Archive | June 2016

QUOTE FOR THURSDAY:

“Possibly most important, only humans, not cardiac monitors, can determine the goals of monitoring for an individual patient with guidance from doing close cardiac EKG monitoring.”

American Heart Association

What does a cardiac rhythm tell us?

heart attack 2   cardiacmonitoring

First the engine to the human body is the heart; our car can’t work without a good working engine just like the body can’t work without a good working heart. In the heart we have a natural pacemaker of the heart which is called a Sinus Node. The sinus node conducts impulses from the top right chamber of the heart to the left chamber in the heart (called Atriums) and follows its way down to the bottom chambers (called ventricles) but for the conduction traveling originally from the right atrium to the left atrium the left side is slightly behind in conduction compared to the right when going down horizontally on each side due to the conduction having to cross over to the left top from the right top of the heart. Than the conduction continues on the atrio-ventricle valves (called AV valves) causing these valves to open and close completely allowing blood to drop in the ventricles from the atriums when open but without back up in the AV valves if the valve completely seals like any valve operating correctly by closing whether it be pipes, actual engine valves, or our veins/arteries or the actual heart in this case in the human body. Whatever valves used in our body or inanimate objects all pretty much play the same role.

The Rt. AV valve is the tricuspid valve the Lt. AV valve is the mitral valve. The conduction continues than to the bottom chambers-ventricles the conduction goes up and around the entire ventricles sensing up actually the purkinje fibers/papillary muscles to aid in contracting (depolarization) and relaxation (repolarization) of the ventricles. This allows the heart to go “Lub Dub” after from the SA node to the end process of conduction (described above) which gives a single beat or pulse. This allows our red blood cells that are more oxygenated than with carbon dioxide in them on the left side to go out the aorta to the bloodstream giving our tissues oxygen all over where needed when leaving the L side of the heart which after the 02 used up it will be returning to the right side when needing to refill with more oxygen and release the C02 from the red blood cells.   How do we get our red blood cells reoxygenated? The right side; when the Lt side is doing its function through this conduction process so is the right side. The Rt side allows the blood on the right side more carbon dioxide red blood cells that are carrying with some oxygen (but very little) so these red blood cells after going through the whole conduction process from the Rt. ventricle enter into the pulmonary artery to the lungs (a much shorter pathway than the Lt. side of the heart sends its RBCs-it goes from the aorta down the body up to the brain and back to the Rt. side of the heart needing more 02). This side is where the RBCs get reoxygenated than reentry to the left side of the heart going through that side out the aorta when those cells get into the Lt. through through our last process of the conduction system. This conduction system is so vital in our heart operating properly.   Since the Rt. and Lt. side have 2 completely different functions with our RBCs in dispensing 02 and C02 but both sides need to work correctly and are vital to keep us alive.

On a tele strip a sinus rhythm is made up of a P wave=Atriums contracting (atrial depolarization) than a straight line= atriums relaxing (atrial repolarization) than followed by a QRS wave=Ventricles contracting (ventricular depolarization) followed by a straight line than a T wave (ventricular depolarization) than in some a U wave. A U wave is on an electrocardiogram that is not always seen. It is typically small, and, by definition, follows the T wave. High probability you will see a U wave in normal sinus rhythm (NSR) or sinus bradycardia (SB). This is because the HR is slow enough to show a U wave on the rhythm you won’t see them in tachycardias. U waves are thought to represent repolarization of the papillary muscles or Purkinje fibers.

A regular QRS measures less than 0.12 which is with all atrial normal rhythms. If your rhythm has started in the atiums (upper chambers than the QRS is normal in measurement but if the rhythm starts in your ventricles-NOT GOOD-than the QRS is wide).

In most cases if the sinus node is working properly (located in the upper Rt chamber or atrium) with the person taking care of their body staying in good shape, eating healthy and getting rest to balance stress and no cardiac disease or in some cases compliance with all above in taking cardiac meds it shows on the telemetry monitor sinus rhythm heart rate (HR) 80 – 100 but if HR over 100-150 the person has sinus tachycardia (fast pulse) or if HR less than 60 it is sinus bradycardia (slow pulse) which maybe normal for the person, like an athlete.  All these rhythms derive from the sinus node originally and have regular rhythms giving you a regular HR not irregular unless you have a premature contraction from the atriums causing a PAC (Premature atrial contraction) or a PVC premature ventricle contraction that pop up in your sinus regular rhythm (but remember simple stress or caffeine can cause this as well as heart disease of many types). These premature contractions pop on the telemetry reading with the ingredients that make up a atrial rhythm = p wave + a normal QRS + t wave unlikely for a u wave or other rhythms as well which we will get into. All these occasional or frequent premature contractions mean is the heart rhythm of the heart is getting irritable. The more irritable any rhythm gets the higher the probability the rhythm can go into a worse rhythm.

PVCs in the rhythm has the features that are the same as a atrial except no p wave with the QRS measuring wide because the contraction is in the Ventricle where the p wave is in the chamber above it (atriums). In the Ventricles where a premature contraction occurs will only have a wide QRS rather than a regular because of the chambers its in=Ventricles.

PVCs will be discussed with Ventricular Rhythms.

If the sinus node breaks down the heart works by having the next area of conduction take over by compensating having the natural pacing take over in the atriums where we have atrial rhythms which start at a HR over 150 unless controlled atrial fibrillation but we’ll get into that rhythm shortly.

The rhythms you see when the atrium is the natural pacemaker of the heart taking over for the SA node that doesn’t work with the heart now compensating with the atrium, they are atrial tachycardia or SVT supraventricular tachycardia, simple meaning above the ventricles. This is where the rhythm is over 150 to 250 showing a p wave and QRS and usually not a T wave but if the HR is slow enough it might show on the telemetry monitor but usually doesn’t. If it shows no PACs or PVCs it’s a regular rhythm.

