such circumstances. Fortunately, these are modifiable factors. That means, people can change these. Non-modifiable factors mean those that cannot be changed: for instance, somebody with a family history of cancer will have higher chances of getting the disease. These are genetic traits. There needs to be developed the maximum awareness that modifiable lifestyle excesses dont just bring on heart disease, stroke or hypertension, but also cancer.

MythCancer iscontagious.

Reality

This is an important myth that even educated people share. If somebody gets cancer, friends and neighbours do not visit, thinking they may also get it. This is a huge issue, because in India we are dependent on social support for emotional sustenance. That often breaks down for cancer patients, who are anyway emotionally disturbed and need more support. Myths like this make them go through social isolation, bringing in more stress. Cancer is absolutely not contagious. In some people, cancers may be caused by certain viruses (some types of human papillomavirus, or HPV, for example) and bacteria (such as Helicobacter pylori). While a virus or bacterium can spread from person to person, the cancers cannot.

MythNourishing foodnourishes cancer cells.

Reality

This is a common and dangerous misconception: if you give nourishing food to a patient, the cancer will grow faster. Hence deprive a cancer patient of food and the cancer will die out. People try to avoid taking nutritious food, become malnourished, their immunity gets weak and they are not able to tolerate chemotherapy, surgery, radiationfor all of which a patient needs to be physically as strong as possible. If they eat well, the immunity system of the body will fight the cancer cells. Remember, our body constantly makes some cells that can convert into tumour cells. At the same time, the body also has the immunity to destroy these cells. If immunity goes down, the patient becomes more prone to having cancer. Keeping yourself healthy and stress-free are the vital preventives for cancer.

THE COSTCancer is now the leading cause of catastrophic health spending, distress financing, and increasing expenditure before death in India

Out-of-pocket expenditure is three times higher for private inpatient cancer care in the country40% of cancer costs are met through borrowing, sale of assets and contributions from friends and relatives These costs exceed 20% of annual per capita household expenditure in 60% of Indian households with a patient with cancer

A lot of my patients ask: Why did I get cancer? I dont smoke, I dont drink, I am a vegetarian, I pray to God regularly, I have never harmed anybody. Then why did I get it? These are some of the most challenging questions oncologists face. And these are also at the intersection of the myths, misconceptions and facts in all discussions on cancer.

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This World Cancer Week, let's separate the myth and reality surrounding it - The New Indian Express

Report: Former Intercontinental Champion Working To Return To WWE Ring – Cultaholic

Throughout his early career, Daniel Bryan suffered at least 10 concussions, which caused a lesion in the brain and forced him into retirement into 2014. While Bryan was ultimately cleared by WWEs medical team in 2018 and has been wrestling in the company ever since, The American Dragon found it difficult to get cleared by WWE despite independent doctors declaring it safe for him to perform. This led to Bryan requesting his release from the company so he could wrestle in Ring Of Honor or New Japan Pro Wrestling, but WWE consistently denied his requests.

Now, a similar situation is seemingly affecting former Intercontinental Champion Santino Marella. The Milan Miracle was forced to retire in WWE in 2014 after undergoing neck surgery for the third time. However, after his release from the company in 2016, Marella came out of retirement and has been sporadically wrestling ever since. He most recently wrestled in the Womens Royal Rumble match as his twin sister Santina but wasnt cleared to take any bumps and eliminated himself from the match, despite wrestling a 10-minute match back in September against Simon Grimm at Josh Barnetts Bloodsport 2.

Marella is determined to end his career on his terms in WWE, however, and Dave Meltzer has reported in the Wrestling Observer Newsletter that the former Miss WrestleMania is travelling to Colombia to undergo stem cell treatment to repair his neck. Meltzer explained other wrestlers like RVD, Kevin Nash, Edge, and Sheamus have all undergone the same treatment and have credited it with helping them prolong their careers.

