Tag Archives: Excruciating

Jameela Jamil shares ‘excruciating regret’ after missing chance to see to friend married to Killers of the Flo – Daily Mail

  1. Jameela Jamil shares ‘excruciating regret’ after missing chance to see to friend married to Killers of the Flo Daily Mail
  2. Filmmaker Isabelle Thomas, wife of ‘Killers of the Flower Moon’ producer, dies of ‘multiple injuries’ Yahoo Entertainment
  3. Oscar-Nominated Producer’s Wife, 39, Dies by Suicide at L.A. Hotel PEOPLE
  4. Isabelle Thomas, Filmmaker and Wife of ‘Killers of the Flower Moon’ Producer Bradley Thomas, Dies at 39 Hollywood Reporter
  5. Wife of ‘Killers of the Flower Moon’ producer jumps to her death from hotel balcony New York Daily News

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North Carolina boy, 6, in ‘excruciating pain’ after overdosing on Delta-9 THC candy mistaken for Skittles – Fox News

  1. North Carolina boy, 6, in ‘excruciating pain’ after overdosing on Delta-9 THC candy mistaken for Skittles Fox News
  2. 6-year-old hospitalized after gobbling Delta-9 THC candy sold to unwitting family: ‘He was in excruciating pain’ New York Post
  3. ‘He was in excruciating pain’: Boy, six, hospitalized after eating THC candy sold in North Carolina restaurant Daily Mail
  4. ‘Something wrong’: Mother buys candy for 6-year-old son, realizes later it was Delta-9 WSOC Charlotte
  5. ‘Excruciating Pain’: 6-Year-Old Hospitalized After Eating Drug-Laced Candy Daily Caller

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‘Octomom’ Nadya Suleman Shares Rare Update on How Welcoming Octuplets Continues to Affect Her Health, Details ‘Excruciating’ Pain – Yahoo Entertainment

  1. ‘Octomom’ Nadya Suleman Shares Rare Update on How Welcoming Octuplets Continues to Affect Her Health, Details ‘Excruciating’ Pain Yahoo Entertainment
  2. ‘Octomom’ Nadya Suleman Talks Staying Fit After Having 14 KIDS Access Hollywood
  3. ‘Octomom’ Posts Workout Selfies & Reveals What Her Body Endured During Pregnancy HollywoodLife
  4. ‘Octomom’ Nadya Suleman Shares Ripped Gym Picture While Revealing She Herniated 3 Discs During Pregnancy Yahoo Entertainment
  5. ‘Octomom’ Nadya Suleman shares inspiring gym selfie after 14 kids GMA
  6. View Full Coverage on Google News

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Oscars 2023: 10 things to know, from a heartwarming comeback story to an excruciating red carpet interview – The Washington Post

  1. Oscars 2023: 10 things to know, from a heartwarming comeback story to an excruciating red carpet interview The Washington Post
  2. ‘Everything Everywhere All at Once’ Dominates Oscars With Seven Wins, Including Best Picture (Full Winners List) Variety
  3. Oscars 2023 Review: A Ho-Hum Affair Loses Its Magic by Playing It Too Safe Yahoo Entertainment
  4. Oscars 2023 Latest News: ‘Everything Everywhere All at Once’ Takes Home 7 Awards The Wall Street Journal
  5. Oscar Winners 2023: Best Actor, Actress, Picture and More (LIVE LIST) The Daily Beast
  6. View Full Coverage on Google News

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Taylor Swift: Ticketmaster fiasco ‘excruciating for me’


New York
CNN Business
 — 

Taylor Swift spoke out Friday about the ticketing debacle that took place this week, as many fans were unable to purchase tickets for her upcoming tour on Ticketmaster.

“It goes without saying that I’m extremely protective of my fans,” Swift wrote on Instagram on Friday. “It’s really difficult for me to trust an outside entity with these relationships and loyalties, and excruciating for me to just watch mistakes happen with no recourse.”

Swift blamed Ticketmaster for the snafu, noting that there were a “multitude of reasons why people had such a hard time” getting tickets.

“I’m not going to make excuses for anyone because we asked them, multiple times, if they could handle this kind of demand and we were assured they could,” the singer wrote. “It’s truly amazing that 2.4 million people got tickets, but it really pisses me off that a lot of them feel like they went through several bear attacks to get them.”

Swift added that she would try to “figure out how this situation can be improved moving forward.”

Sales for the singer’s new Eras Tour began Tuesday, but the heavy demand snarled the ticketing site, infuriating fans who couldn’t snag tickets. Customers complained about Ticketmaster not loading, saying the platform didn’t allow them to access tickets, even if they had a pre-sale code for verified fans.

On Thursday, Ticketmaster announced that the sale to the general public, which was scheduled to begin Friday, had been canceled due to “extraordinarily high demands on ticketing systems and insufficient remaining ticket inventory to meet that demand.”

“To those who didn’t get tickets, all I can say is that my hope is to provide more opportunities for us to get together and sing these songs,” Swift added.

