Patient Education Essentials

The Science of Stress Recovery

Tue, 30 Sep 2025 19:14:19 GMT

The Science of Stress Recovery: How Healthcare Workers Can Protect Their Health

Introduction: Stress Is Built Into the Job

Working in healthcare means being immersed in stress every day. Whether it’s long shifts, emotionally intense situations, or the physical demands of clinical work, stress is part of the profession. For many nurses and clinicians, it’s not about if stress happens, but how to recover from it.

Research consistently shows that stress recovery is just as important as stress exposure. Without proper recovery, stress accumulates and contributes to fatigue, impaired decision-making, burnout, and even long-term health issues such as cardiovascular disease [1,2]. With the right strategies, however, healthcare workers can build resilience and sustain their ability to care for others without sacrificing their own well-being.

This article looks at the science of stress recovery and offers practical, evidence-based strategies tailored to those working in demanding clinical environments.

Why Recovery Matters in Healthcare

Recovery isn’t just about “rest.” Physiologically, it means giving the body and mind a chance to restore balance after stress activation. In healthcare work, the sympathetic nervous system (“fight or flight”) is often on high alert. Effective recovery reactivates the parasympathetic system (“rest and digest”), lowering heart rate, blood pressure, and muscle tension while improving digestion, sleep, and mood regulation [3].

For nurses and healthcare professionals, this is more than theory:

Shift work disrupts natural circadian rhythms [4].
Emotional stress from patient care increases mental load [5].
Physical stress from long hours on one’s feet and patient handling strains the body [6].

When recovery is insufficient, performance drops, errors increase, and burnout risk rises [7]. Protecting recovery is therefore not a luxury — it’s a clinical necessity.

The Physiology of Stress and Recovery

To understand recovery, it helps to look briefly at the underlying physiology.

Stress response (sympathetic activation) : During high-pressure situations — like managing multiple patients or responding to emergencies — stress hormones (adrenaline, cortisol) surge. This prepares the body for action but comes at a cost if prolonged [8].
Recovery response (parasympathetic activation) : Once the stressor passes, recovery requires the body to switch gears. Heart rate variability (HRV) is one reliable measure of how effectively the nervous system shifts between stress and recovery states. Higher HRV generally indicates better resilience and recovery capacity [9].
Chronic imbalance : If stress outpaces recovery for too long, the nervous system stays in a state of “hyperarousal,” leaving workers wired but exhausted — a hallmark of burnout [10].

The key is to actively support the recovery side of the equation, especially when stressors are built into the job.

Evidence-Based Recovery Strategies for Healthcare Workers

1. Breathing Techniques to Reset the Nervous System

Slow, deep breathing is one of the fastest ways to re-engage the parasympathetic system. Studies show that paced breathing at around 6 breaths per minute enhances HRV and improves stress resilience [11].

Practical tip : Between tasks or during short breaks, take 2–3 minutes to focus on slow diaphragmatic breathing. Inhale through the nose for about 4–5 seconds, exhale gently for 5–6 seconds.
Why it works : This pattern optimizes the balance between oxygen and carbon dioxide, stimulates the vagus nerve, and signals the body that it’s safe to relax [12].

Even a short breathing reset can improve focus and reduce physiological stress levels during a busy shift.

2. Micro-Recovery Breaks During Shifts

Many healthcare workers push through long shifts without adequate breaks. However, micro-recovery — even a few minutes — can have outsized benefits.

Examples : stepping outside for fresh air, stretching in the break room, listening to calming music, or taking a mindful pause before charting.
Science behind it : Short breaks reduce cumulative stress load, preventing the escalation of fatigue. Studies in occupational health show that even micro-breaks improve cognitive performance and reduce musculoskeletal strain [13].

Instead of waiting for long off-shift recovery, think of recovery as something you sprinkle into the workday.

3. Protecting Sleep in Shift Work

Sleep is the cornerstone of recovery, but shift work often disrupts circadian rhythms. Poor sleep quality compounds stress and increases risk for chronic disease [14].

Evidence-based tips:

Keep your sleep environment dark, cool, and quiet (use blackout curtains or an eye mask).
Follow a wind-down routine — even 20–30 minutes of reading, light stretching, or breathing exercises before bed can help.
Avoid large meals and stimulants (like caffeine) within a few hours of sleep.
Try to maintain consistent sleep and wake times when possible, even on days off.

Prioritizing sleep is not indulgent — it’s essential for clinical performance and patient safety.

4. Nutrition as a Stress Buffer

Stress depletes energy reserves, and in high-demand jobs, it’s easy to lean on quick fixes like sugar or caffeine. While these provide temporary relief, they can worsen energy crashes later.

Practical strategies:

Carry healthy snacks (nuts, fruit, yogurt) to stabilize blood sugar during long shifts.
Stay hydrated — even mild dehydration worsens fatigue and mood [15].
Balance meals with protein, complex carbs, and healthy fats to support steady energy release.

Nutrition may not eliminate stress, but it strengthens the body’s resilience against it [16].

5. Movement and Posture Resets

Healthcare work often involves either prolonged standing or repetitive physical strain. Small posture resets can make a big difference.

Stretching : A few minutes of neck rolls, shoulder stretches, or gentle spinal twists can relieve tension.
Walking breaks : Short walks boost circulation, mood, and cognitive clarity [17].
Posture awareness : Standing tall with open chest and relaxed shoulders helps breathing efficiency and reduces musculoskeletal strain [18].

These small resets counteract the physical stress of clinical work while also engaging recovery pathways.

6. Building Peer Support and Emotional Recovery

Stress is not just physical — emotional load is heavy in healthcare. Sharing experiences with colleagues, debriefing after difficult cases, or having peer support groups helps prevent stress from being internalized [19].

Why it works : Emotional recovery reduces the risk of compassion fatigue and burnout. Research shows that social support is one of the strongest buffers against chronic stress [20].
Practical approach : Take a few minutes post-shift to talk with a trusted colleague, or join structured peer support sessions where available.

Putting It All Together

Stress is inevitable in healthcare, but poor recovery doesn’t have to be. Think of recovery as a skill to be practiced, not just a passive process. The strategies above — breathing, micro-breaks, sleep hygiene, balanced nutrition, posture resets, and peer support — are all small but evidence-backed tools that add up.

Healthcare workers are trained to monitor patient vitals closely. Applying the same principle to your own body — noticing fatigue, mood, or HRV patterns — allows you to adjust before stress turns into burnout.

Conclusion: Protecting the Protector

As healthcare professionals, you are constantly giving to others. But without effective recovery, that generosity comes at the cost of your own health. By applying science-based recovery strategies, you not only protect yourself but also ensure you can keep delivering high-quality care for years to come.

Recovery is not optional. It is the foundation that allows healthcare workers to thrive in one of the most demanding, rewarding, and essential professions.

About the Author

Dr. Antti Rintanen , MD, MSc, is a Finnish doctor and the author of The Internet Doctor . With a background in both clinical medicine and engineering, he focuses on translating complex science into practical strategies for stress recovery , nervous system health, and sustainable performance in everyday life.

References

Shanafelt TD, Noseworthy JH. Executive leadership and physician well-being: nine organizational strategies. Mayo Clin Proc. 2017;92(1):129–146. https://pubmed.ncbi.nlm.nih.gov/27871627/
McEwen BS. Protective and damaging effects of stress mediators. N Engl J Med. 1998;338(3):171–179. https://pubmed.ncbi.nlm.nih.gov/9428819/
Thayer JF, Lane RD. Claude Bernard and the heart–brain connection: further elaboration of a model of neurovisceral integration. Neurosci Biobehav Rev. 2009;33(2):81–88. https://pubmed.ncbi.nlm.nih.gov/18771686/
Kecklund G, Axelsson J. Health consequences of shift work and insufficient sleep. BMJ. 2016;355:i5210. https://pubmed.ncbi.nlm.nih.gov/27803010/
Alodhialah AM, Almutairi AA, Almutairi M. Exploring nurses’ emotional resilience and coping strategies in palliative and end-of-life care settings in Saudi Arabia: a qualitative study. Healthcare (Basel). 2024 Aug 19;12(16):1647. https://pubmed.ncbi.nlm.nih.gov/39201205/
Scott-Marshall HK, Tompa E, Foley M, Khokhar A, Mustard C, Amick BC. Safe limits on work hours for the nursing profession: a rapid review. Front Glob Womens Health. 2024;2:1455422. https://pubmed.ncbi.nlm.nih.gov/39544998/
Aiken LH, et al. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA. 2002;288(16):1987–1993. https://pubmed.ncbi.nlm.nih.gov/12387650/
Chrousos GP. Stress and disorders of the stress system. Nat Rev Endocrinol. 2009;5(7):374–381. https://pubmed.ncbi.nlm.nih.gov/19488073/
Shaffer F, Ginsberg JP. An overview of HRV metrics and norms. Front Public Health. 2017;5:258. https://pubmed.ncbi.nlm.nih.gov/29034226/
Maslach C, Leiter MP. Understanding the burnout experience: recent research and its implications. World Psychiatry. 2016;15(2):103–111. https://pubmed.ncbi.nlm.nih.gov/27265691/
Lehrer PM, et al. Heart rate variability biofeedback increases HRV and improves emotional well-being. Appl Psychophysiol Biofeedback. 2003;28(1):7–20. https://pubmed.ncbi.nlm.nih.gov/32385728/
Gerritsen RJ, Band GP. Breath of life: the respiratory vagal stimulation model of contemplative activity. Front Hum Neurosci. 2018;12:397. https://pmc.ncbi.nlm.nih.gov/articles/PMC6189422/
Tucker P, Folkard S, Macdonald I. Rest breaks and accident risk. Lancet. 2003;361(9358):680. https://pubmed.ncbi.nlm.nih.gov/12606184/
Flo E, et al. Shift work disorder in nurses—assessment, prevalence and related health problems. PLoS One. 2012;7(4):e33981. https://pubmed.ncbi.nlm.nih.gov/22485153/
Ganio MS, et al. Mild dehydration impairs cognitive performance and mood of men. Br J Nutr. 2011;106(10):1535–1543. https://pubmed.ncbi.nlm.nih.gov/21736786/
Torres SJ, Nowson CA. Relationship between stress, eating behavior, and obesity. Nutrition. 2007;23(11-12):887–894. https://pubmed.ncbi.nlm.nih.gov/17869482/
Nath A, Schimmelpfennig S, Konradt U. Effects of Office-Yoga and Walking at the Workplace to Improve Health and Wellbeing: A Longitudinal Randomized Controlled Trial. Occupational Health Science. 2024;8:679–709. https://link.springer.com/s41542-024-00194-y
Peper E, Lin IM. Increase or decrease depression: how body postures influence your energy level. Biofeedback. 2012;40(3):125–130. https://www.ovid.com/10.5298/
Rushton CH, Batcheller J, Schroeder K, Donohue P. Burnout and resilience among nurses Practicing in High-Intensity Settings. Am J Crit Care. 2015;24(5):412–420. https://www.researchgate.net/281517751
Uchino BN. Social support and health: a review of physiological processes potentially underlying links to disease outcomes. J Behav Med. 2006;29(4):377–387. https://pubmed.ncbi.nlm.nih.gov/16758315/

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Disclaimer: This article was written as a guest post for Write Shift RN LLC's blog. The information in it may not be wholly fact-checked or edited, allowing the reader to see the writer's work and skills firsthand. This information is not intended as medical advice. It is for informational and educational purposes only. Always talk to your doctor or other qualified healthcare providers about any questions or concerns you may have regarding medical conditions.

Salt and High Blood Pressure: Myth or Truth?

Mon, 04 Sep 2023 20:10:05 GMT

Salt and High Blood Pressure: Myth or Truth?

Written by Nancy Ezebuiro

Medium portfolio

Salt is an age-long staple to diets and has various uses, from preserving food to adding flavor to meals. With how nutrition has evolved over the years, your viewpoint on how its consumption affects health must be well-informed.

High blood pressure, or hypertension, is a common medical condition that may lead to serious health problems left untreated. The relationship between salt and high blood pressure is one topic with misconceptions and arguments in food and wellness.

In this article, we will consider high blood pressure , the role of salt in the human body, and the link between salt consumption and blood pressure. We will also debunk myths about their relationship, examine other contributing factors, explore healthier alternatives for salt, and offer practical recommendations for managing your blood pressure through dietary changes.

Understanding High Blood Pressure

What is Blood Pressure?

Blood pressure (BP) is the pressure of circulating blood against blood vessel walls. Simply put, it measures the pressure of the blood in your arteries as your heart beats and relaxes.

Blood pressure is measured with a sphygmomanometer and expressed with two numbers like a fraction. The unit for measurement is millimeters of mercury. The top number, the systolic pressure, is the blood pressure in your arteries when your heart beats or contracts. The bottom number, the diastolic pressure, is the blood pressure in your arteries when your heart relaxes between each beat.

The Role of Salt in the Body

One interesting thing about the human body is that it self-regulates.

One of the ways that the body does this is through homeostasis - the process through which it maintains stability while adjusting to optimal conditions, especially when the external environment changes. The kidneys play a significant role in homeostasis by maintaining fluid levels and electrolyte balance. The kidneys also help regulate blood pressure by secreting hormones that constrict or relax the vessels responsible for transporting blood.

Salt is essential to the normal function of our body. It assists with muscle function and nerve transmission. It contributes to homeostasis by maintaining fluid balance and supporting the operation of the kidneys.

The Connection Between Salt and the Development of High Blood Pressure

It is not news that too much salt consumption is detrimental to your health. Some research has shown there may be a solid connection between salt and the development of high blood pressure.

Too much salt can increase the sodium in your bloodstream and disrupt the body's electrolyte balance. High sodium levels cause your body to retain more water and fluid to dilute and reduce it. Higher fluid levels and water in the blood increase the pressure exerted against the blood vessels' walls, raising the blood pressure.

This sequence of events potentially leads to hypertension - high blood pressure.

Debunking the Myth: Does Salt Directly Cause High Blood Pressure?

Certain historical perceptions show that increased salt consumption would contribute to the subsequent increases in blood pressure. However, recent studies and publications have demonstrated that the relationship between both is less direct.

Medical News Today highlights a recent study submitted at Experimental Biology 2017 that shows a different view of the sodium-hypertension relationship. Lynn Moore from Boston University School of Medicine and her team studied data across 2,632 adults aged 30-64 from the Framingham Offspring Study. The research showed that those with lower sodium intake (less than 2,500 mg/day) had higher blood pressure than those who had consumed higher quantities of sodium over 16 years. The findings were contrary to the general assumption about sodium consumption. Instead, they aligned and added to recent studies that showed a "J-shaped relationship" between cardiovascular risk and sodium intake. The growth curve indicated an exponential growth of risk of cardiovascular diseases regardless of the level of salt intake.

Here is the implication - a level of salt intake such as the one suggested by the World Health Organization (<5 g per day) is equally dangerous as a level >12 g per day. It also indicates that the recommendation for sodium intake may need to be revised.

This study also highlighted the importance of high potassium consumption on blood pressure and other cardiovascular diseases . Individuals with the lowest blood pressure had the highest intake of potassium and sodium and vice-versa.

Given the limited effect of sodium consumption on high blood pressure, dietary recommendations and guidelines may change subsequently. Genetics, age, lifestyle choices, BMI, and underlying health conditions are contributing factors that must also be considered.

The Impact of Other Factors on Blood Pressure

The research above suggests that excessively low and high salt consumption harms your health. As a result, it is essential to note that increased salt consumption is not the only cause of elevated blood pressure levels.

Focusing solely on limiting salt intake is insufficient in managing blood pressure, as increased salt consumption causes elevated blood pressure levels. Other factors should be considered as well, including:

Age
Genetics
Lifestyle choices
Stress management
Underlying health conditions

Age and Genetics:

Research has shown that blood pressure tends to rise with age. Genetics and family history also greatly influence every individual's propensity to high blood pressure.

Lifestyle choices:

Negative lifestyle changes, such as excessive alcohol intake and smoking, significantly elevate blood pressure.

Smoking constricts the blood vessels and increases heart rate. By raising blood pressure, the risk of potential heart failure increases.

Positive lifestyle choices like eating healthy and exercising can help lower blood pressure and improve an individual's overall health.

Potassium consumption also plays an essential role in regulating blood pressure. Hence, a well-rounded diet would include potassium-rich foods.

Stress management :

Long-term stress may contribute to sustained high blood pressure. Short and sustained blood pressure spikes can lead to heart attacks and strokes due to frequent dilation and constriction of blood vessels.

Underlying Health Conditions:

Underlying health conditions like kidney diseases, diabetes, and hormonal disorders can impact blood pressure levels.

Alternative Seasonings and Flavor Enhancers to Replace Salt

Various herbs, spices, and flavorings are healthier alternatives to salt. Some of these include:

Herbs: These can be in the fresh or dried form (basil, parsley, cilantro)
Spices (cumin, turmeric, nutmeg)
Aromatic vegetables (onions, ginger, garlic, Bell peppers)

Tips for Reducing Your Salt Consumption

Here are some tips to help reduce your salt intake:

Lower your intake of packaged and processed frozen foods: Packaged foods such as meat, fruits, and vegetables usually contain added high-sodium seasonings and sauces used to preserve the foods. You can drain the brine (salty water) used to preserve canned foods and rinse the food thoroughly to remove excess salt. Incorporate fresh cuts of meat, fruits, and vegetables that do not contain sauces or seasonings in your diet.
Cook more often: Cooking at home gives you control over the seasonings used in your meals. It would also help reduce the intake of restaurant foods, which usually contain high sodium levels. When you decide to dine out, research extensively.
Use herbs and spices: Choose natural spices and herbs as an alternative to salt. These spices may be dried or fresh and add a lot of natural flavor to your meals.
Read food labels: Food labels usually include the dietary content of each product on the Nutrition Information Panel. Compare the dietary value of similar products.
Reduce the intake of sauces and packaged seasonings: Sauces used in making curry and dipping sauces usually contain significant amounts of salt. Ensure that you research well and take these sauces in minimal quantities, as some brands may have inscriptions that indicate they have "less salt or sodium" but are not "low in salt or sodium."

In conclusion, salt is not the only cause of high blood pressure. While salt intake reduction plays a significant role in a healthy lifestyle, it is only a small factor in managing blood pressure. Choosing a balanced approach to your nutrition and lifestyle would benefit blood pressure and overall health.

Always consult a health professional before making significant changes to your diet.

References

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Disclaimer: This article was written as a guest post for Write Shift RN LLC's blog. The information in it may not be wholly fact-checked or edited, allowing the reader to see the writer's work and skills firsthand. This information is not intended as medical advice. It is for informational and educational purposes only. Always talk to your doctor or other qualified healthcare providers about any questions or concerns you may have regarding medical conditions.

The dog days of summer have come and gone....Are you hydrated?

Sat, 19 Aug 2023 22:48:09 GMT

The dog days of summer have come and gone....Are you hydrated?

Written by Summer Bagley, RN

When the intense hot days of summer arrive, it can be easy to forget the need for adequate hydration. Rising temperatures and more time outside can quickly deplete our bodies' water reserves without us realizing it.

The human body is approximately 60% water . It is essential for life and the health of every cell in your body. Water assists with temperature regulation, circulatory function, and metabolism. Maintaining adequate levels of water in the body is crucial to optimally perform all these vital functions.

Conversely, long periods without adequate water can have signiﬁcant and life-threatening eﬀects on the body.

What is a healthy hydration zone?

The Natural Institutes of Health suggests:

For Men - 3 liters or 12.5 cups of water per day

For Women - 2.2 liters or 9 cups of water per day

Meeting daily hydration needs is critical because many body parts require large amounts of water to function optimally.

Drinking plenty of water before a workout, a workday, traveling, or spending excess time outdoors can also go far in managing your hydration health. In addition, end each day with an extra hydration boost as you prepare for a long stretch without water intake while you sleep.

Repeat the cycle by hydrating upon rising to start the day replenished.

Timers, electronic reminders, and keeping insulated bottles of water on hand wherever you go can help ensure you keep on target.

What is dehydration?

Dehydration is deﬁned as using or excreting more ﬂuids than one consumes, which is easy to do in warmer weather. Young children, older adults, and people with compromised immune systems are particularly at risk for dehydration.

The signs and symptoms of dehydration:

Dark-colored urine
Decrease urination
Constipation
Lightheadedness
Fatigue
Headache

These can all indicate you need to drink more fluid.

Not all ﬂuids are beneﬁcial, however.

Some fluids may increase your risk for dehydration, such as:

Coﬀee
Caﬀeinated Tea
Caﬀeinated Energy Drinks
Carbonated beverages

People often blame caffeine for causing dehydration. However, more recent studies have shown that low to moderate levels of caﬀeine have very little dehydrating eﬀects, perhaps debunking the long-held belief that caﬀeine is inherently dehydrating.

Alcohol, on the other hand, is very dehydrating due to its diuretic eﬀect on the kidneys. A diuretic is a substance that helps the body rid itself of extra ﬂuid and salt. According to Medical News Today , when consumed in large quantities, alcohol can have a signiﬁcant eﬀect on electrolyte balance, vitamin deﬁciencies, cardiovascular complications, and weakened immune systems.

When in doubt, drink water. Hydrate before you have the urge to drink.

Remember, you are ultimately in charge of keeping yourself in a healthy hydration zone.

Sources:

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Benefits of Exercise for Women

Thu, 10 Aug 2023 00:27:30 GMT

Benefits Of Exercise For Women

Written by Anthonia Okereke

Exercise is the active movement of the body to expend energy. It burns calories and maintains health and fitness.

I bet you know that exercise is good and improves well-being, but how often do you engage in it?

By the end of this article, you will see the immense benefits of exercise and have a stronger reason to block out time for it.

It can be tiring for women to have a consistent exercise routine due to:

Time constraints.
Family obligations.
Career pursuits.
Sickness.
Lack of motivation

These reasons are enough to make you remove exercise from your schedule or forget about it altogether.

Why should you exercise?

A 1988 to 2010 survey reported a spike in women who do not exercise. It rose from 19.1% to 51.7%.

A sedentary lifestyle has adverse consequences, such as increasing your risk of developing some diseases. This could be prevented with a more conscious attempt to exercise regularly.

Some benefits of exercise to women:

Weight loss

Being overweight or obese has increasingly become a global crisis.

The World Health Organisation states that almost 60% of European adults are obese or overweight. At the same time, The World Obesity Federation predicts that global obesity rates will rise to 18% in men and 21% in women by 2025.

A more worrisome prediction is that it will reach 51% by 2035. That means over half the world's population will be overweight or obese.

Certain things may increase your risk of gaining weight:

Moreover, the major things that can make you gain weight are:

Physical inactivity
Unhealthy eating habits as suggested by BMJ Open .

Simply put, eating more calories than you are burning off causes weight gain.

Some studies have indicated that being overweight or obese can put you at risk of developing some diseases , including cardiovascular disease and type II diabetes.

Despite these worrisome facts, the good news is regular exercise and a healthy diet may help you lose weight.

Brain Health

Exercise can boost your brain strength and aid you to think, learn, and problem-solve better.

It may promote new brain cell formation and improve cognitive abilities such as memory, focus, and reasoning.

According to Psychological Medicine , exercise can lower cognitive impairment risks such as Dementia and Alzheimer's by 28% and 45%, respectively.

Improved sleep

According to The National Heart, Lung, and Blood Institute , insufficient sleep could devastate physical and mental health over time.

Many studies show a person's sleep quality affects physical health and causes emotional irritability, depression, and low attention span.

Over time it could cause health concerns, such as hypertension , diabetes , and other endocrine disorders .

Fortunately, regular exercise improves sleep quality.

Much research on the effects of exercise on sleep quality supports this assertion, such as the one published in The Journal Of Maturitas on exercise enhancing sleep quality in middle-aged women.

Another study published in The Health Psychology suggested older adults with poor sleep quality due to physical inactivity could improve sleep quality with moderate-intensity exercise.

Cancer prevention

Exercise may reduce the incidence of cancer, especially colon and breast cancer.

More so, regular exercise may improve health even in established cancer cases.

According to the American Cancer Society , exercise is associated with a lower risk of several types of cancer, including:

breast cancer
prostate cancer
colon cancer
endometrial cancer
pancreatic cancer

Bone Strengthening

Exercise strengthens the bones as well as other tissue in the body.

It improves bone mineral density by increasing the rate at which new bone cells form, which can decrease the chances of a fracture.

Exercise can help prevent bone loss caused by lower estrogen levels in post-menopausal women. But you don't have to wait till after menopause to start exercising. Start now!

According to the National Institute of Arthritis and Musculoskeletal and Skin Disease , the best exercise for stronger bones are weight-bearing exercises that make you work against gravity like:

walking
hiking
jogging
climbing stairs
playing tennis
dancing
resistance exercise like weight lifting

Heart health

Recent findings have associated being active with a greater than 50% reduction in risk of death, as The American Journal Of Preventive Medicine suggested.

According to a report by The New England Journal Of Medicine , physically inactive middle-aged women who did less than 1 hr of exercise per week experienced a 52% increase in all causes of death, a doubling of heart disease-related deaths, and a 29% increase in cancer-related deaths than physically active women.

Diabetes prevention and management

Exercise could aid in preventing and managing diabetes and may improve glucose balance in the body. Regular exercise may improve how your body responds to insulin.

The American Journal Of Preventive Medicine confirmed physical activity in older adults with diabetes could be rewarding even if only done once a week.

The American Diabetes Association suggests adults with diabetes should indulge in both aerobic and resistance exercises.

Always talk to your healthcare provider before beginning any exercise routine, especially a rigorous one.

Increased productivity and positive outlook

A few minutes of exercise could improve mood, anxiety, focus, and concentration.

Many studies have confirmed that exercise can improve your mood, such as those published in The Brain Plasticity , The Journal Of Psychology , and The Journal Of Psychosomatic Research .

The American actress and model Bridget Moynahan may have spoken from experience when she said, "If you are healthy all around, you will feel better, and if you feel better, you will have a more positive outlook." It's all connected.

Ditch the excuses and exercise to give your brain the boost it needs to perform well.

Increased longevity

Exercising doesn't just improve your overall health and well-being but may help you live longer. Being physically active, regardless of the activity you are engaging in, is much better than not being active at all.

An article published in Circulation indicates exercising more than the recommended amount may have even more health benefits.

The current recommendations are 150 to 300 minutes of moderate activity or 75 to 150 minutes of vigorous exercise weekly.

I hope this article inspires you to exercise regularly to prioritize your health and well-being.

References

Uri, L. 2014, March. Obesity, Abdominal obesity, physical activity and caloric intake in US adults:1998-2010. The American Journal Of Medicine. https://www.who.int/news-room/fact-sheets/detail/physical-activity

Kluge H.H.P. 2022, March. Weltgesundheitsorganisation Regionalbüro für Europa. WHO European regional obesity report. n.d https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9107388/#bb0100

Bergstrom, A. 2001,June. Overnight as an avoidable cause of cancer in Europe. https://pubmed.ncbi.nlm.nih.gov/11169969/

Ni, M.A. 2004, August. Asian Pacific cohort studies, collaboration body mass index and cardiovascular disease in the Asia-Pacific region: an overview of 33 cohorts involving 31000 participants. International Journal Of Epidemiology. https://pubmed.ncbi.nlm.nih.gov/15105409/

Macon is, R.J. 2006, October. Body size and prostate cancer: systematic review & meta-regression analysis. Cancer Causes Control. https://pubmed.ncbi.nlm.nih.gov/16933050/

Hamer, M. 2009, January. Physical activity and risk of neurodegenerative disease: a systematic review of prospective evidence. Psychological Journal. https://pubmed.ncbi.nlm.nih.gov/18570697/

National Heart, Lung, and Blood Institute. 2022, June. Sleep deprivation and deficiency, how sleep affects your health. https://www.nhlbi.nih.gov/health/sleep-deprivation/health-effects

Michael, R.I. 2016, July. Why sleep is important for health: a psychoneuroimmunology perspective. Annual Review Of Psychology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4961463/

Jacob, A.R. 2027, June. Effect of exercise on sleep quality and insomnia in middle-aged women: A systematic review and meta-analysis of randomized controlled trials. Mauritas. https://pubmed.ncbi.nlm.nih.gov/28539176/

Matthew, P.B. 2012, September. Moderators and Mediators of Exercise-Induced Objective Sleep Improvements in Midlife and Older Adults with Sleep Complaints. Health Psychology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210555/

The Surgeon General Report. 2019, December. Bone health and osteoporosis. National Institute of Arthritis and Musculoskeletal & Skin Disease. http://catalog.niams.nih.gov/search/Exercise%20for%20bone%20strength%20

Jonathan M. 2004, Dec. Fitness versus physical activity patterns in predicting mortality in men. American Journal Of Preventive Medicine.

https://linkinghub.elsevier.com/retrieve/pii/S0002-9343(04)00622-9

Frank, B.H. 2004, December. Adiposity as compared with physical activity in predicting mortality among women. The New England Journal of Medicine. https://www.nejm.org/doi/10.1056/NEJMoa042135?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200www.ncbi.nlm.nih.gov

Katrina, L.P. 2018, November. Physical Activity Guidelines for Americans from the US Department of Health and Human Services. Circulation Cardiovascular Quality Outcome. https://pubmed.ncbi.nlm.nih.gov/15616204/

The American Diabetes Association Professional Practice Committee. 2022, January. Facilitating behaviour change and well-being to improve health outcomes: standards of medical care in diabetes. https://diabetesjournals.org/care/article-lookup/doi/10.2337/dc22-S005

Julia, C.B. 2017, March. The effects of acute exercise on mood, cognition, neurophysiology and neurochemical pathways: A review. Brain plasticity. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5928534/

Shing-Yu, C. 2019, January. Special Issue -Therapeutic benefits of physical activity for mood: A systematic review on the effects of exercise intensity, duration and modality. The Journal Of Psychology. https://www.researchgate.net/publication/328300714_Special_Issue_-_Therapeutic_Benefits_of_Physical_Activity_for_Mood_A_Systematic_Review_on_the_Effects_of_Exercise_Intensity_Duration_and_Modality

World Health Organisation. 2020, November. Every move counts towards better health. https://www.who.int/news/item/25-11-2020-every-move-counts-towards-better-health-says-who

World Health Organization. 2022, October. Physical Activity. https://www.who.int/news-room/fact-sheets/detail/physical-activity

American Cancer Society. June 2020. American Cancer Society guidelines for diet and physical activity.American Cancer Society Journal. https://www.cancer.org/cancer/risk-prevention/diet-physical-activity/acs-guidelines-nutrition-physical-activity-cancer-prevention/guidelines.html

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

How to support your loved one through their first year of nursing.

