Marijke: nurse turned writer

New Year: New Resolutions? Maybe Not a Good Idea

2012-01-02T20:57:00.000-05:00

It's the same thing every year: come the holiday season, we start hearing from gyms, exercise companies, diet gurus, and all other types of life improvement people and groups, all encouraging you to contact them so they can help you keep your New Year Resolutions. The typical ones are, of course, losing weight, getting fit, spending less money, spending more time with the people you love, and so on. But while the intention is good, is making such resolutions such a good idea? Does it work? If you're like most people - probably not.

Most our flaws, as we may see them, come from years of accumulation. That extra 30 pounds you're carrying around? That didn't just happen over a few weeks. Your smoking habit? It didn't start last month. Spending too much money? Surely that's nothing new. In other words, it took years to get where we are now, it seems almost foolhardy to think that it can take only weeks to get out of these habits.

The other drawback is that New Year's Day is an arbitrary day on the calendar. It's only one of 365 (or 366) days and it's really not that much different from any other. Except perhaps in a bad way: there is a lot of pressure on that one day. Because it is a new year, people expect others to proclaim that they will honour that new year with a new twist on life. And they'll watch you. Promise you'll lose weight? What will your friends and family say when they see you having a beer or helping yourself to a second scoop of ice cream?

All this isn't to say that we can't and shouldn't make changes. Most of us do have areas where we can improve our life. So if picking the first day of a new year isn't the right thing to do, what is?

Pick a date

First, don't be pressured because of the time of year. Allow yourself to choose when you want to make the changes in your life. Experts who help people quit smoking often say to pick a quit date - so you can do the same. Pick a date when you feel it would be good for you to start going to the gym, stop watching so much TV, start organizing your messy room, and so on. But pick a date that doesn't have any strings attached to it. Pick a day that is just an ordinary day. Write down that date, circle it on the calendar, and tell others if you think it will help. Do what you can to ensure that you will be ready when that date comes.

Make a lifestyle change - not a habit change

It's all so negative: I have to stop smoking. I have to lose weight. I have to become more organized.... Rather than focusing on what you have to do (or feel you have to do), focus on what you can do to help achieve the goals. If you want to stop smoking, changing habits that encourage cigarettes may be a big help. Do you join coworkers for a coffee and cigarette at break time? Why not go for a walk and have a cup of tea instead? Do you always have a cinnamon donut from the coffee shop on the way to work? Why not stay at home a bit longer and make your coffee, enjoying it there? Do you see the difference? You're not trying to deprive yourself - you're trying to change the circumstances so you don't engage in the behaviours you are trying to avoid.

Don't bite off more than you can chew

As mentioned already, these habits didn't just start overnight and they won't stop overnight. The best way to make stop doing something that you feel is harmful is by making lifestyle changes overall. If you want to start exercising, start out with something manageable, that you would be least likely to ditch because you can't do it. Don't pay a fortune to join a gym that you may not use. Just start walking, outside if possible. Walking outside gives you the advantage of scenery, people watching, changes in terrain, and getting some fresh air. You can choose to walk just a few blocks in the beginning, walking farther and farther as you become used to it. You can walk alone or with a partner. And it is very do-able. You can add to the walking once you are comfortable with it. Join a class maybe, go swimming, or do some other activity. Gyms are great places to work out, but before committing the money, be sure that the gym is a place you will go.

If you're trying to lose weight, don't look at *all* the weight you have to lose. It may be too overwhelming. Why not start at losing the first 10 pounds or going down a clothing size? If you give yourself smaller goals, you are much more likely to reach them.

Focus on the positive

Did you miss walking three times out of five days last week because of commitments? Don't beat yourself up. You walked twice, right? Did you walk most of the days the week before? Will you walk most of them next week? Don't focus on what you didn't do - focus on what you DID do.

It's the same thing for losing weight. Were you eating a healthy diet for the past few weeks? Did you just slip up and have a couple of glasses of wine at dinner and then a bigger piece of birthday cake than you felt you should have? Ok, you did. But what about all those other dinners where you didn't have wine and didn't eat cake? Those have to count for something, don't they? Don't focus on the "slipping," focus on the times you felt you did what you wanted to do.

Celebrate your successes

Reward yourself. The carrot is so much more appealing than the stick. If you have a goal, such as going down a clothing size, tell yourself you can buy a new pair of jeans. If your goal is to become more organized in your bedroom, promise yourself a new book or pair of earrings if you manage to keep it organized for a set amount of time. Do you want to exercise more? Treat yourself to a special coffee or lunch after you've walked a certain amount of days. Of course, things are often better if done and celebrated with someone else, so if you have support, take advantage of it and let others help you celebrate.

Forget the New Year Resolutions. Make changes in your life when you want to make them because you choose to make them.

Bone marrow transplants - would you consider being a donor?

2011-11-16T11:20:00.001-05:00

This is a reprint of a blog post from 2008, but the topic is as timely now as it was three years ago.

Many people donate blood. Many people have signed organ donor cards. But how many people are registered to be able to donate bone marrow?

Bone marrow donation has a lot of misconceptions but if everyone who gave blood - and those who didn't - would register for bone marrow donation, the number of lives that could be saved would be astronomical.

According to the Canadian Blood Services, and keep in mind that the US is not that different, "About 1,500 Canadians have received transplants through the Canadian Blood Services Registry. However, even with millions of donors on registries worldwide, a perfect bone marrow match isn’t always available."

First, what is bone marrow and why is it so darned important?

Bone marrow is the soft tissue that is found inside our bones; it's the spongy tissue in the breast bone, ribs, hips, pelvis, skull and spine. The role of bone marrow is to make blood cells - white blood cells to fight infection, red blood cells to carry nutrients from the lungs to the body tissues, and platelets that allow the blood to clot.

People with diseases that affect the bone marrow die of infection or inability for their blood to clot. The most commonly known disease that requires bone marrow transplant is leukemia, although there are many more.

What is involved in being a donor?

Not too much initially, really. First, you need to register and your local blood collection agency needs to know what genetic make-up you have. So, that means providing a swab from inside your mouth or a vial of blood for testing.

After this has been tested, you are entered into the bone marrow data base. Now - you may never ever be called - or you might. If your marrow is found to be a match to someone in need, anywhere, you will be called and asked if you still want to donate. This is a critical moment - if you register to donate, you just may be called.

Waiting for a donor to be found is tough. A friend of mine waited for a donor. One was found and she was so cautiously optimistic. Something happened, however, and the donor backed out. My friend was devastated - as were we. Finally, a donor was found, but I can't imagine what must have been going through her mind while she waited for it to actually happen.

How is the bone marrow taken from you and given to the recipient?

Bone marrow donation is typically done as day surgery although you could be kept in the hospital for a day or two. There's no doubt that there is some discomfort involved. You will feel soreness in the hip area for a few days after the procedure, but it isn't unbearable.

You would receive either a general anesthetic or a spinal before the procedure is done. The marrow is removed from the large bones of your pelvis using a needle. Afterwards, if you need, usually over-the-counter medications will relieve any pain. The marrow is then processed and the recipient gets it through an IV.

Are there any risks when donating?

Donating marrow is a medical procedure and no medical procedure can guarantee that there are no risks. However, that being said, considering the number of bone marrow donations done, it's been found that it is a very safe procedure. The risks do include a reaction to the anesthetic and infection where the needle was injected. Rarely, there may be some tissue damage.

So, we're back to the question: Would you consider becoming a bone marrow donor?

Identifying Anxiety and Seeking Help

2011-11-09T17:47:00.001-05:00

Stress and anxiety aren't new feelings/emotions, although we seem to have tried to corner the market on it these days. People worried and stressed over life and family since time began. Hunters had to find food. Nomads had to find safe places for shelter. Farmers needed their crops to grow. Parents needed their children to stay healthy and grow up to adulthood, and the cycle continued as society changed and developed. Some eras were more filled with worry than others, but no matter what, humans always had something to worry about.

Today, our stresses and anxieties are very different, yet they are strikingly similar at the same time. Many people worry about how they are going to feed their families and keep a roof over their head, because they aren't working or they are one of the millions of working poor. People stress over their or their loved ones' health; sons, daughters, spouses, and friends are still going off to war; farmers still are at the mercy of the weather; and children still pull away from their parents, going off on adventures and spreading their wings. But what seems to be so different is how we are dealing - or not dealing - with our stresses and anxieties.

There is now more acceptance to admitting to stress and anxiety than may have been a few generations ago. There is so much acceptance that a whole industry has sprouted with the goal of helping people manage or avoid stressful or anxious feelings. But how do you find which one works for you? Do you need to spend a lot of money trying different methods until you find a way of easing your anxiety? What if you worry about never being able to stop worrying?

There's no easy solution. It's not always a terrible thing to be anxious sometimes; the problem is how often and how anxious you feel. If your anxiety is keeping you from living your life as you would like it, keeping your from trying new things, and is making you feel badly about yourself, then it's probably best that something be done about it.

Identify the cause

If possible, you need to identify what is causing your anxiety. Do you get anxious if you have to do something, like get in an elevator or meet new people? Are you worried about your performance at work, your children, or your health? Do you feel that you're anxious about just about anything and everything? If you want to try to manage on your own, there are many options, from trying meditation and yoga to following self-help programs and reading advice books or columns. No one method is good for everyone. If you've heard of a great book that helped your cousin and when you read it, it does nothing for you - don't give up. That just means it wasn't the right thing for you.

Self-help programs

Be cautious when trying different programs or techniques. If you are reading information on the Internet, check first to see that the website is credible and that the information you are reading is helpful, not harmful. Some simple tricks to check out a site's legitimacy is by checking the "about us" section. Who is running the site? Who is writing the material? Does the site have any back up from a university or some organization that is known in the field? How long has it been running and - an important thing - are they trying to sell you something or promise you a miracle cure?

If the site is trying to sell you something, is it something that must be bought or is it something that can be obtained for free elsewhere? Google the program and read opinions and comments - not just the good ones! Is the site promising you a miracle cure or a guaranteed outcome? If so, it may be a good idea to run away as fast as you can. Nobody can guarantee a positive outcome and there is no miracle cure, as much as we would like one. It's tempting to want to believe it, but it's not going to happen.

Asking for help

If you're not the type to go it alone or you feel that your anxiety and problems have gotten to the point that you can't deal with them alone, there are other options. Visiting and speaking to your family doctor (or nurse practitioner) is the best place to start. By doing a physical exam, your doctor may be able to rule out a physical problem that could be causing the anxiety and he or she may be able to refer you to a counselor, therapist, or psychologist to help you learn how to manage your anxiety.

Therapy

Therapy does seem like a scary word to many people. They may envision being prescribed medications that may change their personality or having to speak to someone who just mirrors back what they're told. But therapy comes in many forms and there is no one-size-fits-all approach. As a consumer, which is what you are when you are seeking help, it is essential that you find the right fit for you. This doesn't mean just finding the right type of therapy, but the right therapist. There could be three therapists offering similar approaches to helping manage anxiety, but two of them may not be the right ones for you simply because of personality differences or there just isn't that "click" that you need, and know, when you find the right person.

Finding a therapist

The best place to start to find a therapist would be by recommendation. Ask your doctor or nurse practitioner if they know of counselor or therapists that they would recommend. If you're comfortable, ask friends if they know of anyone. If you do visit someone who has been recommended, don't feel that you have to make it work if something doesn't seem right. A therapist who works well with one person may not be a good fit for another. It happens all the time - don't feel you must stick with someone just because he or she was recommended.

In addition to getting referrals, you can check lists of accredited counselors in your neighborhood, or call the licensing bodies or organizations. It may take a while to find a therapist who you trust and with whom you can work, but it's worth the effort in the long run.

Allow yourself to heal

Anxiety can be all-consuming. It can overwhelm you and seriously affect your quality of life. Learning to manage your anxiety can be just as frightening because you may discover issues that you would rather not delve into or it just may be hard work that you didn't think you would have to do. But if you stick with it, if you work with your therapist or go it alone, the results on the other side of the journey may be very surprising: happiness and contentment, with a minimum of anxiety. Isn't it worth the try?

Managing Pain Properly - No Matter What Age

2011-10-31T15:00:00.001-04:00

Everyone experiences pain at some point in their life, be it the sudden (acute) pain from a bad cut or a broken bone or the chronic pain of a back injury or migraines, just to name a few causes. Acute pain is generally well treated because it is usually caused by something you can see (a cut, a surgical incision, a broken bone), and many analgesics (pain relievers) are meant to handle the pain. Chronic pain, however, can't be seen clearly, can't be identified easily, and certainly can't be treated easily. But is it because it *can't* be treated, or because it *isn't* being treated. There are arguments for both sides.

Throughout my work as a nurse, I saw pain (mis)management for many patients. Rarely were the patients over medicated - they were much more likely to be undermedicated. This happens for many reasons, the most common ones being:

The person assessing the pain is using his or her own thoughts of pain as a measuring stick as to how painful a certain situation should be.
The person assessing the patient doesn't see the patient acting in a way that he or she feels a patient in pain should be acting.
The analgesics prescribed are not effective for the type of pain the patient is experiencing.

Not only did I see it in my professional life, I've seen it personally as well, most recently over this past weekend. My mother fell over a week ago and broke her ankle. Then we were told it was her hip too, now we are back to "just" her ankle. The thing is, she has other chronic problems - in particular a badly damaged back - that cause a lot of pain so at home, she was on a constant dose, every day, of a pain reliever that kept her pain at bay. Once she was admitted to the hospital, this constant pain reliever was discontinued because the doctors needed to assess her overall health.

After a few days of very severe pain, she was prescribed a patch of a medication called fentanyl. It's a great (in my opinion!) way of delivering medication, because the patch goes on your skin and delivers a constant dose of analgesia for three days. There is no up and down of pain reliever levels in your blood, it is always there. After three days, it needs to be replaced, but it is a simple procedure of removing the old patch and applying the new one.

In my mother's case, she had to have the patch removed the same day she was going to surgery for her ankle, so she didn't have a new patch put on. This was Saturday. I went in to see her on Sunday and she was in a lot of pain - more than just post-surgical pain at her ankle, her back was very, very painful. I wasn't sure why, so I looked for her pain patch. She didn't have one. She should have.

I went to speak to her nurse who was puzzled that I would be asking for a pain patch - she said that she would have it again in three days, when it was time for the next switch. I explained to her that she had no patch at that time - nothing. No pain relief other than the short acting acute pain reliever they were giving for her surgical pain. The nurse didn't seem to understand my argument. I kept saying, the patch should have been put back on - it wasn't put back on. It doesn't make sense that my mother (or any patient) should have to wait three days because that is what the medical record said. The medical record is assuming that she had HER PATCH ON.

After much discussion, the nurse said she would call the pharmacy (of the hospital) to see what she should do. Sure enough, she was in my mother's room within a half hour with a new patch for her. When we asked her why my mother hadn't been receiving this pain relief for her chronic back pain, the nurse answered something to the effect of "here we are only concerned with the surgical problem, not her other ones." What?

So, what was wrong with this picture? A lot.

We have an 82-year-old lady who is in a lot of pain from the new fracture and from the old back injury. She has been taking long-term pain medication for years, so her body is used to a certain level of analgesia in her system. This chronic pain medication was taken away from her and not replaced. Therefore, she was in much more pain than she had to be. Because the nurses couldn't be bothered with learning about all of my mother's medical issues, they didn't understand why the chronic pain medication (the patch now) was vital for her recovery. If you are in pain, you can't do your rehab exercises, get out of bed, or even think of getting better. Then the cycle began. Because the nurses didn't understand why her chronic pain relief was necessary, she didn't get it. Because she didn't get it, she had more pain....

Pain is not something that can be ignored, regardless of the cause. A patient who is having pain cannot heal properly. The amount of energy it takes to deal with pain is taken away from the energy needed to heal.

I will be discussing this issue with the hospital once everything has settled down. I do have to say, I was absolutely not impressed with the cavalier attitude of someone who wasn't in pain regarding someone who was.

Healthier Children Through Play

2011-10-19T00:50:00.001-04:00

There are words of gloom and doom all over the media these days: Our children are out of shape, lazy, fat, and developing adult lifestyle-related illnesses, such as type 2 diabetes. And, what is even more frightening, for the first time, this new generation may actually have a shorter lifespan than that of the generation before. Is it all this serious? Is this just a Chicken Little "the sky is falling" subject? Unfortunately, the answer is, yes, it is this serious and no, it's not a Chicken Little scenario.

According to the Nemours Foundation, one out of three American children are overweight or obese. In Canada, it's estimated that 26% of children are overweight or obese. This isn't just a few children. This is millions of children in North America whose health is at risk.

So, what is causing the problem? Why are so many of our children so overweight? Unfortunately, it's not just one thing. Of course, diet is a major issue - generally children who eat well-balanced and healthy portions of meals don't have a weight issue. But our society pushes high calorie, high fat, processed foods because everything has to be done fast, be ready, and convenient. And these are generally not the health choices. The other main culprit for the child obesity problem is lack of exercise. If you don't exercise, use your body, you can't burn off excess calories. Not only will the weight come on, the muscles won't get strong and the whole body suffers.

Is There Time for Play?

"But there's no time for play," you may say. Between the children being at school (sometimes with rather long commutes), at daycare, at music lessons, doing their homework, and so on, where will they find the time to be active?

It used to be that children had plenty of active time at school. Between the recesses in the morning (and sometimes afternoon), plus the play period after lunch, children had the opportunity to run around the school yard, play tag, toss a ball, and just be free to have fun. Unfortunately though, recesses are being cut back in some schools. There's even talk of eliminating them in some places. In addition, many schools use recess as a punishment. If a student doesn't behave or hasn't done her homework, for example, recess is taken away - effectively eliminating any chance the child has for burning off any energy and experiencing social interaction beyond that of inside classes.

Playing at home outside after school isn't an option for many children. They either live in parts of the city where they can't safely play unsupervised; they're in daycare or after school care, so not at home; or there isn't anyone else around to play with them because either the neighborhood children are not allowed the freedom to play outside or they are themselves in daycare.

Another opportunity for exercise used to be from getting to and from school. Children would walk back and forth or ride their bikes. That's not a common sight these days. Parents are often seen driving their children to school even if they only live a few blocks away. For some parents, it is a matter of convenience - they're dropping off their children at school while on the way to work, but other parents don't want to walk (or bike) with their children and they certainly don't trust their children to go alone. The result: no exercise for either child or parent.

Finding the Time for Play

It may seem rather simplistic to say that all we need to do is find the time for children to play, but it could be as simple as that. However, finding the time itself isn't always the easy part. In order for each family to decide that they need to exercise more, allow their children more freedom in what they play and when, the family has to find out what is preventing the play time. If it's because the children have too much homework, this is an issue that should be brought up to the school. If it's lack of space, you may have to look for available play space. If it's time, then scheduling play time, free time, needs to become a priority. Our children are not as healthy as they should be and allowing them to play, to run, to enjoy being children is actually a good way to improve their health. Isn't it worth the investment?

To read about games that we used to play as children and some blog posts and article on playing, visit GamesWeUsedToPlay.ca.

Games We Used to Play

2011-09-11T09:54:00.003-04:00

Every generation says the generation before is different - and this isn't usually meant in a good way. The older generation complains that the newer one doesn't have the same work ethic, doesn't have the same respect for elders, and so on. Now, whether that is true, I can't say, but I do know that the children of today, in North American society, often do not have the same opportunities for free play that we did. This, to me, means they are missing out on something vital, something important in their development.

When we played for hours with our friends, without adult supervision, while we were having fun, we also had to make rules, enforce rules, mediate problems, and sometimes learn to deal with things that just weren't fair. These are all tools that we took with us into adulthood. Was it fair to always be picked last for a team? No, of course not. Is it fair when the child with the ball takes it home because he feels that he wasn't being treated with enough respect? Again, of course not. But much of this was negated by the fun of playing hours long games of tag and hide-and-seek, without being told to be careful, watch what you're doing....

There is a lot of research going on into the importance of free play and it is quite interesting. To encourage discussion of the subject, I have started a website called Games We Used to Play: A Hop, Skip and Jump Down Memory Lane.

The goal of the site is to gather as many stories of games from across the world as we can. One person from one country may post they played a certain game one way, but someone else may recognize it as a game they called a different name and they played with slightly different rules. I am also adding articles about different issues about free play and I encourage people to comment on them, to add their point of view.

Games We Used to Play also has a Facebook page, where we can share more information, and we are on Twitter, at @gamesweusedtopl.

Support Your School Nurse - Even if you don't have kids.

2011-09-07T10:22:00.002-04:00

School nurses play a vital role in our society and most people probably don't even give them a second thought - unless they are thinking about the "cushy" job they may have. Those who think this may be surprised to learn that the school nurse they may remember from the childhood is long gone and the school nurses of today are in a specialty all its own.

In an article I wrote for GE Healthymagination This Isn't Your Mother's School Nurse, I talk about the many issues that school nurses face that they didn't exist a generation or so ago. School nurses are dealing with sick or disabled children who, years ago, would never have been able to attend a school or who may not have lived to school age.

School nurses also have to deal with children who may rarely, if ever, see a doctor or nurse practitioner outside of school. The children may either have no health insurance or may be in a family situation that doesn't allow for preventative health care. School nurses also have to deal with the realities of this generation, which include coordinating and running disaster plans for events such as natural disasters, crime and terrorism. They need to deal with children who are abused or neglected, as well as those who are homeless. And there is so much more.

It was very interesting to speak to the two nurses I interviewed for the article. There are statistics that show that schools who have nurses, particularly full-time nurses, have better attendance rates. We know that if children go to school regularly, they have a better chance of graduating and moving on to further education or finding good, productive work out of high school. School nurses do the actual nursing tasks that teachers and administrators have to do if there are no nurses - and in this day and age of education cutbacks, we can't afford to have teachers doing non-teaching work.