Another atrial rhythm is atrial flutter or A- Flutter)=AFL which shows only QRSs with flutter waves. A regular rhythm but this rhythm needs to be changed or in time the heart will stress out and lead on to more dangerous rhythms. This has no p waves but flutter waves with QRS waves. You can have 2 flutter waves to every QRS wave or 3 to every QRS or 4 flutter waves to every QRS or even 5 but the it can even be a variable ratio of flutter waves to every QRS wave meaning the rhythm is getting more irregular and dangerous. If left untreated, the side effects of AFL can be potentially life threatening. AFL makes it harder for the heart to pump blood effectively. With the blood moving more slowly, it is more likely to form clots. If the clot is pumped out of the heart, it could travel to the brain and lead to a stroke or heart attack.

The treatment for aflutter is cardioversion using a defibrillator in sync mode so when the shock is given it lands with the R wave and avoiding the vulnerable T wave section which if the shock landed their could put this rhythm into V Tac or V fib. The other atrial rhythm is atrial fibrillation (afib) and if under 100 great for if its chronic afib it will be hard to change to NSR but if a new Dx. of afib higher odds with cardioversion it will shock it the rhythm back into NSR. Those who are chronic afib or new afib that can’t convert to NSR usually are given Coumadin and ASA aspirin to keep the blood from clotting in the heart and breaking free with the irregular rhythm. Also possibly used is Beta blockers that slow the conduction of impulses down being a beta blocker it blocks the beta stimulus especially lopressor or Metoprolol that is a selective beta 1 stimulus blocker which is in the heart to slow the HR down. Than there is calcium channel blockers possibly used to slow down the HR if needed by blocking cardiac cells sending impulse signals from the top to the bottom of the heart. Keeping afib under 100 of a pulse rate and more like 80 or less can live a completely normal life if compliant with meds, diet and exercise.

QUOTE FOR WEDNESDAY:

“Heat stroke is the most severe form of heat illness and is a life-threatening medical emergency. When a child is suffering from heat stroke, their body loses the ability to regulate its own temperature. Your child’s temperature can soar to 106 degrees or higher, leading to brain damage or death if it’s not treated quickly.”
MEDLINEPLUS
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Part II COMMON PROBLEMS THAT HAPPEN DURING THE SUMMERTIME!

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1-Dehydration and Heat Stroke:

Dehydration and heatstroke go hand in hand,” says Peter Galier, MD, associate professor of medicine at the David Geffen School of Medicine at UCLA. “It happens most commonly in people who are out in the sun.”

What happens, explains Galier, is that people sweat and replace their lost electrolyte-packed body fluids with only water. Dehydration can soon follow, and heatstroke can set in if a person becomes so dehydrated they can’t sweat enough to cool down, and their body temperature rises.

How to avoid it. “If you are outside and sweating, you should be drinking at least a 50-50 mix of Gatorade and water, which has potassium and sodium,” Galier tells WebMD. “You need to be drinking at least one small liter bottle of this mix every hour if you’re working or exercising in the sun.”

Warning signs. “Symptoms of dehydration can run the gamut from thirst and general fatigue, to headaches, nausea, and confusion,” says Galier. “Heatstroke symptoms are also headache and confusion, but include delirium and even hallucinations.”

What to do. While mild dehydration can be treated by rehydrating with fluids, heatstroke is more serious. “If you have heatstroke, you need to go to the emergency room so you can have intravenous fluids,” says Galier. “With really bad heatstroke, your kidneys can shut down.”

2-Poison Ivy and Poison Oak and Poison Sumak:

Poison ivy, poison oak, and poison sumac are plants that cause a rash in those allergic to them. This rash is caused by a chemical in the sap. About 50%-70% of people are sensitized to this chemical and are, therefore, allergic. Virtually everyone will eventually become sensitized if repeatedly exposed.

The old adage still rings true, explains Galier. “Leaves of three — let them be,” he says. So when the summer months begin, plan ahead when you know you’re going to be trekking through the woods.

Remember the old adage: “Leaflets three, let them be.” Poison ivy and poison oak have a triple-leaf structure you can learn to recognize — and then avoid.

Remember poison oak is more allergenic than poison ivy and poison oak is poison sumac, a deciduous woody shrub or small tree that grows 5–20 feet tall and has a sparse, open form. It inhabits swamps and other wet areas, pine woods, and shady hardwood forests. In Florida, poison sumac has been confirmed in the north and central regions, as far south as Polk County.

Figure 10. 

Poison sumac leaves consist of 7–13 leaflets arranged in pairs with a single leaflet at the end of the midrib. Distinctive features include reddish stems and petioles (Figure 10). Leaflets are elongated, oval, and have smooth margins. They are 2–4 inches long, 1–2 inches wide, and have a smooth, velvety texture. In early spring, the leaves emerge bright orange. Later, they become dark green and glossy on the upper leaf surface and pale green on the underside. In the early fall, leaves turn a brilliant red-orange or russet shade

How to avoid it.Poison ivy or oak is a tri-leafed plant, usually with a little yellow and purple, and it tends to be anywhere with shrubbery, hiding out with other vegetation,” says Galier. “So stay out of shrub areas or wear high boots or high socks, stay on the path, and don’t touch anything you don’t recognize.” You find both in the woods also.

Warning signs. Poison ivy, oak or sumac can creep up on you, even if you wear head-to-toe clothing. “It’s the oil of the leaf that’s the problem,” says Galier. “If you take your clothes off and you touch your clothes, you’re going to get it.” The “it” he’s referring to is the itching and swelling.

