Treating Michigan's fungal meningitis patients: Ann Arbor hospital opens new ward, brings in nurses
Nurse Larry Johnson fills out charts Thursday in the fungal meningitis ward at St. Joseph Mercy Ann Arbor in Superior Township. Johnson, who works as an oncology nurse at St. Joseph Mercy Port Huron, is among a group of nurses from other Trinity Health System hospitals that have responded to a call to help care for fungal meningitis patients in Ann Arbor.
Melanie Maxwell | AnnArbor.com
Doctors and nurses at St. Joe’s and at hospitals in 19 states across the country are dealing with an extremely rare illness with no established course of treatment. Friday, the hospital was treating 79 patients -- up six from the day before, which is more than the total caseload that many other states dealing with the outbreak have all together.
In Michigan, 129 of the 158 cases linked to the fungal meningitis outbreak have been treated at St. Joseph Mercy Ann Arbor at 5301 McAuley Drive in Superior Township as of Friday.
As a result, the hospital has had to open a previously unequipped ward in its recently built patient tower last week and has brought in additional nurses to provide the round-the-clock treatment and observation of the fungal meningitis patients.
Joyce Young
Courtesy photo
In a matter of 48 hours, crews had equipped 16 private patient rooms on the 10th floor of the tower with all of the beds and technology necessary to house specialized patients. The remaining 16 rooms on the floor remain as empty shells, awaiting monitors and amenities to house patients.
Additionally, the Trinity Health System has sent out a call for additional nurses to volunteer to work at the St. Joseph Mercy Ann Arbor location to help accommodate the demanding patient load.
The nationwide fungal meningitis outbreak is linked to a Framingham, Mass. company’s injectable steroids contaminated with fungus. At the New England Compounding Center, federal investigators have found many potential contaminants, including standing water, mold and water droplets, according to a report by the Associated Press.
The facility has been closed since early October, and Massachusetts officials are working to permanently revoke its license, according to the Associated Press.
Four Michigan facilities received shipments of batches of contaminated steroids manufactured by the NECC.
Among the facilities was Michigan Pain Specialists in Brighton, where the steroids were administered as injections to relieve joint and back pain. Though none of the injections were administered at St. Joseph Mercy Ann Arbor, several physicians who practice at St. Joe’s also practice privately at the Brighton facility.
The federal government has launched a criminal investigation into the outbreak, which is linked to the illnesses of 480 patients, including 33 deaths across the U.S. as of Friday.
Throughout the investigation in to the outbreak -- which was first announced to have infected Michigan patients Oct. 6 -- St. Joseph Mercy Ann Arbor has managed one of the largest patient populations with fungal meningitis in the country.
At the University of Michigan Health System, one fungal meningitis patient is currently being treated, spokesman Pete Barkey said. Throughout the entire outbreak, UMHS has treated three fungal meningitis patients.
Larry Johnson, a nurse from St. Joseph Mercy Port Huron who volunteered to help with the fungal meningitis outbreak patients being treated in Ann Arbor, walks down the hallway of a ward Thursday opened specially for fungal meningitis patients with Joyce Young, chief nursing officer.
Melanie Maxwell | AnnArbor.com
Nurses have come to St. Joseph Mercy Ann Arbor from Columbus, Ohio; Port Huron and Grand Rapids. They'll be serving two-week tours in Ann Arbor.
For nurses who are licensed to practice in Ohio, the Michigan board has provided emergency reciprocity for those nurses to be licensed to practice in Michigan, Young said.
Among those volunteers is Larry Johnson, an oncology nurse from St. Joseph Mercy Port Huron. He’s been working at the hospital in Port Huron for about two years, where he typically administers chemotherapy treatments to cancer patients.
Johnson said he had been following the news of the fungal meningitis outbreak before learning of its effects on the Trinity Health System.
Last week, Johnson said he heard of the call for nurses from one of his superiors. There was no question in his mind what his answer would be.
“My first thought was absolutely, I want to help,” Johnson said. “I had no qualms about saying yes.”
Last Saturday, Johnson drove to Ann Arbor and went through an orientation. Sunday, he was straight to work and clocked a 16-hour shift. Since then, he’s been working 12-hour days.
Johnson, who also is an on-call firefighter with the Fort Gratiot Fire Department, said the long hours are standard for him.
“The biggest thing that is different with the fungal meningitis patients, is the fear of the unknown,” Johnson said. “People are afraid of the unknown. They want to know that someone cares enough to find out what happened to them.”
As a nurse, Johnson said he makes a special point to educate patients and their families.
Before he became a nurse, Johnson was injured in an accident that almost resulted in the loss of his right arm. While in the hospital, Johnson said his attending nurse wasn’t as supportive as he felt she could have been, and it inspired him to be more personable in his own career.
“I was going to be the one that was not like that,” Johnson said. “I know what it is to be afraid.”
Nurse Larry Johnson checks on a fungal meningitis patient Thursday in a ward at St. Joseph Mercy Ann Arbor in Superior Township.
Melanie Maxwell | AnnArbor.com
The two drugs being used to treat fungal meningitis patients are very toxic and have side effects that include hallucinations.
