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PoultryCast 0109a Show Notes:

Traveling to other countries can often require an adjustment to new ways of doing things; there is an aspect of uncertainty in even the smallest of tasks. This is part of the joy of travel, but there are times when weary travelers appreciate any efforts to cut through the confusion. Some places handle this better than others; for example, almost as soon as I got off the plane in Hong Kong, I knew I was in good hands.

I first got a sense of the efficiency of Hong Kong when I passed through Immigration, and had my body temperature scanned remotely to see if I was running a fever (important for a region trying to limit infectious diseases such as avian flu). I was further impressed with Hong Kong’s technological prowess when I discovered I could purchase a stored-value transit pass, called an Octopus card, which I could not only use on trains, buses, and trams, but could also use to buy snacks from a convenience store or food from certain restaurants. I found out later that locals can also buy rings, watches, and even cell phones that contain the Octopus chip, enabling them to simply wave their hands (or phones) over the special card readers to make a purchase.

Another way in which Hong Kong tries to make life easier for visitors (and probably residents as well) is by posting numerous signs that are not only very specific, but sometimes exceedingly courteous. There are not many places where you could find a sign advising you to “Beware of sudden pushing out door” (for other examples of these signs, see My 12 Favorite Signs in Hong Kong on SenseList).

While all these things are wonderful, my favorite piece of technology that makes life easier for visitors (and residents of course) is the Central–Mid-Levels Escalator. Stretching from the Central district of Hong Kong Island up to the heights of the Mid-Levels residential neighborhoods, the escalator is a godsend for footsore travelers.

Escalating the Situation
The Central–Mid-Levels escalator system, which opened in 1994, consists of twenty escalators and three moving sidewalks, and measures 800 meters (1/2 mile) in length, making it the longest outdoor covered escalator in the world. It takes about twenty minutes to ride the escalators from the bottom to the top (or vice versa), but it takes less than that if you walk while they move, as most people do.

The escalators run from 6 a.m. to midnight, descending for the first 4 hours (bringing morning commuters down from upper levels), and then reversing direction around 10:20 a.m. to carry passengers up the hill. There are entrances and exits at each street it intersects (14 in total), making it easy to stop at whichever level you choose.

Up, Up and Hooray
During the time we spent in Hong Kong recently, we rode the escalators almost every day, finding them an extremely useful way to get from our hotel midway up the slope of Victoria Peak to the center of activity downtown and back again. One of the things I enjoyed most about riding the escalators was the opportunity to peek at the activity taking place on either side, from apartment life on the upper levels to the bustling bars, restaurants, and stores on the levels closer to the center of the city.

While for many people who rode the escalators alongside us, it was just an ordinary commute to work, we found the journey to be a fascinating glimpse of urban life in Hong Kong. Not only that, but the ease, efficiency, and simplicity of the system made us, foreigners though we were, feel right at home. —Morgen Jahnke

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Categories: Interesting Places, Society & Culture

The Hong Kong Tourism Board Web site is a good place to find more information about visiting Hong Kong.

Anne Gold’s 2001 article in the International Herald Tribune, Hong Kong’s Mile-Long Escalator System Elevates the Senses: A Stairway to Urban Heaven is a good overview of the sights and businesses near the escalator.

Two restaurants we found near the escalator and thoroughly enjoyed, Eat Right (4 Shelley Street, Central), and Mix (23 Hollywood Road, Central & other locations), both offer health-conscious and delicious food at reasonable prices.

The hotel where we stayed in Hong Kong, Bishop Lei International House, is located near the top of the escalator at 4 Robinson Road.

We found Lonely Planet Best of Hong Kong to be a helpful guide during our time in Hong Kong.

Did you find this article interesting, entertaining, or useful? If so, please consider donating a few dollars to the author to support the ongoing development of Interesting Thing of the Day.  [Donate via: Amazon.com Honor System | Other/More Information]

℗ & © 2007, alt concepts, inc.

(Podcast)
Some people call it "the flesh-eating bacteria."  It's medical name is necrotizing fasciitis.  Whatever you call it, it's bad stuff.  It's not all that common, but you couldn't convince Ricky Oliver of that.  He thinks it got him over the New Year holiday while he was deer hunting in south Texas.  Now he's recovering at home with newly-grafted flesh on his left arm.  His wife, Shannon, tells me the story.

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15:00 minutes

For More Information:

http://www.emedicine.com/derm/topic 743.htm
http://www.dshs.st ate.tx.us/idcu/disease/strep/groupa/faqs/
http://www.emedicine.com/EMERG/top ic332.htm
http://en.wikipedia.org/wik i/Necrotizing_fasciitis

A FULL TRANSCRIPT OF THIS PODCAST FOLLOWS:

Here is a story that will make your skin crawl.

Ricky Oliver of Huntsville was doing what a lot of Texans were doing last December 30th. He was deer-hunting in south Texas. He was having a good time. He had shot and field dressed a deer, so he had meat for his freezer.

