Pregnant woman's wreck has happy ending

Monique Whitfield started feeling pain in her lower back and stomach sometime Tuesday morning.

Could this be the onset of labor, she wondered, or was it kidney stones acting up again?

"I didn't know," Whitfield admitted.

Regardless, she needed to get it checked out. So she got in her car and headed toward Baptist Memorial Hospital-Golden Triangle.

But she decided to take a quick detour first.

Whitfield owns a beauty salon in Columbus, and the power bill was due.

She took the Main Street exit onto Highway 82 eastbound, and at around 12:15 p.m., she lost control of her car.

"It didn't go as planned," Whitfield said.

As Whitfield was driving along the exit ramp, her car ran off the right side of the road. The dark blue Dodge Ram Charger knocked down a light post and highway signage, traveled down a slope and ended entrenched in the trees alongside the highway.

"It was already slippery because it had been raining," Whitfield said. "When I got to the curb, I hit the brakes, and I lost control of the car."

She was nine months pregnant.

'Two angels'

Derek Whitfield, Monique's husband, was the first one to receive a phone call from his wife after the crash.

"I was scared," he said. "I didn't know. Anything could have happened (to the pregnancy)."

Monique Whitfield was unable to open her door due to trees and bushes surrounding the wrecked vehicle.

"It was awful," Monique Whitfield said.

However, two passersby saw the accident and called for help.

"Thank God for the two people who did see the accident," Diane Moore, Monique's mother, said. "I thank God for the two angels he sent."

Emergency response units rushed to the scene, removed shrubs and branches to get a stretcher near the driver's side door and carried Monique from the vehicle to a nearby ambulance. She was transported to BMH-GT.

Prognosis good for Liberty Elementary student

She was bubbling and laughing and bouncing off the walls one day and the next day she was at the doctor’s office hearing a horrifying diagnosis.

That’s about how fast the events of the last few weeks have happened for Kolbye Kaye Hamilton, 6, of Sallisaw.

“She woke up that morning and said her side hurt. She had very obvious blood in her urine,” Kolbye Kaye’s mother, Debra Hamilton, said of the morning of Sept. 8, the day all this began.

“I took her to see Dr. (Jennifer) Scofous here in Sallisaw. Dr. Scofous sent us to Sparks in Fort Smith for a CT scan. They thought she might be passing a kidney stone and blood clots.

“They sent us home with antibiotics. Several days later she was still hurting and there was still a lot of blood in her urine. We knew something wasn’t right. We got Dr. Scofous to refer us to Children’s Hospital in Tulsa. Our first appointment was on the 15th. They did a scan with dye in it,” Hamilton said.

Within 24 hours the pediatric urologist called them to tell them they needed to get back as soon as possible.

“They called us on Friday and said they had found a large mass on her right kidney,” she said. “That’s when we learned about the nephrectomy, the removal of a kidney.”

Less than a week later, her happy, bubbly daughter went into surgery for more than three hours to remove a kidney that had been diagnosed as a stage II Wilms tumor.

Hamilton said the doctors explained that Wilms tumors typically occur in children under the age of eight years old.

“They explained the tumor is a result of a kidney cell that failed to mature before she was born. After a child is born the cell tries to catch up and instead forms a cancer,” Hamilton said.

Doctors operated on Sept. 21 to remove the cancerous kidney. Pathology reports indicated that the cancer had spread to four of the 11 lymph nodes removed with the kidney.

“They put in a port for chemo,” Hamilton said. “Kolbye Kaye has named it Sally. She’s got a good attitude about it. She knows it’s going to save her life.”

Hamilton said the doctors expected her to remain in intensive care for three to five days, but she did so well she was out of ICU in 24 hours and home on Sept. 25.

“She feels good right now. She’ll be homebound, but if she feels like going to school she will be able to,” Hamilton said.

Kolbye Kaye is in Gloria Neer’s first grade class at Liberty Elementary School in Sallisaw.

