September is Sepsis Awareness Month

Infections - we all get them. We may get a cut on our leg that we didn't clean out properly or we may develop a urinary tract infection or even influenza. We may have surgery that has complications or develop a disease like cancer, that leaves us prone to getting infections. However we get the infection, be it viral, bacterial or fungal, there's always the chance that our body will overreact and we develop sepsis.

But what is sepsis? According to Sepsis Alliance, it's the body's toxic response to an infection. In other words, as your body tries to fight the infection, it goes into overdrive and ends up trying to kill you. Some people call it blood poisoning, but that isn't a good word for it because it doesn't accurately describe what is going on.

Once sepsis sets in, your body's organs begin to shut down and eventually, it may cause death. If not death, you could end up having a limb - or several - amputated in order to save your life.

Right now, every 1.75 seconds, someone in the world is diagnosed with severe sepsis. Many more are developing sepsis. In the United States, every 2.5 minutes, someone dies of sepsis. Thousands more are left with life-altering after effects.


September is Sepsis Awareness Month. Please take a few minutes to learn about sepsis and to spread the word. It may be a cliche, but the life you save may be your own.

What Are Advanced Directives?

Death isn’t usually a topic that someone thinks about on a regular basis, but it is one of the realities of life. When the subject does come up, most people think about funerals, burials, reading of wills, and the many tasks that come after a death. But, how many people know – and have put down on paper – how they would like to be cared for in the period before they die if they aren’t able to make such decisions on their own?

Putting Your Wishes in Writing

Living longer

As we all age and as doctors are able to cure more diseases, we in the Western world aren’t dying as young. We are living longer, sometimes with chronic or fatal diseases. This puts us in a position where we may be alive but may not be mentally capable of deciding on what sort of care we should be receiving.

Loved ones may have to choose for us, often leaving them with many questions about if this is really what we would have wanted.

Advance directives

Advance directives are important documents that can save much heart ache. These documents can ensure that you get the care that you want and expect, and that you can be allowed to die in peace and dignity when the time comes.

Advance directives take the burden off of your loved ones who may be stressed and unwilling – or unable – to make these important decisions for you.

Also called living wills or DNR orders

Advance directives are sometimes called living wills or DNR (do not resuscitate) orders. In some places, they may be called a power of attorney. That term, though, differs in different parts of the country and may not mean the same thing where you are. This is important because if you believe that you have a legal document and it is not considered legal in your area, your wishes may not be carried out.

To be sure that your document is legal and actionable in your state or province, it’s best to go to a lawyer and make sure it meets all the requirements of your state or province. Medical and legal people want to be sure that you have made these decisions while you are of sound mind, that what is written is truly what you want, you understand what is written, and that the decisions that you are making are truly your own.

What to include in your advance directive

When considering your advance directives, you will need to be as direct and explicit as possible. Do you want to be fed by a tube if you can’t eat yourself? Do you want to be kept on a respirator if you can’t breathe on your own? Do you want invasive diagnostic tests done if you fall further ill? Do you blood transfusions? How far do you want people to go to keep you alive? And when do you want them to let go? You may even include information about organ and/or tissue donation.

Make other people aware

Once you have made your advance directives, make sure that the important people in your life have a copy. The document won’t be of any use if no-one knows about it or don’t have access to it. Don’t keep it in your safety deposit box, for example. You can give copies to family members, your doctor or friends. You can even keep one in your wallet so you have it with you in case of emergency.

Review your choices regularly

After the advance directive has been arranged, be sure to review them regularly. Situations change and people change; how you feel when you write the initial document may not be the same as a year later. Your final will is a very important document – and so is your living will.

Accepting Palliative Care

The death of Canadian politician Jack Layton has reminded us how aggressive cancer can be. Sadly, it still claims many lives. When people are at the end of their life, they would likely benefit from palliative care - often called hospice care. This was a piece I wrote for my website and I think it bears repeating here:

When living with a chronic illness that will lead to death or a fatal disease, the time comes when you may be told that you should consider receiving palliative care.

Shock and Distress

People with chronic or fatal illnesses often live in hope that something can be done to prolong life, if not cure it, even if they do know that this isn’t realistic. When confronted with the idea of palliative care and what this care means, it can be shocking and distressing, because it drives home the point that life won’t be prolonged and that they can’t be cured. In fact, they may feel as if their doctor has given up.

This feeling may be particularly strong when children are involved. It may not be easy for parents to decide on accepting palliative care for their child, feeling as if they have somehow failed in their role as parents.

Transition to Palliative Care

The idea of palliative care shouldn’t come as a shock. If someone has a fatal or chronic illness, or is deteriorating to the point that end-of-life care is being considered by the healthcare staff, the subject should be brought up long before the transition is made.

Proper preparation is the key in a smooth transition from active treatment to comfort care. The patients and their families must come to grips with their new reality of palliative care and they have to be open and willing to accept it for the care to be of any benefit to them.

Unfortunately, the awareness of the need for palliative care isn’t always obvious to the doctors who are still actively treating dying patients because the whole idea of end-of-life care is still fairly new. While a doctor may still be in the “save the patient” mode, he or she may be reluctant to think about palliative care for the patient.

Agreeing to Palliative Care

Once a patient has agreed to transfer to palliative care, they are able to benefit from their services. But, it’s not unusual for someone who has accepted the idea of the care to become resistant or question the need again once they are receiving the end-of-life services. At this point, it’s important for the team to understand and to be able to work with the patient and the family as they go though this phase.

Family and Friends

An issue that may come up when patients enter palliative care is the difficulty that some family members and friends may have with the decision. While the patient may be ready and accepting of the end-of-life, family and friends may not be. The palliative care team is there for not only the patients under their care, but their family and friends too. They can help by talking to them, providing information, and being a shoulder for them to lean on.

It happened again: Fire deaths preventable had there been a smoke detector

It happens every year, several times a year, but people still don't get the message. Smoke detectors aren't an extra doodad for your home - they are a vital part of your safety. Yet, hundreds of people die in fires when they would likely have lived had they had a functioning smoke detector in their home.

It happened again this week in Montreal, Canada. A kitchen fire, not that big but very smoky, took the life of a father and his three year old son. The boy's mother was clinging to life, but the news just reported that she died this morning. The sad part? When firefighters arrived on the scene, they couldn't get the front door open - something was blocking it. It was the bodies of the three people inside. They made it to the front door, but couldn't open it.

Deaths send another tragic message


Senseless deaths that could have, and should have, been avoided. They died from smoke inhalation, not the fire.

According to the local news, as always after a situation like this, local firefighters and students went door-to-door to check on neighbouring homes and whether they had functioning smoke detectors. Not surprisingly, many did not. Some had detectors but no batteries. One family had something taped over the beeper so it wasn't so loud. The firefighter who saw that one said that the alarm would not have been loud enough to wake someone from a sound sleep.

The United States Fire Administration reports that there were 356,200 fires in the U.S. in 2009; 2,480 people died and 12,600 were injured. Not all deaths and injuries were due to smoke inhalation, but they do count high in the numbers.


FireSafety.gov has good information on using smoke detectors, where they should be installed and how to maintain them. If you are a renter, check your rental agreements. In many places, the building owners are required by law to provide the detectors but the tenants are required to keep them in working order.

If your landlord won't provide you with a detector, this is not something you want to be without. Consider it an investment in your and your family's lives.