Friday, July 20, 2007

A quilty week

All writing, editing, and research can make Marijke a dull girl. So, I spent my spare moments this week putting together a baby quilt. I wasn’t planning on it, but my daughter is going to San Francisco on Saturday and she’s staying with her friend’s sister who has a baby. So, what to bring to say thank you? A quilt made by your mom, what else? In one week no less, because you don't give your mom any more notice than that.

This quilt was a pattern that I adapted from Australian Patchwork & Quilting, Vol. 15, No. 6. Autumn Swirls, page 38. It looks nothing like the one in the magazine at all – that one was a sedate adult quilt. I rather like the way it turned out as a bright child’s quilt.

I’m an avid quilter. I have been quilting for about 18 years or so and have made over 100 of them. I almost exclusively hand quilt because I don’t enjoy sitting in front of my sewing machine. I have a wonderful machine, a Husqvarna Iris, but I really consider sitting in front of the machine to piece my quilts a necessary evil. I did hand piece one quilt, a double wedding ring quilt for my husband’s niece.

The arcs were paper pieced, but the rest was put together and quilted by hand. I’m very proud of that quilt; it turned out beautifully. But if I hand pieced all my quilts, I don’t think I’d have gotten past two or three.

I have a few favourite quilts, and this one was an accidental favourite. I call it my nine-patch colour wheel. It lives at a friend’s house now and I think it was one of the quilts that I found hardest to give.

While I was putting this baby quilt together this week, I was reminded that I haven’t been working on anything calling for that type of creativity for quite a while. As I’m trying to build up my freelance career, I’m working day and night, well, more night than day – that’s the way I prefer to work. But the creativity of working on quilts was just not coming through. I have a real talent for taking fabrics and colours, and combining them into beautiful patterns and designs. I don’t think about it, I just take fabrics and combine them by instinct. But as I was using my imagination and creativity in writing, did I have enough left for my quilting? Was that why I wasn’t putting any of my fabric creations together?

There’s a quilt on my hoop now that’s been there for several months. I’d made it for last August, for a friend’s 50th birthday. I only had the top ready by her birthday and I promised her I’d get it quilted quickly. Problem was, the quilt wouldn’t “talk” to me. I rarely follow patterns when I’m quilting; the quilt tells me how I should quilt it. I’ve tried pushing the issue and quilting whatever pattern I decide to, but I either end up very unhappy with the end product and not liking the quilt, or I give up and tear it all out, to start all over. I can’t say how a quilt talks to me. My nine-patch colour wheel quilt top sat in a cupboard for over a year. I’d pull it out every so often and look at it, trying to figure out how I would quilt it. Nothing would come to mind, so I’d fold it up and put it away until next time. Finally, one day, as I looked at it again, I knew how I would quilt it and it turned out beautifully. I know, it sounds odd – but what can I say? It works.

So, maybe instead of working this weekend, I will finish the quilt for my friend. It’s very pretty and not doing a heck of a lot for her sitting here in my living room.
News for today:

Thursday, July 19, 2007

Caregiver depression

There’s an article in today’s Montreal Gazette about caregivers and depression. It’s not new or breaking news, but it is something that needs to be brought to the forefront because of the many caregivers who are suffering silently from depression, anxiety, helplessness, and isolation.

Many people find themselves in the position of caring for an ailing family member or members. In our North American society, we usually aren’t prepared for this role and the job can be brought upon us so gradually that we don’t notice we’re doing it until it’s too late, or it’s thrust upon us so suddenly that we don’t know what has hit us.

As the population ages, more people are finding themselves in the position of caregiver. In many families, it’s one sibling who takes over the bulk of the work either because of geography or by design. Initially, the care is usually done without many issues, but as the person who needs care becomes more dependant, sicker, and/or more demanding, the caregiver can find him or herself working harder, working longer, and becoming more isolated.

It’s easy to see caregiver burn out and depression in the hospital setting. Many times, they just can’t handle the care any more and bring their loved one to the emergency room, hoping and praying for some sort of salvation. Unfortunately, the way our system is set up, rarely is that salvation available. We have a serious shortage of quality chronic care beds. We also have a serious shortage of people available to go and help out in the home or to provide respite care.

Often, the caregivers don’t know they are burning out until they do. They become ill themselves or they become overwhelmed with what is expected of them on a daily basis.

If you know someone who is a caregiver, even if you can’t lend a hand with the care, you can lend an ear, an arm, a shoulder. Be there, offer to help in ways that you can. If the caregiver doesn’t know of resources, maybe you can do the searching and provide the information. Caregivers don’t just need the help now, they need the help over the long-term, and even once their sick family member has gone.

And if you are the caregiver, take time for yourself. There is no point in being selfless and devoting yourself full-time to caring for someone else if you are going to end up sick yourself. You can only do a good job if you are healthy yourself – emotionally as well as physically.

