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For the past two years, 52-year-old Kendra Jackson of Omaha, Nebraska just thought she had a bad cold."When it first started out, I just thought it was my allergies or a runny nose -- like the beginning of a fresh cold," Jackson said.The coughing, sneezing and runny nose began 2? years after Jackson was involved in a serious car accident. She remembers hitting her face against the dashboard, and she has struggled with migraine headaches ever since.In 2015, Jackson's "runny nose" began to worsen."When it didn't go away, I kept going back and forth to the doctors, and they prescribed every kind of medicine you can think of, and my nose just kept on running," she said.The doctors she saw told her that she probably had allergies. But this year, Jackson went to physicians at the University of Nebraska Medical Center and learned the real reason behind her nasal discharge: a cerebrospinal fluid (or CSF) leak caused by a small hole in her skull."She would wake up in the morning after sleeping upright in a chair, and the whole front of her shirt was wet with fluid. It was a lot of fluid," said Dr. Christie Barnes, a rhinologist at the University of Nebraska Medical Center and a lead surgeon on the case.Jackson said she was losing about half a liter of fluid per day.A physician's assistant "astutely recognized right away that this was something different than a runny nose and was consistent with a CSF leak. So we had her collect her fluids and sent it off for evaluation," Barnes said.Cerebrospinal fluid is a clear, colorless fluid that surrounds and protects the brain and spinal cord. The fluid also helps to remove waste products from the brain and distribute nutrients and other substances throughout the central nervous system, according to the Cleveland Clinic."CSF is a fluid that actually bathes the brain. Because the skull is a fixed box and the brain is a nice soft organ, it needs to be protected from moving around inside that hard box," Barnes said. "So it actually provides a cushion for the brain and the spinal cord."Cerebrospinal fluid is produced continuously in the brain and is normally absorbed into the bloodstream through protrusions in the outer membrane of the brain, called the dura mater.But in Jackson's case, a tiny hole in her cribriform plate -- a thin bone that separates her cranial and nasal cavities -- allowed the fluid to drip into her nose and mouth, resulting in her symptoms.According to Barnes, this part of the skull is "very thin, less than a potato chip. And it's one of the most common locations for this type of a CSF leak," Barnes said.Cerebrospinal fluid leaks are relatively rare, occurring in approximately five in 100,000 individuals worldwide every year. They are most commonly caused by trauma or surgery, according to the CSF Leak Association.In Jackson's case, the physicians believe that her car accident may have caused a small hole that increased in size over time."She was rear-ended and had head trauma, so it's certainly possible," Barnes said. "It may have caused a bit of a thin area there. Her symptoms actually started a little bit after (the accident), so for her, I think there's probably a combination of both the trauma and the increased pressure."Depending on the amount of fluid loss, cerebrospinal fluid leaks can be life-threatening. They also place the patient at an increased risk of infections such as meningitis, according to Barnes.In order to treat Jackson's condition, physicians at the University of Nebraska Medical Center performed a surgery that plugged the hole in her skull using tissue from her nose and abdomen, Barnes said."I used tissue from the inside of her nose to plug the leak," Barnes said. "I also borrowed some abdominal fat; it makes a great plugging agent in this location, so with just a tiny bit of fat, I was able to plug the leak."Almost a month after the surgery, Jackson is back home and reports that the mysterious drip has disappeared."I don't have the nasal drip anymore, but I still have the headaches," she said. "I actually feel pretty good, and I'm able to get a little bit of sleep."Though her condition is rare, Jackson wants people to know that cerebrospinal fluid leaks can occur, particularly after head trauma: "For people who hear my story, if they're tasting a very salty taste and something's draining in the back of your throat, it's probably something other than allergies. So get to the doctor." 4474

Florida Panhandle officials are trying to figure out how to resume classes after Hurricane Michael damaged or destroyed many schools last week.Schools in at least eight counties -- Washington, Liberty, Jackson, Gulf, Gadsden, Franklin, Calhoun and Bay -- will remain closed until further notice, the office of Gov. Rick Scott said Monday in a news release.The challenge is especially daunting in Bay County."I would say every single school in Bay County has some type of damage, some more extensive than others," said Steve Moss, vice chairman of Bay District School Board. "Some it'll probably take weeks or months to get online. Some it will take years."The only thing left of some of our schools ... is the foundation."Moss said he and his colleagues are working to come up with a plan to get thousands of students back in the classroom as soon as possible."We basically have 26,000 students here in Bay County," he said. "They still need educational services. They still need to learn."High school seniors have been told they will be able to graduate, Moss said. Younger students won't be held back from the next grade."Now, to be able to do that, they have to been in a classroom setting," according to state law, Moss said, with the wreckage of Jinks Middle School's gymnasium in Panama City, Florida, behind him.It was just renovated last month, with a new floor and lighting, Moss said. But now the gym's interior is completely exposed to the elements and the floor is littered with debris.Bay County's school officials are holding a meeting Monday morning to discuss how to get students back in classrooms, Moss said. 1644