The next step for this energetic first grader will be 18-24 weeks of chemotherapy and possibly radiation. Blood work every week will be a necessity.

“She’s got a good attitude now, but she doesn’t know about all the side effects, like losing her hair,” Hamilton said.

She said the prognosis is very good as 90 percent of children with a stage II Wilms tumor survive.

“The next year is going to be hard,” Hamilton said. “Up to six months of chemo and then six months for her immune system to get back to normal.”

Family and friends have set up a number of benefits to help the family with the costs of traveling to the hospital and related expenses.

Prepared Patient: Responding to Acute Pain

Jan Adams, 66, a retired general practitioner who lives a Minneapolis suburb, has had multiple experiences of acute pain—most of which were managed well but one that was not. While Adams’ post-surgical back pain received excellent care, her most traumatic experience with acute pain came during an emergency gastrointestinal procedure.

Lys Fulda, a 36-year-old sales and marketing professional from Chicago, also had a terrifying experience with acute pain during a root canal in her 20s, which left her with a fear of dentists that took 10 years “and a very patient dentist” to conquer.

Fifty-four-year-old Mike Gaynes, a media consultant, suffered extreme acute pain during an attack of kidney stones. On his way to a hike with his wife, he was suddenly overcome by it. “I’ve never been shot or stabbed, but talking to people who have, that’s the closest thing to it,” he says.

Getting the Right Help for Acute Pain

Whether caused by injury, surgery or a toothache so bad it slams you awake in the middle of the night, acute pain is difficult.. Receiving prompt and helpful treatment can make all the difference in the world. But lack of care or inadequate care means that the acute pain may develop into chronic agony.

Fortunately, acute pain is not always long lasting or overwhelming, such as when you have short severe cramp or multiple bee stings that can be handled with time, over-the-counter medication and other home remedies [See sidebar].

Since individuals’ tolerance for pain varies widely, the question of when pain itself requires urgent medical attention is difficult to answer. Chest pain should prompt a visit to the emergency room, of course—but other types of pain are trickier to call.

“If it hurts like hell, come to the E.R.,” says Dr. Sergey Motov, assistant program director for emergency medicine at Maimonides Medical Center in Brooklyn. “The problem is that it’s so subjective, there’s no really good objective way to tell when [help is required]. If it’s the worst pain you’ve ever experienced, [come].”

Once you seek medical attention, you should be treated promptly and with compassion. “If you don’t treat acute pain properly, it can become chronic,” Motov says. “If someone comes in with acute pain and it’s sub-optimally treated, they go home and come back in three days and it’s sub-optimally treated again and later on they’re in chronic pain, that started with us because we did not address the acute pain properly in the first place.”

So how should extreme acute pain be treated? Jan Adams, a retired general practitioner herself, describes receiving excellent care after she had back surgery following an injury. She was immediately given strong opioid medication because of the intensity of the pain.

“What they did right was allow me to manage how much pain medication I needed for the first few days,” she says. “I needed more at first and what they did right was to allow me to manage the pain, understanding that there’s a big difference between abuse of pain medication and acute pain use of narcotics.”

Mike Gaynes, a media consultant, received similarly caring treatment with opioids when he reached the ER suffering with kidney stones. Although he does not normally have high blood pressure, the pain had made it skyrocket. “This was cork-popping,” he says, “They gave me I.V. morphine and it helped somewhat, then they gave me more and it helped a little more. It took the edge off but did not shut [the pain] down entirely.”

Hospitals analyzing the radiation risk

Dr. Paul Gabriel saw a young man in the Grant Medical Center emergency department last week who had kidney pain and blood in his urine.

The default step for the ER director would be to order a CT scan. But the patient had undergone six scans — including one the month before — that all confirmed kidney stones.

To send him for another was probably a waste of time and resources, but more important, it was going to increase the man’s lifetime exposure to radiation.

So they agreed to skip the test.