The issues for Ticketmaster started on Tuesday, when the site’s sale kicked off for “verified fans” — a mechanism aimed at eliminating bots that gives presale codes to individuals.

The “verified fan” platform was created in 2017 to help Ticketmaster handle situations of enormous demand, but as more than 3.5 million people pre-registered to be a Swift “verified fan” the system became overwhelmed. That’s the largest registration in the company’s history, according to Ticketmaster.

“Historically, working with ‘Verified Fan’ invite codes has worked as we’ve been able to manage the volume coming into the site to shop for tickets,” the company wrote on Thursday in a blog post that has since been taken down. “However, this time the staggering number of bot attacks as well as fans who didn’t have invite codes drove unprecedented traffic on our site.”

Ticketmaster noted that it “usually takes us about an hour to sell through a stadium show,” but the site slowed down some sales while delaying others to “stabilize the systems.” That brought everything to a halt.

The site seemed to have avoided major problems on Wednesday when pre-sales began for Capital One credit card holders. But the company’s inability to deal with demand for Swift’s tour as well as a lack of tickets to meet further demand essentially killed Friday’s planned sale to the general public.

Fans blamed Ticketmaster while others, including members of Congress, heavily criticized the company’s control of the live music industry.

“Ticketmaster’s power in the primary ticket market insulates it from the competitive pressures that typically push companies to innovate and improve their services,” Senator Amy Klobuchar wrote in an open letter to its CEO on Wednesday. “That can result in the types of dramatic service failures we saw this week, where consumers are the ones that pay the price.”

Senator Richard Blumenthal echoed Klobuchar’s concerns, tweeting that the tour “is a perfect example of how the Live Nation/Ticketmaster merger harms consumers by creating a near-monopoly.”

“I’ve long urged DOJ to investigate the state of competition in the ticketing industry,” he said. “Consumers deserve better than this anti-hero behavior.”

The New York Times reported Friday that the Department of Justice has opened an antitrust investigation into Live Nation, the parent company of Ticketmaster, citing people familiar with the matter. The investigation is centered around whether Live Nation Entertainment abused its power over the live music industry, the Times wrote.

The Justice Department has been contacting music venues and other ticket market participants in recent months, asking about Live Nation’s practices and industry dynamics, the Times added.

The Justice Department and Live Nation did not respond to CNN’s requests for comment.

The backlash also highlighted the enormity of Swift’s popularity

The pop star has had countless hits over her career, built up an ultra-loyal following of fans — better known as “Swifties” — and recently became the first artist ever to simultaneously claim all top 10 spots on the Billboard Hot 100 following the release of her latest album, “Midnights,” which came out last month.

Her Eras Tour — which kicks off in Glendale, Arizona on March 17 and wraps up in Los Angeles on August 9 — is hitting 52 stadiums across the US.

Ticketmaster noted on Thursday that more than two million tickets were sold Tuesday for Swift’s upcoming tour — the most ever for an artist in a single day. The company also said that demand for tickets to the Eras Tour was twice that of 2022’s top five tours and the Super Bowl combined.

“Based on the volume of traffic to our site, Taylor would need to perform over 900 stadium shows (almost 20x the number of shows she is doing),” Ticketmaster wrote on Thursday. “That’s a stadium show every single night for the next 2.5 years.”

Tickets for Swift’s upcoming tour also resulted in astronomical prices on ticket resale sites, with some tickets being listed for tens of thousands of dollars.

Since her debut album in 2006, Swift has also built herself into a cultural icon with immense influence to move the needle over issues in the industry. She has taken on music streaming services like Spotify

(SPOT) and Apple Music regarding artist pay and is currently re-recording her songs to reclaim ownership of her masters.

In many aspects, as goes Swift, so goes the music industry.

Serona Elton, professor of music industry at the University of Miami’s Frost School of Music, further explained Swift’s popularity by noting her success in both music sales and touring. Most music is now consumed via streaming, she said, which is more popular among younger generations who skew slightly female.

“The demographic group that is driving the highest percentage of music consumption sees themselves in her, and closely relates to what she sings about,” she said.



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Woman left in excruciating pain and half blind due to dirty makeup bag

Laura Hawkins awoke one morning unable to open her right eye (Picture: SWNS)

Laura Hawkins, 24, woke up one day while travelling across Australia in ‘excruciating’ pain.

She was unable to open her right eye, despite having used eye drops from the pharmacist the previous day in an attempt to treat what she thought was just run-of-the-mill conjunctivitis.

‘I got someone at the hostel to drive me straight to A&E because I just knew something was not right,’ said Laura, who was three months into her adventure to Australia.

‘I’d had conjunctivitis before and this was definitely not it.

‘I woke up and I couldn’t physically open my eye.

‘Even just a tiny bit of light getting in my eye would feel like a burning or stabbing pain.