For the sixth time in the Atlantic hurricane season, people in Louisiana are once more fleeing the state’s barrier islands and sailing boats to safe harbor while emergency officials ramp up command centers and consider ordering evacuations.The storm being watched Wednesday was Hurricane Delta, the 25th named storm of the Atlantic’s unprecedented hurricane season. Forecasts placed most of Louisiana within Delta’s path, with the latest National Hurricane Center estimating landfall in the state on Friday.The center’s forecasters warned of winds that could gust well above 100 mph (160 kph) and up to 11 feet (3.4 meters) of ocean water potentially rushing onshore when the storm’s center hits land.“This season has been relentless,” Louisiana Gov. John Bel Edwards said, dusting off his now common refrain of 2020 - “Prepare for the worst. Pray for the best.”A hurricane warning has been issued for a stretch of the northern U.S. Gulf Coast. The National Hurricane Center in Miami said Delta is expected to become a major hurricane again, like it was days earlier before crossing part of Mexico’s Yucatan Peninsula. But some weakening is forecast once Delta approaches the northern Gulf Coast on Friday.So far, Louisiana has seen both major strikes and near misses. The southwest area of the state around Lake Charles, which forecasts show is on Delta’s current trajectory, is still recovering from an Aug. 27 landfall by Category 4 Hurricane Laura.Nearly six weeks later, some 5,600 people remain in New Orleans hotels because their homes are too damaged to occupy. Trees, roofs and other debris left in Laura’s wake still sit by roadsides in the Lake Charles area waiting for pickup even as forecasters warned that Delta could be a larger than average storm.New Orleans spent a few days last month bracing for Hurricane Sally before it skirted to the east, making landfall in Alabama on Sept. 16.Delta is predicted to strengthen back into a Category 3 storm after hitting the Mexican Yucatan Peninsula on Wednesday, then weaken slightly as it approaches Louisiana. The National Hurricane Center forecast anticipated the storm will come ashore in a sparsely populated area between Cameron and Vermilion Bay.Edwards said President Donald Trump has agreed to sign a federal emergency declaration in advance for the state. The Democratic governor said he doesn’t expect widespread mandatory evacuations.But Edwards said Wednesday that Delta is moving fast, so hurricane force winds could reach well inland, and expected heavy rains could cause flooding.Plywood, batteries and rope already were flying off the shelves at the Tiger Island hardware store in Morgan City, Louisiana, which would be close to the center of the storm’s path.“The other ones didn’t bother me, but this one seems like we’re the target,” customer Terry Guarisco said as a store employee helped him load his truck with plywood needed to board up his home.In Sulphur, across the Calcasieu River from Lake Charles, Ben Reynolds was deciding whether to leave or stay. He had to use a generator for power for a week after Hurricane Laura.“It’s depressing,” Reynolds said. “It’s scary as hell.”By sundown Wednesday, Acy Cooper planned to have his three shrimp boats locked down and tucked into a Louisiana bayou for the third time this season.“We’re not making any money,” Cooper said. “Every time one comes we end up losing a week or two.”Lynn Nguyen, who works at the TLC Seafood Market in Abbeville, said each storm threat forces fisherman to spend days pulling hundreds of crab traps from the water or risk losing them.“It’s been a rough year. The minute you get your traps out and get fishing, its time to pull them out again because something is brewing out there,” Nguyen said.Elsewhere in Abbeville, Wednesday brought another round of boarding up and planning, said Vermilion Chamber of Commerce Executive Director Lynn Guillory.“I think that the stress is not just the stress of the storm this year, it’s everything – one thing after another,” Guillory said. “Somebody just told me, ‘You know, we’ve really had enough.’”On Grand Isle, the Starfish restaurant planned to stay open until it ran out of food Wednesday. Restaurant employee Nicole Fantiny then planned to join the rush of people leaving the barrier island, where the COVID-19 pandemic already devastated the tourism industry.