What to do. It’s time to get out the topical anti-itching cream again, like calamine lotion. “If you can suffer through it and it doesn’t get worse, you can ride it out,” says Galier. If it gets worse, you’ll need to see a doctor for topical steroids or oral steroids.”

Who Is Allergic to Poison Ivy, Poison Oak, and Poison Sumac?

Have you ever wondered: Can I get poison ivy? What you’re really asking is: Am I allergic to the plant? Not everyone is. Up to 85% of Americans are allergic to poison ivy, leaving at least 15% resistant to any reaction.

If you are allergic to poison ivy, you’re more likely to be allergic to poison oak and poison sumac, because all three plants contain the same rash-triggering plant oil called urushiol (pronounced yoo-ROO-shee-all). You’re also more likely to have an allergic reaction to other plant resins, such as the oil from Japanese lacquer trees (used on furniture), mango rinds, and cashew shells.

Sensitivity to poison ivy, poison oak, and poison sumac varies from a mild to severe reaction, and may not cause any reaction at all the first time you’re exposed. Some adults who reacted to poison ivy as children may find that they are now less sensitive. Some may even lose their sensitivity altogether.

What Causes the Rashes of Poison Ivy, Oak, and Sumac?

Many people break out in a rash when urushiol touches the skin. And even if you don’t recall touching the leaves of poison ivy, oak, or sumac, you may have unwittingly come in contact with their roots or stems.

Urushiol quickly penetrates the skin, often leaving red lines that show where you brushed against the plant. Symptoms appear 24 to 72 hours after exposure. Scratching the itchy rash doesn’t cause it to spread but can prolong skin healing and cause a secondary infection. The rash isn’t contagious, so you won’t spread it to others by going to school or work.

What Are the Symptoms of an Allergic Reaction to These Plants?

Symptoms, which generally last from one to two weeks, include:

  • Red streaks or patches
  • Itching
  • Rash
  • Swelling
  • Blisters that may “weep” (leak fluid) and later crust over
  • Inflammation and a burning sensation

Does it matter which plant you’re exposed to? NO unless you know Poison ivy, oak, and sumac all fall into the plant species called Toxicodendron, so the allergic reaction to all of these plants has the same name: Toxicodendron dermatitis. There are actually four poisonous plants in this group, since poison oak has both a western and an eastern variation. All four plants contain urushiol, so the skin reaction and treatment are essentially the same.

How Are Poison Ivy, Oak, and Sumac Rashes Diagnosed?

Poison ivy, oak, and sumac are generally diagnosed by their common symptoms of a rash, blisters, and itching following activity outside in a forest or field, but if you have any doubt, ask your doctor.

What’s the treatment for any 3:

  • Wash the area well with mild soap and lukewarm water as soon as possible after contact.
  • Wash all clothes, shoes, socks, tools, pets, and toys that may have become contaminated.
  • Cool compresses may help during the blistering phase.
  • Use a topical corticosteroid cream on the rash as directed by your doctor and there are some OTC corticosteroid ask your doctor.
  • Try calamine lotion for the itching, but avoid skin products that contain anesthetics or antihistamines, which can cause their own allergic reaction.
  • To help relieve the itch, try cool showers or a mixture of baking soda and water applied to the area. If sleep is a problem because of the itching, try an over-the-counter antihistamine at night.
  • Apple Cider Vinegar takes out the toxins of the rash with rubbing alcohol decreasing the rash irritation by topically applying it when needed but remember it does dry out the skin. When I had poison oak just after this Memorial Day 2016 I applied the apple cider vinegar about 3 to 4 times a day for 15 minutes give or take and applied rubbing alcohol about 6 to 7 times when it was bad 1st into 2nd week and less in the end of the 2nd and 3rd week.
  • With little itching to none the rash of any 3 will last about 3 weeks. It all depends how sensitive you are to the oil of these leaves. Worst thing you can do is constantly itch the area causing the rash to create another one to even breaking the skin integrity leading to infection and now expect this to be on you a month or more.

Call your doctor or a dermatologist for:

  • Severe blistering, swelling, and itching
  • Symptoms in sensitive areas such as the eyes, lips, throat, or genitals
  • Fever
  • A rash over large areas of your body
  • A rash lasting longer than a week to 10 days
  • Blisters that become infected with pus

Get immediate medical help for any difficulty breathing or severe coughing after exposure to burning plants.

In some cases, an oral steroid or other medication may be needed to relieve severe symptoms.

Transmission can occur in one of three ways:

  • Direct contact with the plant
  • Indirect contact when you touch pets, gardening tools, sports equipment, or other objects that had direct contact with the plant
  • Airborne contact from burning these plants, which releases particles of urushiol into the air that can penetrate the skin, eyes, nose, throat, or respiratory system

Mosquito Bites:

While mosquito bites used to be little more than annoying and itchy bumps on your arm or behind your ear, now we have even more reason to avoid them with things like West Nile virusand Triple E (Eastern equine encephalitis) making headlines.

How to avoid it. Your attack against a mosquito bite is three-pronged, according to the CDC’s web site: “Use insect repellent, particularly those with DEET, picaridin, or oil of lemon eucalyptus; wear as much clothing as the warm weather will allow; and avoid the outdoors during dusk and dawn — peak biting times.”

Warning signs. Mosquito bites will appear as red, raised bumps on your skin. Worse, they’ll itch.

What to do. Mosquito bites usually go away in less than a week, according to the web site of the University of Maryland Medical Center. In the meantime, you can wash the area and keep it clean, use an ice pack or a cool compress to alleviate itching, take an antihistamine, or use an anti-itching cream, such as calamine lotion.