“He was extremely appreciative,” Gabriel said. “He said, ‘I don’t want to have cancer in 20 years,’ and I said, ‘I don’t want you to.’ ”

Americans are increasingly asking whether medical professionals are doing all they can to limit patients’ exposure to CT scans and X-rays.

Doctors and hospital leaders say they’re investing time and money making sure that decisions are medically wise and err on the side of protecting patients.

“There’s everywhere in America a growing awareness,” said Dr. Richard White, chairman of radiology at the Ohio State University Medical Center. “The awareness is justified, but some of the fear isn’t.”

Patients with cancer, gastrointestinal disorders or repeated kidney stones, for example, have repeated scans and should be most concerned, White and others said.

And if the scans begin early in life, there’s more reason to be cautious, as radiation exposure over many years poses more risk.

Two years ago, news that Cedars-Sinai Medical Center in Los Angeles gave hundreds of patients about eight times the normal amount of radiation during diagnostic scans drew the attention of patients, doctors and regulators, and it has served as a catalyst for improvements nationwide.

Last month, the Joint Commission, which accredits hospitals and often prompts quality-improvement efforts, sent a notice urging health-care providers to find new ways to avoid repeated doses of harmful radiation.

In the past 20 years, Americans’ radiation exposure has nearly doubled because of increased use of imaging.

“CT scanning has become the single-most-important source for radiation exposure in humans,” said Dr. Pablo Ros, chairman of radiology at University Hospitals in Cleveland.

“It’s very successful, very powerful and provides a lot of information, but particularly our nonradiology colleagues may not realize the significance of the radiation exposure,” he said.

At times, those tests aren’t necessary, or the patient might be better served by other diagnostic tools, such as ultrasound or MRI.

If a patient does need a CT scan, the dose can be limited. Other times, no scan is really needed, but doctors feel obligated to order one to guard against legal problems.

“We order way too many CT scans. There’s tremendous pressure,” Gabriel said.

To reduce exposure, hospitals are buying better equipment and educating referring physicians about how best to determine whether CT scans or X-rays are really needed, White said.

At Ohio State and other centers, technicians have been trained to better tailor the scans to patients.

“A little tiny lady won’t get the same strength of the power of the beam as a larger person,” White said.

This practice “takes some more time and effort, but once it’s put into the daily grind, the techs respond well and the patients like it,” Ros said.

Michelle Hamilton, director of radiology at Mount Carmel West, said conversations with patients about the risks and benefits of scans are routine.

And the hospital continues to evaluate changes it can make to reduce exposures, including recently lessening the dosing for cardiac CT scans.

One important advance within the OhioHealth system has been a viewing program that allows radiologists to look at all the scans a patient has had within the system, said Dr. Harlan Meyer, radiology medical director at Grant.

They can see all exams since 2003, and if a patient has had 25 since then, it qualifies as a “ radiation alert,” prompting more evaluation. In some cases, those patients go on to undergo a different diagnostic approach, such as MRI, Meyer said.

Fight kidney disease with weight, not water: prof

Drinking lots of water will not protect your kidneys from disease, but avoiding being overweight might.

That is the message from British kidney researcher and specialist Prof Peter Mathieson, who said in Dunedin yesterday there was a need for increased awareness of kidney disease.

That would include an end to people being squeamish about urine.

People were insufficiently receptive to the messages about keeping their kidneys healthy, but it was the job of health professionals to make information about kidney disease more accessible.

Kidney disease was "not a very sexy subject", but it was a significant health burden.

The best way to prevent kidney disease was to control diabetes and obesity.

Not gaining weight was the most important thing people could do to keep their kidneys healthy, Prof Mathieson said.

Having your blood pressure checked and controlled if necessary, moderating salt and alcohol intake, and "good levels" of physical exercise also played a part.

There was no evidence drinking lots of water protected kidneys, and the vogue for everyone to drink bottled water had no health evidence to support it, he said.

The body's thirst mechanism was extremely powerful and "if you need more water you will feel thirsty. If you don't feel thirsty, you don't need it".

Tap water was perfectly adequate, he said.