Mon, 31 Jul 2023 23:43:22 GMT

Support your loved one through their first year of nursing.

Written by Kristen Westphal, RN, HSN, BSN

Did you think supporting your loved one through nursing school was challenging? Well, here you go by their side for their first year as a nurse. Make sure you buckle up because the first year as a nurse can be just as grueling.

If you need support as a new nurse, share this with your loved ones, and know that you are not alone during this season.

Shift Work

A new nurse's pace is usually slower than they would like, and often that means falling behind on tasks and charting. Many nurses work exhausting 12-hour shifts. Overnight 7 pm to 7 am shifts are common amongst new nurses.

These long shifts take a toll on mental and physical stamina. Learning new concepts and practicing tasks can be daunting for the first, second, or third time with little rest or sleep.

Nursing is mostly "learn as you go." New anxieties will likely arise during the first few years on the job.

Imposter Syndrome

Some nurses can experience imposter syndrome, especially during the first few years of practice.

Imposter syndrome manifests internally and is related to the pretense of not having the overall knowledge and ability needed to do tasks within their scope of practice.

This syndrome can correlate with anxiety, depression, and mental stress, contributing to career-related burnout. Learn more about imposter syndrome .

How to support your loved one

Supporting a loved one can look different from person to person.

You may already know what makes this particular person in your life tick, what soothes their soul and fills their bucket. One idea is dropping off their favorite beverage at their new place of employment.

Why not pick up a box of coffee and some treats for their shift buddies?

Such a gesture can help your new nurse become part of their team and encourage new friendships to bloom. Sharing goodies with their coworkers can encourage a willingness for future collaboration and teamwork.

When your new nurse needs assistance, coworkers will remember someone went out of their way for them to do something nice and be willing to do the same in return.

Here are a few more ideas I've formulated to assist you in getting a head start. Be sure you tailor the support for the nurse in your life.

● Run a bath for your new nurse after a long shift.

● Encourage them to be very involved in their self-care.

● Extend an ear to hear out how their day was. Listen to their struggles and resist the urge to have the answers.

● Encourage them to seek mental health assistance when needed.

Summary

As a nurse, I find myself on the precipice of engaging with my niece as she embarks on taking the NCLEX and starting her career. I hope to add encouragement during her journey and support her in any way I can.

The stress of becoming a new nurse while learning the ropes during the first year is a challenging feat to embark on. An encouraging team of loved ones can make all the difference to the new graduate nurses in your life. Many nurses have stories of how it can be soul-crushing while learning the ropes during the first year of nursing.

Caring for a caregiver in your life is not always smooth sailing during the first year of nursing, but the payback will be tenfold.

Sources:

https://www.ncbi.nlm.nih.gov

https://health.clevelandclinic.org/a-psychologist-explains-how-to-deal-with-imposter-syndrome/ [KVW9]

Kristen Westphal, RN, HSN, BSN is a new nurse after working as a flight attendant for 23 years. She describes becoming a nurse as the best decision she has made. Kristen lives in Chicago and works as a school nurse for Chicago Public Schools. She works as a freelance health content writer during her free time. Her true joy comes from adventuring out of the big city and into nature with her best four-legged friend, Wilson.

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

How to Enjoy Life After a Mastectomy

Thu, 06 Jul 2023 22:22:30 GMT

How to Enjoy Life After a Mastectomy

Written by Cheri Coles

Unquestionably, there's no instant cure for enjoying life after a mastectomy.

In fact, the journey begins before the actual surgery.

Once you've been informed that all other alternatives have been exhausted and breast removal is the only option, you experience an overflow of emotions.

Then, the questions come:

What will my life be like?
How do I tell my family?
Will I want others to see me after my breasts are gone?
Will I still be beautiful?

These are all normal reactions.

But there's still more to come.

The doctor will advise on follow-up treatment, wound care, diet, and exercise protocols before you leave the hospital.

As with all other major surgeries, you will go through a healing process.

This could include symptoms like:

Pain
Swelling
Numbness
Other physical challenges
Emotional struggles

Before going any further, it's important to note the reason behind the procedure.

Breast Cancer Caused the Mastectomy

Breast cancer is the underlying cause of having a mastectomy.

The CDC defines breast cancer as "a disease in which cells in the breast grow out of control."

Please understand that breast cancer is usually treatable, especially if discovered early.

But finding the disease requires having a routine diagnostic test, such as a mammogram .

Unfortunately, earlier detection doesn't necessarily mean the treatment will be successful.

There are different types of breast cancers, and some are more aggressive than others.

Now that you have some background on the cause of the mastectomy, one question remains.

What is a mastectomy?

A Mastectomy Changes Your Life

A mastectomy is a surgery where one or both breasts are removed. Depending on your circumstances, the doctor will remove all or part of a breast.

A mastectomy may be performed as a treatment for certain types of breast cancer.

It could also be done as a precaution when there is an increased risk of developing breast cancer.

Before your hospitalization, you and your specialist will discuss the different types of breast reconstruction methods that are available. And you will choose the one that best suits your needs.

Now that you've had the surgery and are going home, what happens next?

At first, you will probably focus on managing the post-surgical experience's medical aspect.

However, after a few weeks, reality sets in.

You just experienced a major life change!

Needs to Address After a Mastectomy

Several needs should be addressed after having a mastectomy.

Attending to these parts of your life could help you gain a positive outlook on your new life's journey and restore your emotional and physical well-being.

Meet Regularly with a Therapist

It's common for depression, sadness, and fear to arise after a mastectomy.

A therapist can help you express your feelings and gain insight into coping strategies.

Of course, your body might look different. And it could make you feel you've lost your femininity or sex appeal. You may need time to adjust to having implants instead of your natural breasts.

Your relationships could also become challenging. You may experience emotional highs and lows about intimacy.

You may be embarrassed by scars, especially if they are keloids.

A further adjustment is accepting your inability to do the same activities you were able to do before the surgery.

Join a Support Group

A support group would allow you to engage with others in similar situations.

It's not always easy to express your deepest thoughts and feelings to your close family and friends, especially those who don't know the extent of what you're going through.

However, within a support group, you'll find women with first-hand experience with what's happening to you physically and emotionally. And they will not judge you.

Have a Discussion with Your Family

Consider sitting down with your family to discuss the outcome of this life-changing event and how it will affect the household.

You may want to ask the other family members to take on duties they aren't used to doing.

Counseling is also available for families trying to understand and cope with the effects of an illness.

Couples therapy can help, as well, to address problems with intimacy.

You and your significant other may need to go over the finances together.

Additional supports, such as a cleaning service or childcare, may need to be added to the budget. Additionally, the costs of special bras and other supplies are another consideration.

Ask Nearby Family and Friends for Help

You may want to enlist the assistance of nearby family and friends.

Having someone else to do things like grocery shopping or picking up the kids would give you time to concentrate on medical appointments, pain management, and other activities associated with your recovery.

Explore a New Hobby

Exploring a new hobby or pursuing an old-forgotten passion might help you to relax.

For instance, maybe you always wanted to paint, or you love to read but never found the time. This could be the perfect opportunity to use your creative energy to lift yourself up.

Final Thoughts

Self-care is vital when you want to enjoy life after a mastectomy. And this includes addressing all unmet needs.

Restorations and adjustments take time. You will need to exercise patience throughout your entire journey.

Your body may never be the same as it was before the surgery. But that doesn't mean you can't enjoy your new life.

It might come with challenges. So why not celebrate the accomplishments?

Your story may be the one the next woman needs to give her a glimmer of hope.

Your medical provider and other healthcare professionals should be able to assist with finding therapists in your local area.

The American Cancer Society has a 24-hour cancer helpline and can help you locate a support group. The organization also has loads of information and resources on its site.

Help is available. It simply takes the courage to ask for it so that you can begin to enjoy life after a mastectomy!

Sources:

What Is Breast Cancer? | CDC

Mammogram Procedure | Johns Hopkins Medicine

Mastectomy - Mayo Clinic

The Emotional Toll of a Mastectomy – Regional Cancer Care Associates

Find Support Programs and Services in Your Area (cancer.org)

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Is Sitting the New Smoking?

Mon, 26 Jun 2023 19:21:39 GMT

Is Sitting the New Smoking?

written by Summer Bagley, RN

This is a shocking statement to hear reported by authoritative sources over the last several years.

We all know how harmful smoking is to our health, but is there any weight to the statement that sitting can be just as bad?

According to Mayo Clinic, research has linked sitting for long periods with several health concerns, including obesity, high blood sugar, excess body fat around the waist, and unhealthy cholesterol levels . These risk factors all correlate to the number one cause of death in the U.S., heart disease .

More people have desk jobs, and we look at screens for hours daily. To add insult to injury, many Americans have an additional sedentary commute via car, bus, or train.

What is the opposite of inactivity?

Movement, action, motion, ﬂow, and exercise .

Movement has many mental and physical health beneﬁts , including:

improved brain health
better cognitive function
reduced risk of anxiety and depression
improved sleep
overall enhancement in quality of life

There are numerous ways to move our bodies.

Tips to help get you up and moving.

1) Set a timer for every 30 minutes. Take 5 minutes to walk, stretch or stand to get the blood and lymph moving in the body.

2) Purchase a standing desk for your home or the oﬃce to allow you to work standing or sitting. These can even be purchased second-hand at an aﬀordable price.

3) Use opportunities to move your body more, such as using the stairs, walking or biking to work, or walking on a treadmill while talking on the phone.

4) Ask a friend or co-worker to walk, hike, or run with you before or after work for accountability.

5) Invest in a treadmill or stationary bike for your work or home space to get more movement when possible.

6) Take a dance class.

Dancing is not only a fun way to accomplish this goal but has also been studied for its health beneﬁts. According to a research study by Frontiers in Psychology , dancing may:

improve emotional health.
reduce stress hormones.
release dopamine.
increase serotonin levels.

This might explain the popularity of health club classes such as Zumba, Dance Yoga, and hip-hop, to name a few. Not only are you moving your body, but you are also releasing feel-good hormones, such as dopamine, into your body, boosting energy and your emotional state.

Summary

We all know how much better we feel after movement. It’s just as crucial for our mental wellbeing as our physical health.

While movement might feel overwhelming or difficult to work into your routine, the beneﬁts you receive will far outweigh the brief resistance to change. Choosing small steps towards better health and increased activity can bring big payoﬀs over time.

Movement is deﬁnitely the new healthy.

Here’s to your health and being more active!

Sources:

FastStats - Leading Causes of Death (cdc.gov)

Frontiers | Engagement in dance is associated with emotional competence in interplay with others (frontiersin.org)

Sitting risks: How harmful is too much sitting? - Mayo Clinic

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

BMI and Health: Should we still bother about the number?

Tue, 20 Jun 2023 18:35:37 GMT

BMI and Health: Should we still bother about the number?

Written by Timilehin Olaniyan

There is no perfect number for a "healthy weight" for all people. Everyone is different, and the right weight will be different depending on the person," fitness trainer and coach Arabella Featherstone declares.

Medicine uses figures to assess health and measure risks, and the BMI (Body Mass Index) is one of those figures. But for these numbers to make sense, they must be inclusive.

Simply put, the BMI is a measurement that uses weight and height to classify an individual as underweight, normal weight, overweight, or obese. Clinicians use BMI to assess a patient's risk for diseases.

However, the integrity of BMI in predicting an individual's state of health is on trial. What are the limitations of BMI, and how should we use BMI?

What does BMI mean?

BMI is a standard metric for measuring overall wellness via weight status.

To calculate your BMI at home, measure your height and weight using a scale and use one of the formulas below to get your BMI:

Metric units: weight (kilogram) divided by height squared (meters)

BMI = kg/m2

Imperial units: weight (pounds) divided by height squared (inches) multiplied by 703

BMI = 703 (lbs/in2)

Alternatively, you can use a BMI calculator, like the one provided by the National Institutes of Health (NIH). Once you calculate your BMI, you can compare the figure with the standard in the scale below to know where you fall.

In fairness to Lambert Adolphe Jacques Quetelet, the mathematician who developed BMI, he used it as a tool for population studies. That is, the numbers may not be ideal for individuals.

The medical community frequently uses it to mirror a patient's health status, but concerns are growing about its reliability and suitability.

Should we still rely on BMI? Experts weigh in.

BMI puts the normal weight between 18.5 to 24.9kg/m2. That means any figure above or below this range is "abnormal." In fairness to BMI, several studies conclude that people with a BMI that falls outside this normal range have an increased risk of certain diseases.

An article by the NIH identifies some health risks of being overweight and obese as

heart disease
stroke
diabetes
sleep apnea
kidney diseases
and more.

These are some of the most common chronic conditions, so the attention that BMI gets is understandable. And most times, BMI measurement is a routine check in the hospital.

But is BMI worth the hype?

Experts don't think so.

Experts Identify some limitations.

It doesn't factor in other things that contribute to health.

"The number does not tell the full story about a person's presence or absence of disease, nor does it actually tell the story of a person's health," says Wendy Schofer, a pediatrician and weight coach.

Schofer encourages her patients and community clients to see health as a dynamic, ongoing process. She focuses on the history and functional assessment instead of the BMI.

"We all have health, not defined by a number or an action. We have health at all sizes and body shapes," Schofer explains.

Michael Green, a board-certified obstetrician-gynecologist with the Northridge Medical Center, expresses a similar opinion. Green believes that BMI falls short of addressing every individual's unique makeup.

For instance, men have more muscle mass and less fat mass than women, but BMI uses the same scale for both genders. Similarly, BMI doesn't factor in that muscle mass declines with age while fat mass increases. And scientists believe that a higher BMI protects older adults against diseases.

It doesn't differentiate between types of body mass.

Body mass includes muscle, fat, water, and mineral. And the most important health risk determiner is fat mass. Unfortunately, the BMI doesn't directly calculate the percentage of fat.

So athletes or people with a higher muscle mass having low body fat may be wrongly categorized on the scale. So a bodybuilder who looks huge may weigh the same as another person who doesn't build muscle but has more fat.

It gives no information about body fat location.

BMI assumes excess fat deposition in any area of the body portends danger. However, that's flawed. In the real sense, fat deposits in the upper regions of the body, like the stomach, are the real concern.

Those who store fat in the lower areas are less likely to be at risk of chronic diseases.

Healthline says fat accumulating in the abdominal cavity, visceral fat, is dangerous.

Essentially, not all fat is dangerous as BMI wants us to believe.

It disregards race

Quetelet used a sample of White European men for his calculation. However, these cut-off points are accepted globally, neglecting our different body compositions and changing demographics.

But the World Health Organization (WHO) has since adjusted the scale for people of Asia due to more incidences of obesity at lower BMI. But that doesn't solve the problem since individual differences still exist. Moreover, these alterations do not mirror the realities of other races.

While we can't ignore BMI, a unique scale for each race may be more beneficial to stem the incidences of misdiagnosis.

How should we use BMI?

Schofer argues BMI doesn't contribute to the assessment of health at all. She contends that focusing on risk isn't helping individuals struggling with their weight.

"And we tend to overly focus on risk instead of looking at an individual's health status. The last thing my patients and clients with higher BMI want to hear about is their risk of diseases," she concludes.

However, Tara Scott, MD, believes BMI can be a starting point to assess clinical disease risk.

Like other health measures, BMI cannot be used as a single health measure. Instead, it gives more information about the future than the current state of health.

Conclusion

We can't trash BMI, but we can alter our approach.

Knowing your BMI is as important as knowing its limitations. And health professionals should apply more caution when counseling people because there is no perfect number for a healthy weight for all people.

Sources:

Ana Gotter. (2021). Visceral fat. https://www.healthline.com/health/visceral-fat

Connor B, et al. (2022). BMI classification percentile and cut off points. https://www.ncbi.nlm.nih.gov/books/NBK541070/

National Institutes of Health. https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm

National Institute of Diabetes and Digestive and Kidney Disease. (2017). Health risks of overweight and obesity. https://www.niddk.nih.gov/health-information/weight-management/adult-overweight-obesity/health-risks

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Bipolar Disorder and Light Therapy: What You Need to Know.

Fri, 02 Jun 2023 19:29:40 GMT

Bipolar Disorder and Light Therapy: What You Need to Know.

Written by Timilehin Olaniyan

The exact cause of Bipolar Disorder (BD) is still unclear.
Investigators say genetics, brain structure, and chemical imbalance are risk factors.
Some evidence suggests light therapy improves depression symptoms in BD.
Bright light treatment (BLT) doesn't affect the remission rate in patients.
Experts don't know the exact mechanism and the effective light strategy remains elusive.

For decades, researchers have sought to unravel the exact cause of bipolar disorder and treatment options. They have turned to genetics, the brain, and even neurotransmitters for answers.

Do scientists have definitive answers? Not yet.

Do they know better than they used to? Definitely.

What causes the mental illness is yet to be fully understood. And research on treatment options is still developing.

This article discusses BD, the causes, and the effects of light therapy on BD.

What is bipolar disorder?

BD is a mental illness associated with alternating periods of lows (or depression) and highs (mania). That is, patients experience symptoms of depression and mania.

During a depressive episode, the person is sad, irritable, and hopeless. They often lose interest in activities they would typically do. This feeling usually persists for days if not treated.

On the other hand, a manic episode features more-than-normal excitement, energy, and talkativeness. At this phase, a patient may be impulsive and find sleeping difficult.

It's important to mention that the everyday ups and downs that an average person experiences are not the same as BD. In BD, the mood swings are extreme and last for days without interventions.

The illness may also affect your relationships with people and impair your thinking and daily activities.

In fact, it's one of the leading causes of disability worldwide. It usually develops during the teenage years or early 20s.

What are the symptoms of bipolar disorder?

BD patients experience two sets of symptoms: depression and mania.

Depression symptoms include:

extreme sadness
loss of energy
sleeping issues
poor concentration and decision making
feelings of hopelessness
eating problems and weight loss
death/suicide

Manic symptoms are:

uncontrollable happiness
excessive self-esteem
difficulty concentrating
extreme irritability
hallucinations (seeing or hearing things that don't exist)
unrealistic beliefs
incoherent thoughts

What causes bipolar disorder?

The underlying cause of the illness is unknown, but several theories have been put forward as to what causes it.

Scientists say it results from a complex interaction of a few risk factors.

These risk factors include:

genetics
altered brain structure
chemical imbalance

How does genetics affect bipolar disorder?

It's long been suspected that BD is hereditary, and evidence supporting the genetics theory continues growing.

Twin studies found that genetics accounts for 60-80% of BD cases.

For a long time, scientists didn't attribute BD to any gene in particular. However, that's changing as evidence continues to finger a specific gene. For instance, new research led by scientists at the Stanley Center for Psychiatric Research spotlights the genetics of BD yet again. The researchers compared 1400 patients with an equal number of healthy controls and found that patients were more likely to carry altered variants of a gene called AKAP11.

In their words, "this analysis revealed rare protein-truncating variants in the AKAP11 gene that raise disease risk several-fold, making it the strongest genetic risk factor found for BD to date."

Does the brain structure have a link?

Studies conclude that the brain structure is slightly altered in BD patients.

However, experts do not know if changes to brain structure cause BD or if it happens because of the condition.

In BD, the gray matter and hippocampus are parts of the brain usually affected. These two are concerned with emotions and memory.

A 2017 MRI study that included 6,503 participants showed that people with BD had less gray matter in the brain when compared with healthy subjects. Similarly, people with this condition have been found to have a diminished hippocampus. This was the finding of a 2016 research that included 133 patients.

Nevertheless, more research is still needed to understand the link fully.

What's the role of neurotransmitters?

Neurotransmitters influence our thoughts, moods, and emotions. So it's not abnormal that scientists have turned to them for answers.

Neurotransmitters play an active role in the development of some mental illnesses. In the case of BD, norepinephrine (or noradrenaline) and serotonin are thought to play a role.

Norepinephrine (NE)

Norepinephrine influences alertness, anxiety, memory, and focus.

Research indicates that low and high levels of NE trigger depression and mania, respectively.

Light therapy offers some prospects for the treatment of bipolar therapy.

Research is still developing; there is some proof that bright light therapy (BLT) helps improve depression symptoms.

BLT has long been used in seasonal affective disorder (SAD), a type of depression due to seasonal changes. Now its efficacy in BD is under investigation.

One meta-analysis of four randomized control trial s (RCTs) provides two major insights:

BLT improved depression symptoms in bipolar patients.
However, it didn't affect the remission rate.

The analysis involved 190 participants (94 patients and 96 control) exposed to varied light intensity, color temperature of light, duration, and exposure.

The researchers say the most efficient light parameter is unknown, but they suggest that light therapy in the morning is better.

Also, the four RCTs analyzed used light therapy as an adjunct, as most patients involved were on antidepressants or mood stabilizers. That means its efficacy as a monotherapy needs probing.

The bottom line

BD is a disabling condition that affects virtually all aspects of your life. It's associated with symptoms of depression and mania.

The main treatment options include medications and psychotherapy. However, there's growing evidence that light therapy may help.

Sources:

Berit K, (2014). Genetics of bipolar disorder. DOI: https://doi.org/10.2147%2FTACG.S39297

Cleveland Clinic. What is seasonal affective disorder? https://my.clevelandclinic.org/health/diseases/9293-seasonal-depression

Cristina C, et al. (2012). Bipolar disorder. DOI: https://doi.org/10.1155%2F2012%2F525837

Hirofumi Hirakawa, et al. (2020). Adjunctive bright light therapy for treating bipolar depression: A systematic review and meta-analysis of randomized controlled trials. DOI: https://doi.org/10.1002/brb3.1876

Masatake K, (2016). Noradrenaline plays a critical role in the switch to a manic episode and treatment of a depressive episode. DOI: https://doi.org/10.2147%2FNDT.S109835

Parts of the brain's hippocampus are diminished in size in people with bipolar disorder. [Story]. (2017). https://www.bbrfoundation.org/content/parts-brain%E2%80%99s-hippocampus-are-diminished-size-people-bipolar-disorder

Researchers find first strong genetic risk factor for bipolar disorder. [News]. (2022). https://www.broadinstitute.org/news/researchers-find-first-strong-genetic-risk-factor-bipolar-disorder

Researchers create a roadmap of bipolar disorder and how it affects the brain. [USC News]. (2017).

https://news.usc.edu/120776/researchers-create-roadmap-of-bipolar-disorder-and-how-it-affects-the-brain/#:~:text=Bipolar%20patients%20tend%20to%20have,are%20normal%20(gray%20colors) .

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

What are Herbal Supplements?

Wed, 31 May 2023 23:17:20 GMT

What are Herbal Supplements?

Written by Kolawole Olawuwo

Herbal supplements are dietary supplements obtained from medicinal plants and used to prevent and treat illnesses .

Herbs and supplements are traditional medicine taken into the body as food. Herbs are plant-based, while supplements can contain a variety of dietary ingredients. They are consumed to enhance health and well-being and are available in various forms.

Plant-based medicine, commonly known as "Herbs," can be consumed as fresh or dried, as a tea or infusion, or as an ingredient in food or nutritional supplement. Supplements are available in various forms, including tablets, capsules, soft gels, powders, liquids, and gummies.

Various medications, both prescription and over-the-counter, are derived from plant sources . However, these medications are composed of refined and purified components and are subject to regulation by the FDA. In contrast, herbal supplements may comprise whole plants or plants fragmented and are not regulated by the FDA.

What are some of the most common herbal supplements?

Many herbal supplements are available in various forms, such as liquids, gummies, and powders . Below is a list of the most sought-after herbal supplements.

• Echinacea

• Garlic

• St. John's Wort

• Turmeric

• Ginseng

• Valerian root

• Gingko Biloba

• Saw Palmetto

Benefits of Taking Herbs and Supplements

People have used herbs and other natural resources to treat illnesses and feel better for thousands of years. It turns out that herbal medicines really do work, which means the ancient folks who used them might have known what they were doing! Here are some of the benefits of taking herbal supplements:

1. Herbal Supplements may Strengthen the Immune System:

Herbal supplements can help strengthen the immune system by protecting the body against infection.

If you're looking for a natural way to support your immune system, consider adding herbs to your diet. Some herbs, such as echinacea and garlic , have been shown to enhance the immune system and help reduce the risk of illness . Incorporating these herbs into your routine may give your body an extra line of defense against harmful germs and bacteria.

2. Herbal Supplements may Aid digestion:

Some Herbal supplements have been used for centuries to support gut health and improve digestion and may offer some relief if you're experiencing digestive problems. Traditional approaches to wellness and natural remedies for a healthier gut have become increasingly popular in recent years , whether through herbs or other natural supplements.

3. Herbal Supplements may Improve Mental Health:

Common examples of herbs that improve mental health include

St. John's Wort can reduce the symptoms of anxiety and depression by raising serotonin levels in the brain .
Ginseng can enhance focus, lessen fatigue, and lift mood .
Valerian root is a natural sedative that can help with insomnia and anxiety by raising GABA levels in the brain .
Ashwagandha can also increase GABA levels in the brain and reduce the symptoms of anxiety and depression .

4. Herbal Supplements may Help Regulate Blood Sugar:

Herbs such as Aloe Vera, Cinnamon, Milk Thistle, Ginger, and Fenugreek may be alternative therapies for Type 2 diabetes.

Always talk to your doctor before taking herbs or supplements to control your blood sugar, and always talk you your doctor before discontinuing your prescribed diabetes treatments.

5. Herbal Supplements may Reduce Inflammation:

Some herbs and spices contain anti-inflammatory chemicals, which may help your general well-being by reducing inflammation . Anti-inflammatory herbs may include:

garlic
ginger
turmeric
black pepper
cinnamon

Potential Risks and Side Effects

While herbs and supplements have many benefits, it is crucial to be aware of their potential risks and side effects. Here are some possible negative effects of using herbs and supplements:

• Allergic reactions: Some people may be allergic to certain herbs or supplements, which can cause symptoms like rashes, hives, or difficulty breathing.

• Toxicity: Herbs and supplements may be toxic if taken in large amounts for an extended period of time.

• Hormonal Imbalances: Some herbs and supplements can affect the hormone levels in the body, which can lead to side effects like acne, mood swings, or changes in menstrual cycles.

• Digestive issues: Some herbs and supplements may cause digestive problems like nausea, diarrhea, or constipation.

It's important to remember that the risks and side effects of herbs and supplements can vary depending on the individual, the herb or supplement in question, and the dosage and duration of use.

Herbs and supplements can also interfere with any prescription medications you are taking. They can decrease their efficacy, or the combination of the two may be harmful.

Always consult a healthcare provider before starting a new herb or supplement to discuss potential risks and side effects and ensure it is safe and appropriate for use.

Safe use of Herbs and Supplements

Safety guidelines for taking herbs and supplements include the following:

• Consult a healthcare provider: Before taking any herbs or supplements, it is essential to talk to your healthcare provider , especially if you are taking any medications, have a medical condition, or are pregnant or breastfeeding.

• Research the product: Do some research to ensure that the herbs or supplements you are considering are safe and effective. Look for reputable sources of information, such as government health agencies, medical institutions, and professional associations.

• Read the label: Always read the label carefully before taking any herbs or supplements. Check the dosage recommendations, ingredients, and any warnings or precautions.

• Start with a low dose: Start with a low dose of herbs or supplements and gradually increase the dosage as needed. This helps minimize the risks of side effects.

• Avoid taking too much: Too many or high doses of herbs or supplements can be harmful. Instead, follow the recommended dosage guidelines and do not exceed the recommended dosage.

• Report any adverse reactions: If you experience any adverse reactions or side effects from taking herbs or supplements, stop taking them immediately and contact your doctor.

SOURCES/CITATIONS

https://www.hopkinsmedicine.org/health/wellness-and-prevention/herbal-medicine

https://www.webmd.com/vitamins-and-supplements/ss/slideshow-herbs-supplements-avoid

https://www.ncbi.nlm.nih.gov/books/NBK536964/

Dietary Supplements: What You Need to Know - Consumer (nih.gov)

St. John's wort - Mayo Clinic

Valerian | NCCIH (nih.gov)

12 Benefits of Ginkgo Biloba (Plus Side Effects & Dosage) (healthline.com)

Ginseng: Health benefits, facts, and research (medicalnewstoday.com)

SAW PALMETTO: Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews (webmd.com) Echinacea | NCCIH (nih.gov)

10 Proven Health BeGARLIC: Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews (webmd.com)benefits of Turmeric and Curcumin (healthline.com)

The growing use of herbal medicines: issues relating to adverse reactions and challenges in monitoring safety - PMC (nih.gov)

9 Most Powerful Medicinal Plants and Herbs, Backed by Science (healthline.com)

St. John's Wort and Depression: In Depth | NCCIH (nih.gov)

8 Ways Ginseng Works for Memory and Brain Health | Be Brain Fit

Valerian: How Does It Help You Relax and Get Better Sleep? (healthline.com)

Effects of Withania somnifera (Ashwagandha) on Stress and the Stress-Related Neuropsychiatric Disorders Anxiety, Depression, and Insomnia - PMC (nih.gov)

Diagnosis and Classification of Diabetes Mellitus - PMC (nih.gov)

Type 2 diabetes: Using herbs and supplements (medicalnewstoday.com)

What to Know Before You Take Herbal Supplements (webmd.com)

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Could Breast Cancer Screening be Improved with the Help of Artificial Intelligence?

