tag:blogger.com,1999:blog-6591975637281144402024-03-06T15:01:41.966-05:00Marijke: Nurse Turned WriterHealth and medical news, sometimes serious and sometimes fun.<br>
I've read that I shouldn't describe myself as a "nurse writer," but I can't figure out why - because that is what I am. <br>Marijke Vroomen-Durninghttp://www.blogger.com/profile/14436563110710429784noreply@blogger.comBlogger741125tag:blogger.com,1999:blog-659197563728114440.post-90892212627807039342019-06-10T13:27:00.002-04:002019-06-10T13:36:40.641-04:00"Have I read anything you've written?"I've been asked a few times, "Have I read anything you've written?" My first smart-ass instinct is to reply, "I don't know, what do you read?" But I don't. Because for some people, meeting a writer is surprising. They don't know what to say and that's the statement that comes out. But once I give them some examples, they often nod and say something like they didn't realize that you could actually make a living as a writer, and they'll watch for my work.<br />
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I'm part of a few writers' groups and associations and we often talk about how others perceive us and our work. Here are some of the most common questions my colleagues and I get:<br />
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<i>What kinds of things do you write about?</i><br />
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Because I'm a nurse, I focus on health and medical writing, but I've also written on lifestyle issues and other topics. I once wrote about newest design ideas for powder rooms and recently, I wrote about divorce after age 50 and how to volunteer in your community.<br />
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<i>Where can I see your writing?</i><br />
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I write for magazines, websites, agencies, and companies. Some of my writing is bylined but much of it isn't. Some of the magazines I write for are for healthcare professionals and others are for the public. For example, if you read Costco Connection, you may have read some of my work, in both the US and Canadian editions. I recently wrote some articles for the Canadian magazine Good Times. Sometimes you will see my writing but won't know it. I've ghostwritten many pieces for healthcare professionals. Their name appears on the byline. I don't mind. It's all part of the job.<br />
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<i>What do you do all day?</i><br />
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Write. Research. Prospect. Market.<br />
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<i>How do you do that all day?</i><br />
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Just how you do your work at your office or place of work. I sit down and do it. I may jump up and down from my desk more than you do, because there's no one around to make comments or silently judge me, but it really is just the same.<br />
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<i>How do you manage to work alone all day though</i>?<br />
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This question is answered differently depending on who you ask because writers are as different as workers in any profession. I love being alone to work. I get distracted way too easily to work around other people. When I worked as a nurse, this wasn't an issue because it's a very physical job and you do certain tasks before moving to the next. But distraction was a problem for me at school and again when I worked in an office. I had one job where I went in to the office twice a week and worked from home three days. My production level plummeted those two days a week because of everyone walking around, talking, noises, smells from food, and I found myself reading the same words over and over again, never fully being able to complete my tasks. At home, I sat at my computer and worked, completing everything in silence.<br />
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I know several writers who like to work in coffee shops or libraries. I can't. The noise and movement around me distracts me too much. I even have a hard time working at home if there's someone else around.<br />
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<i>Don't your chores at home distract you?</i><br />
<i><br /></i>
No, they don't. Having said that, I do do some chores during the day. Because I take breaks, I wander and may empty the dishwasher, throw in a load of laundry, or walk over to the grocery store or bank. But that's no different than an employee popping outside for a cigarette, running over to a nearby store to pick up a few things, or a couple of employees spending time in the coffee shop for their break.<br />
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<i>Do you make any money working at your little job/hobby/work thing?</i><br />
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I do get this question sometimes and I'm never sure what to answer without sounding defensive. Yes, I make a good living doing my "little job." I never imagined this was possible. It's not a little job. It's no more a little job than the job my husband goes to each morning or the hospital job I went to for years. My writing isn't a hobby and it's not something I do for pin money. I work five days a week (mostly) and earn enough to pay my share of the bills and more.<br />
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<i>I'm interested in being a writer. How do I do that?</i><br />
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First, it's important to understand what you mean by being a writer. Do you see yourself at a desk, typing out the next prize-winning novel? Do you want to write only for major news magazines or women's magazines? What do you mean "be a writer"?<br />
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Most writers I know do a combination of writing, from writing content to articles for magazines. Content is anything you read, from newsletters and articles for trade magazines to captions below photos and the back of cereal boxes. One of my major clients is Sepsis Alliance (sepsis.org). I wrote just about all their content. From describing what sepsis is to providing materials for people to buy or download, that's my work. It's not bylined and you won't see my name anywhere on the text. One of my favorite/favourite pieces is a <a href="https://www.sepsis.org/sepsis-alliance-news/caregiver-guide-for-sepsis/" target="_blank">guide I wrote</a> for caregivers. Again, my name isn't on it, but I know I wrote it and that's what counts.<br />
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But I also write bylined articles for other clients. I write content like "what is asthma" and pieces like that for another anchor client and others when they hire me. I've also done some journalistic writing for medical and health stories. For those, I get to speak to incredibly interesting people, from world renowned experts to members of the public. There are so many stories to share.<br />
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I don't do long-form journalism. I leave that to others. The longest stories I've written were about 2,500 words. Generally, my pieces are much shorter. I did write my own book, <a href="http://www.justtherightdose.com/" target="_blank">Just the Right Dose: Your Smart Guide to Prescription Drugs & How to Take Them Safely</a>. I do have ideas for other books, but I've not gotten around to actually writing them yet.<br />
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So, that's a long way of saying, you need to decide what you want to do to be a writer. Do you want to specialize, as I did, or be a generalist, like many others? Do you have the skills to be a writer? Do you know other writers? Do you know what kind of writing you want to do?<br />
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<i><b>A word of advice if you're starting out.</b></i><br />
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I'm anti-content mill. Absolutely and totally anti-content mill. Content mills are sites that recruit writers to work pennies, for less than minimum wage. I've seen ads offering $10 for a 300 word or longer article. Some will argue that some writing work is better than no writing work, especially when starting out. But content mills that pay so low do not put out good quality work. They don't (generally) have great editors, which is how you learn to be a great writer. A great editor makes your work much better. And with the content mills, you have to write so much to make any real money, you don't have time to market yourself for higher paying jobs, and to improve your skills.<br />
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If you are serious about wanting to be a freelance writer, there are some books and groups I recommend. For example, I highly recommend Jennifer Goforth Gregory's book, <a href="https://www.amazon.com/Freelance-Content-Marketing-Writer-business/dp/1732240906/ref=sr_1_1?keywords=freelance+marketing+writer&qid=1560186256&s=gateway&sr=8-1" target="_blank">The Freelance Content Marketing Writer</a> . (I'm not affiliated, just a big fan of the book and I know Jennifer. She's awesome.) Jennifer's advice is spot on. She explains how to find work that doesn't pay below minimum wage. She also has a <a href="https://www.facebook.com/groups/FreelanceCMW/" target="_blank">Facebook group </a>that is chock full of advice and experience.<br />
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Early on, I learned a lot from a group called <a href="http://www.freelancesuccess.com/" target="_blank">Freelance Success</a>. There is an annual fee, but I credit this group with my success. The members range from beginners to very experienced, and their input and answers to questions are invaluable. Don't be fooled by the basic website design. I still learn from the other members, but now I'm able to offer information and answer questions myself.<br />
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<i>Other tips: </i><br />
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<b>If you're not sure about basic grammar and writing rules, find a class. </b>It can be online or in person, but refreshing your knowledge is important. For some reason, I kept writing "alot" instead of "a lot," in a college English course. The teacher patiently kept correcting it until I finally figured it out. Read a lot (see, I got it right there!). Read what you would like to write. See how others write, see their style, and how they outline their articles. The best way to learn how to write is to read what successful writers have already published.<br />
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<b>Be professional. </b>Even if you're just starting out, you can be professional. That means sending out professional emails and responses. Don't use an email address like MommyLovesDaddy@whatever.com. Be punctual. Deliver on time. Use spell check, but don't depend on it. Reread and reread again before pressing "send." Back up your work. Your editor doesn't want to get an email asking for more time because you lost your files when your computer crashed. Ask questions when you don't know something. Ask for help if you need it. And listen to your clients' critiques. We don't always get it right the first draft. Sometimes we write in the wrong voice. Or there are times when we don't interpret the instructions properly and we have to redo your work. It happens. How you react to those issues is what distinguishes you from others.<br />
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<b>Don't be too hard on yourself.</b> I was lucky. Most of my first clients were wonderful. They had great editors who helped me learn how to adjust my writing for each client. Then I hit an editor who ripped my work apart. Ripped. It. Apart. She made me feel like the world's worst writer and I was devastated. There was so much red in the tracked changes, it looked like there'd been a massacre on my screen. After a day of angst and beating myself up, I rewrote the piece and she ran it. When she retired a few months later, she wrote to tell me I was one of the best writers she worked with. That made my jaw drop. But it also made me realize that although she might have been a bit kinder in her approach, it wasn't *me* that she was trying to fix. It was the writing.<br />
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If you want to be a writer, give it a try. But be realistic. Know what you are getting in to and have a business plan. Because you're not just being a freelance writer. You're running a business. One where you are the boss, the employee, and the quality control.<br />
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<br />Marijke Vroomen-Durninghttp://www.blogger.com/profile/14436563110710429784noreply@blogger.com0tag:blogger.com,1999:blog-659197563728114440.post-17939223519672223622019-06-02T19:37:00.001-04:002019-06-02T19:48:53.723-04:00Infection Following Natural Disasters - Take Care<span style="font-family: "arial" , "helvetica" , sans-serif;">Following every natural disaster, we see television news and online videos of destruction. Images of destroyed homes, cars and trucks flipped over, and boats well inland instead of in the water, show us the massive damage nature can cause. But for the thousands who are living through the seemingly unprecedented number of tornadoes, serious storms, and flooding, it’s not a video. It’s very real. The disasters are leaving thousands of families uprooted, with some losing loved ones.</span><br />
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<span style="font-family: "arial" , "helvetica" , sans-serif;">But after the storms have passed over and the waters have receded, after the news cameras leave and people stop taking videos, the residents are left with not only putting their lives back together, but with the potential of serious illness or injury, after the fact. <br />
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While the emergency is occurring, the most important issue is survival. This means taking cover or evacuating. But once the imminent threat has left, other dangers may lurk. From broken water and sewage systems to terrified wild animals, survivors may be exposed to dangers they’ve never faced before. <br />
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</span> <span style="font-family: "arial" , "helvetica" , sans-serif;">Infection following a natural disaster is common in many areas. Infections can spread quickly in crowded shelters. People who walk around the disaster area can injure themselves by tripping on debris. They can cut themselves while trying to move things or be hit by material that may still be falling. Frightened pets and wild animals may be driven into unfamiliar territory and may bite.<br />
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</span> <span style="font-family: "arial" , "helvetica" , sans-serif;">With so many tornadoes touching down in North America this spring, I thought it would be a good idea to discuss the topic. A while ago, I wrote about the connection between national disasters for Sepsis Alliance, an organization I work with. If you would like to read more about the types of infections that could follow a natural disaster, visit <a href="https://www.sepsis.org/sepsis-and/sepsis-natural-disasters/" target="_blank">Sepsis and Natural Disasters</a>, found on the Sepsis Alliance website.<br />
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<br />Marijke Vroomen-Durninghttp://www.blogger.com/profile/14436563110710429784noreply@blogger.com0tag:blogger.com,1999:blog-659197563728114440.post-43802608405928453892019-05-13T22:00:00.000-04:002019-05-14T09:37:54.905-04:00Dementia: It's More Than Alzheimer's DiseaseSay the word "dementia," and most people think about Alzheimer's disease. We can't blame them; Alzheimer's disease affects almost <a href="https://www.alz.org/alzheimers-dementia/facts-figures" target="_blank">6 million Americans</a> and many millions more across the world. It is the most common cause of dementia. But dementia is more than Alzheimer's disease.<br />
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So, what is dementia? Dementia is a decline in mental ability that affects your daily life. Dementia is not a specific disease on its own. It can be caused by Alzheimer's disease, Lewy body dementia, vascular dementia, or frontotemporal dementia (FTD), among others. It can also be caused by other diseases, like Parkinson's disease and Huntington's disease.<br />
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But if the end result is the same and there's no cure, is it really important to know what type, what it's called? Absolutely. We need to know that there are different types of dementia because the research and management differs according to the disease. For example, Alzheimer's disease is caused by plaques and tangles that build up in the brain. It usually strikes later in life, although there is a rare form of early-onset Alzheimer's disease that can strike people in their 40s and 50s. Lewy body dementia is caused by a build up of protein in the brain and it can start in the 50s. FTD is caused by a degeneration of the neurons (nerve cells) in the frontal and temporal lobes of the brain. It is these parts of the brain that control language, personality, and behaviour. According to the National Institute of Neurologic Disorders and Stroke (part of the National Institutes of Health), there are three main groups of FTD: progressive behaviour/personality decline, progressive language decline, and progressive motor decline. FTD can be defined in other ways though. The Association for Frontotemporal Degeneration defines FTD types as:<br />
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<ul>
<li><a href="https://www.theaftd.org/what-is-ftd/behavioral-variant-ftd-bvftd/" target="_blank">Behavioural variant FTD</a> (bvFTD). It is also called frontotemporal dementia or Pick's disease.</li>
<li><a href="https://www.theaftd.org/what-is-ftd/primary-progressive-aphasia/" target="_blank">Primary progressive aphasia</a> (PPA)</li>
<li><a href="https://www.theaftd.org/what-is-ftd/progressive-supranuclear-palsy/" target="_blank">Progressive supranuclear palsy</a> (PSP). It may be called "atypical Parkinsonism" by some.</li>
</ul>
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<br />
What makes FTD particularly brutal is it strikes early, most often from about 45 years on, often when couples still have children at home and may even be caring for their own parents. But it can affect people as young as in their 20s.<br />
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It's difficult to tell how many people in North America have FTD. A study <a href="https://www.cambridge.org/core/journals/canadian-journal-of-neurological-sciences/article/the-prevalence-and-incidence-of-frontotemporal-dementia-a-systematic-review/F9B6DDFC2310DB4E02A500DD0A3A9263#" target="_blank">published in 2016 </a>found that the diagnostic process was so diverse that it was impossible to tell how many people were truly affected by FTD. The authors looked at 26 studies looking at the incidence or prevalence of FTD, published between 1985 and 2012. They concluded that about 2.7% of all cases of dementia (any age) were caused by FTD. Yet, the National Institute of Neurologic Disorders and Stroke estimates that there may be many more people with FTD than we realize, perhaps as many as <a href="https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Frontotemporal-Disorders" target="_blank">10% of people with dementia</a>.<br />