She had gone to bed with what she thought was just conjunctivitis, but woke up in excruciating pain (Picture: Courtesy Laura Hawkins / SWNS)

‘Throughout the day before, my eye had gotten more swollen and shut over and gunky which I knew wasn’t good, and then the morning after, I just couldn’t open my eye at all so I couldn’t tell if I could see or not.’

At the hospital Laura was sent straight to an optimologist, who discovered that Laura had a corneal ulcer, which left untreated could have left her blind.

And the cause of this? Laura’s dirty makeup bag.

Laura had started wearing glasses when she was 10 years old and made the switch to contact lenses when she was 16.

She had been using two-week disposable contact lenses where she would take them out before bed, placing them in a saline solution overnight and putting them back in in the morning.

She was three months into a trip to Australia (Picture: Courtesy Laura Hawkins / SWNS)

The contact lenses were supposed to last for two weeks but despite Laura’s careful handling, it appears one lens picked up bacteria from the makeup bag where they were stored.

After a course of strong painkillers and eye drops, doctors scraped bacterial cells from Laura’s eye for testing.

They believe the bacterial infection was picked up from her makeup bag, where the contact lens case had been stored every night during her time in Australia.

Laura was in hospital for over a week then had to recover at a friend’s house for nearly a month.

A trip to hospital resulted in a course of painkillers and having her eye scraped to test the bacteria (Picture: Courtesy Laura Hawkins / SWNS)

Despite three cancelled flights due to the pandemic, Laura was finally able to return home to her family with a huge eye patch over her eye on the plane on March 26.

Over a year on from her scary experience, Laura now has permanent scarring on her right eye and has just been referred for a corneal transplant on the NHS.

Laura, who works as a personal trainer, said: ‘I’ve been left with really bad scarring as it was really deep and on my vision.

‘Doctors said wait a year and see if the vision is any better but if not, I can have a corneal transplant so I’m being referred for that now.

‘My peripheral vision and central to the right vision in my right eye, it’s now like there’s a white sheet over it.

Months later, Laura is still struggling with her vision (Picture: Courtesy Laura Hawkins / SWNS)

‘I can’t really see that well out of that eye, and especially when it’s night time and there’s bright lights, I just can’t see. I tried driving at night and I just can’t do that now.

‘Looking in the mirror, I can see there’s like a white bit from my pupil to the outside colour of my iris. I can see the scarring in photos as well.

‘I’d been wearing contact lenses for a good few years before this and never had any problem but I also didn’t know the risk of wearing them.

‘I always cleaned my hands before and after putting the contact lenses in and I used the saline solution as you’re supposed to.

‘What the doctors think happened is that either I scratched my eye taking the lenses out or the contact lens itself was contaminated.

‘I’d taken the lenses out the night before and everything had seemed normal. I definitely don’t think I scratched my eye, it didn’t hurt at all when I took the lenses out.

Doctors think the infection was a result of Laura storing her contact lenses in her makeup bag (Picture: Courtesy Laura Hawkins / SWNS)

‘I didn’t wear contact lenses for over half a year after this happened, I just stuck to glasses, I didn’t want to put anything near my eye.

‘I have researched into contact lenses since and whilst it isn’t common, people do get infections from their contact lenses so I think there should be more pre-warning when you get given them at your eye test as this was so bad.

‘Nobody warned me what could happen – they told me the importance of cleaning my hands and using the saline solution, which I always did, but they never said that this could happen.’

Specsavers clinical services director, Giles Edmonds, said: ‘It’s important that good hygiene is always followed when handling contact lenses. You wouldn’t put something dirty into your mouth so why would you do the same with your eyes?

The personal trainer may need a corneal transplant (Picture: Courtesy Laura Hawkins / SWNS)

‘Clean, dry hands should always be used when putting in and taking out lenses and always rub, rinse and store your lenses in the recommended solution.

‘You need to be mindful of where you store your lens case too as it can easily pick up bacteria in its surroundings, which can result in red eyes, irritation or even infection.

‘For example, if you keep your lenses in a makeup bag, which is a breeding ground for bacteria, always be sure to wash your hands after opening the case and before handling your lenses.

‘Don’t forget to clean your case regularly too as advised by your optician.

‘To keep your eyes healthy, you should also apply your lenses before putting on makeup.

‘Contact lens wearers shouldn’t use tap water or any other water on your lenses or case and should remove lenses before going in the shower or swimming to also reduce the risk of bacteria getting into the eye.’

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Get in touch by emailing MetroLifestyleTeam@Metro.co.uk.


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I Had Monkeypox, and the Physical and Emotional Pain Were Excruciating

  • Insider’s Joel Marino got monkeypox in July. The pain was so bad he couldn’t lie down at times.
  • Marino said the stigma was awful — with monkeypox, people look at you differently.
  • This is Marino’s story, as told to Insider reporter Hilary Brueck.

I spent most of June isolating with COVID-19, a disease I’d managed to avoid until this summer. Frustratingly, as an out gay man, the diagnosis meant spending nearly all of Pride Month by myself, pacing my New York City apartment. I canceled plans with friends and stayed in.

