Monday, July 8, 2019

Like a Heat Wave, Burning in My Heart


On a nice sunny California day, you find yourself hiking through the redwood forest in Yosemite National Park.  As you come around a bend to a small opening among the trees, you find a husband and wife in the clearing. The wife comes up to you, she is frantic and says that her husband is not acting right and may have had a seizure.  You approach the husband and note that he is very sweaty, flushed in the face, confused and not answering questions coherently. You suspect that he has a heat related illness. Despite his protestations, you are able to coax him into the shade and apply cold-water compresses. The park rangers are notified and they transport him to an Emergency Room. 

Heat related illnesses range from benign heat cramps, to heat exhaustion, to heat stroke, a life-threatening emergency. Our Yosemite hiker likely had heat stroke. Heat related illnesses are becoming more prevalent with global warming and heat waves that occur more often and that are more intense.  In fact, last month, June 2019, was the warmest June ever recorded. The hot June was mostly driven by a heat wave in Europe.  Temperatures in France topped 110 degrees and in Athens the Acropolis was closed due to the heat.  There seemed to be no escape from the heat in June as Anchorage Alaska hit 90 degrees for the first time ever.

Heat stroke is a medical emergency and must be recognized and treated immediately. There are two types of heat stroke. In classic heat stroke, there is exposure to excess heat, as during a heat wave. The body cannot dissipate the heat in the environment. It occurs in the elderly, in chronically ill patients and in those who cannot take care of themselves (for example an infant in a hot car).  Exertional heat stroke occurs with excess production of heat. The body’s ability to dissipate the heat is overwhelmed by the heat produced. It strikes those who do strenuous physical activity, such as athletes, farm laborers, firefighters and soldiers. It does not always occur in hot weather and can happen at any time. Often overmotivation from peers or coaches drives the victim beyond what they can handle. In both types, there is a very high body temperature (often over 104 degrees), which leads to break down of tissue within the body, followed by multiorgan failure and, if not treated, death. 

Symptoms of heat stroke include high fever, fast heart rate, fast breathing, and low blood pressure. In exertional heat stroke there is sweating but the skin is dry in the classic form, reflecting the fact the body can’t adapt to the heat. The brain is very sensitive to high fever and heat stroke victims can have confusion, dizziness, agitation, combativeness, slurred speech, nausea, vomiting, seizures and loss of consciousness. The muscles of the body can break down and there is often kidney and/or liver damage as well.  The treatment of heat stroke is to cool the patient as quickly as possible. In the exertional form, immersion in cold water is often used.  In elderly, classic heat stroke victims, immersion is not practical so strategies include infusing a cool solution via an IV line, application of cold packs and using a cooling blanket. Promptly diagnosing heat stroke and rapid cooling often reverses heat associated organ problems, without long-term consequences. Staying indoors, in air conditioning, during heat waves, may prevent classic heat stroke. Prevention also includes checking on elderly or vulnerable persons frequently during heat waves to ensure that they are coping. 

Heart patients and patients with peripheral arterial disease are especially vulnerable to the heat. Cardiovascular problems can impair the body’s ability to open up blood vessels. If blood vessels cannot open up, heat cannot be dissipated through the skin and heat stroke results.   In addition, many heart medications can make handling the heat more difficult. Patients with high blood pressure and those with heart failure are often on diuretics (“water pills”).  These medications tend to dehydrate patients. If exposed to extreme heat while on a diuretic, the salt and water lost through sweat exacerbates dehydration, leading to low blood pressure, loss of consciousness or kidney problems. Other medications, such as calcium channel blockers, ACE inhibitors (for example, lisinopril) and ARBs (for example, losartan) coupled with excess heat can lead to low blood pressure. The best advice for heart patients in a heat wave is to stay inside, in air-conditioning. In addition, it is best not to walk, exercise or work in the yard in the middle of the day during hot days. Go outside early in the day or after sunset, when the temperature is generally lower. 

Enjoy the summer, but be cool and be careful on those hot humid days, don’t let a heat wave burn your heart.

Saturday, July 6, 2019

Chios

My grandmother, Mary Kostomenos (later Mary Thomas) was born on the island of Chios in either 1899 or 1903. She left the island with her sister Margarite (Rita) and emigrated to the United States in August 1920 with her future father-in-law (John Thomas) and sister-in-law (Penelope Thomas).  Here is log book from Ellis Island documenting her entry into the US (in the log her last name is spelled Costomenu).



She returned to Chios for a visit in 1974. Except for her, no one in our family has ever visited Chios until I had the opportunity to go from June 30 2019 to July 4 2019. This is a summary of what I learned before leaving and while on the island of Chios.