So, please, support your local school nurses. They need to be part of the core group of professionals students encounter at school every day. Having a school nurse is not a luxury. It's a necessity, whether you have children or not.

September is Sepsis Awareness Month

2011-09-01T07:50:00.000-04:00

Infections - we all get them. We may get a cut on our leg that we didn't clean out properly or we may develop a urinary tract infection or even influenza. We may have surgery that has complications or develop a disease like cancer, that leaves us prone to getting infections. However we get the infection, be it viral, bacterial or fungal, there's always the chance that our body will overreact and we develop sepsis.

But what is sepsis? According to Sepsis Alliance, it's the body's toxic response to an infection. In other words, as your body tries to fight the infection, it goes into overdrive and ends up trying to kill you. Some people call it blood poisoning, but that isn't a good word for it because it doesn't accurately describe what is going on.

Once sepsis sets in, your body's organs begin to shut down and eventually, it may cause death. If not death, you could end up having a limb - or several - amputated in order to save your life.

Right now, every 1.75 seconds, someone in the world is diagnosed with severe sepsis. Many more are developing sepsis. In the United States, every 2.5 minutes, someone dies of sepsis. Thousands more are left with life-altering after effects.

September is Sepsis Awareness Month. Please take a few minutes to learn about sepsis and to spread the word. It may be a cliche, but the life you save may be your own.

What Are Advanced Directives?

2011-08-29T09:06:00.002-04:00

Death isn’t usually a topic that someone thinks about on a regular basis, but it is one of the realities of life. When the subject does come up, most people think about funerals, burials, reading of wills, and the many tasks that come after a death. But, how many people know – and have put down on paper – how they would like to be cared for in the period before they die if they aren’t able to make such decisions on their own?

Putting Your Wishes in Writing

Living longer

As we all age and as doctors are able to cure more diseases, we in the Western world aren’t dying as young. We are living longer, sometimes with chronic or fatal diseases. This puts us in a position where we may be alive but may not be mentally capable of deciding on what sort of care we should be receiving.

Loved ones may have to choose for us, often leaving them with many questions about if this is really what we would have wanted.

Advance directives

Advance directives are important documents that can save much heart ache. These documents can ensure that you get the care that you want and expect, and that you can be allowed to die in peace and dignity when the time comes.

Advance directives take the burden off of your loved ones who may be stressed and unwilling – or unable – to make these important decisions for you.

Also called living wills or DNR orders

Advance directives are sometimes called living wills or DNR (do not resuscitate) orders. In some places, they may be called a power of attorney. That term, though, differs in different parts of the country and may not mean the same thing where you are. This is important because if you believe that you have a legal document and it is not considered legal in your area, your wishes may not be carried out.

To be sure that your document is legal and actionable in your state or province, it’s best to go to a lawyer and make sure it meets all the requirements of your state or province. Medical and legal people want to be sure that you have made these decisions while you are of sound mind, that what is written is truly what you want, you understand what is written, and that the decisions that you are making are truly your own.

What to include in your advance directive

When considering your advance directives, you will need to be as direct and explicit as possible. Do you want to be fed by a tube if you can’t eat yourself? Do you want to be kept on a respirator if you can’t breathe on your own? Do you want invasive diagnostic tests done if you fall further ill? Do you blood transfusions? How far do you want people to go to keep you alive? And when do you want them to let go? You may even include information about organ and/or tissue donation.

Make other people aware

Once you have made your advance directives, make sure that the important people in your life have a copy. The document won’t be of any use if no-one knows about it or don’t have access to it. Don’t keep it in your safety deposit box, for example. You can give copies to family members, your doctor or friends. You can even keep one in your wallet so you have it with you in case of emergency.

Review your choices regularly

After the advance directive has been arranged, be sure to review them regularly. Situations change and people change; how you feel when you write the initial document may not be the same as a year later. Your final will is a very important document – and so is your living will.

Accepting Palliative Care

2011-08-24T11:43:00.000-04:00

The death of Canadian politician Jack Layton has reminded us how aggressive cancer can be. Sadly, it still claims many lives. When people are at the end of their life, they would likely benefit from palliative care - often called hospice care. This was a piece I wrote for my website and I think it bears repeating here:

When living with a chronic illness that will lead to death or a fatal disease, the time comes when you may be told that you should consider receiving palliative care.

Shock and Distress

People with chronic or fatal illnesses often live in hope that something can be done to prolong life, if not cure it, even if they do know that this isn’t realistic. When confronted with the idea of palliative care and what this care means, it can be shocking and distressing, because it drives home the point that life won’t be prolonged and that they can’t be cured. In fact, they may feel as if their doctor has given up.

This feeling may be particularly strong when children are involved. It may not be easy for parents to decide on accepting palliative care for their child, feeling as if they have somehow failed in their role as parents.

Transition to Palliative Care

The idea of palliative care shouldn’t come as a shock. If someone has a fatal or chronic illness, or is deteriorating to the point that end-of-life care is being considered by the healthcare staff, the subject should be brought up long before the transition is made.

Proper preparation is the key in a smooth transition from active treatment to comfort care. The patients and their families must come to grips with their new reality of palliative care and they have to be open and willing to accept it for the care to be of any benefit to them.

Unfortunately, the awareness of the need for palliative care isn’t always obvious to the doctors who are still actively treating dying patients because the whole idea of end-of-life care is still fairly new. While a doctor may still be in the “save the patient” mode, he or she may be reluctant to think about palliative care for the patient.

Agreeing to Palliative Care

Once a patient has agreed to transfer to palliative care, they are able to benefit from their services. But, it’s not unusual for someone who has accepted the idea of the care to become resistant or question the need again once they are receiving the end-of-life services. At this point, it’s important for the team to understand and to be able to work with the patient and the family as they go though this phase.

Family and Friends

An issue that may come up when patients enter palliative care is the difficulty that some family members and friends may have with the decision. While the patient may be ready and accepting of the end-of-life, family and friends may not be. The palliative care team is there for not only the patients under their care, but their family and friends too. They can help by talking to them, providing information, and being a shoulder for them to lean on.

It happened again: Fire deaths preventable had there been a smoke detector

2011-08-18T13:30:00.000-04:00

It happens every year, several times a year, but people still don't get the message. Smoke detectors aren't an extra doodad for your home - they are a vital part of your safety. Yet, hundreds of people die in fires when they would likely have lived had they had a functioning smoke detector in their home.

It happened again this week in Montreal, Canada. A kitchen fire, not that big but very smoky, took the life of a father and his three year old son. The boy's mother was clinging to life, but the news just reported that she died this morning. The sad part? When firefighters arrived on the scene, they couldn't get the front door open - something was blocking it. It was the bodies of the three people inside. They made it to the front door, but couldn't open it.

Deaths send another tragic message

Senseless deaths that could have, and should have, been avoided. They died from smoke inhalation, not the fire.

According to the local news, as always after a situation like this, local firefighters and students went door-to-door to check on neighbouring homes and whether they had functioning smoke detectors. Not surprisingly, many did not. Some had detectors but no batteries. One family had something taped over the beeper so it wasn't so loud. The firefighter who saw that one said that the alarm would not have been loud enough to wake someone from a sound sleep.

The United States Fire Administration reports that there were 356,200 fires in the U.S. in 2009; 2,480 people died and 12,600 were injured. Not all deaths and injuries were due to smoke inhalation, but they do count high in the numbers.

FireSafety.gov has good information on using smoke detectors, where they should be installed and how to maintain them. If you are a renter, check your rental agreements. In many places, the building owners are required by law to provide the detectors but the tenants are required to keep them in working order.

If your landlord won't provide you with a detector, this is not something you want to be without. Consider it an investment in your and your family's lives.

On Chemo? Remember to tell your doc about herbal supplements you take

2011-08-17T10:30:00.000-04:00

If it's natural, it's safe, right? If this statement is true, then arsenic and digitalis wouldn't be harmful. Just because a product is natural, coming from the earth or water, does not mean that it is necessarily harmless or safe.

Of course, arsenic and digitalis are extreme examples, but even the approved products sold in the stores and recommended by natural health practitioners are not safe for everyone, which is why it is important to understand what you are taking, how it affects your body, and what interactions it may have with your own medical situation and any medical treatment you may be undergoing.

People who are receiving chemotherapy for cancer are often tempted by supplements, as well as the more standard vitamins, for a variety of reasons, the most common being to deal with the unpleasant effects of chemo and to try to keep their body as healthy as possible throughout the treatment. These are good goals, but as a press release issued last month by Northwestern Memorial Hospital warns, "Acai berry, cumin, herbal tea, turmeric and long-term use of garlic – all herbal supplements commonly believed to be beneficial to your health – may negatively impact chemotherapy treatment." The problem isn't the supplement itself, but how it interacts with everything else your body is being subjected to.

Herbal supplements, defined as plant or plant parts used for therapeutic purposes, can interact with chemotherapy drugs through different mechanisms. Some herbs can interfere with the metabolism of the drugs, making them less effective while other herbs such as long-term use of garlic may increase the risk of bleeding during surgery. While culinary herbs used in small quantities for flavoring are generally safe, consuming large amounts for prolonged periods of time may have a negative effect on the body when going through chemotherapy. "

Recent research shows that 50 percent of patients undergoing chemotherapy did not tell their doctor they were taking alternative therapies. “Some believe it’s not important, while others are uncomfortable admitting they are pursuing alternative therapies,” said [June M.]McKoy, [MD, geriatrician at Northwestern Memorial Hospital and lead investigator on the ASCO presentation]. “The truth is, integrative approaches can be beneficial for cancer patients, but it’s important to take these approaches at the right time and under the supervision of your doctor.”

So, be safe - before taking any substances that your doctor and cancer team isn't aware of, check with them. You may want to bring the actual label of the product you want to take in case there is more in the product than you realize. Different brands may have different binders, dosages, etc.

Back to school means colds, pain and stress... or does it?

2011-08-15T17:03:00.000-04:00

Most parents know that when it's back-to-school time, they start seeing more colds and viruses coming home from school. Other parents see their children developing back pain (heavy backpacks may be the culprit), headaches, stress, and other ailments that they didn't see throughout the summer holidays. Much of this is preventable, with a bit of time and know how.

1- Colds and viruses: Wash your hands, wash your hands, and wash your hands some more. It's not easy to ensure your children wash their hands at school, but you can be sure they do so as they walk in the door. Make it part of the routine: come home, dump the school bag and wash your hands.

Another tip that I used at home when my children were small is we all had our own toothpaste. It was amazing how much that one new rule decreased the number of illnesses that were shared. Most of us don't share toothbrushes, right? But if one child has a cold, uses that brush on the family toothpaste, the virus is easily spread. So, every child gets their own toothpaste. This may also solve the problem that some families have: not all children agreeing on the type or flavor of toothpaste.

2- Headaches: if your child is coming home with headaches, there are a few things you can do to see if you can track down the culprit:

Is your child eating breakfast and lunch?
Is your child getting enough to drink and not getting dehydrated?
Is the bus ride home long and noisy?
Are your child's eyes ok or might he or she need glasses?

Of course, these are only a few reasons why children may get headaches, but they are common reasons. If you can find the cause, you're one step closer to finding the solution.

3- Back pain: if your child has a heavy backpack and doesn't wear it properly, this could lead to back pain. If you're child isn't the only one with a heavy load to carry, it may be worth speaking to the school about strategies to literally lighten the loads.

4- Stress: Stress is a tough one to pin down. Some kids rarely experience it, others are stressed all the time. The important thing is to be sure that you acknowledge that your child may be stressed. It used to be that parents and teachers denied that this was even a possibility, but stress is real, no matter how old you are. If you think your child may be stressed, it may take quite a while to figure it out - sometimes they aren't entirely sure of it themselves.

To lower stress levels in the family overall, here are some tips:

Develop a routine for before and after school. While it may be tough to begin one, routines do help children feel secure if they are feeling out of sorts.
Ensure the children get enough sleep.
Ensure good eating habits. Proper meals, sitting down and taking the time to eat them is not only a healthy thing to do, it's a good time to interact with one another.
Allow for non-scheduled activities. Allow your kids to be kids and enjoy having nothing to do. While it may seem counter-productive in this "must hurry, must be busy" society, there's a lot to be said about day dreaming and just doing nothing once in a while.

WebQuit, a free, online smoking-cessation study

2011-08-14T11:23:00.000-04:00

Are you trying to quit smoking and interested in participating in an online smoking-cessation study? If so, you're in luck. Until August 31, 2011 you can see if you are eligible to enroll in WebQuit, a free, online smoking-cessation study being conducted by Fred Hutchinson Cancer Research Center.

The study began in June 2010 and was designed to look at to improve effectiveness of online smoking-cessation programs. Many people who would like some help to quit smoking but don't want to or can't attend personal group meetings or help groups may choose to use an online program. However, they aren't always effective and can stand some improving, study directors say.

Considering their easy availability and accessibility (24 hours a day), it may be surprising to learn that online smoking cessation programs aren't very successful overall.

According to a recent press release:

Study participants will learn new tools for dealing more effectively with urges to smoke. They also will receive step-by-step quit guides and create personalized plans for staying smoke-free.
Participants will be randomly assigned by computer (like the tossing of a coin) to one of two online smoking-cessation programs. The success rates of participants will then be compared.

To participate, you will have to complete online questionnaires, including one 15-minute follow-up survey. Eligible participants must be at least 18 and not currently participating in other smoking-cessation programs, among other requirements.The study is funded by a grant from the National Cancer Institute.

To enroll in the WebQuit study or for more information, please visit www.webquit.org

Good luck!

Medical Comic Strip, Hits Close to Home!

2011-06-24T14:29:00.000-04:00

Despite the stress and drama of working in health care, nurses and doctors (and other healthcare professionals) can often find something to laugh about. You'll notice that when a group get together and start trading war stories about things that happened during a particularly trying shift.

While some "outsiders" may think it's cruel that we laugh at these things, people need a way to cool off, to laugh at some things, or else the stress just gets to be too much. For instance, not too long ago, I was working in an office setting (not a medical office) where we had doctors come for occasional clinics. I answered the phone and someone said "I'd like to make an appointment with the doctor please." I responded by telling him that there would be no doctor available that whole week and that we were not yet sure if one would be coming in next week. His response? "Ok, I'd like to make an appointment with the doctor for tomorrow then." Um, no... you can't... there is no doctor here this week. "Oh, ok," he said. "I'll make an appointment for next week then."

Did he even listen to what I said at the beginning of the conversation?

This, of course, is just a small snippet of the types of conversations we can have, but when you get a day when most of your conversations like that, you either pull out your hair or you laugh. Luckily, most of us choose to laugh, or there would be an awful lot of bald people in health care.

All this is a run up to a neat comic strip I came across today. So far it is only in French, but there are plans to have it translated in the (near?) future. Even if you don't understand French, some of the comedy is universal, regardless of the language.

The comic strip creators are an ER doctor and nurse who are working together on this project. They are from the Quebec City region and they are drawing on experiences and stories from others. They even invite ideas. So, have a look. I believe that most people will be able to understand. But, I am very eager for them to get this translated because, as much as I enjoy their comics, I'd love for so many more people to as well.

You will find the STAT comic strip at statcomics.com and the weekly strip on the BD de la semaine.

Gastric Surgery – A miracle cure for obestity or false hope?

2011-06-17T12:15:00.001-04:00

There’s been quite a bit in the news lately about gastric bypass surgery and lap banding. It’s now being introduced for morbidly obese children who have no hope of losing weight in the “traditional” ways, but some people are questioning if this is really the way to go.

First, what exactly is gastric bypass surgery?

Gastric bypass surgery is surgery that is done to restrict your stomach from being able to receive more than a small amount of food. The idea is that if your stomach cannot take the food, you will not take in as many calories, thus losing weight and then maintaining a healthier weight in the future. If part of the intestine is bypassed, then not as many calories are absorbed from the food you do eat.

One type of surgery, the roux-en-y, makes the stomach smaller when the surgeon uses surgical staples to make a pouch in the stomach that will receive the food. This smaller “stomach” is then connected to the intestines. Gastric banding involves having a band placed around the upper part of your stomach. This creates a small pouch to hold food. Because your stomach is made smaller, you are limited as to how much food you can consume in one sitting. The advantage that banding has over bypass surgery is the band can be adjusted to regulate how quickly or slowly the food passes through. This is done through a port that is under the skin. The doctor uses a needle to infect or remove water that fills the band.

Why do the surgery?

Gastric surgery for weight loss is supposed to be the last ditch attempt for people who are obese, not merely overweight. Many of those who undergo weight loss surgery have tried every diet or weight loss program they could, with little or no success. The surgery gives them a feeling that they can get control of this, lose weight, and keep it off.

Why not just lose the weight?

It does seem fairly simple, right? Don’t eat as much, do a bit of exercise, and lose the weight. Unfortunately, this doesn’t work for everyone for a variety of reasons. Many people who are overweight do manage to lose some weight while dieting, but many also gain it right back because they haven’t addressed the problems that caused the weight gain to begin with.

Complications

Gastric surgery for weight loss is surgery and comes with all the risks of surgery. While surgery is a risk for all people, it is even more so for people who are overweight or obese. Some common complications with surgery of any type are:

Blood loss
Blood clots in the legs (deep vein thrombosis)
Infection at the surgery site
Pneumonia

Complications specific to gastric bypass surgery include:

Narrowing of the opening between the smaller stomach and the intestine
Ulcers
Iron and vitamin deficiences
Loosening of the staples
Stomach pouch may stretch after time.
Injury to stomach during surgery
Nausea and vomiting

Complications for gastric banding are:

Band may cause irritation to the stomach or slip out of place
Irritation and inflammation of the stomach lining, ulcers
Reduced absorption of nutrients
Nausea and vomiting
Port may become infected

The success of surgery?

Is the surgery successful? For some people, it is very successful. They learn new ways of eating and they change their lifestyle, in addition to having the surgery. For others, it isn’t a success, many times because they don’t make the necessary changes. Yet others experience the complications listed above and, unfortunately, some do die.

Future

A concern that many people have is we don’t know the long-term outlook for people who have had these weight reduction surgeries. While this may not be an issue for adults, it could be very much an issue for children who have the surgery. The decrease in nutrients could have a long-term effect on adult health; doctors just don’t know.

If you are considering gastric surgery for weight loss, this is something that must be thought through and discussed with your doctor. It’s not a magic cure, but it may be the only one for some people.

This blog and link requests - usually refused

2011-05-25T21:33:00.002-04:00

I frequently get emails asking for me to link websites, either in a blogroll or through text links in a post. The vast majority of the websites are income-producing sites. I always refuse those. Others I refuse are ones that are one-sided or promote something I don't believe is good medicine. Let me explain why.

If you look at the sidebar on this site, you will see that my website is HON certified. This certification is valuable and it means the site meets certain standards set by the association. I am not allowed to advertise nor promote items or services that could be questionable. I am not allowed to make money from this site and I have to be very cautious about promoting any website that derives income from linking, etc., such as the nursing education information websites, from which I get many requests. Finally, any news I report must be verifiable and meet reasonable journalistic requirements.

Although I don't update the blog as often as I used to, I still monitor it every day and appreciate that I get many visitors each day because of some of the content. Every time I vow to be more present here, I get busy again with my regular work and this blog is neglected yet again. But even though I don't update regularly, some of the information, such as seniors who break their hip, remain quite popular. For this reason, it is important that it keep its status.

If I believe that a site fits mine, I will link it. If I feel that a site isn't ready but has potential, I will write back and explain why I feel this way and I will consider it at a later date. Getting angry at me (as some have) won't make me change my mind. I am often willing to help people, but I am not obligated to, so getting angry and lashing out won't really change things.

There is a lot of health information on the Internet. Some surveys say that health information is the most commonly searched information of all. The problem lies not with the searching, but in the trusting of sites. While there are many great sites out there, there are even more dangerous ones - sites that give misinformation or one-sided information. When you are looking for information, please be careful. Look to see who is writing the information. Who is sponsoring the site? Are they trying to sell something? Who do they link to? Do they link to reputable places?

Wrong information can be dangerous - be careful.

May is Fibromyalgia Awareness month

2011-05-08T14:07:00.000-04:00

Every month is chock full of awareness dates, but this May, fibromyalgia awareness has more meaning to me. For years, I've been having issues that had me visiting doctors, trying to figure out what was wrong. The biggest problem was that all my tests all came back negative, normal. On paper, I was as healthy as could be. In person, not so much. Recently, one doctor actually sat down and listened to all my complaints - not just one or two specific to a specialty in medicine. He came out and said I had fibromyalgia.

Now, to be perfectly honest, that was not what I wanted to hear, but it was what I expected to hear. I would have preferred to hear that I was hypothyroid or something like that - allowing me to have something that can be identified and specifically treated. But, no such luck. However, it is nice - for me - to have a name to what has been plaguing me all these years. I no longer feel like I'm lazy or worthless because I am too sleepy to get through the day without at least one nap, if not two. I no longer think I'm a wimp because something that causes moderate discomfort to one person is extremely painful to me. I no longer think I have some terrible illness because of the pain I have, because I know it's "normal" for me to have it.

There are many websites that discuss fibromyalgia and there is a lot of misinformation out there. So if you are trying to learn more, I urge you to be sure you go to legitimate places, not sites that promise you cures if you send them money. I'm not saying there aren't some things that can help manage fibro, I just don't want people falling for snake oil cures.

How can you be sure the site is on the up and up? Look at the "about us" section and see who is backing the site and where the information is coming from. How long has the site been in existence? Do other sites link to it? What sites do they link to? Do they say anything that looks too good to be true?

Be careful, do your due diligence. It's bad enough having a syndrome that isn't understood, you don't want to be scammed either, right?