This was supposed to be the year that nothing was going to stand in my way. The start of the pandemic in 2020 and the 2021 Delta surge had put a damper on two Pride celebrations; I didn’t want to miss out on a third. 

So once my week of fever, fatigue, and chills was behind me, and I tested COVID negative for three days in a row, I made a beeline for a queer dance party in Manhattan on the last Sunday in June. 

It was a fantastic night. Finally, after so many months of being careful, getting vaccinated and boosted, and taking necessary pandemic precautions (which, honestly, meant less dating), I was able to touch strangers again and we could enjoy it. I danced, I kissed, I conquered. I met someone and we asked each other coyly, “Your place or mine?”

Monkeypox feels like something that happens to other people. Until it’s not.

Monkeypox lesions visible near my hairline.

Joel Marino


There wasn’t much talk about monkeypox going around the club then. People briefly mentioned it, if nothing else to laugh at the bad name, but it still felt like something that was happening to other people, somewhere else. 

My mom, who was already worried about me recovering from COVID, had texted me and suggested that maybe I should get vaccinated with Jynneos, but there were barely any monkeypox vaccines available in the city at that time. It was so hard to get an appointment, people often waited hours and hours in the blistering sun, and I just thought, “What are the chances, really, of catching this thing?” I hadn’t heard of anybody who had caught monkeypox yet in my social circle, or even on social media.

I spent a week feeling good after the party, reconnecting with friends after my COVID infection, and soaking up summer. 

Then, about nine days after the dance, I started to feel a strange itch in the back of my throat. The tickle progressed into swelling over the next several days. I went to urgent care. No one even mentioned monkeypox. It wasn’t on my mind, or anyone else’s. I was tested for strep, syphilis, and other diseases. Nothing came back positive. 

My monkeypox appeared overnight



I counted at least 25 lesions on my body, including on my face, arms, legs, glutes, and in my mouth.

Joel Marino


On Sunday, a full two weeks after the party, I woke up and suddenly realized my throat was so swollen I couldn’t swallow properly. I couldn’t talk. I rushed to the mirror and, to my horror, my body was covered in little pimples and blisters. They had surfaced overnight like a bunch of mosquito bites. 

I had little red bumps all over my body — I counted more than two dozen on my face, hands, arms, legs, abdomen, and butt. I knew instantly that I had caught monkeypox. The incubation period lined up neatly with the dance party. 

The monkeypox diagnosis was so much harder on me than COVID, not just physically (the lesions were so painful at times that I could not even sit or lie down) — mentally and spiritually, the disease also really took a toll.

COVID didn’t hurt me in the same way emotionally. The disease has been intensely studied for more than two years, there are vaccines, booster shots, and treatments available, plus I knew what to expect. I have so many friends who’ve shared what it feels like to get COVID, so my loss of smell and taste weren’t a surprise, and mercifully the US now has a bountiful supply of free, at-home tests to confirm a diagnosis.

Surviving monkeypox meant dealing with internalized homophobic thoughts I hadn’t acknowledged in years

Monkeypox felt like my punishment for being a proud gay man. Having grown up in a fundamentalist Christian family, the son of a Pentecostal minister, I found thoughts that I’d abandoned long ago racing back into my fever dreams.

As I sweat through my sheets and my temperature climbed to 104 degrees Fahrenheit, I briefly considered going to the hospital, but I worried about putting others at risk, or getting stuck at the hospital for days on end, and eventually I thought, “Well, I just got through COVID by myself. I can get through monkeypox by myself, too.” 

Being home alone with monkeypox gave me a lot of time to think, overthink, and dissect my own thoughts about the diagnosis: “Is this a punishment from God? Have my wanton ways caught up to me? Have I been too hedonistic, and this is the universe’s cruel way of telling me so?”

Ideas about being gay that I hadn’t grappled with since my father put me into a single session of “reparative therapy” at age 19 all came swirling back. 

I wasn’t the only one having them.  

A lot of people have been spewing nasty rhetoric, both clear and coded, about the ways that people are getting monkeypox, suggesting monkeypox spreading to kids is something predatory and pedophilic, or even just that the disease isn’t their concern. Marjorie Taylor Greene’s comments that monkeypox is “not a threat” to “most of the population” were probably some of the most upsetting for me — such a classic othering of gay people, much like what happened during the AIDS crisis when I was a kid. It’s painful to see people still react this way when gay people get sick.

Watching episodes of “RuPaul’s Drag Race” and “Love, Victor” as I recovered really helped me counterbalance the apocalyptic, religious thoughts going on in my head. “Hey, it’s OK being gay, Joel,” I told myself. “Keep remembering that.”



“RuPaul’s Drag Race” was my salve for internalized homophobia.

VH1


My colleagues sent me pints of ice cream as a get-well gift, and the cold treat really helped with swelling in my throat (so did gargling salt water, although it was too painful at first). 