My great-grandparents were born and spent their lives on Chios. My great grandfather, George Kostomenos, was born on Chios in 1851. He had a grocery store. He married my great grandmother in 1881 (around the time a great earthquake hit and devastated Chios in March 1881). He died in 1918. My great grandmother, Harikleia Vorria, was born on Chios in 1853. She was a housewife. She died in 1916. They had nine children: Irene, Nicholas, Angelo, John, Stanley, Rita, Demetrios, Michael and of course, Mary. (From the family tree generously supplied by George and John Thomas). Before leaving for Chios I wrote to the General Archives on Chios asking for information about the family. Here are their replies:

Mr Georgeson
Here in General Archives of Chios we have notary books from all the villages of Chios from 1700 ci. to 1914, we found the surname Kostomenos in the villages below: in town of Chios, Pyrgi, Kalamoti, Karyes. 
Sincerely
GAK-Archives of Chios

Mr Georgeson

I attach the documents of the marriage pre-agreement of George Kostomenos and Harikleia Vorria and the receipt of dowry,  from the 991 notary book of town of Chios.  

Here are the documents:








Prior to going to Chios, I met my cousin Efie Georgakopoulos in Athens. I asked her to help translate the documents. Even she had trouble due to the fact that they are hand written and hard to understand and they were written in Katharevousa, an earlier form of Greek not used today. This is what she was able to discern.

This document is from October 1880. It is an agreement to marry, apparently written by George. In it he agrees to marry Harikleia within one month, otherwise there is a fine! My understanding is that this was an arranged marriage. 


This document is a receipt of the dowry, written in January 1881. I am not sure when they were married, presumably between October 1880 and January 1881. It talks about George receiving a house, furniture and utensils.  There is mention of 40 pounds English (the currency), so there may have been a monetary exchange as well. This was also written by George.

To find out more about the family, Efie suggested going to the kafeneio in Pyrgi (the village where my grand mother was born, more about that later). She said "pick the old one"- referring to the kafeneio- and ask if there is family in town. Also she suggested going to the church, asking for the priest and and asking for baptismal records. Lastly, she said go to the municipality in the capital city of Chios and ask for the records from Pyrgi.

Pyrgi is in the Mastichochoria, a series of villages in southern Chios. This area is known for, and is the almost exclusive world producer of, masticha. Masticha is a resin that drops from the lentisk tree. These trees thrive in the hot dry climate of southern Chios and are found everywhere in the region- behind fences, presumably as part of family farms, but also by the side of the road. 

Pyrgi is the largest and most important village in the Mastichochoria. The village is known for its beauty and the intricate grey and white patterns seen on almost every building in town.  These patterns are produced by a technique called Xysta which uses cement, volcanic sand and lime to produce these wonderful patterns.

Here are some pictures from Pyrgi:



The church and the main plateiea (town square).

Here are some good examples of the xysta on the buildings around town:













 When Sue and I arrived in Pyrgi, we parked and walked to the town cemetery, seeking gravestones for George and Harikleia. We walked around the cemetery for a few minutes (I really know how to have fun on vacation), but all of the stones were much more recent.  We later learned that after 5 years, old graves are dug up and the bones moved to an ossuary (no cremation for the Orthodox). I didn't inquire at a kafeneio (my Greek is not good enough to describe what I was looking for), but we had a long discussion with the local souvenir shop owner. Neither she nor the locals in the shop knew of any Kostomenoi in town. We tried the church in town, but it was closed at mid-day so I could not ask about records.

The next day, we drove into the main town of Chios (also called Chios) and luckily we found their Town Hall (the names of the buildings were all in Greek. I had asked out hotel manager and he drew a great map of the town and showed me where the Town Hall was. He was a wonderful source of information). In the Town Hall, my Greek was good enough so that I found the records department and a young, very helpful gentleman who spoke very good English. He searched on his computer and found a Mary Kostomenos, born in 1899, but this was the person's married name. In addition, she died in 1982 (my grandmother died in 1984). It seemed that it was not the right person. I asked him to  print out the records anyway, but he said he couldn't, citing privacy policies! So, unfortunately, I could not gather any more information about the family on Chios.

Just a quick bit about masticha. Masticha was known and valued since ancient times. The sultans and rulers of the Ottoman Empire enjoyed it so much that they left southern Chios alone when they over ran and took over the island in the medieval era. The Turks left the people alone to produce masticha and took and used the yearly output of masticha for themselves. Today, masticha is used in just about everything- gum, soap, liquor, lotions, shampoo. It is also felt to have medicinal properties as well. There is a great, new Mastic Museum just outside of Pyrgi, which we visited. The views were stunning and the history of masticha was very interesting. 

Here is the museum, with Pyrgi in the background.





The lentisk tree, with surrounding white crystals. The crystals are the resin, the masticha. We would see these all around the area.