For the avoidance of doubt, Meltzer wrote: A huge thing that may even revolutionize careers is the stem cell treatment that a lot of wrestlers have used flying to Colombia. The idea is that it regrows tissue and discs and regenerates injuries. A lot of talent, Kevin Nash, Rey Mysterio, Rob Van Dam, Brian Cage, Edge, Sheamus and many others have gone there for treatment. Anthony Carelli (Santino Marella) is there this week and he noted on Sunday Nights Main Event in Canada that every wrestler who has gotten that treatment except Kurt Angle, whose damage must have been so bad that it simply was beyond repair, has ended up with good results from it. While Edge never talked about it, that is said by others to be part of what has allowed him to return. Carelli, who has had back and neck issues that ended his career, is looking to return to wrestle and end his career on his own terms, as well as go back to competing in age group judo.

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Report: Former Intercontinental Champion Working To Return To WWE Ring - Cultaholic

Life and death in Wuhan: On the front lines fighting coronavirus – Nikkei Asian Review

WUHAN, China (Caixin) -- In the coronavirus epidemic, doctors on the front lines take on the greatest risk and best understand the situation. Peng Zhiyong, director of acute medicine at the Wuhan University South Central Hospital, is one of those doctors.

In an interview on Tuesday with Caixin, Peng described his personal experiences in first encountering the disease in early January and quickly grasping its virulent potential and the need for stringent quarantine measures.

As the contagion spread and flooded his ICU, the doctor observed that three weeks seemed to determine the difference between life and death. Patients with stronger immune systems would start to recover in a couple of weeks, but in the second week some cases would take a turn for the worse.

In the third week, keeping some of these acute patients alive might require extraordinary intervention. For this group, the death rate seems to be 4% to 5%, Peng said. After working 12-hour daytime shifts, the doctor spends his evenings researching the disease and has summarized his observations in a thesis.

The doctors and nurses at his hospital are overwhelmed with patients. Once they don protective hazmat suits, they go without food, drink and bathroom breaks for their entire shifts. That's because there's aren't enough of the suits for a mid-shift change, he said.

Over the past month on the front lines of the coronavirus battle, Peng has been brought to tears many times when forced to turn away patients for lack of staffing and beds. He said what really got to him, though, was the death of an acutely ill pregnant woman when treatment stopped for lack of money -- the day before the government decided to pick up the costs of all coronavirus treatments.

Here is our interview with the ICU doctor:

Screening criteria were too tough in the beginning

Caixin: When did you encounter your first novel coronavirus patient?

Peng Zhiyong: Jan. 6, 2020. There was a patient from Huanggang who had been refused by multiple hospitals and was sent to the South Central Hospital emergency room. I attended the consultation. At the time, the patient's illness was already severe, and he had difficulty breathing. I knew right then that he had contracted this disease. We debated at length whether to accept the patient. If we didn't, he had nowhere to go; if we did, there was a high likelihood the disease would infect others. We had to do a very stringent quarantine. We decided to take the patient in the end.

I called the hospital director and told him the story, including the fact that we had to clear the hospital room of other patients and to remodel it after SARS standards by setting up a contamination area, buffer area and cleaning area while separating the living areas of the hospital staff from the patients'.

On Jan. 6, with the patient in the emergency room, we did quarantine remodeling in the emergency room and did major renovations to the intensive care unit. South Central Hospital's ICU has 66 beds in total. We kept a space dedicated to coronavirus patients. I knew the infectiousness of the disease. There were bound to be more people coming in, so we set aside 16 beds. We did quarantine renovations on the infectious diseases area because respiratory illnesses are transmitted through the air, so even air has to be quarantined so that inside the rooms the air can't escape. At the time, some said that the ICU had a limited number of beds and 16 was excessive. I said it wasn't excessive at all.

Caixin: You predicted in January that there would be person-to-person transmission and even took quarantine measures. Did you report the situation to higher-ups?