My scars, both the physical and emotional ones, are still healing

As I recover from monkeypox, I’ve been spending time visiting my family, and it’s nice to be together in person with the people I love after spending so long by myself sick and in isolation this summer. But there are things we do not mention. 

I haven’t pointed out to them the still-healing monkeypox scars on my body, the pinkish new skin left where lesions have scabbed off. Acknowledging the scars would be acknowledging my gayness in front of them. We don’t do that anymore. I came out to my family as a teenager, and after many contentious years in my 20s, we’ve reached a place now where nobody really wants to talk about my homosexuality. It’s too upsetting for everybody, including me. Seeing the visible scars of my infection as I type on my computer makes me wonder: “Is this something I have to address?” 



What my thumb looked like on July 13, left, and July 21, right. I named this particular lesion “Postule Malone.” There was also “Susan Boil” on my leg, a cluster on my torso I called “Legions of Tomorrow,” and “Blister Mistoffelees” on my nose.

Joel Marino


Once you have monkeypox, people start looking at you differently. A lot of my friends have asked me some version of a raised-eyebrow “How did that happen?” — which is something no one ever wondered about my COVID diagnosis. 

Now I tell all my gay friends, “Please get vaccinated as soon as you can.” Some have, others say “I’m careful” or “I’m in a relationship,” suggesting they aren’t worried about getting infected yet. 

People need to realize monkeypox is happening to people they know and love. And it isn’t a punishment for any moral misdeeds.

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An ER doctor says he’s sick of seeing monkeypox patients misdiagnosed, only to end up in the hospital in excruciating pain

Dr. Graham Walker, an emergency physician, treats monkeypox patients in San Francisco.Courtesy of Graham Walker

  • Experts in San Francisco, Miami, and the UK say many monkeypox cases are being “missed.”

  • Some patients are receiving false negative monkeypox tests, while others are being misdiagnosed.

  • Fear, stigma, miscommunication and misunderstanding all contribute.

More than 7,100 monkeypox patients have been diagnosed in the US since this outbreak began with a single case in mid-May.

But Dr. Graham Walker, an emergency physician in San Francisco, says that many more monkeypox patients are not being given the care and attention they deserve to prevent, diagnose, and treat this infectious disease efficiently.

Walker says he’s seen “several patients” whose monkeypox diagnosis was “missed” by another provider before they landed in his ER in excruciating pain.

“I had a patient who, I saw their record from another facility, and it said, ‘lesions only in the genitals, so unlikely to be monkeypox,'” he told Insider.

Other clinicians and scientists in the US, the UK, and West Africa say the same: monkeypox is being widely underdiagnosed.

Some misdiagnosed patients end up in so much pain they can’t wear clothes

Across the country from Walker’s ER, Dr. Lilian Abbo, an infectious disease specialist at the University of Miami, says she’s noticed the same issue.

“We have seen patients that have been going up to seven centers: three different urgent cares, dermatologists, and ERs to try to figure out what is going on,” she said during a recent Infectious Diseases Society of America telebriefing, stressing the need for better awareness of how monkeypox can present.

Better awareness can have huge implications for both treatment, and disease containment. It’s possible that if close contacts find out early enough in the course of their infection (meaning, in the first 4 days after an exposure) the Jynneos smallpox vaccine may be used to prevent monkeypox infection altogether.

But, “by the time they arrive,” many patients who’ve been misdiagnosed “may have been healed, or some of them may have progression of disease,” Abbo said. That progression can be painful.

Patients in this outbreak have, in some of the most severe presentations, been unable to use the toilet, because the pain around their anus and genitals becomes so severe. “One of my patients said ‘I can’t even wear pants or underwear without pain,'” Walker said.

‘Textbook’ descriptions of symptoms aren’t always accurate

Matt Ford underestimated the pain from monkeypox.Matt Ford

Part of the reason why monkeypox is being underdiagnosed is that this disease outbreak isn’t operating like the “textbook” monkeypox presentations of the past, with a classical fever, swollen lymph nodes in the neck, and headache all appearing before pox surface on the face and on the hands.

Instead, monkeypox lesions may be lodged in the rectum, lymph node swelling may be present only in the groin, and it’s not unusual for a single pock to be the only marker of a person’s entire infection.

A July 21 New England Journal of Medicine compilation of 528 case reports from 16 countries around the world establishes some clear patterns for this outbreak. Nearly two-thirds of the patients studied had lesions in their anogenital (private) area, with a majority of patients counting less than 10 lesions on their entire body.

Patients were “presenting with symptoms that weren’t part of the case definitions,” NEJM study author Chloe Orkin told Insider. “The important thing is to help doctors to recognize it.”

Fever, fatigue, muscle aches and headaches were some of the most common pre-rash signs a monkeypox infection was budding, which also makes it easy for people to confuse the condition with COVID, initially.

“Every single patient I’ve talked to has done a COVID test when they had a fever, and they’re like, ‘oh, it’s not COVID,'” Walker said.

