The Milwaukee Protocol

[Levi]

Sounds like the ticket for desperate CFS/ME sufferers with a compassionate medical team and $800,000 burning a hole in their pockets . . .

http://en.wikipedia.org/wiki/Milwaukee_protocol
http://www.scientificamerican.com/article.cfm?id=jeanna-giese-rabies-survivor&sc=WR_20081014

recommended in the Journal of NeuroVirology two years ago that physicians exercise "caution" in using the treatment, because it is too expensive and lacks " a clear scientific rationale." Willoughby says it cost about $800,000 to treat Giese.

 

[Stone]

Rabies is really on my mind lately. I live in a condo-community and we have big red notices posted on our mail boxes warning us about a rabid fox in the area. Last summer, several people a block away from my home were bitten by a fox in broad daylight in their front yards! They never found the offending animal and the people that were bitten had to undergo rabies shots. The fox in question this year, has been seen all around our building by myself and others. I've seen her (I've decided it's a female for no particular reason) in the parking lot on 3 different nights, skulking around the bushes and not displaying aggressive or odd behavior, but my son has seen her walking around in the daytime behind the building which is NOT normal for foxes which are largely nocturnal, and if you do see them in the day time, they did not intend for you to. This one was just walking out in the yard in the middle of the afternoon. We're nervous when we walk our small dogs, and when/if we take our 15 month old grandson outside, it's only on my husband's shoulders, and just to the car and back. I'm telling you, it's a little unnerving, especially for the elderly ladies in the bldg who customarily sit outside in the afternoons and chat. They're not there. Everyone's on lock-down except the fox! I've explained to the neighbors that if the thing does bite you, you will have to get rabies shots, but they are not a nightmare. The're not fun, but it's not a medical calamity unless you DON'T get them. Still, I don't blame them for staying indoors. Just the thought is enough.

 

[Levi]

Medical calamity

Right, watch out for that fox. I was bitten by a feral cat out by the goat pen a few days ago. I usually avoid doctors like the plague, and refuse to see one unless I am bleeding badly. My doc felt that in this case rabies would be a long shot, and recommends against rabies shots, so I will skip them. He has only had a few patients die of rabies.

Statistically, I should be mostly out of the woods if I don't start foaming at the mouth by the first of next year, although some oddball cases have very long incubation periods. The virus does not travel in the bloodstream, instead it travels along a nerve pathway, so it is hard to detect/diagnose until it hits the brain.

My M.D. mentioned that besides the low risk, in the event I am unlucky and get the disease, he can probably keep me out of pain until I fade away into a fatal delirium, so its no big deal. I selected this M.D. because he is not likely not likely to get carried away and over-treat me for something that causes an iatrogenic illness. I would never mention ME/CFS to him, he would only scoff at the concept.

(snipped) I've explained to the neighbors that if the thing does bite you, you will have to get rabies shots, but they are not a nightmare. The're not fun, but it's not a medical calamity unless you DON'T get them.

 

[Stone]

Wow. Did the feral cat just come up and bite you or what? I don't know the specifics of the incident but I don't hear about people getting bitten by feral cats every day. I mean, unless you were poking at the kitty with a stick or something I worry that it may have been diseased to act like that. Were you feeding the cat? I'm just trying to figure out why you and/or your doctor are sure you don't need treatment. In my case, there's a rabies problem in the area where dozens of rabid animals are found every year in this county and surrounding counties and it's really getting out of hand. I live in one of the busiest parts of a good sized city, not in a rural area as you apparently do. You were kidding about the doctor only having had a few patients die of rabies, weren't you? I'm sorry, it's late and I'm growing more gullible every day, please tell me you're joking. If you're not kidding, are you sure you wouldn't benefit from a second opinion, even though you abhor doctors? I truly do understand your feelings toward doctors. But doctors are sort of like enemas; nobody really wants to use them, but there are times when you're really glad they're there.

 

[Levi]

Well,

I am not kidding. He told me his former rabies patients ended up "toast". So he knows the seriousness of the disease. As for a second opinion, he called his bud's in the local public health dept. For their opinion right in front of me during the exam. They in turn called their higher ups, and chewed on the decision for a few hours before recommending against rabies shots. So he is not a complete idiot.

The cat has been sleeping with my goats for a couple of years, they have made a pet of him. He has been healthy except for tapeworms; he's been feeding on rodents, lizards, bats, birds and gophers. He was provoked because earlier in the day I had noosed him, put him in a pet carrier, and taken him to the vet to get neutered, treated for tapeworm, rabies shots, and vaccinated. That went well enough, but the pet carrier he was in has a dicey latch requiring a two handed release, and he exploded past the door onto me during the release process. I had to put my arms and hands up to protect my face as he came right over the top of me. I had a thick leather jacket on and heavy welding gloves, but he bit right thru the gloves into my thumb. Have not seen him since.

