Ten reasons to head to the ER

Emergency room doctors see the worst-case scenarios, the weird fluke accidents, the mysterious ailments and miraculous recoveries. They’re also no strangers to the symptoms that patients didn’t take seriously until it was almost too late.

Here, ER docs share 10 red flags that patients often ignore—but which should be addressed urgently:

Sudden confusion or personality change

Sudden confusion or a personality change could indicate a stroke, an infection like sepsis, or low blood sugar, she adds, which is why it’s essential to seek immediate care at the ER.

Unusual upper back pain

Always pay attention to severe pain in your upper back or between your shoulder blades, especially if it comes on suddenly or is accompanied by other symptoms like nausea or dizziness. “Call 911. It could be a sign of a heart attack.” For some people—including women—heart attack pain shows up in surprising places, like the back, neck, or jaw.

Sudden, unexplained severe itching

If you can’t stop scratching—especially if you itch all over instead of in just one spot—you could be experiencing the beginning of an anaphylactic reaction. Even more alarming: if your symptoms are accompanied by nausea, vomiting, or diarrhea.

Vomit that’s a certain color

Bile, which is usually green, “can indicate a really dangerous obstruction in their intestines…” If your throw-up looks like coffee grounds—it’s dark brown or even black—it might include blood that’s been partially digested by stomach acids. Red vomit triggers even louder alarm bells, indicating “there’s quite a lot of blood moving.”

A sense of doom

When extreme anxiety strikes out of nowhere, take it seriously—especially if it’s accompanied by trouble breathing, a racing heart, or dizziness. It could be the body’s reaction to a heart attack or blood clot, or a severe allergic reaction. “If it’s new, intense, or feels different than usual anxiety, don’t ignore it.”

Randomly passing out

Fainting or almost fainting without a clear cause can be a red flag for abnormal heart rhythms, internal bleeding, or neurological issues. That said, it could also be the result of dehydration or standing up too fast.

White poop

If you’re having white bowel movements, it’s possible your bile tract could be obstructed, meaning bile—which contributes to the normal color of stool—isn’t reaching the intestines. “The scary thing that does that is pancreatic cancer.”

Urinary retention

There is one clear sign that constipation needs to be addressed urgently: you’ve stopped being able to pee. A full, impacted bowel “can cause bladder obstruction because, anatomically, it can press a lot in that pelvic region,” he says. “If somebody’s not urinating, that’s a big problem.” Not resolving the matter in a timely manner can ultimately lead to kidney failure.

Shortness of breath while lying down

Gasping for air when you’re horizontal could signal heart failure, a blood clot in the lungs, or a silent heart attack.

Leg pain or swelling in one leg

If you’re experiencing leg pain or swelling in just one leg, and if it’s also red, warm, or painful, you could have deep vein thrombosis, which requires urgent treatment. That blood clot could break loose and travel to your lungs, causing a pulmonary embolism, which can be fatal.

Full article (1,350 words, more details): https://time.com/7307026/when-to-go-emergency-room-symptoms/. Also see my post Emergency room tips.

Good news from Fix the News:

For over a century, Africa’s ‘meningitis belt’ stretching from Senegal to Ethiopia, has suffered deadly outbreaks every few years. Now, a breakthrough 13 years in the making could stop those outbreaks for good. Developed by the Serum Institute of India, the Men5CV vaccine protects against five major bacterial strains for just $3 a dose. It’s already rolling out in Niger and Nigeria, while Mali, Ghana, Burkina Faso, Chad and Togo all have plans to introduce it in the coming months. Telegraph

And an image from my collection:

Helmet ad

“Helmets have always been a good idea”: https://www.youtube.com/watch?v=pD-f45TbvEw. Two minutes 20 seconds.

Good news from Fix the News:

Ebola outbreak in the DRC met with absolutely off-the-charts public health capacity. The DRC just confirmed a new outbreak of Ebola, BUT in under 24 hours, the virus was isolated, sequenced and the sequence data made publicly available. Genuinely incredible to see this kind of resolution and turnaround go from sci-fi to feasible over the course of the last decade. Wow.

And for some reason, this picture is just super funny to me:

Surprising solution to gun violence

Techniques other than prison can make a big difference (bolding is mine):

A second, complementary approach that has historically not been part of the public debate is to help young people navigate the difficult situations that our past policies have failed to fix.

Consider an exercise practiced in one of Chicago’s most effective violence intervention programs, Becoming a Man (BAM). Teens are paired up; one is given a rubber ball, and the other is given 30 seconds to get the ball out of his partner’s fist. Inevitably, the two teens end up on the ground, wrestling and fighting to get – or keep – the ball.