The only thing though was that his left hand had tangled with a mesquite thorn while he was in the south Texas brush. Not unusual for anyone who spends time in the country in the south Texas, but it may have been what started his harrowing journey to death's door and the removal of a great deal of flesh from his arm and hand.

You see, within a period of several days, Ricky had to fight off a frequently deadly infection from what is often called flesh-eating bacteria. It is called necrotizing fasciitis and it is gruesome and hideous and just goes to remind us how little bugs can still kill us dead. I talked to Shannon Oliver, Ricky's wife, about the ordeal.

Ed Blackburn: Would you tell our listeners what happened that Saturday, December 30th?

Shannon Oliver: My husband was deer-hunting in south Texas. He had killed his deer and walking through the brush and everything. He got the thorn in his hand then he claimed the deer and everything seemed to be okay. He drove home Sunday. That is 7-8 hours drive home and by the time he got home, he had been sick with the cold and then his hands started swelling up Monday. So, we did the normal thing of the hot water and Epson salt and soaking it, and then by Monday night, he had a little mark come up on his hands about the size of a nickel. He thought that is where the thorn had poked him in his hand and I, you know, messing with it and everything and picking at it and stuff. By the next morning, he was now -- I thought he was in there sick to his stomach, so I went up and it was just coughing up blood and stuff. There again, I thought it was -- we all thought it was the flu, symptoms and stuff. So, by the time we walked in the doctor's office and sat down, the doctor mainly told us, "What took you so long to get here?" I kicked myself 100 times for not doing something earlier, but we just thought he had the flu.

He immediately told us to go to the emergency room and then from the Huntsville Emergency Room, they wanted to send him somewhere, Cornroe or College Station or something, somewhere where there was infectious disease doctor and a hand doctor. We wound up going to College Station Medical Center and when we got there within an hour, they head him into OR.

Ed Blackburn: And they knew what it was right off the bat by looking at it?

Shannon Oliver: Pretty much. Apparently, the doctor has seen several patients with this before. They took him in at 10:00, 10:20 they started surgery, and a little after 1:00 a.m., the doctor walked out and says that he was taking a little break. He told me that Ricky was a man standing in the middle of the forest on fire. His kidneys, liver, lungs were all shutting down and my scare was they were fixing to amputate his arm.

Ed Blackburn: But what did the doctor say that it was?

Shannon Oliver: The necrotizing fasciitis.

Ed Blackburn: And it moved pretty fast, didn't it?

Shannon Oliver: Yes. When the doctor came out at 1:00, he said, "I cannot catch up with it. It is moving faster than I can catch it." Apparently, what he was trying to do was to go around it, you know, cutting the flesh out on his arm and he just couldn't catch up. He said he could see it moving and there was like a green fluorescent line going through ... up his arm.

Ed Blackburn: That was an indicator of how this disease or, I guess it's a bacteria, isn't it?

Shannon Oliver: It is bacteria. It's flesh-eating bacteria and to this day we do not know if it was the thorn, the deer, the deer and the thorn, or if they came from another small cut on his hand. We do not know if he brushed up against something. What they told us that we carry strep on you everyday and with his immune system down already, his body was in line.

Ed Blackburn: I see. Well, now, in your email as you related some of the events that occurred, I think you described that they actually peeled the flesh off his whole arm, is that right?

Shannon Oliver: Yes, they took the skin, the flesh, but the muscle and the tendons wasn't there. He had some above his elbow all the way down to the last joint on his fingers.

Ed Blackburn: What did his hand look like that Monday night before you all made the decision to move in?

Shannon Oliver: Across his knuckles, that one little spot are red that I had saw had moved all the way across his knuckles like a strip across there of redness and then patches, there were blisters, they are like the color of cabbage. I want to say like the shape of broccoli. It was just bigger, somewhat taller, they were reddish, purpley-looking.

Ed Blackburn: That sounds ugly.

Shannon Oliver:  He was not in a coma, but they had him so sedated and they had him on the top, antibiotics, double doses on his four antibiotics to get rid of these bacteria. Then Thursday, they did a shift change Thursday morning. The nurse looked at him and he had had a couple of red marks on his right hand and mainly they had trouble getting the IV in and stuff Tuesday night because I guess from his body shutting down and stuff. They couldn't get to the vein and everything. So, three hours later when she looked to check his IV again, a blister came up again on his right hand, on his wrist. She kindly got me and she said, "I've already told the doctor. This is a concern," and I said, "That's it. It's the same thing." The doctor came in and he start off about not jump to conclusions and when he popped it open, he said, "Call OR, we're going back." He said, "Let's go ASAP."

Ed Blackburn: And so they worked on his hand a little bit?

Shannon Oliver: They cut a piece out of his wrist and one on the side and some other places to make sure that they weren't missing it, but he came back and said there was not anything in the right hand, but if you would've saw the first hand to start with and then saw the right hand, there was no way I believed him standing there telling me that. He had this very concerned look on his face, the doctor did.