Other times, diagnoses are missed because providers don’t get a “good, aggressive scrub” of the lesions, he said.

“I’ve seen that before, where people have had a test that came back negative and I’m like, ‘you have literally every symptom of monkeypox, this looks exactly like all the other monkeypox cases I’m seeing, and we’ve ruled out other stuff, like herpes, syphilis, whatever.'”

Some people avoid monkeypox diagnosis because it can be stigmatizing, painful, and lonely

Early treatment is key to curb a monkeypox infection and prevent the excruciating pain it causes. The antiviral drug Tecovirimat (TPOXX) can help, as well as prescription painkillers which are stronger than Motrin and Advil.

But many patients, fearing stigma and lacking information, are not seeking help.

One of Walker’s patients had been managing his lesions alone for two full weeks, when he finally decided to seek treatment.

“He just wanted to manage it at home. He was worried about the stigma, he said he’d never had an STD before. But the pain was so severe, he finally came in,” Walker explained. “There’s lots of fear, there’s lots of anxiety, and to be honest, there’s probably a lot of people who aren’t diagnosed yet,” he added.

Dr. Jason Zucker, an infectious disease specialist at New York Presbyterian hospital, said “even patients with mild disease have been taking it very hard” when they receive a monkeypox diagnosis.

“In addition to this stigma, patients who are diagnosed then isolate at home for up to four weeks alone,” he told journalists on a Zoom call Friday. “It’s important to make sure that we’re all cognizant of this, that we all work together to reduce stigma, and that we offer patients mental health and other supportive resources after their diagnosis.”

A Nigerian doctor spotted this kind of monkeypox in 2017. He hopes people will finally start funding research on this virus.

In Nigeria, where Dr. Dimie Ogoina has been studying monkeypox outbreaks linked to sexual contact since 2017, he says he’s struggled with similar issues of confusion and stigma, which both make it harder to get a sense of the true scope of any outbreak.

Often, he suspects, patients with “genital lesions” aren’t coming to the hospital to be properly diagnosed, instead, they’re just going to the pharmacy for STD treatment.

“There are a lot of things that still not known about monkeypox”  because “it has been a neglected disease,” Ogoina told Insider. “Since the global north is now having cases, I’m sure there will be investments in research, and we will be able to uncover most of these unknowns.”

Read the original article on Insider

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An ER doctor says he’s sick of seeing monkeypox patients misdiagnosed, only to end up in the hospital in excruciating pain

Dr. Graham Walker, an emergency physician, treats monkeypox patients in San Francisco.Courtesy of Graham Walker

  • Experts in San Francisco, Miami, and the UK say many monkeypox cases are being “missed.”

  • Some patients are receiving false negative monkeypox tests, while others are being misdiagnosed.

  • Fear, stigma, miscommunication and misunderstanding all contribute.

More than 7,100 monkeypox patients have been diagnosed in the US since this outbreak began with a single case in mid-May.

But Dr. Graham Walker, an emergency physician in San Francisco, says that many more monkeypox patients are not being given the care and attention they deserve to prevent, diagnose, and treat this infectious disease efficiently.

Walker says he’s seen “several patients” whose monkeypox diagnosis was “missed” by another provider before they landed in his ER in excruciating pain.

“I had a patient who, I saw their record from another facility, and it said, ‘lesions only in the genitals, so unlikely to be monkeypox,'” he told Insider.

Other clinicians and scientists in the US, the UK, and West Africa say the same: monkeypox is being widely underdiagnosed.

Some misdiagnosed patients end up in so much pain they can’t wear clothes

Across the country from Walker’s ER, Dr. Lilian Abbo, an infectious disease specialist at the University of Miami, says she’s noticed the same issue.

“We have seen patients that have been going up to seven centers: three different urgent cares, dermatologists, and ERs to try to figure out what is going on,” she said during a recent Infectious Diseases Society of America telebriefing, stressing the need for better awareness of how monkeypox can present.

Better awareness can have huge implications for both treatment, and disease containment. It’s possible that if close contacts find out early enough in the course of their infection (meaning, in the first 4 days after an exposure) the Jynneos smallpox vaccine may be used to prevent monkeypox infection altogether.

But, “by the time they arrive,” many patients who’ve been misdiagnosed “may have been healed, or some of them may have progression of disease,” Abbo said. That progression can be painful.

Patients in this outbreak have, in some of the most severe presentations, been unable to use the toilet, because the pain around their anus and genitals becomes so severe. “One of my patients said ‘I can’t even wear pants or underwear without pain,'” Walker said.

‘Textbook’ descriptions of symptoms aren’t always accurate

Matt Ford underestimated the pain from monkeypox.Matt Ford

Part of the reason why monkeypox is being underdiagnosed is that this disease outbreak isn’t operating like the “textbook” monkeypox presentations of the past, with a classical fever, swollen lymph nodes in the neck, and headache all appearing before pox surface on the face and on the hands.