After the teens switch roles and the same struggle occurs, the BAM counselor asks why no one just asked their partner for the ball. They usually look surprised and say something along the lines of, “The other guy would have thought I’m a wuss.” The counselor asks the partner if that’s true. The usual answer: “No, I would have given it to him. It’s just a stupid ball.”

This exercise, called “the fist,” doesn’t teach participants to be better people. Instead, it gives them the tools they need to address the actual problem: the situation. By teaching young people to slow down during stressful situations, it helps them navigate in-the-moment decisions that could otherwise lead to violence.

About 2,200 words: https://www.cnn.com/2022/04/23/opinions/surprising-solution-to-gun-violence-ludwig/index.html.

And good news from Fix the News:

The global energy transition will cost a lot less than we think
With estimates ranging from $3 trillion to $12 trillion, the cost to green the world’s economy can seem inconceivable but The Economist argues the cost will actually be closer to $1 trillion annually – or 1% of global GDP. Most analysts overestimate energy demand and underestimate technological advances.

An archived copy of The Economist‘s article is here. Important paragraph:

First, the scenarios being costed tend to involve absurdly speedy (and therefore expensive) emissions cuts.

Second, they assume that the population and economy of the world, and especially of developing countries, will grow implausibly rapidly, spurring pell-mell energy consumption.

Third, such models also have a record of severely underestimating how quickly the cost of crucial low-carbon technologies such as solar power will fall.

Fourth and finally, the estimates disgorged by such modelling tend not to account for the fact that, no matter what, the world will need to invest heavily to expand energy production, be it clean or sooty. Thus the capital expenditure needed to meet the main goal set by the Paris agreement—to keep global warming “well below” 2°C—should not be considered in isolation, but compared with alternative scenarios in which rising demand for energy is met by dirtier fuels.

Scamming the scammers

Apate’s aim is to defeat global phone scams with conversational AI, taking advantage of systems already in place where telecommunications companies divert calls they can identify as coming from scammers.

Kafaar was inspired to turn the tables on telephone fraudsters after he played a “dad’s joke” on a scam caller in front of his two kids while they enjoyed a picnic in the sun. With inane chatter, he kept the scammer on the line. “The kids had a very good laugh,” he says. “And I was thinking the purpose was to deceive the scammer, to waste their time so they don’t talk to others.

“Scamming the scammers, if you like.”

So AI bots are wasting the scammer’s time, and (I like this bit particularly) they are learning what is most effective at doing that. Link (1,100 words): https://www.theguardian.com/technology/article/2024/jul/07/ai-chatbots-phone-scams.

Scammers are trying to make a “sale.” If you waste their time, they can’t be scamming someone else. My own experience is that a phone scammer usually asks for the expiration date on my credit card early in the conversation, so I just say, “Oh, the card’s in the other room, hold on a second.” Then I put the phone on the desk and go on with other stuff for ten minutes.

Some things to watch for:

Scammers can use a fake Caller ID. The number that is displayed is not trustworthy.
Government agencies don’t contact you via phone. I got a very realistic-sounding scammer pretending to need my Medicare number in order to send me a new card. She even knew the first two and last two letters/numbers… which in fact are the same for everyone, or something. (I told her I’d check with the Social Security website.)
“Windows” doesn’t call you either. It’s a scam.
If you think a caller is a scammer, don’t even pick up. That tells them that at least they found a real person, and you’ll get more calls. (Unless you want to chat and waste their time.) A real person will leave voicemail.
Never use the word “Yes” with a phone scammer. Supposedly this can be recorded as proof that you agreed to sign up for something.
Email: No real site will email you asking you to enter a password. Hover your mouse over the link. That will show you the actual link, which can be entirely different from the displayed link.

And just two of many good news items from Fix the News:

A ‘liberal, democratic, non-discriminatory, non-sectarian Bangladesh’
Following the ‘people’s victory‘ after student protests in July, the country’s new caretaker leader, Nobel Prize winner Muhammad Yunus, has called for a ‘new Bangladesh‘, promising free, fair, and participatory elections and emphasising the role of citizens in deciding the government’s fate. It’s still early days—but if even half those promises are met, it will be a huge victory for democracy. Time

US cancer death rates have fallen by a third since 1999
A new CDC report has found that cancer death rates dropped from 200.7 per 100,000 people in 1999 to 142 per 100,000 in 2022. This equates to roughly three million additional Americans alive today due to reduced cancer death rates over the past two decades. The decrease is credited to advances in treatment, technological innovations, and lower smoking rates. Baltimore Sun

Flight safety video

The Hobbit was filmed in New Zealand. Air New Zealand takes advantage… (4 min 38 seconds): https://www.youtube.com/watch?v=qOw44VFNk8Y. This one is based on the third movie, others include https://www.youtube.com/watch?v=cBlRbrB_Gnc.