Walnut recall in Canada due to e. coli contamination

2011-04-07T09:24:00.000-04:00

This is a press release issued by the Canadian Food Inspection Agency.

CERTAIN BULK AND PREPACKAGED RAW SHELLED WALNUTS MAY CONTAIN E. coli O157:H7 BACTERIA

Related alerts: 2011-04-04 | 2011-04-03

OTTAWA, April 3, 2011 - The Canadian Food Inspection Agency (CFIA) and Amira Enterprises Inc. are warning the public not to consume certain bulk and prepackaged raw shelled walnut products described below because these products may be contaminated with E. coli O157:H7.
All raw shelled walnuts sold from bulk bins, all package sizes and all lot codes / Best Before dates of the following raw shelled walnuts and products containing walnuts are affected by this alert. The affected products were available for purchase from January 1, 2011, up to and including April 4, 2011. The raw shelled walnuts are imported from the USA.

Brand	Product
Amira	Raw shelled walnuts sold from a bulk bin*
Amira	Prepackaged raw shelled walnuts (Halves/Pieces/Crumbs)
Tia	Prepackaged raw shelled walnuts (Halves/Pieces/Crumbs)
Merit Selection	Prepackaged raw shelled walnuts (Halves/Pieces/Crumbs)
Amira	Mistral Mix containing walnuts
Tia	Mistral Mix containing walnuts
Amira	Salad booster containing walnuts
Tia	Salad booster containing walnuts

*The brand name Amira may not be marked on the raw walnuts sold from the bulk bins.
Consumers who have purchased walnuts from bulk bins are advised to contact the retailer to determine if they have the affected product.
These products have been distributed in Atlantic Canada, Quebec, and Ontario. However, they may have been distributed nationally.
This is an ongoing food safety investigation. The Public Health Agency of Canada (PHAC) is investigating a multi-provincial outbreak of E. coli O157:H7 illnesses in collaboration with provincial health authorities as well as federal health partners including the Canadian Food Inspection Agency and Health Canada.

Public Advisory: E. coli outbreak - At this time, the outbreak investigation indicates that several individuals have reported consuming raw shelled walnuts.

Food contaminated with E. coli O157:H7 may not look or smell spoiled. Consumption of food contaminated with these bacteria may cause serious and potentially life-threatening illnesses. Symptoms include severe abdominal pain and bloody diarrhoea. Some people may have seizures or strokes and some may need blood transfusions and kidney dialysis. Others may live with permanent kidney damage. In severe cases of illness, people may die.

Amira Enterprises Inc., St. Laurent, QC is voluntarily recalling the affected products from the marketplace. The CFIA is monitoring the effectiveness of the recall.
For more information, consumers and industry can call one of the following numbers:
Amira Enterprises Inc. at 1-877-383-9823 or info@amira.ca
CFIA at 1-800-442-2342 / TTY 1-800-465-7735 (8:00 a.m. to 8:00 p.m. Eastern time, Monday to Friday).

For information on E. coli O157:H7, visit the Food Facts web page at: http://www.inspection.gc.ca/english/fssa/concen/cause/ecolie.shtmlhttp://www.inspection.gc.ca/english/fssa/concen/cause/ecolie.shtml

Faces of Sepsis

2011-04-01T14:47:00.002-04:00

22-year-old JonyRose Filip died of sepsis following a urinary tract infection.

Read her story on the Faces of Sepsis.

Migraine Rates Rising?

2011-03-27T09:16:00.000-04:00

Could it be that more people are experiencing migraines than ever before? If a recent study from the Norwegian University of Science and Technology (NTNU) is right, then it's true: migraine sufferers are becoming more numerous.

According a press release discussing the study, there was a 1% increase in people who reported having migraines - now 12%, up from 11%. The issue that seemed to puzzle researchers the most was why the increase occurred. They couldn't find one particular cause for the rise.

What is the difference between migraines and headaches? Here is a video that does a good job of explaining the difference.

In a previous blog post about migraines, I gave some basic information about migraines:

Migraines are very common. According to statistics, up to 17% of women and 6% of men have had at least one migraine. Some people have occasional migraines, but some experience chronic migraines. These, according to the MayoClinic.com, are migraines that occur 15 or more days per month. The National Headache Foundation reports that 80% of migraines are severe and up to 24% of people with migraines have had to go to the emergency room.

What causes migraines? We don’t really know but we do know that there are many triggers. The most well-known ones are migraines that occur with a woman’s menstrual cycle or the ones that occur when some people drink red wine or eat chocolate. Other triggers can be:

- Alcohol
- Allergies
- Bright lights
- Changes in weather patterns
- Lack of or too much sleep
- Loud noises
- Skipping meals
- Stress (physical or emotional)
- Strong odours

Do you have migraines? What do you do about them?

Diabetes "Hotspots" in the US

2011-03-21T10:27:00.000-04:00

An interesting study has identified 10 states as being hotspots for type 2 diabetes. They are:

California: 6.6 million people with diabetes;
Texas: 5.5 million;
Florida: 4.2 million;
New York: 2.9 million;
Ohio: 2.1 million;
Illinois: 2 million;
Georgia: 2 million;
Pennsylvania: 1.9 million;
North Carolina: 1.9 million; and
Michigan: 1.6 million.

The sad and frustrating thing for healthcare professionals is that many cases of type 2 diabetes are preventable. Unlike type 1 diabetes, which often, but not always, begins in childhood, type 2 diabetes can result from being overweight and inactive.

According to the CDC, type 2 diabetes (previously called adult-onset or non-insulin dependent diabetes) accounts for 90% to 95% of all diagnosed cases of diabetes. Let me repeat that: 90% to 95% of all diagnosed cases.

The American Diabetes Association reports: In 2007, diabetes was listed as the underlying cause on 71,382 death certificates and was listed as a contributing factor on an additional 160,022 death certificates. This means that diabetes contributed to a total of 231,404 deaths.

Diabetes is more than just a disease that affects your blood sugar. High blood sugar levels affect your whole body drastically. Having diabetes increases your risk of developing heart disease, nerve pain (particularly in your feet) and inability to fight infection. Having diabetes can lead to an often fatal illness called sepsis. Diabetes can cause kidney disease, too.

The cost of diabetes is enormous. From the financial aspect of dealing with the supplies to manage the disease, to the lost days of work. Diabetes affects the community as a whole.

Are you at risk for diabetes? Take the ADA Risk Test to find out.

Are iodine tablets necessary?

2011-03-17T14:10:00.001-04:00

With all that is going on in Japan right now, the world is focused on the radiation that appears to be leaking from the crippled nuclear power plants. This is scary because we know that radiation is very harmful to us - and as a result, some people are panicking who maybe don't need to panic.

While the Japanese who are close to the incident do have reason to be fearful, those of us in North America are at very little risk. According to the experts who have been interviewed, even if radiation does get into the atmosphere, by the time it would blow over to the west coast of NA, the radiation levels would be minimal. So, is the rush on potassium iodine tablets justified? Not likely.

Iodine tablets don't protect you from overall radiation exposure. They protect your thyroid from damage, which is important, but only one part of your body that can be damaged. And, it can't reverse any effects - it is only preventative. But another thing to remember is that it is a salt and considered a medication - and it can be harmful to some people, so it shouldn't be taken without consulting with your physician.

According to the CDC:

Taking KI may be harmful for some people because of the high levels of iodine in this medicine. You should not take KI if
• you know you are allergic to iodine (If you are unsure about this, consult your doctor. A seafood or shellfish allergy does not necessarily mean that you are allergic to iodine.) or
• you have certain skin disorders (such as dermatitis herpetiformis or urticaria vasculitis).
People with thyroid disease (for example, multinodular goiter, Graves’ disease, or autoimmune thyroiditis) may be treated with KI. This should happen under careful supervision of a doctor, especially if dosing lasts for more than a few days.
In all cases, talk to your doctor if you are not sure whether to take KI.

For more information on potassium iodine, check out these sites:

Charlie Sheen, Brittany Spears, are we seeing any similarities?

2011-03-02T19:31:00.000-05:00

With the entertainment world sitting in a front row seat, watching Charlie Sheen’s self-destruction, isn’t anyone reminded of something similar happening to Brittany Spears not all that long ago?

At first, Sheen’s behaviour looked like typical spoiled brat behaviour – just as Spears’ behaviour did. But as Sheen is spinning further and further out of control, it’s like watching Spears all over again.

While we don’t have an official diagnosis on Spears and nobody has diagnosed Sheen, it seems pretty obvious to the average person that there is much more going on than just bad behaviour.

According to the National Institute of Health, one in four American adults have a mental disorder. The Canadian Mental Health Association says that 20% of Canadians will experience a mental health issue at some point in their lives.

While some mental illnesses are depression and anxiety (which can be life threatening), they include other types, such as bipolar disorder, schizophrenia, and obsessive-compulsive disorder, among many others.

Mental illness is not anything to laugh about. If it turns out that Sheen is just being a jerk, then well, that’s what he is. But it doesn’t seem that way and rather than laughing at him and giving him all this attention, maybe we should walk away and hope that he gets the help it looks like he needs.

Earthquake in New Zealand

2011-02-22T16:31:00.001-05:00

Although Canada is a half a world away from New Zealand, many of us here feel shock and horror at what happened in Christchurch again yesterday - another earthquake. Whenever an earthquake strikes a populated area somewhere in the world, my heart goes out to the many people who lose their homes, their livelihood, and all too often - loved ones and friends.

My thoughts also go out to the health and medical needs for the survivors and the healthcare personnel who must provide them. To be a nurse, providing care to wounded survivors, is difficult enough, but when the nurse's home may have been destroyed or if she may have lost loved ones herself, that makes it all that more difficult.

Are you prepared in case of an emergency? The Canadian government often puts out information on producing emergency kits and keeping them close. Here in Montreal, we experienced the big ice storm in 1998, when much of the province lost power and, sadly, some people did lose their lives. Many of us said we learned from that experience and that we wouldn't be caught without emergency supplies ever again. But how many of us have kept that promise to ourselves? I have a strong feeling that would be not too many of us.

Here is what the Canadian government says should be in a minimal emergency kit in every home, from the Health Canada website:

Put together an emergency kit with enough basic supplies for at least 72 hours. Make sure your kit is easy to carry. Keep it in a backpack, duffel bag or suitcase with wheels, in an easy-to-reach place, such as your front door closet. As a minimum, the kit should contain the following:
two litres of water per person per day, plus water for pets;
a three-day supply of food (including pet food) that will not spoil, such as canned food, energy bars, dried foods (remember to replace the food and water at least once a year);
a manual can opener;
flashlight, batteries, candles and matches or lighter;
a battery-powered or wind-up radio, plus extra batteries;
a first aid kit, including such essentials as ASA, ibuprofen, anti-nausea and anti-diarrhea products;
special items, such as feminine hygiene products and prescription medications (In an emergency, pharmacies may be closed for some time. Talk to your doctor about preparing a "grab and go" bag with a two-week supply of your medications. Also, ask how often you should replace the medications with a fresh supply);
some cash (or travellers cheques) in small bills, change for telephones;
copies of your emergency plan, contact information and other important documents (license, birth certificate, passport, etc.) stored in a waterproof container; and
a change of clothing and footwear for each family member
In addition to preparing a kit, it is also a good idea to stock up on non-perishable items (e.g., toilet paper, paper towels, more candles, dried or canned foods, etc.) in case stores remain closed or you are unable to leave your home during an emergency.

Another important issue is to know where to go and what to do in case of an emergency. Do you have a "safe spot" designated for you and other family members to congregate in case your home is not accessible? Do you have phone numbers (cell phones, most likely in emergencies) of people who you would need to get in touch with?

Now is as good a time as any to get your things together. As we can see at what happened in NZ or in fires in California late last year, we just never know when we may need to take care of ourselves.

It has been way too long since my last post

2011-02-22T16:17:00.000-05:00

Where has the time gone? I could have sworn I just posted lasted week, but imagine my shock when I saw the last time I posted, it was in December?

I can only say, I keep meaning to post, but then I get distracted and the thought flies out of my head as quickly as it entered. I am being kept busy with my Sepsis Alliance work - although not so busy that I don't have time to post here.

I think what happens is I write so much health stuff, either for Scrubs, Nursing Link, or any of my other clients, that when I think about writing here, I'm out of steam. Luckily for me, there is a lot of content on this site, so I still get a lot of hits. Most people, though, only come by through finding a particular topic on Google or some other search engine. They find what they're looking for and then they don't come back. Perhaps it's time to start working on that loyal reading audience again!

Something this blog has brought me are interesting connections. It seems there are many nurses who would like to get into writing. I receive emails every so often from nurses who would like to start writing but don't know where to begin. I don't mind taking the time to answer - after all, the best way to learn something is to ask questions, right? Most of the time, people are very appreciative, but there is the odd person - now and then - who can't be bothered to even say thank you. Really. I can't imagine writing a total stranger to ask for help or advice only to not acknowledge that this person took the time to write back. Thankfully, they're in the minority.

So, we're near the end of February and let's see if we can get this blog kick started yet again, shall we?

How is the flu vaccine made?

2010-12-14T07:29:00.001-05:00

Well, it's official. Flu season has hit North America. Some people are getting hit hard, while others are dodging the bullet. If you've been a regular reader here, you'll know that I support the flu vaccine and do encourage people to get it (Winter's coming...so are colds and the flu). But, it is a personal choice (thankfully!), so the best we pro-vaccination folks can do is try to encourage it.

Have you ever been curious about how the flu vaccine is made? The Government of Ontario (Canada) has put out a some videos about influenza and they've included this animated video called You and the Flu, Making the Vaccine.

What do you think about the flu vaccine debate? Did you or will you be vaccinated?

Sepsis: Emergency, a video

2010-11-30T08:50:00.001-05:00

If you have been following this blog for a while, you likely know about my involvement with the patient advocacy group, Sepsis Alliance. It's a very worthwhile organization that strives to increase awareness of the deadly disease, sepsis.

The recent death of actor Lesley Nielsen is just one of thousands from sepsis. Although the news reports say that Mr. Nielsen died of "complications from pneumonia," this is what sepsis is: "complications of...."

Sepsis Alliance has just made public a fantastic video to help explain the seriousness of the disease and I encourage you to watch it - and pass it on. As. Dr. O'Brien says in the video - this is a disease that we can affect tomorrow: we can reduce deaths up to 50% starting tomorrow, if only we all knew and understood what sepsis was - allowing us to detect it early enough.

Sepsis: Emergency

Haiti and the cholera curse

2010-11-17T08:50:00.001-05:00

We've been seeing on the news that the besieged country Haiti is now stricken with the extremely contagious and dangerous disease, cholera. Cholera is a disease that we don't see in developed countries and it's likely a disease that we can't even imagine. How can diarrhea kill so quickly? It's not very difficult with a disease like this.

What is cholera?

Cholera is a water-borne disease, which means it is transmitted through contaminated water, but it can also be transmitted through contaminated food. The bacteria, Vibrio cholerae, causes excessive watery diarrhea, which left untreated, dehydrates your body very quickly. So quickly that in severe cases, it can cause death within hours.

Can cholera be treated?

One of the saddest things about a disease such as cholera is that it is very easily treated. Fluids need to be replaced and as long as the patient is able to take in fluids by mouth, oral rehydration fluid that consists of water, sugars, and electrolytes, is relatively inexpensive and very effective. Once someone is beyond taking fluids by mouth, intravenous fluid is the only option.

Can cholera be prevented?

Cholera is an extremely preventable infection - clean water is all that is needed. Unfortunately, there are places in the world that don't have access to clean water or they did at one time, but a breakdown in infrastructure destroyed their source.

North America isn't immune to cholera. While in the present day, we don't have it, we have had it and the potential is always there. In 1911, deaths from cholera were reported in the New York Times, the result of poor sanitation in ships transporting immigrants to the country. It can strike any part of the world. Cholera's seven pandemics

It's sad that in this day and age, we still have a deadly infectious disease, which we know how to prevent and to treat if it is spread. Even sadder, is that the people who are dying from cholera are those who are the poorest of the world.

UN targeted in Haiti cholera violence
Haiti cholera deaths over 500

Shoulder Injury Update - 11 months later. It's a good one.

2010-11-08T05:10:00.004-05:00

On Thursday, it will have been 11 months since I hurt my shoulder. For those who are not regular readers, I was moving on Dec. 11, 2009, and I fell while we were still moving stuff out of the old house. I dislocated my shoulder big time and ended up in the emergency department of the local hospital while the move continued without me. Not being there during the move could be considered a stroke of genius, but my method to absent myself did leave a lot to be desired!

It was tough going to get my shoulder to start healing properly. I have nothing but praise for the wonderful physio team that was following me (and still does) during my healing and rehab. I was discouraged many times because the pain just didn't want to go away, despite our many efforts, which included active and passive physio, therapeutic massage, injections of cortisone, consumption of anti-inflammatories and so on.

Finally, in mid-September, before my trip away with my husband to celebrate our 25th wedding anniversary, my shoulder doc offered to inject Orthovisc into my shoulder. He said that the problems I was experiencing weren't so much the dislocation any more but other injuries, including rotator cuff problems.

The medication is a combo anti-inflammatory and lubricant that is approved for use to treat osteoarthritis of the knee. My doctor, however, has been trying it for injuries like mine to the shoulder. So, I went for it. I won't lie and tell you it didn't hurt - IT HURT LIKE THE DICKENS. But, as he explained, my shoulder was so inflamed and so irritated, that there was no way it wouldn't hurt to inject it.

Within a couple of days, I was ready to nominate the doctor for sainthood. My pain scale went down from a regular 6/10 with occasional bumps to 7 or even 8, to 2 or 3/10 with occasional - get this - zero.

He told me not to baby my arm but to be reasonable and careful. So my husband and I went off and had a fabulous, fantastic vacation, during which my shoulder just caused a bit of a problem, but nothing significant.

I went back to see him last week and my shoulder is doing great. Still hurts sometimes but I have the go ahead to become more active, with a few limitations. The journey is just about over.

Anyone who has chronic pain knows how demoralizing it is. It's frustrating and sobering. You just can't live like you want to when you're limited with the pain and, in my case, with the knowledge of moving the wrong way would pop the shoulder right out of place, as I had done a few times already.

But now I can put this all behind me. On Dec. 11, we're here for one year and I still love the place. We made the right decision to move.

So, what will the next year bring? Lots of health and happiness - that's what!

Illness Strikes 1 person in U.S. Every 2.5 Minutes - Now Affects Lily Allen

2010-11-07T09:07:00.000-05:00

If you heard about an illness that struck down one more person in the United States every 2.5 minutes, wouldn't you want to know what it was? If you knew that about one-third of the people hit by the illness died, wouldn't you want to know about it? If you knew that many of those who do survive are left with amputations of legs and/or arms, memory deficits and other physical problems, wouldn't you want to know what it is?

"It" is sepsis.

Many of you may have heard of blood poisoning. Sepsis is the true term for the illness that used to be though of as blood poisoning. Currently, UK pop singer Lily Allen is fighting sepsis, or septecemia.

Sepsis is the number one cause of death among people who have AIDS. It is a major cause of death from cancer. Most often, if you read or hear about someone who had died of "complications of cancer/pneumonia/influenza," they've died of sepsis.

Did you know that Johnny Depp's daughter, Lily-Rose survived and won her fight against sepsis? Here are some other famous people, most of whom did not win their battle:

Jim Henson, creator of the Muppets - influenza
Pope John-Paul II, Brazilian model Mariana Bridi Costa and singer Etta James - urinary tract infection
Fred Hersch, jazz composer and musician - lives with HIV/AIDS

To read of some of those who were affected by sepsis, there are some wonderful and heart-wrenching stories at Faces of Sepsis, at the Sepsis Alliance site, www.sepsisalliance.org. SA also has a facebook page.

Here's to hoping that Lily Allen wins her battle. The world doesn't need to lose yet another person to this treatable illness.

Winter is coming... so are colds and the flu

2010-11-01T19:48:00.000-04:00

Yup, if you live in the northern parts of the world, you know that winter is coming and it seems to be coming a lot faster in some parts than in others. But even if you live in warmer areas, colds and influenza can still strike, so you're not entirely out of the woods. Sorry!

Some people still believe that getting cold or wet can make you sick, it's not true. A cold virus or influenza virus is there whether you're cold or not. But, being cooped up on a crowded bus with the windows closed and not going outside very much, spending more time indoors with people around you - that does help spread viruses. So, that is why people seem to get sicker in the winter than in the summer.

Avoiding the colds and flu:

Wash your hands. Wash your hands. Wash your hands.

There you go. That's the secret. When someone is sick and they pull open on the door handle, borrow your pen, use your keyboard, or press an elevator button and they you touch any of those - if you don't wash your hands, the next time you bring your hands to near your face, you just might be transferring the virus to your own body. So - wash your hands!

Don't be fooled by people who don't look sick. You can be infected with the influenza virus and not look or feel it for up to 24 hours before you realize you're sick. So, the coworker that looks fine today? He may be flat on his back with the flu tomorrow and neither of you know it yet.

Get vaccinated

Yes, many people feel that vaccinations are a waste of time and are dangerous. Well, they're not a waste of time and what is dangerous is getting the flu and dying. While we know that high-risk groups like the elderly and those with chronic illnesses can be hit hardest with the flu and develop severe and fatal complications, these complications can strike anyone. Just ask 24-year-old Jen Ludwin, who came down with H1N1 last year. Here is her story: Faces of Sepsis - Jen Ludwin

Of course, not everyone can be vaccinated - there are reasons why someone may not be able to, such as allergies to the vaccine. They need to be extra careful with the handwashing and avoid areas where they may be exposed to people who are already ill.