Fri, 26 May 2023 23:03:01 GMT

Could Breast Cancer Screening be Improved with the Help of Artificial Intelligence?

Written by Pamela Wirth, PhD

Breast cancer is the most diagnosed cancer in the United States, with over 200,000 new cases each year.

Mammograms, which are X-rays of breast tissue, are routinely used to screen patients for breast cancer.

After the radiologist checks the X-ray, they may order more testing if needed. If the radiologist sees an unusual spot on the X-ray, surgery may be needed to remove the area. This is called a biopsy.

The lab will create a microscopic slide from this tissue for the pathologist to review. Pathologists may look at 200-300 slides under the microscope each day. While incorrect diagnoses by pathologists are rare, 1-2% of cases may be given the wrong diagnosis [1].

The use of artificial intelligence (AI) to help reduce the work of pathologists is being explored by several labs . AI Systems are machines that replace the need for humans and can help doctors with their daily tasks.

The most common AI system in the pathology laboratory is a digital slide scanner. Doctors use digital slide scanners to share tissue images with others worldwide without sending valuable slides through the mail [2].

Preparing the digital slide scanner requires loading a set of slides onto the machine, and creating a detailed picture of the specimen. These machines can be “trained” using a large set of existing slides that several pathologists have already evaluated.

Machine software teaches the machine how to find key features in these slide sets that are normal or diseased. Based on this first set of data, the machine will then be able to recognize the same features in new tissues. As more biopsy data is added to the system, the machine becomes better at reading slides [3].

Newer pathologists may benefit the most from this technology as they are more likely to miss important details in a specimen.

About 40% of women in the United States have dense breast tissue, which can be difficult to diagnose since these normal tissue areas can mimic cancer on an X-ray. These patients are often asked to return to the doctor’s office for more screening or testing.

AI systems may be able to separate those patients into groups that need more testing versus those that do not [4].

While AI systems are promising, their use is limited in the United States until more data becomes available.

Sources:

Dileep G, Gianchandani Gyani SG. Artificial Intelligence in Breast Cancer Screening and Diagnosis. Cureus. 2022;14(10):e30318. Published 2022 Oct 15. doi:10.7759/cureus.30318
Madabhushi A, Doyle S, Lee G, et al. Integrated diagnostics: a conceptual framework with examples. Clin Chem Lab Med. 2010;48(7):989-998. doi:10.1515/CCLM.2010.193
Pallua JD, Brunner A, Zelger B, Schirmer M, Haybaeck J. The future of pathology is digital. Pathol Res Pract. 2020;216(9):153040. doi:10.1016/j.prp.2020.153040
How GE Healthcare and Intel and AI are Optimizing Cancer Screening of Dense Breast. GE Healthcare. Accessed January/ 01/2023. https://www.gehealthcare.com/

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Immune Checkpoint Inhibitors

Sat, 29 Apr 2023 21:50:49 GMT

How Immune Checkpoint Inhibitors Work and the Effect on Your Body

Written by Jill Squire, BSN, RN, OCN

This article aims to help you understand

How checkpoint inhibitor immunotherapy works with your immune system to help your body fight cancer
The importance of informing your cancer care team immediately of any changes you experience

The Difference Between Immunotherapy and Chemotherapy

Immunotherapy has revolutionized cancer care over the past two and one-half decades. As part of cancer treatment, immunotherapy may be used by itself or in various combinations with surgical, chemotherapy, or radiation therapy.

Immunotherapy is different from chemotherapy.

Cancer cells typically rapidly replicate or reproduce.

Chemotherapy attacks rapidly multiplying cells in your body to eradicate cancer cells. Chemotherapy will often affect quickly replicating normal cells, such as your hair and the lining of your intestines, causing many of the symptoms we associate with chemotherapy.

Immunotherapy works with your immune system to recognize and destroy cancer cells.

There are several varieties of immunotherapy, and they each work in different ways. One is not necessarily better than the other for fighting your cancer; an immunotherapy treatment decision depends on several factors, including your cancer cell type.

A few words on cancer treatment planning

Some cancer treatment plans combine chemotherapy and immunotherapy, other combinations may include radiation or surgery, and some may consist of only one treatment type.

The treatment decisions depend on several factors unique to each individual, including:

past medical history
current overall health
current medical conditions
to what areas of the body the cancer has spread
how deep the cancer is embedded
with what critical organs the cancer is entwined or near
the cancer cell type
the aggressiveness of the cancer
chance of recovery from treatment
ability to tolerate a treatment

Consider this is your life and future steps forward. Embrace speaking up for yourself and understanding your treatment plan. You and your doctor can discuss all of the above factors to decide on your goal of treatment (Mayo Clinic, 2021):

cure
control of the cancer (which may be for several years), with a good quality of life
comfort

Some keys to success with cancer treatment

There are some relatively simple things you can do that may have a positive impact on how well you do through your treatment and your goal of cancer treatment:

● Consider writing down the various parts of your treatment plan and each part's timing.

● Keep a cancer care journal to help you be an active part of your healthcare team.

● Read and review the information about your treatment and cancer that your healthcare team gave you.

● Write your questions in your journal about your

○ treatment plan

○ medications

○ cancer

○ symptoms and managing symptoms

○ financial concerns with treatment in your journal

○ diagnostic testing schedules

○ treatment and doctor office locations

○ insurance coverage

● Note the answers to your questions in your journal

● Maintain your health to the best of your ability with exercise cleared by your doctor, regular sleep, and a good diet (CDCBreastCancer, 2022).

● Wash your hands often before touching your face or eating to avoid illness; avoid sick people and crowds (CDCBreastCancer, 2022).

● Understand your insurance benefits and ensure you are with in-network providers to avoid large bills, which avoids some stress. Member service for your health insurance can assist you. Consider requesting a case manager from your health insurance company.

A brief schooling on the white blood cells of your immune system

White blood cells find and attack foreign organisms in your body. Several types of white blood cells form this pillar of your immune system (Cleveland Clinic, 2021). They are a motley but effective crew:

Neutrophils – go into dark places without fear, killing bacteria, fungi, and foreign matter
Lymphocytes – these Special Ops cells fight viruses and produce proteins to help your body combat infections; they are the mighty T Cells and B Cells
Eosinophils – think of eosinophils as your exterminator; they find and destroy scary parasites and cancer cells; they might help out the basophils here and there.
Basophils – go after the allergens and cause inflammatory responses of coughs, sneezes, and runny noses (tell your desk-mate next time you sniff that it is your basophils' fault)
Monocytes - the kindly custodians, defend against infection by sweeping up those damaged cells

Are you ready? We are going to a dance with T Cells.

How Immune Checkpoint Inhibitors (ICI) work:
or what happens when Checkpoint Inhibitors crash the T-Cell and cancer cell dance party?

Cancer cells use proteins called checkpoint proteins to disguise themselves from T Cells.

Think of the cancer cell checkpoint protein and the T Cell partner protein as joining hands to dance together. The checkpoint inhibitors prevent the cancer cells and T Cells from becoming friendly dance partners.

Normally, the cancer cell binds its checkpoint protein to a partner protein on the T Cell (so they become friendly dance partners). This binding prevents the T Cell from recognizing the cancer cell as a foreign invader (or an enemy dancer partner).

Checkpoint inhibitors stop the checkpoint proteins from binding with their partner proteins on T Cells (and unmasks the enemy dance partner cancer cell). With checkpoint proteins inhibited, T Cells recognize the cancer cells as invaders and will attack them.

Possible Serious Effects on Your Body and How to Stay Ahead of Them

Many cancer care professionals consider immune checkpoint inhibitors the most significant cancer treatment developed in the past decade. The downside to this progress in the fight against cancer is the checkpoint inhibitor T Cells may attack healthy cells of organs , causing inflammation.

This inflammation may lead to possible mild to severe or even life-threatening issues. These are called Immunotherapy-Related Adverse Events, or irAEs.

An irAE can occur anywhere in the body at any period of time after beginning this therapy.

A good way to judge if you are possibly having symptoms is if anything feels or looks different from how it did before you started therapy, it is a symptom.

Journaling or logging your symptoms can make them easier to

describe
track
report to your cancer doctor

Report symptoms as soon possible, even if minor.

Your doctor can use this information to treat the possible inflammation, an irAE, often before it becomes severe.

The Most Common Immune Adverse Events from Checkpoint Inhibitor Immunotherapy

Because these are common does not make them any less significant. The most common side effects are:

rash
diarrhea
fatigue

Rash or redness, itchiness : This is one of the most common irAEs and affects up to 70% of people who receive an ICI. Skin reactions from ICIs can get worse quickly, so the more rapidly you and your doctor get the rash under control, the better. Immediately report any symptoms of itchiness, redness, rash, bumps, weeping, or open areas to your doctor.

Diarrhea : Abdominal pain and bowel movements that are watery, bloody, or with mucous in them are all cause for concern. Report any of these symptoms, which could indicate a condition known as colitis, immediately to your doctor. Control of colitis begins with immediately reporting any symptoms to your doctor, followed by prompt evaluation and treatment.

Fatigue : Being bone-tired or fatigued may seem somewhat expected in cancer treatment. Fatigue with Immune Checkpoint Inhibitors (ICIs) could be a symptom of one of the more severe reactions. All symptoms are important to report immediately to your doctor, including fatigue.

If your fatigue is determined as not related to anything more serious, try to manage your fatigue with the following or similar strategies (Memorial Sloan Kettering Cancer Center, 2022):

good sleep hygiene
exercise
good nutrition
meditation
managing your work schedule
getting rest
planning activities around rest times
obtaining emotional support

If you find fatigue considerably impacts your quality of life, talk with your doctor to see if there are other things you can do to combat the fatigue. Consider discussing different treatment options with your doctor if the quality of your life is deeply affected by fatigue.

With ICIs, anything which feels or looks different is essential to report to your doctor

Signs and symptoms which may seem incidental to you but are important to report immediately are:

diarrhea
rash
darkened urine
headache
blurred vision
numbness or tingling in your extremities
a new cough
shortness of breath
difficulty moving or feeling any of your fingers, toes, arms, or legs
fatigue
anything which feels or looks different or is changing

Management by your doctor of your immune-related Adverse Event (irAE)

Your checkpoint inhibitor cancer treatment will likely continue uninterrupted or with only a brief interruption with early recognition and treatment of an irAE (Schneider et al., 2021).

Your doctor may use steroids, other medications, or other treatments to get the inflammation under control so that you can stay on your ICI treatment (Schneider et al., 2021).

Sometimes, diagnostic tests are needed to confirm the type or degree of inflammation to determine the best course of action (Schneider et al., 2021).

Your doctor may refer you to a specialist to manage your inflammation, such as a gastroenterologist for managing colon inflammation (colitis) or a dermatologist for managing skin rashes and itchiness (Schneider et al., 2021).

Some types of organ inflammation require permanent stoppage of immunotherapy to protect overall health, no matter how early you and your doctor identify it (Schneider et al., 2021). An example of this would be inflammation of the heart.

Early identification is vital to treat these serious and possibly life-threatening conditions immediately.

Other important things to understand

Read information about your checkpoint inhibitor immunotherapy given to you by your doctor. It may contain important information for you to know, such as:

● understand what type of inflammation you are most at risk for with your specific treatment

● make sure you know how to report symptoms to your doctor and the necessary phone numbers for reporting

● carry a wallet card for your particular type of immunotherapy

● ask what other important information your doctor wants you to know

● know your treatment or medication schedule

● Don't be afraid to ask your doctor questions. Use your journal to write down questions for your doctor when you think of them

A wallet card communicates the specific immune checkpoint inhibitor you receive with other healthcare providers. Different checkpoint inhibitors have different levels of risk for the organs on which they may have the most effect. Individual immunotherapy websites often have wallet cards available to print. You can make your own wallet card, writing on a piece of paper to carry with you:

● the name of your immune checkpoint inhibitor

● when you started the treatment

● the name of your doctor with a phone number

● the name of your hospital and a phone number

● A wallet card identifying the current specific checkpoint inhibitor therapy is an essential communication tool to show other healthcare providers, especially when traveling.

● Review the information your doctor has given you regarding your treatment and make a note of important points.

To summarize:

● Immune checkpoint inhibitors can be an effective medical cancer therapy. They have revolutionized cancer treatment.

● Immune checkpoint inhibitors allow the T Cells of your immune system to recognize and attack cancer cells.

● Immune checkpoint inhibitors may cause mild to severe inflammation anywhere in the body.

● The severity and or location of the inflammation determines your doctor's decision regarding continuing, pausing, or stopping the immune checkpoint inhibitors.

● Early recognition and reporting to your doctor of inflammation symptoms possibly caused by immune checkpoint inhibitors often leads to better outcomes.

● A good way to judge if you are possibly having symptoms is if anything feels or looks different from how it did before you started therapy, it is a symptom.

● Journaling or logging your symptoms can make them easier to describe, track, and report to your cancer doctor.

● Report symptoms as soon as possible, even if minor. Your doctor can use this information to treat the possible inflammation, irAE, often before it becomes severe.

With quick recognition and reporting of possible inflammation from your immune checkpoint inhibitor, you are giving yourself the best opportunity for your cancer treatment to work for you and have a good quality of life.

The information in this article is not intended to take the place of advice from your physician and is not medical advice.

References:

Apalla, Z., Rapoport, B., & Sibaud, V. (2021). Dermatologic immune-related adverse events: The toxicity spectrum and recommendations for management. International Journal of Women's Dermatology, 7(5Part A). https://doi.org/10.1016/j.ijwd.2021.10.005

ASCO Staff. (2022, March 1). What oncologists think about when recommending a cancer treatment plan. Cancer.Net. https://www.cancer.net/blog/2022-03/what-oncologists-think-about-when-recommending-cancer-treatment-plan

Cancer Care. (2022, June 24). Communicating with your health care team (K. Nugent LCW, Ed.). CancerCare. https://www.cancercare.org/publications/53-doctor_can_we_talk_tips_for_communicating_with_your_health_care_team

Cancer.Net. (2022, May). Side effects of immunotherapy (Cancer.Net Editorial Board, Ed.). Cancer.Net. https://www.cancer.net/navigating-cancer-care/how-cancer-treated/immunotherapy-and-vaccines/side-effects-immunotherapy

CDCBreastCancer. (2022, June 9). Staying healthy during cancer treatment. Centers for Disease Control and Prevention. https://www.cdc.gov/cancer/survivors/patients/staying-healthy-during-cancer-treatment.htm

Cleveland Clinic. (2021, July 23). White blood cells: What are they, normal ranges, role & function. Cleveland Clinic. https://my.clevelandclinic.org/health/body/21871-white-blood-cells

Cleveland Clinic. (2023a). Chemotherapy: Types & how they work. Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/16859-chemotherapy

Cleveland Clinic. (2023b). How immunotherapy works to treat cancer. Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/11582-immunotherapy

Hashash, J. G., Francis, F. F., & Farraye, F. A. (2021). Diagnosis and management of immune checkpoint inhibitor colitis. Gastroenterology & Hepatology, 17(8).

Mayo Clinic Staff. (2021, June 18). Cancer treatment decisions: 5 steps to help you decide. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/cancer/in-depth/cancer-treatment/art-20047350

Memorial Sloan Kettering Cancer Center. (2022, December 12). Managing cancer-related fatigue. Memorial Sloan Kettering Cancer Center. https://www.mskcc.org/cancer-care/patient-education/managing-related-fatigue

National Cancer Institute. (2022, April 7). Immune checkpoint inhibitors. National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/types/immunotherapy/checkpoint-inhibitors#what-side-effects-are-caused-by-immune-checkpoint-inhibitors

Schneider, B. J., Lacchetti, C., & Bollin, K. (2022). Management of the top 10 most common immune-related adverse events in patients treated with immune checkpoint inhibitor therapy - PubMed. JCO Oncology Practice, 18(6). https://doi.org/10.1200/OP.21.00776

Schneider, B. J., Naidoo, J., Santomasso, B. D., Lacchetti, C., Adkins, S., Anadkat, M., Atkins, M. B., Brassil, K. J., Caterino, J. M., Chau, I., Davies, M. J., Ernstoff, M. S., Fecher, L., Ghosh, M., Jaiyesimi, I., Mammen, J. S., Naing, A., Nastoupil, L. J., Phillips, T., … Bollin, K. (2021). Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy: ASCO guideline update - PubMed. Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology, 39(36). https://doi.org/10.1200/JCO.21.01440

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

What is the link between PCOS and Diabetes?

Fri, 14 Apr 2023 20:26:20 GMT

What is the link between PCOS and Diabetes?

By Timilehin Olaniyan BPharm, MPSN.

About 6-15% of women of childbearing age live with polycystic ovary syndrome (PCOS). More than half of this population will develop type 2 diabetes by 40, as revealed by the United States Centres for Disease Control and Prevention (CDC).

Scientists do not know the exact cause of PCOS, but research suggests that women with PCOS are insulin resistant.

Insulin resistance occurs when your cells don't respond to normal insulin levels, affecting their ability to convert blood glucose to energy. And insulin resistance is the primary cause of type 2 diabetes.

Approximately 70% of women with PCOS are insulin resistant.

However, that's not all. To fully make sense of the link between PCOS and diabetes, a brief overview of these conditions is necessary.

What is PCOS?

PCOS is a disorder of the hormonal and metabolic systems in women of childbearing age. It is one of the leading causes of infertility in women .

With PCOS, tiny fluid-filled sacs called cysts form around the ovary. This situation impairs ovulation and causes menstrual abnormalities.

"Just having ovarian cysts isn't enough for a diagnosis. Lots of women without PCOS have cysts on their ovaries, and lots of women with PCOS don't have cysts", according to the CDC.

Doctors base the diagnosis of PCOS on the presence of any 2 of these three symptoms:

Irregular menstruation or its absence
Higher-than-normal levels of male hormones
Several small cysts on the ovaries

What Causes PCOS?

Opinions are sharply divided on the exact cause of PCOS.

Some experts believe that the overproduction of the male sex hormone, testosterone, drives PCOS. Others argue for insulin resistance, while some investigators propose a multifactorial approach.

A range of evidence backs both schools of thought, making it difficult for experts to reach a consensus.

Doctors at the ENDO 2022 debate titled "PCOS: Who's Really Driving the Bus?" canvassed different positions.

"Insulin resistance leads to hyperinsulinemia, which drives the production of androgens", Dr. Ricardo Azziz, a professor of obstetrics and gynecology at the University of Alabama, states.

On the other hand, a professor of molecular medicine at the Icahn School of Medicine, Dr. Andrea Dunaif, argues that too much testosterone is the causal factor.

Explaining why everyone with type 2 diabetes doesn't get PCOS, Dr. Azziz revealed that PCOS is more than just insulin. "It's not sufficient to be just insulin resistant," he says.

Also, the CDC proposes that insulin resistance plays a pivotal role.

In addition to insulin resistance and excess androgen, Mayo Clinic lists heredity and low-grade inflammation as possible risk factors.

But Johns Hopkins says insulin resistance drives higher androgen levels.

As of today, the medical community agrees that the exact cause is unclear. More studies are needed to unravel this.

What are the symptoms of PCOS?

PCOS symptoms include

irregular periods: women with PCOS have fewer periods every year
weight gain: due to increased insulin level
excessive hair growth in unusual places
acne

How are PCOS and Type 2 Diabetes linked?

The relationship between PCOS and type 2 diabetes isn't fully understood. But most theories use insulin resistance to explain the link between these conditions.

With type 2 diabetes, your cells are resistant to insulin. Since insulin resistance has also been observed in PCOS patients, the risk of diabetes is about 3 to 8 times higher in people with PCOS.

Like type 2 diabetes, obesity or being overweight are risk factors for PCOS. Around 38-88% of women with PCOS are obese or overweight . The percentage is similar for diabetes.

Nevertheless, it's not known if obesity is a risk factor for developing diabetes in PCOS.

In the same vein, evidence suggests a higher risk of gestational diabetes mellitus (GDM) in patients with PCOS.

A study conducted in one Chinese hospital concluded that of the 196 PCOS patients that participated, about 24% had an incidence of GDM.

Below is a rundown of studies linking PCOS and diabetes.

A study that compared the risk of developing type 2 diabetes in women with PCOS and women without PCOS among Danish women found that the risk of developing type 2 diabetes is 4-fold in women with PCOS.

A 2014 Australian study that included women from the national health insurance database found a positive correlation between PCOS, T2DM, and GDM.

This review also found that PCOS and type 1 diabetes are associated. "Hence, screening for PCOS and androgen excess should be included in current guidelines for managing type 1 diabetes in women," the authors noted.

How to co-manage type 2 diabetes and PCOS?

Lifestyle modification is the best approach to co-managing both diseases. Regular exercise and a balanced diet are often recommended.

Diet : Foods with high glucose values worsen insulin resistance and should be avoided. Avoid sweetened beverages, fruit juice, trans fat, and dried fruit if you have these conditions.

Carbs like broccoli and whole fruit are healthier because they are fiber-rich. Opt for a diet with high nutrients, low fat, and calories.

Shed excess weight: Obesity and being overweight complicates PCOS and diabetes. It has been found that fat deposition in the mid-section plays the highest role.

A 5-7% weight reduction is beneficial. You should also note that diet plays a role in your weight loss journey, so go for food that aid weight loss.

Regular exercise : Exercise increases insulin sensitivity and helps you cut excess weight. Beneficial exercises include brisk walking, bicycling, and swimming.

What is the takeaway?

Women at risk should watch out for the symptoms of these diseases. Regular screening helps identify their symptoms and allows early detection.

Practice lifestyle modifications and talk to experts.

Sources:

Barber TM, et al. (2021). Obesity and polycystic ovary syndrome. DOI: doi.org/10.1111/cen.14421

Bjugstad (2022). Insulin and Androgens in Polycystic Ovary Syndrome: Which is the Causal Factor.

https://pro.endocrineweb.com/conference-news/insulin-and-androgens-in-polycystic-ovary-syndrome-which-is-the-causal

Escobar-Morreale HF, et al. (2016). Type 1 Diabetes and Polycystic Ovary Syndrome: Systematic Review and Meta-analysis. DOI: doi.org/10.2337/dc15-2577

Glintborg D, et al. (2017). Development and Risk Factors of Type 2 Diabetes in a Nationwide Population of Women With Polycystic Ovary Syndrome. DOI: doi.org/10.1210/jc.2017-01354

Jamil AS, et al. (2014). A case-control observational study of insulin resistance and metabolic syndrome among the four phenotypes of polycystic ovary syndrome based on Rotterdam criteria. DOI:

doi.org/10.1186/1742-4755-12-7

Joham AE, et al. (2014). Gestational Diabetes and Type 2 Diabetes in Reproductive-Aged Women With Polycystic Ovay Syndrome. DOI: doi.org/10.1210/jc.2013-2007

Li X, et al. (2021). The risk factors of gestational diabetes mellitus in patients with polycystic ovary syndrome. DOI: doi.org/10.1097%2FMD.0000000000026521

Marshall JC, et al. (2012). Should all women with PCOS be treated for insulin resistance? DOI:

doi.org/10.1016/j.fertnstert.2011.11.036

Mayo Clinic Staff. (2017). Polycystic ovary syndrome (PCOS).

mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439

Polycystic ovary syndrome (PCOS) Fact sheet. (2018).

womenshealth.gov/a-z-topics/polycystic-ovary-syndrome

Polycystic Ovary Syndrome.

https://www.hopkinsmedicine.org/health/conditions-and-diseases/polycystic-ovary-syndrome-pcos

Author Bio:

Timilehin Olaniyan is a pharmacist who writes health and medical content. He leverages his training, experience, and practice to provide well-written content that educates professional and lay audiences. He believes bridging the communication gap in health information will help people make smarter health decisions. He aims to increase access to evidence-based health content. He has over seven years of experience and has earned the top-rated badge on Upwork. He enjoys playing and watching football.

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

BLOOD PRESSURE

Tue, 28 Mar 2023 17:08:29 GMT

BLOOD PRESSURE

Written by Dr. Tejal Parmar

Every visit to your doctor usually starts with checking your "vitals," or "vital signs."

What are these vital parameters?

They usually include your

heart rate
oxygen saturation (pulse ox)
respiratory rate
temperature
blood pressure

Why is it important to know your blood pressure?

Why does the reading include two numbers?

What happens if the numbers are too high or too low?

Let's understand the basics of blood pressure monitoring and at-home care.

WHAT IS BLOOD PRESSURE?

We need oxygen to survive; every small cell needs it.

We inhale oxygen into our lungs, and our blood vessels take it from our lungs and carry it to each cell of our bodies.

The heart (or pump) ensures that oxygen reaches everywhere by squeezing the blood through the blood vessels. This squeeze naturally produces a current in these vessels called "blood pressure."

WHAT DO THE TWO NUMBERS MEAN?

Your heart contracts (or squeezes) to push blood through your vessels. Then it relaxes. This cycle continues all day, every day.

The first number (the systolic) in a blood pressure reading measures the pressure exerted on the blood vessels when your heart is contracting.

The second number (the diastolic) measures the pressure when your heart is relaxed.

UNDERSTANDING THE MEANING OF HIGH AND LOW BLOOD PRESSURE

If the heart needs to do more work to push blood through the blood vessels (like pumping water out from a narrow hose), the pressure in these vessels will be consistently higher than normal. This is called hypertension or high blood pressure.

If your heart cannot pump effectively, the pressure in your blood vessels will be lower than normal. This is called hypotension or low blood pressure.

From a clinical point of view, hypertension is more concerning, being on the list of WHOs global targets for risk reduction by 2030. 1

WHO CAN GET HYPERTENSION?

According to the American Heart Association, several medical conditions may increase your risk of developing hypertension, including

HEALTH IMPACTS OF HIGH BLOOD PRESSURE

Before discussing preventive measures, it is crucial to understand the effects of hypertension. You may not notice any symptoms of high blood pressure initially, so checking your blood pressure and keeping track of them is even more necessary.

High currents in the vessels thicken the walls over time, and the opening narrows, compromising the blood supply to organs and other tissues in the body.

Over time, the blood vessels weaken due to the stress on their walls, and cholesterol from the blood can easily stick to these weak walls.

These narrowed arteries can affect

the kidneys, causing kidney failure
the brain, causing a stroke
the heart, causing chest pain or a heart attack
the eyes, causing difficulty in seeing
the sexual organs, causing sexual dysfunction 3

HOME MONITORING

Who should monitor their blood pressure at home, and how often should they do it?

Adults aged 18 to 40 with a family history of high blood pressure and those already on medication controlling their blood pressure can check yearly.

Individuals with uncontrolled hypertension and the elderly population might require more frequent checks. Ask your doctor how often you should check and record your blood pressure.

Home monitoring is not a substitute for visiting the physician's clinic. Do not reduce or stop your prescribed medications based on home monitoring readings. Always talk to your physician before making any changes to your medications.

What equipment do you need?

An automated blood pressure monitor with a cuff is all that is required.

How do you record your blood pressure?

Sit on a chair with a table in front of you. Stay calm, so stress does not raise your blood pressure higher.
Place your arm on the table with the palm facing up, so it is at the same level as your heart, and strap the cuff around it.
Turn the power on. The cuff will inflate. This might be slightly uncomfortable.
Make a note of the reading and turn the power off.

BLOOD PRESSURE CATEGORY

SYSTOLIC mm Hg (upper number)

and/or

DIASTOLIC mm Hg (lower number)

NORMAL

Systolic LESS THAN 120

and

Diastolic LESS THAN 80

ELEVATED

Systolic 120 – 129

and

Diastolic LESS THAN 80

HIGH BLOOD PRESSURE (HYPERTENSION) STAGE 1

Systolic 130 – 139

Diastolic 80 – 89

HIGH BLOOD PRESSURE (HYPERTENSION) STAGE 2

Systolic 140 OR HIGHER

Diastolic 90 OR HIGHER

HYPERTENSIVE CRISIS (consult your doctor immediately)

Systolic HIGHER THAN 180

and/or

Diastolic HIGHER THAN 120

Chart source: American Heart Association 4

Use a journal book or sample charts from the AHA to maintain a log for your physician.

Should I check the BP on the right or left arm?

Either arm is fine. According to AHA, a difference of less than 10mmHg systolic pressure on both arms is normal.

Why is my blood pressure lower at home?

Anticipatory stress can raise your blood pressure. This frequently happens in a doctor's office when you're waiting to see the doctor or receive test results. In fact, there's a name to this phenomenon- "white coat hypertension."

PREVENTING HYPERTENSION

Regardless of family history, studies have proven that maintaining a healthy lifestyle can significantly drop the risks of developing life-threatening hypertension.

Tailoring your lifestyle to improve cardiovascular function has proven benefits.

Exercise

Regular moderate physical activity can lower the BP reading by up to 8 mmHg.