And more good news from FutureCrunch (now Fix the News):

The proportion of the world’s adults with a net worth of less than $10,000 has plunged from 75% in 2000 to less than 40% in 2023. The percentage of American workers earning under $15 an hour has dropped from 32% to 13% in just two years. The US Internal Revenue Service just collected a record $1 billion in past-due taxes from millionaires. Gavi’s Big Catch-Up begins, allocating 200 million vaccine doses to children missed during COVID-19. Saudi Arabia announces an unprecedented pension reform package, addressing critical issues such as retirement age and maternity leave. Johnson & Johnson agrees not to enforce its patent on critical TB medication in South Africa.

The myths holding back police reform

From Neil Gross, professor of sociology at Colby College and a senior fellow at the Niskanen Center in Washington, DC:

Myth #1: The police can’t prevent crime

Although I can understand why some people might feel this way—if you live in a neighborhood with persistent crime and what seems like an oppressive police presence, say—research shows that the opposite is true. All else being equal, the larger the number of police officers in an area, the less crime there tends to be, at least for many kinds of crime…

Myth #2: Police reform compromises public safety

for the US as a whole, property crime has been sloping downward more or less uninterrupted since the early 1990s, as measured by official reports to police as well as anonymous victimization surveys.

And now, preliminary data from the largest US cities show a major drop in homicides for the first half of 2023. (Not for all cities. Violent crime in Washington, DC, for example, including homicide, is up this year.)…

Myth #3: Because of policing’s racist origins, there is nothing we can do to improve it

Policing, for its part, has transformed over the decades, as any historian of the subject can attest, and this is also true along the dimension of race. While stubborn racial disparities remain in use of force, arrest rates for petty offenses, routine traffic stops, internal hiring and promotion, and other aspects of police operations—disparities every department should work to minimize—and while horrific evidence of racial animus continues to surface with disturbing frequency, there can be no serious question that policing in 2023 looks very different than it did in, say, Birmingham, Alabama in 1963, when “Bull” Connor, the notoriously racist public safety commissioner, directed his officers and their dogs to viciously attack civil rights protesters because of his opposition to integration.

Very detailed and interesting, with history and real-life examples. 3,600 words: https://time.com/6316258/myths-police-reform/.

And more good news from FutureCrunch (now Fix the News) (bolding is mine):

Europe’s crackdown on air pollution cuts heart disease deaths
Europe recorded the largest annual decline in PM2.5—the air pollution most closely linked to harmful health effects—of any region of the world between 2010 and 2019. As a result, deaths in the region from heart disease attributed to pollution fell by 19.2% and from strokes by 25.3%. This amounts to 88,880 fewer heart disease deaths and 34,317 fewer stroke deaths. FT

Avoiding car crashes

Six million car crashes a year in the United States, leading to 30-40,000 dead Americans every year. Here are six main causes. Read the full article on how to avoid them:

The Rolling Right Turn on Red

You approach a red light, and you’re about to turn right. You slow down but don’t come to a full stop. As you continue to roll, you look to your left to see if there are any cars coming at you from that direction. You turn your head back to the right and suddenly, out of nowhere, there’s a pedestrian or a bicyclist…

The rolling right on red now accounts for 6 percent of all pedestrian fatalities, and the number is on the rise. Worse still, 21 percent of the deaths happen to kids.

Falling Asleep

…about 7 percent of all car crashes, and 21 percent of fatal crashes, happen to drowsy drivers.

Loss of Control

…accounts for 11 percent of all crashes. It’s comforting to think that these unfortunate drivers occupy the bottom 11 percent of the driving skill scale, but science has some humbling news for us. It turns out that most of us think about driving skill far too simply… Aggressive maneuvering and taking a sharp curve too fast account for about 5 percent of all crashes. Another 2 percent happen when we don’t slow down for water on the road.

The remainder of these crashes happen when another driver or even a sudden turn in the road puts us in a surprise situation that demands an instant response. We imagine ourselves coolly responding when something unexpected pops up, but most people overreact and overcompensate and sometimes kick their car afterward.