While you can get over a cold, usually pretty easily - they can also be severe. Unfortunately, we're no closer to solving the common cold problem now than we were years ago. But we can help either prevent or decrease the severity of influenza. Think about it.

Fish Oil for Healther Gums

2010-10-28T18:14:00.000-04:00

Gum disease isn't something many people think about. They think about their teeth and, for the most part, try to be sure they don't lose them, but not so much care is done for the gums. The thing is, without healthy gums, you can't have healthy teeth. So, what to do?

Besides the usual recommendations of brushing your teeth well and flossing regularly, there is now the recommendation that omega-3 fatty acids, or fish oil, may help your gums stay healthy.

A study published in November's issue of Journal of the American Dietetic Association found that people who participated in the study and who had higher levels of fish oil consumption were less likely to have gum disease than people who consumed little or no omega-3 fatty acids.

The study was not a long-term study, in fact it was only a snapshot of one day of consumption, but it does lead to some interesting questions about more benefits from fish oil than originally thought.

You can read more about the study in this article, Fish Oil Might Help Fight Gum Disease

Most popular blog page here - broken hips and elderly

2010-10-26T12:42:00.000-04:00

When you write for a blog or maintain your own blog, you never know which posts will garner the most attention - good or bad. For this blog, the most popular, by far, is a post I put up on July 26, 2007 - that's over four years ago. It still gets several visits per week from new people who find it through Google or other search engines.

According to the blogger stats, Broken hips in the elderly can lead to death has been viewed 1,274 times. The next closest comes in at only 504 times, written earlier this year, Another Medication Recall - Is Anything Safe?

The visitors come from all over the world. So far this month, there have been:

2219 visitors from the United States
191 from the United Kingdom
147 from Canada
55 from Macedonia
54 from the Netherlands (I wonder if some of their searches were for "Marijke")
41 from Luxembourg
41 from Russia
38 from Australia
36 from Switzerland
36 from India

Sometimes I'm referred from individual blogs, but when I go back to see how I'm linked, I can't find it. Or, other times, I see that the blog or website has copied my information word for word. That is a big, BIG no-no. Whatever I write here is mine for you to read and that's it. No-one is allowed to just republish it on their site. Unfortunately, not everyone understands that yet.

I get a lot of emails too, but what I would like are COMMENTS. Yup, just a comment or two a day would make me feel like there's really someone out there. :-)

Ok, have a great day everyone! And if it's not a great day, I really hope things do get better for you.

A blood pressure reading with that shave sir?

2010-10-25T21:42:00.000-04:00

It may sound odd, but a study published online in the Archives of Internal Medicine earlier today has found that if neighborhood barbers can take customer blood pressures, hypertension care is improved in African-American men.

African-American men are one of the groups that are at increased risk of developing hypertension. The problem is that hypertension, or increased blood pressure, is a silent disease until after it has already done damage to the body. The only way to detect hypertension is through blood pressure screening. However, to do that, the patients have to willingly go to a clinic or doctor's office to have their blood pressure checked.

In this particular study, which took place over 10 months, barbers offered to take their customers' blood pressure when they came in for a hair cut. The barbers also promoted physician-follow up and provided patient education material about hypertension and its long-term effects. Seventeen barber shops participated in the study and reached 1,300 men. All 17 shops offered the screenings and then were divided into the intervention and comparison groups.

Both groups of shops took initial blood pressure readings of the men. In the eight comparison shops, the men were then offered standard educational material about hypertension. In the nine intervention shops, after the initial blood pressure reading, the men were offered free checks with every hair cut. If the BP reading was high, the barber encouraged the patron to see a doctor and the man was given a free haircut if he returned with a doctor-signed referral card. If the man did not go to the doctor, the barber called the study's staff to arrange a visit and would then give the customer the information.

Results of the study showed marked improvements in blood pressure levels among the barbershop patron who went to the shops in the intervention program.

This isn't the first time that the neighborhood barber shop has been the center of medical and screening programs. According to a press release issued by Cedars-Sinai Medical Center,

Since the 1980s, African-American-owned barbershops and hair salons have hosted screening programs for medical conditions that disproportionately affect African-Americans. Victor's study concludes that if hypertension intervention programs were put in place in the estimated 18,000 African-American barbershops in the U.S., it would result in the first year in about 800 fewer heart attacks, 550 fewer strokes and 900 fewer deaths.

Interesting and effective way to reach people, isn't it?

Fentanyl Transdermal System: Recall

2010-10-22T14:48:00.000-04:00

Do you or someone you know use a Fentanyl patch for pain relief? If so, please take note of this recall.

October 21, 2010 - Morristown, NJ - Actavis Inc. today announced a voluntary recall to the wholesale and retail levels only of 18 lots of Fentanyl Transdermal System 25 mcg/hour C-II patches manufactured for Actavis by Corium International in the United States.

Actavis identified one lot of 25 mcg/hour Fentanyl patch (Control/Lot # 30349) shipped to market that contained one patch that released its active ingredient faster than the approved specification in laboratory testing. An accelerated release of Fentanyl from a 25 mcg/hour patch can lead to adverse events for at-risk patients, including excessive sedation, respiratory depression, hypoventilation (slow breathing), and apnea (temporary suspension of breathing). The patches are packaged individually and boxed in quantities of five patches per box.

Fentanyl Transdermal System is indicated for the management of persistent, moderate to severe chronic pain that requires continuous, around-the-clock opioid administration for an extended period of time and cannot be managed by other means such as non-steroidal analgesics, opioid combination products, or immediate release opioids.

As a precautionary measure, although unaware of any injuries associated with this issue, in addition to the aforementioned lot, Actavis is recalling the additional Control/Lot numbers noted below due to the possibility that additional patches may release active ingredient faster than the approved specification. The Control/Lot number appears on the bottom of the product box and on the black and white side of each individual patch packaging, in the lower left corner.

Recalled Control/Lot #s
30041, Exp 12/2011	30258, Exp 03/2012
30049, Exp 12/2011	30349, Exp 03/2012
30066, Exp 12/2011	30350, Exp 03/2012
30096, Exp 01/2012	30391, Exp 03/2012
30097, Exp 02/2012	30392, Exp 04/2012
30123, Exp 01/2012	30429, Exp 04/2012
30241, Exp 02/2012	30430, Exp 04/2012
30256, Exp 02/2012	30431, Exp 04/2012
30257, Exp 03/2012	30517, Exp 04/2012

Actavis has operators available to help customers, health professionals and consumers with the following information:

Medical Issue/Adverse Event/Product Questions
1-877-422-7452 (24 hours/day, 7 days/week)
Return/Reimbursement Questions
1-888-896-4562 (24 hours/day, 7 days/week)

Adverse reactions or quality problems experienced with the use of this product may be reported to the FDA's MedWatch Adverse Event Reporting program either online, by regular mail or by fax.

Online: www.fda.gov/medwatch/report.htm

Regular Mail: use postage-paid, pre-addressed Form FDA 3500 available at: www.fda.gov/MedWatch/getforms.htm. Mail to address on the pre-addressed form.

Fax: 1-800-FDA-0178

Great non-health, non-nursing news

2010-10-22T03:42:00.000-04:00

Those of you who know me or know my work, know that I am primarily a medical and health writer. I do dabble in other types of writing, but the health stuff is my bread and butter. And that's fine; it's what I know and what I'm good at.

Every so often, I like to reach beyond health and medicine, trying other types of writing. Some of this is writing essays. This isn't something I consciously decided to do until I took an essay-writing class. All of a sudden, I learned that, yes, I can do this.

I'm very pleased to announce that a book, a compilation of essays, has been published and one of the 28 essays is mine. To learn more, please visit Essays: Fits, Starts and More.

New CPR Guidelines

2010-10-21T11:40:00.002-04:00

Hey folks - how many of you out in the Internet land know how to do CPR? Of course, you may say, but I don't leave the house - I'm on the computer all day long. ;-) But seriously, everyone should know how to do CPR. It's an amazing feeling knowing that you can possibly save a life just because you know what to do if someone's heart decides to stop.

When I taught first aid (many!) years ago, I used to say that I thought CPR should be taught in the high schools and be a requirement for graduation. But many people get the heeby-jeebies thinking about doing artificial respiration. I can't say I blame them.

Although I've done CPR more times than I can remember in the hospital situation, it was nothing compared to the one time I did it on the street. I have to say I didn't quite enjoy the AR part of the whole thing. Luckily, the breathing part is no longer an important part of the recommended CPR. In fact, it's been eliminated from the on-the-street recommendations.

In the "old" days, the thing to remember was ABC: Airway, Breathing, Circulation. Now, we just care about getting that circulation going. You just get to work pumping the heart. How fast? This is where being a BeeGees fan comes in. Believe it or not, the experts have found that the ideal compression rate for CPR is if the compressions are done to the beat of Staying Alive. How ironic is that?

Anyway, you can go to the American Heart Association to learn more about the new way to do CPR and who knows - maybe one day, you may save a life.

Preventing Winter Falls

2010-08-02T07:18:00.002-04:00

For those of us who have to walk on ice and hardened snow, we know how careful we need to be to prevent a potentially disastrous fall. One way to stay safe while on ice is to use the slip on traction aids sold by various manufacturers. These have hard plastic and/or metal spikes that dig into the snow and ice.

While effective, these slip-ons are not always appropriate for use. For example, you can't wear them inside because they become a slippery danger on hard floors. So, if you're shopping and going in and out of various stores, it can be difficult to slip the spikes on and off. For some elderly people, this could be too difficult due to physical issues.

Now, the Toronto Rehabilitation Institute in Canada is working on something else to help people stay safe while outside: Winter tire boots.

According to this CBC article, 'Winter tire' boot aims to thwart icy falls, this type of footwear would help not only seniors, but the young and healthy who could fall and end up with serious injury.

Would you wear boots like this? Do you think it's worth the money and time to put research into these things, or should people just learn to be more careful? What do you think?

Caffeine OK for Pregnant Women Once Again, Sort of

2010-07-22T10:47:00.003-04:00

For all the women who avoided caffeine while they were pregnant or are doing so now, the news has changed yet again. It seems that some caffeine is ok, say new guidelines issued by the American College of Obstetricians and Gynecologists. Moderate seems to be one cup or glass of coffee or caffeinated beverage per day.

Researchers looked at the risk of miscarriage in relation to caffeine intake and found no increased risk of miscarriage when women consumed one cup or glass of caffeinated drink per day. Of course, they were talking about regular sized cups and glasses, not mega-sized, and they were talking about regular coffee and drinks, not the super caffeinated "gives you wings" types of drinks.

This is good news though for women who really enjoy their coffee or tea. So much of what we do centers around the baby's health, understandably, but the warnings that women are given about the multitude of things they shouldn't do while pregnant can make you feel as if you're depriving yourself. Of course, unless you're addicted to coffee or tea, you don't *have* to have it, but sometimes sitting down to a nice cup of your favorite drink is just what you need to have.

So, there you have it. Right now, today, drinking a moderate amount of coffee while pregnant is ok. We'll see what research brings tomorrow.

Friday Is "Is It Hot Enough for You?" Day

2010-07-21T10:11:00.004-04:00

Some of you live in perpetually warm areas but some of us are in areas that are treated to heat only at certain times of the year. And as much as we treasure the warmer times, heat waves are something we can do without. One big reason for this is it gets so tiresome to hear "Hot enough for ya?" from just about everyone you meet. This is only rivaled by the winter greeting, "Cold enough for ya?" that we hear the other months of the year.

But seriously, heat and heat waves are nothing to joke about. In 2003, much of Europe was covered by a serious heat wave that killed over a thousand people in the Paris, France area alone.

Do you know the symptoms of heat exhaustion and heat stroke? Would you know what to do if you recognized it?

When the human body gets too hot, it begins to sweat. This is a good, healthy reaction to heat. The thirst means we need fluid, and the tiredness means we need to slow down. These are all good signals that we should notice and take notice of. However, many of us don't and this is what causes problems.

Heat exhaustion is the mildest form of heat-related illness. Signs and symptoms include (from MedicineNet.com):

heavy sweating
paleness
muscle cramps
tiredness
weakness
dizziness
headache
nausea or vomiting
fainting

At this point, the affected person needs to be taken out of the heated area and protected from the sun. An air conditioned environment is best but if you are outside, a shaded, protected area is better than nothing. If possible, the person needs to drink water or other non-alcoholic, non-caffeine fluids to start the rehydration process. If he or she is wearing heavy clothes, remove them as much as possible. Finally, a cool shower (NOT cold) or bath could be helpful as well.

Once the body stops sweating, that means we've entered the danger zone. The body can no longer try to regulate its temperature through the regular means, so it's shutting down to try ot protect itself. At this point, you've reached heat stroke. The frightening thing is that heat stroke can come on very quickly and suddenly, so monitoring heat exhaustion is vital. The signs and symptoms of heat stroke include (from MedicineNet.com):

high body temperature,
the absence of sweating, with hot red or flushed dry skin,
rapid pulse,
difficulty breathing,
strange behavior,
hallucinations,
confusion,
agitation,
disorientation,
seizure, and/or
coma.

People with heat stroke need immediate emergency medical help. While waiting for help, you can do the same things that are recommended for heat exhaustion.

Prevention is really the best solution. Don't over exert yourself while in the heat, be it inside or outside. Drink plenty of water and other non-alcoholic drinks, even if you don't feel thirsty. If you don't have air conditioning at home, try to go somewhere that does, like a mall or a movie. Doctors are saying that two hours of exposure to air conditioning helps your body cope overall with the oppressive heat.

Finally, don't forget to check up on the vulnerable, particularly the elderly and those who live alone. They may not be able to get help on their own.

IVF to Be Paid by Quebec

2010-07-20T09:03:00.003-04:00

If you are a couple struggling with infertility, are an in vitro fertilization candidate and you live in the province of Quebec in Canada, then you may feel like you've had some good luck come your way. The provincial government has decided that women will be allowed three tries at in vitro on the government's dollar - or in reality, the tax payers' dollar.

Is this a good idea? Some say yes, others say no.

Infertility is a difficult struggle for many couples. The amount of effort and money that goes into trying to conceive can be astronomical. Sometimes the tries are successful, resulting in a full-term pregnancy, sometimes they aren't.

The government says that this is a good use of the healthcare money. The birth rate is down in the province and we need repopulation so we can take care of others as they age. New blood, so to speak, is always needed so we have people growing up and becoming productive citizens. On the other hand, many who can't have children biologically end up adopting children who otherwise would have no family. A recent letter to the editor in the English Montreal daily pointed this out. The couple tried iIVFand was not successful. They are now the happy parents of adopted children. If theIVF had succeeded, those children may not have been adopted.

And what of the cost? The Quebec medicare system is bursting at the seams. Some people feel that they're not getting adequate care for life threatening and/or life changing health issues, often because of lack of funding. Many pregnant women can't find obstetricians, pediatricians are not taking new patients and finding a family doctor is getting close to impossible in some areas. By inviting women to have IVF on the provincial tab, we are causing an increased need for obstetricians, specifically those who work with infertility issues, nurses and obstetrical beds, pediatricians and family doctors for the babies, and so on. If we don't have enough to go around now, how can this be a good thing with even more babies?

There are those who argue that the medical system is for medical issues: if you're sick, you get treated. They say that IVF should not be included because infertility isn't an illness. Well, pregnancy isn't either, but it's covered by medicare. So, where do you draw the line?

So, for those women (and men) who have been trying to have children but can't - is this a good idea? Or should IVF remain the domain of private insurance or self-funding?

I'm back and I promise to stay

2010-07-19T09:31:00.002-04:00

To my regular readers, I'm sorry for the long absence. Much has happened that has kept me occupied and unable to update this blog. Since this blog is my way of staying in touch with people who are interested in health issues, I decided that I needed to make this a priority, so here I am.

There is so much going on in the health world that it takes time to sift through all the news that is emerging every day. It's amazing how much research is going on and what issues are being debated.

Right now, I'm doing a lot of work for Sepsis Alliance (www.sepsisalliance.org) and we're supposed to be presenting our new website very soon. I hope you'll check it out because sepsis is a major problem in this world.

On the personal side, my shoulder - which I dislocated in December - is still causing me problems. It looks like surgery is the only option at this point. To say I'm looking forward to that would be an outright lie but, it sure would be nice to be pain-free and not have to worry if the shoulder is going to pop out of its joint.

So, onwards and forward. Let's get this blog popular again!

Helen Mirren thinks nurses and prostitutes are pretty well the same

2010-06-15T23:14:00.002-04:00

Message to British actress Helen Mirren: Nurses are not prostitutes and prostitutes aren't nurses. Perhaps you should rethink what you said on David Letterman's show last night.

Perhaps Helen's agent should advise that Helen stick to acting and only open her mouth to eat or to utter a line that was written for her - that way, she may stay out of trouble. She was in some trouble last year because of some controversial comments about women and rape and now, she's at it again. A YouTube video has surfaced for people who don't stay up late enough to watch the Late Show. The video shows Helen being interviewed by Dave about her upcoming movie. He asks her about research in a brothel and the subject turns to hookers, prostitutes.

Dave asks Helen if she thinks that prostitutes were victims and this leads them to the life they lead. Here is Helen's answer:

A lot of them are damaged. They come from dysfunctional backgrounds and that’s what led them to this place. But also, a lot of girls who work in that industry actually come from the nursing industry, which kind of makes sense. Because they’re used to naked bodies. It’s not intimidating to them, the ...

What can we say in response? It's to jaw dropping to formulate a coherent response. Here is a post I wrote about it on another blog, if you'd like to check it out:
Actress Helen Mirren Likens Prostitutes to Nurses

It's been a while since I posted - sorry about that. I attended a writing conference two weeks ago and I was busy clearing up work so I could attend, and then I had to work to catch up!

Happy Birthday - Enjoy it because you have it

2010-05-13T11:25:00.002-04:00

Getting older - everyone does it, unless they're no longer living. That does sound trite, doesn't it? But it's true.

We hear it all the time, people bemoaning the fact that they're turning 30, 40, or the big 50. They won't admit it, they make a big deal about saying that they're not acknowledging it. They don't want a party. They're feeling badly about their age.

But what is the option? If you're alive, you get older. And, in most cases, getting older is something to celebrate. You've lived another year, you've touched more people. You may have made a difference in some more lives. Getting older isn't a death sentence, it's a life sentence. It means you are alive, breathing, and hopefully, loving and having fun.

I'm going to turn 49 in two weeks. I have already told my family that I fully expect a big party for my 50th next year. Why deny the age - I will be 50 years old next year. And with that 50, I'll have experienced highs and lows, but by being 50, I'm still around to experience more of them.

I'd be a liar if I say I don't look back sometimes and wish I could relive a particular time and done things differently. But we can't, so it's just wishful thinking.

Did you realize that in palliative care and hospice, birthdays are usually celebrated? Because in palliative and hospice care, the focus is on every day you are alive and if your birthday comes up, it's worth acknowledging it. Ignoring it won't make it go away.

In this world where we do our best to look our youngest, where we try to defy nature with surgery and Botox, and other invasive procedures, what happened to appreciating what we have, what we've done?

Shoulder Update - Not Looking Great

2010-05-05T10:36:00.000-04:00

It's been a while since I wrote about my shoulder, which I dislocated on Dec. 11, 2009. You would think by now, it would have been healed and history, but unfortunately it hasn't healed and it's not history.

After attending weekly (yes, every week) physiotherapy sessions, the pain in the shoulder decreased a lot, range of motion increase quite a bit, but there is still pain and there is still not complete return of use. So, the orthopedic surgeon sent me for magnetic resonance imaging (an MRI) with contrast.

The contrast was intra-articular, which means the doctor injected the contrast right into my shoulder. The needle is inserted sort of between the shoulder and the collar bone. To say it hurt is an understatement. It felt as if I had dislocated it all over again and I don't do well with pain like that. I was expecting an IV contrast. Ouch. But, it had to be done (just don't ever ask me to do that again!).

The results of the MRI are not encouraging so I'm waiting to see if surgery is in the picture.

"sequela of anterior shoulder dislocation with an old mild Hill-Sachs fracture and tear of anterioinferior apspect of labrum with focal post traumatic chondropathy of anterioinferior aspect of labrum (GLAD injury)."

That's a fancy way of saying, "oops, her shoulder is messed up." The Hill-Sachs fracture is a type of break that very typically happens with an anterior shoulder dislocation, as I had. But I'm not sure if they mean "old" as in from December, or "old" as in a previous injury I sustained about 15 or 16 years ago.

It does sound like surgery is the next step, but we'll find out next week for sure.

So, I leave you with these words of advice: DON'T FALL! Especially on moving day (Diary of My Separated Shoulder)

Another Medication Recall - Is Anything Safe?

2010-05-04T22:23:00.000-04:00

It may be a blanket statement to say the general public is not exactly trusting pharmaceutical companies these days, but when parents are told of massive children's medications recalls, it's hard not to think in terms of generalizations. Parents don't generally like to give their children medications to begin with, so it's an act of trust when they do - trust in the company that manufactured the drugs. Yet, it wasn't that long ago that parents learned that they shouldn't be giving cough and cold medicine to young children - something they had been assured by the big companies was safe (Cough medicine warning extended to under 6 year olds).

Over the generations, we have come to trust medications, such as antibiotics and chemotherapy, to save our lives. Other medications, such as allergy medications, make our lives easier (and can be life saving), while yet others are life-enhancing medications, like medications for erectile dysfunction or Botox for cosmetic purposes. But as the years go by, how is it that these medications, which we literally trust with our lives, are frequently being found to be more dangerous than we thought or - in the case of the recent recall - not meeting standards and may be harmful?

The latest recall involves children cold, allergy, and fever medicines from McNeil Consumer Healthcare. These include liquid formulations of:

Tylenol
Motrin
Zyrtec
Benadryl

You can view the full list here on the McNeil website.