Aerobic exercises help lower blood pressure. These can include

walking
swimming
cycling
running

A study conducted on treadmill use three times a week showed a drop in blood pressure in individuals with hypertension that was not responding well to medication. 5

Additionally, resistance training also reduces the baseline blood pressure, and isometric handgrip training (IGHT) helps the most. 6

Consult with your doctor regarding which kind of exercise best suits you.

Along with exercise, your diet plays a big role in your heart's health and your blood pressure.

The DASH Diet

Short for Dietary Approach to Stop Hypertension, the DASH diet focuses on increasing potassium, calcium, and magnesium and reducing sodium in your diet with ingredients found easily in the local markets.

Sodium draws water into the blood vessels, contributing to high blood pressure.

Overall, the diet includes whole grains, fresh fruits, and vegetables.

Saturated fats, sugars, full-fat dairy, and fatty meats are only consumed in lower proportions. 7

You can find a thorough serving guide on DASH diet: Healthy eating to lower your blood pressure - Mayo Clinic . As you start cutting down on highly processed and low-sodium foods, it will take a few weeks for you to adjust to the new palate. Start slowly and steadily for better results.

REFERENCES:

Hypertension [Internet]. [cited 2023 Mar 22]. Available from: https://www.who.int/news-room/fact-sheets/detail/hypertension .
High blood pressure  [Internet]. www.heart.org. [cited 2023 Mar 22]. Available from: https://www.heart.org/en/health-topics/high-blood-pressure
Health threats from high blood pressure [Internet]. www.heart.org. [cited 2023 Mar 22]. Available from: https://www.heart.org/en/health-topics/high-blood-pressure/health-threats-from-high-blood-pressure .
Monitoring your blood pressure at home [Internet]. www.heart.org. [cited 2023 Mar 22]. Available from: https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings/monitoring-your-blood-pressure-at-home
Dimeo F, Pagonas N, Seibert F, Arndt R, Zidek W, Westhoff TH. Aerobic exercise reduces blood pressure in resistant hypertension. Hypertension [Internet]. 2012 Sep [cited 2023 Mar 22];60(3):653–8. Available from: https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.112.197780
Cornelissen VA, Fagard RH, Coeckelberghs E, Vanhees L. Impact of resistance training on blood pressure and other cardiovascular risk factors: a meta-analysis of randomized, controlled trials. Hypertension [Internet]. 2011 Nov [cited 2023 Mar 22];58(5):950–8. Available from: https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.111.177071
Managing blood pressure with a heart-healthy diet [Internet]. www.heart.org. [cited 2023 Mar 22]. Available from: https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/managing-blood-pressure-with-a-heart-healthy-diet

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

A Guide to Ovarian Cancer

Wed, 22 Mar 2023 20:29:36 GMT

A Guide to Ovarian Cancer

written by Doreen Udoudom

In ovarian cancer, there is an abnormal growth of cells in the ovaries. The ovary is an almond-shaped organ responsible for producing eggs and the female hormones estrogen and progesterone.

According to the American Cancer Society , ovarian cancer is the fifth leading cause of death in women in the United States, causing more deaths than cervical, vulvar, vaginal, and uterine cancers.

This article will discuss ovarian cancer types, causes, diagnosis, and treatment.

What are the types of ovarian cancer?

Ovarian cancer is classified based on the cell it originates from. Types of ovarian cancer include:

Epithelial ovarian cancer is the most common and deadliest type of ovarian cancer. It starts on the outermost surface of the ovary.
Germ cell ovarian cancer is a rare form of ovarian cancer that begins in the eggs.
Stromal ovarian cancer is even rarer than germ-cell ovarian cancer. It develops from the cells that produce progesterone and estrogen.

What causes ovarian cancer?

The exact cause of ovarian cancer is unknown. However, there are some risk factors.

Using fertility treatment: Women who conceive via in-vitro fertilization (IVF) are at risk of ovarian cancer.
Age: Older women are at risk of developing ovarian cancer.
Inherited genes: Having relatives from both sides of the family with ovarian cancer is a risk factor.
Obesity: Women with a BMI of at least 30 have a high risk of developing ovarian cancer.
Having children later in life: Women who have never gotten pregnant or have kids after age 35 are at risk of developing ovarian cancer.
Endometriosis
Starting menstruation early or starting menopause late
Taking hormone therapy after menopause

What are the symptoms of ovarian cancer?

Ovarian cancer can grow in a woman's body for a while before symptoms appear. It is often called a silent killer because the symptoms may mimic symptoms of other conditions like constipation, indigestion, and premenstrual cramps.

Other symptoms of ovarian cancer include:

Bloating
Pain in the abdominal area
Lump or swelling in the abdomen
Frequent urination
Changes in eating habits
Bleeding from the vagina.
Unexplained weight loss
Fatigue
Diarrhea

How do doctors diagnose ovarian cancer?

Because symptoms of ovarian cancer are typically confusing, it is difficult to diagnose early.

If your doctor thinks you have ovarian cancer, they will do a pelvic exam.

Other tests to diagnose ovarian cancer include transvaginal ultrasound and a CA-125 blood test.

How do doctors determine the stage of ovarian cancer?

Doctors determine the stage of ovarian cancer by a process called staging.

The cancer stage determines its seriousness and the best treatment options for it.

They typically use the TNM system from the American Joint Committee on Cancer to stage ovarian cancer. This system uses the factors below to determine the stage of cancer.

T : The size of the tumor
N : Are the lymph nodes involved?
M : Metastasis (has it spread to other body parts?)

What are the stages of ovarian cancer?

Ovarian cancer ranges from stage 1 to stage 4, with stage 1 being the earliest stage and stage 4 being the latest.

Stage 1 Ovarian Cancer

In stage 1 ovarian cancer, the cancer is found on only one or both ovaries and fallopian tubes but hasn't spread to other sites.

There are three groups: 1A, 1B, 1C

Stage 1A: the cancer is in only one ovary or fallopian tube.

Stage 1B: cancer is in both ovaries and fallopian tubes.

Stage 1C has three groups:

Stage 1C1 means the tissue surrounding the tumor bursts during surgery, which might spread cancer to the pelvis and abdomen.
Stage 1C2 means the cancer is present in the outer surface of both ovaries and fallopian tubes.
Stage 1C3 means the cancer is present in the fluid ( ascites ) taken from the abdomen during surgery.

Stage 2 Ovarian Cancer

In stage 2 ovarian cancer, cancer has extended to other organs in the pelvis.

There are two groups: 2A and 2B.

Stage 2A means cancer has spread to the uterus.
Stage 2B means the cancer is found in other organs in the pelvis but hasn't extended beyond the pelvis.

Stage 3 Ovarian Cancer

In stage 3 ovarian cancer, cancer has spread to other organs beyond the pelvis. For example, it might be present in the lymph nodes or abdomen.

There are three groups: 3A, 3B, 3C

3A has two groups: 3A1 and 3A2

Stage 3A1 means the cancer is in the lymph nodes in the abdomen.
Stage 3A2 means cancer in the peritoneum, the abdominal lining covering the abdominal organs.

Stage 3B means small cancerous growths (2cm or less) are on the abdominal lining.

Stage 3C means larger cancerous growths (more than 2cm) are on the abdominal lining.

Stage 4 Ovarian Cancer

In stage 4 ovarian cancer, cancer has extended to the lungs and liver.

There are two groups: 4A and 4B

Stage 4A means the cancer is present in the lungs but hasn't affected other organs, such as the liver and spleen.
Stage 4B means the cancer is present in the liver or spleen and other sites outside the peritoneum.

What are the treatments for ovarian cancer?

Your doctor will recommend treatments based on the stage of cancer. Treatment options include:

Can you prevent ovarian cancer?

There are no foolproof ways to prevent ovarian cancer. But the steps below can help reduce your risk.

Giving birth
Taking birth control pills for more than five years
Breastfeeding
Having your ovaries removed or a hysterectomy (an operation involving removal of the uterus or cervix)

Summary

Ovarian cancer can be challenging to diagnose early because its symptoms mimic symptoms of other health conditions.

Talk to your healthcare provider if you have any symptoms or risk factors of ovarian cancer and schedule a test.

Sources:

https://www.cancer.org/cancer/ovarian-cancer/about/key-statistics.htm

https://www.cancer.org/research/acs-research-highlights/ovarian-cancer-research-highlights/a-new-gene-is-linked-with-the-deadliest-type-of-ovarian-cancer.html#:~:text=The%20Challenge%3A%20About%2090%25%20of,deadliest%20type%20of%20gynecological%20cancer .

The untapped potential of ascites in ovarian cancer research and treatment

https://www.cancer.org/cancer/ovarian-cancer/detection-diagnosis-staging/staging.html

https://www.cancer.org/cancer/ovarian-cancer/about/key-statistics.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5653668/

https://www.cdc.gov/cancer/ovarian/basic_info/symptoms.htm

https://www.facs.org/quality-programs/cancer-programs/american-joint-committee-on-cancer/

https://www.cancer.org/cancer/ovarian-cancer/causes-risks-prevention/risk-factors.html

https://www.cdc.gov/cancer/ovarian/basic_info/prevention.htm

https://www.nhs.uk/conditions/ovarian-cancer/symptoms/

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Adaptogens: Wellness Wonder or Marketing Myth?

Thu, 16 Mar 2023 23:20:54 GMT

Adaptogens: Wellness Wonder or Marketing Myth?

Written by Kate Byrd, PharmD

Adaptogen was once a buzzword limited to the wellness world. Now you'll find adaptogens everywhere, from supermarkets to Sephora.

But what exactly are adaptogenic herbs? What do they do, and are they effective?

Here's the information you need to know.

What are adaptogens?

Adaptogenic herbs and roots have been used in Chinese and Ayurvedic healing traditions for centuries. Yet, despite this rich history, the term " adaptogen " wasn't coined until 1947 in the Soviet Union.

During the Cold War, Soviet scientists sought a substance to increase the body's resistance to stress and improve performance. And that's precisely what adaptogenic herbs claim to do.

Adaptogens have no standardized or medical definition. The term broadly refers to any non-toxic plant believed to help the body overcome stress, increase endurance, and enhance well-being.

What do adaptogens do?

Proponents claim adaptogens boost

energy
performance
calm
focus
mood
sex drive

They may also

rebalance hormones
strengthen the immune system
normalize blood sugar
fight cancer
lower blood pressure

However, exactly how they do this is not fully understood.

Experts theorize that adaptogens regulate the response to stress in the hypothalamic, pituitary, and adrenal glands.

Another way adaptogens could work is by activating anti-stress genes. A 2018 study found that adaptogens turn on specific genes that protect cells from stress damage.

Are adaptogens effective?

Research supporting these claimed benefits is limited.

There are few human studies on adaptogenic herbs. Most evidence is from studies using animals or human cells.

Data proves that adaptogens can affect the stress response at a cellular level . However, whether this cellular response applies to the entire human body is unknown.

Popular adaptogenic herbs and their benefits:

Several herbs qualify as adaptogens. Each has unique properties that are useful for specific issues.

These are the best-researched adaptogens:

Ashwagandha or Indian Ginseng

Ashwagandha, or Indian Ginseng (Withania somnifera), is a shrub used traditionally in Ayurvedic medicine. Several clinical studies have demonstrated that ashwagandha may effectively treat anxiety, stress , and insomnia .

Tulsi or Holy Basil

Tulsi, or Holy Basil (Ocimum sanctum), is a perennial plant from the mint family. It's also commonly used in Ayurvedic practice. Research shows it may

Asian or Korean Ginseng

Asian or Korean Ginseng (Panax ginseng) is a slow-growing plant native to the mountainous regions of East Asia. Data suggests the root may

Are adaptogens safe and practical options for you?

Here are a few things to consider before taking adaptogens:

Adaptogens can interfere with medications and cause side effects.

Like food, adaptogenic herbs can interact with certain medications., and mild side effects and health risks could occur.

Keep a list of all medications and supplements you take. This list can help healthcare providers decide on a treatment plan and avoid possible drug interactions.

Supplements, such as adaptogens, aren't regulated by the U.S. Food and Drug Administration for safety or effectiveness.

Be sure to research each brand you consider. Learn where their herbs come from and whether they're certified for good manufacturing practices (GMP) . Also, look for products tested by independent laboratories to assure purity and potency.

Adaptogens alone aren't always the answer.

Regular exercise, eating well, and adequate hydration also improve health naturally.

Mindfulness and meditation may lower stress significantly.

Adaptogens without lifestyle changes might not be enough to make a difference.

Adaptogens' safety during pregnancy or breastfeeding isn't established.

There's very little research on the risks of adaptogenic herbs during pregnancy or breastfeeding.

Consult your healthcare provider before using adaptogens while pregnant or nursing.

The bottom line:

Today, people are turning to adaptogens as a natural way to lower anxiety, reduce stress, and promote overall wellness.

Adaptogenic herbs are now available in

teas
tinctures
gummies
powders
capsules
beauty products

As of 2022, the adaptogens market is valued at $10 billion.

Although traditionally used in herbal medicine and linked to health benefits, more research is needed to support their use.

Talk to your healthcare provider or pharmacist to determine if adaptogens could benefit your wellness routine.

Sources:

https://www.ema.europa.eu/en/documents/scientific-guideline/reflection-paper-adaptogenic-concept_en.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8398443/#!po=4.05405

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3991026/

https://pubmed.ncbi.nlm.nih.gov/30466987/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573577/

https://pubmed.ncbi.nlm.nih.gov/34559859/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5539010/

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0061271#s4%20target=

https://pubmed.ncbi.nlm.nih.gov/23301896/

https://pubmed.ncbi.nlm.nih.gov/20141583/

https://www.nature.com/articles/ijir201245

https://www.aafp.org/pubs/afp/issues/2017/0715/p101.html

https://www.goodrx.com/healthcare-access/medication-education/creating-medication-list-tips-examples

https://www.fda.gov/drugs/pharmaceutical-quality-resources/facts-about-current-good-manufacturing-practices-cgmps

https://www.gminsights.com/industry-analysis/adaptogens-market-statistics

Author Bio:

Kate Byrd, PharmD, is a medical writer who received her doctorate in pharmacy from the University of California, San Francisco. With over 15 years of experience as a community pharmacist, she now enjoys creating engaging content. Relatable, reliable, and inspiring writing is her specialty.

Connect with her on LinkedIn to learn more.

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

What Effects does Alcohol have on the Body?

Tue, 07 Mar 2023 00:02:25 GMT

What Effects does Alcohol have on the Body?

written by Casey Magill RN, BSN

Website: https://thefreelancern.com/

Alcohol consumption is a controversial topic.

How much is too much, and does it really cause health problems?

The answer to that is "yes."

Studies have shown that heavy alcohol intake affects not only your physical condition but also your relationships and overall livelihood.

In this post, we'll be looking at the effects of alcohol on the body.

The Brain

Drinking alcohol at an early age significantly impacts brain function. Because our brains are still developing during our childhood and teen years, alcohol can severely alter a young person's ability to reason and process emotions.

Ongoing alcohol use leads to long-lasting difficulty with speech and coordination, diminished memory function, and an inability to make good decisions.

Once the brain is damaged by heavy alcohol consumption, it cannot be repaired.

The Heart

A one-time event of alcohol misuse or excessive alcohol intake over a long period can both damage the heart .

Consuming alcohol in large quantities stretches the heart muscle, causing it to become too thin to pump blood throughout the body adequately. When the heart has to work harder, there is a greater chance of developing high blood pressure or an irregular heartbeat. The heart can only try to compensate for so long before it becomes very weak and fails completely .

The Liver

Heavy drinking causes large amounts of fat to build up in and around your liver.

Heavy alcohol consumption will eventually cause liver diseases like hepatitis, cirrhosis, or cancer. In all these conditions, the tissue in the liver is destroyed, making the damage permanent. When this happens, the only option for treatment is a liver transplant.

The Pancreas

Alcohol causes the pancreas to become irritated and swollen, a condition known as pancreatitis.

The pancreas plays a key role in our digestive process and produces insulin to regulate blood sugar levels.

When the pancreas isn't able to function correctly, it can lead to issues with how our body absorbs nutrients or a worse diagnosis (such as diabetes.)

Immune System

Our immune system keeps us from getting sick or at least decreases the amount of time our body spends fighting an ailment.

Alcohol causes our immune system to become weak, making us more vulnerable to infections and increasing the time it takes to recover from an illness.

Cancer

Consuming alcohol in large quantities greatly increases a person's risk of cancer . Not just one type of cancer, but several, including

Mouth, Larynx, Pharynx, and Esophagus
Liver
Colon / Rectum
Breast (greater risk even with minimal alcohol intake)
Stomach cancer

In addition to alcohol use, smoking , other forms of tobacco, and being overweight raise the probability of a cancer diagnosis even more.

People are often told it's okay to drink alcohol in moderation. But what exactly does that mean?

The recommendation is:

Two drinks (or less) per day for men
One drink (or less) per day for women

Remember that external factors influence whether or not consuming alcohol is safe (such as age, environment, current health status, etc.). However, in any case, prolonged alcohol use will inevitably begin to disrupt the body's ability to function normally.

Resources:

World Health Organization: Alcohol

https://www.who.int/news-room/fact-sheets/detail/alcohol

National Institute on Alcohol Abuse and Alcoholism: Alcohol's Effects on the Body

https://www.niaaa.nih.gov/alcohols-effects-health/alcohols-effects-body

American Cancer Society: Alcohol and Cancer

https://www.cancer.org/healthy/cancer-causes/diet-physical-activity/alcohol-use-and-cancer.html

National Institute on Alcohol Abuse and Alcoholism: Drinking Levels Defined

https://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Can you get Pregnant if you have an IUD?

Mon, 06 Mar 2023 03:49:46 GMT

Pregnancy With an IUD

Written by Ruth Mielke, DNP, RN, CNM

An intrauterine device (IUD) is a small T-shaped device inserted into your uterus to prevent pregnancy. It is considered a long-term but reversible form of contraception. It is one of the most effective and popular forms of birth control available.

There are two types of IUDs.

Copper: makes the uterus inhospitable to sperm. (Brand name: ParaGard)
Hormonal: Releases a progesterone-like hormone called progestin which prevents the ovaries from releasing eggs (Brand names: Kyleena, Liletta, Mirena, and Skyla)

All IUDs are more than 99% effective, but none are 100%.

This article will discuss how you can get pregnant while you have an IUD, what to do if you think you are pregnant and have an IUD, the risks associated with pregnancy with an IUD for both the woman and the fetus, and options to consider.

How Can You Get Pregnant With an IUD?

There are several possible ways pregnancy can occur after you have an IUD inserted:

Your IUD can become displaced or fall out after insertion. This is more common if the IUD is placed after a vaginal delivery or an abortion and usually occurs within three months. You can get pregnant if you are unaware the IUD is no longer in place.
You can get pregnant if you have intercourse within seven days of having a hormonal IUD placed. Hormonal IUDs can take up to seven days to be effective, depending on when in your menstrual cycle the IUD is placed. It is effective immediately if placed while you are on your period.
You can become pregnant if your IUD has been in place longer than recommended and has expired. It is essential to know the expiration date of your IUD.

What should You do if you have an IUD and Suspect You are Pregnant?

If you are concerned your IUD has failed, talk to your healthcare provider about using emergency contraception (EC) . Emergency contraception can prevent pregnancy if you discover your IUD is not in place within a few days of having intercourse.

You may notice typical signs of pregnancy if you become pregnant with an IUD. Some of these symptoms can be similar to side effects from your IUD, which can be confusing. These signs include:

Missed period (you may not have a period if you have a hormonal IUD)
Nausea with or without vomiting
Sore and enlarged breasts
Mild cramping
Mild spotting
Fatigue
Increased urination
Food aversions

You can take a home pregnancy test if you suspect you are pregnant. These tests are about 99% accurate. If you have periods with your IUD, you can take the test on the first day of your missed period. If your IUD causes irregular periods, wait a week or two to take a test.

If you have unusual symptoms, talk to a healthcare provider. They can confirm if your IUD is still in place and verify if you are pregnant or not with a urine or blood test.

What are the Risks with Pregnancy and an IUD?

IUD pregnancies are more likely to be ectopic or occur outside the uterus.

Most commonly, ectopic pregnancies occur in the fallopian tubes . The tubes can burst and cause life-threatening bleeding. The pregnancy will not develop past a few weeks. Symptoms of an ectopic pregnancy include:

Sharp pain in your abdomen, pelvis, shoulder, or neck
Severe pain on one side of your abdomen
Vaginal bleeding
Dizziness
Fainting
Rectal pain or pressure

An ectopic pregnancy is an emergency. If you are concerned about having an ectopic pregnancy, seek medical attention immediately.

If you are pregnant and have an IUD, you are at high risk for adverse pregnancy outcomes, such as:

miscarriage , also known as spontaneous abortion
preterm rupture of the amniotic sac
preterm delivery due to infection
placental abruption , when the placenta pulls away from the uterus before the baby is born

For your baby, giving birth with an IUD in place is associated with higher neonatal intensive care unit (NICU) admission rates and more severe illnesses such as infections.

What are my options?

There are two main options if you become pregnant with an IUD – continue your pregnancy or terminate the pregnancy. If it is ectopic, termination is necessary because the embryo cannot survive outside the uterus, and you have a significant risk of bleeding and even death.

If you continue your pregnancy, the recommendation is to remove your IUD. There are significant improvements in pregnancy outcomes after removing an IUD in early pregnancy versus leaving it in the uterus.

If your healthcare provider can see and grasp the strings of your IUD, they will gently remove it. If they cannot see the strings, you may need an ultrasound to find your IUD. If the IUD is above the cervix , your provider may remove it using a special scope that looks inside your uterus.

Removing the IUD reduces the risk of pregnancy complications. The IUD needs to be removed during the first trimester . Even when your IUD is removed, your pregnancy is at high risk, but removing the IUD lowers your risk.

If you choose termination , also known as abortion, your doctor will remove your IUD at the same time. Different termination methods are used depending on how far along your pregnancy is. Your provider will go over your options with you.

Summary

IUDs are an effective and safe form of contraception. But like every method of contraception, they can fail.

The earlier pregnancy with an IUD is identified, the better your chances of being able to continue your pregnancy if you desire.

Knowing the signs of pregnancy and when to contact your healthcare provider is essential.

Sources:

https://www.plannedparenthood.org/learn/birth-control/iud

https://www.ncbi.nlm.nih.gov/books/NBK557403/\

https://health.ucsd.edu/news/features/Pages/2020-01-15-personalizing-iud-choice.aspx#:~:text=There%20are%20four%20leading%20types,environment%20not%20suitable%20for%20sperm .

https://my.clevelandclinic.org/health/treatments/24441-intrauterine-device-iud

https://www.mayoclinic.org/healthy-lifestyle/getting-pregnant/in-depth/symptoms-of-pregnancy/art-20043853

https://www.womenshealth.gov/a-z-topics/pregnancy-tests

https://www.mayoclinic.org/diseases-conditions/ectopic-pregnancy/symptoms-causes/syc-20372088#:~:text=Often%2C%20the%20first%20warning%20signs,and%20which%20nerves%20are%20irritated .

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3418877/#:~:text=Compelling%20evidence%20has%20demonstrated%20that,in%20such%20cases%20%5B18%5D .

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3418877/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5893319/[KVW18]

Author Bio:

Ruth Mielke is a certified nurse midwife and RN with over two decades of clinical experience. She has a Doctorate in Nursing Practice. Ruth is expanding her career to include freelance health and wellness writing.

Portfolio

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Tumor lysis Syndrome- When your kidney says it's too much!

Sun, 05 Mar 2023 21:06:12 GMT

Tumor lysis Syndrome- When your kidney says it's too much!

written by Mohamed Nezar Abo Halawa

It starts with someone undergoing chemotherapy.

Suddenly, he feels his heart rate rising, his muscles weakening, and his catheter shows a few drops of urine.

The healthcare team is suspicious, so they run an electrolyte panel revealing large amounts of potassium, phosphate, and surprisingly low calcium levels. To confirm their suspicion, they do a kidney function test, which shows – as expected – deteriorating kidney function. It's now clear the patient developed Tumor lysis syndrome (TLS).

Doctors are prepared and immediately initiate treatment protocol, saving this patient from a life-threatening condition.

Introduction

"Emergency" implies immediate medical intervention is necessary to prevent severe complications or death.

In oncology, it's no different: Tumors kill people directly due to pressure on neighboring vital organs or indirectly as a side effect of the aggressive chemotherapy.

Tumor Lysis Syndrome (TLS) shares in both categories, so it is not a surprise it is the most common oncologic emergency requiring rapid and standardized intervention.

When does it occur?

TLS is common after initiating aggressive chemotherapy against cancer, most notably blood cancers like leukemia and lymphatic system tumors like fast-growing lymphomas.

And it can happen suddenly, even before initiating treatment in large tumors with high proliferation rates.

How does it occur?

When tumor cells die, they suddenly release massive amounts of intracellular electrolytes, nucleic acids, and metabolites into circulation.

The most important electrolytes are potassium, uric acid, and phosphate — an evil element that catches calcium, creating a double effect by causing hypocalcemia and hyperphosphatemia.

Your kidneys filter one-fifth of your blood every minute, removing those rushing metabolites and keeping your blood levels balanced.

But at a certain point, they become saturated and can no longer keep up. At this point, symptoms begin to appear.

High potassium directly affects your heart rhythm.
Calcium levels cause muscle twitches and numbness.
Uric acid finds your acidic urine the best place to rest, forms stones blocking the only source of excretion, and pushes toxic waste products like urea back into your blood.
Eventually, the accumulation of these toxic electrolytes causes multiple organ failure (MOF) leading to death.

Diagnosis

TLS is usually diagnosed by electrolyte abnormalities occurring three days before and up to 7 days after chemotherapy treatment.

Since many conditions cause electrolyte imbalances, diagnosis is established in 2 stages:

Laboratory studies to detect and measure uric acid, potassium, phosphorus, and calcium levels
A kidney function test

Prevention

Prevention is always better than management.

For this reason, doctors usually have electrolyte levels at their fingertips. In addition, frequent blood work can help with early recognition of kidney and metabolic disturbances, which helps significantly with prevention.

Risk assessment

Setting criteria for risk assessment helps increase rapid responses to this emergency.

Tumors are classified by their potential to cause TLS. They may be classified as high, intermediate, or low risk, depending on certain factors, including

Tumor size: Larger tumors with higher growth rates have more cells and, thus, more electrolytes released into the blood.
Chemotherapy intensity: The chemotherapy's intensity affects the cell destruction rate.
Tumor response: Some are sensitive and easily destroyed with better clinical outcomes, while others are resistant and require more than one drug. The risk of TLS is higher in the former due to their easy breakdown letting a gush of electrolytes into the blood.
Hydration status: if the patient is dehydrated, their blood pressure will drop, reducing the flushing effect of blood in the kidneys and paving the way for uric acid to crystallize in the kidney.

The process of prevention relies mainly on the awareness of these criteria.

Treatment

The hallmark of prevention is keeping renal function alive by aggressive hydration before treatment and continuous monitoring of the kidneys.

Aggressive hydration will improve blood flow to the kidneys, diluting the large concentrations of electrolytes and preventing the formation of uric acid crystals in the kidneys.

Patients at risk for developing TLS, such as patients about to receive chemotherapy for cancer with a high cell turnover rate, should receive prophylactic anti-uric acid drugs. Two drugs work together to prevent uric acid build-up

Allopurinol prevents uric acid formation.
Rasburicase eliminates already-formed uric acid.

The goal is to improve kidney function and clear its pathways to remove harmful electrolytes.

If the preventive measures aren't helpful, or if the electrolyte abnormalities are severe enough to produce clinical effects, the patient will start to feel the effects of these electrolyte imbalances.

Doctors usually continue with hydration and then shift their focus to eliminate the monster –uric acid!

Uric acid is best concentrated in acidic urine.

Urine is naturally acidic, so an infusion of NaHcO3 to make urine turn alkaline prevents the concentration of uric acid into crystals.

Doctors may increase the dosage of anti-uric acid drugs or add different drugs with different mechanisms to eliminate the uric acid and prevent renal failure.

The concern becomes excess circulating electrolytes messing with your organs. Managing these high levels will relieve patient symptoms and help move to the next step of kidney optimization.

Hemodialysis is a quick and efficient practice to reduce harmful electrolytes level. If the kidneys are badly injured, doctors will use dialysis to artificially simulate the kidney's blood filtration until they are confident your kidneys can keep up with the demand. Doctors may sometimes use it as a first choice if the electrolytes are critically high and must be decreased quickly.

Summary

By increasing public awareness and reporting, patients and physicians will be equipped for such life-threatening conditions, and simple preventive measures can be implemented.

Guaranteeing the best results from chemotherapy treatment is a shared responsibility.

Sources:-

· Adeyinka and Bashir, "Tumor Lysis Syndrome - StatPearls - NCBI Bookshelf.":

https://www.ncbi.nlm.nih.gov/books/NBK518985/

· Howard, Jones, and Pui, "The Tumor Lysis Syndrome."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3437249/#R28

· Larson, Richard, and Ching-Hon Pui. 2022. "UpToDate." Www.uptodate.com. May 24, 2022.

https://www.uptodate.com/contents/tumor-lysis-syndrome-pathogenesis-clinical-manifestations-definition-etiology-and-risk-factors?sectionName=PATHOGENESIS&topicRef=17050&anchor=H491545&source=see_link#H1

· Coiffier, Bertrand, Arnold Altman, Ching-Hon Pui, Anas Younes, and Mitchell S. Cairo. 2008. "Guidelines for the Management of Pediatric and Adult Tumor Lysis Syndrome: An Evidence-Based Review.

https://pubmed.ncbi.nlm.nih.gov/18509186/

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Do home remedies improve your health?

