Category Archives: Life & Death

SIDS – SUDDEN INFANT DEATH SYNDROME

“Medical examiner responds to second sleep-related infant death this week.”

This headline got my attention when it was posted online Nov 13, 2014, by Shakara Robinson of WDJT58 in Milwaukee. I’ve been meaning to write about Sudden Infant Death Syndrome, or SIDS, since I started DyingWords as I feel it’s the most tragic, misunderstood, and preventable type of death.

The article continued…

The Milwaukee County Medical Examiner’s Office responded to the death of a one-month-old infant Wednesday morning near 27th and Meinecke. Officials say the baby boy was pronounced dead at the home in the 2400 block of N. 27th Street just after 8 a.m. Initial reports suggest the baby was sleeping with his mother. An autopsy is scheduled for Friday. This is the second sleep-related infant death the Milwaukee County Medical Examiner’s Office has reported this week. A 10-day-old baby boy was pronounced dead November 10 near 81st and Oklahoma after sleeping in bed with his mother and a sibling.

I’ve attended too many SIDS cases in my time as a police officer and coroner. They are, by far, the most difficult deaths to investigate – not because of the lack of medical evidence – it’s the emotional trauma suffered by the families which sticks to the investigators.

Sudden Infant Death Syndrome is the unexplained and unexpected death of a seemingly healthy baby aged less than 1 year old. These deaths are legally classified as SIDS if the cause can’t be explained after a thorough investigation that includes an autopsy, examination of the death scene, and review of the clinical history.

SIDS is sometimes termed ‘SUID’ for Sudden Unexplained Infant Death. Historically it’s been called crib death because many infants die in their cribs. It’s been occurring as long as humanity has been around.

SIDS is also different from positional asphyxia, accidental smothering, and accidental strangulation which are provable causes of death. In SIDS, the infant just stops breathing without an external event.

SIDS is the third leading cause of infant mortality in the world (following malnutrition and infectious disease) and it’s the leading cause of death among infants aged 1– 4 months. Although the overall rate of SIDS has declined by more than 50% since 1990, rates for black and aboriginal infants remain disproportionately higher than the rest of the population. Curiously, it occurs frequently in colder months and in homes with many occupants.

There’s no proven death mechanism for SIDS, yet it’s a recognized cause of death (COD). It appears that SIDS is associated with abnormalities in the portion of an infant’s brain that controls breathing and arousal from sleep.

Infants are at their highest risk for SIDS during sleep. Typically, the infant is found dead after having been put to bed and there’s no sign of struggle or abuse. For some reason they just stopped breathing which, in turn, causes hypoxia or a lack of oxygenated blood to the brain resulting in cardiac arrest.

Most SIDS cases occur when babies are placed on their stomachs to sleep rather than on their backs or sides. Some researchers have hypothesized that stomach sleeping puts pressure on a child’s jaw, therefore narrowing the airway and hampering breathing.

Another theory is that stomach sleeping increases an infant’s risk of “rebreathing” his or her own exhaled air, particularly if the infant is sleeping on a soft mattress or with bedding, stuffed toys, or a pillow near the face. In that scenario, the soft surface creates a small enclosure around the baby’s mouth and traps exhaled air. As the baby breathes exhaled air, the oxygen level in the body drops and carbon dioxide accumulates. Eventually, this lack of oxygen contributes to SIDS.

Also, infants who succumb to SIDS may have an abnormality in the arcuate nucleus, a part of the brain that controls breathing during sleep. If a baby breathes stale air and doesn’t get enough oxygen, the brain triggers the baby to wake up and cry. That movement changes the breathing and heart rate, making up for the lack of oxygen. But a problem with the arcuate nucleus deprives the baby of this involuntary reaction.

Many doctors believe multiple factors contribute to SIDS.

Sleeping on stomachs
Exposure to tobacco smoke in the womb or after birth
Sleeping in bed with parents
Premature birth
Being a twin or triplet
Born to a teen mother

Regardless, the biggest preventive of SIDS is always placing your little one on the back to sleep.

These tips from the Centers for Disease Control address the risk of succumbing to SIDS:

Place her on a firm mattress to sleep, never on a pillow, waterbed, sheepskin, couch, chair, or other soft surface. To prevent rebreathing, do not put blankets, comforters, stuffed toys, or pillows nearby.
Don’t use bumper pads in cribs. Bumper pads can suffocate or strangulate.
Make sure he’s immunized. Babies who are immunized have a 50% lower risk of SIDS.
Make sure she’s not too warm while sleeping. Keep the room at a temperature that feels comfortable for an adult in a short-sleeve shirt. Some researchers suggest babies who get too warm go into a deeper sleep, making more difficult to awaken.
Do not smoke, drink, or use drugs while pregnant and do not expose your baby to secondhand smoke. Infants of smoking mothers during pregnancy are 3 times more likely to die of SIDS than smoke-free moms. Exposure to secondhand smoke doubles your baby’s risk of SIDS. Researchers speculate that smoking affects the central nervous system, starting prenatally, and continuing after birth, which places your baby at increased risk.
Receive early and regular prenatal care.
Make sure he has regular checkups.
Breastfeed, if possible. There’s evidence that breastfeeding decreases the incidence of SIDS. Breast milk naturally immunizes her from infections that increase the risk of SIDS.
If he has Gastroesophangael Reflux Disease (GERD), be sure to follow your doctor’s guidelines on feeding and sleep positions.
Put her to sleep with a pacifier during the first year of life. If she rejects the pacifier, don’t force it. Pacifiers are linked with lower risk of SIDS. If you’re breastfeeding, try to wait until after she’s 1 month old so that breastfeeding can be established.
While he can be brought into your bed for nursing or comforting, put him back in his crib or bassinet when you’re ready to sleep. It’s okay to keep him in your room. Just don’t run the risk of rolling over and smothering him.
Don’t assume others will place her to sleep in the correct position. Insist on it. Advise sitters and child care personnel not to use the stomach position to calm an upset baby.

Vaccinations have been a suspect in the cause of SIDS. From 2 – 4 months old, babies begin getting primary vaccinations. Co-incidentally, this is the peak age for SIDS. The timing of these two events might seem suspicious, however exhaustive studies conclude vaccinations are not a SIDS risk factor. Inversely, vaccinations are the leading cause of infant survival.

Now, I have a personal suspect in infant deaths that are mistakenly classified as SIDS.

This culprit is Stachybotrys chartarum. It’s an extremely toxic black mold found in cellulose rich building materials which requires high heat and moisture in order to grow and is associated with wet gypsum material and wallpaper.

Health problems related to this nasty mold have been documented in humans and animals since the 1930s. It’s also considered a likely candidate for the Biblical condition mistranslated as “leprosy”.

Today, Stachybotrys is linked to sick building syndrome. It’s not firmly established in scientific literature, but I find it very suspicious that the disproportionately high rate of SIDS in blacks and aboriginals can be linked to environmental conditions where Stachybotrys is prominent.

I’m not being racist here. I’m being a realist. The majority of SIDS deaths I attended were in the Canadian aboriginal (First Nations) demographic. Looking back at my notes, these deaths were mostly in the cool seasons when the residential heat was artificially high and the ventilation was low. The social state of these communities leads to a high occupancy ratio and an extremely high humidity factor in their houses – the perfect breeding ground for toxic black mold.

My theory continues. The most vulnerable climate-exposure period for infants is when they’re building their immune system – 1 to 4 months. Contacting an environmental airborne pathogen like Stachybotrys can result in a mycotoxicosis causing a metabolic, respiratory, or cardiac disorder which could trigger sudden death.

I’m not saying most SIDS cases are pathogen related. Ultimately, all deaths have an anatomical cause that unplugs the central nervous system. I just think that many infant deaths written off as SIDS have a root cause hidden in their environment.

If you have an infant in your family, please, please check the bedroom for any sign of black mold. It’s most observable in window tracks but thrives behind the walls and in any dark, warm, and wet place.

If you’ve experienced a SIDS death contact the American SIDS Institute www.sids.org for grief counselling, support, and referrals.

Or contact me if you’d like to talk.

HOW DO YOU WANT TO DIE?

I’m thrilled to death to have Seth Godin do this guest post on DyingWords. Seth is an internationally known author, speaker, businessman, and all-around mover & shaker. He originally posted this on his own blog at www.sethgodin.com on June 13, 2013, and generously offered to share it here. Thanks Seth!

Let’s assert that you’re almost certainly not going to be the very first person to live forever. Also worth noting is that you’re probably going to die of natural causes.

The expectations we have for medical care are derived directly from marketing and popular culture. Marcus Welby and a host of medical shows taught us about the heroic doctor, and more than that, about the power of technology and intervention to reliably deliver a cure.

It’s not a conspiracy — it’s just the result of many industries that all profit from the herculean effort and expense designed to extend human life, sometimes at great personal cost.

Hence the question: Do you want to choose whether or not you will be a profit center in the ever scaling medical-industrial complex? One percent of the population accounts for 30% of all health care expenditures, and half of those people are elderly.

Most of that care is designed to prolong life, regardless of the cost, the pain, or the impact on the family. A lot of doctors are uncomfortable with this, but they need you to speak up and make a choice (in advance) about what you’d like. Some people want the full treatment, intervention at all costs.

If that’s your choice, go for it. But be clear, in writing, that you’d like to spare no expense and invest in every procedure, even if it’s pointless and painful. Don’t be selfish and let someone else have to guess.

On the other hand, you have the right to speak up, and stand up, and clearly state if you’d prefer the alternative. Many people prefer a quiet dignity that spares them, and their family, pain and trauma. But you have to do it now, because later is too late.

The web makes it easy to generate and sign a simple generic form. Or even better, go find the forms by state or province. If those pages are down, try a search “health care proxy” and the name of your state or province. I suggest http://mydirectives.com and consider the “Five Wishes” at http://www.agingwithdignity.org/ .)