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Aside from the toll FTD takes on the people who have it and the ones who love them, it has a high financial toll. A study published in the journal <i><a href="https://n.neurology.org/content/89/20/2049" target="_blank">Neurology</a></i> in 2017 compared the economic burden of FTD in the U.S. with Alzheimer's disease. The researchers found that the annual cost of caring for someone with FTD was twice that of someone with Alzheimer's disease. Part of the increased cost is the young age of people diagnosed with FTD, compared with Alzheimer's. Younger age at diagnosis means a loss in household income as the patient can no longer work, and the spouse or partner may have to miss work or quit altogether to provide care.<br />
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I have a particular interest in FTD. Dear friends have been living with this disease in their family for the past few years. It's a cruel disease that so few people know about. I was glad to see earlier this month, the CBS news show 60 Minutes ran a segment on FTD, called <a href="https://www.cbsnews.com/news/frontotemporal-dementia-devastating-prevalent-and-little-understood-60-minutes-2019-05-05/?fbclid=IwAR3UfSXlWu6ocU_AHQBsqavE8b4V8UTdc9o22W6kOzu30LIvQfZU0OpiJTc" target="_blank">Frontotemporal dementia: Devastating, prevalent, and little understood</a>. If you have 15 minutes, I encourage you to watch it. There is much more to FTD than the segment can show, but it's a good primer for people who have never heard of it.<br />
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This blog post touched very briefly on FTD. There is so much more to the disease. To learn more about FTD, visit <a href="https://www.theaftd.org/what-is-ftd/disease-overview/" target="_blank">The Association for Frontotemporal Degeneration</a> and/or the National Institute of Neurologic Disorders and Stroke's section <a href="https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Frontotemporal-Disorders" target="_blank">Frontotemporal Disorders: Hope Through Research</a>. If you suspect that someone you love may have FTD, seek help. If you have resources you would like to share, please leave the information in the comments. While there is no cure, having a diagnosis and support are important.Marijke Vroomen-Durninghttp://www.blogger.com/profile/14436563110710429784noreply@blogger.com0tag:blogger.com,1999:blog-659197563728114440.post-28484597135189711562019-05-06T17:31:00.001-04:002019-05-06T17:33:41.239-04:00Do Celebrities Owe Us Health Information? Prince Harry & Meghan Markle, for exampleIt's all over the news - a <a href="https://www.cbsnews.com/live-news/royal-baby-meghan-duchess-of-sussex-prince-harry-baby-boy-today-2019-05-06-live-updates/" target="_blank">new royal has been born</a>. Prince Harry's glowing announcement of his son's birth was delightful. He was awed and in love. But how much does he owe the public about the details and photos, and everything else people want to know?<br />
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There was a lot of discussion when people realized that Meghan Markle's delivery wasn't going to be done the same way as her sister-in-law's. Catherine/Kate Middleton, Duchess of Cambridge, was pushed into the spotlight hours after the birth of her three children. Many felt her appearance was unfair to both her and women around the world who know it's not common to look so spectacular after having a baby. Yet, many others felt it was their right to know about Baby Cambridge when he or she did arrive.<br />
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We also see this when celebrities become ill or are injured in some way. Some famous people choose to speak out early, often to beat gossip. The most recent example is Alex Trebek, who spoke out about his pancreatic cancer diagnosis and, most recently, about <a href="https://www.yahoo.com/lifestyle/alex-trebek-gets-real-deep-192125633.html" target="_blank">depression and other issues</a> that surround living with such a serious disease. And when they die, the public also wants to know why. <a href="https://www.latimes.com/local/education/la-sci-stroke-young-adults-luke-perry-john-singleton-20190506-story.html" target="_blank">Luke Perry and John Singleton</a> both died after having a stroke. This seemed all the more tragic because of their young age. But other times, celebrities die and the cause is never announced. Their fans are curious, but the family may prefer to keep quiet.<br />
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Do those in the public eye owe it to anyone to share their health news? Some argue that if people choose to live publicly, all bets are off. And to be fair, when a celebrity does share a diagnosis, public awareness skyrockets. Parkinson's disease saw a big increase in awareness after it became known that Muhammed Ali and Michael J. Fox had/have it. When awareness grows, so does screening, diagnosis, and treatment. Donations for research may increase and this all works for the better. But if someone is living with a serious illness, publicity is an added stress - one that can make life much more difficult.<br />
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I have to admit, I was delighted for Prince Harry. I have a soft spot for him. I still picture him walking behind his mother's coffin. As rich and privileged as he is, losing your mom at that age is devastating. So to see him happy pleases me. But do I have to know? No, I don't. And if he chooses to keep certain details secret, then I feel that is his choice. Life will go on, whether we know about Baby Sussex or not.Marijke Vroomen-Durninghttp://www.blogger.com/profile/14436563110710429784noreply@blogger.com0tag:blogger.com,1999:blog-659197563728114440.post-62451371293394709662018-03-14T08:59:00.000-04:002018-03-14T09:04:20.220-04:00I Remember Martin<!--[if gte mso 9]><xml>
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="header"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="footer"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="index heading"/>
<w:LsdException Locked="false" Priority="35" SemiHidden="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="table of figures"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="envelope address"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="envelope return"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="footnote reference"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="annotation reference"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="line number"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="page number"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="endnote reference"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="endnote text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="table of authorities"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="macro"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="toa heading"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List 4"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List 5"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Bullet 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="List Number 5"/>
<w:LsdException Locked="false" Priority="10" QFormat="true" Name="Title"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Signature"/>
<w:LsdException Locked="false" Priority="1" SemiHidden="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text Indent"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Message Header"/>
<w:LsdException Locked="false" Priority="11" QFormat="true" Name="Subtitle"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Date"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text First Indent 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Body Text 2"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Hyperlink"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="FollowedHyperlink"/>
<w:LsdException Locked="false" Priority="22" QFormat="true" Name="Strong"/>
<w:LsdException Locked="false" Priority="20" QFormat="true" Name="Emphasis"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Plain Text"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="E-mail Signature"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Top of Form"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Normal (Web)"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Acronym"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Address"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Cite"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Code"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Keyboard"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Preformatted"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="HTML Typewriter"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="No List"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Outline List 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Colorful 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Columns 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table 3D effects 3"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Elegant"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
Name="Table Subtle 1"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" Priority="39" Name="Table Grid"/>
<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" UnhideWhenUsed="true"
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<w:LsdException Locked="false" SemiHidden="true" Name="Placeholder Text"/>
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<w:LsdException Locked="false" Priority="60" Name="Light Shading"/>
<w:LsdException Locked="false" Priority="61" Name="Light List"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 1"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 1"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 1"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 1"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 1"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 1"/>
<w:LsdException Locked="false" SemiHidden="true" Name="Revision"/>
<w:LsdException Locked="false" Priority="34" QFormat="true"
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<w:LsdException Locked="false" Priority="29" QFormat="true" Name="Quote"/>
<w:LsdException Locked="false" Priority="30" QFormat="true"
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<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 1"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 1"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 1"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 1"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 1"/>
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<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 1"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 1"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 2"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 2"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 2"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 2"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 2"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 2"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 2"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 2"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 2"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 2"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 2"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 2"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 2"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 2"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 3"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 3"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 3"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 3"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 3"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 3"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 3"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 3"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 3"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 3"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 3"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 3"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 3"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 3"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 4"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 4"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 4"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 4"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 4"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 4"/>
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<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 4"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 4"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 4"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 4"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 4"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 4"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 4"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 5"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 5"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 5"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 5"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 5"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 5"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 5"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 5"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 5"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 5"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 5"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 5"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 5"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 5"/>
<w:LsdException Locked="false" Priority="60" Name="Light Shading Accent 6"/>
<w:LsdException Locked="false" Priority="61" Name="Light List Accent 6"/>
<w:LsdException Locked="false" Priority="62" Name="Light Grid Accent 6"/>
<w:LsdException Locked="false" Priority="63" Name="Medium Shading 1 Accent 6"/>
<w:LsdException Locked="false" Priority="64" Name="Medium Shading 2 Accent 6"/>
<w:LsdException Locked="false" Priority="65" Name="Medium List 1 Accent 6"/>
<w:LsdException Locked="false" Priority="66" Name="Medium List 2 Accent 6"/>
<w:LsdException Locked="false" Priority="67" Name="Medium Grid 1 Accent 6"/>
<w:LsdException Locked="false" Priority="68" Name="Medium Grid 2 Accent 6"/>
<w:LsdException Locked="false" Priority="69" Name="Medium Grid 3 Accent 6"/>
<w:LsdException Locked="false" Priority="70" Name="Dark List Accent 6"/>
<w:LsdException Locked="false" Priority="71" Name="Colorful Shading Accent 6"/>
<w:LsdException Locked="false" Priority="72" Name="Colorful List Accent 6"/>
<w:LsdException Locked="false" Priority="73" Name="Colorful Grid Accent 6"/>
<w:LsdException Locked="false" Priority="19" QFormat="true"
Name="Subtle Emphasis"/>
<w:LsdException Locked="false" Priority="21" QFormat="true"
Name="Intense Emphasis"/>
<w:LsdException Locked="false" Priority="31" QFormat="true"
Name="Subtle Reference"/>
<w:LsdException Locked="false" Priority="32" QFormat="true"
Name="Intense Reference"/>
<w:LsdException Locked="false" Priority="33" QFormat="true" Name="Book Title"/>
<w:LsdException Locked="false" Priority="37" SemiHidden="true"
UnhideWhenUsed="true" Name="Bibliography"/>
<w:LsdException Locked="false" Priority="39" SemiHidden="true"
UnhideWhenUsed="true" QFormat="true" Name="TOC Heading"/>
<w:LsdException Locked="false" Priority="41" Name="Plain Table 1"/>
<w:LsdException Locked="false" Priority="42" Name="Plain Table 2"/>
<w:LsdException Locked="false" Priority="43" Name="Plain Table 3"/>
<w:LsdException Locked="false" Priority="44" Name="Plain Table 4"/>
<w:LsdException Locked="false" Priority="45" Name="Plain Table 5"/>
<w:LsdException Locked="false" Priority="40" Name="Grid Table Light"/>
<w:LsdException Locked="false" Priority="46" Name="Grid Table 1 Light"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark"/>
<w:LsdException Locked="false" Priority="51" Name="Grid Table 6 Colorful"/>
<w:LsdException Locked="false" Priority="52" Name="Grid Table 7 Colorful"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 1"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 1"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 1"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 1"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 1"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 1"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 2"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 2"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 2"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 2"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 2"/>
<w:LsdException Locked="false" Priority="51"
Name="Grid Table 6 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="52"
Name="Grid Table 7 Colorful Accent 2"/>
<w:LsdException Locked="false" Priority="46"
Name="Grid Table 1 Light Accent 3"/>
<w:LsdException Locked="false" Priority="47" Name="Grid Table 2 Accent 3"/>
<w:LsdException Locked="false" Priority="48" Name="Grid Table 3 Accent 3"/>
<w:LsdException Locked="false" Priority="49" Name="Grid Table 4 Accent 3"/>
<w:LsdException Locked="false" Priority="50" Name="Grid Table 5 Dark Accent 3"/>
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<br />
<i style="font-size: 12pt;">This was an essay I wrote many years ago, about a patient who stayed with me throughout my career. </i><span style="font-size: 12pt;"> </span><br />
<span style="font-size: 12pt;"><br /></span>
<span style="font-size: 12pt;"><br /></span>
<div class="MsoNormal">
I remember Martin. I was 20 years old, barely a nurse. He
was 53 and about to die. <o:p></o:p><br />
<br /></div>
<div class="MsoNormal">
While I was studying nursing in the late 1970s and early
80s, there wasn’t much emphasis placed on dying. We were focused on saving
patients, teaching them how live with chronic diseases, or helping them heal
from various medical procedures. Patients did die of course, but that was when
we failed to keep them alive. Palliative and hospice care had been introduced,
but were not yet mainstream. We were taught that nurses helped save people, and
this is what I believed. Until the day I met Martin.<o:p></o:p></div>
<div class="MsoNormal">
Martin was admitted to our medical unit to die – to 514, a
private room across from the nurses’ station. He had been living with cancer
for a few years now and had come to the point that his chemotherapy was no
longer providing him with a good quality of life. He had stopped all treatment,
including kidney dialysis. On his admission papers, we were told that he would
likely die within three days – four days at the most.<o:p></o:p></div>
<div class="MsoNormal">
I was next in line for admissions that day, so Martin became
my patient. I watched as he came out from the elevator. He walked slowly,
deliberately towards the unit. I noticed that he wasn’t much taller than I was.