Who, among parents of young children, didn't have at least one of these in their medicine cabinets?

Luckily, the problem was recognized and the company issued the recall notice, but it makes one wonder, how many problems are there with medications that we don't find out about? And how can something like this happen? Haven't the pharmaceutical companies learned anything yet about consumer trust?

Pharmaceutical companies aren't bad guys - they do work that do save lives. But there is something seriously wrong with a system that:

A) makes prices of some medications so expensive that only the very rich can afford them
B) allows medications to go to market and remain on the market despite reports of less than desirable reactions
C) allows medications with quality issues to get into the market

Without the pharmaceutical companies, many of us would not be alive, but that doesn't excuse the problems that seem to be cropping up fairly regularly. We're not talking about a minor lifestyle issue here, we're talking about complicated chemical compositions that affect how we thing, live, breathe, move, and just about anything else.

Have you had any bad experiences with medications?

National Nurses Week is Coming Up

2010-04-27T12:26:00.002-04:00

Are there any non-nurses who know that there is a National Nursing week in May? For those of you who didn't know, what is your reaction to this? Do you feel it's something that is important?

Nurses seem to be torn on this matter. In one way, it is nice to be recognized (officially) for the work we do. On the other hand, is it a way of appeasing nurses so they won't be so difficult for administration to deal with them? Some nurses feel that a recognition day or week is insulting - what about the other 51 weeks of the year?

What gets to them, I believe, is many facilities take this week to throw trinkets at the nurses, a few pens, a breakfast, maybe a vase of flowers at the desk. Of course, some facilities do much more elaborate things too. And, no matter how inexpensive or cheap a gift is, isn't a gift a gift? I'm not so sure.

I've heard people comparing Nurse Appreciation week to Mother's Day and Father's Day. Is this a fair comparison? Maybe not. Other than Administrative Assistant week (what used to be Secretary's Day) or Teacher's Appreciation week, there doesn't seem to be any other type of {insert profession here} Week. And, if you look at it, admin assistants, nurses, and teachers generally tend to be women. When was the last time you heard about Mechanical Engineer Week? Urban Planner Week? Plumber Week?

Whatever side of the argument you're on, it doesn't take much to appreciate a nurse. A smile, a thank you. A sincere appreciation of what it is nurses do to help people. That's from the general public. From the admins? More appreciation and understanding of what we do. Nix the stupid rules that some facilities have that do nothing more than foster hard feelings. Pay the nurses more. Hospitals say they don't have more money to spend, but how many of us have seen money spent on events, items, and issues that really could have been done without?

Volcano-Stranded and Low on Medications

2010-04-21T09:53:00.002-04:00

People who take medications or use medical supplies (such as catheters or ostomy equipment) are encouraged to always bring along more than they would need for their stay. The reason has always been because you could get delayed or run into problems, and you may not necessarily be able to renew your prescription or obtain more supplies where you are.

This problem has been brought to light especially during the extended vacations, business trips, and other voyages out of home countries because of Iceland's volcano eruption and the massive closure of air space across parts of Europe.

While for some people, not taking their medications may only result in mild discomfort, for others, it can very well be life threatening. Take, for example, Sophie Longton, a woman from the United Kingdom who has been stuck in Malaysai since the air space has been closed. According to this BBC News article, 'My medication is running out', the 23-year-old woman who lives with cystic fibrosis, is coming dangerously close to exhausting her medication supply. This could be disastrous for her, especially since she is beginning to show signs of developing an infection.

What more could Ms. Longton have done? She traveled with extra medications, but how much extra is sufficient? One would hardly think that you would need more than a week of extra medication in case of emergency, right?

What about you? Do you travel with extra supplies or medications in case of emergency? What do you consider a safe cushion?

Should pregnant doctors work in abortion clinics?

2010-04-13T13:10:00.003-04:00

Now this is a situation I never thought of. If a woman is going to have an abortion, is it a conflict or a problem if the doctor performing the abortion is obviously pregnant?

A doctor in the United Kingdom asks exactly that question in a piece she wrote for the medical journal, BMJ. Is it appropriate for an obviously pregnant doctor to be doing abortions? While she was doing rotations, she was assigned to work in an abortion clinic. She was seven months pregnant at the time.

The article was not about whether she wanted or did not want to terminate pregnancies, but the situation she found herself in:

Is it appropriate for patients to see a pregnant doctorfor their termination of pregnancy appointment? Is it suitableto have an obvious reminder of the alternative consequence whenpatients are already facing a difficult decision? Pregnancyis a familiar sight in society, and some may argue it is inevitablethat some patients will be seen by a pregnant doctor. Why thenis it common for efforts to be made to arrange ultrasonographysessions for women wanting an abortion separate from routineantenatal scanning? (BMJ 2010;340:c867)

What do you think?

Contest for Diabetes Book Over at Gadabout Health

2010-04-04T12:12:00.003-04:00

Just a quick drive-by post for today, Easter Sunday.

A writer friend of mine is doing a book blog tour about a book she wrote on living with diabetes, or more specifically, helping others live with diabetes: 21 Simple Things You Can Do To Help Someone With Diabetes.

She wrote a guest post for me over at Gadabout Health: Diabetes – Cherie Burbach Guest Post & Book Giveaway! So if you are interested in diabetes, because you or someone you know has it, you may want to either buy the book (link is above) or check out the post and see if you can win a copy.

Good luck!

Monthly Health Awareness for April

2010-04-01T07:26:00.002-04:00

Do you pay attention to the different Health Awareness months/weeks/days? Various health issues fill the calendar with awareness months that are meant to educate the general public about the individual causes.

Some months and causes seem to go well, hand-in-hand. For example, February is Heart Month and May is used to raise awareness of Lyme Disease. Others appear to be more random, such as Juvenile Arthritis Awareness Month, which is in July. The organizations that sponsor the special awareness times put a lot of time and effort into their public service announcements. But do they make an impact on the general public?

How many of you, who aren't directly affected by the disease or problem, have heard of National Radon Action Month (January), Children of Alcoholics Week (February), National Women and Girls HIV/AIDS Awareness Day (March) and National Facial Protection Month (April)?

The point is, some issues are out there, in our faces all the time. We all know about breast cancer awareness spots, heart attack information and so on, but there are many other health issues that need to be addressed. So, are these groups doing a good job spreading the word? What do you think?

For your information, here are the April Health observances, as per the 2010 National Health Observances Calendar:

1 - 30 Alcohol Awareness Month SAMHSA's Health Information Network P.O. Box 2345 Rockville, MD 20847-2345 (877) 726-4727 English/Spanish (240) 221-4292 Fax shin@samhsa.hhs.gov ncadi.samhsa.gov/seasonal/aprilalcohol/ Materials available Contact: None designated	1 - 30 Foot Health Awareness Month American Podiatric Medical Association 9312 Old Georgetown Road Bethesda, MD 20814-1621 (301) 581-9227 (301) 530-2752 Fax ahberard@apma.org www.apma.org Materials available Contact: Angela Berard
1 - 30 Irritable Bowel Syndrome Awareness Month International Foundation for Functional Gastrointestinal Disorders P.O. Box 170864 Milwaukee, WI 53217-8076 (888) 964-2001 (414) 964-1799 (414) 964-7176 Fax iffgd@iffgd.org www.aboutibs.org/site/about-ibs/april-ib s-awareness-month Materials available Contact: Nancy Norton	1 - 30 National Autism Awareness Month The Autism Society 7910 Woodmont Avenue, Suite 300 Bethesda, MD 20814-3067 (800) 3–AUTISM (328-8476) (301) 657-0881 (301) 657-0869 Fax info@autism-society.org www.autism-society.org/naam Materials available Contact: None designated
1 - 30 National Cancer Control Month American Cancer Society 250 Williams Street NW Atlanta, GA 30303 (800) ACS-2345 (227-2345) www.cancer.org Materials available Contact: National Office	1 - 30 National Child Abuse Prevention Month Child Welfare Information Gateway Children's Bureau ACYF, AFC, HHS 1250 Maryland Avenue SW, #8111 Washington, DC 20024 (800) 394-3366 (202) 260-9345 Fax info@childwelfare.gov www.childwelfare.gov/preventing/preventi onmonth/ Materials available Contact: None designated
1 - 30 National Donate Life Month Division of Transplantation, Healthcare Systems Bureau Health Resources and Services Administration U.S. Department of Health and Human Services Parklawn Building, Room 12C-05 5600 Fishers Lane Rockville, MD 20857 (888) 275-4772 (703) 821-2098 Fax ask@hrsa.gov www.organdonor.gov/get_involved/donateli femonth.htm Materials available Contact: Division of Transplantation Staff	1 - 30 National Facial Protection Month American Association of Oral and Maxillofacial Surgeons American Academy of Pediatric Dentistry American Association of Orthodontists 9700 West Bryn Mawr Avenue Rosemont, IL 60018 (847) 678-6200 inquiries@aaoms.org www.aaoms.org Materials available Contact: AAOMS Communications
1 - 30 National Minority Health Awareness Month Office of Minority Health U.S. Department of Health and Human Services P.O. Box 37337 Washington, DC 20013-7337 (800) 444-6472 (240) 453-2883 Fax info@omhrc.gov minorityhealth.hhs.gov/templates/browse. aspx?lvl=2&lvlid=182 Materials available Contact: None designated	1 - 30 National Sarcoidosis Awareness Month National Sarcoidosis Society National Sarcoidosis Foundation 2525 South Michigan Avenue Chicago, IL 60616 (312) 567-6626 (312) 567-6144 Fax sarcoidosis3@gmail.com www.nationalsarcoidosisfriends.org Materials available Contact: Glenda Fulton
1 - 30 National Youth Sports Safety Month National Youth Sports Safety Foundation One Beacon Street, Suite 3333 Boston, MA 02108 (617) 367-6677 (617) 722-9999 Fax nyssf@aol.com www.nyssf.org/campaign.html Materials available Contact: Rita Glassman	1 - 30 Occupational Therapy Month American Occupational Therapy Association 4720 Montgomery Lane P.O. Box 31220 Bethesda, MD 20824-1220 (301) 652-6611 (800) 377-8555 TDD (301) 652-7258 Fax praota@aota.org www.aota.org/news/consumer/ot-month.aspx Materials available Contact: None designated
1 - 30 Sexual Assault Awareness and Prevention Month Rape, Abuse & Incest National Network (RAINN) 2000 L Street NW, Suite 406 Washington, DC 20036 (800) 656-4673 info@rainn.org www.rainn.org Materials available Contact: None designated	1 - 30 Sports Eye Safety Month American Academy of Ophthalmology P.O. Box 7424 San Francisco, CA 94120-7424 (415) 447-0213 (415) 561-8533 Fax eyemd@aao.org www.geteyesmart.org/eyesmart/injuries/in dex.cfm Materials available Contact: Georgia Alward
1 - 30 Women’s Eye Health and Safety Month Prevent Blindness America 211 West Wacker Drive, Suite 1700 Chicago, IL 60606 (800) 331-2020 (847) 843-8458 Fax info@preventblindness.org www.preventblindness.org Materials available Contact: PBA Consumer and Patient Hotline	5 - 11 National Public Health Week American Public Health Association 800 I Street NW Washington, DC 20001-3710 (202) 777-2509 (202) 777-2500 TTY (202) 777-2532 Fax bithiah.lafontant@apha.org www.nphw.org/nphw10/home1.htm Materials available Contact: Bithiah Lafontant
7 World Health Day Pan American Health Organization WHO Regional Office for the Americas 525 23rd Street NW Washington, DC 20037-2895 (202) 974-3156 (202) 974-3645 Fax www.who.int/world-health-day/en/ Materials available Contact: None designated	8 National Alcohol Screening Day^® Screening for Mental Health, Inc. One Washington Street, Suite 304 Wellesley Hills, MA 02481 (781) 239-0071 (781) 431-7447 Fax smhinfo@mentalhealthscreening.org www.mentalhealthscreening.org/events/nas d/ Materials available Contact: Ariela Edelson
20 Sexual Assault Awareness Month Day of Action National Sexual Violence Resource Center 123 North Enola Drive Enola, PA 17025 (877) 739-3895 (717) 909-0714 Fax resources@nsvrc.org www.nsvrc.org/saam/current-campaign/day- of-action Materials available Contact: Lauren Sogor	24 - May 1 National Infant Immunization Week National Center for Immunization and Respiratory Diseases Centers for Disease Control and Prevention 1600 Clifton Road NE, MS E-05 Atlanta, GA 30333 (800) CDC-INFO (232-4636) (404) 639-8200 (404) 639-8905 Fax cdcinfo@cdc.gov www.cdc.gov/vaccines/events/niiw/default .htm Materials available Contact: Michelle Basket
24 - 25 2010 March for Babies March of Dimes Foundation 1275 Mamaroneck Avenue White Plains, NY 10605 (800) 525-9255 (914) 997-4617 Fax marchforbabies@marchofdimes.com www.marchforbabies.org Materials available Contact: Bob Aglione	24 World Meningitis Day Confederation of Meningitis Organization CoMO, Meningitis Centre Telethon Institite for Child Health Research P.O. Box 866 West Perth AUSTRALIA, 6872 linda@ichr.uwa.edu.au www.comoonline.org/wmd.html Contact: Linda Gibbs

U.S. Federal Court Denies Vaccine/Autism Claim

2010-03-13T09:30:00.002-05:00

In a blow to those who still believe that childhood vaccines cause autism, the United States Court of Federal Claims has ruled against claims from three families that childhood vaccines that contained mercury-based preservative thimerosal contributed to autism that affects their children.

The thing is, even the researchers who did the flawed research have recanted, saying that they had made a mistake in their judgment that the vaccines contributed to the development of autism. And yet, the idea still persists.

Learning your child has autism is devastating. We don't want our children to have disabilities, to not be "perfect." Autism is a long road and the more severely your child is affected, the hard a road it is to navigate. And, it is normal, natural, to want someone or something to blame - but we need to find the right thing to blame.

The argument is that people have seeming normal children until they have their first vaccine injections. Within days, some say, their child becomes different as autistic symptoms begin to develop. But what doesn't come across is that autism has been around for generations. It was just often misdiagnosed or not diagnosed at all, in children with mild cases. And, the argument that we have more autism now could be explained with we have better understanding and diagnosis of the condition, and are therefore recognizing and diagnosing it more often. As well, the symptoms of autism often show up just at the same age/time that the vaccines fall so it isn't unnatural to want to blame the vaccines.

This post isn't going to change anyone's mind. Many who read it will nod their head in agreement, some will be outraged at my thoughts, and others won't really care either way or don't know what to think. All I do know is that we don't want to see our children struggle or suffer and most of us will do anything we can to keep that from happening. Too bad we can't always prevent the bad things from happening. As a mother, I do know that.

According to b5, I'm an "aggregator"

2010-03-11T17:53:00.002-05:00

Harrumph. Years of blogging for b5media and now I'm an aggregator?

Blisstree is a re-launch of an existing b5 property that was essentially an aggregator.

The definition of "aggregator" is someone who gathers things. Excuse me, my CV does NOT say I'm an aggregator. I'm a writer - and a good one. I enjoyed working for b5media and I'm proud of the work I did. I'm trying to be a good sport about the whole thing. After all, business is business and part of business is making changes, which may include laying off staff that they feel they no longer need. But they don't need to belittle the work that was done by the many bloggers who worked for them. They don't need to insult us, do they?

Healthcare Workers Helping Haitians Help Themselves

2010-03-11T07:45:00.002-05:00

The horrendous events of Haiti's earthquake earlier this year are fading from the news. We do see images from time to time and hear reminders about the devastation that occurred as a result of the tremors. The Haitian disaster was compared to the Chilean earthquake that happened just a couple of weeks ago - and the comparisons were not favorable.

For those of us who work in health care, we're reminded of our role in helping others. And many of us think about our own mortality, particularly when we think about the deaths of several Haitian doctors, nurses, and other people who work in the field.

As with most natural disasters around the world, the international community responded in a wonderful way. Countries and private companies and citizens provided money, supplies and their own workers. Sadly though, this isn't enough to help rebuild a country that needed rebuilding before the earthquake.

One of the problems that seems to hit Haiti the hardest, but also affects other so-called developing countries, is that many of the international groups, be they non-governmental organizations (NGOs) or governments, tend to rush in and try to take over. They want to do things their way and feel that if they could just teach the Haitians how to do the work and function the way the helpers think they should, all will be well.

But a country isn't that different from a business. A well-run business usually pulls information and resources from its employees and its supporters. Outside people who try to tell the business owner how to run their company are generally not well received. Their suggestions may be worth incorporating into the business structure, but outsiders don't usually come in, set up camp, and then tell the president of the company how to run it. Countries are no different.

In order for the Haitian people to get on their feet and stay there, they need to run their own country. They may need us to provide them with the skills and the know-how, but they also need to take responsibility and learn how to use those skills and know-how to be their own bosses. Just a we need to let our families grow up and learn on their own, developing countries must as well.

There's an excellent article in the March issue of the New England Journal of Medicine, Recovering from Disaster — Partners in Health and the Haitian Earthquake, written by Tracy Kidder. Although the whole article makes excellent point, the last two paragraphs are particularly important, to me. If you have a minute, I suggest you take the time to read the piece. Even better, perhaps you can come back here and comment, letting us know what you think and how you feel.

Good Health Equal Good Sex, Researchers Say

2010-03-10T07:58:00.002-05:00

According to an article published today on bmj.com, if you're in good health, you are twice as likely to be interested in sex, compared with people who are in poor health.

To determine how good health affects sexual activity and if they could predict how long a healthy sex life could be expected, researchers surveyed 3,032 people (1,561 women) between the ages of 25 and 74 and another group of 3,005 people (1,550 women) between 57 and 85 years of age.

The researchers asked the participants about their relationship status, the quality of their sex lives, the frequency of sexual activity, and their general health status (rated between poor and excellent). What they found was that men at the age of 30 years could look forward to about 35 years of sexual activity and women at the age of 30, almost 31 years. Interestingly, if the men and women were married or in an intimate relationship, the gender difference between the two went down.

The results reveal that men are more likely to be sexually active, report a good sex life and be interested in sex than women. This difference was most stark among the 75 to 85 year old group, where almost four out of ten (40%) males compared to less than two out of ten (17%) women were sexually active.

When looking at the health aspect, men lost more years of sexual activity due to ill health than men.

Some may ask what the importance of such a study is. Being sexual is a part of human nature and it can help people feel better about themselves both physically and emotionally. The thing is, do we feel healthier and happier if we have more sex or do we have more sex because we are healthy and happier?

More interesting news:

Allow Your Body to Adjust to Time Change

Virus can attack prostate cancer

In paying for sex changes, Cuba breaks from past

Life After b5media

2010-03-09T11:26:00.004-05:00

Many of my writer friends have asked me what I'm going to do next with the most recent cleaning out of the b5media studios. They know I blogged for three of their blogs and hope that I'm going to land on my feet. I won't trash the company - they did keep me busy for a few years. I just wish things had been done differently.

Am I going to land on my feet? Of course I am! :) Seriously. Although I do blog on health issues, both here and now at GadaboutHealth.com, I am primarily a writer for other media, online and in print. I write for companies that hire me to write patient education material; edit, rewrite, or write material for professionals, such as other nurses or paramedics; and a host of other things.

I won't deny that blogging for b5media was good to me. It gave me enough of an income that I could pick and choose which writing jobs I wanted to take. That is a freedom that not enough people have. So, what am I going to do?

I'm going to ramp up my marketing strategy, send out more queries - something that I tend not to do too often - and LOIs (letters of introduction). Scanning the job listings is a given. Although there's a lot of garbage out there, there are some diamonds. You just have to dig hard enough and long enough to find them. And network. I'm contacting clients of days gone by, talking to fellow writers, and following leads. You just never know who knows what company is hiring.

So, back to the drawing board. And if you hear of anything, I'm listening!

Q&A About Nurses Becoming Writers

2010-03-08T08:22:00.004-05:00

I get emails from nurses who would love to get into writing. Some like the idea of being a writer, others can no longer do the physical work of a nurse and feel that writing may help them continue to earn a living while still using their nursing knowledge.

Here are some of the most common questions I get and the answers I usually give:

How did you get into writing?

I always enjoyed writing and language itself. It is a gift that comes to me and always has. I studied nursing because I felt I had to be practical and choose a career where there would always be work. But, writing and the need to write never left my soul.

As a result, when the Internet became more available to the everyday person, I began reading more and reaching out, trying to write when I could. The rest just happened.

What was the first thing you had published?

My first piece of writing that was published in a print magazine was an article for nurses about using the Internet. It was published in the mid-90s in the journal The Canadian Nurse. My first on-line piece was an article on Alzheimer's disease, some time before the Canadian Nurse article.

Should I take a writing course?

Taking courses is rarely a bad idea. We can always learn how to do things better. The first writing course I ever took was a mandatory one on how to write a paper, a first semester university course that I took when I went back to school around 1994 or so.

The course was incredibly helpful. Although I thought I knew a lot about how to write, there were a few consistent errors I was making and my prof cured me of those. I took a few more writing and editing courses later on and I learned something from each course I took.

How do I start?

This is the big question. How you start writing depends on how serious you are and what your goals are.

Can you write? Many people believe that writing is easy. While the actual action of putting the words to paper (or on the screen) is easy, finding the right words and putting them in the right order, using the right tone and feel, isn't. Not everyone can write well. You need to be honest with yourself as to whether you do have that ability. Technically, do you know the difference between paraphrasing and copying? Do you understand the seriousness of plagiarism? It's sad how many people don't know this. Can you credit sources properly?

How are your research skills? Writing rarely comes without research. You need to be able to look for information and to be able to judge if the information is credible and usable.