Nearly 80% of people infected with West Nile virus will not have any symptoms. If you start to experience symptoms like fever, headache, body aches, nausea, vomiting, and sometimes swollen lymph glands or a skin rash on the chest, stomach, and back, according to the CDC’s web site, see your doctor. There’s a chance these could be symptoms of West Nile virus.

Swimmer’s Ear:

Swimmer’s ear is a kid’s nightmare when summer finally arrives.

“Just like when your fingers get pruney when you’re in the water too long, the same thing happens to your ears,” says Galier.

When you swim, or even shower or bathe, water can get trapped in your ear canal, causing the canal to get inflamed and infected.

How to avoid it. Gone are the days of Silly Putty in your ears. Now it’s simply wax ear plugs, or custom-fit ear plugs, explains Galier, to prevent swimmer’s ear.

Warning signs. “The symptoms of swimmer’s ear are ear pain and decreased hearing,” says Galier.

COMMON PROBLEMS THAT HAPPEN DURING THE SUMMERTIME!

SUMMERTIME PROBLEMS1   SUMMERTIME PROBLEMS1A SUMMERTIMEPROBLEMS1C

 1. BOATING ACCIDENTS:

People’s biggest mistake by far is drinking and boating. People get out there and drink alcohol all day in the sun, and you end up with the same accidents you have with driving — with the added risks of falling out of boats, getting hit by propellers, and drowning.

It’s also easy to get lax about life jackets. Kids need to have them on all the time. Even if having them under the seat fulfills the law, in an accident, chances are anyone who doesn’t know how to swim won’t be able to get to them in time. When you are going to be out on a boat or at the beach with a child, you take on the responsibility to maintain the safety of that child and basic lifesaving skills are a must, not a luxury; especially for parents.   The courses are easy, usually just one day or half a day and you may save your child’s LIFE or the child you take the responsibility in caring for. There’s no mouth-to-mouth [resuscitation] anymore if you are not trained — just chest compressions but if you get BCLS certified (basic care in life support) your CPR certified.

You can find first aid, cardiopulmonary resuscitation (CPR), and other emergency lifesaving courses near you with the American Heart Association’s ECC (Emergency Cardiovascular Care) Class Connector tool online at americanheart.org. or near you where you live.

2. Mower Injuries

We know almost every homeowner loves the sight of a pristine, neatly mowed yard. But in their haste to get that lawn in shape, some people forget to take precautions. “In the warmer months we see lots of mower injuries to toes, hands, and fingers getting caught in blades, and things like rocks and sticks getting flung out of them. People will start tinkering with the mower and reach under it to unclog it, and forget there’s a spinning blade there or take the key out when going under to see what clogged the blade from working. Those can be preventative moves and result in hideous injuries for some permanent and with others temporary.

They’re also hard to repair, because not only can whirling blades cause complex lacerations and fractures, but they can bury contaminants like grass and dirt in the wound putting the wound at risk for infection. To be safe:

Wear closed-toed shoes — preferably with a steel toe — when you mow, along with goggles or sunglasses, gloves, and long pants that will protect you from flying debris.

Keep kids away from the push mower and off the riding mower. Riding mowers are not just another ride-on toy.

Get a professional to service your mower or learn how to do it properly. Important: Disconnect the spark plug to prevent it from accidentally starting. Turning a push mower’s blade manually can ignite the engine.

3. Dehydration Disasters

You’ve romped outdoors with the kids all day, and your water bottle ran dry long ago. Suddenly you feel dizzy and lightheaded, and your mouth tastes like cotton. You’re dehydrated — meaning you haven’t taken in enough fluids to replace those you’ve been sweating out.

People can get dehydrated any time of year, but it’s much more common in the summer months, when they are active outdoors in the warm sun. Heatstroke is the most severe form of dehydration. That’s when your internal temperature rises to dangerously high levels. Your skin gets hot, but you stop sweating. Someone with heatstroke may pass out, have hallucinations, or suffer seizures.

Preventing dehydration and heatstroke is so easy: Drink plenty of fluids, especially water, take regular breaks in the shade, and try to schedule your most vigorous outdoor activities for times when the heat isn’t so strong, such as early morning or late afternoon.

For persons suffering more serious dehydration or heatstroke, get them indoors, have them lie down, and cool them off with ice packs and cool cloths. Someone who is seriously affected by the heat may need intravenous fluids in the ER.

4. Sunburn

With all the skin cancer warnings, you’d think Americans would be getting fewer sunburns, not more. But you’d be wrong. The percentage of adults nationwide who got at least one sunburn during the preceding year rose from 31.8% in 1999 to 33.7% in 2004, according to the CDC.

Your risk for melanoma doubles if you’ve had just five sunburns in your life. A sunburn is a first-degree burn, right up there with thermal burns. Also, we even see some second-degree thermal burns, often when people are out drinking or falling asleep in the sun and don’t realize how long they’ve been out there.

In addition to practicing “safe sun” — wearing sunscreen that protects against both UVB and UVA rays, long-sleeved shirts, and wide-brimmed hats, and staying out of blistering midday rays — there are things you can do to treat a severe sunburn, Stanton says:

-Drink water or juice to replace fluids you lost while sweating in the hot sun.

-Soak the burn in cool water for a few minutes or put a cool, wet cloth on it.

-Take an over-the-counter pain reliever, such as acetaminophen.

-Treatitching with an OTC antihistamine cream or a spray like diphenhydramine (such as Benadryl), which helps block the inflammatory reaction.

-Apply an antibiotic ointment or an aloe cream with emollients that soften and soothe the skin directly to the burned area.

-You’re going to have a pretty miserable 12 to 24 hours with the initial symptoms no matter what you do.