Fri, 03 Mar 2023 23:11:24 GMT

Do home remedies improve your health?

written by Lynn Bomett, LPN

Most people, if not all, have gotten sick from minor illnesses, such as the common cold or flu, skin rashes, and toothaches. Others may have medical conditions that require medical interventions.

Either way, home remedies have been tried in most households.

So much is written about remedies in your kitchen or over-the-counter supplements.

Can home remedies improve your health, though?

Some home remedies may improve your health or relieve symptoms depending on the severity of your health condition, but they may not always be effective for chronic medical conditions.

Some of the questions to ask yourself before and while taking home remedies are:

Are they really effective?
How do I know that they are effective?
Do they need to be combined with something else to be effective?
Are there any potential interactions?
Is a lifestyle change more effective?

Vitamin C

Vitamin C is known to be effective.

Vitamin C is a supplement used mainly to boost the immune system. It is considered generally safe. Evidence shows that a targeted daily dose may help treat colds and flu.

Primrose

While most home remedies are known to be effective for minor health conditions, some are less effective than others. For example, Primrose , used to treat eczema, is not effective in relieving itching, and researchers could not find it beneficial to eczema.

Cinnamon

Cinnamon is in many spice drawers. People believe it helps diabetes, but no evidence shows it improves any medical condition.

When used in large amounts, it may be bad for your liver.

Cinnamon is associated with other complications such as mouth sores, lower blood sugar levels, and difficulty breathing.

Elderberry

Some home remedies require combining them with other supplements to be effective. Consider the herb elderberry. It is more effective when used with vitamin B, vitamin B6, and vitamin E .

Tumeric

Turmeric is a commonly talked about remedy found in most households. The component curcumin is said to help with joint pain in people with osteoarthritis.

Also, turmeric is more effective and absorbs better when taken with black pepper.

More research is required to explore its benefits on depression and dementia.

Possible interactions with other medications

Home remedies can pose serious problems if taken with prescription medications. Talk to your doctor before starting any new medications or supplements.

For example, elderberry is considered a diuretic and could cause complications if you take other medication.

Is a Lifestyle Change more effective?

Lifestyle changes will not always keep you from getting sick, as in the case of contagious illnesses. But overall, healthy lifestyle changes improve the quality of life and may minimize the chances of getting sick.

We’ve all heard the line “prevention is better than cure.” Healthy choices may prevent sickness or even improve a disease. Some of the changes necessary to have a healthier life are

Eating natural foods
Avoiding processed foods
Drinking plenty of water
Avoiding stress
Stopping smoking
Checking your blood pressure
Washing your hands regularly

In conclusion, most people choose home remedies because they are readily available, cheaper, and may be effective for minor health problems. They may even help you avoid a trip to the doctor or be helpful for those with limited access to healthcare. However, always talk to your doctor before adding new supplements or other remedies. Also, talk to your doctor if

Symptoms persist even with the use of the home remedy
You have an underlying medical problem
The symptoms become unbearable
You develop an obvious reason that something is wrong, such as nausea, vomiting, or abdominal pain

Sources

https://www.novanthealth.org/healthy-headlines/which-natural-remedies-to-take-and-avoid-for-colds-flu-and-covid-19

https://www.nycpainspecialists.com/blog-1/2020/7/2/the-effectiveness-of-home-remedies

https://www.webmd.com/balance/ss/slideshow-home-remedies

https://www.webmd.com/diet/elderberry-health-benefits#:~:text=The%20berries%20and%20flowers%20of,ease%20cold%20and%20flu%20symptoms

https://www.healthline.com/health/home-remedies#chili

https://newsnetwork.mayoclinic.org/discussion/home-remedies-lifestyle-changes-can-help-your-heart-health

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Is Your Baby In Container Jail? Spring Him On Good Behavior!

Wed, 01 Mar 2023 01:57:15 GMT

What is Container Baby Syndrome ? And what new parents need to know about it.

written by Kimberly Hennerfeind RN

According to the American Academy of Pediatrics, the official definition of Container Baby Syndrome comes from the American Physical Therapy Association (APTA), which describes it as problems, movements, and behaviors caused because a baby spending too much time in a container.

A container?

While that's a strange way of putting it, it's accurate. So many new gadgets used to comfort an infant and bring convenience to new parents to "free up their hands" are on the market.

This article will discuss Container Baby Syndrome, what babies are at risk of, and how to avoid it. We will also tell you how to prevent this from happening to your little one. Read on!

So, what counts as a container, and why does it matter?

● Car seats

● Strollers

● Jumpers

● Bumbo seats

● Baby walkers

● Vibrating chairs

● Bouncy swings

● Activity gyms/centers

● Slings and packs

● Nursing pillows

And more.

All of these can be considered containers.

Great! I'm home alone. Should I feel guilty for putting the baby in the vibrating chair and bringing her to the bathroom while I shower?

Absolutely not.

Many of these devices are marketed to parents to improve their baby's development. However, the opposite is true.

Why?

Because they restrict movement by not allowing natural mobility and strengthening of your baby's little muscles and desire to interact with the environment.

What does this mean for my baby?

Restricting movement is harmful to your baby because it can lead to the following:

● Decreased movement, strength, and coordination: your baby can be delayed in gross motor skills

● Vision, speech, hearing, and delays in processing information: due to your baby's inability to explore their environment

● Flathead ( plagiocephaly ): the back of the head is abnormally flat.

● Facial asymmetries: the face appears asymmetrical as a result of the flattened head

● Torticollis : tightness of the neck muscle (sternocleidomastoid) on one side or the other limiting your baby's ability to turn their head. This creates a preference for one side only, making it difficult for them to turn their head to the other side.

● Decreased strength, coordination, and movement: causing your baby to be delayed in their gross motor skills

● Attention Deficit Hyperactivity Disorder (ADHD): from lack of movement and sensory stimulation

● Spinal issues: Confining your baby may cause positions that are not in correct alignment, causing the curvature not to develop correctly

● Increased weight/obesity: from lack of movement

What can be done?

Your pediatrician will check your baby head to toe physically and developmentally.

Parents know their babies best, though. So if you think something is concerning, bring it up.

If your doctor notices any of the above issues, they may refer you to a physical therapist.

A skilled therapist will:

● Use age-appropriate toys to entice your baby to move and work muscles for strength

● Will help baby sit up without a container if they are delayed in this area

● Place much emphasis on teaching the parent correct positioning and reasons why it's important

● Teach parents ways to encourage development at home and limit time in containers.

How to prevent Container Baby Syndrome

● Make sure your baby is getting increased tummy time when awake (with adult supervision)

● Hold your baby periodically throughout the day instead of leaving him in a container

● Limit the time your baby spends in containers

● Allow your baby to play in a playpen

● While supervising, place the baby on the tummy or back on a blanket to play

But my doctor told me to put my baby on his back!

The American Academy of Pediatrics (aap.org) has decreased Sudden Infant Death Syndrome (SIDS) through its Safe Sleep Campaign. Healthcare professionals taught "back to sleep," and moms and dads dutifully listened.

Placing your baby on her back is the safest position when sleeping, and using equipment such as car seats is a must when traveling.

Putting a baby in a container for short periods is acceptable, and a few minutes of tummy time daily will help their development; but while sleeping, they should be on their backs.

Safe sleep tips

● Always put the baby back to sleep. Sleeping on a baby's back makes it less likely to die of Sudden Infant Death Syndrome (SIDS).

● Always put a baby in a crib to sleep. The baby should be placed in a separate sleep area but in the same room as the parents.

● Take out any loose objects, bedding, or soft toys from the baby's sleep area. Only have a tight-fitting sheet with no pillows or blankets.

● Take out any bumper pads. These can cause suffocation.

● Quit smoking. Including during pregnancy and any secondhand smoke after the baby comes home.

● Mothers are encouraged to breastfeed for the first six months. Breastfeeding reduces the risk of SIDS.

Related Resources

https://napacenter.org/tummy-time-toys/

https://www.parents.com/baby/development/physical/tummy-time-guide/

https://www.parenting.com/activities/baby/best-tummy-time-toys/

Kimberly Hennerfeind, RN has almost 30 years of experience focusing primarily on NICU, pediatrics, and legal case review. She lives near Nashville, TN, with her husband and has two grown sons, twin granddaughters, Boston terriers, and German shepherds.

https://nursingnotesllc.com/

https://www.linkedin.com/in/kimberly-hennerfeind-rn-76551348/

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Prevention of disease through diet and exercise

Tue, 28 Feb 2023 04:38:47 GMT

Prevention of disease through diet and exercise

written by Esther Jeariogbe

Death—and sometimes disease— is inevitable for all humans, but lifestyle changes may prevent some diseases. Day in and Day out, people worldwide die from diseases that may have been avoidable.

This article covers lifestyle and diet modifications that may help reduce the chances of these health diseases and deaths resulting from them.

Why are these lifestyle changes important?

The World Health Organization's research in 2019 reveals that the leading causes of death and disability worldwide are coronary artery disease (CAD), ischemic stroke, diabetes, some specific cancers, and several other non-communicable diseases.

Some factors that lead to these non-communicable diseases are known to be modifiable to improve the quality of life.

A subtle change in our daily habits may go a long way in preventing some diseases.

Here are some lifestyle changes that could significantly improve quality of life and prevent diseases. While these changes do not have to be immediate, making a conscious effort to implement them will be more than helpful.

Avoid Tobacco Use

The consistent use of tobacco products in any form is one of the main risk factors for several chronic diseases, including cancer, lung diseases, and heart diseases.

It is not enough to avoid using it yourself. It is vital to stop any unnecessary exposure to smoke. Secondhand smoke is just as harmful.

Avoiding using tobacco or exposure to it will help reduce the chances of several chronic diseases.

Maintain a Healthy Weight

Several studies have revealed a relationship between some health issues, such as diabetes and cardiovascular disease, and obesity.

Being obese also interferes with sexual function, breathing, mood, and social interactions.

A healthy weight makes it easier for your bones, muscles, brain, heart, and other organs to play their parts smoothly and efficiently for many years without the complications associated with being overweight.

Prioritizing a healthy diet and regular exercise are the best way to reduce body weight.

Increase Physical Activity

We live in a generation where sitting in one spot for an extremely long time is normal.

Whether it is because our work requires long sitting hours, or we prolonged hours in front of the television, or using other digital devices, a lack of physical activity can lead to heart disease in people without any risk factors.

Moving more and sitting less have a lot of benefits for health. Regular exercise improves sleep, increases your ability to perform everyday activities, and improves bone and muscle health.

Eat a Healthy Diet

Aside from changing our sedentary lifestyles, we also need to change our diet to decrease the risk of diseases. Some of these dietary changes include.

Eliminate trans-fat from your diet. Trans fat, commonly found in packaged foods, baked goods, cooking oils, and spreads, contributes to many premature deaths from coronary heart disease. You can replace saturated and trans fats with unsaturated fats, such as omega-3 fatty acids.
Eat fruits and vegetables regularly. A diet rich in fruits and vegetables can reduce your risk of heart disease, stroke, eye problems, gastrointestinal problems, lower blood pressure, and prevent some types of cancer.
Limit the sodium in your diet. Too much sodium in your diet may cause a spike in blood pressure. Limiting sodium in the diet will help reduce the chances of a stroke or heart disease.

In conclusion, a few changes here and there that may seem insignificant can help drastically improve your quality of life.

Resources:

World health organization

https://www.who.int/news/item/09-12-2020-who-reveals-leading-causes-of-death-and-disability-worldwide-2000-2019

https://www.who.int/health-topics/tobacco#tab=tab_1

Harvard T.H. Chan School of Public Health Obesity Prevention Source

https://www.hsph.harvard.edu/obesity-prevention-source/obesity-consequences/health-effects/

Impact of changes in television viewing time and physical activity on longevity: a prospective cohort study

Sarah Kozey Keadle, Hannah Arem, and Charles E. Matthews

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4683741/

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

The Potential Benefits of Practicing Self-Advocacy with Your Healthcare

Sat, 25 Feb 2023 21:52:12 GMT

The Potential Benefits of Practicing Self-Advocacy with Your Healthcare

Written by Jill Squire, BSN, RN, OCN

It IS all about you - you and your healthcare, to be more specific.

Self-advocacy for your healthcare does not come naturally. It is easy to feel intimidated by the various facets of healthcare and the hurried people involved.

There is more and more evidence that being an informed advocate for yourself has several benefits:

ensuring care delivered to you is tailored to your needs
improved understanding of various healthcare options
improved well-being
a more positive relationship with your healthcare team

Before we go further, a definition may be helpful: a healthcare provider is any healthcare team member involved in providing healthcare to you.

The following is a tool kit that breaks down how to advocate for yourself in the complex world of healthcare:

Tool #1

Be informed about your healthcare decisions with well-vetted sources, such as MedlinePlus, a service of the National Library of Medicine (NLM), the world's most extensive medical library, which is part of the National Institutes of Health (NIH).

Tool #2

Knowing that being informed and asking questions does NOT mean you are questioning your provider's knowledge or intelligence; you are asking so that you have a better understanding and believe all of your reasonable options are being openly discussed.

Tool #3

Pay attention to your body. Your provider is an expert in their discipline; you are THE expert in your body. Note when something feels different; write it down if it happens again or hurts or causes a lot of concern. Let your provider know about the event, the nature of the sensation, and what possibly brought it on. Note when you feel well, and keep that activity, sleep pattern, and nutritional habits going.

Tool #4

Take responsibility for your lifestyle decisions. This does not mean, for example, that you cannot advocate for yourself if you smoke cigarettes. What it does mean is that with smoking comes adverse effects on your health, which you need to be honest about when talking with your providers.

Even better, work closely with your providers to try quitting smoking, and have them on your team to cheer you on. You might be amazed at how much your providers will respect you for being open with them and start working with you in a team-spirit way. They may sense your investment in yourself and want to be part of your success.

Tool #5

Keep a healthcare journal on paper or your phone. There are several parts to this tool that all work together:

A journal inspires confidence when meeting with your provider and alerts your healthcare team that you do pay attention.
Include dates and names of any significant diagnoses, a quick entry of the treatment for each diagnosis, and the treating provider you can pull up and review.
Keep a symptom log. Write down dates and times of significant or repetitive events when you don't feel right or have discomfort. Write down the:
date and time
duration
nature of discomfort
what may have brought on the event
Write down questions for your provider so you remember when you go see your provider. Include anything of interest you would like to discuss in terms of options for your healthcare.
Keep track of dates, times, names, subjects, contact information, and notes from important discussions concerning your healthcare, whether billing, scheduling of diagnostic studies, or anything else.

Tool #6

Understand your medications: Write in your medical journal how and when you should take EACH medication, along with details such as

Should they be taken with food or on an empty stomach?
What time of day should you take each of them?
Is there something else you would like to try?
Would you like to attempt a trial pause?
Are they working?
Can you afford them?
Are they causing any uncomfortable side effects, such as dizziness or nausea?

Tool #7

Clear and respectful communication with your provider during and between visits can improve the patient/care provider relationship.

Tool #8

Know your healthcare benefits. This can help you avoid a lot of headaches and heartache.

Look up in-network providers or call your member services and ask for a list of in-network specialist providers near you specific to your needs.
Understand your deductible, co-insurance, flexible savings, and healthcare savings accounts. Your insurance company's member services will likely be happy to help.
Avoid using out-of-network providers, which can snowball into a financial disaster.
Work with your primary care provider or a specialist to get a medical necessity prior authorization to go out of network if you cannot find a provider who fits your needs.

Tool #9

When preparing to contact or visit your primary care provider, write an agenda in your journal, along with the facts you have gathered and the questions you want to ask. This is especially helpful if you only have 15 minutes with them; knowing exactly what you want to discuss will give you the most value for your time.

Tool # 10

Expect a good outcome from your encounter with your provider. This will help calm your nerves and set a good tone for your visit.

Tool #11

Prepare to be honest, even if the topic of conversation is potentially embarrassing. How can your provider help you if they are not aware of the full extent of your concerns?

Tool # 12

Approach your visit with a sense of cooperation. This is you and your provider working together, not your provider telling you how things will go.

Tool #13

Take notes during your visit and put them in your journal, or have someone with you to do so. A second set of ears is often helpful in any event. The notes will help ensure you remember the options discussed, and you can then look up information from vetted sources to make an informed decision.

Tool #14

Repeat back to your provider from your notes what was discussed. This ensures you understand what you and your provider discussed. Update your notes if your provider clarifies anything.

Tool #15

Don't be afraid to change providers if your current provider attempts to intimidate you from advocating for yourself or talks over you and ignores what you have to say.

Trust in your provider is critical.

Summary

When you take responsibility for your personal health decisions, communicate clearly, keep a journal, make an agenda, expect a good outcome, and use the rest of the tools in your toolbox, you have an excellent chance of gaining traction and satisfaction in your healthcare.

More than likely, you will have a more open and honest relationship with your doctors and other providers and see your healthcare expenditures and doctor trips decrease.

You may feel better, have more energy, and gain increased enjoyment from life. It takes time, but even small changes will bring improvement. Go forth and advocate!

I would love to hear how this journey goes for you JillSquire@TheBirdingNurseFreelance.com

References:

ASH 2021: The Importance of Patient Self-Advocacy, Rozalynn Hite, HealthTree Foundation

https://healthtree.org/myeloma/community/articles/ash-2021-importance-of-self-advocacy

Why You Should Keep a Symptom Journal, Lisa Maria Basile, EndocrineWeb.com

https://www.endocrineweb.com/why-you-should-keep-symptom-journal

Don't be Shy – four tips for talking with your doctor, Wellness and Prevention, Hopkins Medicine

https://www.hopkinsmedicine.org/health/wellness-and-prevention/dont-be-shy-4-tips-for-talking-to-your-doctor

Patient Guide: Ten ways to improve communication with your doctor, UPMC Western Maryland

https://www.wmhs.com/patient-guide-10-ways-improve-communication-doctor/

The Effect of Patient Self-Advocacy on Patient Satisfaction: Exploring Self-Compassion as a Mediator Leslie Ramos Salazar To cite this article: Leslie Ramos Salazar (2018): The Effect of Patient Self-Advocacy on Patient Satisfaction: Exploring Self-Compassion as a Mediator, Communication Studies, DOI: 10.1080/10510974.2018.1462224 To link to this article: https://doi.org/10.1080/10510974.2018.1462224

https://self-compassion.org/wp-content/uploads/2018/05/Ramos2018.pdf

Talking With Your Doctor, National Coalition Cancer Survivorship

https://canceradvocacy.org/resources/publications/talking-with-your-doctor/

Self-Advocacy Handbook, National Coalition Cancer Survivorship

https://canceradvocacy.org/wp-content/uploads/Self_Advocacy.pdf

Biography:

Jill Squire is a long-time oncology RN with experience in Emergency Room (ER), critical care, administrative, and stem-cell transplant nursing. Jill was certified for the third time in 2022 in Oncology Nursing (OCN). She currently works as an Oncology and Hemophilia Complex Case Manager and is building a secondary freelance writing career in health, healthcare self-advocacy, and bird watching. Jill's passions are informed health self-advocacy, shared decision-making, and reading and professionally publishing relevant evidence-based practice. For fun, Jill enjoys trail cycling, hiking, and birdwatching with her husband; and baking for her family. Jill believes health and enjoying the outdoors have a positive connection, even if for just a few mindful moments. She feels privileged to serve both as a co-facilitator for the Cancer Bridges GI Cancer Support group and as a reverent witness to the support offered by the members to one another.

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Ways to be Happy During Menopause

Thu, 23 Feb 2023 23:32:40 GMT

Ways to be Happy During Menopause

Written by Lynn Bomett

As life happens, age creeps up on us all. We begin to think about retirement plans, travel, and enjoying life with grandchildren.

But for women, menopause can be the opposite of joyful. It can be emotionally draining for some.

The question of how to maintain happiness and enjoy life during menopause begs an answer.

In this article, we will explore ways to maintain happiness during menopause.

Go outdoors.

A change in environment or scenery impacts how we feel about ourselves.

There is just something about going outside that changes how you feel. With fluctuating hormone levels during menopause, spending time outside helps improve your mood and focus and can help support aging.

Research has found that people who spend time outdoors are happier , healthier, less stressed, more creative, and more socially connected.

Being outdoors also improves short-term memory loss and helps fight anxiety and depression.

Get out with friends.

Women are often called the backbone of the home, taking care of everyone else's needs in the family and leaving no time to care for themselves. Sometimes everything can be overwhelming, especially during menopause.

Menopause is a journey that requires self-care. Finding ways to focus and care for yourself increases happiness and improves the quality of life.

Going out on a date with a friend, a workmate, or even a group of women allows for a different focus, environment, and something different to talk or laugh about.

Having a social network during menopause may improve mood and decreases the chances of depression.

Eat a healthy diet.

Eating a healthy diet, such as a diet high in vegetables, fruits, and healthy proteins and fats, has been found to support physical wellbeing and is associated with better mental health outcomes and happier lives.

H ealthy fats , like omega-3 fatty acids, may help with menopause symptoms. You can find Omega-3 fatty acids in:

Oily fish, such as salmon, mackerel, tuna, herring, and sardines
Nuts, such as walnuts
Seeds, such as flaxseeds and chia
Certain oils, such as soybean and canola oil

Dark chocolate may also help pick you up during those roller coaster moments.

Avoiding foods such as soda, caffeine, hot peppers, and alcohol helps reduce the symptoms of menopause.

Go to sleep.

Studies from the University of Pennsylvania show that sleep disturbances and insomnia associated with menopause increase stress, sadness, and mental exhaustion. On the other hand, getting enough sleep increases mental alertness and improves focus.

If you have difficulty sleeping or staying asleep at night, talk to your doctor about ways to improve your sleep quality.

Don't worry.

Fluctuating hormone levels during menopause cause increased anxiety which may lead to unhappiness and depression. Finding ways to introduce joy may improve your mood.

Taking your mind off your circumstances and the symptoms of menopause by doing something that takes all your attention, like playing the piano, knitting, or writing, may reduce stress and decrease worry.

Exercise.

Exercising during menopause may improve your mood. In addition, increasing your activity levels can lead to weight loss, improved menopausal symptoms, and better quality of life.

Avoid being idle.

Staying busy can keep your mind off the menopausal symptoms and stressful circumstances in your life. Try a new activity or learn a new hobby. Take up baking, knitting, writing, or puzzles. Or look for someone to help. Sometimes doing something for someone else can get your mind off your problems and ignite joy within.

Sources

https://www.forbes.com/sites/quora/2019/05/30/being-outside-has-profound-effects-on-your-health-according-to-science/?sh=116e78e615a1

https://pubmed.ncbi.nlm.nih.gov/31268832/

https://www.verywellhealth.com/perimenopause-anxiety-5218736

https://www.hsph.harvard.edu/news/magazine/happiness-stress-heart-disease/

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Does Menopause Increase your Chances of other Medical Conditions?

Thu, 23 Feb 2023 22:17:43 GMT

Does Menopause Increase your Chances of other Medical Conditions?

Written by Nameera Pervez Temkar

Website: https://nameerapervez.com/

Menopause is the cessation of your menstrual cycle and usually begins in your 40s or 50s .

Now while menopause can bring a sense of relief and joy with no longer having to deal with cramps, mood swings, and bleeding, with it comes an increased risk of certain medical conditions.

Why does menopause bring about an increased risk of medical conditions?

Your menstrual cycle is regulated by estrogen, progesterone, Follicular stimulating hormone, and luteinizing hormone. During menopause, these hormones decrease, causing an increased risk of various diseases.

What are the symptoms of menopause?

Yes, with the start of menopause, you can say bye to menstrual cramps and mood changes, but menopause has its own symptoms.

Many of the symptoms are directly related to the hormonal changes in your body.

Based on an evidence review , several symptoms are evidence of menopause

Vaginal dryness
Vasomotor symptoms, such as hot flashes
Sleep disorders and insomnia
Depression

What health conditions are you at an increased risk for following menopause?

Osteoporosis

For bones to be strong, a balance of bone-forming cells, called osteoblasts, and bone-absorbing cells, called osteoclasts, is required. Estrogen deficiency in menopause activates both of these cells, but the bone-absorbing cells become dominant, leading to decreased bone mass in menopause.

Kidney dysfunction

A study found that increased follicular stimulating hormone (FSH) in post-menopausal women increases your risk for kidney problems.

Cardiovascular risk

Cardiovascular fat is the excess fat around the heart and the large blood vessel bringing blood to the body, the aorta. Evidence suggests cardiovascular fat increases your Coronary Heart Disease(CHD) risk.

This study shows how post-menopausal women are at increased risk of cardiovascular disease.

● Post-menopausal women have more visceral fat (fat on their abdominal organs) and less subcutaneous fat (fat present beneath your skin) in the abdomen.

● Visceral fat is metabolically active, which can affect your heart.

● Increasing visceral fat and the decreasing subcutaneous fat storage capacity indicate more fat is being deposited in other areas, like the heart.

● In women of reproductive age, estrogen teams up with fat tissue leading to protective cardiometabolic effects , meaning they protect the heart to some extent. Menopause leads to the partial reversal of this protective cardiometabolic effect.

Obesity

Estrogen plays a leading role in female obesity. Higher estrogen levels may restrain fat accumulation, and lower estrogen levels during and after menopause may lead to obesity.

Summary

Menopause is the cessation of the menstrual cycle, and with it comes an increased risk of certain medical conditions due to the decline in estrogen.

Hormone therapy has been used for women suffering from menopausal symptoms. Still, long-term use of hormone therapy comes with increased risks of cardiovascular conditions and cancer in women over 50.

Talk to your doctor about what treatments are best for your menopausal symptoms.

Sources:

Long‐term hormone therapy for perimenopausal and post-menopausal women - PMC (nih.gov)

Ovarian hormones and obesity - PubMed (nih.gov)

Menopause - Symptoms and causes - Mayo Clinic

Menopausal Symptoms and Their Management - PMC (nih.gov)

Mechanism Underlying Post-menopausal Osteoporosis: HIF1α is Required for Osteoclast Activation by Estrogen Deficiency (jst.go.jp)

Cardiovascular Fat, Menopause, and Sex Hormones in Women: The SWAN Cardiovascular Fat Ancillary Study | The Journal of Clinical Endocrinology & Metabolism | Oxford Academic (oup.com)

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Lung Cancer in Non-smokers

Thu, 23 Feb 2023 00:04:57 GMT

Lung Cancer in Non-smokers? Why This is Possible

written by Ijeoma Adiele

In layman's thinking, lung cancer would affect only those who are heavy smokers or have had lung diseases. Although this would increase their lung cancer risk, that's not always the case. People with risk factors for lung cancer or exposure to dangerous chemicals can also develop lung cancer.

The Centers for Disease Control and Prevention (CDC) records 20,000-40,000 cases of lung cancer in non-smokers or people who have smoked not more than 100 cigarettes in their entire life.

Exposure to smoke caused about 7,300 of these lung cancers, while radon contributed to 2,900 cases. Like every other cancer type, lung cancer spreads fast.

So, what does this tell us? First, lung cancer isn't limited to smokers. In this article, we'll discuss the possibility of lung cancer development in non-smokers and why this is possible.

What Type of Lung Cancer Affects Non-Smokers?

The non-small cell lung cancer (adenocarcinoma) is common in non-smokers and affects about 50-60% .

Squamous cell carcinoma affects 10-20% of non-smokers, small cell lung cancer affects 6-8%, and the other types of lung cancer affect a smaller fraction.

Let's have an in-depth look at these lung cancer types. Shall we?

Adenocarcinoma

Adenocarcinoma takes the lead in affecting non-smokers. If you're diagnosed with adenocarcinoma, it means cancer developed in the tissue lining the inside of your organs— the glandular tissue . These organs include the colon, esophagus, lungs, prostate, and pancreas. In this case, it's the lung.

Adenocarcinoma develops in the lung periphery and alveolar type II cells and occurs when the cells of your glandular tissue start to grow out of control.

Squamous Cell Carcinoma

Squamous cell carcinoma , on the other hand, is a non-small cell lung cancer. This type occurs when the squamous cells lining the bronchi of the lungs start to multiply. These tumor cells eventually metastasize and spread to other body parts.

Do you know what's puzzling about this cancer of type? Men are more likely to develop squamous cell carcinoma than women, which is proof of the sex-specific differences in these cancer types.

Small-Cell Lung Cancer

Small-cell lung cancer in non-smokers is rare compared to other cancer types. Yet, it's an aggressive and fast-growing cancer that usually forms in the lungs and spreads to other body parts.

Small-cell lung cancer may occur as a combined form of adenocarcinoma and squamous cell carcinoma, or it may develop outside the lungs. But the latter is rare.

In this cancer type, cells are smaller than regular, thus the name. It is more prevalent in men than women and starts in the bronchi of the chest.

Some symptoms of small-cell lung cancer include bloody sputum, chest pain, and cough.

Risk Factors for Lung Cancer

There are a few reasons lung cancer may develop in non-smokers.

Genetic Mutation: For lung cancer, mutations in the epidermal growth factor receptor gene (EGFR), KRAS, and TP53 are the main drivers for non-small cell lung cancer. These mutations turn on proteins responsible for increasing the division of damaged cells. When this happens in the lung over time, it causes a tumor and, subsequently, lung cancer.

Family History: If you have family members who have had lung cancer, you have a higher risk of developing it yourself. Now, this is not to scare you. But with this information, you can prevent lung cancer in you and other family members.