He had piercing blue eyes in a round, creased face, and fading blond hair. He
was so polite, so nice, so alive. I was told to complete the admission like all
others – take a nursing history, ask the questions, fill out the forms. In
other words, I was to act as if he was like every other patient on our floor.
But he wasn’t. At least he wasn’t to me.<o:p></o:p></div>
<div class="MsoNormal">
Other than a few patients who had died while I was on duty,
and grandparents who I barely knew and who had died in country on another continent,
I had little experience with death. But I knew that Martin wasn’t just another
patient.<o:p></o:p></div>
<div class="MsoNormal">
For the first few hours, I didn’t know what to say to him. I
went in and out of his room more than I normally would have. I was looking for
a way to connect with him. But I didn’t know how. What to say? What to do? I
had no guidance, no map.<o:p></o:p></div>
<div class="MsoNormal">
His daughters came. They were my age, another thing to think
about. Martin wasn’t just a patient. He wasn’t just a dying patient. He was a
father of two young women who would soon be losing their father. His wife came.
She quietly cried in the hall for a few minutes before composing herself. She
would be a widow in a few days.<o:p></o:p></div>
<div class="MsoNormal">
I had been warned that Martin would start to lose mental
function as toxins built up in his blood – he would become confused,
disoriented. I wanted to connect with him before this happened. But I had no
idea how. What I didn’t know was that Martin did.<o:p></o:p></div>
<div class="MsoNormal">
During one of my visits in his room, he said, “Can I talk to
you? Do you have a moment?” I had more than a few. I had cleared away all my
other work so I could have time for him. He asked me to sit. I did.<o:p></o:p></div>
<div class="MsoNormal">
I don’t recall all that Martin talked about, but I do
remember him saying how he was afraid that he might start not making sense. How
he might say one thing but mean another. He told me that certain things just
didn’t matter any more. He explained it by comparing shapes and colors –
triangles and circles, red and green. He said, does it really matter that the
shapes or colors aren’t the same? Does it really matter that we aren’t all the
same?<o:p></o:p></div>
<div class="MsoNormal">
For the rest of that afternoon, I took care of Martin’s
physical needs as he talked about his life, what he had done, and his love for
his wife and his daughters. He talked about his regrets and the things he
wouldn’t get to do. And he talked about dying. How he was afraid, but he knew
it was time.<o:p></o:p></div>
<div class="MsoNormal">
I went off shift at 4 pm. I didn’t want to go to work the
next day. I didn’t want to witness Martin’s decline. I didn’t want to see him
die. But I did, because that is what nurses do.<o:p></o:p></div>
<div class="MsoNormal">
The next morning, I listened to our change-of-shift report
and the nurse described Martin’s night. It hadn’t been an easy one. The team
leader had thoughtfully given me a lighter patient load so I could spend time
caring for Martin. As I entered his room that morning, it was obvious that the man
I knew the day before was already gone. He barely opened his eyes, barely
responded to my questions. <o:p></o:p></div>
<div class="MsoNormal">
I tended to him, talking to him every step of the way. I
talked about some of the things he had mentioned just the day before. And
sometimes there was just silence.<o:p></o:p></div>
<div class="MsoNormal">
The rest of the day, there was always a family member in
Martin’s room and I didn’t want to intrude. I popped in to do what needed to be
done, and then left the family to themselves. I left at 4 pm again, after
saying my good-byes to the family. I wasn’t scheduled to work the next day. I
would likely never see them again. I had no idea what to say.<o:p></o:p></div>
<div class="MsoNormal">
I thought a lot about Martin that night and all the next
day. When I returned to work for my next shift, there was a new patient in 514
– someone with hopes of recovering and going home. Martin was gone. <o:p></o:p></div>
<div class="MsoNormal">
Twenty-five years later, I began working in hospice The time, the place, and the situations were all very different from that first
experience with an expected death. I knew what to do. But I never forgot
Martin. When I think about him from time to time, I don’t see him as he lay
dying, but as the 53-year-old man who walked onto our floor. And those piercing
blue eyes.<o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<!--EndFragment--><br />Marijke Vroomen-Durninghttp://www.blogger.com/profile/14436563110710429784noreply@blogger.com0tag:blogger.com,1999:blog-659197563728114440.post-6657605780398690472018-02-09T23:10:00.000-05:002018-02-09T23:10:04.280-05:00Over 90,000 Page Views for a Post I Wrote in 2008Wow. Just wow.<br />
<br />
I was poking around in my blog stats this evening. I began writing this blog almost 11 years ago now, so there are lots of posts. Some years, I'm great about posting often. Other years, well, to be honest I don't think about posting here. For a several years, if you Googled "nurse writer," I was one of the top three hits and often the first one. Now I'm not even on the front page. Ouch. I get busy with paying work and feel guilty about not posting here. But it is gratifying to know that even whien I'm not posting, people are reading. Some of my posts have been read thousands of times.<br />
<br />
I try to write about topics that I think you will find interesting. Sometimes I get it, other times I don't. But I sure struck a chord when I wrote, <a href="http://medhealthwriter.blogspot.ca/2008/08/how-can-you-die-from-pneumonia-bernie.html" target="_blank">How Can You Die From Pneumonia? Bernie Mac Did. </a><br />
The post has been viewed as, of this evening (11 pm EST, Friday night), 90,415 times. This is a particularly interesting post for many cases, but maybe even more now given the flu season we're having. The runner up post, <a href="http://medhealthwriter.blogspot.ca/2007/07/broken-hips-in-elderly-can-lead-to.html" target="_blank">Broken Hips in Elderly Can Lead to Death</a>, has been read almost 45,000 times.<br />
<br />
So stay tuned for more stories. Who knows what I may find.Marijke Vroomen-Durninghttp://www.blogger.com/profile/14436563110710429784noreply@blogger.com0tag:blogger.com,1999:blog-659197563728114440.post-38600174998875250692018-02-06T15:12:00.003-05:002018-02-06T15:45:24.517-05:00This Is Us took a beloved character, but how?If you have been following the TV show <a href="https://www.google.ca/url?sa=t&rct=j&q=&esrc=s&source=web&cd=4&cad=rja&uact=8&ved=0ahUKEwi8gs2Lh5LZAhUrw1kKHXpfAsYQFgg7MAM&url=https%3A%2F%2Fen.wikipedia.org%2Fwiki%2FThis_Is_Us_(TV_series)&usg=AOvVaw1rz9235a5G5bkkwShOdJ9Q" target="_blank"><i>This Is Us</i></a>, you've known from the start that a popular character, Jack Pearson, had died. But what the audience didn't know until this past weekend was how Jack died. Now we know. (<i>If you haven't watched this episode yet and you plan on it, there is a spoiler ahead. Stop reading now if you don't want to know.</i>)<br />
<br />
The series has been following the lives of a family, three adults (Kevin, Kate, and Randall) and their mother (Rebecca), 20 years after Jack dies. His children are haunted by his death and we're given glimpses of the past throughout the episodes. On Sunday's episode, the family home burns down. Jack rescues everyone in the house, goes back to get the dog and some treasures. He comes out of the fire, but succumbs later in the hospital to a heart attack, what Rebecca was told was a widowmaker. But what is a widowmaker heart attack?<br />
<br />
A widowmaker is a term used to describe a massive heart attack usually caused by a total blockage of the largest of the heart's arteries, the left anterior descending artery. It's frequently fatal and it strikes people in their 40s or 50s, although it is much more common among men. In the show's story line, Jack's heart attack was caused by smoke inhalation, but there is usually no one specific cause of a widowmaker. Many of us have heard of seemingly healthy men (usually) going about their day and suddenly having a massive heart attack, often with no advance warning. However, some survivors will tell you that they did have symptoms, but they just didn't put two and two together.<br />
<br />
Since February is Heart Month, it's a good time to review the signs and symptoms of a heart attack:<br />
<br />
<ul>
<li>A feeling of pressure, squeezing or tightness in your chest </li>
<li>Pressure or pain radiating down one or both arms, your jaw or into your back</li>
<li>Nausea, indigestion</li>
<li>Sweating</li>
<li>Dizziness</li>
<li>Feeling of impending doom</li>
</ul>
<br />
<br />
Women may have different symptoms. They may not have that typical chest pain but more nausea or indigestion, lasting for long periods.<br />
<br />
If you feel that you may be having a heart attack, call 9-1-1 immediately. The 9-1-1 operator may advise you to chew a low-dose aspirin if you have them on hand. Do not try to drive yourself to the emergency room because if you pass out while you are driving, you will cause an accident that could injure others. At the same time, having someone else drive you could cost you valuable time. First responders are trained to assist people who are having heart attacks and may be able to stabilize you before transporting you or during transport.<br />
<br />
If you find someone who having or has had a heart attack, call 9-1-1 immediately. If they are unconscious, do not try to give them an aspirin. If the heart has stopped, start CPR.<br />
<br />
Not everyone knows how to give CPR, but it is strongly recommended that everyone learn how and also to learn how to use an automatic external defibrillator machine. More public places are placing these AEDs in strategic places so they can be used in case of emergency. To learn more about CPR, even if you've not taken a course, go to the <a href="https://www.mayoclinic.org/first-aid/first-aid-cpr/basics/art-20056600" target="_blank">Mayo Clinic site</a>, where they explain the steps.<br />
<br />
Heart attacks are frightening. If you have a family history of heart disease or have risk factors for heart disease, consult your doctor about how best to reduce your risk of a heart attack. You can also visit the <a href="https://www.google.ca/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0ahUKEwiw-N7Vi5LZAhWyq1kKHfRFDlkQFggsMAA&url=http%3A%2F%2Fheart.org%2F&usg=AOvVaw1nAkicBz4CiPFT-Ay_HQ3E" target="_blank">American Heart Association</a> or the <a href="https://www.google.ca/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0ahUKEwjhjsrli5LZAhWHm1kKHe3SBnsQFggsMAA&url=http%3A%2F%2Fwww.heartandstroke.com%2F&usg=AOvVaw1DtD_SSChHVI4oB6QxyQxd" target="_blank">Heart and Stroke Foundation of Canada</a> to learn more.<br />
<br />
<br />
<br />
<br />
<br />Marijke Vroomen-Durninghttp://www.blogger.com/profile/14436563110710429784noreply@blogger.com0tag:blogger.com,1999:blog-659197563728114440.post-64028078449243993262018-02-04T14:09:00.002-05:002018-02-04T14:13:52.169-05:00Is the flu as scary as media stories make it out to be?The seasonal flu, influenza, is front page news across North America. Every day we are reading or hearing of someone who has died - and often it is someone young and healthy, the last person you would expect to die from the flu.<br />
<br />
So is the flu as scary as the media is making it out to be? Yes - and no.<br />
<br />
Millions of people around the world get the flu. They can be very sick for a few days with body soreness and muscle aches, terrible cough, fever, and more. But after a few days of rest and rehydration, they start to recover and gradually return to their daily activities. Some people may feel fatigued or have a lasting, nagging cough for weeks after the flu, but for the most part, they get better and the flu becomes part of the past.<br />
<br />
But some people who get the flu get seriously ill. Some die. Some survive, but leave the hospital weeks and months later, with amputations or other life changing complications. And, because we can't tell ahead of time who may become so sick, this is why the flu is scary. I know of a woman who is 94 and was hospitalized last week with pneumonia following the flu, and she is now fine. Usually, it is seniors or those with chronic diseases who are the most likely to become severely ill from the flu. Yet this year, we have also heard of young children and young adults who were perfectly healthy before they got the flu, and they died. <br />
<br />
The most common path to severe illness from the flu is pneumonia. Because influenza is a respiratory illness, it can lead to pneumonia. (There is no such thing as a gastro flu or a tummy flu.) Pneumonia can be very serious and can cause you to develop <a href="http://www.sepsis.org/" target="_blank">sepsis</a>, your body's reaction to an infection. This is what can lead to death.<br />