5. Picnic Poisoning

Food poisoning puts about 300,000 people in the hospital every year, hitting its peak in the summer months. You don’t want diarrhea to be the souvenir of your family’s annual summer picnic.

Anything that has mayonnaise, dairy, or eggs in it and any meat products can develop some pretty nasty bacteria after only a couple of hours unrefrigerated. Every summer we’ll have five or six people coming in from the same reunion or family picnic with food poisoning symptoms.

To prevent food poisoning, follow the U.S. Department of Agriculture’s advice to:

  • CleanWash your hands as well as the surfaces where you’ll be preparing foods.
  • Separate — Wrap raw meat securely and keep it stored away from other food items.
  • Cook — Bring along a meat thermometer. Grilling meat browns it very fast on the outside, but that doesn’t mean it’s safe on the inside. Steaks should be cooked to a minimum internal temperature of 145 degrees, ground beef and pork to 160 degrees, and poultry to 165 degrees.
  • Chill — Keep everything refrigerated as long as possible. Store perishable picnic items in an insulated cooler packed with ice, and follow the “last in, first out” rule — whatever you’re going to eat first should go at the top of the cooler.

Mild cases of food poisoning can be cared for at home. Avoid solid foods, and stick with small, frequent drinks of clear liquid to stay hydrated. Once the nausea and vomiting have eased, you can try bringing food back into your diet — slowly and in small, bland portions (Grandma knew what she was talking about when she recommended tea and toast to settle an upset stomach). If symptoms persist for more than a couple days (or more than 24 hours in small kids), see a doctor.

Independence Day arrives. Many people love fireworks, but fireworks don’t necessarily love them back. Nearly 9,000 individuals were injured by fireworks in 2009, according to the U.S. Fire Administration, and two were killed. We see pretty significant hand and eye injuries from fireworks every summer. The safest way to watch fireworks is at a professionally sponsored display. At least six states ban all consumer fireworks, and several more allow them only with limitations. But if you can buy fireworks legally and want to set off a few at home, take these precautions:

  • Keep a hose or fire extinguisher handy to put out small fires.
  • Keep children away from fireworks.       Everybody loves to give sparklers to kids, but they burn very hot and can cause significant eye injuries. In fact, a sparkler can burn as hot as 2,000 degrees — hot enough to melt some types of metals.       They can go off quickly and cause burns or just explode in your hand.

To care for a fireworks burn, wrap it in a clean towel or T-shirt saturated with cool water and get to an emergency room to have the injury checked out.

QUOTE FOR MONDAY:

“People who are physically active, eat a healthy diet, do not use tobacco, and practice other healthy behaviours reduce their risk for chronic diseases and have a much reduced rate of disability compared to others who don’t do this lifestyle.”

British Columbia Ministry of Health

 

Aging in style or just looking like your suppose to, you make the choice!

aging and healthaging and health2

 

I am enjoying my adulthood journey and wish I could say the same for many of our aging population. What I am observing as a RN, daughter and friend I must say it is a concern to me…why do people of age want to home in on talking about their illness (s) and making it their main topic of conversation? I can understand when a crisis happens, there is a new diagnosis that is heavy on their mind and that there stages they go through (shock, grieving, angry, bargaining, depression and acceptance) but I am not talking about this. I am talking about the need to focus on the aging process as a loss and a ‘giving up’ instead of looking at it for what it is… a time of a new stage in life from 40 and on some sooner where your process of mind and physical body goes through changes that can offer freedom, curiousity, and enjoyment. Let me give you some examples.

A family member of mine is in the last stage (I know I am not there but almost 30 years of care with geriatrics I have an idea how many live, some healthy with going about each day with a form of a work out or others closed in a box in their own world. There are conditions that slow us down but don’t cripple us and having a condition that isn’t curable many can be kept under controll. Though many like my family member give in or give up to the condition because or are set in their ways set to no change not paying attention to what they ate or stop exercise and the amount they eat. By doing this behavior what develops is weight gain and the signs started showing up of further health conditions like obesity, adult diabetes II (occurs 45 and up roughly), cardiac disease that would have never had occurred if the individual balance rest, a form of light exercise and good diet eating. On top of that from the immobility of sitting in the house or wherever you may sit all day gives you also sedentary lifestyle=less tone to the muscles with less muscle and more fat and stiffening of the muscle and joints that increases the risk of pulling a muscle or back which did to my family member, at first. Now over 6 years uses a cane and can barely walk with sciatica damage and the MRI and CatScan recently done only supposedly shows arthritis. Prevent this people just through a routine of balancing rest, exercise program (intense or slight work out = only 15 minutes a day), and good healthy dieting and high probability you will live longer with a better healthy tone body. The KEY to obtaining this is start YOUNG and you will get into this as a routine and it will feel like it’s a regular part of your life with you wanting to do it but if your elderly you can still do it. It maybe harder but go about it with your primrary MD’s approval with reviewing what is ok for a daily 15 minute exercise with proper dieting balancing this with rest. When he have a chance to correct obesity and prevent disease situations grab the opportunity before it is too late and unbearable to exercise, get out of the house, and now you sit in the house with few nearby to come and visit or even want to. Like many other family members and families in the world going through this that ill one limits the places they can go, limits independence (they have to be driven long distances 30 minutes away, have to do there shopping etc…). Where when they had there independence with having conversations with them other than there condition made you more out to look forward to visiting them. It’s just normal. Same example as if having a long term friend or sister you hung with for decades parting and gossiping and eating out and shopping together now moves into adulthood married with children. Than this sister depends on you for babysitting frequently, driving or picking the kids up frequently from school events, gossips about how bad the marriage is for 6 years now. Like anything else negativism all the time seen and heard you don’t want to be around. It is unfortunate but true. You on the other side feel obligated to do so for all the years of good life with that person but life good be better in the end if that family person doesn’t put themselves in that situation but it doesn’t always work that way. So make your life better and don’t but yourself in that situation. I am very much tryng to do so. One way of reaching it is through good diet (treats now and than), good exercise, and balance with good rest; doesn’t always work that way with work but I try to make up for it.   My family member by diet alone, could help the situation. One by making good diet decisions and don’t eat after 5pm or 6pm and good healthy food. Don’t have a dinner 9pm at night; or usually big meals after 6pm and make smaller meals.