Patients routinely ask Johnson if and when they’ll get better; if the side effects from the medication are permanent; when they’ll be able to go home.
“Sometimes, we’re not able to tell them the answer they want to hear,” Johnson said. “They feel such an utter loss of control.”
Patient care also has increasingly included social workers and spiritual guidance, Young said.
“There’s a lot of fear in what they’re going through,” Young said of the patients.
Johnson said at times, he grapples with the patients’ reality.
“Sometimes, my heart is heavy,” Johnson said. “At times, it’s emotionally taxing.”
Fungal meningitis patients need a lot of specialized care, and many need to be constantly hooked up to specialized heart monitors. Many have been through neurosurgical procedures, Young said.
Staff at St. Joseph Mercy Ann Arbor have daily conference calls and are in constant communication with the Centers for Disease Control and Prevention to guide their treatment plans and provide updates.
“Really, we’re in uncharted waters,” Johnson said. “It’s scary.”
Amy Biolchini covers Washtenaw County, health and environmental issues for AnnArbor.com. Reach her at (734) 623-2552, amybiolchini@annarbor.com or on Twitter.
Comments
mhirzel
Mon, Nov 19, 2012 : 2:40 p.m.
There are a few people commenting here who could benefit enormously by reading the essay below. "If everybody believes something, it's probably wrong." http://www.thedoctorwithin.com/doors/doors-of-perception/
BhavanaJagat
Sun, Nov 18, 2012 : 8:06 p.m.
Spiritual Care for Meningitis Victims: These patients are indeed victims of a disease in which the infectious agent has no chance of causing this problem in their routine lives. I must thank the doctors and the nursing staff who are helping these victims providing care and comfort apart from medication to treat the infection. When we know the patient as a 'whole' person, we naturally give attention to the anxiety caused by this infection. All of these patients had back or joint pain to begin with. Kindly tell us as to how they are currently coping with that problem of back or joint pain which has contributed to this predicament.
music to my ear
Mon, Nov 19, 2012 : 3:47 p.m.
I was talking about the clinic in Brighton that she got the shot from those people at the clinic had no clue those shots were contaminated, thank you 1 bit for the back up, yes the one reasonable is the clinic that made the drug and disturbed to all the other unsuspecting clinic.
Kim Gray
Mon, Nov 19, 2012 : 3:41 p.m.
I work at SJMH, but this comment is mine. You have asked a great question @Bhavana. SJMH has recently supported patients and family attendance at daily peer support meetings with a facilitator from Pastoral Care or Social Work. Additional discussions are taking place for a larger support group strategy. Further, SJMH has been actively working on 'caring for the caregivers' and the emotional and physical toll this extended outbreak is taking on all staff. Hope that helps.
1bit
Mon, Nov 19, 2012 : 12:03 p.m.
Bob, anything you eat or drink could be contaminated. We trust a lot of things in our lives to others. The doctors thought they were helping; they were wrong and ended up violating their oath because they trusted the pharmacy. When you buy produce from Kroger or wherever, you are trusting it is not contaminated. Or if you buy a bottle of Tylenol. And the list goes on and on...
Basic Bob
Sun, Nov 18, 2012 : 9:20 p.m.
"she is aware it is not the clinics fault" Someone injected this toxin into her body, are you saying the clinic was not responsible for that? Did the clinic prescribe the lethal "medication", procure it, and administer it? Sad that it could be considered by some to be someone else's fault.
music to my ear
Sun, Nov 18, 2012 : 8:37 p.m.
medications.therapy and praying. that is all they can do .my friend says she cannot trust any clinic now ,and she is aware it is not the clinics fault. I can only comfort her will love sympathy and lending an ear when she needs to vent,so people were other than their back were in pretty good shape it has decreased their active lives. it is just so sad.
music to my ear
Sun, Nov 18, 2012 : 6:57 p.m.
My friend is on her third stay at St. Joes due to this meningitis, she is having a horrible time trying to fight this infection ,fungus in the body is awfu,l she needs our prayers, all these patients and nurses do to try and get through these illnesses .
Red Rose
Sun, Nov 18, 2012 : 6:54 p.m.
Thank heavens for people like Larry Johnson.
mhirzel
Sun, Nov 18, 2012 : 4:34 p.m.
Sign of the times, Mr. Howard, that we have all the negative comments on your comment, when, as you and I know, you are 100% correct about the anti-fungal, anti-viral, anti-bacterial properties of vitamin C. It's more effective, at appropriate dosages, than ANY high-priced pharmaceutical on the market. (99.9% correct: It is 100 grams, not milligrams.) I don't bother making such comments any longer, as, for one's generous effort to inform, the lemmings will always come down hard with their "evidence based" insults. Sad that the insanity just has to run itself out, though I salute you for your effort.
1bit
Mon, Nov 19, 2012 : 11:59 a.m.
Two peas in a pod. Since you both believe so strongly, let's offer a little hypothetical test. Go get one of these contaminated injections in your back and take your vitamin C and see how that works. Here's the good news, you've only got about a ten percent chance of getting the problem anyway so ninety percent of the time you'll think it actually worked.
