Eeyore's News and View

Face transplant recipient: 'I'm not a monster'
May 6, 2009 - 7:36am

This is a photo, supplied by the Cleveland Clinic, of Connie Culp, after an injury to her face, left, and then as she appears today. Culp is underwent the first face transplant surgery the United States at the Cleveland Clinic in December 2008. Culp spoke to the media at a news conference at the Cleveland Clinic in Cleveland, on Tuesday, May 5, 2009. The 46-year-old mother of two lost most of the midsection of her face to a gunshot in 2004. (AP Photo/Cleveland Clinic-HO) By MARILYNN MARCHIONE
AP Medical Writer
CLEVELAND (AP) - When Connie Culp heard a little kid call her a monster because of the shotgun blast that left her face horribly disfigured, she pulled out her driver's license to show the child what she used to look like. Years later, as the nation's first face transplant recipient, she's stepped forward to show the rest of the world what she looks like now.
Her expressions are still a bit wooden, but she can talk, smile, smell and taste her food again. Her speech is at times a little tough to understand. Her face is bloated and squarish. Her skin droops in big folds that doctors plan to pare away as her circulation improves and her nerves grow, animating her new muscles.
But Culp had nothing but praise for those who made her new face possible.
"I guess I'm the one you came to see today," the 46-year-old Ohio woman said at a news conference at the Cleveland Clinic, where the groundbreaking operation was performed. But "I think it's more important that you focus on the donor family that made it so I could have this person's face."
Until Tuesday, Culp's identity and how she came to be disfigured were a secret.
Culp's husband, Thomas, shot her in 2004, then turned the gun on himself. He went to prison for seven years. His wife was left clinging to life. The blast shattered her nose, cheeks, the roof of her mouth and an eye. Hundreds of fragments of shotgun pellet and bone splinters were embedded in her face. She needed a tube into her windpipe to breathe. Only her upper eyelids, forehead, lower lip and chin were left.
A plastic surgeon at the Cleveland Clinic, Dr. Risal Djohan, got a look at her injuries two months later. "He told me he didn't think, he wasn't sure, if he could fix me, but he'd try," Culp recalled.
She endured 30 operations to try to fix her face. Doctors took parts of her ribs to make cheekbones and fashioned an upper jaw from one of her leg bones. She had countless skin grafts from her thighs. Still, she was left unable to eat solid food, breathe on her own, or smell.
Then, on Dec. 10, in a 22-hour operation, Dr. Maria Siemionow led a team of doctors who replaced 80 percent of Culp's face with bone, muscles, nerves, skin and blood vessels from another woman who had just died. It was the fourth face transplant in the world, though the others were not as extensive.
"Here I am, five years later. He did what he said _ I got me my nose," Culp said of Djohan, laughing.
In January, she was able to eat pizza, chicken and hamburgers for the first time in years. She loves to have cookies with a cup of coffee, Siemionow said.
No information has been released about the donor or how she died, but her family members were moved when they saw before-and-after pictures of Culp, Siemionow said.
Culp said she wants to help foster acceptance of those who have suffered burns and other disfiguring injuries.
"When somebody has a disfigurement and don't look as pretty as you do, don't judge them, because you never know what happened to them," she said. "Don't judge people who don't look the same as you do. Because you never know. One day it might be all taken away."
It's a role she has already practiced, said clinic psychiatrist Dr. Kathy Coffman.
Once while shopping, she heard a little kid say, `You said there were no real monsters, Mommy, and there's one right there,'" Coffman said. Culp stopped and said, "I'm not a monster. I'm a person who was shot," and pulled out her driver's license to show the child what she used to look like, the psychiatrist said.
Culp, who is from the small town of Unionport, near the Pennsylvania line, told her doctors she just wants to blend back into society. She has a son and a daughter who live near her, and two preschooler grandsons. Before she was shot, she and her husband ran a painting and contracting business, and she did everything from hanging drywall to a little plumbing, Coffman said.
Culp left the hospital Feb. 5 and has returned for periodic follow-up care. She has suffered only one mild rejection episode that was controlled with a single dose of steroid medicines, her doctors said. She must take immune-suppressing drugs for the rest of her life, but her dosage has been greatly reduced and she needs only a few pills a day.
The clinic expects to absorb the cost of the transplant because it was experimental, doctors said. Siemionow estimated it at $250,000 to $300,000. That is less than the $1 million that other surgeons estimate it costs them to treat other severely disfigured people through dozens of separate operations, she said.
Also at the Cleveland Clinic is Charla Nash of Stamford, Conn., who was attacked by a friend's chimpanzee in February. She lost her hands, nose, lips and eyelids, and will be blind, doctors said. Clinic officials said it is premature to discuss the possibility of a face transplant for her.
In April, doctors at Harvard-affiliated Brigham and Women's Hospital in Boston performed the nation's second face transplant, on a man disfigured in a freak accident. It was the world's seventh such operation. The first, in 2005, was performed in France on Isabelle Dinoire, a woman who had been mauled by her dog.
On the Net:
Cleveland Clinic: http://www.clevelandclinic.org/face