<br />
Every year, researchers try to come up with a vaccine for the seasonal flu. Some years, it's fairly effective. Other years, it's barely effective. And the researchers and pharma companies get a lot of flak for this. What many people don't realize is that we can't know 100% what flu virus is going to be the one to hit the hardest from year to year, so the scientists are working on an educated guess. The seasonal flu viruses change and mutate, and because it can take months to produce a vaccine, what may have been effective against a specific virus one month, may no longer be effective months later because the virus mutated and changed.<br />
<br />
This begs the question - why bother with a flu vaccine at all then? Because it is somewhat effective. The flu vaccine can help prevent the flu for some people. It can help lessen the severity of the illness in others. But it can't claim to protect you completely - it can only be used as one tool in a toolkit for flu prevention. Compare it to wearing a seat belt. The seat belt helps reduce your risk of injury or death in a car accident - but it can't guarantee it. (When seat belt laws came into force where I live, I knew a woman who would pretend to wear the seat belt, just loop it over her shoulder, because she said that no law would tell her that she should wear her seat belt. Now, 30+ years later, you should see how fanatical she is about making sure her grandchildren are securely fastened in the car.) We know that seat belts save lives. We also know that if you do have the flu vaccine, you've decreased your risk of getting sick.<br />
<br />
There are still people who believe that the flu vaccine can make you sick with the flu. It can't. As has been said over and over again, it doesn't contain a live virus, and you need a live virus to cause illness. That's not to say that some people don't get sick after they've been vaccinated. Some people are exposed to the flu before they have their injection - it takes up to two weeks for the vaccination to work. So if you're exposed to the flu just before or just after you have your vaccination, you're still going to get it. Other people report feeling fatigued, feverish, not well overall after getting their vaccine. This isn't the flu, but likely their body's way of coping with a vaccination. It's not comfortable and it would be best not to be sick at all, but it's not the flu.<br />
<br />
I've read people saying that more people are dying now of the flu than before precisely because of the vaccines. They say that no one died of the flu before that. To those people, I say Google the Spanish flu. I am pretty sure we didn't have vaccinations back then yet (yes, that is sarcasm). Then Google other flu epidemics. There are others that occurred before we had seasonal flu vaccines. <br />
<br />
<h3>
How can you prevent getting or giving the flu? </h3>
<br />
<b>You can reduce your risk by washing your hands frequently.</b> The flu virus can live on solid surfaces like door handles, bank machines, even store counters, for days. Wash your hands as soon as you get home or arrive at work. Clean your hands if you've been out shopping or handling things that others may have. Try to avoid touching your face, especially your hands, nose, and eyes, before you've washed your hands. Cleaning your hands will also reduce the risk of you spreading the virus if you have the flu but don't know it yet.<br />
<br />
<b>Get vaccinated.</b> There's still time. Flu season can run up to the end of April, so some protection is still possible. If you don't want to get vaccinated, there's nothing I can say that will convince you, but if you do want to get the vaccine, you still can.<br />
<br />
<b>Stay home if you're sick. </b>I know it's not easy. We all have bills to pay and responsibilities to uphold. But going out sick will just make more people sick. And although the chances are very likely that you'll get better and go on, someone else who gets the virus from you may not be so lucky.<br />
<br />
<b>Sneeze or cough into your sleeve.</b> Your clothes are washable and less likely to come into contact with a surface that someone else will touch. <br />
<br />
<h3>
<b>What should you do if you get the flu?</b></h3>
<br />
Rather than repeating what has already been written, you can go to this information I wrote for Sepsis Alliance: <a href="https://www.sepsis.org/sepsis-and/influenza/" target="_blank">Sepsis and Influenza</a>. There, you'll find not only more information on the flu itself, but the signs and symptoms, as well as when to see a doctor.<br />
<br />
Good luck during this flu season. It's a bad one.<br />
<br />
<br />Marijke Vroomen-Durninghttp://www.blogger.com/profile/14436563110710429784noreply@blogger.com0tag:blogger.com,1999:blog-659197563728114440.post-87123921706980186162017-06-27T09:12:00.000-04:002017-06-28T15:54:33.681-04:00Cue the Music: It's a Small World (and you meet people in the most unexpected places)I'm sending out this blog post from lovely Charleston, S.C. I was invited here on a press trip sponsored by the American Cancer Society and Extended Stay America hotels, to highlight <a href="https://www.extendedstayamerica.com/acs-partnership" target="_blank">Hotel Keys of Hope.</a> It's a program that offers low or no-cost hotel rooms to people who are diagnosed with cancer and must travel away from home for treatment.<br />
<br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjOozJr_2gc0LzNDVDu-K2F0cjvEQy8pokQoymmBIEX9kF_QOaJQH-vL0JSuh7mALtBZCYbVNXZlfW8p6OC_c_sLZ7ybwXhHFewMAkhsXYOFW94MfrC7rSFb9JTpNNW_wx1RmNqz9ZvGFw/s1600/waterfront+1.JPG" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="640" data-original-width="480" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjOozJr_2gc0LzNDVDu-K2F0cjvEQy8pokQoymmBIEX9kF_QOaJQH-vL0JSuh7mALtBZCYbVNXZlfW8p6OC_c_sLZ7ybwXhHFewMAkhsXYOFW94MfrC7rSFb9JTpNNW_wx1RmNqz9ZvGFw/s200/waterfront+1.JPG" width="150" /></a>It's no secret that being ill with an illness like cancer can have a significant financial impact and this program aims to help relieve some of that impact and stress. I'll write more about the program tomorrow - we have one more day (today) of this event and I have more to learn. But I was psyched about a "it's a small world" moment I had yesterday.<br />
<br />
When you're on a press trip, you rarely know anyone else. It's like being invited to a big party and you don't even really know the host. So no matter how introverted or shy you may be, you have to put yourself out there. In this case, I have stories I have to write about the people I meet, so I really need to put myself out there.<br />
<br />
As I was going around meeting my fellow event attendees, I saw a lovely young woman and her companion who I'd not met yet, so I went over to chat. As we exchange the usual "where are you from?" question, she told me they were from Montreal. OK. I live in Montreal. Small world. Where in Montreal. St-Henri. Ok, small world continued. My oldest son lived there for a while and my youngest son works in that area now. I told her I live in NDG (another borough). She said she had too and mentioned a street not far from me. Ok, this world is getting smaller. Then I mentioned the suburb I grew up in and raised my children (Chateauguay), and that's when things got really "woah." She went to school on our street. She is the same age as my daughter, but they went to different schools.<br />
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: left; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhBhveHZFza9hyZiNMZVn5vlpOLlkFO3f2B6C_K8SIMhCYgj_xzU3KKR-ohR_TXqCYFFaPICcud7GuV4EgUFhfbbliAbpl9S0bi3L4krTgg8deTr38NO_OF87WYn4JdUIFt8hb_70-DG08/s1600/nalia.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="960" data-original-width="720" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhBhveHZFza9hyZiNMZVn5vlpOLlkFO3f2B6C_K8SIMhCYgj_xzU3KKR-ohR_TXqCYFFaPICcud7GuV4EgUFhfbbliAbpl9S0bi3L4krTgg8deTr38NO_OF87WYn4JdUIFt8hb_70-DG08/s320/nalia.jpg" width="240" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Nalie Augustin (she's the younger, prettier one!)</td></tr>
</tbody></table>
And then I realized who she was. <a href="http://www.nalie.ca/" target="_blank">Nalie Augustin</a>. She is a young woman who had been diagnosed with breast cancer when she was 24 - a very unusual diagnosis at that age. She had been featured in our local news and that's where I'd seen her. You can read about her on her website and <a href="http://www.nalie.ca/blog/" target="_blank">her blog</a>. <br />
<br />
She and her boyfriend, Vee, are taking videos and lots of photos of their time here because that's what they do. Nalie has a <a href="https://www.youtube.com/user/nalieagustin" target="_blank">YouTube show,</a> in addition to her site, blog, and other social media presence. She offers tips to others who are living through cancer. She has a mission:<br />
<br />
<br />
<br />
<blockquote class="tr_bq">
<b>"As a Writer, YouTuber and Speaker, I share my journey for 3 reasons:<br />
</b><br />
<b>Inspiration: </b><span style="font-weight: 400;">I want to inspire
you to NEVER GIVE UP! Whether it’s cancer, or whatever it is you wish to
conquer, take whatever you can from my crazy journey and let it
catapult you into LIVING the life you’ve always dreamed of. </span><b><br />
</b><span style="font-weight: 400;"><br />
</span><b>Aspiration:</b><span style="font-weight: 400;"> I have big
dreams and I refuse to let cancer stop me from achieving them. Knowing
that life is short and clearly, we have no idea what tomorrow will bring
– every day, I aspire to be better, do better and make a difference in
this world for as long as I’m in it. </span><span style="font-weight: 400;"><br />
</span><span style="font-weight: 400;"><br />
</span><b>Awareness: </b><span style="font-weight: 400;">It is my duty to prove that breast cancer doesn’t just happen to elder women. That even the</span><span style="font-weight: 400;">
healthiest people are not exempted. Generation X- Y – Z: Check your
boobs! I vow to leave as much information as possible for women who may
follow my footsteps by providing knowledge that I wish I had!"</span></blockquote>
<br />
She's an amazing woman with a great message to share. I'm glad I met her. <br />
<br />
<br />Marijke Vroomen-Durninghttp://www.blogger.com/profile/14436563110710429784noreply@blogger.com1tag:blogger.com,1999:blog-659197563728114440.post-90790157121511594492017-06-26T06:40:00.000-04:002017-06-26T07:02:11.894-04:00Do Nurses Have a Role in Complementary Therapies?<style>
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Last year during the Olympics, the
practice of cupping was brought to the forefront. Many athletes were spotted
sporting large round welts on their their back, shoulders, and upper chest that
were caused by cupping. This caught the attention of the sports analysts and
reporters, and the Western world quickly became interested in this new-to-them
practice.</div>
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<br /></div>
<div class="MsoNormal">
<a href="http://www.acupuncturetoday.com/abc/cupping.php">Cupping</a>
is an old traditional form of Chinese medicine, often used in conjunction with
acupuncture. I went for acupuncture last week to help deal with a headache I had since January. It was a sinus-type headache but tests and scans showed that there was no infection, allergies, inflammation, nothing. So, I returned to an acupuncturist I'd visited a few years before. I forgot that she did cupping after the acupuncture session:</div>
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<br /></div>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjliVgJyO5iDnrg2u34KY8-b0yJKEUQx2tlFnSNScEeoCZ40i0cB8-9_lpCHtIRZmU4UnVs0IrtE5rG3V6hBKaFZ_WZrfvRM_iNwZRCFj3R0l6GY_RlgISXrcnOrROEFdkBi0HuLZGpbi4/s1600/cupping.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" data-original-height="960" data-original-width="721" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjliVgJyO5iDnrg2u34KY8-b0yJKEUQx2tlFnSNScEeoCZ40i0cB8-9_lpCHtIRZmU4UnVs0IrtE5rG3V6hBKaFZ_WZrfvRM_iNwZRCFj3R0l6GY_RlgISXrcnOrROEFdkBi0HuLZGpbi4/s200/cupping.jpg" width="150" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Cupping mark on my shoulder</td></tr>
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<br /></div>
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It doesn't hurt while cupping is done and while it looks like a nasty bruise, it's only tender if you press hard on it. It looks awful but - my headache is virtually gone. It's down to about 10% of what it was before. I'll be going for another session later this week. So was it the acupuncture? The cupping? Both?</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Practitioners claim that cupping can treat many disorders,
including asthma, arthritis, GI upsets, and chronic pain, among others.