Instead, monkeypox lesions may be lodged in the rectum, lymph node swelling may be present only in the groin, and it’s not unusual for a single pock to be the only marker of a person’s entire infection.

A July 21 New England Journal of Medicine compilation of 528 case reports from 16 countries around the world establishes some clear patterns for this outbreak. Nearly two-thirds of the patients studied had lesions in their anogenital (private) area, with a majority of patients counting less than 10 lesions on their entire body.

Patients were “presenting with symptoms that weren’t part of the case definitions,” NEJM study author Chloe Orkin told Insider. “The important thing is to help doctors to recognize it.”

Fever, fatigue, muscle aches and headaches were some of the most common pre-rash signs a monkeypox infection was budding, which also makes it easy for people to confuse the condition with COVID, initially.

“Every single patient I’ve talked to has done a COVID test when they had a fever, and they’re like, ‘oh, it’s not COVID,'” Walker said.

Other times, diagnoses are missed because providers don’t get a “good, aggressive scrub” of the lesions, he said.

“I’ve seen that before, where people have had a test that came back negative and I’m like, ‘you have literally every symptom of monkeypox, this looks exactly like all the other monkeypox cases I’m seeing, and we’ve ruled out other stuff, like herpes, syphilis, whatever.'”

Some people avoid monkeypox diagnosis because it can be stigmatizing, painful, and lonely

Early treatment is key to curb a monkeypox infection and prevent the excruciating pain it causes. The antiviral drug Tecovirimat (TPOXX) can help, as well as prescription painkillers which are stronger than Motrin and Advil.

But many patients, fearing stigma and lacking information, are not seeking help.

One of Walker’s patients had been managing his lesions alone for two full weeks, when he finally decided to seek treatment.

“He just wanted to manage it at home. He was worried about the stigma, he said he’d never had an STD before. But the pain was so severe, he finally came in,” Walker explained. “There’s lots of fear, there’s lots of anxiety, and to be honest, there’s probably a lot of people who aren’t diagnosed yet,” he added.

Dr. Jason Zucker, an infectious disease specialist at New York Presbyterian hospital, said “even patients with mild disease have been taking it very hard” when they receive a monkeypox diagnosis.

“In addition to this stigma, patients who are diagnosed then isolate at home for up to four weeks alone,” he told journalists on a Zoom call Friday. “It’s important to make sure that we’re all cognizant of this, that we all work together to reduce stigma, and that we offer patients mental health and other supportive resources after their diagnosis.”

A Nigerian doctor spotted this kind of monkeypox in 2017. He hopes people will finally start funding research on this virus.

In Nigeria, where Dr. Dimie Ogoina has been studying monkeypox outbreaks linked to sexual contact since 2017, he says he’s struggled with similar issues of confusion and stigma, which both make it harder to get a sense of the true scope of any outbreak.

Often, he suspects, patients with “genital lesions” aren’t coming to the hospital to be properly diagnosed, instead, they’re just going to the pharmacy for STD treatment.

“There are a lot of things that still not known about monkeypox”  because “it has been a neglected disease,” Ogoina told Insider. “Since the global north is now having cases, I’m sure there will be investments in research, and we will be able to uncover most of these unknowns.”

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Monkeypox Patients Report Excruciating Pain and Lack of Guidance as U.S. Cases Mount

Taber Feltner, a research associate in Iowa City, Iowa, said he noticed some worrying symptoms in mid-July, a few days after returning home from a trip to Chicago.

A rash developed in his groin, which he initially brushed off as ingrown hairs. But within a few days, he developed a fever of over 103 degrees Fahrenheit and the rash transformed into painful, pus-filled lesions.

“I’ve never been that sick in my life,“ said Mr. Feltner.

More than two months after monkeypox was detected in the U.S. as part of a global outbreak mostly among men who have sex with men, transmission shows no sign of slowing. The U.S. has surpassed Spain as the country with the most known cases. Federal officials are considering whether to declare monkeypox a public-health emergency.

The continuing spread of monkeypox has prompted the World Health Organization to declare a global health emergency. WSJ’s Denise Roland explains what you need to know about the outbreak. Photo: Kena Betancur/AFP/Getty Images

Patients said they are navigating the outbreak without sufficient guidance from physicians and public-health officials on how to treat the disease and prevent its spread. Mr. Feltner said he wasn’t able to get vaccinated before travel because Iowa gave priority to people who had been exposed to monkeypox. He said he was mocked by healthcare providers when he attempted to seek care and struggled to find adequate expert information about the disease. He said he has relied on social media and the anecdotal accounts of other patients to fill the gaps.

“Trying to get questions answered was impossible,” said Mr. Feltner.

Public-health experts and community advocates said the Biden administration and the Centers for Disease Control and Prevention were too slow at responding to the outbreak when it first emerged and continue to take insufficient action to stem the spread of the virus.

“We’re not getting streamlined communication to communities. People are making things up as they go. That’s not the best public-health strategy,” said Jason Rosenberg, a member of ACT UP NY, an HIV/AIDS advocacy organization.