Chemical weapons disposal on fast track
WASHINGTON — The Pentagon plans to speed the destruction of its aging chemical weapons by more than three years with a $1.2 billion acceleration of construction at two new disposal plants, budget documents show.
The proposal represents a 60% increase in projected spending through 2015 to build the plants at the Pueblo (Colo.) Chemical Depot and the Blue Grass (Ky.) Army Depot, totaling more than $3.2 billion over that period, according to the documents, obtained by USA TODAY. Those sites will be the last to eliminate their stockpiles — and the only ones to use chemical neutralization instead of incinerators.
Despite the acceleration, the Pentagon doesn't expect to eliminate all of its chemical weapons until 2021, well past the 2012 deadline set by the international Chemical Weapons Convention. To date, the military has destroyed 60% of the stockpile, which includes VX, GB and mustard gas produced before the weapons program was ended in 1969.
Defense officials declined to comment on the budget plan because it is not yet released. They did confirm the faster disposal timeline tied to the increased spending.
"The department is committed to accelerating," said Jean Reed, who oversees the program. The weapons "need to be destroyed both for the potential threat they could pose if they fell into the wrong hands and … to reduce the potential risk to local communities and (workers)" of an accidental leak.
The new plan would increase 2010 spending for the Pueblo and Blue Grass plants by 29%, to $550 million.
The question is whether budgets in later years will meet projections, said Craig Williams, head of the Chemical Weapons Working Group, which represents communities near stockpiles. Disposal has been slowed before when projected funds didn't materialize, he added, and such inconsistency "is not sensible or appropriate."
Russia, which has the world's largest chemical arsenal, also has had funding problems and has destroyed just 30% of its 44,000 tons of chemical arms.
Sen. Mitch McConnell, R-Ky., said he is "pleased" by the new budget plan. "Once the acceleration options are implemented, I expect even more time can be cut from the schedule."
http://www.usatoday.com/news/military/2009-05-05-chemicalweapons_N.htm

Here are a couple of Swine Flu head lines and the talley so far (all are RED)
Flu cancels U.S. Navy mission in Pacific
05 May 2009 21:01:54 GMT Source: Reuters
WASHINGTON, May 5 (Reuters) - The U.S. Navy said on Tuesday it decided not to send a warship on a planned humanitarian mission to the South Pacific after one crew member fell ill with the H1N1 virus and 49 others developed symptoms.
The San Diego-based USS Dubuque had been scheduled to sail on June 1 to begin a four-month mission to deliver medical, dental, veterinary and engineering assistance to Samoa, the Solomon Islands, Tonga, Kiribati and the Marshall Islands.
Navy Lt. Sean Robertson said ailing crew aboard the 16,900-ton (15,300-tonne) amphibious vessel were put on a five-day course of Tamiflu on April 30. The remaining 370 crew members and staff began a 10-day prophylaxis course on May 3....
http://www.alertnet.org/thenews/newsdesk/N05509787.htm