News for today:
Chlamydia common among young women and men
Interventions During Hospital Stays Can Help Motivate Smokers to Quit
Intensive training of young tennis players causes spinal damage
Very young babies vulnerable to sudden death while seated
Low hospital staff levels increase infection rates

Wednesday, July 18, 2007

Patient education - a valuable part of health care

Providing patient education is a very important aspect of quality health care and is the responsibility of all the healthcare professionals. In an ideal world, all healthcare professionals would have the time and resources to provide good patient education to all patients. The problem lies in lack of time, lack of resources, and even lack of ability sometimes.

As a nurse, one of the tasks I enjoyed most was the patient education part of my work. If I had a patient who was newly diagnosed with diabetes, I liked the challenge of educating this person about the disease. If a patient was coming in with recurrent asthma attacks, again, patient education was called for. Teaching an elderly patient about a new medication protocol, helping someone learn how to look after a dying family member, these were all parts of my job that made me feel like I was actually making a difference. Unfortunately though, we didn’t always have the tools to reach all the patients.

While we may have pamphlets or hand outs, not all the patients learn best that way, and we don’t always have time sit down and spend quality teaching time. And what about the teaching needs that weren’t so obvious? These include how to help patients learn how to ask for help, how to communicate with their doctors, and even how to identify that they need to learn things.

As our patients have so many different abilities in terms of comprehension, learning style, education, and even language ability, there is no one-size-fits all approach to patient education. Many institutions are great for having pamphlets to hand out that may explain someone’s new diagnosis or treatment – but not everyone learns well by reading. Adults have particular learning styles. They can be visual learners, auditory learners, or kinaesthetic and tactile learners – or a combination thereof. In the healthcare system, we tend to forget that people learn in different ways. Some like to have things demonstrated, others like to read about it, and yet others need to actually do it in order for it to be processed together. Or, they can need all three, but which style depends on what they’re trying to learn.

A new study about asthma education just came out. One of the findings was that the education that was being done was not consistent so the studies couldn’t identify what was working or not. One expert commented on the study and pointed out that education is the mainstay of chronic diseases like asthma, diabetes, and hypertension, to name a few. The better educated the patients are, the better they can care for themselves, or the better they can recognize signs that they need help – earlier in the disease process – allowing them to get proper help before the situation becomes too serious.

Educating patients on how and when to take their medications properly decreases the incidence of non-compliance (patients not taking their medications properly), overdoses, and serious side effects. Teaching people how to make their home safe to reduce falls reduces emergency room visits and hospital stays, particularly among the elderly.

As medical or health writers, we often take on the role of educator too. We describe illnesses, injuries, treatments, and outcomes. We report on new therapies and treatments that have been deemed not safe. It’s our role to be sure that the information we are getting across to the public is accurate, timely, and, importantly, actionable. There’s no point in telling a person that the drug they are taking isn’t considered safe any more but there aren’t any options. Even if it is “continue taking the medication until you have discussed this with your doctor,” we have to give them something to do.

Lots of interesting news today!
Can't resist putting this one in. :-)
Asthma Education in the ER Could Help Patients Avoid Repeat Hospital Stays

Better Births Feature Continuous Care for Moms, “Kangaroo” Care for Kids
Growth Hormone Injections Add Height, But Kids Stay Short
Vitamin C Offers Little Protection Against Colds
Exercise, exercise, rest, repeat -- How a break can help your workout
U.S. children's hospital using Toronto technology to screen brain injuries
Nonsmall cell lung cancer -- chemotherapy before surgery appears better than surgery alone
Orthodontic treatment -- no better in childhood than during adolescence
Colposcopy: Playing music helps women relax
Diet very high in fruit, vegetables does not appear to reduce risk of breast cancer recurrence
New review adds more reasons to avoid diabetes drug Avandia
ABILIFY(R) (aripiprazole) Supplemental New Drug Application Receives Priority Review by U.S. FDA for Adjunctive Treatment in Adults With Major Depressive Disorder
FDA Approves Extina(R) for the Treatment of Seborrheic Dermatitis
Acetaminophen Safe, Effective After Wisdom Tooth Removal

Tuesday, July 17, 2007

What's that study telling me?

How often have you read a news story that screams out that a there is a new drug breakthrough or a dramatic discovery? And how many times have you read a while later that the findings weren’t quite what they had been presented to be?

Many times, these stories arise from newly published studies in journals such as the New England Journal of Medicine or Lancet. Many journalists can get advance copies of articles from these and many other journals so they can prepare their stories for publication when the embargo is lifted. I’m lucky enough to get advance copies of some studies because of one of my clients. I write up articles geared towards journalists to create interest in the study findings. I enjoy this because I get to interview the lead author and another expert in the field while I prepare my story and I’ve learned some interesting things.

Unfortunately, some articles get published that seem to skirt the boundaries of informing the public of new findings and sensationalism. While it may seem that the studies are saying there is a new cure or a certain food causes cancer, rarely are studies that cut and dry. They can be, but it’s not common. The writer’s role is to understand what the study is saying without exaggerating the findings. Another important aspect to medical reporting is to use the correct wording, not to make absolute claims but to actually report what is being said. I have an advantage here because of my many years of a nurse and how we were taught to write in our patients’ charts.