However, in some very hot parts of the world, such as Saudi Arabia, there was a need to keep up fluid intake to prevent the urine becoming too concentrated, because this could lead to kidney stones.

Prof Mathieson would ban high energy drinks if he could.

While they did not have a direct damaging effect on kidneys, their high calories led to associated health risks.

There were "very powerful" statistics suggesting the current generation of children would have a lower life expectancy than their parents.

Parents, who generally wanted their children to have a "better deal", should start disease prevention early.

This included encouraging physical activity and avoiding junk foods and high calorie drinks.

In the United Kingdom, there had been an emphasis on increasing physical exercise in the young, but this was not addressing the major problem of calorie intake, he said.

Prof Mathieson, who was the foundation professor of renal medicine at Bristol University where he is now the dean of medicine and dentistry, has been studying protein in urine, a sign of kidney disease; and ways to prevent kidney disease.

Often kidney disease was diagnosed late because it did not produce early symptoms.

A key to early detection was screening the urine for protein using sensitive tests, and the United Kingdom Government was being encouraged to introduce that.

In the long term, it was hoped research would lead to the ability to predict, by genetics or other means, who was at risk; and aim preventive strategies at those people.

People needed to realise paying for treating complications from obesity and diabetes rather than concentrating on prevention was "already overwhelming most of the developed world economies" where some form of health rationing was inevitable.

There were not enough kidney transplants available and the cost of dialysis meant clinicians would be forced to choose which patients would get a good quality of life on dialysis because they were dealing with a "finite resource".

WHMP radio personality Chris Collins recovering after near-death ordeal

"Look, I'm not dead," said Chris Collins from his home Tuesday, as he sought to dispel rumors that suggested that very thing. "I'm also not brain-dead, blind, or any of the other things people have heard."

Of course, Collins, 43, who had been WHMP's news and program director since 2001 before his major organs shut down, was at death's door all summer and not expected to pull through. All of it brought on, he said, by a decade of burning candles at both ends and playing "fast and loose with Type 2 diabetes for years. I was riding for a fall."

He also strongly relates to the tail-end of "The Sopranos'" run, where Mob boss Tony, in a coma after being shot by his uncle, goes into this altered state as a harried heating salesman from Arizona, Kevin Finnerty. Collins can tell you about comas.

And talk about a shell of one's former self. In the last six months, between kidney failure, a three-week coma and open heart surgery, Collins has involuntarily shed 116 pounds, which puts him roughly at his 1986 fighting weight of 212, when he was the goalie for Greenfield High's hockey team. Not that he's in any shape to start lacing 'em up and taking his place between the pipes. But he's alive. Which may be some sort of a modern miracle in itself. "My nurses couldn't believe I was alive," he said.

Collins' ordeal began in late March, with intense pain in his back. Since he had been rushed to the hospital 2½ years before with what turned out to be kidney stones, he thought he was in for more of the same. But this time it proved to be a blocked right ureter, which led to a kidney infection. "My kidneys basically stopped functioning," he said. "It came out of the blue - I never saw this happening."

Co-workers at WHMP who saw him taken by ambulance to Cooley Dickinson that morning suspected it was a heart attack.

Renal stents were inserted to allow Collins' kidneys to function. He was sent home to recuperate, but the drug regimen he was prescribed had adverse affects. "I had (the stents) in for three months," he said, "but the bloating - I bloated like a mile-high balloon. Couldn't sleep, could barely walk upstairs; it was obvious that something was wrong. My echocardiogram was high but normal, but my symptoms were not consistent with that," he said.

An ambulance's wail could be heard once again in Collins' ears. "The last thing I remember is being wheeled into the Franklin ER.," said Collins. The paddles of a defibrillator shocked his heart back to life and again when he was rushed to Baystate Medical Center in Springfield. Collins credits cardiologist Mara Slowsky with saving his life. "She saw that my heart was beating at 15 percent capacity. Major blockage. They drained 2 liters of fluid out of my chest."