Generally, the practitioner heats the air in a cup, usually with a flame, and
the cup is placed on the skin. This produces suction. It’s believed that this
suction promotes blood flow to the area, resulting in better health. When the
cup is removed, a red or bruising mark may be left behind.</div>
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<br /></div>
<div class="MsoNormal">
Regardless of what we may personally believe about
complementary and alternative medicines, patients are using them. An
article I wrote for <a href="http://nursing.onclive.com/publications/oncology-nurse/2015/october-2015/integrative-healthcare-caring-for-the-whole-patient"><i style="mso-bidi-font-style: normal;">Oncology Nursing News</i></a> in 2015 stated
that, “53% of American adults used CIT [complementary and integrated therapies]
at some point in their lifetime, and 42% said they used it within the past
year. People with cancer reported even higher use: 65% of cancer survivors used
CIT at some point, and 43% used it within the past year.”</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
As nurses in North America, we generally work in facilities that
focus on evidence-based medicine. Some facilities have developed
integrative therapy departments, where patients can benefit from complementary
medicines, such as acupuncture or massage therapy, along with Western
medicines. These include facilities such as <a href="http://www.hopkinsmedicine.org/integrative_medicine_digestive_center/">Johns
Hopkins</a>, <a href="http://my.clevelandclinic.org/services/wellness/integrative-medicine/about">Cleveland
Clinic</a>, and <a href="http://www.mayoclinic.org/departments-centers/general-internal-medicine/minnesota/overview/specialty-groups/complementary-integrative-medicine">Mayo
Clinic</a>. I wasn’t able to find any similar departments associated with
Canadian hospitals, although many major cities do have integrative medical
clinics. So what do we say if patients ask us our opinions on complementary
medicine?</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
The College of Registered Nurses of Nova Scotia <a href="https://crnns.ca/wp-content/uploads/2015/02/Complementary-and-Alternative-Health-Care.pdf">published
guidelines</a> for nurse practitioners and registered nurses on the topic. The
document reviews the nurses’ role in therapies, the nurses’ ethical and
professional responsibilities, and how nurses might have a role in practicing
complementary therapies. The college concluded: “Registered nurses and nurse
practitioners can be actively involved in the delivery of CAHC therapies or
simply help clients access appropriate information and make treatment
decisions. Regardless of their role, RNs and NPs must be well informed and possess the appropriate knowledge
and skills to provide safe care. Having evidence informed knowledge of
potential benefits and risks of particular therapies is crucial. As RNs and NPs
strive to provide comprehensive care for their clients, they must always ensure
that they practise CAHC within the context of a nursing framework and within
their standards of practice and code of ethics.”
</div>
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<br /></div>
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Personally, I believe in some types of complementary
medicine, but not necessarily alternative medicine. I have used acupuncture and
massage therapy with good results. Complementary means that the
treatment is in conjunction with evidence-based medicine practices. Alternative
implies that the treatment is instead of. However, regardless of our own
beliefs, it is vital that our patients trust us enough that they tell us if
they are undergoing other forms of treatments or therapies. They may be more
willing and open to telling their nurses than their doctors, for fear that
their doctors will insist that they stop their treatments. As nurses, we can
help them understand why it’s important that they be open with their treating
physicians.</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
Do you see a role for nurses in complementary health
practices?</div>
<div class="MsoNormal">
<br /></div>
<div class="MsoNormal">
<br /></div>
Marijke Vroomen-Durninghttp://www.blogger.com/profile/14436563110710429784noreply@blogger.com0tag:blogger.com,1999:blog-659197563728114440.post-28997122610758914212017-06-01T09:59:00.001-04:002017-06-01T09:59:15.808-04:00Sepsis – So Deadly, So Under Recognized<br />
I work with a US-based group, <a href="http://www.sepsis.org/" target="_blank">Sepsis Alliance</a> (SA). It’s a patient advocacy group with a mission to raise sepsis awareness and save lives. While it’s an American organization, the situation in the US parallels that of Canada when it comes to sepsis recognition and management. According to a report issued by Stats Canada in 2011, one in every 18 deaths in Canada is due to sepsis—one out of every 18. In the US, it kills over a quarter of a million people every year. That is a lot of deaths. Why is this happening?<br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjEi3siVPNBe-d6vhajSDiHyZNO-f-dGSXKMs2puUU2AgbyxXSFuLOubuJPQ4zFntBSwBb5N3ZWBF81tjMT31T9qzmUf09RHWPKW9EJAJvajfvjrtV_rovH2RntbM-LjlmEB1jhiN5Cl4A/s1600/clock+sA.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" data-original-height="1000" data-original-width="750" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjEi3siVPNBe-d6vhajSDiHyZNO-f-dGSXKMs2puUU2AgbyxXSFuLOubuJPQ4zFntBSwBb5N3ZWBF81tjMT31T9qzmUf09RHWPKW9EJAJvajfvjrtV_rovH2RntbM-LjlmEB1jhiN5Cl4A/s320/clock+sA.jpg" width="240" /></a></div>
Sepsis isn’t always preventable, this is true, but early detection and treatment often prevents it from progressing to severe sepsis and septic shock. A couple of years ago, I saw how effective a sepsis protocol can be. A family member who had a stroke was diagnosed with endocarditis while in the ICU. He showed the classic signs of sepsis onset and the staff was all over it, preventing more complications. Research has shown that for every hour patients with severe sepsis aren’t treated, their chance of survival drops by 8%. Like stroke and myocardial infarctions, there is a “golden hour,” during which immediate treatment can mean the difference between life and death.<br />
<br />
I’ve learned a lot about sepsis and its impact over the past seven years, working with SA. One of my tasks is to respond to emails from people who want to share their stories of sepsis, hoping to spread the word to spare someone else the same pain. The stories, which are published on the site, are heartbreaking: parents who lost children, children who lost parents or siblings, survivors who live with life-changing effects caused by sepsis. So many of these victims may not have been in that situation if they or someone else had recognized the signs and symptoms of the condition. <br />
<br />
Jim O’Brien, MD, former medical director of SA, often says that we could—right now—cut the sepsis death rate in half even without new technology, new tests, or new medications, simply with early recognition and immediate treatment with antibiotics and fluids. But there lies the rub –sepsis has to be recognized in time for successful treatment. People need to know about it and how to recognize it. <br />
<br />
According to annual surveys commissioned by SA, most people have never heard the word “sepsis,” and many of those who have, don’t know what it means. The medical community is partly responsible for this. We talk about people dying of complications of pneumonia, of urinary tract infections, or meningitis. But that’s not that they died of; they died from sepsis. If someone has cancer, develops an infection and dies, it’s not the cancer that killed, them, it’s sepsis. But we don’t say that.<br />
<br />
In three months it will be September, Sepsis Awareness Month. Let's find ways to spread awareness, to educate people about this often fatal illness that no one knows about. If you'd like to learn how, SA has developed tool kits for the public, professionals, and the media: <a href="http://www.sepsis.org/sepsisawarenessmonth/" target="_blank">Sepsis Awareness Month.</a><br />
<br />
<br />
<br />Marijke Vroomen-Durninghttp://www.blogger.com/profile/14436563110710429784noreply@blogger.com0tag:blogger.com,1999:blog-659197563728114440.post-14673388589605538602017-04-12T10:33:00.000-04:002017-04-13T05:44:06.805-04:00Whistle Blower Nurse Fined by Her Own Professional BodyI have two questions for you:<br />
<br />
If you see something wrong and this something is hurting or having a negative impact on people, is it not your duty to speak out about it?<br />
<br />
Does it matter what your profession is if you do call it out?<br />
<br />
The answer to the first question should be - in my opinion - yes, it is your duty. The answer to the second question seems to be a bit more complicated if you are a nurse and you live in Saskatchewan, Canada.<br />
<br />
I remember reading about Carolyn Strom last year and I didn't think too much about the story because I figured that the story didn't have legs and that everything would work out. I was wrong.<br />
<br />
Two years ago, Carolyn, an RN, wrote a post on her Facebook page about the quality of care her grandfather received in a long-term care facility, particularly at the end of his life when he was in palliative care. She criticized the care, but according to reports, she also offered solutions - being a nurse herself, she understood the issues associated with caring for patients in a long-term care environment. However, her professional body, the Saskatchewan Registered Nurses Association, charged her with professional misconduct and Carolyn was fined $26,000.<br />
<br />
What is worrisome about this is that Carolyn was not acting as a nurse at the time, she was acting as a private citizen who was concerned about the lack of quality care not just for her grandfather, but other patients at this facility and similar ones. She was expressing her frustration and disappointment as anyone might. Except, she has an RN behind her name, which apparently means she's not allowed to express those thoughts.<br />
<br />
According to the <i><a href="http://www.theglobeandmail.com/opinion/a-preposterous-injustice-grieving-nurse-slapped-with-a-26000-fine/article34642979/" target="_blank">Globe and Mail</a></i>, this is what Carolyn wrote:<br />
<br />
<blockquote class="tr_bq" style="background: rgb(255, 255, 255); border: 0px; font-family: Garuda, Verdana, Geneva, sans-serif; font-size: 12px; font-stretch: normal; line-height: 1.5; margin-bottom: 20px; outline: 0px; padding: 0px; vertical-align: baseline;">
“My grandfather spent a week in palliative care before he died and after hearing about his and my family’s experience there, it is evident that not everyone is ‘up to speed’ on how to approach end of life care or how to help maintain an aging senior’s dignity.<span style="background-color: transparent;"> </span></blockquote>
<blockquote class="tr_bq" style="background: rgb(255, 255, 255); border: 0px; font-family: Garuda, Verdana, Geneva, sans-serif; font-size: 12px; font-stretch: normal; line-height: 1.5; margin-bottom: 20px; outline: 0px; padding: 0px; vertical-align: baseline;">
“I challenge the people involved in decision making with that facility to please get all your staff a refresher on this topic and more. Don’t get me wrong, ‘some’ people have provided excellent care so I thank you so very much for your efforts, but to those who made Grandpa’s last years less than desirable, please do better next time.”</blockquote>
So, Carolyn was charge by the body's disciplinary committee with five breaches:<br />
<br />
1- Not respecting patient confidentiality<br />
2- Failure to follow proper channels in making a complaint<br />
3- Making comments that have a negative impact on the reputation of staff and a facility<br />
4- Failure to first obtain all the facts<br />
5- Using her status of registered nurse for personal purposes<br />
<br />
Here are my arguments:<br />
<br />
1- When it is your family member, patient confidentiality doesn't work here. When my mother was dying last year, I could have written about it all I wanted as long as she had never expressly forbidden it. (This charge was dropped).<br />
<br />
2- Should Carolyn have written a letter to the facility or gone higher? Yes, she should have. However, she could have done so and still posted on social media as a private citizen. Many of us have stories of letters of complaint we've written that were never addressed.<br />
<br />
3- So, does this mean we can't bash United Airlines for the horrible video of a man being forcibly removed from his seat a few days ago? Because it would have a bad reputation on the staff and organization?<br />
<br />
4- Can anyone ever obtain all the facts?<br />
<br />
5- We all use our background, education, and "status" for personal purposes. It's who we are. Does this mean that I can never comment on anything health or medical related - because I'm a nurse? Why is her call out of her grandfather's care any different than a sibling who isn't a nurse might have been?<br />
<br />
So, what is the message here? If you're a nurse and you see bad care, shut up. Don't tell anyone. Don't vent on social media. Don't criticize. If you do, you're guilty of professional misconduct.<br />
<br />
<br />
You can read more about her story here on the <a href="http://www.cbc.ca/news/canada/saskatoon/carolyn-strom-appeal-grandfather-facebook-comments-1.4064502" target="_blank">CBC website</a>.<br />
<br />
And there is a <a href="https://www.gofundme.com/support-nurses-right-to-speak-out" target="_blank">GoFundMe</a> page raising money to help Carolyn pay those ridiculous fines, if you feel so inclined to help her.<br />
<br />Marijke Vroomen-Durninghttp://www.blogger.com/profile/14436563110710429784noreply@blogger.com0tag:blogger.com,1999:blog-659197563728114440.post-90908485906648060622017-02-28T08:48:00.000-05:002017-02-28T08:48:00.865-05:00Your Failure to Plan Doesn’t Constitute an Emergency On My Part: Mandatory Overtime<div class="MsoNormal">
<span style="font-size: 12pt;"> </span><span style="font-size: 12pt;">When we think of mandatory – or forced – overtime, our minds
might go back to the day before labor unions, when people in factories were
steadily working hour after hour, day after day, in unsafe and unpleasant
conditions. But mandatory overtime is not a thing of the past for some nurses
in Canada. It’s a reality.</span></div>
<div class="MsoNormal">
<o:p></o:p></div>
<div class="MsoNormal">
No one argues that units must be staffed – there must be a
certain number of nurses to maintain a safe level of patient care. But what
happens when there is no staff to cover the next shift? <o:p></o:p></div>
<div class="MsoNormal">
At first, supervisors usually ask for volunteers who would
like to work overtime. But what does the hospital do when no nurse steps
forward? If they can’t call for outside help (private agencies), their only
option may be to pressure nurses into working another shift or, to bluntly tell
nurses that they must stay. This is mandatory overtime, although they may not
use those words.<o:p></o:p></div>
<div class="MsoNormal">
While the administrators are solving their staffing
problems, they are causing a whole host of problems for their nurses who need
or want to go home – they may have daycare issues, classes to attend, senior
relatives to care for, important appointments to keep, or they may need to get
some much needed sleep. <o:p></o:p></div>
<div class="separator" style="clear: both; text-align: center;">
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjH5wWTkxNMoW5Cgqr9KEp8OX9meSORSjvwslkPPe8hpAiWTXZ9Pj3Qa4RnnhMjLxibcoMEnXMhJgZRHsihfFADxWyz5NxmZxJkRF0zzl0KQgmRmpmBTl8GNlF_kXJhyiF_szcQWPJsggE/s1600/istock_nurseBP.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjH5wWTkxNMoW5Cgqr9KEp8OX9meSORSjvwslkPPe8hpAiWTXZ9Pj3Qa4RnnhMjLxibcoMEnXMhJgZRHsihfFADxWyz5NxmZxJkRF0zzl0KQgmRmpmBTl8GNlF_kXJhyiF_szcQWPJsggE/s1600/istock_nurseBP.jpg" /></a></div>
<div class="MsoNormal">
If nurses refuse to work overtime, they may be threatened with
“abandoning their patients.” However, according to the Canadian Federation of
Nurses in their <a href="https://nursesunions.ca/position-statement/mandatory-overtime">position
statement</a> on mandatory overtime, this is not true. The union says, ”It is
important [to know] that refusing duty to care is not [to be] confused with
client abandonment, which occurs when a nurse leaves before the end of a
scheduled shift, or being unavailable during a scheduled shift for a period of
time that compromises patient/resident/client care.” So, by saying that you
can’t/won’t work an extra shift, you cannot be told you are abandoning your
patients. But that is on paper. Our conscience may say otherwise. <o:p></o:p></div>
<div class="MsoNormal">
Research has shown that tired workers make more mistakes.