There are some nurses who would write in a chart, “Patient slept well all night,” or “patient pain-free all shift." That’s a big no-no because it’s really not for us to say. It’s entirely possible that every time the nurse walked into the room to assess the patient that he was snoring away, and it’s entirely possible that he woke up moments later, only to drift off shortly before the next time the nurse checked in. Or, the patient may truly have slept all night, but didn’t feel refreshed or didn’t feel that she slept all night. The patient may have been in pain, but didn’t want to bother the nurse or felt that she could cope. The patients may say to the day staff, “I barely slept all night!” or “I was in pain all night.” But, when the day staff got report from the night staff, the nurse said the patients slept well or was pain-free. Thus, the importance of writing “Patient appears to have slept well all night,” or “patient sleeping at each round, appears comfortable.” It’s not incorrect to write, “Patient not complaining of pain,” or “patient denying pain.” This way, the nurse is writing exactly what is observed – not what he or she thinks is happening.

The same sort of thing exists with medical writing. If a new drug is helping a lot of patients, appears to be a cure of sorts, it’s much better – in my opinion – to write “Drug ABC Improving Life for Many Patients with XYZ Disease,” or “Drug ABC Appears to Cure Some With XYZ Disease.” I think it’s irresponsible to write a headline like “Drug ABC New Cure,” or “Patients with XYZ Cured with Drug ABC,” both types of headlines we have seen in the past.

When reading a study, it’s also important to understand how it’s being presented and if the findings are reliable. Is the study randomized? Is it blinded? Who sponsored the study? How big is the study group? There’s a huge difference between a study of 5,000 participants and 35 participants. Keep in mind, though, that some illnesses or injuries are not common so a study of 5,000 or even 500 would be virtually impossible. So, is the study of something that is fairly well known or is it of something rare?

What are the researchers looking for? Do they have one specific goal or was the finding an outcome that popped out of nowhere but was significant enough to be noticed? How long did the study take, if appropriate, and how long were the patients followed after?

There are many questions you need to ask yourself when reading these studies and one that some journalists and writers seem to ignore are, what are the weaknesses of the study? When reading a study, there’s a general format. The authors discuss why the study is important, how they went about it, how they calculated the results, the results, a discussion about the results, and a conclusion. In the discussion section, there should be a part about the study’s weaknesses. No matter how well planned a study, there are always some drawbacks. They could include study size (too small), subject choice (too homogenous, too broad), not long enough, too many surgeons performing the surgeries, and the list goes on. It’s essential that these weaknesses be pointed out so that the reader can decide how this may or may not affect how he or she views the findings.

Reading studies can be intimidating sometimes. I still read some that leave me wondering what the heck I’m reading. But if you plan on writing about a study, be sure that you understand the significant findings, why and how they came about, and how someone who isn’t involved in the study feels about the findings. This outside expert can provide a good balance.

News for today:
Older, cheaper diabetes drugs as good as new
Weight training can help with heart trouble: AHA
Many cases of Lyme disease going undiagnosed
Overcrowding leads to lung infections in Inuit

Monday, July 16, 2007

Splinters hurt

I was working in our dining room yesterday and somehow got a whopper of a splinter in my foot. Our house is 45 years old and the dining room has the original wood floor that hasn’t been refinished. Every so often, a splinter of wood pops up and reminds us that we need to get this done.

It was pretty big and I thought I got it out but that doesn’t seem to be the case. So, in an attempt to get the darned thing out, I tried my old stand-by methods, none of which worked, and then it was on to the Internet to see what advice others have to offer. The advice was pretty well to take tweezers and pull the splinter out. Right. That didn’t work – which is why I’m looking for ideas.

I figured that it was a good idea to soak my foot to soften the skin and maybe work the splinter out, but so much for my good idea. I found this on a site HealthWorld Online : “don't let the area around a wooden splinter get wet. A wooden splinter that gets wet will swell. This will make it harder to remove.” Oh. Ok then. I guess I won’t be using their next piece of advice: “soak the skin around the splinter twice a day. Place one teaspoon of baking soda in a cup of warm water and wet the affected area. After a few days, the splinter will likely slip out.”

On the bright side, I now know what to do if I ever get a bunch of cactus spines: “To remove a large number of close-to-the-surface splinters such as cactus spines, apply a layer of hair removing wax, facial gel or white glue, such as Elmer's, to the skin. Let it dry for 5 minutes. Gently peel it off by lifting the edges of the dried wax, gel or glue with tweezers. The splinter(s) should come up with it.” I did know this trick and have used white glue for small splinters. It does work.

So, here I sit, splinter and all. Good thing I don’t have to dress up in heels because right now, my daughter’s flip-flops are feeling pretty comfy!

News for today:

Low birth weight not necessarily cause for alarm: study
Study Looks at Whether Vaccines Promote False Sense of Security
Diabetes drug side effect reports in U.S. triple
HIV Prevention Clinical Trial Negates Women's Diaphragm Use