Thursday, May 7, 2009

How to Take Care of Maggot Infestation in Humans

"eeeeeew!!", that's the reaction everyone has on reading the phrase, "maggot infestation of live humans!!" a concept which has given rise to many urban legends. The reality is that alive humans DO get infected with maggots.

Maggot is the common term used to refer to fly larvae. Undoubtedly, there are as many types of maggots as there are flies. Depending on the parent fly, maggots may have characteristic features such as a certain coloration and measurement. Most of them however are worm-like, headless, limbless creatures with their length ranging from 1-30 millimeter. They are equipped with hook like structures which help them remain lodged at host site until they are ready to pupate.

Uses of Maggots
Maggots are used extensively as baits for fishing and as food for meat eating pet animals. They are also used for therapeutic purposes to clean persistent wounds and encourage faster healing. This process referred to as maggot debridement therapy is performed under medical supervision using laboratory grown dead tissue eating maggots.

Forensic scientists use maggots developing in dead decaying bodies to gauge the time of death.

Maggots are even used in making a special kind of Italian cheese named formaggio marcio or casu marzu. This extra soft cheese, obtained by the action of digestive juices of Piophila casei maggots, is legally banned for obvious health reasons.

Maggot Infestation of Living Beings
At times, maggots start developing in living beings, a condition medically termed myiasis. It may occur in animals as well as humans. The condition may affect genitalia, anus, intestines, eyes, mouth, ears, nose and sinuses of suitable hosts.

Maggot infestation symptoms depend on the affected site. Larvae lodging themselves in the intestines may cause nausea, severe diarrhea, stomach ache and other gastrointestinal complications. When affecting nose, the maggots may cause edema, headaches and fever. Skin infestation may cause an outburst of rashes.

The primary cause of maggot infestation is unhygienic living conditions. Inadequate care of open wounds and lesions as in case of cancer patients or diabetics may also be a causative factor. With general hygiene practices in place, maggot infestation is quite unheard of and comes as a complete surprise. But you know, here in India we have a colorful idiom which roughly translates to cursing someone with an invasion of worms. After seeing maggots infesting a live human, this is the only saying that comes to mind and then one realizes, "our forefathers certainly knew enough about the grossness of this situation to come up with a curse like that!"

In spite of following a hygienic routine, at times it is just impossible to control certain things. Open wounds, facial cancers and lesions for instance attract flies even if they are covered properly. It's in such cases simply a matter of time…

Treatment for Maggot Infestation
The only positive angle to maggot infestation is that the larvae eventually fall out of the body because they typically pupate in dry places. But, the very thought (and sight too) of a living human being housing hundreds of worm-like wriggling creatures in the body and/or jumping out of it is so horrifying that patients and their caregivers find it difficult to stand it.

Patients can be taken to a hospital where the medical staff may apply local anesthesia, apply pressure on the affected area to force the maggot peek out of the wound when it is quickly pulled out with a forceps. The wound is then cleaned and covered with bandages. If done clumsily, this procedure runs the risk of larval body breaking while being extracted out. The ensuing release of larval body fluids may cause an allergic reaction in the host.

A safe way of getting rid of maggots is by blocking their oxygen supply. Doctors recommend using petroleum jelly or 100% pure turpentine oil. Both these components force the maggots to come out of deeper layers of the skin. Turpentine oil however has other side effects. Always consult your doctor about optimum dosage and the way in which turpentine oil needs to be used.
Once the maggots are out, primary caregivers need to be more proactive. Change the dressing more frequently. Apply generous amounts of prescribed medication. Check if using petroleum jelly or turpentine oil along with medication is okay. Take care that at least the patient's room has no flies. With due precautions, maggot infestation may not recur.

Monday, April 27, 2009

Taking Care of Fistula, Open Wounds and Odors in Cancer Patients

Some cancer patients develop abnormal holes inside or on their body. Such unnatural openings in the body, referred to as fistula, do not form in a healthy body. Artificially created holes, as in case of body piercings, differ from fistula in the sense that skin surrounding these holes heals properly in a healthy body. In cancer patients however, fistula formation may not heal. Instead, it may grow bigger paving way for larger and larger open wounds.

Those who are dealing with it know very well how difficult it is to take care of such non-healing wounds. Constant pus secretion is an additional problem. Another serious issue associated with open wounds is the number of flies, insects, cockroaches and even small rodents they attract. Maggot infestation then becomes only a matter of slight negligence.

The situation gets complicated even more if the patient has that sickening cancer smell about him/her. Though everyone is concerned about the patient, the strong unpleasant odor makes it next to impossible to even come near the patient. Friends and family members too start hesitating.

Through our struggle with cancer, we accidentally came across an effective solution – the use of neem leaves charred in cow's milk ghee. Notice that this is "an effective solution" only in terms of better managing the fistula and odor. It does NOT in anyway cure it.

Before proceeding, let's first talk about neem and ghee.

Neem, Azadirachta indica, commonly found in South Asian countries and Africa is said to have exceptional medicinal qualities. All parts of this tree are used to produce a variety of medicinal products. Use of neem in soaps, hair care and skincare products is very common. Local people frequently use its soft twigs for daily dental hygiene. Adding neem leaves to bathwater is considered to prevent skin problems.

Ghee, or clarified butter is again very popular in South Asian countries including India, Sri Lanka, Bangladesh and Pakistan. Though people living in rural areas prepare ghee regularly even today, those living in urban regions simply purchase it from a store. Those new to ghee can find it in a nearby South Asian or Indian groceries store.

How to Blend Neem and Ghee Together?
The procedure for preparing this blend was printed in a widely published local magazine. Since we had nothing to lose, we thought of giving it a try, more so because neem and ghee are devoid of any side effects.

Take some ghee made from cow's milk and neem leaves. Here in India, we just pluck a few twigs from the tree, pick the leaves and discard the rest. I'm not sure how one can mange to get neem leaves in places where neem tree is not so common.

Melt the ghee in a suitable cooking pot, add neem leaves to it and let it cook until the leaves are charred. When cooking, the leaves make a crackling sound and eventually blacken totally. Turn off the heat at this time and let the brew cool down. Skim all leaves out of the ghee, crush them with your hands and mix them back in ghee. Store this preparation. It lasts as it is for a long time.

How To Use Neem and Ghee Paste?
Before using the neem and ghee preparation, clean the wound properly according to your doctor's advice. Smear some neem-ghee paste just before applying bandage. Cover the wound as advised.

Advantages of Using Neem and Ghee Paste
The neem ghee paste is a good amalgamation of excellent medicinal properties in an efficient lubricant. The use of this preparation helped us in many ways. To begin with, it prevented minor skin ruptures which invariably occurred in spite of us being extremely careful when changing the dressing. This in turn immediately brought down patient discomfort when changing bandage.

The pus secretion also became somewhat controlled.

Other significant benefits we observed were a dramatic loss of the repulsive smell and flies hovering around the patient. Of course, it didn't affect the rate at which the disease progressed, but at least it made it easier to keep the fistula clean and the patient almost odor free.