Tired workers have more accidents going home. They are unhappier overall, and
their health may suffer over the long-term. In fact, a 2015 review study,
published in the <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2960295-1/fulltext"><i style="mso-bidi-font-style: normal;">Lancet</i></a>, looked at people who
consistently worked more than the usual 40-hour workweek. The researchers found
several studies that concluded that these workers are at a higher risk of
stroke. <o:p></o:p></div>
<div class="MsoNormal">
This problem must be addressed, particularly as patients who
are in the hospital are sicker than they ever were before. They need more eyes
on them, more procedures done with them, and more split second decisions made.
Their nurses must be on the ball and refreshed, not tired and frustrated
because they are at work against their will.<o:p></o:p></div>
<div class="MsoNormal">
The union’s position paper goes on to say, “With the
exception of disaster situations, or emergency circumstances (where the Code of
Ethics outlines the duty to provide care), nurses unions feel that there are no
circumstances whereby employers should mandate employees to work overtime.
Mismanagement of human resources and chronic unfilled vacancies do not
constitute emergency conditions or grounds for ordering mandatory overtime.
Additionally, the right to refuse duty to care may also be applied during an
emergency situation when ability to provide safe care is compromised by
unreasonable expectations, lack of resources or ongoing threats to personal
well-being.”<o:p></o:p></div>
<div class="MsoNormal">
In other words, your failure to plan ahead of time doesn’t
constitute an emergency on my part.<o:p></o:p></div>
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What do you think hospitals should do if there is no one
available when a nurse’s shift is over?<o:p></o:p></div>
Marijke Vroomen-Durninghttp://www.blogger.com/profile/14436563110710429784noreply@blogger.com6tag:blogger.com,1999:blog-659197563728114440.post-59608065255025574322017-02-24T08:24:00.001-05:002017-02-24T08:31:41.127-05:00Do You Take Your New Prescriptions Right Away?I came across an interesting, but not unsurprising press release this morning. It seems that a study done in Spain found that over 15% of patients who received a new prescription did not get it filled. The study, which was published in the <i><a href="http://onlinelibrary.wiley.com/doi/10.1111/bcp.13215/abstract" target="_blank">British Journal of Clinical Pharmacology</a></i>, found that initial medication non-adherence, or non-compliance, was 17.6%.<br />
<br />
The most common medication prescriptions not filled were for a certain type of pain reliever (22.6%) and the least common was for ACE inhibitors, usually used to manage high blood pressure, hypertension (7.4%).<br />
<br />
Understanding why someone doesn't fill or take a new prescription is important and it can have a substantial impact on a person's health. Do they not fill the prescription because they don't agree with the diagnosis? Can they not afford the medication? Do they plan to do so later but then get too busy or forget? Did someone talk them out of it?<br />
<br />
The researchers did find that the patients who were most likely not to fill their prescriptions were:<br />
<br />
<ul>
<li>Younger adults, </li>
<li>Americans (the study was done in Spain), </li>
<li>Having a psychological or psychiatric disorder, </li>
<li>Having a pain disorder, or</li>
<li>Receiving treatment by a substitute/resident GP in a teaching center.</li>
</ul>
<br />
<br />
<blockquote class="tr_bq" style="background-color: white; box-sizing: border-box; color: #333333; font-family: "Open Sans", "Helvetica Neue", Helvetica, Arial, sans-serif; font-size: 14px; margin-bottom: 15px; margin-top: 5px;">
"We are especially concerned about the high rates of initial medication non-adherence in chronic treatments such as insulins, statins, or antidepressants and suspect that it is also related to an increase in costs, so we are designing an intervention targeting high risk patients," said Dr. Maria Rubio-Valera, senior author of the <em style="box-sizing: border-box;">British Journal of Clinical Pharmacology</em> study.</blockquote>
<br />
So what can we do to about this? Patients must take control of the conversation, no matter how hard <br />
it might be. Patients need to ask their doctors why they are prescribing medications. If they don't understand the responses, the patients need to push for clarity. And if the patients feel they won't or don't want to take their medications, they have to relay this to their doctors so alternative treatments can be discussed. It's not a good idea to let the doctor believe you are going to be compliant if you don't plan on it.<br />
<br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiZKHqiQ2smSGlXPtlusJuc8XH-XQ2qYfmETNC92gkOHWKaPZ8YbW94GIbwzZlShMoqdeG0C-8B3oRejsd_V_7q5gkJaxdpcSrNF-zzU6Rfw926rLW5Puvc-1F2266eZUAMC4kX1cBOT_s/s1600/Free+Image+-+pills+out+of+bottle.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiZKHqiQ2smSGlXPtlusJuc8XH-XQ2qYfmETNC92gkOHWKaPZ8YbW94GIbwzZlShMoqdeG0C-8B3oRejsd_V_7q5gkJaxdpcSrNF-zzU6Rfw926rLW5Puvc-1F2266eZUAMC4kX1cBOT_s/s200/Free+Image+-+pills+out+of+bottle.jpg" width="133" /></a>And how can healthcare professionals help? Nurses, for example, are often in a good position to question why patients aren't taking their medications and to explain why the medications are necessary. Many times patients will tell nurses things that they would never discuss with their doctor. And doctors need to be aware, or more aware, of why their patients may be reluctant to fill that prescription. Taking a few minutes to explain why it's important and to actually ask if there are any concerns regarding the medication, the treatment overall, or even the cost, could make a big difference.Marijke Vroomen-Durninghttp://www.blogger.com/profile/14436563110710429784noreply@blogger.com0tag:blogger.com,1999:blog-659197563728114440.post-200331030314170232017-02-13T06:00:00.000-05:002017-02-13T06:00:08.174-05:00Facebook, Instagram, and Twitter – Nurses Beware?Should nurses be using social media? Of course, there’s nothing to stop nurses from having social media accounts. These accounts allow them to chat with friends and family members, share photos, and learn about what’s new in the cyberworld. But when social media crosses over into the work and professional world, things can start to get murky.<br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEihA8n1Xis07Nb1m_OZQlxzyCJ90RrM4t8Kat1aRxFUStbrciDwXsvRr715A__w5jHJeZ9LuyicAiAI58OllWO3B3MEI0hepNuP5Z3Z84eakXSPig6njW7x25hBpcku_-s-CderKeY2x1k/s1600/internet+surfing+dreamstime_xs_29126056.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="211" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEihA8n1Xis07Nb1m_OZQlxzyCJ90RrM4t8Kat1aRxFUStbrciDwXsvRr715A__w5jHJeZ9LuyicAiAI58OllWO3B3MEI0hepNuP5Z3Z84eakXSPig6njW7x25hBpcku_-s-CderKeY2x1k/s320/internet+surfing+dreamstime_xs_29126056.jpg" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-family: inherit; font-size: xx-small;">© Gajus | Dreamstime.com - <a href="https://www.dreamstime.com/royalty-free-stock-image-closeup-woman-surfing-internet-image29126056#res17647513">woman surfing internet</a></span></td></tr>
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It’s reality – nurses share stories with each other. I don’t know many nurses who don’t swap some at-work tales about particularly memorable patients or situations. We usually are very mindful of not providing details or enough information that someone could be identified, but part of this peer-to-peer sharing can be helpful in allowing us to blow off steam, to get support, or even to learn things about how other nurses may have handled a particular situation. But speaking to one nurse in a social situation and telling a story online where hundreds of people could see it – or more if the story is spread by others – is a different situation. What may not be recognizable to a person in a one-on-one conversation, may be identifiable to someone in a much bigger crowd. <br />
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Some nurses have taken this storytelling a step further by taking photos at work and sharing them online. Taking photos and sharing them without the subject’s permission is almost always a no-no, but to do so in a healthcare environment? It seems surprising that any nurse would think that is ok to do. But it has happened. According to a <a href="http://www.medscape.com/viewarticle/753317_3" target="_blank">Medscape article</a>, a nurse in a trauma unit did just that. <br />
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We also have to think about ourselves, our privacy, and our safety. Unfortunately, not all the people we deal with at work are nice. While most of our patients, clients, and families are good people and wouldn’t want to harm us, there are always a few who are either very unhappy with the care they’ve received (or didn’t, depending on the situation) or are generally unhappy people overall. With it being so easy to track people down using the Internet, the risk of being found through social media by people who may want to cause problems is there. <br />
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It’s also possible for patients or families to investigate nurses by looking at their online profiles. If they find photos or comments that could be seen as unprofessional, this could cause conflict at work, and employers may see this as a breech of ethics. <br />
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We could argue that what we do on our own time, professional-looking or not, is our own business, but not everyone sees it that way. The Medscape article says: "We violate our patients' trust if there are pictures of us on Facebook behaving unprofessionally, making off-color remarks, or expressing certain opinions online. Patients do see these things, and some are actively looking for them. It's our professional obligation to behave in a certain manner." <br />
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Do you use social media? If you do, do you have rules about what you will post and what you won’t?<br />
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<br />Marijke Vroomen-Durninghttp://www.blogger.com/profile/14436563110710429784noreply@blogger.com0tag:blogger.com,1999:blog-659197563728114440.post-24395652867574711172017-02-08T06:32:00.000-05:002017-02-08T09:15:19.575-05:00No Time to Exercise - Short Bursts of Activity Work TooWe hear it all the time when it comes to getting exercise: "Just get moving," or "take the stairs instead of the elevator or escalator," but do those short bursts of energy really make a difference in our overall fitness levels? For those who are used to seeing friends and colleagues going to the gym for hours on end or running long distances, a shorter time for exercise done at home (or at work) may seem too good to be true. But it's not, say many exercise gurus, including the author of the book One-Minute Workout and a new study published in the journal <i>Medicine & Science in Sports & Exercise</i>.<br />
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According to a press release issued today:<br />
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<span style="background-color: white; color: #333333; font-family: "open sans" , "helvetica neue" , "helvetica" , "arial" , sans-serif; font-size: 14px;">"Interval training offers a convenient way to fit exercise into your life, rather than having to structure your life around exercise," says </span><span style="background-color: white; color: #333333; font-family: "open sans" , "helvetica neue" , "helvetica" , "arial" , sans-serif; font-size: 14px;">Martin Gibala, a professor of kinesiology at McMaster and lead author on the study. </span><span style="background-color: white; color: #333333; font-family: "open sans" , "helvetica neue" , "helvetica" , "arial" , sans-serif; font-size: 14px;">"Stair climbing is a form of exercise anyone can do in their own home, after work or during the lunch hour," says "This research takes interval training out of the lab and makes it accessible to everyone."</span></blockquote>
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The researchers performed a small 6-week study (31women) that evaluated two protocols. The women were sedentary before beginning the study. Sessions took place three times a week and took about 30 minutes total over the course of a week, 10 minutes per session for warm up, cool down, and recovery.<br />
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<tr><td class="tr-caption" style="text-align: center;">© Dirima | Dreamstime.com - <a href="https://www.dreamstime.com/stock-photo-sporty-woman-running-climbing-stairs-urban-female-athlete-hiit-workout-image71662748#res17647513">Sporty woman running and climbing stairs</a></td></tr>
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The first experiment had subjects performing three 20-second sessions of continuous stair climbing at maximum ability ("all-out") compared with subjects who exercised with the same intensity but on exercise bikes. In the second experiment, the participants vigorously climbed up and down one single flight of stairs for 60 seconds. According to the press release, both protocols increased the participants' cardiorespiratory fitness. (Note: I was unable to find the study online so I can't be more specific with these findings). Considering how tiring it can be to climb stairs, this doesn't seem to be a stretch.<br />
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But not everyone has stairs at home, so if doing stairs isn't your thing, there are other options that may prove equally effective. A new iBook called <a href="https://itunes.apple.com/us/book/how-to-watch-tv-and-get-fit/id1150148522?ls=1&mt=11" target="_blank">How to Watch TV and Get Fit, 3 Minutes at a Time</a>, by Debbie Rahman, presents you with a 12-week program that works on helping your cardio, strength, and balance. The book's website has a few <a href="http://watchtvandgetfit.com/sample-videos" target="_blank">sample 3 minute exercise videos</a> (Disclosure: I recently met the art director of this project). Again, this approach may seem too good to be true, but if you're trying to squeeze some exercise into your life but something more structured isn't going to work, a program like this could be the answer.<br />