Exposure to Radon: Radon is a radioactive gas found in indoor environments. Prolonged exposure to this gas can cause lung cancer. Radon causes 3-14% of lung cancer cases. So, inspect your home and office to ensure it is safe .

Exposure to Arsenic: Arsenic in the air or drinking water is a risk factor for lung cancer. It accumulates over time and can activate cancer-inducing mutations, causing lung cancer.

Second-hand Smoke: Exposure to second-hand smoke increases your lung cancer risk by 25-30% . You may also inhale cancer-causing substances that can trigger lung cancer in your body. So, to avoid these, it's best to avoid staying around smoking people.

Symptoms of Lung Cancer

In most cases, symptoms of lung cancer don't show up in the early stages. Symptoms usually only show up as it progresses, and we highlighted a few of them below:

persistent coughing that gets worse over time
a chest infection that keeps coming back
chest pain
coughing up blood or dark sputum
trouble swallowing
swelling in the face or neck
shortness of breath
unexplained weight loss
loss of appetite
persistent tiredness

If you notice any of these symptoms, we advise you to see a healthcare provider for a proper diagnosis.

Diagnosis

Diagnosis for lung cancer occurs in different steps and begins with a blood test to check for the possibility of a chest infection. Once this test clears that, you can proceed to other diagnostic methods.

Chest X-ray examines the lungs, airways, heart, blood vessels, and bones of the chest and spine. Your healthcare provider will look for large gray clumps of cells that look like tumors.

A chest X-ray can only detect possible lung cancer at an advanced stage. Also, a doctor can only describe an abnormal growth seen by a chest X-ray as a lung nodule, lung mass, lung lesion, or a lung neoplasm.

A low-dose CT scan uses a series of X-rays at low radiation to capture images of different body parts. They are more likely to show cancerous growth than a regular chest X-ray.

But you should seek medical advice on getting a CT scan because only high-risk individuals need one. Also, excess radiation from these scans can cause cancers in a healthy individual.

A bronchoscopy involves a doctor running a lighted tube into your trachea down to your lungs. They can then observe the inside of the lungs for abnormal growth or lung problems.

This test is sensitive and requires a professional. Also, it is most likely the last confirmation test after finding a tumor or abnormal growth during a chest X-ray or CT scan.

Your doctor will collect samples of these growths and test them through biopsy to confirm if it's a cancerous growth.

Because bronchoscopy can cause complications , your doctor will likely only recommend this test if you are at high risk for lung cancer.

Treatment

Surgery is best suited for small or non-small cell lung cancer that hasn't spread. In this case, a specialist can easily remove these single tumor growths and some surrounding healthy tissues to avoid possible cancer growth.

During chemotherapy , a doctor administers different medicines to you through a drip into your vein or a combination of tablets. These medicines destroy cancer cells and stop them from growing.

Radiation therapy uses high-energy beams to destroy cancerous cells. They do this by damaging the DNA of these cancerous cells, which stops their growth. So, as these cells die, the body breaks them down and removes them from the body.

Targeted drug therapy targets the proteins responsible for the changes in cancerous cells. These drugs can destroy lung cancer and prevent growth by attacking and changing how these proteins work.

Immunotherapy activates your immune system to fight lung cancer cells. This medicine attacks foreign bodies in your lungs and your body generally. Three types of lung cancer therapy are immune checkpoint inhibitors, cancer vaccines, and adoptive T-cell therapy.

The Bottomline

Although smoking is the number one risk factor for lung cancer, people with genetic susceptibility and exposure to dangerous chemicals can also develop lung cancer.

To prevent cancer, eat a healthy diet, and avoid carcinogens and second-hand smoke.

See a doctor immediately for a proper diagnosis if you notice any symptoms.

Sources:

Malhotra J, et al. (2016). Risk factors for lung cancer worldwide. European Respiratory Journal. https://erj.ersjournals.com/content/48/3/889.long

Lung cancer among people who never smoked | CDC. https://www.cdc.gov/cancer/lung/nonsmokers/index.htm#:~:text=Lung%20cancer%20can%20be%20caused,of%20lung%20cancer%2C%20and%20asbestos .

Sabbula BR, et al. (2022). Squamous cell lung cancer. In: StatPearls. StatPearls Publishing. https://pubmed.ncbi.nlm.nih.gov/33232091/#:~:text=Squamous%20cell%20carcinoma%20(SCC)%20of,the%20lung%2C%20especially%20in%20women .

Stapelfeld C, et al (2020).Sex‐specificity in lung cancer risk. Int J Cancer.

https://onlinelibrary.wiley.com/doi/full/10.1002/ijc.32716

Torres-Durán M, et al. (2016). Small cell lung cancer in never-smokers. European Respiratory Journal. https://erj.ersjournals.com/content/47/3/947#:~:text=SCLC%20is%20an%20infrequent%2C%20highly,by%20the%20World%20Health%20Organization .

Chang YS, et al. (2021). Mutation profile of non-small cell lung cancer revealed by next generation sequencing. Respiratory Research. https://respiratory-research.biomedcentral.com/articles/10.1186/s12931-020-01608-5

US EPA O. What is epa's action level for radon and what does it mean? https://www.epa.gov/radon/what-epas-action-level-radon-and-what-does-it mean#:~:text=Because%20there%20is%20no%20known,is%20about%201.3%20pCi%2FL .

Health problems caused by second-hand smoke. https://www.cdc.gov/tobacco/secondhand-smoke/health.html#:~:text=

Chest infection. https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/chest-infection#:~:text=A%20chest%20infection%20is%20an,infected%20person%20coughs%20or%20sneezes .

Stahl DL, (2015). Complications of bronchoscopy: A concise synopsis. Int J Crit Illn Inj Sci. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4613418/

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

That Age-Old Question: When Should I Eat?

Mon, 20 Feb 2023 23:58:05 GMT

That Age-Old Question: What When Should I Eat?

Written by Nicole Hill RN

Gaining in popularity, intermittent fasting (IF) simply restricts when you eat as opposed to what you eat. This growing trend d eserves a closer look. Here are seven things you should know about IF.

Variations of IF

There are different ways to fast, which gives some flexibility for people who want to give it a go. These variations include:

Time-restricted feeding, where eating is limited to certain hours of a day
5:2 strategy - fasting two days a week, eating normally five days a week
Every other day fasting or low-calorie days

IF works for weight loss, but . . .

Studies reveal that it isn’t any better than the traditional calorie-cutting method. For some people, fasting might as well be a torture technique. It can cause fatigue, dizziness, or even low blood sugar in some people. IF is not a good option for them.

Others find that IF is a simple lifestyle change that becomes easier over time once their body adjusts. Something is enticing about eliminating the need to count calories or restrict certain foods or food groups. Instead, one simply watches the clock. As the saying goes, the best diet is the one you can stick to.

It’s not a magic pill.

Sorry, but what you eat still matters. Although IF focuses on limiting the time window for eating, what you put in your mouth still plays a crucial role. Eating junk, highly processed foods, or only one kind of food will sabotage your efforts.

Fortunately, IF works well with proven healthy diets, such as the Mediterranean or DASH diets.

More than weight loss - What else can it do?

Growing research suggests IF shows promise in improving overall health even without weight loss. Heart health, metabolic health, cognition, and life span are some areas being looked at. Here are some potential benefits of IF.

Lowering of LDL or “bad” cholesterol
Decrease in blood pressure in people with hypertension
Stabilization of blood sugar levels and improved insulin sensitivity
Reduction of oxidative stress and free radicals
Decrease in chronic inflammation
Protection of brain function
Improvement of the gut microbiome
Appetite regulation
Improved sleep
Increased longevity

Since obesity, high cholesterol, and hypertension are risk factors for heart disease, stroke, and kidney disease, IF may reduce the incidence of these conditions. Likewise, insulin resistance and obesity are associated with diabetes, meaning that IF may help prevent or delay this common disease. In fact, many processes within the body impact and influence other systems. Unfortunately, it is difficult to pinpoint what has a causal relationship to disease prevention and what is merely a correlation.

The big BUT . . .

Though IF has been trending for a few years, more research is needed to demonstrate its health benefits adequately.

First of all, because there are different forms of fasting, studies vary widely on protocol, duration, and baseline characteristics of the sample population. These differences create a challenge when looking at the reliability of results.

Secondly, overviews of past IF studies demonstrate mixed results . For example, some studies conclude IF has little effect on fasting glucose levels, whereas other studies tell a different story. Where mixed results exist, further investigation is warranted.

And lastly, many studies, especially ones relating to the longevity of life and cognitive function , have been conducted on mammals other than humans. It will take years of research to say with certainty if IF has similar effects on humans as on mice. IF hasn’t been around long enough yet.

When all is said and done, you should take the potential benefits with a grain of salt (or salt substitute, as it were). The good news is that scientists have been interested in IF, and research continues, helping people determine what might work for them. So keeping an eye out for new developments in IF is a good idea for those who want to try it.

Not for everyone

Like many things, IF must be an individual decision based on multiple factors.

Some groups of people should avoid it or at least discuss with their healthcare provider whether or not it’s a good idea. These groups are:

Children, adolescents, and the elderly population
Pregnant or breastfeeding women
People with a history of an eating disorder
People with diabetes and taking medications, especially insulin
People who are underweight
People with digestion issues

Trying it out

IF is considered generally safe if common sense is used. If you’d like to give it a try, here are a few things to keep in mind:

Keep hydrated - the fasting period does not exclude water
Start slowly to make it easier to adjust to increasing fasting times
Drink coffee or tea while fasting (without the sugar and cream, of course)
Get plenty of sleep
Be mindful to avoid overeating during feeding periods
Eat nutritious, filling foods

People like the flexibility and simpleness of IF, and many have seen positive results. There are even apps out there to help you navigate it. Done right, IF is a lifestyle change that is sustainable and healthy.

Sources:

Intermittent Fasting in Cardiovascular Disorders—An Overview - PMC

Intermittent Fasting and Metabolic Health - PMC

Cardiometabolic Benefits of Intermittent Fasting | Annual Review of Nutrition

Intermittent Fasting: Is the Wait Worth the Weight? - PMC

Intermittent Fasting: A Heart Healthy Dietary Pattern? - PMC

The Effects of Intermittent Fasting on Brain and Cognitive Function

Bio: Nicole Hill is a freelance health content writer. She has over 20 years of nursing experience in various settings, including hospital, community, school, and camp. ER has been her main area of expertise, but she loves that nursing affords many opportunities in different areas. Now she is excited to expand into writing. Connect with her on LinkedIn or on her website, Vital Nurse Writer

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Can I heal my Digestive System Naturally?

Wed, 15 Feb 2023 23:47:55 GMT

How can I heal my digestive system naturally?

by Tasneem Kaderi

We all know that a healthy digestive system is super important, but it can be tough to know where to start when improving your gut health. The entire digestive system covers from esophagus to the bowel is what consists of gut health which is responsible for breaking down food into essential nutrients that help us run our bodies. That means that if anything goes wrong, you may be at risk of diseases. Next time you're eating a meal and suddenly feel like you have the runs, it may be because you're having an early warning sign of leaky gut.

The stomach is where the real action takes place. The first step is to mix food with powerful chemicals in the gut. Bile, hydrochloric acid and digestive juices are essential for this mixing and if there is a shortage of any of these the process is off to a poor start. Regular, soft, bulky and comfortable bowel movement is vital to health. But something is seriously wrong with our society as 4 million American say they are constipated most or all of the time. ¹

Constipation is referred to passing stools less than 3 times per week. Proper bowel movement includes concepts of proper transit time and regularity, which are important for healthy bowel movements. However, the longer products of digestion stay in the colon, the more chances that they have decomposed into unhealthy components called stool impurities.

Eating a high fiber diet is important for your digestive system. A high fiber diet helps keep your digestive system healthy and functioning properly. Fibers such as vegetables, fruits and whole grains will help prevent constipation while they also contribute to weight loss. High fiber foods also help treat conditions like diverticulosis, irritable bowel syndrome, hemorrhoids and more.

Source: National Library of Medicine

Tips to heal your digestive system naturally

The best way to counter the effects of a bad diet is by adding probiotics to your routine. Probiotics help preserve a good state of health, promote digestion and maintain proper hydration in the body.

Chances are, our day-to-day routine involves a lot of work and stress. This eventually pressures us to consume more food than necessary. In fact, it is believed that 70% of your diet should consist of high-quality foods that can benefit your body.

It's a known fact that our body needs foods in order to function properly. You also have to have a healthy lifestyle as well, which includes healthy eating habits along with regular exercise in order to prevent muscle wasting and promote weight loss.

Some of the tips to heal your digestive system are listed here as follows:

1. Eating more fiber- vegetables and fruits, yogurt, probiotics and fermented foods

2. Exercising for 30 minutes daily. Mild to moderated physical activity

3. Drinking more water and cutting down on meat

4. Cutting down sugar and artificial sweeteners. Reducing stress and getting enough sleep

Signs of an unhealthy digestive system

There are these two variables that influence the gut influence namely the gut microbiota and the gut barrier.

Our gut is the gateway through which food, water, and other substances pass into our bodies. The function of the gut is to receive these substances, break them down into smaller molecules, and then either absorb them or eliminate them.

If this breaking down process goes wrong, large molecules can leak from the gut into the blood and cause an immune response. This is called a “leaky gut” and can lead to many health conditions, including autoimmune diseases and allergies.

Too much sugar, trans-fats and processed food can cause your gut to become unhealthy. This creates a leaky gut, allowing undigested food particles to pass from the digestive tract into your bloodstream and causing inflammation in various parts of your body. Left untreated, leaky gut can lead to a wide variety of health issues including autoimmune diseases, cardiovascular disease, cancer, neurological issues and more.

The gut microbiome gets disturbed due to a number of reasons:

1. Processed and Inflammatory Foods- According to the Standard American Diet, foods such as refined carbohydrates and industrial seed oils are a risk to gut. This particular diet reduces the bacterial diversity in the gut and induces inflammation thereby leading to adverse health effects.

2. Low Fiber Intake -A diet poor in fiber is likely to cause the gut microbiome to be derived of it and lead to reduced beneficial bacteria.

3. Stress- It alters the gut and leads to health conditions.

4. Chronic Infections- Bacterial, fungal and viral infections alter the gut microbiota.

5. Antibiotics and other medications- Antibiotics, birth control pills, NSAIDs, proton pump inhibitors all alter the gut according to research. ²

6. Abnormal sleep schedule- It is really important to sleep well for the gut to function properly. Disruption in the circadian rhythm causes imbalance in the biome.

How does unhealthy digestive system affect your overall health?

Unhealthy digestive system is characterized by gut bacteria becoming potentially harmful when the ecosystem undergoes abnormal changes. Imbalance in the gut bacteria causes symptoms like bloating, adnominal pain and diarrhea. Many other diseases are linked to an unhealthy digestive system namely inflammatory bowel disease (IBD), obesity, diabetes, heart diseases, liver diseases, HIV, cancers and autism. ³

The gut and liver have a close interplay based on the evidence that the gut absorbs beneficial substances produced by the liver, which affect the metabolism of other organs in the body. A high-fat diet may be associated with obesity and insulin resistance, which contribute to type 2 Diabetes T2D. ³

The gut-microbiota is an important part of the human body and is considered as a reservoir of harmful microbes. Cancers such as gastrointestinal and prostate cancer are caused due to the presence of microbial pathogens or disorder in the intestinal bacterial community.

The incidence of inflammatory bowel disease (IBD) is increasing globally. The cause of IBD remains to be unknown but intestinal dysbiosis as a result of inflammation has been proposed to be involved in its development. ³ Another type of inflammatory bowel disease is Crohn’s disease (CD).

Summary

Our modern lifestyles are stressful, busy and fast paced. Food is too often processed, bad fats and sugars added to foods, additives in processed foods or fat free hassles on the way to work. When you simplify your diet, you are making it easier to digest food properly and so get more energy out of it.

Digestive system is essential because it provides the energy which is needed to fuel the body and survive. Everyone has an adequate diet but your digestive health is what really counts. The nutrients won’t be absorbed and energy won’t be provided if the digestive system isn’t strong. Consuming food in their natural form and single ingredient foods are easily broken down by the digestive system. Avoiding foods that are high in sugar, refined, added preservatives, emulsifiers, saturated fats and convenience food can ease the load that the digestive system faces when these are taken in.

The health of your gut bacteria is essential for maintaining a healthy metabolism and their role in controlling inflammation and fighting infections. A diet rich in fiber can help boost digestion along with a healthy microbial population.

An epidemiological study has shown that eating yogurt can prevent age-related weight gain. ⁴ Dietary probiotic consumption provides good intestinal health by altering gut bacteria. Since digestive system has an important impact on human health and diseases, it should be considered as a center point in preventing and treating chronic diseases.

Food is food and if it doesn’t nourish and support you, it doesn’t matter how much you love it. Our bodies need to feel good, so why would we feed them the empty calories that cause one of the biggest weight gain factors and feel hungry more often?

References:

1. Khalsa KP, Tierra M. The way of ayurvedic herbs: The most complete guide to natural healing and health with traditional ayurvedic herbalism. Lotus press; 2008.

2. Gill SR. pop M, Deboy RT, Eckburg pB, Turnbaugh pJ, Samuel BS, Gordon JI, Relman Da, Fraser-Liggett cM, Nelson KE. Metagenomic analysis of the human distal gut microbiome. Science. 2006;312(5778):1355-9.

3. Zhang YJ, Li S, Gan RY, Zhou T, Xu DP, Li HB. Impacts of gut bacteria on human health and diseases. International journal of molecular sciences. 2015 Apr;16(4):7493-519.

4. Mozaffarian, D.; Hao, T.; Rimm, E.B.; Willett, W.C.; Hu, F.B. Changes in diet and lifestyle and long-term weight gain in women and men. N. Engl. J. Med. 2011, 364, 2392–2404.

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Do I have Dry Eye Syndrome?

Fri, 10 Feb 2023 23:55:16 GMT

Do I have Dry Eye Syndrome?

Written by Kristin Wheeler, RN

Do you experience any of the following symptoms in your eyes:

Itching or redness
Have a gritty or sandy feeling
Burning or pain
Swollen or irritated eyelids
The sensation that something is in your eye that should not be there

These can all be signs that you might have dry eye syndrome.

Dry Eye Syndrome is one of the most common reasons people visit the eye doctor. The severity can vary from being a mild annoyance to being quite uncomfortable and affecting your daily activities.

Over 58% of the general population have symptoms of dry eye syndrome. Most people have mild symptoms, but 30% of those affected will have moderate issues, and 12% will suffer from severe symptoms that can affect their quality of life (5).

How Tears Work

Tears are made in glands above your eyes, and blinking washes these tears over your eyes. The tears help clean any bacteria or foreign material and drain out of the tear ducts found in the inner corner of the eyes.

Tears generally keep your eyes moist and healthy; they create a tear film over your eye composed of three different layers (oil, water, and mucous), which all work together to maintain moisture and help you have good vision.

Dry eye can occur if you have any issues with the production of tears or poor quality of the tears; this imbalance can then lead to inflammation and damage to the eye surface. (2,4)

Are you at higher risk for Dry eye?

Dry Eye Syndrome can occur in anyone, but you may be at higher risk if you have any of the following:

Age 50 or more
Female
A diet low in Omega 3 Fatty Acids (found in salmon, walnuts, and chia seeds) or Vitamin A (found in leafy green vegetables, carrots, cantaloupe, and eggs)
Wear contacts
Look at a computer screen for extended periods
Take certain medications like diuretics (“water pills,” usually prescribed for blood pressure), beta-blockers (usually for heart problems or blood pressure), anti-histamines (usually for allergy or cold symptoms), sleeping pills, or anxiety and antidepressant medicine
Have certain diseases like thyroid disease, rheumatoid arthritis, lupus, or Sjogren’s Syndrome
History of refractory surgery (like LASIK) (1,2)

Diagnosing Dry Eye Syndrome

Your eye doctor can diagnose dry eye syndrome with a complete eye exam.

They will assess your eyelids, cornea, and your blinking under a bright light. They may also put in eyedrops which will dye your tears and then assess your eyes under a blue light which checks the tear film. If the tears break apart quickly, they are unstable, indicating dry eye. This dye can also identify problems on the surface of the eye. (5)

Treatments

The recommended treatment for dry eye syndrome will depend on how severe it is found to be.

Initially, a person may be advised to use over-the-counter artificial tears or rewetting drops; these can be used as often as needed. Other suggestions would be lifestyle changes

avoiding airflow to the face/eyes (fans used at night, heaters blowing in the car, hairdryers)
reducing screen time
using a humidifier when the weather is colder to provide more moisture in the air

Lid hygiene (warm compresses to the eyes and lid scrubs) and getting Omega 3 fatty acids in your diet can also be recommended.

Other treatments that may be recommended for more moderate and severe symptoms are

eye ointments and gels
punctal plugs (temporary or permanent plugs put into the tear ducts to help keep the moisture on the eye)
moisture goggles, pulsed light therapy
prescription eye drops or steroid medications
surgical procedures in some situations (3)

Other Preventative Strategies

Drink plenty of water.
Wear protective / wraparound glasses when out in the sun and wind.
Avoid alcohol and smoking.
Take frequent breaks from screen time – use the 20-20-20 rule (every 20min of screen time, look at an object 20 feet away for 20 seconds). (5)
Keep the computer screen at or below eye level, so you do not need to open your eyes as wide – this may help the tears remain longer in your eyes. (4)
Eat a healthy diet that includes omega-3 fatty acids.

References

Bio:

Kristin Wheeler, RN has been a nurse for 28 years, most recently working in a Weight and Wellness Center which specializes in bariatrics and obesity treatment. She has over 10 years of experience working in family practice and worked as a care coordinator for patients with chronic and complex health needs. Kristin has worked in acute care settings, homecare, ambulatory care, and specialty areas.

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Can we Prevent Antibiotic Resistance?

Fri, 10 Feb 2023 23:12:14 GMT

Can we Prevent Antibiotic Resistance?

by Dr. Tasneem Kaderi

Antibiotic resistance is a worldwide threat occurring when bacteria change in response to the use of antibiotics.

A growing number of infections are becoming difficult to treat as antibiotics are becoming less effective. In this review, we shall understand how healthcare providers and patients can combat antibiotic resistance and reduce the misuse of these medicines and the role of prescriptions.

While the causes of this pandemic are complex, the effects are simple: we need to change how we use antibiotics.

These medicines save lives and make us healthier, but if left in the wrong hands, they can endanger us all—in hospitals, nursing homes, and our homes. We must all see antibiotic resistance as a global problem and act together to solve it.

The World Health Organization (WHO) estimates that without changes in human behavior, antibiotic-resistant bacteria will become an even more significant threat in the future. Nevertheless, antibiotics remain the treatment of choice for many infections and can be lifesaving.

Antibiotic-resistant bacteria emerge as a result of antibiotics being used incorrectly or too often, which may cause serious illnesses and even death.

We as a society need to take certain steps to reduce and limit the impact of antibiotic resistance. Some of the steps that we can take at an individual level are as follow:

Use only prescribed antibiotics.
Never demand antibiotics or share leftover antibiotics.
Washing hands, practicing safer sex, regular vaccinations, and hygienic food preparations can prevent infections.

The WHO recommends choosing foods that are organic and healthy, produced without the use of antibiotics.

Source: World Health Organization (WHO)

Antibiotic resistance is an important cause for concern today, as it can endanger the survival of patients. The emergence of antibiotic resistance happens for different reasons; some are overused, lack of research and education, improper use, and contamination. To prevent its spread, you must reduce your consumption patterns, understand the reason behind different resistance patterns and know how to keep yourself safe from infection.

A study predicted that approximately 30% of oral antibiotic prescriptions in the US were inappropriately prescribed to patients.2 Medical procedures lose their effectiveness when antibiotics no longer perform. Patient experiences treatment failure, extended hospital stays, expensive drugs, and, most importantly, health-related stress. Antibiotic resistance also has a role in the economy, as it delays the number of individuals that can return to the workforce.

What is antibiotic resistance?

Antibiotic resistant bacteria, also known as superbugs, are gross. For instance, a urinary tract infection (UTI) can be caused by bacteria that common antibiotics can no longer kill. This makes the UTI more challenging to treat and leads to complications. For example, amoxicillin can no longer kill off the bacteria because prolonged use of antibiotics has allowed the bacteria that commonly cause UTIs to mutate and render the amoxicillin useless.

Antibiotic resistance refers to the ability of bacteria to resist one or more antibiotics by developing mechanisms that prevent, inhibit, or impede the action of the antibiotics. The main routes of resistance development involve modifications of the antibiotic molecules or target sites and global cellular responses.

Ways to prevent antibiotic resistance:

Promoting awareness of all stakeholders: World Antibiotic Awareness Week aims to promote awareness around antibiotic resistance and encourage best practices.
Containment of bacterial transmission and prevention of infection: Adopting the highest levels of sterile practices in a health care facility to prevent the spread of any infection
Surveillance of healthcare-associated infections and antibiotic resistance: This helps identify the problem's magnitude and factors affecting the infection.
Antibiotic stewardship: Antimicrobial Stewardship Programs can help optimize the treatment of patients with infections, reduce adverse events associated with antibiotic use, and improve healthcare outcomes.
Education for changing behavior

Causes of antibiotic resistance

Unnecessary antibiotic use, poor hygiene, and inappropriate antibiotic use are contributing factors to the development of antimicrobial resistance. Our actions as a society directly affect the health professionals we trust with our health care and our use of antibiotics.

If we misuse antibiotics, bacteria can become resistant, meaning the antibiotics will not be able to kill them. This means when we need antibiotics again, they won't work. If we raise awareness of this issue so others also take action, doctors can learn it is time to approach treatments differently without resorting too quickly to antibiotics. In this way, mortalities will be reduced, and antibiotic development can continue unhindered.

Symptoms of antibiotic resistance

Antibiotics can help treat many kinds of infections and are on hand in most hospitals. But if you develop an antibiotic-resistant infection and don't respond to the standard antibiotics, you may need clinic-based treatments or a hospital stay.

Your healthcare provider will likely take a sample of your infected tissue and send it to a lab. Once the type of infection is determined, tests can predict which antibiotics will kill the germs. You may have an antibiotic-resistant infection if you don't get better after treatment with standard antibiotics.

Treatment for antibiotic resistance

Normal human microbiota act as a barrier against colonization by pathogenic microorganisms. Using antimicrobials in a manner that minimizes disturbance to the normal flora reduces the risk of the emergence and spread of resistant strains between patients and the transfer of resistance genes between microorganisms, thereby reducing the risk of the development of new antimicrobial-resistant bacteria in healthcare settings.

The antibiotics work by fighting against the bacteria causing the infection. They don't, however, work against all types of infections. For example, antibiotics aren't effective when given for the common cold, middle ear infections, sore throats, and flu.

Poor hygiene and poor infection control are responsible for spreading germs and providing adequate opportunities for resistant bacteria to grow, making more people sick and increasing the need to take antibiotics.

FAQs

Who are at risk of antibiotic resistance?

The more antibiotics you take, the greater your chances of developing antibiotic resistance.

People with asthma and chronic obstructive pulmonary disease may be at greater risk of developing antibiotic-resistant organisms, such as the common cold.

People with HIV infection should avoid penicillin and erythromycin.

Organ transplant recipients are at particular risk of developing antibiotic-resistant bacteria because they are often given high doses of antibiotics during their hospital stay.

How is antibiotic resistance diagnosed?

Antibiotic-resistant infections are becoming more and more of a problem worldwide due to the overuse and misuse of antibiotics. We only know what type of bacteria is causing an infection once we treat someone. At that point, we are also aware that the resistant bacteria have become immune to treatment with medication typically used for that disease. This new resistance problem may limit treatment options, and our ability to cure and prevent infection can become compromised.

Source: Cleveland Clinic

Summary

We can try inculcating certain habits that can reduce AMR and make our environment a safer spot -

Antibiotic resistance is happening across the world. More bacteria have become resistant with the increasing use of antibiotics.
One thing to understand is we don't become resistant to antibiotics, bacteria do.
Antibiotics don't help when you suffer from coughs, colds, sore throats, or ear infections.
Antibiotics are only to be used by prescription.
Good hygiene can help stop antibiotic resistance by reducing the need for them.
Like any other medicine, antibiotics do have side effects. Unnecessarily using them comes with its associated risk.

References:

Soothill G, Hu Y, Coates A. Can we prevent antimicrobial resistance by using antimicrobials better?. Pathogens. 2013 Jun 10;2(2):422-35.
Leal JR, Conly J, Henderson EA, Manns BJ. How externalities impact an evaluation of strategies to prevent antimicrobial resistance in health care organizations. Antimicrobial Resistance & Infection Control. 2017 Dec;6(1):1-1.
de Angelis C, Nardone A, Garifalos F, Pivonello C, Sansone A, Conforti A, et al. Smoke, alcohol and drug addiction and female fertility. Reprod Biol Endocrinol [Internet]. 2020 Dec [cited 2022 Nov 26];18(1):21. Available from: https://rbej.biomedcentral.com/articles/10.1186/s12958-020-0567-7

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

7 Superfoods that Improve your Immune System

Wed, 08 Feb 2023 22:44:01 GMT

7 Superfoods that Improve your Immune System

written by Marvellous Olayinka

Your body is repeatedly exposed to various harmful organisms, such as bacteria, viruses, and fungi, daily.

Your immune system serves as a barrier that protects your body from the impact of these harmful organisms.

How important is your diet for your immune system?