Albert Howard
Sun, Nov 18, 2012 : 4:45 p.m.
@ mhirzel thank you
Sarah
Sun, Nov 18, 2012 : 1:41 p.m.
One of my friends' husband is a nurse at St. Joe's and he, as well, has been assigned to these cases. I wish you had the opportunity to focus on the caregivers like him, who are pulling longer hours and extra days to help care for the patients. While it does show the magnitude of the outbreak that other nurses are being called in, how about the ones who live and work here and how much they're putting in, as well?
Reason
Sun, Nov 18, 2012 : 1:32 p.m.
I'm really impressed by Larry Johnson and his attitude toward nursing. I'm sure his compassion makes a huge difference in patients' experiences of a tough situation. Since he's been a patient, he really understands how hard it is. SJMH is lucky to have him.
Albert Howard
Sun, Nov 18, 2012 : 12:41 p.m.
Problem: This is a fear tactic campaign from the Center for Disease Control and Prevention in Atlanta. Big Pharma + FDA + Profits = 'the nationwide fungal meningitis outbreak'. Swine Flu PR all over again. Stop lying to the people! Solution: 100 mg of intravenous Vitamin C drip. I get this when necessary. This is not what they want you to know because there is no financial gain. Read Vitamin C Infectious Diseases, and Toxins: Curing the Incurable, by Thomas E. Levy, M.D., J.D. (you should take a blood test for Vitamin C first) (consult a doctor/licensed physician)
1bit
Mon, Nov 19, 2012 : 11:54 a.m.
You win the "Worst Post of the Year", sir. We've had some terrible ones but yours takes the cake. Where to start? People are dying of fungal infections and your advice is intravenous Vitamin C? You do realize that you can get about the same amount of vitamin C just from drinking a glass of orange juice? And that these people aren't dying from scurvy? No, I'm sorry, but your Internet medical degree has been revoked. Please move on.
Basic Bob
Sun, Nov 18, 2012 : 4:40 p.m.
"just getting a shot (for) back pain" Sounds like you are a little too trusting of the physician and HIS quackery.
WalkingJoe
Sun, Nov 18, 2012 : 4:03 p.m.
@Albert Howard, I agree with jon totally. I knew someone who died from this and the family is devastated. They thought he was just getting a shot to ease his back pain and instead ended up very ill and then died. Maybe you should met and say this face to face to one the families who lost a loved one and see how they feel about your cruel and thoughtless comment.
A2comments
Sun, Nov 18, 2012 : 3:21 p.m.
You are one scary dude...
jon
Sun, Nov 18, 2012 : 3:05 p.m.
Conspiracy theory and quackery are not the answer. Your comment is an insult to the people suffering from this outbreak, their families, and the people caring for these patients. I suggest you show a little respect and keep your comments to yourself unless you have any evidence your theory and proposed cure have any validity in treating fungal infections on and around the spinal cord.
Sue
Sun, Nov 18, 2012 : 12:25 p.m.
Excellently written coverage. Thank you for keeping us updated on this horrific event. I am so deeply sorry for all those affected.
A2comments
Sun, Nov 18, 2012 : 12:22 p.m.
Why does St. Joe get the vast majority of patients over UMHS? Why the sudden increase in patients? We're past the 6 week period where CDC said symptoms might show. Transfers from other hospitals?
talker
Fri, Nov 23, 2012 : 3:09 a.m.
Some doctors on staff at St.Joes have a practice in Brighton where they injected the tainted medical compound. The patients acquired fungal meningitis at the pain clinic of these St. Joe's doctors. It it also a reputation issue? Thus, treating the victims has become a specialty at St. Joes. That provides concentrated treatment for a rare outbreak.
1bit
Mon, Nov 19, 2012 : 11:46 a.m.
Answers: 1. When this was first coming out, the CDC wanted to consolidate everything to the fewest number of centers. It is easier to coordinate care when you are dealing with one hospital rather than ten. There is no advantage for people to go to UMHS as no one is an "expert" on this problem. 2. As noted by the other posters, many patients who were thought to be in the clear are now being found to have abscesses. These have to be surgically drained and these patients need to be monitored to make sure there is no recurrence and no other secondary problems.
a2citizen
Sun, Nov 18, 2012 : 5:08 p.m.
Maybe St. Joe's is equipped to better handle this specific problem.
Barb's Mom
Sun, Nov 18, 2012 : 2:14 p.m.
A2comments, It could be the majority of the cases are going to St Joes because of the type of Health Insurance they have. Patients with Priority Health, normally can't go to UMHS.
ottozrule
Sun, Nov 18, 2012 : 1:09 p.m.
@A2comments, USA Today had an article last week that I think answers your 2nd question: http://www.usatoday.com/story/news/nation/2012/11/06/secondary-infections-meningitis/1686549/
ottozrule
Sun, Nov 18, 2012 : 12:50 p.m.
Following discharge, many patients have to be readmitted due to a secondary infection with abscess at the site of the injection. What happened to all the planned new cooperation between U Hospital and St. Joe? Was it just a bunch of lip service? UMHS should step up to the plate and help!