Do you like to blog? A blog is a good way to commit to writing something on a regular basis, learning what people like to read about and how to promote yourself.

Do you have a niche? Is there something specific that you are passionate and knowledgeable about? Can you zero in on something that isn't as well-known or that needs more expertise?

Are you able to commit? Can you follow through on a project, providing the clients with what they have hired your for?

Can you handle having your writing edited? Some people go into writing thinking that if they write something, it will be published as-is. While I am lucky enough to have this happen to me many times, there are times when my writing is edited so much, I barely recognize it. Sometimes, this happens because the client didn't like how I approached the topic, other times, there are several editors working on one piece ("editing by committee") and this results in a multitude of changes. And some other times, it's because the client feels that they can write it better than you did. Having your work edited can be a bit painful sometimes - particularly if you don't agree with the changes. So you have to know if you can live with that, but also be self-confident enough to speak up if you feel that the editor is introducing aspects to your piece that you know shouldn't be there. Editors are great to have on your side, but they're human too. Sometimes, things happen.

Can you deal with the financial up and downs of freelancing? New writers may be stunned to know that sometimes we wait for months to be paid for a piece we wrote on a rush deadline. A rush deadline for writing doesn't usually translate into a rush deadline for payment. I have to say, I've been very fortunate. The vast majority of my clients have paid me on time or within reasonable delays. There have a been a few that pushed the limits, one I had to chase down, and one who refused to pay me full payment. But, as I say, for me, this is unusual. For other writers, it happens more often.

So, where do I start?

Write up a resume of your skills and any experience you have in writing. If you have contacts in the field, you may want to let them know that you are looking for work.
Start your blog if you want to follow that route. This gives you a presence on the Internet. It's this blog that made me the number one Google hit if you type in "Nurse writer."
Read writing books and writing magazines. There are many great writing sites online as well. Read, read, and then read some more. You can't write if you don't read. You have to understand the differences in different types of writing, such as the big difference between writing for online and writing for print. Read what other nurses are writing about.
Decide what you want your focus to be. Although I write for all types of audiences, from professional to general public, my passion is writing for the every day person. I love taking complicated medical health information and writing it up in an understandable and, if possible, fun way.
Ask questions but, and this is important, be judicious about what you ask and who you ask. Freelance writers are among one of the most giving and sharing groups of people I have ever worked with. But, they are also very busy trying to make a living of their own. While most don't mind helping new writers, it is frustrating to take the time to answer questions and make suggestions, never to get a "thank you" in return. Also, watch the type of questions you ask. Many can be answered if you look them up and it is a bit frustrating to be asked basic questions that can be found with a bit of effort.
Join writing groups, either in person or online. Other writers are a great resource and sometimes, they ask questions you didn't even know you had.
Don't give up. If this is what you want to do, stick to it.

Good luck!

Breast Feeding the Wrong Child

2010-03-07T16:20:00.005-05:00

Moms - if you breastfed your baby(ies) and you found out that a mix up in the hospital caused you to nurse another woman's infant, how would you react? Is it gross? Is it more concerning about the mix up than anything else? Is it something worth suing about?

Baby mix ups have happened from time to time. We like to think that we've got fool-proof methods in place, but mix ups still occur. According to this article, such an incident is sue-worthy: Breast-Feeding the Wrong Baby.

The article explains how a nurse brought the wrong baby to a mother who went on to breast feed the child. Well over a year later, the mother who did the nursing has filed a 30,000 dollar lawsuit against the hospital. Did you get that first part? *Over* a year later.

Here are my thoughts:

1- I nursed three children and I could identify all three from the day they were born. I find it highly unlikely I would not recognize my own child.

2- If the situation was so traumatizing for the mother, why wait a whole year (actually, more) before launching a lawsuit?

3- Is it really that terrible that one child receive another (healthy) mother's breast milk? We used to have wet nurses, women still do nurse others' babies for a variety of reasons, and we have breast milk banks for premature babies.

and finally, the biggie for me:

4- Should the mother of the mistakenly nursed baby be the one who is freaked out and suing?

It's the last point that really makes me wonder.

What do you think?

~~~

Don't forget to check out www.GadaboutHealth.com for more health-related stories and www.GadaboutMedia.com for entertainment and lifestyles fun.

Healthbolt and Diseases & Conditions Blog Now History

2010-03-05T11:04:00.002-05:00

Many of my readers here follow my posts over at Healthbolt and at the Blisstree Diseases and Conditions blog. Sadly, many of us received our termination notices this morning and those blogs are no longer part of my life. It is all part of b5media's "redirection," or whatever they call it.

In the meantime, I'll be working hard to help build up the new network I began with Gayla Baer, www.gadabouthealth.com. We'll have the stuff we had at Healthbolt and more.

In the meantime, my shingle is out: "Work wanted!"

While I am a health and medical writer, blog writing helps supplement the income when projects are slow, and they help give a break in serious writing when the writing jobs are plentiful. So, if you hear of anything that may be a good fit, please pass it on.

The Freedom of Less Pain

2010-03-03T11:23:00.002-05:00

I don't think people realize how draining pain is until they stop feeling that pain on a constant level.

I've been blogging a bit about my shoulder since I separated it on December 11, 2009. It is now March 3, 21010 and I only now have spent my second virtually pain-free day since the accident. I also can't get over how good I feel.

Chronic pain is a major health problem in North America. Many people live with chronic back pain, but there are others who live with arthritic pain, migraines, fibromyalgia, and just about any type of pain you can think about - and they're expected to get through life each and every day as if they didn't have it.

The problem with pain is that someone else can't see it. If you have a broken leg, people see the cast and can clue in that you're likely not very comfortable. If you've got a visible reason for your pain, it's ok to feel that pain - others expect it. But if you don't have something noticeable that can warn others, then your pain is unexpected and often uncomfortable for others. After all, how can they identify with you if they can't see or understand where the pain is coming from?

How many people who get migraines have heard comments from others about how they have bad headaches, but they find a way to cope. How many people with irritable bowel syndrome get little sympathy from someone who can't understand what if feels like to have it seem like your gut is all twisted and tied in knots? Or the person with back pain who is feeling pretty ok, but makes the wrong move and gets a "zing" in the spine that is strong enough to bring him to his knees?

I have to admit, I was getting very discouraged. I go to physio every single week, never missing one. I follow up the next day with a therapeutic massage - never missing a week. I do my exercises, but my shoulder didn't seem to be getting any better. And worse, it was still hurting. And then, all of a sudden, it was as if a switch had been thrown.

I'm not completely pain-free yet. The shoulder hurts when I do certain movements it doesn't want me to do, but the ever-present pain seems to have gone. I cannot be more grateful for that.

If you don't know what it's like to have constant pain, how do you react when someone else has it? Is it tough for you to understand?

My neck pain is caused by my breathing - who knew?

2010-02-18T09:08:00.002-05:00

You know the whole, the hip bone is connected to the thigh bone thing? There really is a lot too it. I'm a believer in how one part of the body affects another, but it's not always obvious and it can be a bit surprising when you learn about different connections.

As many of this blog's readers know, I separated my shoulder in December. I'm going for intense physio and therapeutic massage to get rid of the pain and regain good range of motion. This week, both my physio and my massage therapist worked on my upper back, the thoracic back because they both noticed that there was a problem there. I also just happened to mention to my physio that when I go for walks, my neck and shoulders begin to hurt, no matter how good my posture may or may not be.

You know what the problem is/was? My breathing. Somewhere down the road, I began using my upper back muscles to breath and not my abdominal muscles. So, when I go for a rapid or long walk, as I get tired, I start breathing harder, using those upper back muscles - which then become fatigued and sore.

I now have some exercises I have to do to try to retrain my mind and body to breathe properly. But I wonder how long I've been doing this and why I started doing this.

Anyway, now that I know, I can work on it and work on it, I will do. Now, do you know how you are breathing? Are you breathing properly? Or as I was?

Five years after suicide

2010-02-12T13:09:00.004-05:00

This coming weekend, it will be five years since my brother took his life. He was 35 years old at the time. How ironic he chose to die in February - Suicide Prevention Month in many places. How ironic and how sad. I somehow doubt he knew about the suicide prevention thing. I doubt he could see beyond his own pain.

I have heard and read many times that people who commit suicide don't really want to die, they just want to stop the pain - and this is the only way they feel they can make it work. Some people say the act of suicide is selfish. Is it? In my opinion, people who get that far into despair don't think about what others are going to feel not because they are selfish, but because they can't get beyond their own pain. This past December, I separated my shoulder and felt the most intense pain I'd ever felt. As I was in pain, I didn't care about anyone else's needs or feelings - I just wanted the pain to go away. I don't see the mental pain as being all that much different. It hurts, just in a different way.

I wrote this post a few years ago and I think it's still pertinent now. I heard on the news the other day that the suicide rate in Canada is dropping - but one death is too much. It's one life lost that likely could have been saved. This is for you JP. I couldn't help you in life, maybe I can help others now:

Suicide, not a disease, so no walkathons, ribbons, or research race

There was more news about suicide yesterday in the papers. This time it’s about whether some antidepressants really do raise or lower the risk of suicide. I don’t know – I’m not an expert in that department. I think suicide is way more complicated than if a drug helps or prevents it. What I do know is that suicide hurts like hell. My baby brother took his life in February 2005. He was 35 years old.

Quebec has one of the highest young male suicide rates in the country. Young men are one of the highest risk groups for suicide. In a youth suicide report published by the Canadian Task Force on Preventative Health Care, it says: “Suicide has accounted for about 2% of annual deaths in Canada since the late 1970s. Eighty percent of all suicides in 1991 involved men. The male:female ratio for suicide risk was 3.8 to 1. In both males and females, the greatest increase between 1960 and 1991 occurred in the 15- to 19-year age group, with a four-and-a-half-fold increase for males, and a three-fold increase for females.”

Statistics aren’t that much better in the United States. Published in Explaining the Rise in Youth Suicide, by David M. Cutler, Edward L. Glaeser, and Karen E. Norberg, March 2001, are these findings: “Suicide rates among youths aged 15-24 have tripled in the past half-century, even as rates for adults and the elderly have declined. For every youth suicide completion, there are nearly 400 suicide attempts.”

According to an article by Stewart Tendler that appeared in the London Times, UK, in November 2004, suicides made up 13% of the inquest deaths in England and Wales in 2003. Compared with 744 women who committed suicide, 2,511 men did. Although the numbers in the UK seem to have stabilized, it is still the younger men, between 15 and 24 years, who have the highest suicide rate.

Excuse me? Did I read that correctly? Eighty percent of the suicides in Canada in 1991 involved men?? Suicide rates have tripled in the US among older teens and there were 1,767 more men in the UK who committed suicide than women? Between 1960 and 1991, there was a 4.5-fold increase for males and a 3-fold increase for females in Canada? Where is the outcry? Where is the demand for something to be done about this? Oh, right, I forgot, we don’t talk about suicide. It makes people uncomfortable. Talking about suicide means that we have to talk about mental illness, depression, pain, and despair. Not exactly cocktail chatter.

I’ve read, although I can’t pull the sources right now, that the rate among young men may actually be higher because of accidents that are really disguised suicides without actual intent, meaning that some of the young men who crash their cars or do dumb stunts that result in death may actually be playing with suicidal behaviour. I can’t back that up, but I do recall reading it. I wonder if there is some merit to that though.

Action has to be taken to help those young people who feel that there is no other outlet, no other way to solve their problems than to end their lives. I’m not a psychologist or a social worker. I don’t have the answers to any of the questions of how to stop this, but if people were dying at these rates of a disease, or some sort of fatal accident, I’m sure that people would be taking action. The only way action is going to happen is if we start to talk about the people who we lose through suicide. We need to bring it out to the forefront of people’s thoughts. We need to do something because our young people, our young men, are so desperate that they see no other way out.

Do I sound angry? I am. I’m angry, upset, saddened, and frustrated. JP was 35 years old. He had a rough life and was never able to get the help he really needed. He hung himself on a Friday night in February. He was alone.

I would do anything to get my brother back. The help I gave him wasn’t enough. The help his friends gave him wasn’t enough. His two young sons weren’t enough. We all tried in our own way, stumbling through the mental health minefield. The help I did give wasn’t enough, he couldn’t take it. I don’t know why, but it didn’t work. I miss him and my mind often goes to where he must have been before he died. My heart still cries for him and probably always will.

We have to stop this. We have to.

Cake for a Cause - who doesn't like cake?

2010-02-11T11:36:00.003-05:00

Cakes come in all types and sizes. I used to decorate cakes as a sideline: birthday cakes, wedding cakes, you name it, I likely did it. It's fun, but hard on the hands if you have one that uses a lot of decorating. And then there's the stress of making sure the cake is *perfect*, particularly if it's for a wedding cake.

Now, I only decorate for fun but I still love looking at nicely decorated cakes. That's why this caught my eye.

I just received an email about a virtual campaign, Kelly's Cake Off for a Cause, to support the fight against ovarian cancer. So, if you're interested, have a look and see if you want to participate.

New York, NY – The flour was flying recently as self-proclaimed baking enthusiast Kelly Ripa and accomplished master baker and cake decorator Buddy Valastro, from TLC’s “Cake Boss,” joined forces at Manhattan’s trendy Chelsea Market to bake lavishly decorated cakes for a cause. The pair teamed up with Electrolux Appliances to host Kelly’s Cake Off in support of the Ovarian Cancer Research Fund.

“Call me a hopeless romantic, but I love Valentine’s Day,” said Ripa, who in addition to her duties as mom, TV personality and Electrolux brand ambassador, is also head of the bake sale committee at her kids’ school. “It’s a great time to show you care – both for the people you love and the causes close to your heart.”
On February 9th, five teams of baking enthusiasts were invited to take part in Kelly’s Cake Off, where they used what they learned from Ripa and the Cake Boss, to decorate their own cakes.

“I couldn’t believe the results!” said Valastro. “And it makes it all the sweeter that it’s all for a good cause.”
Starting today, exclusively at Kelly-Confidential.com, people can cast a vote for their favorite cake from Kelly’s Cake Off. For every vote cast, Electrolux will donate $1 to The Ovarian Cancer Research Fund (OCRF) as part of its $500,000 commitment to help fight ovarian cancer.

Visitors to the Web site can get in on the cake decorating action, too. People can decorate and send a special virtual cake to a friend, family member or someone they love. For every cake sent, Electrolux will donate another $1 to OCRF. Plus, Buddy’s top cake decorating tips are available -- sure to inspire baking enthusiasts and novices alike.

And, to encourage people to help spread the word, everyone who logs on to the site and sends a virtual cake will be automatically entered for a chance to win every baker’s dream: a stylish new Induction Range from Electrolux.
“Electrolux is getting behind OCRF in a big way again this year – with great initiatives to get people involved in supporting the cause and the launch of our new Induction Range,” said Kevin Scott, Electrolux Major Appliances President and CEO, North America. “In fact, we’re donating $100 to OCRF for each range sold this month.”

Olympic viewing - waiting for injuries?

2010-02-02T19:00:00.003-05:00

Do you watch the Olympics? Within days, athletes from around the world will descend upon Vancouver, British Columbia, Canada and area for the 2010 Winter Olympics where dreams may be achieved and hopes dashed.

I like to watch the competitions, although I much prefer to watch the summer olympics. But watching the winter sports has me often sitting on the edge of my seat, waiting for someone to have a spectacular fall, hoping that a severe injury isn't the result.

In our chase to become the fastest, jump the highest, and twist and flip the most times, some of our athletes end up sustaining incredible injuries, some of which are career threatening, others even life threatening.

Am I the only one who cringes when the athletes put themselves in this position?

Diary of My Separated Shoulder

2010-01-09T16:13:00.004-05:00

Dec. 11, 2009 early morning.

Dear Diary,

It's moving day! We're moving from this large 4-bedroom home to a much smaller second floor flat/condo - downsizing at its best. But all the hard work will be worth it. Bring on the movers!

Dec. 11, late evening.

Dear Diary,

Well, the move didn't go as planned. Not at all. The movers came alright. They were doing a great job packing up their van. The problem was me. I fell. Hard. Very Hard. I had gone outside to go to the car and I slipped on some hard snow and landed on my left side. Did I mention that I fell hard?

Diary, I remember lying there on the snow thinking, "this cannot be happening, this did NOT just happen." But it did. If anyone ever tells you that they've separated their shoulder and it hurts, believe them: it was the worst, most intense pain I have ever felt in my life.

I had an anterior separation that required me to be "out" to put back in. Did I mention it hurt?

December 14

Dear Diary,

Went to see the orthopedic surgeon for follow-up. There were others there with shoulder injuries, not to mention all the other broken bones and stuff. Anyway, the doctor said my shoulder is exactly where it's supposed to be and I can start physio. Oh joy. It still hurts.

Problem is, when you do a good job separating your shoulder, it's not just the bones that shift, you stretch or tear the ligaments all around the shoulder. That's what causes a lot of the pain and, uh, discomfort.

Christmas Day

Dear Diary,

Boxes are still everywhere. I'm not allowed to use my arm to move, lift or anything. My physio warned me that it could dislocate again at any time if I'm not careful. Decided not to wear my sling to family Christmas dinner because it clashed with my outfit. Yeah. Right. That was a bright decision (NOT).

December 29

Dear Diary,

Much improvement in my shoulder although still painful. It seems it's the muscles that are causing all the pain. They're very tense and knotted so we have a bright idea of me seeing a massage therapist the day after my physio sessions. Oh boy.

December 30

Dear Diary,

Whose flipping idea was it to go for a massage???? OWWWWW

New Year's Day

Dear Diary,

Shoulder still hurts. Is it going to stop hurting eventually? Well, maybe if I stop using it but how can you not react when you open a cupboard and something comes falling off the shelf right towards your head? Of course your arms (notice the plural) are both going to go above your head to protect yourself. Ouch.

January 5, 2010.

Dear Diary,

Woohoo, physio says I'm allowed to move my arm a whole 20 degrees away from my body. Also have exercises to strengthen the muscles again. Standing against the wall, forearm against it and gently push for three seconds times 10 times. Same with the wrist. Who would have thought that an arm can get tired of doing such a simple exercise?

January 6

Dear Diary

Saw the doctor again. Shoulder is healing, woohoo! She did, however, caution me. Said I have to be more careful. Does that mean I can't play indoor soccer at the end of the month. Physio is frowning on that idea. Also saw the massage therapist again. Not as bad today. I have a feeling I will not be so generous tomorrow morning after I wake up.

January 9

Dear Diary,

IT'S BEEN ALMOST A MONTH. Can you please tell my shoulder that it's had enough time off and it's time to start being a team player again?

Thanks.

Entertainment or Way Beyond: A Child's Death Twittered

2009-12-18T17:00:00.004-05:00

Twitter has been in the news, for better or worse, for the past year or so. Some people use Twitter for the odd updates, others are addicted to it or like to use it for shock value. One famous case occurred just a couple of months ago when Penelope Trunk twittered about her miscarriage during a meeting.

Some people were disgusted with her cavalier attitude, while others applauded her for her open communication. Others just shrugged their shoulders in a "what can you do? fashion.

But now, Twitter and its reach is under fire again, for a much more tragic reason. Shellie Ross, a 38-year-old mother, twittered that her son was drowning - her two-year-old son. He had fallen into the family swimming pool and emergency services were trying to rescue him.

Many people are harshly critical of Ross and her twittering. There were reports that she twitters extensively and this gave people license to blame her twittering for lack of parenting. Of course, this can't be a conclusion to be drawn - we don't know the woman at all. But it's out there. But, is that really that issue that is drawing such ire? Or is it the fact that someone has the presence of mind to twitter as people are trying to resuscitate her child?

I'm sure that the last thing on her mind was to draw such attention to herself and her family tragedy. The loss of a two-year-old is a major, major tragedy. But she has, unwittingly, brought this to the attention of millions of people.

Is twittering for entertainment only? Or, as Ross meant it to be, for support and prayer at a time of extreme need? What do you think?

~~~

Dislocated shoulders, concussions and a move: still very grateful

2009-12-13T21:58:00.002-05:00

It's been a busy few months. We sold our house after having it on the market for about 8 months, bought a new place in the city (we were in a suburb) and moved. It all ended up happening quite quickly once we sold our house.

Stress takes a toll on your body, whether it's a good stress or a bad one. It's known that changing jobs - even a good change, moving, marrying, divorcing, having a baby, and so on, are all stressful times in our lives. It's important to stay healthy during those times because once you do start getting run down, it's hard to get back up to full form.

Luckily for us, we stayed pretty healthy for the most part, although I think that stress did get to us from time to time.

This past Friday, the 11th, was moving day. The big day. So, as the movers were taking the furniture from our home, I went to my car and, before I knew it, I was on the ground - in agony. I have no memory of falling at all, just lying on the ground with a shoulder that hurt more than anything I'd ever experienced in my life. Worse than childbirth, without a doubt.

It turns out that I separated my left shoulder, so off to the hospital for some major drugs to knock me out so they could reset the shoulder. In the meantime, the move was going on. Thank God for capable children who are now adults. They had no idea what to do, but they managed and they did a fantastic job.

After five hours (about) in the hospital, my husband and I headed for our new home. Of course, now I can't do anything, so all my plans are out the window. After a quick supper, the youngest (18) goes off to coach floor hockey as he does every Friday night. Problem was, while he was there, he whacked his head good and hard on a wall overhang as he ran down some stairs. The result? A mild concussion and sutures in his scalp. Oops. That's got to hurt.

Ok, so now the new place is a mess and two of the three people living here are out of commission. but you know what? That's ok. That's very ok.

The place is perfect to me. The bathroom that I had redone, is perfect, amazing, gorgeous. It fits the style of this 1930 building perfectly. The rooms are actually big enough for the furniture I kept; I thought it was going to be crowded.