I was very patient when I learned about the family member changes 6 years ago with no progress just the opposite to even activities of daily living capabilities and than what go me was that member getting use to it and being drawn in to live that way where it’s like a addition now. This can definitely end your life sooner so it is up to you.he had to change his eating habits, monitor his blood sugar, and learn to give himself insulin shots. I understood it would take him time to adjust, so his constant talking and yes, even complaining, was expected. As a friend, it was my job to help that loved individual go through this transition and give the needed support to ease all the changes that the family member would have to go through.

So, here’s his story now. That member is less than 81 years old and has had this condition for several years, continues to make this health issue the topic of conversation to me, family members, and friends even when things are going really well. The fact is, this condition for getting close to 10 years, my family member, has chosen to play the ‘poor me scenario’ at times it appears to come across as. The doctor and myself as a RN almost 30 years has provided excellent information and several resources to help with coping. In only took me 6 years with some family sibling help to have her agree it’s time to move out of the house I grew up in since 1966. No one else lives in that house.

It is taking a toll on my psychic energy. In other words, it sucks the life right out of me and, after visiting, I am tired after 14 hours working and so ready to take a nap.

I see this with other friends going through a similar situation with some family member also. They talk about their arthritic aches and pains plus stiffness in their joints as much as they do about the changes in the weather. These are chronic conditions, meaning they will experience this from time to time, and talking about it obsessively won’t change a thing.

At what point do people decide that the aging process means they need to constantly talk about their health issues? At what point do they stop engaging in healthier topics of conversation? What are the reasons for this shift in how they converse with people and, more importantly, do they even realize how depressing this whole routine is?

Again being a RN around geriatrics I understand. One reason may actually be major depression (also known as clinical depression) , which is a medical illness. It is a chemical imbalance in the brain and can appear in people regardless of age, race or economic status. The illness can appear after a triggering event or for no apparent reason at all or simple normal with being alone by yourself (possible spouse deceased, friends moving if not dying off as age progresses) but when will the stop? At this point I highly doubt it and for me writing with some exercise busy in work and a good love life all help out.

TO HELP YOU DETECT THIS EARLY OR EVEN POSSIBLY STOP IT.

Look for signs of:

  • Constant complaints of aches and pains (back, stomach, arms, legs, head, chest) , fatigue, slowed movements and speech, loss of appetite, inability to sleep, weight increase or decrease, blurred vision, dizziness, heart racing, anxiety. •An overall sadness or apathy, withdrawn; unable to find pleasure in anything or unable to have the need to get out to family gatherings or go to church anymore like previously it was considered a regular routine of that person’s life.
  • •Also irritability, mood swings or constant complaining; nothing seems to make the person happy. •Talk of worthlessness, not being needed anymore, excessive and unwarranted guilt. •Frequent doctor visits without relief in symptoms; all tests come out negative.
  • Another reason is ‘doing as others do’. Meaning they mimic what other elders are doing. Again if that is what they see and hear from their associates, there is a strong chance they may get caught up in the same negative behavior.
  • Alcoholism can mask an underlying depression.
  • Another reason is the lack of stimulation, which will give them other things to talk about. Many times, elders find themselves alone with infrequent visitation from family and friends. They concentrate on familiar things like illnesses, chronic aches and pains, and the medications they take which become their major thing to talk about.

I too, have minor health issues, however I chose to acknowledge approaching it like this ‘it is what it is’, as my love says. I have been dealt this hand and therefore in my optimal level I will do what I can to not let it slow me down. The other side to the coin is how you look at that ½ glass of water. It can be I have the worst condition and play “feel sorry for me scenario” not even realizing it since it it talked about all the time or like I look at life there are so many worse of then me with disease, no home, no family, no friends and just surviving possibly getting a meal each day, if that. As I said, I am an observer of people partly because I am an RN and it’s part of my job. I have made note that those individuals who are really struggling with major health issues many hardly complain at all. They keep a positive attitude and, in doing so, don’t let their condition stop them from enjoying life or start a negative domino effect that just keeps dropping on top of another till it crashes all of them and unfortunately when continues to have a life spreading to others with that effect you turn them away. Like everyone else we all have our headaches and on high probability in adulthood health issues with losses and aches & pains. You have to deal with them in a positive note. Meaning don’t blame the world or someone else for your health situation unless its real and lack of moving around (going out) even 10 minutes exercise a day or 2 to 3 times a week one hour exercise for elderly (just simply walking) with good dieting and rest will take you along way. Going the opposite way gives you a shorter life and highier odds a unhappier with lonely life. Along with keeping a positive attitude, you may also find things that attract your likes as opposed to dislikes which will keep you busier in life and people benefit from being around cheerful positive people that attracts them to have you back more.

Not to far away from being elder in about 15 to 20 years, I hope to stir the Pagan (polytheistic or open minded) community to take notice of how they choose to age. Are we aging with grace or are we just aging? Talk to the God and Goddess for help in modifying your way of thinking so you can handle life’s little ups and down. If you have family and / or friends who are displaying this type of behavior, show empathy and love by helping them comprehend the negative effects that persist when they chose to concentrate on their health issues in a pessimistic way. Sometimes it becomes a habit and they don’t even realize how often it occurs.