Peng: This disease really did spread very fast. By Jan. 10, the 16 beds in our ICU were full. We saw how dire the situation was and told the hospital's leadership that they had to report even higher. Our head felt it was urgent too, and reported this to the Wuhan city health committee. On Jan. 12, the department sent a team of three specialists to South Central to investigate. The specialists said that clinical symptoms really resembled SARS, but they were still talking about diagnosis criteria, that kind of stuff. We replied that those standards were too stringent. Very few people would get diagnosed based on those criteria. The head of our hospital told them this multiple times during this period. I know other hospitals were doing the same.

Before this, the specialists had already gone to Jinyintan Hospital to investigate and made a set of diagnosis criteria. You had to have had exposure to the South China Seafood Market, you needed to have had a fever and test positive for the virus. You had to meet all three criteria in order to be diagnosed. The third one was especially stringent. In reality, very few people were able to test for a virus.

On Jan. 18, the high-level specialists from the National Health Commission came to Wuhan, to South Central Hospital to inspect. I told them again that the criteria were too high. This way it was easy to miss infections. I told them this was infectious; if you made the criteria too high and let patients go, you're putting society in danger. After the second national team of specialists came, the criteria were changed. The number of diagnosed patients rose quickly.

Caixin: What made you believe the new coronavirus could be transmitted between people?

Peng: Based on my clinical experience and knowledge, I believed that the disease would be an acutely infectious one and that we needed high-level protection. The virus isn't going to change based on man's will. I felt we needed to respect it and act according to science. Heeding my requirements, South Central Hospital's ICU took strict quarantine measures, and as a result, our department only had two infections. As of Jan. 28, of the entire hospital's medical personnel, only 40 have been infected. This is way less compared with other hospitals in terms of percentage of total medical staff.

It pains us to see the coronavirus develop to such a desperate state. But the priority now is to treat people; do everything we can to save people.

Fatality rate for acute patients is 4% to 5%. Three weeks determine life and death

Caixin: Based on your clinical experience, what's the disease progression of the new coronavirus?

Peng: Lately I've been spending daytimes seeing patients in the ICU, then doing some research in the evenings. I just wrote a thesis. I drew on data from 138 cases that South Central Hospital had from Jan. 7 to Jan. 28 and attempted to summarize some patterns of the novel coronavirus.

A lot of viruses will die off on their own after a certain amount of time. We call these self-limited diseases. I've observed that the breakout period of the novel coronavirus tends to be three weeks, from the onset of symptoms to developing difficulties breathing. Basically going from mild to severe symptoms takes about a week. There are all sorts of mild symptoms: feebleness, shortness of breath, some people have fevers, some don't. Based on studies of our 138 cases, the most common symptoms in the first stage are fever (98.6% of cases), feebleness (69.6%), cough (59.4%), muscle pains (34.8%) and difficulties breathing (31.2%), while less common symptoms include headaches, dizziness, stomach pain, diarrhea, nausea and vomiting.

But some patients who enter the second week will suddenly get worse. At this stage, people should go to the hospital. Elderly with underlying conditions may develop complications; some may need machine-assisted respiration. When the body's other organs start to fail, that's when it becomes severe, while those with strong immune systems see their symptoms decrease in severity at this stage and gradually recover. So the second week is what determines whether the illness becomes critical.

The third week determines whether critical illness leads to death. Some in critical condition who receive treatment can increase their lymphocytes, a type of white blood cell, and see an improvement in their immune systems, and have been brought back, so to speak. But those whose lymphocyte numbers continue to decline, those whose immune systems are destroyed in the end, experience multiple organ failure and die.

For most, the illness is over in two weeks, whereas for those for whom the illness becomes severe, if they can survive three weeks they're good. Those that can't will die in three weeks.

Caixin: Could you give more details on clinical research? What percentage of cases develop from mild conditions to severe conditions? What percentage of serious cases develop into life-threatening ones? What is the mortality rate?

Peng: Based on my clinical observations, this disease is highly contagious, but the mortality rate is low. Those that progressed into the life-threatening stage often occurred in the elderly already with chronic diseases.