Flu virus kills Texan, European cases rise
HOUSTON (Reuters) - A Texan with H1N1 flu died earlier this week, state officials said, only the second death outside Mexico where the epidemic appeared to be waning.
Health officials said the outbreak seemed to be slowing in the country hardest-hit by the virus but the World Health Organisation gave a different picture for Europe.
There, the virus was still spreading and WHO laboratories confirmed more infections in Britain, Spain, Italy and Germany -- taking the U.N. agency's toll on Wednesday to 1,516 officially reported cases in 22 countries.
The bulk of these remain in North America.
The WHO confirmed 822 infections and 29 deaths in Mexico, and 403 infections and one death in the United States.
Its tally, which lags national reports but carries more scientific weight, includes a Mexican toddler who died in Texas last week but not the later death of the Texan woman in her 30s who U.S. health officials said had chronic health problems.
They predicted the virus known as swine flu -- actually a mix of pig, human and bird flu elements -- would spread and inevitably kill some people, just like seasonal flu.
U.S. authorities say they have another 700 "probable" cases.
"Those numbers will go up, we anticipate, and unfortunately there are likely to be more hospitalisations and more deaths," U.S. Health and Human Services Secretary Kathleen Sebelius said.
Canada has reported 165 and the WHO said on Wednesday there were 27 cases confirmed in Britain, up from 18.
Spain and Italy both had three more cases, and Germany one more. Guatemala was the 22nd country to confirm a case.
PANDEMIC ALERT REMAINS
For authorities worldwide, the question remained how far the virus would spread and how serious would it be. The WHO remained at alert level 5, meaning a pandemic was imminent.
"If it spreads around the world you will see hundreds of millions of people get infected," said the WHO's Dr. Keiji Fukuda.
If it continues to spread outside the Americas, the WHO would probably move to phase 6, a full pandemic alert. This would prompt countries to activate pandemic plans, distribute antiviral drugs and antibiotics and perhaps advise people to take other precautions like limiting large gatherings.
"It's not so much the number of countries, but whether the virus sets up shop in any of those countries like it has here and starts to spread person to person. And given the number of countries that have cases, one would think that eventually that criteria would be met," said acting CDC director Dr. Richard Besser.
He and Fukuda said it would be important to watch the Southern Hemisphere, where winter and the flu season are just beginning.
Other pandemics have started with a mild new virus in spring that came back to cause severe disease later in the year.
WHO said it would begin sending 2.4 million treatment courses of Roche AG's ROG and Gilead Sciences Inc's Tamiflu, an antiviral proven effective against the new flu, to 72 nations.
CHINESE HEAD HOME
An aircraft carrying 98 Chinese stranded in Mexico by the flu outbreak arrived in Shanghai on Wednesday and all appeared healthy but will have to spend a week in quarantine.
An AeroMexico plane had arrived in Shanghai a day earlier to pick up dozens of Mexicans who had become pawns in a row about how far governments should go to stifle fears of the virus.
None of 43 Mexicans that China had quarantined showed symptoms of H1N1, prompting Mexico to accuse China of discrimination. China denied this, saying isolation was the correct procedure.
http://in.reuters.com/article/worldNews/idINIndia-39423520090506

U.S. reports 642 new H1N1 flu cases
WASHINGTON (Reuters) - The United States now has 642 cases of the new H1N1 flu, with two deaths, the Centers for Disease Control and Prevention reported.
CDC officials have said they expect the new swine flu to spread to all 50 states, to cause severe disease and some deaths, although most cases have been mild.
Mexico has confirmed 42 deaths and said it was impossible to get samples from about 70 more people who died of flu-like illness recently. Globally, more than 1,600 cases have been reported in 23 countries.
http://www.reuters.com/article/domesticNews/idUSTRE5454GZ20090506?feedType=RSS&feedName=domesticNews&rpc=22&sp=true