“The epidemic, the coronavirus, put a lot of people out of work. Now, having to leave once a month for these storms — it’s been taking a lot,” said Fantiny. She tried to quit smoking two weeks ago but gave in and bought a pack of cigarettes Tuesday as Delta strengthened.While New Orleans has been mostly spared by the weather and found itself outside Delta’s cone Wednesday, constant vigilance and months as a COVID-19 hot spot have strained a vulnerable city still scarred by memories of 2005′s Hurricane Katrina. Delta’s shifting forecast track likely meant no need for a major evacuation, but the city’s emergency officials were on alert.“We’ve had five near misses. We need to watch this one very, very closely,” New Orleans Emergency Director Collin Arnold said.Along with getting hit by Hurricane Laura and escaping Hurricane Sally, Louisiana saw heavy flooding June 7 from Tropical Storm Cristobal. Tropical Storm Beta prompted tropical storm warnings in mid-September as it slowly crawled up the northeast Texas coast.Tropical Storm Marco looked like it might deliver the first half of a hurricane double-blow with Laura, but nearly dissipated before hitting the state near the mouth of the Mississippi River on Aug. 24.“I don’t really remember all the names,” Keith Dunn said as he loaded up his crab traps as a storm threatened for a fourth time this season in Theriot, a tiny bayou town just feet above sea level.And there are nearly eight weeks of hurricane season left, although forecasters at the National Weather Service office in New Orleans noted in a discussion Tuesday of this week’s forecast that outside of Delta, the skies above the Gulf of Mexico look calm.“Not seeing any signs of any additional tropical weather in the extended which is OK with us because we are SO DONE with Hurricane Season 2020,” they wrote.___Santana reported from New Orleans. Gerald Herbert in Theriot, Louisiana; Kevin McGill in New Orleans; Melinda Deslatte in Baton Rouge, Louisiana; Leah Willingham in Jackson, Mississippi; and Jeffrey Collins in Columbia, South Carolina, contributed to this report. 6475

Firefighters battling the West Coast wildfires say this year's blazes are some of the worst they have ever seen.They say the fires are taxing the human, mechanical and financial resources of the nation's wildfire fighting forces to an extraordinary degree. And half of the fire season is yet to come.Heat, drought and a strategic decision to attack the flames early combined with the coronavirus to put a historically heavy burden on fire teams.Justin Silvera is a 43-year-old battalion chief with Cal Fire, California's state firefighting agency. He says new fires break out before existing ones are contained.“There’s never enough resources,” said Silvera, one of nearly 17,000 firefighters in California. “Typically with Cal Fire we’re able to attack — air tankers, choppers, dozers. We’re good at doing that. But these conditions in the field, the drought, the wind, this stuff is just taking off. We can’t contain one before another erupts.”According to The Associated Press, fire crews have been summoned from at least nine states and several other countries, including Canada and Israel. Mutual agreements for agencies to offer assistance have been maxed out at nearly all levels of government."We know that there's really nothing left in the bucket," Washington State Forester George Geissler told The Associated Press. "Our sister agencies to the south in California and Oregon are really struggling."Western states have been seeking assistance in fighting wildfires since mid-August. On Aug. 19, California, Gov. Gavin Newsom asked for assistance from other states in fighting fires, saying that resources were already "stretched." Since then, hundreds of thousands of acres have forest has continued to burn.The Associated Press also reports that experts believe the COVID-19 pandemic has contributed to the historic fire season. In June, U.S. Forest Service Chief Vickie Christiansen issued a directive to aggressively fight all fires, hoping to minimize the need for large groups of firefighters before blazes got out of control.However, experts say that the directive allowed forest fire fuels that would have typically already burned to build up, allowing the fires to spread more quickly in recent weeks.Officials hope that cooler, wet weather in the Pacific Northwest could assist firefighters in containing blazes in the coming days. However, forest fire season lasts through October on the West Coast, meaning officials still face an uphill battle. 2475

Friday, Oct. 16 has been dubbed Global Cat Day, a day dedicated to saving cats and kittens from being killed.This comes at a time when many longstanding threats to felines have the potential to race forward, according to Alley Cat Allies.The organization dedicated to protecting cats says local shelters have seen an increase in impoundments as the pandemic continues to hit families financially, leaving them unable to care for their beloved animals."Too often, our disconnect from society during the pandemic is allowing dangerous animal control and shelter policies to advance unchecked in our communities,” said the organization’s president, Becky Robin son. “Global Cat Day is a reminder that the international movement to protect cats can never stop, even when so much of the world does."In addition to families turning over their felines, the organization says less cats are being spayed or neutered due to many veterinary clinics operating at reduced capacity.Robinson said these developments will impact cats for years to come.“Global Cat Day 2020 is a day to c