If you're not kidding, are you sure you wouldn't benefit from a second opinion, even though you abhor doctors?

Since I have had photo-sensitivity, numbness and tingling in extremities, and many other rabies-like symptoms for decades, I am not likely to notice anything different or unusual until I see frothing at my lips in the event this cat is rabid.

 

[Stone]

Whew! I'm a lot less worried now. I'm sorry to be so nosy but I was amazed at the whole thing given what's going on around my neighborhood. I can see now that the cat was not displaying odd or particularly aggressive behavior considering the circumstances. He perceived himself in clear and present danger, having been abducted by aliens, taken away in their ship and forced to undergo strange medical procedures. In his mind it must have been a harrowing experience, as it is even for a more domesticated animal, but I think it's very good of you to take the time, effort and money to take care of him which is the truly responsible thing to do. I hope he comes back to his goat friends so you can keep an eye on him. In my neck of the woods they would have made you quarantine him for a set period of time and they would even pay you a visit to make sure you are complying. In some cases they will make the owner put the animal down so it can be examined for rabies. I do hope you don't develop symptoms, but it sounds like your chances of being okay are very high. Although you already have the symptoms you mentioned for decades, I imagine you would probably know if something just feels different.

As for me, I developed a neurological condition that clearly felt different to me and not my usual CFS stuff, but it took over a year to get a doctor to believe me that this was entirely different from CFS or FM. A whole year, and now I probably have permanent neurological damage because of that. I wish I had never told that doctor I had CFS. When my daughter, who also has CFS had a herniated disc in her back, she had to go to a completely new doctor and not tell him she has CFS or FM in order to get it looked at objectively and properly diagnosed and treated. Best of luck to you.

 

[August59]

Hey Stone - I just noticed you was from North Carolina (that is what NC stands for isn't it). I'm in the other Carolina. Anyway, back to the rabies topic as we have a lot of raccons around here that get very sick and everybody thinks they have rabies and really get bent out of shape, but the raccons actually have parvo. The key is very aggresive behavior and if they are nocturnal and see them in the middle of the day. The racoons with parvo are just generally drunk acting, but can be salivating. Unfortunately there is nothing you can do for them at that point and they have to be put down, it's not fun but has to be done.

One of my best friends (when I was very young) and I were out playing in the words and came across wild rabbit that just acted funny, so of course we had to catch it, but my friend grabbed the head end and I got the back, but the rabbit proceeded to bite the crap out of my friend. We ran home, about a mile, and they took my friend to the health department. We had to go back and look for the rabbit that was still where we left it. We had to kill that rabbit and send it's head to the SC Health Dept headquarters in Columbia. Meanwhile my friend had to start the "shots" in the stomach, which would have ended up being "21" off them. As luck would ahve it my friend was informed after about 7 days that the rabbit was not rabid and was allowed to stop the shots. Rabies can still cause some scary times!

 

[Stone]

Yes, rabies really can cause some scary times! It's amazing that rabies is having such a resurgence in this day and age. What's going on? What's causing this? Where did rabies go for so long and why is it back? I wish I understood more about this phenomenon, or is it really a phenomenon? Does it naturally run in cycles like this? People routinely vaccinate their pets these days, don't they? Are pets even a factor in what's happening right now with our wildlife? I'm concerned about our natural wildlife. What could happen with all that? I think I'll see if 'Old Yeller' is available on the 'watch instantly' menu on Netflix. Sounds good for Friday afternoon entertainment...well maybe. <heavy sigh>

 

[maha22]

I had 90 minutes to kill at the US Embassy yesterday. Between meetings, type of thing.

So after I grabbed some lunch -- the Embassy has a rather decent little cafeteria -- I parked myself in the little library with my laptop. The library is all reference books and magazines, and seems to be mostly used for language lessons. Still, it was a place to be.

After an hour or so, I decided to give myself a short break. Strolled over and browsed the magazine section. National Geographic, no. Time, definitely no. The Economist, would take too long. Scientific American... sure, okay.

And that's how I found out about the Milwaukee Protocol.

Rabies is really scary. You can get it from even small bites or scratches, and if you don't start treatment before symptoms appear, you die. Period, full stop. The only treatment at that point is to alleviate your symptoms, i.e. make dying easier. Decades of determined effort have made rabies rare in the US, but it's still horribly common in the rest of the world, with tens of thousands of people dying every year.
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