Your immune system is a complex network of cells (like white blood cells), tissues, organs, proteins, and chemical substances.

The cells of your immune system fight against harmful organisms systematically.

They identify whether an organism is harmful or not.
They destroy the organisms.
They reactivate more quickly and effectively when they re-encounter the same organism later.

The immune system can become compromised when an adequate and healthy diet is neglected.

Nutrition plays an essential role in maintaining a healthy immune system by

Making certain proteins, such as antibodies.
Helping make new cells.
Regulating immune cell metabolism.
Protecting the body from oxidative stress and free radical build-up.
Supporting and strengthening the body's normal intestinal bacteria, which in turn strengthens the immune system.

A sure-fire way to amp up your immunity is by eating foods rich in certain nutrients like:

Zinc
selenium
Iron
Magnesium
Copper
Folate
Vitamin A
Vitamin B
Vitamin C
Vitamin D
Vitamin E

Now you might be wondering what types of foods are excellent for your immune system.

Here are seven superfoods to skyrocket your immunity:

Yogurts

Known for their soft, smooth, and creamy texture and sweet or sour taste (depending on the flavor), yogurts are a staple rich in calcium, protein, and probiotics.

Probiotics in yogurts improve gut health and immunity by increasing immune cell production and stopping infectious agent growth, including a host of harmful bacteria.

A study was conducted on athletes to determine the effects of probiotics in eliminating cell damage. Researchers discovered that, due to the nature of athletes' intense physical activity, they are more prone to upper respiratory tract infections and digestive problems, particularly diarrhea. However, upon consuming foods rich in probiotics, respiratory infections and digestive issues were significantly reduced.

Another study demonstrated that eating yogurts daily can reduce the likelihood of vaginal yeast infections in women.

Dark chocolate

"Wrapped in shiny wrappers,

golden, red, silver, and brown,

chocolate, the king of sweets,

everyone's favorite treat,

drop it in your mouth,

it slips and melts,

bittersweet with nuts,

lover's gift, chocolate kiss!"

Most people who relate to the above poem by Reshma Ramesh can attest to the goodness of chocolates. Still, other than dark chocolate's reputation for being the king of sweets, dark chocolate is packed with powerful antioxidants and anti-inflammatory agents, including flavanols, catechins, and polyphenols.

Antioxidants protect the body and its immune system against free radicals, which are notorious for causing cancer, chronic health problems, and aging.

A recent study involving five healthy adults aged 25-50 asked the participants to eat 48 grams of dark chocolate daily for eight days. Blood samples were drawn from each participant before and after the experiment. The blood samples were analyzed to determine how dark chocolate consumption impacts gene expression and immune system function. The participants demonstrated an increase in gene expression, which promotes the activation of white blood cells, which help ward off infections and diseases.

Also, new evidence is emerging about the role of dark chocolate in fighting off colds and reducing cough due to theobromine , an antioxidant found in high concentrations in dark chocolates.

Sweet Potatoes

Sweet potatoes contain 77% water,20% carbohydrates,1.6% protein, and 3% fiber. Also, sweet potatoes are an excellent source of beta-carotene (a provitamin), which is then converted to vitamin A upon digestion.

The various compounds that make up sweet potatoes boost the immune system by preventing inflammation and cellular damage caused by free radicals.

The fiber content of sweet potatoes aids constipation and contributes to maintaining a healthy gut since 80% of the immune system occupies the gut.

A study carried out on infants in their first year found that infants that regularly consume the right portion of high-fiber foods, like certain fruits and vegetables, demonstrated increased levels of fecal butyrate, which indicates a reduced propensity to develop allergies and asthma later in life.

Green Tea

Green tea's ability to strengthen the immune system can be attributed to EGCC(epigallocatechin) , a powerful antioxidant in green tea leaves.

The reason why green tea trumps other teas can be attributed to the way green tea is processed. Camellia Sinensis (green tea) leaves undergo a steam-dry process for a short period and at a regulated temperature to prevent the fermentation of essential compounds, which makes green tea a rich source of antioxidants.

During the wake of the COVID-19 pandemic, many researchers experimented with the idea that green tea may suffice as a broad-spectrum therapeutic agent due to the presence of polyphenols in green tea and the lack of cytotoxic effects compared to other drugs, which makes green tea polyphenols a promising antiviral agent.

Green leafy vegetables

Top on the list of foods that boost the immune system are green leafy vegetables.

Broccoli, kale, cabbage, spinach, lettuce, arugula, etc., belong to a family of green leafy vegetables called" cruciferous vegetables."

Cruciferous vegetables are notable for their role in preventing certain diseases, including cancers, due to nutrients like vitamin C, vitamin E, vitamin K, folate, and minerals.

A 2018 study published in the international journal of cancer examined a group of women aged 27-59 years and observed that frequent consumption of cruciferous vegetables is associated with reduced breast cancer risk.

In addition to cancer prevention, green leafy vegetables are also great sources of folic acid, which is responsible for the production and maturation of healthy red blood cells.

Poultry

Consumption of poultry foods like chicken, turkey, and eggs provides you with a daily required amount of protein and vitamin B6.

Vitamin B6 is best known for its role in brain development and the production of antibodies for immune function.

Among the many health-promoting benefits of poultry foods, chief among them is the healing power of chicken soup, which is an excellent source of zinc, magnesium, and antioxidants.

Chicken soup has been lauded as a cure for colds for centuries because of a compound called carnosine, which relieves congestion, the stuffy feeling in your nose and throat. Studies have shown that carnosine cures a cold by reducing inflammation in the upper respiratory tract by stopping the migration of neutrophils , a component of the white blood cells, which contributes to your body's inflammatory response.

Eggs also strengthen your immune system because of vitamin A, vitamin E, selenium, and antioxidants. The major antioxidants found in eggs are lutein and zeaxanthin , which plays a role in reducing certain eye diseases, including cataracts, etc.

Nuts and Seeds

There's a lot to love about nuts and seeds. Options like: almonds, Brazil nuts, pecans, walnuts, cashew nuts, hazelnuts, flax seeds, pumpkin seeds, chia seeds, etc., just to name a few, are excellent immune system boosters.

Nuts and seeds are rich sources of fiber, protein, iron, and omega-3 fatty acids.

Research has shown that when consumed with vitamin C-rich foods, such as tomatoes, seeds and nuts help to reduce the likelihood of diabetes and heart diseases and also help maintain a healthy weight.

While it's true that nuts have a high percentage of total fats, spanning from 46% in cashew nuts to 76% in macadamia nuts . The total fat content in most nuts is chiefly attributed to monounsaturated fatty acids, best known as healthy fats, which help reduce low-density lipoprotein (LDL) cholesterol in the body.

Final takeaway:

Living healthy should be at the forefront of your mind at all times, and one of the ways to achieve this is by maintaining an optimal immune status.

A list of immune-boosting foods to help you get started has been discussed above. Be intentional about incorporating these superfoods into your daily diet. When unsure about your immune status, consult your healthcare provider for clarification and further medical advice.

References:

Berk, L., Bruhjell, K., Peters, W., Bastian, P., Lohman, E., Bains, G., Arevalo, J., & Cole, S. (2018). Dark chocolate (70% cacao) affects human gene expression: Cacao regulates cellular immune response, neural signaling, and sensory perception. The FASEB Journal, 32(S1). https://doi.org/10.1096/fasebj.2018.32.1_supplement.755.1

Calder, P. C. (n.d.). The immune system: a target for functional foods? | British Journal of Nutrition. Cambridge Core. https://www.cambridge.org/core/journals/british-journal-of-nutrition/article/immune-system-a-target-for-functional-foods/F78BF5CD910E58626D1AF79B47EFCBE9

Lollo, P. C. B., de Moura, C. S., Morato, P. N., Cruz, A. G., Castro, W. D. F., Betim, C. B., Nisishima, L., Faria, J. D. A. F., Maróstica, M., Fernandes, C. O., & Amaya-Farfan, J. (2013). Probiotic yogurt offers higher immune protection than probiotic whey beverages. Food Research International, 54(1), 118–124. https://doi.org/10.1016/j.foodres.2013.06.003

Van de Water, J., Keen, C. L., & Gershwin, M. E. (1999). The Influence of Chronic Yogurt Consumption on Immunity. The Journal of Nutrition, 129(7), 1492S-1495S. https://doi.org/10.1093/jn/129.7.1492s

Marvellous Olayinka is a freelance content writer who specializes in health and wellness. She is also currently training to be a medical doctor. You can connect with her on LinkedIn or check out her health blog , where she shares informative tips on healthy living.

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Is Weight Loss Surgery an Option for Me?

Fri, 20 Jan 2023 20:11:34 GMT

Is Weight Loss Surgery an Option for Me?

Written by Andrea Wickstrom, BSN, RN

Bariatrics is a medical specialty in the treatment of obesity. A bariatric doctor may use surgery as one of many options to help patients lose weight.

Bariatric surgery, commonly known as weight-loss surgery, has become an increasingly popular choice for patients with significant weight loss needs and those who have not been successful with more traditional attempts, such as diet, exercise, or medical management.

How does weight-loss surgery work?

Multiple methods can be used to manipulate the stomach and intestines, which handles digesting food and absorbing nutrients (including calories).

Part of the surgical approach is to restrict or cut away much of the stomach and create a significantly smaller food pouch.

Another technique is to re-route and bypass the small intestine, severely reducing calorie absorption .

These physical changes may also affect hormonal cravings, appetite, and feeling sick after eating fatty and high-sugar foods.

Both approaches, done separately or in combination, can cause drastic weight loss.

What are the types of weight loss surgeries?

Over time, the types of bariatric surgeries have evolved and become less invasive.

Often the selected procedure can be done laparoscopically (making multiple small incisions in the abdomen and using thin instruments and scopes). This approach usually has a reduced recovery time. However, depending on the severity of obesity, one larger open incision may be required.

Currently performed procedures are:

Adjustable gastric band (Lap Band) An inflatable band is placed around the upper part of the stomach to create a small pouch. It has an accessible port under the skin for multiple restriction adjustments.
Vertical Sleeve Gastrectomy (Gastric Sleeve) The outer curve of the stomach is cut away and left with a narrow tube or sleeve-like shape.
Roux-en-Y (Gastric Bypass) Part of the stomach is stapled into a smaller pouch. Then the small intestine is re-routed to the new pouch and the lower intestinal tract.
Biliopancreatic Diversion with Duodenal Switch (Mixed surgery) Comparable to combining the gastric sleeve with the Roux-en-Y. This type of procedure is seldom used and reserved for patients with the most severe obesity due to severe nutrient deficiencies.

How do I start the process?

First, you will need to talk with your doctor. Many healthcare organizations have dedicated clinics with specially trained staff to aid in the weight loss journey.

There are many steps to complete beforehand, including visits to a dietician, psychologist, and physical therapist, to name a few.

Pre-operative testing may include heart, intestinal, and liver scans.

Smokers will need to quit at least six weeks before surgery. If you have diabetes, the bariatric doctor will want to get your blood glucose levels under control first to improve postoperative healing.

Who qualifies for surgery?

Many insurance companies and bariatric clinics have specific criteria for individuals to meet before qualifying for surgery. These criteria may include

numerous failed weight loss attempts
a body mass index (BMI) of 40 or higher (this number is a calculation based on your height and weight)
a BMI above 35 with a secondary condition related to obesity, such as type 2 diabetes, heart disease , high blood pressure, or elevated cholesterol
a medically supervised weight loss attempt

A bariatric surgeon may also deny your request for surgery if you

have an uncontrolled mental health disorder
abuse drugs or alcohol
are high risk for complications
are unable to follow lifelong nutritional supplement requirements

What are the benefits of surgery?

Bariatric surgery is the most beneficial treatment for people with severe obesity and has the best long-term results.

However, surgery has many purposes, not just weight loss.

The goal is to improve overall health.

As a person begins to lose weight, secondary diseases often improve or resolve. Symptoms of asthma, joint and muscle pain, sleep apnea, and acid reflux will also likely be reduced.

Many patients experience an improved quality of life.

What are the risks and potential complications?

No surgery is without risks and possible complications.

Your bariatric surgeon will discuss all the surgical risks with you during the consultation. Potential postoperative complications include:

staple leaks
bleeding
blood clots
infection
blockages

What happens after surgery?

After surgery, your diet will be restricted and advanced slowly over the following months.

The bariatric team will guide you in returning to activities and exercise.

Support groups can help you through your weight loss journey and help you maintain your lifelong healthy lifestyle habits.

Lifelong follow-up with the bariatric team is crucial for long-term success.

Is surgery right for me?

Many traditional and medical approaches to weight loss can be successful. But if you need to lose a significant amount of weight and cannot achieve it without surgical intervention, bariatric surgery may be one more tool in your weight-loss toolbox to accomplish your health goals.

Sources

https://www.mayoclinic.org/tests-procedures/bariatric-surgery/about/pac-20394258

https://www.merckmanuals.com/professional/nutritional-disorders/obesity-and-the-metabolic-syndrome/obesity

https://www.merckmanuals.com/professional/nutritional-disorders/obesity-and-the-metabolic-syndrome/bariatric-surgery

https://www.niddk.nih.gov/health-information/weight-management/bariatric-surgery/definition-facts

https://medlineplus.gov/weightlosssurgery.html

Bio: Andrea Wickstrom has been an RN for over twenty years. Most of her experience has been cardiology related in the hospital setting (bedside and stress testing), but she also has worked in homecare, the cardiac medical device industry, and school settings. She also has a heart for people struggling with unsuccessful weight loss and finding hope in bariatric surgery.

LinkedIn: www.linkedin.com/in/andrea-wickstrom-rn-one-up-nurse-write

www.OneUpNurseWriter.com

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

The Healing Power of Music

Tue, 17 Jan 2023 23:22:16 GMT

The Healing Power of Music

By Heather Johnson, RN, BSN

thewritestuffhealth.com

Music is a powerful thing. We know it can evoke emotions and be a huge part of a culture. It is used in worship in many religions. Movie producers hire a composer to help tell the story or give an emotional impact. The Greek philosopher Pythagoras prescribed music as medicine.

Can it help your health?

Music and the Brain

Our brains can distinguish between music and noise. It responds to rhythm, tone, and repetition. The brain is responsible for interpreting what your ears hear. Different parts of the brain respond to components of music like pitch, melody, memory, and emotional response. When you listen to music, you use many parts of your brain. Music isn't music to us without the brain.

Music for Stroke Aftercare

According to the NIH, "Music-based interventions may be helpful in the rehabilitation of people who have had a stroke."

A 2019 review study of music used during the rehabilitation of stroke patients showed "Musical interventions could be beneficial for the functional recovery of an upper extremity."

Another review study showed music's usefulness in lowering depression post-stroke. Knowing that the brain is stimulated in many different areas while a person is listening to music, it is no surprise that music could be very beneficial for stroke victims. Patients who have had a stroke often need to "exercise the brain" to help regain the function that was lost after the stroke. What a fantastic way to exercise!

Music Therapy

Music therapy has been used in clinical settings for decades. For example, as a nurse in the ICU, I often used a music therapist to help my patients ease their pain or anxiety.

I also saw it helped many sleep deprived (a common issue in the ICU) patients fall asleep quickly.

The music therapist learns what music the patient likes, knows what their needs are, and plays music for them. Often the patient will sing along or play another instrument they know. It was a welcomed break from their illness. I often saw clinical signs of improvement, like less pain or lower blood pressure and heart rate. The patients were more relaxed, and I saw more smiles from them. Indeed, studies have recommended nurses use music to help their patients' anxiety levels.

Music to Help You Heal

We all want a strong immune system to fight against things like viruses and cancer. Music has been shown to increase gamma globulin A and boost killer T cells, parts of our complex immune system that fight against illnesses and diseases. When we are stressed, our cortisol levels increase. This lowers our immune response, increases recovery time, and puts us at risk of diseases and illnesses.

Music reduces stress (as evidenced by lower cortisol levels). So this can be another tool in our belt to boost our immune system.

Music for Anxiety and Depression

Most of us have probably struggled with anxiety, especially in recent years. Often we want a quick solution that doesn't involve medication.

Listening to music can be a great way to reduce your anxiety and help with depression. It increases your "feel-good hormone" called dopamine. In addition, it has been shown to increase serotonin (which helps with sleep and mood) and endorphins (responsible for lowering stress and pain response). This can help you feel better mentally.

Taking care of your mental health is important, and what better way than to enjoy your favorite music?

Music in Exercise and Sports

It would be difficult to imagine a high-intensity workout without music. Listening to music with the same tempo as your workout can motivate you and keep your intensity on track.

It has been shown to produce a slight increase in performance in sports and exercise. In fact, many sports and athletic competitions have rules in place about personal music devices while competing, being that it might be an unfair advantage.

Music is played in sports arenas and fields all over the world.

Regular exercise will improve your health, and music can help your exercise efforts in many ways.

Music Frequency and Cell Health

Exciting new research is being done on music's ability to alter non-auditory (hearing) cells.

In this study, dissonant music (non-rhythmic) caused cell death, and resonant music positively affected cells. This base research can open up new studies on music and frequency and its effect on health.

Frequency in music is the speed the air vibrates, which determines the pitch of a sound. The frequency of the music we listen to could help our health.

A study found that subjects who listened to the same music but at different frequencies (440Hz and 432 Hz) experienced different bodily effects. When subjects listened to music tuned to 432 Hz, their blood pressure, heart rate, and respiratory rate went down. When they listened to music tuned to 440 Hz, there was no change.

Many alternative medicine practitioners who use sound therapy on their patients are convinced that listening to specific frequencies can help heal the body.

Indeed, sound therapy has been used in healing practices for centuries. Tibetan singing bowls, drums, and tuning forks are tools of this trade, and many have benefitted from them.

More research is needed on frequency and sound healing, but it is an exciting subject that deserves more attention. You can find many videos with different musical frequencies you can try for yourself.

Summary

Music can be great for your health.

It can help with anxiety, illness and recovery, and sports performance. It may even go as deep as affecting your very cells.

Find a great music app and make playlists to help your health journey.

Explore different types of music and listen to them often. Discover your body's reactions to certain music and use it to your advantage.

Some things you must do to maintain health can be difficult or tedious, but music is a fun and easy way to help reach your health goals.

Sources:

[Efficacy of Music Therapy in Functional Recovery of the Upper Limb After a Stroke: a Systematic Review and Meta-Analysis] - PubMed (nih.gov)

The effect of music as an intervention for post-stroke depression: A systematic review and meta-analysis - PubMed (nih.gov)

NCCIH | NCCIH (nih.gov)

Effects of music in exercise and sport: A meta-analytic review. (apa.org)

(PDF) Exposure to Music Alters Cell Viability and Cell Motility of Human Nonauditory Cells in Culture (researchgate.net)

Music Tuned to 440 Hz Versus 432 Hz and the Health Effects: A Double-blind Cross-over Pilot Study - PubMed (nih.gov)

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Covid Nasal Vaccine

Tue, 17 Jan 2023 22:24:53 GMT

COVID Nasal Vaccine

written by Swathi Gadadasu

COVID-19 emerged as a global pandemic in 2019, affecting the lives of many and causing the death of 6,697,393 people over the globe. https://covid19.who.int/

Importance of the vaccine

Vaccines contain inactive or dead organisms that activate the body's immunity and produce antibodies against the specific infection.

When the pathogen enters the body via infection, our immunity will be ready with antibodies, so the chance of recovery is higher and the risk of death lower.

Development of the COVID Vaccine

Clinical research can be divided into two eras, pre-covid and post-covid. The covid pandemic has played an important role in the field of clinical research, with the onset of faster progression of all procedures required for the completion of clinical trials.

In the era of lockdown too, researchers over the globe worked 24/7 to develop a vaccine against the covid virus. Their endless determination and hard work led to the development of the covid vaccine that has saved many lives globally.¹

The COVID Vaccine

The covid vaccine has been utilized by all countries and proven to reduce the severity of the disease and death rates. In addition, the side effects of the vaccine are minor. However, it is injected into the muscles, requiring administration by trained health professionals.

The idea of the nasal covid vaccine has been introduced and developed, but it's still in the clinical trial phase.

Many people have wondered if the intranasal vaccine will have any advantages over the earlier vaccines.

Limitations of the Muscular Vaccine

The intramuscular covid vaccine is effective in activating the immune system. Still, the person infected with the covid virus can spread the virus to others. In addition, immune cells produced by the vaccine help protect from lower respiratory tract infections but are less effective for upper respiratory infections.

Covid infection is airborne, but this vaccine is unable to stop the infection at the most common site of entrance of the virus to the body, the nose. Since it is given into the muscles, it takes 10-14 days to immunize the individual for the covid virus.²

The advantages of the nasal vaccines are

The administration does not require trained professionals.
The nasal vaccine is available in powder form, making transportation very easy and economical.
The nasal vaccine can be self-administered.
The nasal vaccine increased immunity faster than the intramuscular vaccine in studies.
People who took the intranasal vaccine were less likely to spread the infection than those who received the intramuscular vaccine.
The nasal vaccine developed mucosal immunity, which helps prevent both upper and lower respiratory tract disorders.
The nasal vaccine is effective in developing immunity locally in the nasal cavity.
Mass vaccination programs can be conducted easily.
It's a needle-free method and can be administered to all ages.¹ ² ³

Let's have a look at some of the limitations of these vaccines:

The intranasal vaccines must complete all the phases of clinical trials before entering the market.
Pregnant women and children were not included in the clinical trial design of these vaccines; thus, the safety and efficacy of the vaccine in this population need to be studied further.
Since it is administered nasally, more doses are needed to maintain local immunity.

Though the advantages of the nasal covid vaccine appear to be greater than in the muscular, the side effects of the nasal vaccine need to be studied in detail which may take some time.³

Summary

Covid nasal vaccines have been proven to be effective in all aspects. However, more research and trials still have to be carried out to rule out potential side effects and aftereffects.

Prevention is better than cure.

Following covid protocols may reduce viral exposure and lower your chances of getting the infection.

References

Chavda VP, Vora LK, Pandya AK, Patravale VB. Intranasal vaccines for SARS-CoV-2: From challenges to potential in COVID-19 management. Drug Discov Today 2021;26:2619–36. https://doi.org/10.1016/j.drudis.2021.07.021 .
Alu A, Chen L, Lei H, Wei Y, Tian X, Wei X. Intranasal COVID-19 vaccines: From bench to bed. EBioMedicine 2022;76:103841. https://doi.org/10.1016/j.ebiom.2022.103841 .
Meenakshi S, Kumar VU, Dhingra S, Murti K. Nasal vaccine as a booster shot: a viable solution to restrict pandemic? Clin Exp Vaccine Res 2022;11:184–92. https://doi.org/10.7774/cevr.2022.11.2.184.

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

The Importance of Women's Health

Wed, 28 Dec 2022 19:44:25 GMT

Why Women's Health Is Important

By Lori Poston

An old expression says, "Women are the backbone of the world."

Nothing could be truer. Women are the nurturers, the caregivers to the sick and elderly. Women do the bulk of the childcare and household work and are the glue that holds the family and the community together. Add in women's economic and political role, and you see how strong and supportive this "backbone" really is.

Here is the caveat, while women are busy taking care of everyone else, they often forget to put their names on the list!

Annual physicals get postponed.

Dentist appointments take a back seat to their kids' needs.

Annual mammograms tend not to be so annual.

Work, childcare, elder care, and household duties leave little time for women's health.

We as a society need to change this scenario. Women, partners, families, work environments, and societal expectations must be adjusted.

We all need to heed the instructions from flight attendants, "put your own facemask on first, so you can help others."

Studies have shown that women juggling all these roles experience a much higher stress rate. This stress can manifest in many ways, such as depression, insomnia, heart disease, high blood pressure, and stroke. In addition, postponing annual pap tests and mammograms can lead to more advanced cancers.

Here are some of the most common health issues facing women:

Heart Disease/Stroke

According to the CDC, heart disease is women's leading cause of death [1] .

Heart disease refers to several heart conditions, including coronary artery disease and heart attack . Such conditions include blood pressure and high cholestero l, and are exacerbated by smoking , stress, and obesity. While you may assume heart disease is more of an issue for men, in reality, almost as many women as men die annually in the United States from heart disease. This number comes out to be approximately one in every five female deaths.

Poor heart health and conditions like high cholesterol and smoking also contribute to the high number of strokes women experience yearly, with strokes being the 5th leading cause of death for women in America [ 2] .

It is essential to know the symptoms of heart disease in women as these symptoms can differ from those of men. The most common symptoms of heart disease are dull and heavy neck, jaw, or throat pain and upper back or abdomen pain. These symptoms may present when a woman is at rest or active. Other symptoms may include nausea, vomiting, and fatigue. Like Type ll diabetes, heart disease may not present itself until it becomes more serious. Therefore, a woman may experience the above symptoms, heart arrhythmias, or palpitations at this time.

Breast Cancer

According to the American Cancer Society, Breast Cancer is the 2nd most common form of cancer found in women and one of the leading causes of death in women [3] .

The best defense against breast cancer is early detection. A monthly breast self-examination and a yearly mammogram are essential in detecting breast cancer before it can spread to other body parts. Unfortunately, women are not taught how to do a monthly self-breast exam. If a woman knows her own body, she may be able to detect changes or abnormalities before they become more severe issues. Teaching teenage girls the importance of self-exams and reducing the fear many women have about doing this quick 2–3-minute check once a month could save lives.

It is important to note that not all breast cancers will present symptoms, which further underscores the need for early detection as someone may have breast cancer and be unaware of it.

Diabetes

Diabetes is also a chief concern for women. Complications caused by diabetes include blindness, kidney disease, depression, and an increased risk of heart disease [ 4] .

Yearly physical examinations and blood tests to assess your A1C (blood sugar) level are crucial in detecting this disease early enough so that you can control your symptoms and avoid more serious complications. To better detect diabetes, women should also be knowledgeable about the symptoms of diabetes. These symptoms include increased thirst, urinating frequently, unexplained weight loss, weakness, exhaustion, mood changes, irritability, sores that are slow to heal, and vision changes.

The symptoms of type II diabetes may not be as common. Many people can live with type ll diabetes for years and not know it, which is another reason why it is so important for women not to postpone their own healthcare exams.

Depression and Mental Health

While both men and women experience depression and mental health struggles, women experience depression almost twice as often as men do, according to the Mayo Clinic [5] .

Depression can make motherhood and family life even more challenging and strain relationships. Consulting with a therapist or doctor can help to combat this disorder. In addition, your doctor may recommend various medications available for treating depression.

Gynecological Health

Gynecological Health covers diverse issues such as pregnancy, cervical cancer, ovarian cancer, pelvic infections, infertility , reproductive problems, pelvic pain, sexually transmitted diseases, and endometriosis. It also covers urological issues such as incontinence, menopause, sexual health, etc.

Menopause is still an under-researched and discussed topic. However, an average of 27 million women between the ages of 45 and 64, or 20% of the American workforce, experience menopause each year, according to the Society for Human Resource Management [6] . In addition to insomnia and hot flashes, women may also experience brain fog, dry skin, and muscle aches.

Incontinence issues are also a common issue. Researchers have found that one in four women experience involuntary urine leakage with aging. Unfortunately, the prevalence of this problem increases with age, with as much as 75% of women over 65 reporting urine leakage [7] .

In addition, after menopause, bone mass also decreases and thus increases the possibility of osteoporosis.

Menopausal issues also include Sexual health problems. While this is a topic finally getting the attention it deserves, many women suffer from dyspareunia (pain with intercourse), which affects relationships and self-esteem. The decrease in the hormone estrogen causes this. Helping women overcome dyspareunia includes options such as hormone replacement therapy, silicone vaginal dilators , and lubricants. As mentioned before, menopause is still an under-researched and under-discussed topic.

Talk with your gynecologist, urogynecologist, pelvic floor physical therapist, or health care provider about any health conditions you are experiencing.

Violence Against Women

Violence against women is a topic that is both underreported and underfunded. Unfortunately, domestic violence affecting the family is a common problem in the United States. As many as ten million people are affected by domestic violence each year. The numbers work out to 25% [8] of women and close to 10 percent of men being victims of domestic violence. In addition, this violence corresponds with a higher rate of depression and suicidal behavior. Sadly, only about 34% of people injured by their partners receive care for their medical injuries.

Studies have also shown that about one-third of people who are abused as children will become abusers themselves.

Children and adults with care and support needs are more likely to be at risk of domestic abuse. This abuse may manifest in physical as well as emotional abuse.

Summary

We must address all areas of women's health in our society. When women are not at their best physically and mentally, their families, relationships, and jobs suffer. And the lack of access to health education and services all play a significant role in the health of the individual, the family, and the community. In addition, we must acknowledge women's many roles economically, politically, and socially.

We need to make healthcare a top priority. Education and supportive work environments that encourage women to take time off for doctor's visits, as well as changing societal mores, all play an essential role. Let's never forget that the "backbone" holds everything together.

Sources:

[1] https://www.cdc.gov/women/lcod/2017/all-races-origins/index.htm

[2] https://www.utmbhealth.com/services/neurology/procedures-conditions/stroke/stroke-facts#:~:text=Stroke%20is%20the%20fifth%20leading,cause%20of%20death%20for%20women .

[3] https://www.cancer.org/cancer/breast-cancer/about/how-common-is-breast-cancer.html

[4] https://www.healthline.com/health/diabetes

[5] https://www.mayoclinic.org/diseases-conditions/depression/in-depth/depression/art-20047725

[6] https://www.axios.com/2022/11/23/the-growing-menopause-at-work-market

[7] https://www.obgyn-care.net/blog/female-urinary-incontinence-is-more-common-than-you-think#:~:text=Urinary%20incontinence%20can%20often%20seem,experience%20some%20involuntary%20urine%20loss .