Despite being just below a busy street, it is so quite and peaceful here, very similar to what we left. Very, very quiet, even at night. It's likely noisier in the summer when the people in the apartment building next door have windows open, but that's city living, right?

I love the place.

Some people thought we were nuts moving into a second floor flat/condo but I think it was exactly the right thing to do.

Oh, did I mention that I absolutely love the place? I never felt this way about any of our previous homes. *This* is the one that was meant to be. :-)

Sore shoulder? Yeah, but that will go away. This feeling of being home? That, my friends, is here to stay.

Dec. 6, 1989, Violence against women

2009-12-06T08:37:00.007-05:00

December 6, 1989. It was a day like many others. I was at home with my then 2-year-old son and my 10-month-old daughter. Nothing of the day would have stood out except for a horrible event that began in the late afternoon.

As we watched the evening news, the drama - the unimaginable - was happening. One gunman, Marc Lapine, had entered Ecole Polytechnique, the engineering school of the University of Montreal. He told the male students to leave. He began shooting the women. By the end of it all, 14 young, bright, promising women had been murdered by a man who resented that they were in the school and not he. Ten women and 4 men were physically injured. And many, many other people, both men and women, were left with the pain of losing their daughter, sister, lover, cousin, aunt, or friend.

The images of the ambulances outside the building, the snow falling in big wet flakes, will always stay with me as I held my own daughter. That same daughter who, 17 years later, was in the building at Dawson College when a gunman opened fire, killing one student. Although she wasn't near the cafeteria where the tragedy occurred, she was in the building and had to be evacuated like thousands of other students. Seventeen years after the Polytechnique massacre, we were again faced with guns and violence in a school, a place where we like to feel our children are safe.

At the time of the Polytechnique, I didn't know if my daughter would grow up to become a lawyer, a business woman, a chef, a teacher - or an engineer. I grew up around engineers. My father taught in the mechanical engineering department at McGill. I know what kind of people, very bright, intense people, study in this field. I know that women were sorely under represented, but it was a man's world back then. And so it was to Lepine too, as he wiped out the lives of 14 young women and forever changed how many Montrealers see the world.

Gun violence in Canada is something that we're often proud doesn't happen here very often. But someone who is going to do horrible things is going to find a way to do it, no matter what. And, Lepine also had a hunting knife - which he also used on at least one woman after she was shot, say news reports.

There have been vigils and there will continue to be vigils in honour of the 14 women who died. But we also can't forget those who survived the trauma, those who lived through seeing their peers killed. We can't forget the families who lost their loved ones. December 6 is a day of remembrance in Canada for all women who suffer from violence. Let's hope that one day, women don't have to be afraid of some men. Wouldn't that be a wonderful thing?

Geneviève Bergeron (born 1968), civil engineering student
Hélène Colgan (born 1966), mechanical engineering student
Nathalie Croteau (born 1966), mechanical engineering student
Barbara Daigneault (born 1967), mechanical engineering student
Anne-Marie Edward (born 1968), chemical engineering student
Maud Haviernick (born 1960), materials engineering student
Maryse Laganière (born 1964), budget clerk in the École Polytechnique's finance department
Maryse Leclair (born 1966), materials engineering student
Anne-Marie Lemay (born 1967), mechanical engineering student
Sonia Pelletier (born 1961), mechanical engineering student
Michèle Richard (born 1968), materials engineering student
Annie St-Arneault (born 1966), mechanical engineering student
Annie Turcotte (born 1969), materials engineering student
Barbara Klucznik-Widajewicz (born 1958), nursing student

Needle Picks and Nurse Fears

2009-11-17T20:07:00.003-05:00

I've been a nurse for over 25 years. While I've picked myself occasionally with clean needles, ones that I was preparing to use (and then tossed), up until now I could say I'd never had a serious needle stick. Unfortunately, I can't make that claim any longer.

After taking blood from a patient this morning, I was trying to retract the butterfly needle into the plastic protective cover, only to have it jam. When that happened, my hand came off the plastic and then kind of rebounded back, embedding the needle into my thumb. Ouch. Blood. Ouch.

So, of course, off for blood tests, paperwork and more. I'm fine; I know I'm fine. The patient is in a low-risk category (probably as low-risk as they come), so I'm confident. But only to a point. You never really know someone and you never know what could show up. So, I wait.

No prophylactic (preventative) medication for me. If the patient had been high-risk, I would have taken the medications. Those things can have nasty side effects though.

But you know what's the worst part about stuff like this? Believe it or not, patient rights. I was lucky. The patient's family was very understanding and gave me permission to get blood samples for HIV and hepatitis. But, they also had the legal right to refuse this.

Years ago, when I worked at an acute care hospital, one of the nurses on my floor had a needle stick from someone who was very high risk. The doctor went in to ask the patient for permission to draw blood for HIV testing and he refused. He refused the next day and the day after that. He never ended up agreeing to it, despite being told why it was being requested.

As a result, my colleague had to take the antiretrovirals for a set period of time, to prevent the possibility of contracting HIV. The law was on the patient's side. But when a the health of a healthcare worker is at risk, shouldn't that trump the rights of the hospitalized patient?

Beware of Fake, Possibly Harmful H1N1 "Medications"

2009-10-20T16:34:00.003-04:00

As with any big news, the scum come out to see how they can benefit. Whether it's fake charities set up using 9-11 as their pitch or looters after an evacuation, there will always be some nasty people who try to take advantage of the situation. Of course, the H1N1 issue is no different.

The United States FDA has issued warnings about various products and supplements touted to help you prevent or treat the H1N1 virus. Besides being a waste of your money, they also could be quite dangerous, depending on their make up and your own personal medical history.

The FDA has provided a widget (in sidebar to the right) that you can use to check if the product you're interested in is on their watch out list or it's approved.