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So whichever approach you use, it's good to know that if you don't have the time or the desire to commit to joining a gym or taking part in lengthy time consuming exercise programs, there is still hope.Marijke Vroomen-Durninghttp://www.blogger.com/profile/14436563110710429784noreply@blogger.com0tag:blogger.com,1999:blog-659197563728114440.post-82557195322522684572017-02-03T04:33:00.001-05:002017-02-03T04:33:57.618-05:00What Do Crocheted Octopuses and Preemies Have in Common?As much as people like to trash Facebook, I have to say it is a great way to learn about ideas and issues around the world - unique things that you may never have heard about otherwise. Take this story for instance.<br />
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Researchers from Denmark discovered that premature babies in neonatal intensive care units (NICUs) respond positively when they have a crocheted octopus at their side. The crocheted tentacles of the octopuses* remind the tiny babies of their umbilical cord. While babies are in utero, they often<br />
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grab hold of their cord as they float around in their cocoon-like home, but once they're born, there's nothing for them to grab on to, other than their life-saving tubes that may be pulled out or dislocated. But babies who were each given a crocheted octopus seemed less stressed. Nurses have observed the babies' heart and respiration breathing rates drop when they are able to hold on to the tentacles. Another important benefit: if the babies are holding and pulling on the tentacles, they are less likely to pull on those tubes.</div>
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A hospital in the UK decided to give their premature babies their own octopus to see if it would make a difference, according to an online article in <a href="http://www.prima.co.uk/family/kids/news/a37423/crocheted-octopuses-help-premature-babies/" target="_blank">Prima</a>. The nurses in the hospital did find that the octopuses helped their little charges.</div>
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First kangaroo care (holding baby to the skin), now octopuses, what next will we find will help those fragile babies?</div>
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*This is the correct plural form of octopus :-) </div>
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<a href="https://en.oxforddictionaries.com/definition/octopus" target="_blank">Oxford Living Dictionaries</a></div>
Marijke Vroomen-Durninghttp://www.blogger.com/profile/14436563110710429784noreply@blogger.com0tag:blogger.com,1999:blog-659197563728114440.post-35261468949566198822017-01-31T05:20:00.000-05:002017-01-31T05:35:05.064-05:00Snow-Related Heart Attacks May Show Up Two Days LaterEvery winter we hear stories about people who have heart attacks after a heavy snowfall. It's not hard to imagine. People who are usually sedentary or moderately active take to shovelling out their driveways or to rescue their cars from mountains of snow pushed to the side of the road. A<a href="https://academic.oup.com/aje/article-abstract/doi/10.1093/aje/kww219/2964505/Time-Course-of-Cause-Specific-Hospital-Admissions?redirectedFrom=fulltext" target="_blank"> new study</a> suggests that while the heart attack/snow shovelling connection is valid, it's the moderate snowfalls that seem to have the most effect. In addition, the heart attacks often present two days after the snowfall.<br />
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<tr><td class="tr-caption" style="text-align: center;">© Luckydoor | Dreamstime.com - <a href="https://www.dreamstime.com/royalty-free-stock-photography-snow-shovel-image37814107#res17647513" style="font-size: small; text-align: start;">Snow Shovel</a></td></tr>
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This large study took place from 2010 to 2015 and looked at over 400,000 adults who had been hospitalized at two hospitals in Boston. The researchers assessed patients who had been admitted with cardiovascular conditions and cold-weather conditions (frostbite and falls/injuries). Interestingly, the researchers found that admissions to hospital for patients with heart disease occurred most often (increased by 23%) after moderate snowfalls, defined as 5 to 10 inches, rather than high snowfalls. Cardiovascular disease admissions actually dropped by 32% on high snowfall days, the authors wrote.<br />
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One theory that might explain why moderate snowfalls have more of an effect is that people may stay inside more during heavier snowfalls and that moderate falls seem easier to manage.<br />
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So be careful, even if the snowfall isn't drastic and beware of the signs and symptoms of a heart attack for a few days after your time shovelling snow:<br />
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<li class="_AXc" style="border: 0px; list-style-type: disc; margin: 0px 0px 4px; padding: 0px;">Pressure, tightness, pain, or a squeezing or aching sensation in your chest or arms that may spread to your neck, jaw or back.</li>
<li class="_AXc" style="border: 0px; list-style-type: disc; margin: 0px 0px 4px; padding: 0px;">Nausea, indigestion, heartburn or abdominal pain.</li>
<li class="_AXc" style="border: 0px; list-style-type: disc; margin: 0px 0px 4px; padding: 0px;">Shortness of breath.</li>
<li class="_AXc" style="border: 0px; list-style-type: disc; margin: 0px 0px 4px; padding: 0px;">Cold sweat.</li>
<li class="_AXc" style="border: 0px; list-style-type: disc; margin: 0px 0px 4px; padding: 0px;">Fatigue.</li>
<li class="_AXc" style="border: 0px; list-style-type: disc; margin: 0px 0px 4px; padding: 0px;">Lightheadedness or sudden dizziness.</li>
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Marijke Vroomen-Durninghttp://www.blogger.com/profile/14436563110710429784noreply@blogger.com0tag:blogger.com,1999:blog-659197563728114440.post-32280864705409469672017-01-27T07:04:00.002-05:002017-01-27T07:04:54.041-05:00My Professional Website Update I've been writing and editing health and medical information since the late 90s, going full-time in 2009. I love my work, even if that means having to do something I'm not thrilled about: marketing. Being a freelance writer means you have to constantly market yourself to ensure a steady flow of clients and work.<br />
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Much of my work comes from repeat clients and I get a good bit through referrals from colleagues or other editors who have passed on my information. But I also have to make sure that I'm out there so people who are looking for health writers - or nurse writers - can know that I'm available. So, as a freelance writer, my website (along with this blog) allows potential clients to find me and see if I might be a good fit for their needs.<br />
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Before I began doing this on a full-time basis, I designed my own website and it worked well. I received many queries, some that resulted in paying work. But as the years passed, my site began to scream out "I designed this myself," and it was no longer a look I wanted. I bit the bullet and hired a web designer. I wanted a site that showed potential clients that I am a professional, but I wanted it clean and something that reflected my niche of health writing. And I got it:<br />
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<img border="0" height="225" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg0p2c04rDUV7zgYBDvw8ss6yokoA4wJmLrZZhBUj0qouwAPQ2HXf_2NtDTx9P6qlshA7pp5VNm5bAz52YdGbp57S1n7jf7YsLKSgwlZ1aV2Tdqy2NwVNEp2wwYdFfBara-QnTThq5rGq0/s320/MHW+screenshot.png" width="320" /><a href="http://www.medhealthwriter.com/" target="_blank">http://www.medhealthwriter.com</a></div>
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The designer nailed it. It's clean, the colors are what I would have picked, and it presents really well.<br />
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There is some debate as to whether writers need their own site now. There are many sites that allow writers to post their CVs or writing samples. I am registered with some, but I think it's important for writers to also have their own space that they're in charge of. The other sites may be helpful, but we're at their mercy, whether it's updated, how it looks, and more. So I think that my website is a good investment.<br />
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So, here is my new website. Here's to a new year of work and discovery!<br />
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<br />Marijke Vroomen-Durninghttp://www.blogger.com/profile/14436563110710429784noreply@blogger.com0tag:blogger.com,1999:blog-659197563728114440.post-46905169157792507292017-01-26T08:33:00.000-05:002017-01-26T09:16:04.382-05:00Are Menopause Symptoms Made Worse by Anxiety?The symptoms of menopause can be distressing for many women. From the hot flashes to insomnia, the severity of the symptoms can affect their quality of life. If we already know that anxiety can make symptoms of any condition worse, does that mean if a woman is anxious, will she experience more drastic menopause symptoms? According to a study published in the journal <i><a href="http://journals.lww.com/menopausejournal/Abstract/publishahead/Association_between_anxiety_and_severe.97842.aspx" target="_blank">Menopause</a></i>, yes, it does.<br />
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The study looked at data from 3,503 women who were post menopausal. The researchers found that 61.9% were depressed and that 13.7% of the women reported a severe impairment in their quality of life; 25.5% mentioned severe urogenital symptoms (vaginal dryness and urinary incontinence) and 18.5% said they had severe psychological symptoms.</div>
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So what does that mean practically? The researchers concluded that screening of women undergoing menopause is important, but it's also important for women themselves to be aware of this possibility. If you do have anxiety or you have started to feel symptoms that make you believe that you're getting increasingly anxious, there are some steps you can take on your own to try to reduce the anxiety. These include things like meditation, mindfulness, exercising regularly, and keeping a journal, for example. Of course, professional help and guidance from a counsellor or therapist may be more appropriate.</div>
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Whichever steps you take, it's important to understand that you're not alone. According to a press release discussing the study:</div>
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<span style="background-color: white; color: #333333; font-family: "open sans" , "helvetica neue" , "helvetica" , "arial" , sans-serif; font-size: 14px;">"Although anxiety is a common symptom during menopause, panic attacks are not," says Dr. JoAnn Pinkerton, NAMS executive director. "This study documents the importance of screening patients for anxiety. If women are having significant anxiety, they should discuss viable treatment options with their healthcare providers. These can include relaxation techniques, caffeine reduction, and exercise. Estrogen therapy or other mood medications might also prove helpful.</span></blockquote>
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Have you gone through menopause? How have you found the process?<br />
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Marijke Vroomen-Durninghttp://www.blogger.com/profile/14436563110710429784noreply@blogger.com0tag:blogger.com,1999:blog-659197563728114440.post-6993340083002627332016-08-29T15:57:00.000-04:002016-08-29T15:57:07.170-04:00Reducing Falls in Seniors Using TechnologyI've written many articles and blog posts about home safety for seniors - how to reduce the risk of falls by changing the environment and by managing health and medical issues. Falls at any age can be serious, but as we age,<a href="http://medhealthwriter.blogspot.ca/2007/07/broken-hips-in-elderly-can-lead-to.html" target="_blank"> one fall can start a domino effec</a>t, leading to severe disability or even death.<br />
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Over the years, researchers have been trying to find ways to predict who is at highest risk of falling and how we can best prevent these accidents from happening. There have been studies that use scores, assessing mental and physical ability, for example, but nothing seems to be too effective yet. Now, with technology advancing as it is, perhaps there is a solution.<br />
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According to this <a href="http://www.eurekalert.org/pub_releases/2016-08/uom-ssi082616.php" target="_blank">press release</a>, researchers have developed sensors that monitor a person's gait and stride, and could predict if the person is at risk for falling within the next few weeks. The sensors kept track of regular motion and walking, and picked up on any changes that could indicate weakness or an irregularity.<br />
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<span style="background-color: white; color: #333333; font-family: "Open Sans", "Helvetica Neue", Helvetica, Arial, sans-serif; font-size: 14px; line-height: 23px;">"Results from an analysis of the sensor system data found that a gait speed decline of 5 centimeters per second was associated with an 86.3 percent probability of falling within the following three weeks. Researchers also found that shortened stride length was associated with a 50.6 percent probability of falling within the next three weeks."</span></blockquote>