Behaviors can be changed, so make up your mind to age with GRACE and not just age.

Part II The top deadliest creatures to man in and out of the USA; especially for traveling!

It’s that time of the year to go on vacation during summer to area warm with beaches or even scuba dive during the vacation but here’s a warning on few creatures deadly to man if in the ocean water especially scuba diving.

Jelly Fish-The Sea Wasp=Box Jelly Fish

 box jellyfish1 box jellyfish2

There are a number of species of box jellyfish, but they are all quite dangerous. The sea wasp box jellyfish is perhaps the most deadly variety. This translucent sea-dweller may not look all that menacing, but it is the most venomous animal on planet Earth. Box jellyfish are deadly to many different animals, not the least of all, us. If you get stung by one of these animals, you are very likely to die. Even if you do not, you will be in tremendous pain for some time afterward.  Box jellyfish are cnidarian invertebrates distinguished by their cube-shaped medusae. Some species of box jellyfish produce extremely potent venom: Chironex fleckeri, Carukia barnesi and Malo kingi. Stings from these and a few other species in the class are extremely painful and can be fatal to humans.

In Australia, fatalities are most often perpetrated by the largest species of this class of jellyfish. The recently discovered and very similar Chironex yamaguchii may be equally dangerous, as it has been implicated in several deaths in Japan.

Box jellyfish are known as the “suckerpunch” of the sea not only because their sting is rarely detected until the venom is injected, but also because they are almost transparent. In northern Australia, the highest risk period for the box jellyfish is between October and May, but stings and specimens have been reported all months of the year. Similarly, the highest risk conditions are those with calm water and a light, onshore breeze; however, stings and specimens have been reported in all conditions.

In Hawaii, box jellyfish numbers peak approximately seven to ten days after a full moon, when they come near the shore to spawn. Sometimes the influx is so severe that lifeguards have closed infested beaches, such as Hanauma Bay, until the numbers subside.

TREATMENT IF POSSIBE: Once a tentacle of the box jellyfish adheres to skin, it pumps nematocysts with venom into the skin, causing the sting and agonizing pain. Flushing with vinegar is used to deactivate undischarged nematocysts to prevent the release of additional venom. A 2014 study reported that vinegar also increased the amount of venom released from already-discharged nematocysts; however, this study has been criticized on methodological grounds.

Removal of additional tentacles is usually done with a towel or gloved hand, to prevent secondary stinging. Tentacles can still sting if separated from the bell, or after the creature is dead. Removal of tentacles may cause unfired nematocysts to come into contact with the skin and fire, resulting in a greater degree of envenomation.

Although commonly recommended in folklore and even some papers on sting treatment, there is no scientific evidence that urine, ammonia, meat tenderizer, sodium bicarbonate, boric acid, lemon juice, fresh water, steroid cream, alcohol, cold packs, papaya, or hydrogen peroxide will disable further stinging, and these substances may even hasten the release of venom. Heat packs have been proven for moderate pain relief. Pressure immobilization bandages, methylated spirits, or vodka should never be used for jelly stings. In severe Chironex fleckeri stings cardiac arrest can occur quickly. Going to the ER never hurts where the hopefully in Hawaii, Japan and other areas known for this problem are updated on the best treatment. Especially where oceans are nearby for the beach scene or scuba diving.

Cone Snail

cone snail2 cone snail

Another ocean dweller to be wary of is the cone snail. It may not look like much, and you may easily mistake it for any other snail on the beach, but it is extremely deadly. Just one drop of its venom can kill twenty human adults. There is no antivenin, which means that if you are stung, you will almost certainly be dead within minutes. Who would think such a small dwelling creature could be so powerful in putting an end to a human life.

Cone snails, cone shells or cones are common names for a large group of small to large-sized predatory sea snails, marine gastropod molluscs. Until recently, over 600 species of cone snails were all classified under one genus, Conus, in one family, the Conidae.

National Geographic (NG) states about this species having it’s own siphon; along with having a breathing tube and is a toxic killer. Snails are usually thought of as slimy, small, and are great with butter sauce after cooked. In the waters of Southeast Asia this creature is considered a underwater tank that has a hard spiral shell and flexible treads. NG also states that down in front this snail is a shell that has a cannon. It has eyesight on each side and hunts primarily by scent using it’s siphon. One of its common prey is the fish which when the mammal detects the cone shell it hides under the rock usually rather that swim away (not a good choice). It still had move to remove. The shell has a long harpoon (a weapon made of modified tooth) in its tube inside the shell it releases by a contraction with its muscle. It releases in this harpoon a venom which can be deadly to the human; it is cocked and loaded aiming it at the fish deeper under the rock not being able to get free at all making the catch simplified for the cone snail and it strikes and paralyzes the fish the siphon sucks the fish in with now having a full belly. Now hides under the rock and sediment with the siphon sticking up as a warning till next time.

They live in the Indian and Pacific oceans, the Caribbean and Red seas, and along the coast of Florida. They are not aggressive. The sting usually occurs when divers in deep reef waters handle the snails. Swimmers and snorkelers are unlikely to find cone snails in shallow intertidal waters. Their empty shells are prized items on sandy beaches. They are nocturnal (more active at night) and they tend to burrow themselves in the sand and coral during the day. Cone snail shells range in size from less than an inch to 9 inches long. Cone snails mainly hunt worms and other snails. A few varieties of cone snails eat fish, and these are the most harmful to humans.

Most stings occur on the hands and fingers due to handling. Mild stings are similar to a wasp or bee sting with localized burning and sharp stinging symptoms. They can be intense and also have numbness and tingling to the wounded area.