Second strain of flu may complicate picture-study
06 May 2009 15:02:09 GMT Source: Reuters
* Mutations seen in seasonal flu strain
* May have caused Canadian late-season outbreak
Maggie Fox, Health and Science Editor
WASHINGTON, May 6 (Reuters) - A second strain of influenza, one of the seasonal strains, may have mutated and may be complicating the picture in Mexico, Canadian researchers reported on Wednesday.
They have found a strain of the H3N2 virus that appears to have made a shift and could have complicated the flu picture in Mexico, epicenter of an outbreak of a new strain of the H1N1 swine flu virus.
One was seen in a traveler returning from Mexico, the team at the British Columbia Centre for Disease Control reported to Pro-MED, an online forum for infectious disease experts. And it may have been involved in an unusually late outbreak of flu in long-term care facilities this year.
The new H1N1 virus has killed at least 42 people in Mexico and two in the United States, has spread globally and brought the world to the brink of a pandemic. It appears to act like seasonal flu but doctors have been confused because it has also killed some young and apparently healthy adults -- not the usual pattern for influenza, which picks off the elderly, chronically ill and very young.
Danuta Skowronski and colleagues said they routinely sequence the hemagglutinin gene from a sample of influenza viruses submitted each season by community doctors, hospitals and care facilities across the province of British Columbia, Canada. Hemagglutinin gives a flu virus the "H" in its name, as in H1N1 or H3N2, and is found on the surface of the virus.
Vaccines target hemagglutinin and when it changes, the vaccine must be changed, too. This year the vaccine targets strains of H3N2 influenza, an H1N1 strain different from the new swine flu strain, and an influenza B strain.
"Until mid-February 2009, amino acid sequences of the hemagglutinin gene of H3 viruses in British Columbia were virtually identical to the vaccine strain," Skowronski wrote.
"In early March 2009, however, we detected additional differences from the vaccine strain among British Columbia viruses collected from facility outbreak settings." They only found these changes in flu samples taken from patients in care facilities.
When news broke of the new H1N1 strain, they ran more tests.
"We have sequenced the hemagglutinin gene of one of the H3 viruses from an ill traveler returning from Mexico and find it shares the same ... changes," they wrote.
"In British Columbia, these H3 mutations arose sometime in early March 2009 and we observe at least one returning traveler to have likely acquired illness due to this virus in Mexico," they wrote.
"We thus also wonder to what extent the profile of influenza-like illness initially reported from mid-March in Mexico may in part be attributed to this H3N2 variant in addition to emergence of the novel A/H1N1 virus."
http://www.alertnet.org/thenews/newsdesk/N06391128.htm

Chinese and American ships clash again in Yellow Sea
China demonstrated its growing naval confidence again in the latest standoff between American and Chinese ships.
The fifth such incident in two months occurred on Friday in the Yellow Sea when a US Navy surveillance ship turned its fire hoses on two Chinese fishing vessels.
A spokesman for the Chinese Foreign Ministry said that the American ship was operating in China’s exclusive economic zone without permission and had violated Chinese and international laws. “We express our concern about this and demand the US side take effective measures to ensure a similar incident does not happen again,” he said.
The USNS Victorious, an ocean surveillance ship designed for anti-submarine warfare and underwater mapping, was conducting what the Pentagon called routine operations in the waters between China and the Korean peninsula. The Chinese vessels came within 100ft (30 metres) of the vessel.
The Pentagon, which accused five Chinese fishing vessels of harassing another US surveillance ship in the South China Sea near Hainan island in March, cited the incident as an example of unsafe Chinese seamanship.
The Chinese vessels did not withdraw until after the Victorious had sounded an alarm and a Chinese military ship, identified by the Pentagon as WAGOR 17, arrived in response to the call for assistance. It shone a light on the fishing vessels until they left.
The Pentagon earlier played down the confrontation, striking a more low-key tone than during the incident two months ago.
A spokesman for the US Defence Department suggested that the United States was looking to avoid the kind of angry exchanges that followed the March incident. He said: “We will be developing a way forward to deal with this diplomatically.”
The comments by the spokesman for the Chinese Foreign Ministry were also less strident than in March, when Beijing accused the US of distorting the truth.
Niu Jun, a professor of international relations at Peking University, said that both sides could do more to calm tensions. “The US should make its intention more transparent. But the two sides should also have talks on this issue and establish a mechanism to solve it,” he said.
It was not the first time the Victorious had encountered Chinese boats. On April 7 and April 8, Chinese-flagged fishing vessels approached the ship and the USNS Loyal as they operated within China’s 200-mile economic zone.
http://www.timesonline.co.uk/tol/news/world/asia/article6233796.ece