Taber Feltner, a research associate in Iowa City, Iowa, said it took several days to get access to testing and treatment for monkeypox.



Photo:

Taber Feltner

The CDC said it was wrong to suggest that it hadn’t taken early and adequate action to mitigate the outbreak and to educate communities about monkeypox.

“All summer, [the] CDC has been working with partners to help put information in the hands of people who may be at highest risk for contracting monkeypox,” an agency spokesperson said, adding that the CDC continues to work with community health organizations to raise awareness about the virus.

The Department of Health and Human Services didn’t immediately respond to requests for comment.

To date, there have been more than 5,800 confirmed or suspected cases in the U.S., mostly among men who have sex with men, federal health officials said. Epidemiologists said the virus is exploiting close-knit social and sexual networks, but knowledge of how the virus is spreading in this current outbreak remains incomplete.

“We have to be very humble about what we know and what we don’t,” said Anne Rimoin, an epidemiologist at the University of California, Los Angeles, who spent two decades studying monkeypox in Africa, where the disease has long been endemic. “What we know is based on studies done in very different epidemiological and ecological contexts. We need to know much more about transmissibility.”

The World Health Organization, which declared monkeypox a global health emergency, says monkeypox is most commonly spread through close contact with an infected person’s rash, lesions and bodily fluids. The virus can also spread via fabrics and other materials, and through prolonged exposure to an infected person’s saliva or mucus.

Aerosol, also known as airborne, transmission of the virus hasn’t been considered to be of significant concern by public-health experts, but some early research suggests it could be possible in certain conditions. Airborne transmission is defined as the dissemination of a virus through very small droplets that remain suspended in the air over long distances and time.

Public-health experts recommended that people at risk for infection get vaccinated when possible, not share bedding or towels, wash hands often, and avoid intimate physical contact with someone with rashes or sores, or limit sexual partners altogether.

People waiting in line for the monkeypox vaccine in Los Angeles last week.



Photo:

robyn beck/Agence France-Presse/Getty Images

A person can spread monkeypox until all their lesions have scabbed and the scabs have fallen off, infectious-disease experts said. Public-health officials have advised potentially infectious people to remain quarantined for the duration of their illness. Monkeypox symptoms typically last two to four weeks, the CDC said.

Most monkeypox cases in the U.S. have been mild, though moderate and severe cases have been reported. A recent study in the New England Journal of Medicine of more than 500 monkeypox patients in 16 countries found that 13% were hospitalized, mostly for pain.

It is hard to predict who will experience a severe case, said Peter Chin-Hong, a professor of medicine at the University of California, San Francisco, noting that patients in his care haven’t been immunocompromised or very old. “The people who are hospitalized are very, very sick,” he said.

Josh Watson of Chicago said he developed lesions on different parts of his body, including some in his throat that made it difficult to eat and drink. He was hospitalized and treated with the antiviral drug tecovirimat in mid-July. The drug, sold by New York-based

Siga Technologies Inc.

under the brand name TPOXX, has been approved by the Food and Drug Administration for the treatment of smallpox, a disease closely related to monkeypox.

Amid the outbreak, the FDA and CDC have approved expanded access of TPOXX to monkeypox patients, but healthcare providers said obtaining the drug has been burdensome. Until recently, it took providers several hours to complete extensive FDA and CDC paperwork and other requirements to get the drug to patients, said Cathy Creticos, medical director of infectious disease at Howard Brown Health, a nonprofit LGBTQ healthcare and social services provider in Chicago. The CDC simplified the protocol to obtain TPOXX late last month.

Twenty days after his first monkeypox symptoms appeared, Mr. Watson said he remained quarantined with a lesion on his foot and lingering fatigue.

“The risks of monkeypox have been severely downplayed,” Mr. Watson said. “People need to know that the risk is greater, the symptoms are greater. What I’d heard is that you get a rash for a couple of weeks and then it’ll go away, you won’t die. But no one was talking about the pain, the difficulty urinating or having bowel movements.”

Tecovirimat, also known as TPOXX, a treatment for smallpox, has been prescribed for monkeypox patients amid the outbreak.



Photo:

yuki iwamura/Agence France-Presse/Getty Images

Some patients with moderate to severe symptoms said their symptoms improved significantly after taking TPOXX. Healthcare providers said most monkeypox cases in the U.S. have resolved without medical intervention.

Mr. Feltner said it took many days before he was able to get access to testing and treatment for monkeypox.

He said a nursing assistant at an urgent-care clinic in Iowa City laughed at him when he suggested he had monkeypox. A doctor at the clinic diagnosed him with herpes and refused to test him for monkeypox, Mr. Feltner said. The doctor sent him home with Valtrex, an antiviral drug used to treat herpes.

The medication didn’t work. “Things just got worse,” said Mr. Feltner, who was eventually hospitalized and given TPOXX.

“Our healthcare system here is definitely not ready for this disease,” Mr. Feltner said.

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