As of Jan. 28, of 138 cases, 36 were in the ICU, 28 recovered, five died. That is to say, the mortality rate of patients with severe conditions was 3.6%. Yesterday, Feb. 3, another patient died, bringing the mortality rate to 4.3%. Given patients in the ICU, it is likely to have more deaths. The mortality rate is also likely to edge up but not significantly.

Those hospitalized tend to have severe or life-threatening conditions. Patients with slight symptoms are placed in quarantine at home. We have not gathered data on the percentage of cases that progress from slight symptoms to serious symptoms. If a patient goes from serious conditions to life-threatening conditions, the patient will be sent to the ICU. Among 138 patients, 36 were transferred to the ICU, representing 26% of all patients. The percentage of deaths among life-threatening cases is about 15%. The mean period to go from slight conditions to life-threatening conditions is about 10 days. Twenty-eight patients recovered and were discharged. Right now, the recovery rate is 20.3% while other patients remain hospitalized.

It is notable that 12 cases were linked to South China Seafood Market; 57 were infected while being hospitalized, including 17 patients already hospitalized in other departments; and 40 medical staff, among 138 cases, as of Jan. 28. That demonstrates that a hospital is a high-risk zone and appropriate protection must be taken.

Caixin: What is the highest risk a seriously ill patient faces?

Peng: The biggest assault the virus launches is on a patient's immune system. It causes a fall in the count of lymphocytes, damage in the lungs and shortness of breath. Many serious patients died of choking. Others died of the failure of multiple organs following complications in their organs resulting from a collapse of the immune system.

Caixin: A 39-year-old patient in Hong Kong suffered from cardiac arrest, and he died quickly. A few patients did not have severe symptoms upon the onslaught of the virus, or in the early stages, but they died suddenly. Some experts argue that the virus triggers a cytokine storm, which ravages the stronger immune systems of young adults. Eventually excessive inflammations caused by cytokine result in the higher mortality rate. Have you seen such a phenomenon in the coronavirus outbreak?

Peng: Based on my observations, a third of patients exhibited inflammation in their whole body. It was not necessarily limited to young adults. The mechanism of a cytokine storm is about whole-body inflammation, which leads to a failure of multiple organs and quickly evolves into the terminal stage. In some fast-progressing cases, it took two to three days to progress from whole-body inflammation to the life-threatening stage.

Caixin: How do you treat serious and life-threatening cases?

Peng: For serious and life-threatening cases, our main approach is to provide oxygen, high-volume oxygen. At first noninvasive machine-pumped oxygen, followed by intubated oxygen if conditions worsen. For life-threatening cases, we use ECMO (extracorporeal membrane oxygenation, or pumping the patient's blood through an artificial lung machine). In four cases, we applied ECMO to rescue patients from the verge of death.

Currently there are no special drugs for the coronavirus. The primary purpose of the ICU is to help patients sustain the functions of their body. Different patients have different symptoms. In case of shortness of breath, we provided oxygen; in case of a kidney failure, we gave dialysis; in case of a coma, we deployed ECMO. We provide support wherever a patient needs it to sustain their life. Once the count of lymphocytes goes up and the immune system improves, the virus will be cleared. However, if the count of lymphocytes continues to fall, it is dangerous because the virus continues to replicate. Once a patient's immune system is demolished, it is hard to save a patient.

Caixin: There is news of some drugs that work. People are hopeful of U.S.-made remdesivir, which cured the first case in the United States. What do you think of the drugs?

Peng: There are no 2019 novel coronavirus-targeted drugs so far. Some patients may recover after taking some drugs along with supportive treatment. But such individual cases do not indicate the universal effect of the drugs. The effect is also related to how serious each case is and their individual health conditions. People want a cure urgently, and that is understandable. But we need to be cautious.

Caixin: Do you have any advice for coronavirus patients?