Some sting symptoms can progress to include cyanosis (blueness at the site due to decreased blood flow), and even numbness or tingling involving an entire limb.

Severe cases show total limb numbness that progresses to the area around the mouth (perioral) and then the entire body. Paralysis (inability to move a part or entire body) can occur leading to paralysis of the diaphragm which stops the ability to breath.

Coma and death can result in severe cases where the diaphragm is paralyzed.

Other symptoms that can occur include: fainting (syncope), itching, loss of coordination, heart failure, difficulty speaking. difficulty breathing, and double vision.

Symptoms can begin within minutes or take days to appear after the venom is injected. 

So again Scuba Divers watch out on your vacation and what you handle!

Treatment:

If SCUBA diving, the diver stung should safely surface immediately accompanied by another diver.

There is no antivenom available for cone snail stings.

Use the pressure immobilization technique:  Use an elastic bandage (similar to ACE bandage) to wrap the limb starting at the distal end (fingers or toes) and wrap toward the body. It should be tight but the fingers and toes should remain pink so that the circulation is not cut off.  The extremity should also be immobilized with a splint or stick of some sort to prevent it from bending at the joints.  The elastic bandage should be removed for 90 seconds every 10 minutes and then reapplied for the first 4 to 6 hours. (Hopefully medical care can be received within this time period.)

Other treatment options that may help include:

  1. Immerse the affected area in water as hot as is tolerable (water temperature not to exceed 140 F or 60 C).
  2. Inject a local anesthetic into the wound area.
  3. Some reports suggest that
  4. Edrophonium (Enlon, Tensilon) 10 mg IV may be used as therapy for paralysis. A 2-mg test-dose should first be administered IV, and if effective, followed by an additional 8-mg dose IV. Atropine (Atreza, Sal-Tropine) 0.6 mg should be immediately available for intravenous administration in case of an adverse reaction to edrophonium.
  5. A 2 to 4 mg dose naloxone (Narcan) given IV may help treat severe hypotension (low blood pressure).
  6. Local excision (cutting out the area stung) by a health care professional (controversial and not widely recommended)
  7. Incision and suction (controversial and not widely recommended)

Other things that may be done:

  1. Avoid excessive movement and keep the patient calm and warm.
  2. CPR may be necessary. Artificial respiration may save the person’s life.
  3. Do not cut into the wound, apply suction, or use a tourniquet. 
  4. BUT going to the nearest ER is the best bet! 

 Black Mamba

black mambablack mamba2black mamba3                         

The Black Mamba is considered to be the longest venomous of all snakes found around Africa. It is also considered to be one of the deadliest. It features a very powerful venom and that has many people running scared from it. They are fast moving snakes and they are know to be aggressive and strike in a moments notice. Black mambas live in the savannas and rocky hills of southern and eastern Africa. They are Africa’s longest venomous snake, reaching up to 14 feet (4.5 meters) in length, although 8.2 feet (2.5 meters) is more the average. They are also among the fastest snakes in the world, slithering at speeds of up to 12.5 miles per hour (20 kilometers per hour).You may be puzzled why they have such a name though as they aren’t black in color. Instead they are gray, olive, or brownish. The color will depend on the natural habitat of the species. They have to be able to blend in if they want the best chance of finding prey. This camouflage also helps them to reduce the chances of being noticed by various predators. They get their name from the blue-black of the inside of their mouths, which they display when threatened.Even though they are very aggressive they do take the chance to escape when they can. Since this snake is so fast they will often do so. However, if they feel backed into a corner, they have eggs around them, or they are agitated they will strike fast. Black mambas are shy and will almost always seek to escape when confronted. When the snake feels its being cornered, these snakes will raise their heads, sometimes with a third of their body off the ground, spread their cobra-like neck-flap, open their black mouths, and hiss. If an attacker persists, the mamba will strike not once, but repeatedly, injecting large amounts of potent neuro- and cardiotoxin with each strike. It is really amazing to see but I do recommend on T.V. not in person.  Many people believe them to be evil due to that particular characteristic. It is a myth that has been passed down in many cultures for hundreds of years. This particular snake is able to move at a speed of up to 12.5 miles per hour for long distances.However, it is quite thin with an overall size of about 3 ½ pounds. In spite of being so thin though they are very strong. This is also a very fast moving type of snake so don’t underestimate what you are dealing with.

Treatment:

Remember, the venom of the black mamba is highly toxic, commonly causing collapse in humans within 45 minutes or less from a single bite. Without effective antivenom therapy, death typically occurs in 7–15 hours. The venom is chiefly composed of neurotoxins, specifically dendrotoxin.

Treatment of a bite by a neurotoxic snake such as a cobra or mamba:

* Stay calm and breathe gently.

* Immediately apply a crepe bandage firmly around the wound, as if for a muscle sprain. This will reduce the amount of venom entering the bloodstream but should not cut off circulation.

* Do not apply a tourniquet.

* Never try and suck the venom out.

*Transport the person to hospital as soon as possible as these snakes have potent venom and anti-venom will be needed.

If you are bitten by a cytotoxic snake such as a black mamba: 

* Drink plenty of fluid unless you have trouble swallowing.

* Apply a sterile dressing to the wound.                                

* Never try and suck the venom out with your mouth.

* Do not squeeze the bite.

* Do not apply a tight bandage or tourniquet.

*Transport the person to hospital as soon as possible. You need the ANTIVENOM!!

 

QUOTE FOR FRIDAY:

“Researchers have even frozen scorpions overnight, only to put them in the sun the next day & have seen them come to life with walking away. But there is one thing scorpions have a difficult time living without—soil. There burrowing creatures. These creatures live in every country but Antarctica.”

National Geographic