Ed Blackburn: I see, but he did his work and then you all moved down to Galveston, right?

Shannon Oliver: Yes, and Friday morning they were talking about getting the ventilator off and everything and then all of a sudden, we're going to Galveston. So, we moved down there to the Burn Center and then Saturday morning, they took the ventilator out and he was starting to come to and everything.

At surgery, it was probably Wednesday or Thursday, they put a big sponge glove on him, on his arm and his hand, and if it had any infection or anything like that, anything, it would suck it out of it, the sponge, the vacuum gloves. When he woke up, he had that glove still on Saturday morning when they took the tube out when he was coming to and felt at that time, he thought he had lost his arm or his hand or something.

Ed Blackburn: Didn't you say that he kind of got his bearings again, he understood what was going on?

Shannon Oliver: Yes, he did. He did. Then they took the sponge glove off and everything and then they tried to do, a couple of days later they tried to do a surgery to skin graft and when they got in there, he had a slimey and a little brownish look to his arm.

He was afraid to use his own [Ricky's] skin since it was going to take so much so they used cadavers' skin. We wore it for four days. They took it off again and it looked good, so the next day they did a skin graft from his legs, from his thighs, and they covered his whole arm in his hand and then four days later, we got to look at it and it looked good and then we had the pancreatitis problem.

Ed Blackburn: Was the diagnosis of the pancreatitis a result of the other injuries to his body?

Shannon Oliver: I think so and all of the information that I kind of researched on the computer. It said from trauma infection and antibiotics can cause the pancreatitis. They treat it there for a couple of days, don't let you eat or anything, trying to get it to come down and finally said, "Okay, you can eat," so they gave him like two pieces of toasts and a little bit of scrambled eggs and then it was not just 600, but they still let us go home but we have been monitoring it at home.

Ed Blackburn: So, you've been home and he is resting and recuperating as we speak?

Shannon Oliver: Yes, he is.

Ed Blackburn: I see. Well, you all certainly been through a bad, bad time and Ricky on his own and I guess your family and your close friends have also been through a tough time.

Shannon Oliver: Yes, sir.

Ed Blackburn: Well, I guess it's kind of a warning to others who spend time outdoors and hunting and fishing and I know for a fact myself, there had been times I've scraped my hand or my elbow or been stuck with a mesquite thorn and I didn't give it a second thought.

Shannon Oliver: Nope, not at all. The guys tell me, "We do it all the time," you know? But his body was just I guess because his immune system was down.

Ed Blackburn: Well, that sounds like a very, very dangerous disease and sounds as well that you all are very lucky and all the prayers and good wishes from friends were helpful.

Shannon Oliver: Yes, sir. I believe that prayer is what got us through this.

Ed Blackburn: Shannon, thank you so very much for your time and once again, sincerely as I can say it, even though I'm a stranger, I wish Ricky a speedy recovery.

Shannon Oliver: Well, thank you so much. Bye-bye.

Ed Blackburn:     Necrotizing fasciitis is an ugly infection. It’s most commonly caused by what’s known as a Group A streptococcus germ …like the germ that causes strep throat. The Strep, as it’s often called is all around us …everyday of our lives. Most of us have a resistence to the bug, but it’s been making headway.

What happens with necrotizing fasciitis is that the germ turns INVASIVE …which means that it invades body tissues. It has a close cousin … the more popularly-known toxic shock syndrome.

Although people call it the flesh-eating bacteria …it’s really not. What happens is …that once it invades body tissue, skin and muscles are destroyed by the toxins that the bacteria release. The toxins cause the over-production of cytokines that in turn over-stimulate macrophages. It’s the microphages that do the damage.

A Necrotizing fasciitis infection starts out with flu-like symptoms. Sometimes it can start out at the site of some kind of trauma …like surgical incisions. Unlike the flu, though, symptoms become worse rather than better.

As the disease progresses, tissues become swollen and the skin distended. Skin color changes radically becoming violet or purple. Most of the time blisters form …some of them large and angry-looking. What’s happening is that subcutaneous tissues are dying …rapidly. Without treatment, the infection is almost 100 percent fatal.

Medical care is a necessity with this bug …not an option.

Treatment usually includes massive doses of antibiotics. Also, depending on how soon the diagnosis is made, surgical exploration is used and infected tissue is removed. In some cases amputation of an infected limb is the only way to the life of a stricken individual.

Although first described medically in 1848, the disease didn’t make itself known to the general population until the 1990s when it got a lot of press.

Although we know that the Group A Streptococcus germ is the primary culprit in this disease, it is still relatively unknown how it turns invasive.

It’s not known how many cases of this disease occur in Texas because it’s not a disease that’s required to be reported to those official agencies that monitor infectious diseases …like the Texas Department of Health Services.

For more information, check out the links listed above.