Peng: The most effective approach to the virus epidemic is to control the source of the virus, stem the spread of the virus and prevent human-to-human transmission. My advice for a patient is going to a special ward for infectious diseases, early detection, early diagnosis, early quarantine and early treatment. Once it has developed into a severe case, hospitalization is a must. It is better to contain the disease at an early stage. Once it reaches the life-threatening stage, it is way more difficult to treat it and requires more medical resources. With regard to life-threatening cases, try to save them with ICU measures to reduce the mortality rate.

Sad story of a pregnant patient

Caixin: How many patients with life-threatening conditions have you treated? How many have recovered?

Peng: As of Feb. 4, six patients in the ICU of South Central Hospital died. Eighty percent of them have been improving, a quarter are approaching their discharge and the remainder are still recovering in segregated wards.

The patient who impressed me most came from Huanggang. He was the first to be saved with the assistance of ECMO. He had contact with South China Seafood Market and was in very serious condition. He was transferred to the ICU and we saved him with ECMO. He was discharged from the hospital Jan. 28.

Caixin: What is your workload and pace like?

Peng: The ICU is overloaded. There are three patient wards with 66 beds in South Central Hospital, housing 150 patients. Since Jan. 7 when we received the first patient, no one took any leave. We took turns working in the ICU. Even pregnant medical staff did not take leave. After the epidemic got worse, none of the medical staff ever went home. We rest in a hotel near the hospital or in the hospital.

In the segregated ward, we wear level-3 protective gear. One shift is 12 hours for a doctor and eight hours for a nurse. Since protective gear is in a shortage, there is only one set for a medical staff member a day. We refrain from eating or drinking during our shift because the gear is no longer protective once we go to the washroom. The gear is thick, airtight and tough on our body. It felt uncomfortable at the beginning, but we are used to it now.

Caixin: Did you experience any danger? For example, in case of intubation, what do you do to prevent yourselves from being infected?

Peng: It is a new coronavirus. We are not sure of its nature and its path of spread. It is not true to say we are not afraid. Medical staff members do fear to some extent. But patients need us. When a patient is out of breath and noninvasive oxygen provision fails, we must apply intubation. The procedure is dangerous as the patient may vomit or spit. Medical staff are likely to be exposed to the danger of infection. We strictly require doctors and nurses to apply the highest-level protection. The biggest problem we face now is the shortage of protective gear. The protective stock for ICU staff is running low, although the hospital prioritizes the supply to us.

Caixin: Is there anything that moved you in particular? Did you cry?

Peng: I often cried because so many patients could not be admitted to the hospital. They wailed in front of the hospital. Some patients even knelt down to beg me to accept him into the hospital. But there was nothing I could do since all beds were occupied. I shed tears while I turned them down. I've run out of tears now. I have no other thoughts but to try my best to save more lives.

The most saddest thing was a pregnant woman from Huanggang. She was in very serious condition. Nearly 200,000 yuan ($28,700) was spent after more than a week in the ICU. She was from the countryside, and the money for hospitalization was borrowed from her relatives and friends. Her condition was improving after the use of ECMO, and she was likely to survive. But her husband decided to give up. He cried for his decision. I wept too because I felt there was hope for her to be saved. The woman died after we gave up. And exactly the next day, the government announced a new policy that offers free treatment for all coronavirus-infected patients. I feel so sorry for that pregnant woman.

The deputy director of our department told me one thing, and he cried too. Wuhan 7th Hospital is in a partnership with our hospital, South Central Hospital. The deputy director went there to help in their ICU. He found that two-thirds of the medical staff in the ICU were already infected. Doctors there were running "naked" as they knew they were set to be infected given the shortage of protective gear. They still worked there nonetheless. That was why ICU medical staff were almost all sickened. It is too tough for our doctors and nurses.

Read the original story here.

Caixinglobal.com is English-language online news portal of Chinese financial and business news media group Caixin. Nikkei recently agreed with the company to exchange articles in English.

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Life and death in Wuhan: On the front lines fighting coronavirus - Nikkei Asian Review