Into the Blind

Ever make a left turn at an intersection when there’s a huge bus blocking your view of what’s coming from the other direction? Or cruise through a red light thinking that there won’t be another car coming across your path? Or even race down a road not realizing that it just might end at some point? The data tell us that 12 percent of all crashes happen when drivers do these things…

The Rear-Ender

Your first job when driving: Don’t hit the car in front of you. As simple as it sounds, hitting the car in front of us accounts for between 23 percent and 30 percent of all crashes.

We drive close to the car in front of us because we think it’ll get us there faster. It’s true, technically, but just barely: Science says we save 26 seconds per day as a result of our hurrying.

Distracted Lane or Road Departure

Your second job when driving is to stay in your lane. Thirty-three percent of all crashes happen when we don’t stay in our lane, or even on the road… the distraction of phones, our attention gets pulled by roadside crashes, billboards, activities inside the car, and mind wandering. Humans are not natural performers when it comes to keeping an eye on much of anything and even less so when asked to attend to several things at once.

About 1,700 words: https://slate.com/technology/2017/11/the-six-main-causes-of-car-crashes.html.

How one city cut gun violence in half

Snippets from the article:

Omaha 360’s strategy is “collaboration, prevention, intervention, enforcement, reentry and support services,” said Willie Barney, CEO and founder of the Empowerment Network. Barney said the program began as a small initiative with seven people, some from the Empowerment Network and others working for the city.
…
Now, places like Boston; Chicago; Kansas City, Missouri; Little Rock, Arkansas; Minneapolis and Tulsa, Oklahoma, are having early conversations about what a similar program might look like in their cities, Barney said.

How it works

Omaha 360 is focused on addressing immediate threats of gun violence as well as the underlying issues that contribute to it….

Lack of employment was a top issue among young people that the group spoke with, Barney said, especially during the summer months.

“The country is not facing one gun violence problem,” Abt said. “It’s facing at least four” — everyday community violence, domestic and intimate partner violence, mass shootings and suicide.

The police department also teaches deescalation tactics, a common move among law enforcement across the nation to try and defuse potentially violent situations.

“A significant portion of our sworn law enforcement officers are crisis intervention team-trained,” Gray said.

https://abcnews.go.com/US/omaha-nebraska-cut-gun-violence-half-become-model/story?id=96799185. About 1,700 words.

Guns are now leading cause of death for US kids

By the numbers: Nearly two-thirds of the 4,368 U.S. children up to age 19 who were killed by guns in 2020 were homicide victims, per the CDC. Motor vehicle crashes, formerly the leading cause of death for kids one and older, killed nearly 4,000 children.

• Another 30% of firearm-related child fatalities were suicides, 3% were accidental and 2% were of undetermined intent.
• Male youths were significantly more likely to be killed by guns, while vehicle crashes claimed more females.
• There were also stark racial disparities. The firearm death rate for Black children was more than four times that of white children, and white children were still more likely to be killed by motor vehicles than guns.
• D.C. had the highest firearm death rate, followed by Louisiana, Alaska and Mississippi.

https://www.axios.com/2022/05/26/gun-deaths-children-america

Reducing violent crime

Last year in Philadelphia, the City of Brotherly Love, 562 citizens were murdered—an all-time high and a 12 percent increase over 2020. Almost 90 percent of these homicides involved firearms, and the spike followed an even bigger surge in 2020, when killings were up by 40 percent. The numbers are sobering, but gun violence has been climbing in the city since 2013.
Philadelphia is not alone. At least ten other major cities lost historic numbers of residents to murder last year.
…
The fact is, we can have safety and justice at the same time. We can reduce violence and promote reform simultaneously. We can be tough when the circumstances call for it and be empathetic and supportive to achieve our goals as well. We have to reject either/or choices and insist on both/and options. We have to remember that it’s about solving a deadly serious problem, not winning an abstract argument. It’s about bringing people back together, not pulling them apart.
…
In Los Angeles, Community Safety Partnership (CSP) officers work in collaboration with community stakeholders in some of the city’s toughest neighborhoods. They work tirelessly to connect residents with public and private resources and form alliances with public health professionals, prosecutors, community advocates, gang interventionists and educators. …. It’s working: a recent report shows that CSP reduced crime while improving relationships with residents.
In Chicago, the Rapid Employment And Development Initiative (READI) works with those at the highest risk for gun violence to help them stay safe, free from incarceration and able to support themselves and their families. … An early analysis indicates that READI is substantially reducing arrests for shootings and homicides among program participants.

Across the country, there are dozens of strategies like these with documented success in reducing gun violence.

2,350 words: https://time.com/6138650/violent-crime-us-surging-what-to-do/