I hope this helps with all this confusion that seems be running rampant. Also, for more information, don't forget about the FDA H1N1 Flu Page and www.Flu.gov.

~~~

Balloon Boy, Reality TV, Hoaxes and Legal Charges

2009-10-18T08:23:00.004-04:00

Was I the only one who thought, right off the bat, that there was something not quite right about the claim that a 6-year-old boy may be on a run-away home-made helium balloon?
(edited to add, I read at 3 p.m., on CNN, that the authorities have admitted that this was a hoax: 'Balloon boy' incident was hoax, sheriff says)

Of course, the authorities had to take the issue seriously. They couldn't take any chances that this wasn't true - but something didn't sit right from the beginning of the story - at least not to me.

I don't watch the TV show Wife Swap very often. Oddly enough, one of the few times I did watch it was when the Heene family was on it. Very odd family, very odd way of living life, but I figured, well, that's what works for them. But when I started getting the unsure feeling about the run-away balloon and then I heard the family's name, I was certain it was a hoax. I wonder what the other family in that episode thinks about the Heenes now. Needless to say, they didn't feel that much love towards them before.

Reality TV is real entertainment for a lot of people. I get that. It's like watching a train wreck. I watched *one* episode of Toddlers and Tiaras, a TLC program about children's pageants. I was shocked and disgusted at what I saw. Six-year-olds prancing, making sexually provocative movements and stances, blowing lipsticked pouty kisses to the crowd. I've watched one or two episodes of condescending Kate and no-back-bone Jon and their eight children. But in truth, I avoid these shows because they have no entertainment value to me. All I see come out of these shows are people who are willing to sell their souls for their 15 minutes of fame. Which, in cases like Jon and Kate, and the Heenes, translate into more than that.

Now that it's strongly suspected that the Heenes did set up a hoax, police are considering charges (Charges pending in balloon saga). Unfortunately, the charges can't be strong enough because it looks like this falls under misdemeanor, not criminal charges. But, I wonder if they can be sued in court to regain some of the costs that were incurred during the search? And I wonder about those kids. Obviously, if this was a hoax, the sibling who "reported" seeing his brother get in the basket was coached to do so, so what is it like in that house?

It's a sad story. And alleged hoaxes like this only make people suspicious when real things occur. Reality TV, I wish you'd go back into obscurity.

Blog Action Day 09 - Climate Change and Health

2009-10-15T06:31:00.002-04:00

Climate change, global warming, greenhouse gases - the news is all around us. Some people believe, some people don't. Some people say we are causing it, some people say that it would be happening anyway. But you know what? We don't all have to agree on what is causing it, but we do know that the world is changing. Today, October 15, 2009, is Blog Action Day and this year, we're addressing climate change.

So how does climate change have anything to do with health issues? It has a lot to do with health.

As early as 2000, the World Health Organization (WHO) found that the warmer, wetter weather was bringing more mosquitoes and causing epidemics of malaria in Rwanda and Tanzania. But, how does that affect people in the more northern countries? After all, malaria isn't a problem in countries like Canada or Sweden. That's true, but while we may not have to worry about malaria, the WHO also found that a type of mosquito called the Asian tiger mosquito, were found in the Netherlands. These mosquitoes can carry dengue fever tick-borne encephalitis is popping up in Sweden.

In Sweden, cases of tick-borne encephalitis have risen in direct correlation to warmer winters. Also in Sweden, more ticks carrying Lyme disease than ever have been found across the country. Asian tiger mosquitoes, the type that carry dengue fever, have been reported recently as far north as the Netherlands.

West Nile disease, which can cause death, is being found in northern United States and Canada, places that never saw the disease before the year 2000. Even cholera is making a come back. Traditionally thought of as a disease that strikes in warm disaster zones when floods in the warm areas encouraged the spread cholera. In 1991, for the first time in that century, cholera hit South America. By the time it passed through the continent, more than 10,000 people were dead.

Even if you don't worry about the more dramatic of diseases, climate warming contributes to smog, which can affect people with lung or heart diseases. Smoggy weather may also cause people to exercise less, reducing their healthy lifestyle.

So what do you think? Is this important enough for us to start to make some serious changes?

Could this be considered a recall? Contaminated cocaine

2009-10-10T22:06:00.003-04:00

I know it's in the best interest of public health, but I can't help but admit I was taken aback to be reading headlines, such as:
Cocaine cut with antibiotic could cause life-threatening infection: health unit
and
Peterborough health warns about contaminated cocaine causing deadly infections

It is a serious issue though, my surprise notwithstanding. According to public health officials, some cocaine dealers have been cutting their cocaine with a veterinary antibiotic powder to make it go farther. The antibiotic, levamisole, is used to treat infections from worms in animals, but is also said to make the effects of cocaine more intense for the user.

This isn't limited to Canada though. In August, it was widely reported that celebrity disc jockey Adam Goldstein (DJ AM) had been found dead from an overdose of drugs, including cocaine. It turns out that the cocaine he had taken had been cut with levamisole.

Officials say that in Canada, about 10% of seized cocaine contains levamisole, in the U.S. - 30%.

Symptoms to watch for if you've used cocaine and may be affected by the antibiotic are:

high fever
chills
swollen glands
painful oral or anal sores
skin abscesses
rapidly occurring lung infection

Having fun over at Healthbolt

2009-10-08T06:36:00.002-04:00

I enjoy writing for all my blogs and most of my writing clients, but I have to say that writing Healthbolt is an absolute blast! I keep finding the coolest things to write about that weren't really appropriate for my regular health blogs.

What kind of topics? Did you know that someone made a teddy bear out of a placenta (Placenta Teddy Bear – Yup, Heard It All Now)? And that researchers are working on a vaccine for cocaine addiction (A Cocaine Vaccine?). I also have a bunch of posts scheduled right up until almost the end of November. It's really amazing what's out there.

If you like quirky news, come on over and check out Healthbolt - I'd love to see you there!

Medical Inventors - do you ever wonder about them?

2009-10-07T07:00:00.005-04:00

Not long ago, I was watching a piece on the television show 60 Minutes and it was about the inventor of the medical respirator, Dr. Forrest Bird. Many years ago, I worked in an intensive care unit and the respirators were often called "birds." I never stopped to wonder why, but now it makes sense.

Today, I was reading the news and I noticed that the inventor of ultrasound to detect cancerous tumors has died (Medical Inventor, Dr. John J. Wild Dies).

When I was watching the piece on Dr. Bird, I began to realize that we have so much around us that affects our life every day, yet most of us likely don't know how they came to be. I realize that some people don't really care, but I think many are like me and like to learn how certain inventions came about.

I've had many ultrasounds, for pregnancies and for illnesses that needed ruling out or diagnosing. When I think back to how the technology was invented, I can't imagine having such a vision of how something could work and then working for years on getting it to function the way you think it should. I mean, I think we all dream of something that we think would be the next greatest invention, but how many of us follow up on it?

If you get a chance to watch the Dr. Bird segment, I recommend it. It's eye opening (to me) to actually see someone who has made such an impact on human life around the world.

I'm the new Healthbolt blogger

2009-10-03T08:59:00.002-04:00

I don't know if any of you have ever read Healthbolt, but it is a fun and quirky type of medical/health blog. It's part of the b5media network, where I used to write Help My Hurt, Womb Within and Cancer Commentary. Those three blogs were blended into a general Conditions and Diseases blog, for which I'm now the primary writer. I also write the Men's Health blog. So, they're keeping me busy there.

The fun in writing for Healthbolt is I can tackle some of the more unique stories. I've got some coming up about someone who makes beautiful glass art of viruses, bad breath destroying an astronaut's dream, and condom negotiation, just to name a few.

So if you're interested in this type of thing, I invite you to head on over and see what's in store for Healthbolt. And don't be shy. Comments and ideas are always appreciated!

Coming October 5: World Habitat Day

2009-09-29T19:35:00.003-04:00

In order to live a healthy life, we need a safe and healthy place to live. A roof over our head, protection from the elements - that's all we really require. But for millions of people, this isn't possible.

The United Nations reports that more than 100 million people around the world today don't have such a roof over their head. They are homeless, subject to the conditions of their environment. Some are homeless because of severe poverty, others have been displaced because of war or famine. They're not safe, they're not protected from the weather. They are alone. Countless more millions do have a roof over their head, but no utilities, no running water, no electricity. We don't have to go far for these. There are people in North America who live in conditions like this.

Globally, within 20 years, 40% of the world's people, 3 billion people, will need homes. Nearly one billion people live in slum conditions. In the United States, one third of the population either don't have homes or have a difficult time managing to afford a home and its costs: one out of every three households in the U.S. spend more than 30% of their income on housing. One in seven spends more than half.

The effects on health can be devastating. A child who doesn't have a home or who lives in slum conditions is at higher risk of developing asthma, contracting viruses, becoming severely injured - or worse - in an accident, such as a fire. Chronic illnesses are common and infectious diseases and viruses, like HIV, are not uncommon.

Imagine living in a tent, with little sanitation, no privacy, nothing to do. Imagine huddling in a squatter community, trying to keep out of the rain and hoping the authorities don't come and drive you away. Imagine not being warm.

The first Monday in October has been named World Habitat Day by the United Nations. Learn what you can do to help by visiting the Habitat for Humanity World Habitat Day website.

Can U Txt S.T.U.P.I.D.?

2009-09-26T20:57:00.002-04:00

Texting in itself isn't a bad thing. I text back and forth with my kids frequently. It's an unobtrusive way to get hold of them and they can get back to me when they can. It's also great for the ones that don't live at home because I don't know where they are and what they're doing, so I am leery about calling them and disturbing them.

BUT, the first time I heard of someone texting while driving, I thought it was a joke. After all, I though, who would be STUPID enough to do that? Apparently - a lot of people.

The American Automobile Association (AAA) surveyed 2,500 U.S. residents 16 and older and, even though almost all of the people who responded said that texting while driving wasn't smart, 18% had done it within the previous month.

I've been behind or beside drivers who are texting and I can't get over the outright stupidity of the action. It's nothing like reaching over and changing a CD. it's nothing like talking to your passenger. It's taking your attention off the road to read, to type, to send.

I really can't believe that people even know that they shouldn't do it and they do. I never thought I'd say this, but geez, what is this world coming to?

Blatant Sexuality to Promote Breast Cancer Awareness

2009-09-22T07:06:00.002-04:00

October is coming fast and it will be Breast Cancer Awareness month. We've all seen the public service announcements (PSAs) and campaigns to help people become more knowledgeable about the disease, but this year, there's a new spin on the whole issue: appealing to the ogling man. Yet another example of sex sells, right?

By having television PSAs of men ogling well-endowed women, or sexy lingerie shots that linger on ample bosoms, the community is trying to appeal to the tendency many men seem to have, that of staring at a woman's chest. By appealing to the men, getting them to understand that if there is breast cancer, they won't have these things to ogle, they may become more aware of it.

But will it work? Somehow, I doubt it. The men who blatantly stare at a woman's physical attributes isn't thinking "oh, we have to save those, let's donate to breast cancer research." Or am I wrong - would a man think that way? Somehow, I doubt it.

My question is, if it's against our sensibilities to have such blatant sexuality in TV commercials, such as beer ads, why is it ok for breast cancer awareness? You can read more about the campaign in this LA Times article, Breast cancer ads use lechery for good.

Now blogging on MomGadget.com

2009-09-21T04:39:00.000-04:00

Ok, I admit it, I love reviewing new things. I may love them, I may hate them, but I have fun trying them. If it's a new gadget, I want it.

So, when a friend and colleague, Gayla Baer, the driving force behind MomGadget.com mentioned she was looking for bloggers, I thought, yes! That's for me. So, if you want to know what's new but also some older stuff revisited, head on over and check us out. There will be a lot of new reviews over the coming weeks as get up to full steam.

See you there!

4-year-old shares his cocaine "candy"

2009-09-20T08:43:00.003-04:00

This falls not only in the "you shouldn't be doing illegal stuff" but into the "watch what you tell your children" categories.

According to an Associated Press news report, a 25-year-old man was about to be caught with several bags of cocaine on him. To avoid this, he stuffed the bags into his son's pockets and told the boy that they were candy. So, what did the boy do? What most 4-year-olds would do if they had a bunch of candy. He shared it.

Luckily (for the boy and the friends, not the dad), a daycare teacher saw what he was doing and she notified authorities. Also luckily, none of the children were harmed.

I've read about parents sticking drugs into their baby's diapers, but this is right up there on the "what were you thinking???" scale.

Ok, so how does this fit into a loose-flowing health blog? Just think of what could have happened to those kids had they consumed enough of the cocaine? Here are just a few of the adverse effects of cocaine. Remember, these are for adults, so imagine them as much, much worse in little children:

High blood pressure
Racing heart
Fast breathing
Agitation and/or confusion
Irritability
Sweating
High body temperature
Stroke
Seizures
Fever
Kidney failure
Heart attack
Sudden death

What more can I say?

Health Care for All in the U.S.? Speech reaction

2009-09-10T16:34:00.002-04:00

I just listened to President Obama's speech on health care reform, presented last night. As a Canadian, I feel like I'm peeking in when I do this but I'm glad I watched it because it did clear up a few things for me.

I do understand that many people are against health reform, but my outsider view sees that as a function of not truly understanding what it is the U.S. government is trying to do. It seems to me that those who are adamantly against reform are the ones who seem to be spreading mis-truths about the issue. So, this is what I got from President Obama's speech:

if you have health insurance and are happy with it, you do NOT have to change from what you have
if you are employed and don't have insurance, you will be able to get insurance
if you have a pre-existing condition or illness, you can NOT be denied insurance coverage
if you have a small business or want to have a small business, there will be ways to help you get coverage for you and your employees
there will be a small public option for those who can't get insurance any other way
there will be no death panels
efforts will be made to contain health care costs, resulting in savings that will help pay for this system
no-one will go bankrupt because they can't afford to get sick

So, if I understand correctly, those seniors who are waving "hands off my medicare" are worried about nothing. Those who are afraid that they'll be told they can't get treatment because they are considered expendable are worried about nothing. Business owners who feel they need to close their doors because they won't be able to afford to insure their employees are worried about nothing. And, those who are making a fortune in insurance companies by spinning things their way DO have something to worry about because they'll now be held accountable.

Can someone explain to me what's so bad about all this?

Doc Raps About H1N1

2009-09-05T22:50:00.003-04:00

The more people who know about the proper way to reduce the risk of H1N1 transmission, the better. So, if it takes a rapping doctor to do it, why not?

John Clarke, MD, medical director for the Long Island Rail Road, has made his own hip-hop rapping video to help spread the word about H1N1. His video was one of 200 submissions to a contest run by the US Department of Health for best H1N1 (swine flu) health warning. Dr. Clarke is now in the final 10.

Check it out at http://www.youtube.com/USGOVHHS - Just go to the right hand side where they list the different videos and click on H1N1 Rap by Dr. Clarke.

Texting in the Dentist Chair?

2009-08-28T08:05:00.002-04:00

I know that getting dental work is rarely at the top of anyone's favourite to-do lists, but it's something that needs to be done in order to prevent serious consequences. I also understand a patient's desire to focus on something else while the dental work is going on and that's why many people use earphones to listen to music during the process. But answering your cell phone and texting while undergoing dental care? That's got to be pushing it.

But, if you think about that there are people who are stupid enough to text while driving, there have to be people who don't think twice about texting while in the dentist chair and that is precisely what some dentists are complaining about.

A news release put out by the Chicago Dental Society says,

More than four out of five dentists surveyed by the Chicago Dental Society revealed that patients send and receive text messages on their cell phones while receiving dental care.
The survey was conducted between July 16th and July 25th via email and among dentists in the Chicago Dental Society's Facebook Fan Page.

In addition to the dentists who said their patients regularly text in the dental chair, 46 percent said this habit hampers their ability to provide care. The high number of dental chair texters is also surprising, given that 32 percent of the dentists indicated they have a cell phone/mobile device policy posted in a visible location in their office.

I don't know. If you're THAT important, maybe you should reschedule your dental appointment for a time when you can arrange for someone to replace you or at least answer your calls and texts.

What do you think?

Murder, Accident or Stupidity?

2009-08-24T21:54:00.003-04:00

I try to stay away from the Michael Jackson thing. I think it's sad that he died and I do believe he was a musical genius. His music was catchy and had something special about it. I also believe he died too young and sometimes wonder what else he may have given the world had he lived longer. But, the whole circus that his death has become is really too much.

As I said, it's sad that he died. I do think it's important that we know if he died accidentally or if someone helped him die - be it intentionally or not. But, are we owed the constant coverage?

I have to admit when I first heard of this death and his doctor's odd (to me) actions, I had many questions. The 9-1-1 call that was played clearly said that the doctor was performing CPR on MJ as MJ lay on his bed. Anyone who knows CPR knows that unless you have a hard board underneath the victim, CPR is useless on a bed. They have to be put on the floor. You need to have a hard surface for the compressions to have any effect.

Then, the news came out with the propofol, the strong sedative that is dangerous if it's not used properly. Propofol is a great medication when it's used for what it's meant to be used for. Obviously, MJ wasn't doing that. Red flags anyone?

Then there were comments from those around MJ or who knew people who knew him. They commented to the effect of "what else could anyone do, if MJ wanted something, you gave it to him." Uh, no. You don't have to. You only have to if you want to keep your lifestyle and your association with him. Otherwise, saying "no" is very easy. It's one syllable, two letters. N-O.

I'm not a fan of what MJ became over the past couple of decades, but I do wish that we could go back to remember MJ the musician. Not the freak show that he became and the circus that was his death.

Farewell Mr. Cronkite

2009-07-18T11:17:00.002-04:00

Walter Cronkite, newsman who was unmatched, died yesterday, at the age of 92. He worked right up to last year, working on documentaries and voice overs after retiring from the CBS anchor desk in the 1980s.

As a Canadian, I didn't watch much of him, but we did know who he was. And, if we turned to the CBS network to watch a program that came after his newscast, we got to watch some of him as we waited for the news to be over.

Even as a child, I remember being impressed with Mr. Cronkite. To me, even now, he is the quintessential newsman. His is the way news should be read. I don't enjoy watching TV news now. I don't want my newscasters raising their eyebrows, creasing their foreheads or frowning as they read the news with their interpretive expressive tones. I want to be told the news - plain and simple. But plain and simple is gone now. I doubt it will come back.

I was watching a special on him this morning and he wanted so badly to go into space. He was like a kid when it came to all things space-related apparently. Maybe now, he's there.

Mr. Cronkite's cause of death is said to be cerebrovascular disease, not unusual for a man in his 90s. RIP Mr. Cronkite.

At that age when friends' parents are leaving us

2009-07-18T11:09:00.002-04:00

It happened again last night. More good friends lost their father/father-in-law to cancer. It was expected, but it doesn't make it that much easier. Just a few years ago, she lost her dad to the same disease.

I'm at the age, 48, where my friends are losing their parents - those who haven't lost them already. It's hard for a friend to watch the pain. We know it hurts but only they can work it through. Unspoken thoughts, sometimes unsaid apologies, can haunt those left behind. But what's done is done and we can't go back and change what we wish we'd done and what we wish we'd said. We can only hope that our loved one knew and understood.

Our niece had a baby girl just two weeks ago - a life just beginning, and Mr. Z left the world - a life ending. The circle of life, as cliched as it is, is truly how the world functions.

To all those who have lost someone important to them or are in the process of having someone going down that path, my sympathy. It's hard. But I do know that it also gets better as we realize that life continues but now with memories.

Toddler survives Yemenia Airbus crash

2009-06-30T06:44:00.003-04:00

A gift of hope was given when a toddler was reported to be found alive after a plane crash into the Indian Ocean. Just imagine the reactions of the rescuers who found the child alive:

CBC
New York Times

News like plane crashes are so sad. Flying is still a very safe mode of transportation, but if a plane goes down, there's so little that can be done. Let's hope this story of a child alive is true. I think we need to hear good news like that.

Added: Well, it seems that the original news reports were wrong. It was an adolescent girl who survived, the sole survivor. One can only imagine the feelings she must have experienced as she waited for rescue.

Pms - Phenobarbital (60 mg) Being Recalled in Canada due to Risk of Accidental Overdose

2009-06-26T18:28:00.001-04:00

I came across this press release from Health Canada. Important information if you take pms-phenobarbitol:

June 26, 2009
For immediate release

OTTAWA - Health Canada is warning consumers that all lots of the prescription drug pms - Phenobarbital tablets in the 60 milligram (mg) format (DIN 00178810) are being recalled because some oversized tablets were recently found on the Canadian market. The oversized tablets were found to contain more Phenobarbital than the label indicates, exposing patients to the potential risk of accidental overdose. The Canadian distributor, Pharmascience Inc. of Montreal Quebec, has initiated a recall of all lots presently on the market.

Phenobarbital is widely used as an anticonvulsant for the treatment of seizure disorders, and it is also used to treat anxiety and sleep related disorders as it has sedative and hypnotic properties.

Health Canada advises consumers currently using pms -Phenobarbital 60mg to return this product to their pharmacist for a replacement. Consumers should not stop taking their medication without consulting a health care professional, as abrupt discontinuation of this medication can cause symptoms of withdrawal (such as irritability, headache, dizziness, sweating, tremors, nausea, vomiting, abdominal cramps, weight loss or anorexia, nightmares, insomnia) and, if used to treat seizures, can result in an increase in seizures.

The oversized tablets may contain significantly more phenobarbital than the 60mg indicated on the label. Symptoms of an overdose may include uncontrolled eye movements, lack of muscle coordination, impaired speech, extreme drowsiness, decreased breathing and heart rate and may begin within 1-2 hours after taking a Phenobarbital overdose. An overdose may be life threatening and can result in a coma and/or cardiac arrest.

In the event of an overdose or if experiencing serious side effects consumers are advised to contact emergency services. Consumers who have used this product and are concerned about their health should contact their health care practitioner for advice. Consumers requiring more information about this advisory can contact Health Canada’s public enquiries line at (613) 957-2991, or toll free at 1-866-225-0709.

To date, no adverse reactions from the use of pms - Phenobarbital 60mg tablets have been reported to Health Canada.

You can report any adverse reactions associated with the use of health products to the Canada Vigilance Program by one of the following three ways:

Report online at the MedEffect™ Canada Web site
Call toll-free at 1-866-234-2345
Complete a Canada Vigilance Reporting Form and either:
- Fax toll-free to 1-866-678-6789
- Mail to: Canada Vigilance Program
  Health Canada
  AL 0701C
  Ottawa, ON K1A 0K9

To have postage pre-paid, download the postage paid label from the MedEffect™ Canada Web site. The Canada Vigilance Reporting Form and the adverse reaction reporting guidelines may also be obtained via this website.

Do we have to know? Michael Jackson "investigation"

2009-06-26T16:37:00.002-04:00

Well, it's been just a little over 24 hours now since the music world was rocked by the news of Michael Jackson's death. Whether you thought him odd or a genius, there's not taking away his musical talent and the many ways he changed and helped grow the music scene since the 70s and 80s.

But now, the reports are abounding about what may have caused his death, his alleged addictions, his illnesses, his private doctor. In the car just now, I heard a report that the L.A. police want to speak with the physician who was with Michael when he died - problem is, they can't find him.

What does concern me is the report that this supposed doctor was doing CPR, according to the 9-1-1 call that was made available. But he was doing it *on the bed*, not on a hard surface like you're supposed to to make the heart compressions effective.

I can understand a non-medical professional stressing out and forgetting that detail, but a doctor? It's one of the first things you're taught about resuscitation in a hospital. That's why "crash carts" have boards on them, so you can slide it underneath the patient between the patient and the soft mattress.

To me, this is important information to know because if it is true, then maybe more people need education regarding the importance of doing CPR properly. But, my desire to know is left at that. Whether he died of an overdose, illnesses, or the result of his body breaking down after years of abuse - that's for his family, not for us. The man is dead. I think we should also let him go.

Exercise/Gym Bootcamps?

2009-06-18T12:46:00.002-04:00

What do you think about the exercise or gym bootcamps many fitness trainers are offering? They're intense sessions that are meant to get you into shape fast in anywhere from a few weeks to a few months.

The thing I'm wondering about is the intensity of the bootcamps. Just as extreme diets don't work over the long term to lose weight and keep it off (for the most part), I was thinking that this would likely be the same with exercise.

Also, we're always being warned to start a new exercise program gradually and to be sure that we're doing what is right for your level. So, how can I, a 48-year-old woman, with a good BMI but not good exercise endurance, take a bootcamp type of class with a group of 20 and 30 somethings who are in better shape? Is it possible?

Have you ever done this type of extreme fitness training? I'm curious - there's one available near me and I've sent the owner some questions. I just don't know if it's something I'm ready or able to do.

It's been way too long - pandemic musings

2009-06-16T21:57:00.004-04:00

Between the pandemic preparation (part of my job), blogging for Blisstree.com and my other freelance work, this blog has taken a big hit.

What's really interesting though, is that I keep getting a consistent number of hits every day as people find my information through search engines, mainly Google.

The pandemic thing is the big thing in my life right now. People are either freaking out over the sky falling in or they're not believing a word that's said. I kind of wish people would fall into the middle somehow.

There's no need to freak. A level 6 pandemic just means that the virus has spread everywhere. It doesn't indicate how severe the virus is or how dangerous it is. In fact, it doesn't tell us much, but it's a formality at this point.

Here in Canada, the upgrade to level 6 made no difference in our preparations at all. The government was already operating at it's highest level for preparation.

Let's face a few facts. The seasonal flu affects millions all over the world - and people die. More people have died of seasonal flu complications than the H1N1 virus - so far. But, getting sick is a fact of life. Of course, we can do steps to minimize this, but it does still happen.

An acquaintance of mine told me that her grandmother's seniors residence closed to visitor when the World Health Organization declared level 6 pandemic. That's ridiculous. Five minutes before they declared it, there was nothing different than five minutes after. As I said, either people are panicking or they're living in dreamland. Neither is a good move.

Be careful, be vigilant about washing your hands, and I suggest going on with your life as you were before. I know I am.

Excellent Piece on Canada's Health System

2009-05-20T22:17:00.001-04:00

Now that the U.S. has a president who seems to really want to do something about medical insurance and affordable health care for all Americans, not just the lucky ones with insurance or so much money that they don't need it, Canada is getting dragged through the mud yet again.

For some reason, many people in the US don't like our Canadian system. Now, that wouldn't be a problem if they really knew what the system was like rather than relying on things they heard or things they think they heard. I say that wouldn't be a problem because there's nothing wrong with good debate if someone knows the facts, whether we agree or not. But, that's the thing - how can American learn about what goes on up here without getting a biased for or against pitch.

Our system isn't perfect - it's far from it. But it's something that we have that helps us when we're at our lowest, our sickest, and our poorest. So most of us will keep it, thank you very much.

If you're interested in reading what I think is an excellent piece on the Canadian system, warts and all, head on over the the CBC site to read My dear American neighbours.

Let me know what you think.

May 6 - 12, 2009/May 11-17 - National Nurses Week

2009-05-02T22:13:00.001-04:00

From May 6 to 12, it's National Nurses Week in the United States and from May 11 to 17, 2009, it's National Nurses Week in Canada.

Nursing is a funny profession. Reactions to nurses range from "only an idiot would choose to be a nurse" to "only very special people can be nurses." Well, I'll tell you - I've met some people I would say are idiots and I wonder how they get their nursing license and I've met some nurses who truly qualify as someone very special. But, for the most part, nurses are like everyone else. We're people, w have our good days and our bad days. We do our best but we make mistakes. We laugh, we cry, we stress and we relax - we're people with a serious job and we hold lives in our hands.

What ticks me off the most as a nurse? People who STILL think that we're doctor wannabees, that we're doctor hand maidens. Nothing could be further from the truth. Nursing and medicine are two completely different professions. Doctors tend to look at specific problems that need curing, healing, or treatment. Nurses see the patients as a whole, and they see the issues that surround the treatments.

A good example is a patient who is in traction after breaking a leg. The doctor operates on the leg and orders the traction, as well as pain medications. It's the nurses who take care of the whole patient - they evaluate and assess the patient for problems related to not moving around. This can cause pressure sores on the skin, constipation, poor nutrition, social isolation and more.

It's the nurses who see the patients 24 hours per day. It's most often the nurses who pick up on the slightly elevated temperature getting a bit higher. Or a slight change in an agitated patient's behaviour. It's the nurses who will see that Mrs. Jones hasn't eaten well for the past couple of days, that Mr. Smith isn't handling his crutches as well as he did last week, and that little Katie is depressed because her parents are fighting while she's in the hospital.

Nurses do follow doctors' orders, but nurses also have a lot of leeway in how they handle certain situations. It's the nurse who decides if a patient's change in condition warrants calling a doctor, for example, or is it something he or she can handle alone?

And don't forget another very important role that nurses have. We're the final layer between you and the doctor. Like nurses, doctors are human. They make mistakes. If a doctor makes a mistake in ordering a medication for you, the wrong dosage or the wrong type, it's the nurse who catches it. He or she can't miss it. If the doctor ordered 100 mg of morphine, 10X the usual dose, and the nurse gives it - it's the nurse who gets into trouble. The nurse should know that you don't give 100 mg of morphine.

If a doctor orders that a dressing be changed once a day and the nurse notices that the wound really needs to be cleaned and redressed more than that - he or she must pass this on to the doctor. It's the nurses' responsibility that the wound be addressed by the doctor because that is the nurses' role - among many others.

Yes, there are bad nurses out there. There are some nurses who started out great but burned out, or they never were that good to begin with. But there are teachers, police officers, administrative assistants, plumbers, electricians, and so on who also fall into that category.

Most nurses are good at what they do and they're doing it because they want to. Nurses are among the very few professions who choose to work with people who are at their worst: in pain, stressed, scared. Be nice to a nurse. Please?

Sex pill for women?

2009-04-30T21:18:00.001-04:00

With all the money that's been spent on developing Viagra and similar medications, now researchers are working on helping women have better sex lives. Is a little pink pill in the offing?

The whole issue of sexuality differs tremendously between men and women. With men, the ability to "perform" often results from illness or physical problem so a medication can help with the most obvious issue with male sexual dysfunction, impotence. But, with women, it's not so obvious. The desire may or may not be there, and if it's there, a woman still may not be able to orgasm. That's not as easy to "fix."

And that brings me to my next point. Medications can be life saving and life affecting. We take chemotherapy to beat cancer, insulin to stay alive with diabetes, aspirin for a headache - but are we really that far that we will take a potentially body altering, complication-causing pill so we can have sex? So we can achieve sexual peaks?

Here is the article that had me thinking about this whole thing: Big pharma's hunt for the big O

What do you think?

Plan B to be available in the US without a prescription

2009-04-22T20:55:00.001-04:00

As similar as Canada and the United States are, there are also many differences. One is that Plan B, the so-called morning after pill, has been available in Canada without a prescription for a while now.

Two provinces (British Columbia and Saskatchewan) keep the product behind the counter, in Quebec, you need a pharmacist to prescribe it, and in the other provinces and territories (Alberta, Manitoba, New Brunswick, Newfoundland and Labrador, Nova Scotia, Nunavut, the Northwest Territories, Ontario, Prince Edward Island, and the Yukon) allow it to be sold off the shelves.

Now, a federal court in the United States has decreed that the FDA must allow the manufacturer of Plan B to apply for marketing without a prescription. Since the FDA didn't appeal the decision, the FDA has announced that they're waiting for the application to be made.

What do you think? Is this a good idea? I have mixed feelings about this. After all, Plan B is a powerful medication. It can prevent the egg (temporarily) from being released by the ovary, prevent fertilization, or it can prevent a fertilized egg from being implanted into the uterus.

The manufacturer says there's no reason that you can't use it more than once (for different cycles) but it shouldn't be used as a regular form of contraception. But, is it safe for women who may not take into consideration other health issues to take a medication like this without medical supervision?

Birth control pills are prescribed by doctors, so I'm not sure that Plan B shouldn't either. Maybe it's not so bad if a pharmacist speaks with the woman first to ensure she's not taking other meds or experiencing other health issues, but to buy them off the shelf - that makes me uncomfortable.

Final cookie diet report

2009-04-09T08:19:00.001-04:00

Ok folks, my cookie diet trial has ended. I ended up staying on it for four weeks because the initial trial of two weeks did show a dramatic weight loss. The second two weeks? Not so much.

Here's the deal. I began the diet four weeks ago because I was planning on losing about 20 pounds and the opportunity came up to try to lose it this way. As I've said in previous posts, I'm really good about losing weight through a well-balanced diet like Weight Watchers, but I thought I'd give this a shot because it's so much in the public eye.

My first impression was the cookies were awful. They turned out not to be so bad at all. I liked the banana boca ones in particular. I lost 9 pounds in the first two and a half weeks. Then it took one and a half to lose a 1/2 pound for a total of 10 pounds.

The diet itself isn't difficult. The cookies, with a full glass of water after, do keep your hunger at bay until you have your sensible meal at supper time. But, it's the sensible meal that was my downfall. I don't mind eating lean chicken or white fish. I like them. But there are only so many ways you can prepare them. I made them with lots of veggies, I mixed them in with big bowls of salad, but sometimes, I wanted some of the rice, potatoes, pasta.

The thing is, I wouldn't have a lot of that forbidden food. I'd have a couple of mouthfuls to have the taste. I don't consider that to be cheating. I think that you can't deprive yourself of a bit of what you really like to eat throughout the whole course of a diet. That's when you fall off your wagon and end up really cheating, because you haven't had any of the food you enjoy and see others eating.

Unfortunately, just those few bites of forbidden foods would keep me from losing weight. To me, there's something not right about not being able to have a few tastes of something.

Ten days ago, I hit 152 pounds, 10 less than when I started. Most of the following 10 days, I didn't cheat at all (not even a few bites). I'd say maybe four of the days I had some tastes. Yet, 10 days later, I'm still at 152 pounds.

I'm not complaining about the weight loss itself. I think losing 10 pounds in four weeks is great and I'm grateful for the kick start it provided me. Helped me feel better about myself to be able to fit into some of my favourite clothes again. But I honestly can't see myself eating only white fish and chicken at night for another few weeks.

So, it's back to WW for me for that final 10 pounds. I have a few of their cookbooks and their recipes are so tasty that it'll be nice to enjoy my food again.

My recommendation: If you really need a kick start to weight loss, the cookie diet is a great idea. What it does is it shows you that you can lose the weight. But, beware of the extremely restrictive sensible meals.

Series on organ donation and transplantation

2009-04-08T09:31:00.001-04:00

One thing that has been keeping me busy for the month of April was a challenge I'd given myself. April is National Donate Life month and I decided to do 30 articles on donations and transplant in 30 days. I know - slightly on the ambitious side. But, I've been talking to some very interesting and fabulous people so I'd like to share the first week's worth of articles. Some are informative, some are touching and one is downright heart breaking, but uplifting at the same time.

Transplants happen to other people…

The gift of sight - a cornea transplant

Age is no barrier for kidney donation

Caring for families after donations

2 heart transplants: 1 Golfer, Erik Compton

An infant lost, another saved

10 organ donation myths

Interesting blogs on organ transplants

So far so good. It's April 8 and that's 8 posts!

Tags: organ transplants, organ donation, transplantation, transplants, kidney donation, heart transplants, organ donation myths

The Busy Syndrome

2009-04-05T20:38:00.002-04:00

Have you ever noticed that it's a badge of honour to be too busy to do something? Someone says, "how are you?" and you respond "Busy!!" With that, you get a nod of approval or commiseration as your acquaintance starts to tell you how buy he or she is too.

Some people thrive on being too busy to do something or they accept to do something but they make sure you know that they really are too busy to do this. Are we all really that busy?

I was thinking about this because right now, I am very busy. While I don't like being bored, I also don't like being overwhelmed and that's how I feel when I get too busy.

My writing here has suffered because of the lack of time and, unfortunately, sometimes something has to give. Since my clients pay me for my writing and my new job (more on that in a bit) pays me, the non-paying stuff gets relegated a bit lower on the totem pole.

Unfortunately, the busy-ness also keeps me from doing things I enjoy, and that's not a healthy thing. We need to stop being busy and take that time. And, that time shouldn't be included in being busy, if that makes any sense.

I love to quilt. I love to design them and see them turn into beautiful and functional works of art. But being too busy takes me away from that outlet, from that joy I experience when I give someone a quilt I designed and made for them. My husband's niece is having a baby in June and I want - of course - to make a baby quilt for her. I've yet to start. That's not right. I don't want to be rushing it; I want it to be the way I see it in my mind. I want it to be as close to perfect as it can be.

So, how do I balance all this with my new job and my writing? I think I've found a way. I've been hired as a clinical resource nurse and I'm working with nurses and nursing staff become up-to-date with new policies and procedures so the patients and residents in our facility can and will get the best nursing care they can. I was originally hired to work 21 hours per week over a four-day period, but something came up and I was asked if I could do one full 8-hour day one day a week to, in a different area. I agreed to do that, but it's thrown a wrench in my carefully laid out plans.

Although my dream was to be a full-time freelance writer, and it was working out, things change. While the economic situation hasn't hit hard for me, the uncertainty of things worries me sometimes. So, when this job came up, I thought I could cut my writing to half time and do the job half time. I did. By finishing up some projects and not taking on any more, I think I was able to strike a good balance. But then, this extra day was thrown in. And that's what is keeping me so busy now. I know it will only be temporary, but I hate being one of those people who answers, "BUSY!" when I'm asked how I am.

What is being so busy going to do to us in the long run? Isn't *not* being busy important too? Isn't not being busy part of winding down, realizing that there's more to life than seeing how much we can cram into a day? I think it is.