He went into a coma - from late July to mid-August he was on extreme life support. "I coded three times and three times they brought me back," said Collins. "It was hour-to-hour, minute-to-minute."

Maxims, aphorisms: true and false

We base much of our lives on scraps of wisdom known as maxims or aphorisms. Some of them have value; many are nonsense, and should be disregarded.

Today, let’s examine some of these pithy sayings.

“This, too, will pass.” That’s known as the kidney stone philosophy. It has some truth to it, in that most events – both good and bad – ultimately fade away. But not always. Ask anyone who has lost a child, or who has contracted AIDS.

“If at first you don’t succeed, try, try again. Then quit. There’s no use being a damn fool about it.” W.C. Fields gave that advice, and I’ve followed it all my life.

Another of his utterances that I heeded for many years: “You can judge a man by what he believes. And I believe I’ll have another drink.”

“When one door closes, another will open.” That saying has sustained millions of people who have met misfortune. It occurs to me, however, that during an economic slump there seems to be fewer doors opening than there are in boom times.

“You’re only as sick as your secrets.” That little piece of rubbish is peddled by amateur therapists who want to peer into every cranny of a troubled person’s mind. Truth is, our secrets are what form much of our character. Without them, we risk turning into human ciphers.

“No pain, no gain.” I’m told such advice is valid for body-builders, who must tear down muscle tissue to allow it to rebuild into even a larger mass. And that hurts. But I don’t think pain or great stress is an automatic prerequisite for all other forms of improvement. Think of being taught how to dance, by an attractive partner. Any pain there?

“Use it or lose it.” What a load. Dear Abby often used that in her advice columns, trying to encourage people to resume romantic relationships after a bust-up. She implied that your erotic apparatus will fall off or dry up unless it’s kept on the firing line. Abby was wrong. Anyone who’s had to undergo celibacy for a time can testify that when the good times resume, the equipment is ready and waiting. And there’s seldom any rust on it.

“Life is either a daring adventure, or nothing.” – Helen Keller.

“If you ain’t busy living, you’re busy dying.”– Bob Dylan.

These examples of all-or-nothing philosophy ignore the fact that most people go along quite well at 30 to 50 mph. We don’t have to be busting a monumental gut or striving for the Olympics in order to enjoy life and find it meaningful. For every person who’d choose daring adventure, ten would opt for solid, predictable comfort.

“The measure of a man is what he does with power.” Quite true. Or how he treats waitresses.

“That which does not kill you makes you stronger.” The German nut job Nietzsche foisted that blob of horse puckey on the waiting world, and it has been gobbled up by millions. Except for people who were maimed while serving in Vietnam and Mideast wars, or survived Hiroshima and Nagasaki, or went through a few years of chemotherapy. Folks like that may not be dead, but they’re seldom stronger.

“Cynicism isn’t smarter, it’s only safer.” Marvelous. Right on target.

“Don’t look back. Someone may be gaining on you.” Pitcher Satchel Paige said that. Few ball players ever gained on him, however.

“There is time for everything.” So said Thomas Alva Edison, who was never a mother with six small children squalling for her attention.

“You got to have a dream. If you don’t have a dream, how you gonna have a dream come true?” Bloody Mary sang that lovely line from a great song in a superb musical, “South Pacific.” Words to live by, through thick and thin.

“Cheaters never prosper.” Hedge fund managers and mortgage brokers throughout the land double over with laughter each time someone breaks out that idealistic adage. The sad truth is that cheaters often have a leg up on all other contestants.

“Never say more than is necessary.” British playwright Richard Brinsley Sheridan (1751-1816) is the source of that quotation, which has been ignored by politicians, columnists and almost everyone else you can name, ever since.

“Life is like a game of cards. The hand that is dealt you represents determinism; the way you play it is free will.” A great deal of wisdom in that statement, but it can drive you crazy if you review some of the stupid moves you’ve freely made, especially after four martinis and Charlene’s fingers caressing your cheek.