There are two critical components: assigning an individual to be your health care proxy, and then telling that proxy, in writing, what you’d like done (and not done) to you when the time comes.

If you’ve ever shared a post of mine, I hope you’ll share this one. If every person who reads this sits down with her family and talks this through (and then tells a few friends), we’ll make a magnificent dent in the cultural expectation of what happens last.

It’s free. It’s not difficult. It takes five minutes. Do it today, if you can, whatever your wishes are. Don’t make the people you love guess and then live with the memory of that guessing.

Some things are more likely to happen if you plan for them. In this case, the end comes whether you plan for it or not.

Planning merely makes it better.

SETH GODIN is the author of 17 books that have been bestsellers around the world and have been translated into more than 35 languages. He writes about the post-industrial revolution, the way ideas spread, marketing, quitting, leadership, and most of all, changing everything. You might be familiar with his books Linchpin, Tribes, The Dip, and Purple Cow.

In addition to his writing and speaking, Seth is the founder of squidoo.com, a fast growing, easy to use website. His blog at www.sethgodin.com (which you can find by typing “seth” into Google or click here) is one of the most popular in the world. Before his work as a writer and blogger, Seth was Vice President of Direct Marketing at Yahoo!, a job he got after selling them his pioneering 1990s online startup, Yoyodyne.

In 2013, Seth was inducted into the Direct Marketing Hall of Fame, one of three chosen for this honour.

Recently, Seth once again set the book publishing on its ear by launching a series of four books via Kickstarter. The campaign reached its goal after three hours and ended up becoming the most successful book project ever done this way. His latest, The Icarus Deception, argues that we’ve been brainwashed by industrial propaganda, and pushes us to stand out, not to fit in.

Thanks so much for generously sharing your wisdom, Seth!

HAPPY BIRTHDAY, STEPHEN KING

The master of horror turned 67 today. I wish him many more years of creative success and providing unselfish guidance and inspiration to writers like me.

I saw the movie Carrie before I’d read anything by Stephen King or even heard of him. I then heard the story behind Carrie, which was his spark to success, and it planted the seed that one day I could become a successful writer, too.

In case you don’t know the story, Stephen King was raising kids, working in a laundry facility, and writing in his spare time. Like so many wanna-be authors, he received many rejections from agents and publishers. He gave up and threw the manuscript for Carrie in the garbage. His wife, Tabitha, fished it out and encouraged him to finish it then submit it to Doubleday. The rest is history.

When you look back over his forty-plus year career it’s, by any standards, impressive. He’s produce fifty novels, five non-fiction books, and around two hundred short stories. Then there’s the movies, TV series, graphic novels, and comics.

Most people know The Shining, The Stand, It, Cujo, Misery, The Green Mile, The Dark Tower Series, and Bag of Bones as household words. His recent works Under The Dome, Dr. Sleep, and Mr. Mercedes will also prove timeless.

My favourite Stephen King books are From a Buick Eight, 11/22/63, and On Writing.

King’s brilliant imagination shines in From a Buick Eight. It’s about a possessed car that a small Pennsylvania police department seized and kept stored in their garage. Down-right freakin’ freaky is the best I can describe the story. It held me right to the last word.

11/22/63 is a take on the November 22nd, 1963, assassination of US President John F. Kennedy. The plot is a time traveller going back to prevent the JFK murder. Knowing what I do about the JFK case, I found his attention to detail and historical accuracy impeccable. No question he did his homework, especially in portraying Lee Harvey Oswald to be the wife-beating asshole he truly was.

Every writer has to read and absorb On Writing – A Memoir of the Craft. This is one of the top five books I’d recommend to writers, regardless of their genre. Here’s a few points to lock in.

The key to good dialogue is honesty
All novels are letters aimed at one person – your ideal reader
Never tell a reader if you can show them
A slower pace gives a bigger and better build
Kill your darlings
Get backstory in as quick as possible
Grammar doesn’t wear a coat and tie
Read a lot and write a lot
Just tell the goddam story

One of Stephen King’s writing techniques is to imagine a ‘What-if?’ scenario and go from there, writing as you go and turning up what the mind uncovers. Misery is a good example. What if a psychotic nurse kidnapped a writer in the Colorado mountains?

Here’s a couple quotes from him on successful writing.

If you wrote something for which someone sent you a check, if you cashed the check and it didn’t bounce, and if you paid the light bill with the money, I consider you successful.

Read and write four to six hours a day. If you can’t find the time for that, you can’t expect to be a good writer.

Sometimes you’re doing good work when it feels like all you’re managing to do is shovel shit from a sitting position.

Some criticize Stephen King for being too long and verbose. I call bullshit. If you analyse his work, you’ll find that every word is necessary to tell the goddam story. And I love his fearless way of saying it.

Dying Words

Provoking Thoughts on Life, Death, and Writing