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If something like this is successful in predicting falls, this could not only help reduce falls, but reduce the worry of family members who are concerned about their older relatives living alone. Good news all around. Kudos to the researchers who are working to keep our seniors safe. After all, it could help us one day too.Marijke Vroomen-Durninghttp://www.blogger.com/profile/14436563110710429784noreply@blogger.com0tag:blogger.com,1999:blog-659197563728114440.post-37884685210401075682016-07-05T05:45:00.001-04:002016-07-05T05:46:42.101-04:00HPV Vaccine Study Shows Reduction in Cervical Cell AbnormalitiesGardasil, a vaccine that helps prevent four human papilloma viruses (HPV) known to cause cervical cancer and cervical warts, was approved in the United States and Canada in 2006. Since then, millions of doses have been given, and probably an equal number of debates about its utility and safety have been argued among both the general public and healthcare professionals.<br />
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<b>New study findings </b><br />
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A new study published last week in the <i><a href="http://www.cmaj.ca/content/early/2016/07/04/cmaj.151528.abstract?sid=1703bfb8-7df7-4d5f-9783-29d1e891ecb0" target="_blank">Canadian Medical Association Journal</a></i> reviewed the efficacy and safety of the vaccine over the past eight years. The study included 10,204 women, aged 18 to 24 years, who had undergone Pap smear testing for cervical abnormalities. Most women in the group, 8,723 (85.5%) did not have any abnormalities, but 1,481 women (14.5%) did; 1,384 of these women had low-grade cervical anomalies and 97 had high-grade abnormalities.<br />
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The researchers found that 56% of the women were not vaccinated with Gardasil and 16.1% in this group had cervical abnormalities. Forty-four percent of the women received at least one dose before their screening test; 84% in this group were fully vaccinated, having received 3 or more doses; 11.8% in the fully vaccinated group had cervical abnormalities. In other words, women who had received the full dose of Gardasil had a lower incidence of cervical abnormalities that could lead to cancer.<br />
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<b>But is the vaccine safe?</b><br />
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Tara Haelle did such a good job last year in her article about Gardasil vaccine that I thought it was better to refer you to her piece: <a href="http://www.forbes.com/sites/tarahaelle/2015/07/15/gardasil-hpv-vaccine-safety-assessed-in-most-comprehensive-study-to-date/#39132d4153ad" target="_blank">Gardasil HPV Vaccine Safety Assessed In Most Comprehensive Study To Date</a>.<br />
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But what about long-term efficacy, some people ask? What if it stops working? Yes, it's true that we don't know if the vaccine's effectiveness will last - but we didn't know that about the other vaccines we took either. I was vaccinated with the hepatitis vaccine when I first began working as a nurse. It was hospital policy and we didn't really have a choice. At the time, we weren't told that it was only effective for 25 years. We didn't know.<br />
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<b>The morality argument</b><br />
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Just a few weeks ago, I read a respectful debate between a group of people who weren't sure if they wanted to vaccinate their teens, both male and female, with Gardasil. Most were in favor of the vaccine, while a few others were either hesitant or against it. I do realize that some parents are distrustful of vaccines, particularly one that appeared to come onto the scene as quickly as Gardasil. But I was surprised to see someone pull out the morality argument in the discussion - that if you gave your daughter Gardasil, you were condoning early sexual behavior.<br />
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That argument always bothers me. We will never control how or when our children have sex simply by not giving them a vaccine for a sexually transmitted infection. That just isn't going to happen. And what about all those whose teens and children whose first sexual experiences aren't their choice? We can never forget the number of teens and children who are abused, who are victims of sexual predators. Using sexual morality as an excuse to not give the vaccine just doesn't hold water.<br />
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So is Gardasil a good thing for our children?<br />
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<br />Marijke Vroomen-Durninghttp://www.blogger.com/profile/14436563110710429784noreply@blogger.com0tag:blogger.com,1999:blog-659197563728114440.post-31653575112555323352016-07-01T07:21:00.000-04:002016-07-01T07:23:38.806-04:00Happy Canada Day! Let's Give Everyone Something to Be Grateful ForIn this time when bad news is hitting us from all sides, I want to take a moment to wish my fellow Canadians a happy Canada Day. I hope that you are able to spend the day as you wish, whether it be with family and friends, or taking some time to yourself. If you're one of the many Canadians who are working today because you are needed, like my fellow nurses, I hope your day is a smooth one, with as few problems as possible.<br />
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Canada is far from perfect. We have serious issues that we need to not only acknowledge, but address in an effective and fair manner. There are Canadians who suffer needlessly as the result of current conditions, such as those who live in impoverished First Nations communities or those who are homeless in our bustling cities. There also many Canadians who are suffering the effects of events that occurred in the past, including residential school survivors and their families. These too, need to be resolved to the best of our ability.<br />
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I don't get political on this blog - it's a health-related project. But often the two cross over. Poverty, illness, illiteracy, abuse, violence - these all affect mental and physical health. For a country to be truly strong, these issues must be dealt with equally for all citizens, regardless of who they are and where they may have come from.<br />
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But how do we do this? It's a huge task and it's not something one person or one organization can do alone. But one person and one organization can be pieces of the bigger puzzle. I try to work on literacy. I strongly believe that the more effectively people can communicate and understand, the better the chances that they can tackle the problems life throws at them.<br />
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However any of us choose to try to help others, we have to remember that we are in this together. We can't allow petty things and small differences divide us. We need to remain a community and reach out to those who need us. This is what makes us strong.<br />
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So Happy Canada Day to my Canadian friends, colleagues, and readers. Let's spend the next 365 days finding ways to help each other, so when our 150th birthday rolls around next year, we have something even more special to celebrate.<br />
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<br />Marijke Vroomen-Durninghttp://www.blogger.com/profile/14436563110710429784noreply@blogger.com0tag:blogger.com,1999:blog-659197563728114440.post-21728592795394793432016-06-19T06:22:00.001-04:002016-06-19T06:22:34.561-04:00Lack of Sleep Makes for Cranky Teens, Says Study - You Think?I'm on the duh-study trail again. My latest find is "Adolescent sleep duration is associated with daytime mood." Well then. What a shocking finding from a National Institutes of Health <a href="http://www.eurekalert.org/pub_releases/2016-06/aaos-asd061516.php" target="_blank">supported study</a>.<br />
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According to the news release (I don't have a copy of the study findings), the researchers studied 97 healthy teens from 14 to 17 years old to follow their sleeping habits. The teens were allowed only 6.5 hours in bed per night for five nights in a row (sleep restriction), then a two-night break (a "washout period") and this was followed by five nights straight of 10 hours in bed per night. The researchers looked at the teens' daily self reports on nervousness, sadness, anger, energy, fatigue, ability to concentrate, and sleepiness.<br />
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According to the news release:<br />
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Results show that adolescents showed increased variability in sadness, anger, and sleepiness when sleep was restricted compared to when sleep was extended. This effect was not moderated by age, sex, race, or the order in which participants underwent the sleep conditions.<br />The study also showed that nightly fluctuations in sleep in healthy adolescents predict worse mood the next day, and worse mood any given day largely predicts unusually bad sleep the next night.</blockquote>
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So here we have it - less sleep equals less happy teens. Any parent could have told us that.<br />
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In all seriousness, the authors do say that the research is necessary because they are concerned about the mental health of teens - an important issue to be sure. But their conclusion, that these findings indicate that by promoting healthy sleep habits, we may be able to reduce the risk of mental health problems among some teens, is too simplistic. We know that lack of sleep causes problems, particularly if it's chronic. We also know that teens need a lot of sleep, as they did when they were infants - a teen's body is growing and changing at incredible rates.<br />
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My issue with these Duh Studies is that they're sent out into the media world without any real meaning. Yes, teens need sleep. Yes, they're crabby and don't function well without sleep. Now what?<br />
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<br />Marijke Vroomen-Durninghttp://www.blogger.com/profile/14436563110710429784noreply@blogger.com0tag:blogger.com,1999:blog-659197563728114440.post-27117139677134953092016-06-15T08:11:00.000-04:002016-06-15T08:11:50.667-04:00Senior Moment - Memory Clutter?We all have our forgetful moments, a word we can't bring to mind, a name we've forgotten, or an appointment that slipped past us. We can't remember everything. Those who can, like actor <a href="http://abcnews.go.com/blogs/entertainment/2012/04/actress-marilu-henners-rare-super-memory-recalls-every-day-of-her-life/" target="_blank">Marilu Henner</a>, are few and far between. But, as we get older, we seem to take more notice when we forget things, often making jokes about aging and memory loss, or perhaps fearing that this is what is happening.<br />
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While memory loss and the fear of dementia are concerning, they don't affect everyone who gets older. Forgetfulness though, is different, and researchers from the Georgia Technical Institute in Atlanta, Georgia, believe that a good part of the aging forgetfulness is merely a matter of us just having too much information to store. In other words, our hard drive has run out of space and certain files have to be archived.<br />
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The <a href="http://www.sciencedirect.com/science/article/pii/S0028393216301178" target="_blank">researchers used EEG to study </a>the brains of two groups of subjects, those over the age of 60 years and college-age students. Both groups were shown photos of every day images and told to focus on certain things and ignore others.<br />
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At first, both groups were able to remember what they were told to focus on, and both had trouble ignoring what they were told pay attention to. But when the older subjects were questioned further about what they were supposed to focus on and remember, over time they became less sure of their responses and the other objects in the photos interrupted their memories. "[W]hen we asked if they were sure, older people backed off their answers a bit. They weren't as sure," lead author Audrey Duarte said in a release. The brain activity, recorded by EEG, showed that the older group put more effort into sorting out the appropriate memories.<br />
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"While trying to remember, their brains would spend more time going back in time in an attempt to piece together what was previously seen," she said. "But not just what they were focused on -- some of what they were told to ignore got stuck in their minds," she added.<br />
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This was a study environment, but we are faced with situations like this every day - walking to work, going out to lunch or dinner with friends, even shopping. We may be in a grocery store, with music overhead, conversations around us, and displays with food tasting, all while we're trying to concentrate on remember what we need to buy. Younger people who are asked what occurred during that time may have an easier time recalling what they saw or heard, while an older person may have to sort through different memories, clutter, trying to pull out what is relevant.<br />
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Why are details like this important to study? Duarte said that such findings could explain why seniors fall for scams that use manipulation. "If someone tells you that you should remember it one way, you can be more easily persuaded if you lack confidence," she said. "This memory clutter that's causing low confidence could be a reason why older adults are often victims of financial scams, which typically occur when someone tries to trick them about prior conversations that didn't take place at all."<br />
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It's an interesting look at memory as we age.<br />
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<br />Marijke Vroomen-Durninghttp://www.blogger.com/profile/14436563110710429784noreply@blogger.com0