[8] https://jech.bmj.com/content/58/7/536#ref-2

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Cholesterol: The Good Guy vs. The Bad Guy

Mon, 26 Dec 2022 08:00:05 GMT

Cholesterol: The Good Guy VS the Bad Guy

Written by Joan Strayham, MSN, RN

Cholesterol is our natural friend. There is an abundance of information to know and understand about cholesterol, such as why we need it, how it helps us, how it harms us, what healthy ranges to strive for, and how we can manage our levels. For this article, we will focus on healthy blood levels of cholesterol, and how abnormal levels can impact our health.

Cholesterol: The Good Guy

Cholesterol is essential to our health. It assists in the production of hormones, such as sex hormones, as well as Vitamin D. It helps our body make cell membranes which produce healthy tissue. Cholesterol assists in providing us with healthy skin and hair. Normal levels of cholesterol also assist the liver in producing bile, which is needed for food digestion.

Cholesterol: The Bad Guy

Having too much cholesterol in our bodies can be very harmful to our health. When too much cholesterol circulates through our body, it builds up in our arteries, clogging them, and making them thick and inflexible. The buildup of cholesterol causes our arteries to harden (plaque); this hardening of the arteries is called atherosclerosis. Atherosclerosis makes our heart and blood vessels work extra hard when providing circulation of blood through the body. Keeping too much of this guy around for too long can damage our arteries, increasing our risk of heart disease and stroke .

So, who is this Cholesterol guy exactly?

“Cholesterol is naturally produced by our bodies. It is a waxy, fat-like substance made in the liver, and found in our blood and all the cells of the body.” (National Cancer Institute) Cholesterol is also found in many of the foods we eat, primarily from animals, such as milk/dairy products, eggs, and meats, including some kinds of seafood.

What makes Cholesterol good or bad?

For this cholesterol guy to move through our bodies it must bind with proteins for proper travel. These proteins and cholesterols together are called lipoproteins. There are several types in our body, but for health management purposes, we will discuss the two main cholesterols here.

LDL (low-density lipoprotein) cholesterol is also known as the “bad cholesterol” because it carries the cholesterol TO your bloodstream, where it goes to work to clog your arteries.

HDL (high-density lipoprotein) cholesterol is also known as the “good cholesterol” because it carries the cholesterol back TO your liver where it can break down. That’s a good thing!

How can I make these two guys more memorable?

HDL -the H represents healthy cholesterol

LDL- the L represents lousy cholesterol

How do I know what a good level of cholesterol is for me?

The best way to measure the level of lipoproteins in our bodies is through blood work called a Lipid Panel (sometimes referred to as Lipid Profile or a Lipoprotein panel). A lipid panel measures:

Total cholesterol
LDL ("bad") cholesterol
HDL ("good") cholesterol
Triglycerides, another type of fat that causes hardening of the arteries

John Hopkins Medicine provides these ranges for the Lipid Panel.

Here are the ranges for total cholesterol in adults:

Normal: Less than 200 mg/dL
Borderline high: 200 to 239 mg/dL
High: At or above 240 mg/dL

These are the adult ranges for LDL cholesterol:

Optimal: Less than 100 mg/dL (This is the goal for people with diabetes or heart disease.)
Near optimal: 100 to 129 mg/dL
Borderline high: 130 to 159 mg/dL
High: 160 to 189 mg/dL
Very high: 190 mg/dL and higher

The above numbers are general guidelines because actual goals depend on the number of risk factors you have for heart disease.

Your HDL cholesterol levels should be above 40 mg/dL. This fat type is good for you because it lowers your risk of heart disease. The higher the number, the lower your risk. Sixty mg/dL or above is considered the level to protect you against heart disease. Remember, this is the “good guy.”

High levels of triglycerides are linked with a higher heart disease risk. Here are the adult ranges:

Normal: Less than 150 mg/dL
Borderline high: 150 to 199 mg/dL
High: 200 to 499 mg/dL
Very high: Above 500 mg/dL

Conclusion

In conclusion, cholesterol can be our friend. But too much of this guy can be detrimental to our health. Sometimes, hereditary factors can cause our cholesterol to be elevated. But often it can be corrected, and we can lead a healthy life. Correcting it sooner rather than later is a good goal.

How can it be controlled? Here are a few things we can do to manage it:

Eat a healthy diet that includes lots of fruit, vegetables, and whole grains.
Limit drinks and foods that have a lot of fat or sugar
Get plenty of exercise , at least 30 minutes every day.
Maintain your weight in a healthy range.
Manage your stress. (Research has shown that chronic stress can raise your HDL)
Stop smoking , or don’t start smoking .
Occasionally, your healthcare provider may recommend medications, called statins, to manage your cholesterol levels. (MedlinePlus)

Sources

https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/lipid-panel

https://medlineplus.gov

https://www.cancer.gov

Joan Strayham, MSN, RN is a freelance Nurse Writer (MS Writer) with more than 40 years of healthcare experience. She also provides public healthcare education through her blog: Just So You Know: Navigating Healthcare Like A Pro

https://www.linkedin.com/in/nursewriter

nursewriter1@gmail.com

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Does Nurse Burnout Affect Patient safety?

Wed, 21 Dec 2022 08:00:01 GMT

Does Nurse Burnout Affect Patient Safety?

Written by Ayla Roberts, MSN, RN

Picture this: You are a nurse on a busy hospital unit. Your unit is short-staffed, so instead of the five patients you are supposed to have (which is already too many), you have been assigned eight. To make matters worse, your certified nursing assistant called out, so you are also responsible for all of your patients’ daily activities, including feeding, toileting, and repositioning. Already, you can feel yourself drowning in the medications, treatments, and hygiene/comfort measures you will be responsible for today.

During the course of your 12-hour shift, your eight patients call you constantly to address their needs. One is in pain. Another needs to go to the bathroom. Another is confused and trying to get out of bed. Another pulled out their IV and is bleeding. Another has a family member who wants to talk to you. Another is nauseous. Another needs to be fed. Another needs to be discharged.

It is impossible to address everyone’s needs in a timely manner. You are only one person, and although you try to prioritize the best you can, some patients will feel neglected. You can’t call on a coworker for help because they are also busy with their eight patients. You feel overwhelmed and you realize you have been set up for failure. When administration receives poor patient satisfaction surveys, they will blame it on you. They will insist there is more you can do to “make the patients happy.”

When the day is done, you have been yelled at, cursed at, and berated because you could not be in all of these rooms immediately when you were needed. You leave work feeling defeated and completely unfulfilled in your career choice. You wonder, in all the chaos, if you kept your patients safe. Did you make a medication error? Did you miss a sign that your patient’s condition was worsening?

What is burnout?

Burnout has been a common issue within the nursing profession for many years. However, since the Covid-19 pandemic, nurses are experiencing burnout at an unprecedented rate. In fact, a new report shows that nearly half of all healthcare workers plan to leave their current positions by 2025. This decision to leave the profession is largely due to burnout.

Burnout is a condition directly related to a person’s workplace conditions and the stress that accompanies them. These factors can include an overbearing workload, ineffective teamwork, and poor organizational processes. Nurses experiencing burnout typical feel emotionally exhausted and detached from their work. They often feel unappreciated, overwhelmed, and demoralized.

But why do nurses feel this way? Why are they experiencing burnout unlike ever before?

In order to understand this, you have to consider all of the challenges that nurses face on a daily basis. As displayed in the example above, nursing is both physically and emotionally demanding. Nurses often deal with inadequate staffing, long work hours, poor unit morale, workplace bullying, and abusive behavior from patients. The level of depersonalization that burned out nurses experience can have serious consequences on care quality and patient safety.

The persistent challenges of patient safety in healthcare

Patient safety remains a steep challenge within the healthcare system. In fact, medical errors are the third leading cause of death in the United States , resulting in more than 250,000 deaths per year. When burnout is added to the mix, studies show that the risk to patient safety increases even more. In fact, there is a direct correlation between a nurse’s mental wellbeing and work performance. This means that nurses who are experiencing burnout are far more likely to experience a negative patient safety event than those who are not.

I believe that the blame cannot be placed solely on the nurse’s shoulders because the system is failing them. Nurses are so bogged down with poor organizational processes and an unrealistic workload that they can no longer do their job well. An overworked, overwhelmed nurse is not a truly safe nurse.

How do we fix this?

If healthcare entities truly care about improving patient safety, the burden of burnout among nurses cannot be ignored. Employers are experiencing increased pressure to provide a mentally safe workplace, but that pressure does not seem to be influencing the healthcare sector like it is other professions.

The truth is, as long as nurses continue to feel overwhelmed by unrealistic workloads, issues with patient safety will continue. A complete overhaul of our healthcare system and organizational processes is needed in order to ensure that nurse workloads are reasonable and safe. Only then will we see a true difference in patient safety outcomes.

References

Bio

Ayla Roberts is a freelance nurse writer and health content creator with over 8 years of clinical experience, primarily in pediatrics. She has also worked extensively in nursing education and healthcare simulation. She holds both a Bachelor's and Master's degree in Nursing, but her first love has always been writing. Connect with her on LinkedIn or visit www.thernhealthwriter.com .

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Signs of Mental Health Conditions in Children

Mon, 19 Dec 2022 08:00:00 GMT

Sign of Mental Health Conditions in Children: How Parents Often Miss It!

written by Andrea Gibbs

When it comes to mental health conditions that affect children, many parents miss them. This is because they mostly happen before the child has reached school age. However, once they begin school, they are more likely to be detected by teachers and officials at school.

Signs of these conditions are not something parents should ignore, as any delay can lead to permanent damage to the child's brain development. Parents need to be aware of any signs that may indicate their little ones are in trouble so they can seek help from a professional immediately.

Signs of Mental Conditions in Children

If you are a parent, chances are you've noticed when your child is having difficulty in school or at home. But what if the problem isn't what you think it is?

Take a look at these signs of mental health conditions in children that parents often miss.

Lack of concentration

Children with mental health conditions can have problems concentrating, following instructions, focusing on what others say, and completing tasks. They may also have difficulty organizing their thoughts or remembering things.

Here are the possible reasons a child with mental health conditions may have poor concentration:

ADHD
Anxiety disorders
Depression
Learning disabilities

As soon as you notice your child has poor concentration, you should consult a doctor or a professional who can help identify the condition and provide your child with the proper treatment.

Bedwetting

Bedwetting is another common sign of mental health conditions in children. This condition has been associated with various emotions, from fear to resentment and anger. In some cases, cognitive developmental delays come hand in hand with bedwetting and can make it more difficult to resolve the issue. This might be due to reasons such as

Psychological or emotional problems: Bedwetting can result from emotional stress caused by traumatic events or disruptions in a child's normal routine.

For examples:

moving to a new place
making the transition from one school to another,
the death of a loved one

These things can make the child insecure and frustrated, which is why they may not be able to control their bladder.

Cognitive developmental delays: This can cause the child to not fully understand the consequences of wetting their bed at night, or they may not realize it's happening.

Medical Problems: Bedwetting can be a sign of physical problems that affect the urinary tract and kidneys.

Lack of speaking

Lack of speaking can indicate a mental health condition. They may not talk at all or only speak erratically. Mental health conditions associated with this include:

depression
anxiety disorders
bipolar disorder
ADHD
autism

Even when a lack of speaking could be due to other factors, such as shyness or introversion, parents must be aware that children may also suffer from something more serious.

Changes in sleep pattern

The most common sign of mental health conditions in children is trouble sleeping.

Kids who are depressed or anxious might have trouble falling asleep and staying asleep, while those with ADHD might be restless at night and have trouble winding down.

Sleep problems are also common for kids with PTSD, who may have nightmares or trouble staying asleep. And have you ever heard a child complain about having "the jitters" before bedtime? That could be a sign that they're suffering from OCD—they can't relax because they're worried about something going wrong at night (like having bad dreams).

Parents need to seek professional help if they suspect their child has a mental health condition because, without treatment, the child could suffer permanent damage to brain development.

Sudden changes in behavior

The signs of mental health conditions in children can be difficult to spot. Some are subtle, but others are so obvious that it's impossible to miss them. Still, sometimes even the most obvious signs are ignored by parents.

Sudden changes in behavior can be shown as:

Irritability or becoming withdrawn: The child becomes moody and defensive.

Symptoms might be the following:

Sulking in a corner, refusing to talk to anyone
Spending most of the day alone in their room, refusing to interact with family members and friends.

Acting out: The child changes their behavior, becoming mouthy or misbehaving.

Symptoms might be the following:

Acting rudely or aggressively towards others-talking back to or ignoring parents and teachers-hitting and kicking other people in anger.
Setting fires or destroying objects in their environment.

Strange or sad: The child becomes unusually quiet or withdrawn, even for them.

Symptoms might be the following:

They spend all of their time alone, minding their own business-they suddenly lose interest in activities they used to enjoy.
They seem depressed or sad for no apparent reason.

Frequent mood swings

Parents often miss the signs of mental health conditions in children because they're so used to their children's mood swings. But there is a difference between normal mood swings and those indicative of a mental health condition.

If your child is experiencing frequent mood swings, you should consider speaking with your pediatrician. Kids with mental health conditions can be prone to mood swings. The signs may be:

being overly happy
being unusually sad or despondent
Phobias and abnormal fears, such as fear of certain animals or darkness.
An individual's mood changes faster than it should in the blink of an eye.

Physical symptoms. If the child is experiencing cuts, bruises, or other forms of physical pain, it may indicate a mental health condition.

Appetite and sleep patterns change. Different things can cause changes in appetite or sleeping patterns, but a few conditions are always associated with an alteration in appetite or difficulty sleeping.

Conclusion:

Mental health conditions are a reality that affects lots of children. If you're concerned about your child's behavior, you should contact your doctor for an evaluation or consultation with a mental health professional. Parents need to be aware of the signs indicating mental health problems in children because it could be much more than just a typical bad behavior.

Author Bio

Andrea Gibbs is the Content Manager at SpringHive Web company , a firm that offers web design services, maintenance, and Internet marketing. She specializes in content marketing, social media, and SEO. She is also a blog contributor at Hanei Health Solutions , a mental health care center, where she writes about topics that relate to mental health and the medical field. When she's not writing or working, she enjoys spending time with her family and friends. Andrea is also an avid reader and loves to travel!

Sources:

Understanding Anxiety: Common Symptoms and Treatment Options (haneihealthsolutions.com)

The Relationship Between Child Anxiety Related Disorders and Primary Nocturnal Enuresis - PMC (nih.gov)

Speech Deficits in Serious mental Illness: A Cognitive Resource Issue? - PMC (nih.gov)

Mood Swings in Children: Causes and What to Do - Cadey

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

The Flu: Then and Now

Wed, 14 Dec 2022 21:21:50 GMT

The Flu: Then and Now

written by Gina Vaughn

By now, everyone has heard of the flu and is familiar with the annual 'flu season. But you may not know that the flu we encounter yearly is a descendant of the Spanish flu.

The Spanish flu is a variation of the H1N1 strain found by examining infected bodies preserved in the permafrost in Alaska . It is the same strain responsible for millions of deaths in 1918 and became known as the worst pandemic in history.

History of the flu

The worst influenza outbreak came early in 1918 but had three major waves within that year.

The first wave in the spring had mild symptoms, with minimal casualties.

The second wave came in the fall of 1918 and was the deadliest of the 3. Officially there were approximately 45 million deaths worldwide, but that number is now considered extremely low. New estimates range from 50-100 million lives lost.

An article published by the Centers for Disease Control states, "More people died during the 1918 pandemic than the total number of military and civilian deaths that resulted from World War I."

It didn't start in Spain.

Initially, Spain was the only country whose media widely reported on the pandemic. Countries like the U.S., Russia, and Britain, who were involved in WW1, were not reporting on it to keep the morale high with the troops.

The perception was since Spain was reporting it, it must have originated there. However, that was not the case. Spain had relatively low numbers because they were not participating in the war and, therefore, did not have large numbers of troops sharing small spaces.

Treatments for Spanish flu

Because scientists didn't know what they were dealing with at the time, there were no vaccines or effective treatments. So instead, doctors gave out aspirin, hoping to heal it, but that proved more harmful than helpful . Some historians believe many individuals died from salicylic poisoning, as patients received more than 30 grams of aspirin daily.

Aspirin was a relatively new drug then, and doctors did not yet understand the side effects and effective ranges. (Today, doctors recommend no more than 4 grams daily.)

Influenza, 100 years later

The flu virus transmits through respiratory droplets, such as when saliva ejects from the mouth or nose while coughing or sneezing.

Research shows that the virus can live outside the body for 48 hours on hard surfaces like metal, glass, and plastic. It can also survive for around 12 hours on soft surfaces such as clothes and fabrics.

Cleaning

It is essential to clean and disinfect surfaces and wash any clothes, pillows, or blankets exposed to the virus to eliminate it. When working with hard surfaces, clean the area first if it has visible dirt, then rinse and use the appropriate EPA-registered disinfectant. Keep in mind that often the surface needs to remain wet with the product for 3-5 minutes to remove all germs effectively.

Who is High Risk?

Young children and those 65 years and older are at a higher risk than the general population. In addition, individuals who are immunocompromised or have a coexisting medical condition may also be at an increased risk .

Speak with your doctor if you have an underlying medical condition or cannot receive the flu vaccination.

Prevention

As we all know, preventive measures can keep us healthy during cold and flu season. Here are a few ways to practice healthy habits to keep sickness at bay:

Get your yearly flu vaccine. It is available for ages six months and older.
Wash your hands with soap and water. Washing your hands is the best way to prevent the spread of disease.
Cover coughs and sneezes with a tissue or the inside of your elbow. Avoid coughing or sneezing into your hands to reduce the spread of droplet contamination.
Avoid close contact with people who are sick. Keeping a distance of six feet between you and others can significantly reduce the spread of respiratory illness.
Avoid touching your eyes, nose, and mouth. This is how viruses enter our bodies.
Clean and disinfect contaminated surfaces and objects. This kills the virus and reduces the risk of contamination.
If you have the flu, stay home until you are fever free for at least 24 hours without fever-reducing medications.

Conclusion

While the flu strain has modified itself over the years, many characteristics have not changed.

However, what has evolved is the science we use to manage viruses and other medical challenges. Research has allowed us to understand their ability to mutate, which lets us predict and better prepare for upcoming mutations. This is seen yearly in vaccine modifications, which better protect us from new strains. The flu remains a serious virus and can potentially be life-threatening. However, with the knowledge of basic hygiene, prevention measures, and the understanding of how viruses work, we can avoid a recurrence of a flu pandemic in the magnitude of 1918.

Sources:

Aspirin Misuse May Have Made 1918 Flu Pandemic Worse -- ScienceDaily

How To Clean and Disinfect Schools To Help Slow the Spread of Flu | CDC

The Deadliest Flu: The Complete Story of the Discovery and Reconstruction of the 1918 Pandemic Virus | Pandemic Influenza (Flu) | CDC

Why the Second Wave of the 1918 Flu Pandemic Was So Deadly - HISTORY

10 Facts About the Flu: Symptoms, Vaccine, and More (healthline.com)

1918 Pandemic Influenza: Three Waves | Pandemic Influenza (Flu) | CDC

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Childhood Immunizations and the Importance of Sticking with the Schedule

Tue, 22 Nov 2022 07:30:00 GMT

Childhood Immunizations and the Importance of Sticking with the Schedule

By: Amanda Jane, RPN | Writer

Skepticism of vaccines has become much more prevalent since the COVID-19 outbreak. Parents are now, more than ever, worried about vaccine safety due to misinformation regarding vaccines. This has leaked over to childhood immunizations and thus, more parents are hesitant to vaccinate their children for childhood illness like polio and tetanus.

Childhood immunizations are a proven way to reduce the chances of contracting vaccine preventable illnesses and have been shown to eradicate diseases such as polio completely. Yet some parents are still worried about vaccine safety and the schedules that are put forth to ensure their children are vaccinated at the best possible intervals.

One of the biggest fears for parents is that their child is going to be exposed to too many illnesses at once through too many vaccines, and they fear that this is going to be hard on the child’s immune system. Parents like to feel in control of their child’s wellbeing and therefore, sometimes feel the need to change or manipulate the schedule in a way they feel is more appropriate to them.

Most parents do vaccinate their children according to their local Public Heath Regulated Vaccine Schedule. In fact, over 90% of North American children up to age 24 months, are vaccinated according to the Centre for Disease Control and Prevention (CDC). This is great news, however; there are still 10% of children up to age 24 months who are unvaccinated and pose a risk to other unvaccinated children and adults and are especially at risk themselves.

Childhood Immunization Schedules across North America are well studied and the best way to prevent children from contracting life-threatening diseases such as hepatitis, meningitis, tetanus, and many other vaccine preventable diseases.

Below, we have outlined exactly why staying on schedule is vital to the wellbeing of children across North America.

The Timing of Vaccines has been Well Studied

Vaccine schedules are set by the Centre for Disease Control and Prevention (CDC) and take into considerations many factors when it comes to administration of the vaccines and their safety. These regulations are set with very high standards by a specific panel of professionals called the Advisory Committee on Immunization Practices (ACIP). This committee is made up of scientists, doctors and Public Health professionals that study the efficacy of vaccines. Common topics discussed within the group include:

The safety and effectiveness of the vaccine when given to a specific age group
The severity of the disease
The outcomes of the disease without the vaccine
The effectiveness of the vaccine and how well it works

Preventing Complications from delayed vaccines

Delaying vaccines can cause potential, life-threatening consequences for children. For instance, when a young child contracts Pertussis, commonly known as whopping cough, there can be serious life-threatening complications that can lead to life-long side effects or even death. For example, the Pertussis vaccine is administered at 2, 4, 6 and 18 months thus giving the child an appropriate amount of immunity to the virus on a schedule that is most appropriate according to the ACIP.

Early Protection is Pertinent

All vaccines are timed appropriately to prevent children from contracting the virus before they are exposed while also giving them proper time for the immunity to build to help them better fight exposure if it happens.

The Measles, Mumps and Rubella (MMR) vaccine is a live-virus vaccine and is first administered when a child is 12 months old. This gives the child plenty of time to build up immunity for when they enter daycare centres and start to become more independent. Children are then boosted with a second dose around 4 years old, giving them optimal immunity to the virus for life.

Full- and Long-Term Protection from Preventable Diseases

Vaccines commonly need to be boosted to best fight off preventative illnesses. When administering the Varicella vaccine to children at their 15-month appointments, it was first thought that one vaccine would be enough to give a child proper immunity, but upon further research and investigation, doctors and scientists noted that children did best when vaccinated again with a booster shot of varicella at 4-6 years old.

It is quite common for the ACPI to revisit the drawing board to come up with the best and most innovative ways to protect children against vaccine preventable diseases such as varicella. This is important and just goes to show the care and consistency that goes on behind the scenes. The CDC advisory committee is revisiting and researching non-stop to help support and prevent vaccine preventable diseases.

Preventing Illness for Others

Heard immunity is a common phrase used to describe those that are vaccinated protecting those that are not from getting sick with vaccine preventable illness. When most of the population is immune, there is much less chance of contracting a virus because it’s not being spread from person to person.

Sometimes children and adult with underlying health conditions such as AIDS or Epilepsy are unable to get all their vaccines due to reactions and contraindications, therefore, it is the duty of their community members to get vaccines to keep everyone safe.

Vaccine schedules set by the CDC and carried out by Public Health Units across North America are very well studied. Schedules have been meticulously created by a team of professionals that have the community’s best interest at heart.

Preventing others from getting sick with heard immunization, is also important and plays a role n keeping people safe.

It is Important to get vaccines as per the local Public Health Guidelines as this is the best way to prevent complications and death from vaccine preventable diseases. Vaccine schedules are important to help enforce early prevention for communicable diseases.

References:

https://www.cdc.gov/vaccines/parents/schedules/reasons-follow-schedule.html

https://jamanetwork.com/journals/jama/fullarticle/2787289

https://www.cdc.gov/vaccines/parents/schedules/sets-schedule.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4943153/

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

RSV: Top 3 Ways to Care for Your Baby at Home

Tue, 15 Nov 2022 07:15:00 GMT

RSV: Top 3 Ways to Care for Your Baby at Home

Written by Joleen Sams

The news is filled with stories about the alarming increase in ER visits and hospitalizations due to a specific virus - Respiratory Syncytial Virus (RSV). For most older children and adults, RSV causes cold-like symptoms. However, for infants and toddlers, RSV can ‘settle’ further down in the lungs, causing bronchiolitis and/or pneumonia.

Read on to discover the top 3 ways you can care for your sick baby at home.

Note - Your pediatrician’s office can offer personalized guidance on what to expect and when to seek professional help for your child. The remainder of this article is intended to give general information and is not medical advice. If you are concerned about your baby’s symptoms, seek professional medical care.

What is bronchiolitis?

Bronchiolitis is inflammation of the smallest airways where gas exchange takes place. Infants and toddlers already have pretty small airways, so it doesn’t take much for those airways to get blocked. RSV and several other viruses can cause this infection.

Symptoms of bronchiolitis in infants and toddlers include:

Fussy, difficult to console
Runny nose
Coughing
Decrease in appetite
Decrease in activity
Poor sleep or sleeping more than usual
Sneezing
Fever
Wheezing

The symptoms typically last about 5-10 days; Days 5-7 are usually the ‘worst’ days for your baby’s symptoms. Healthychildren.org gives a great overview of symptoms that need professional attention.

Top 3 Ways to Care for your Baby with Bronchiolitis

1. Suction

Suction, suction, suction! Keeping your baby’s upper airway (Nose, mouth, throat) clear of mucus is the most helpful thing you can do. A clear airway allows more air to move into the lungs. More air in the airways = more oxygen for gas exchange!!

Suction Devices

The devices used to suction are officially called nasal aspirators. The three most common are:

Bulb suction.
Did you keep the blue bulb thing you got at the hospital? Watch this quick video on how to use the original ‘baby booger getter.’
Electric suction devices.
These use battery power to create suction. Brand options include Braun and Watolt
Parent-powered devices
NoseFrida is the most well-known brand, but there are several different types available
Basically, these are flexible straws that let you suck out your baby’s mucus. The concept is gross, but they are all designed with filters and barriers to keep the snot from getting to the adult.

Of all these options, the parent-powered ones are the most effective . As a nurse and mom, I personally attest that the amount you can suction is the closest thing to the wall suction used in the hospital.

Key points for suctioning at home

Swaddle: everyone loves a good baby burrito. Most of the time we say not to put their arms in so they can get to their face, but that won’t help here. Put those arms down straight on their sides and wrap ‘em up tight! (Obviously, undo your swaddle after you’re done suctioning.)

Saline drops: a couple of saline drops in the nostril will help loosen up the mucus and make it easier to suck out. These are available in the infant care aisle.

Timing: Suction before each feeding. This allows your baby the best chance of getting as much nutrition in before they tire out from trying to eat or drink. When they are not eating, suction as needed to keep their little airways clear.

2. Fluids

Feed Smaller amounts, but offer more times per day

Dehydration is the main reason infants and toddlers are hospitalized when they get sick. Your child is using more energy than normal just to fight the infection and breathe.

If your baby usually eats every 3-4 hours, try offering ½ their usual feeding amount at the 2–3-hour mark. You can always prepare more breastmilk or formula if needed.

For older infants and young children - make sure that liquids are readily available and that you are offering them at least a few times an hour. Offer easy-to-eat foods that your child likes.

Watch for wet diapers

Your baby should continue to make wet diapers even when they are sick. If the diaper has been dry for more than eight hours, you need to call their pediatrician or seek other medical help.

3. Hand Hygiene

We’re all well versed in hand-washing and other infection control measures almost 3 years into the pandemic, but the importance cannot be understated.

Wash your hands often and wash them well!

Hand Washing is the number one way to prevent the spread of viruses and bacteria to others - just do it!

Wrap-up

Any time your child is sick is scary for parents; bronchiolitis is no exception. However, even the best parental care won’t keep all children out of the pediatrician's office, urgent care, or ER. If you are concerned about your child, call your child’s doctor or seek other medical care immediately. Trust your instincts - you have them for a reason.

For infants and children that are sick, but not sick enough to be hospitalized, here are the top 3 things you can do to support your child through bronchiolitis:

Suction: Use a parental suction device for the best results.
Fluids: Offer smaller amounts more times during the day.
Hand Hygiene: Wash often and use hand sanitizer when soap/water are not available.

Take a deep breath and know that your infant will feel better in a few days. You’ve got this!

References

https://www.washingtonpost.com/health/2022/10/21/rsv-spread-explained/

https://www.cdc.gov/rsv/about/transmission.html

https://www.healthychildren.org/English/health-issues/conditions/chest-lungs/Pages/RSV-When-Its-More-Than-Just-a-Cold.aspx

Author Bio:

Joleen Sams is a Family Nurse Practitioner with over 15 years of experience in the healthcare industry. Her areas of expertise include NICU, pediatrics, and mental health. She strives to provide insightful and educational information to her audiences.

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

CT Scans and PET Scans

Tue, 08 Nov 2022 21:42:30 GMT

CT Scans and PET Scans

written by Katherine Garner

PET and CT scans are both important imaging tools, but you might not know the differences between them. This article will explain what PET and CT are, how they produce images, and in which situations each scan may be used.

What are PET and CT?

PET and CT stand for Positron Emission Tomography and Computed Tomography, respectively. Tomography - with roots in the Greek tomos, meaning ‘section’ or ‘slice’ - is the process of imaging the inside of the body in a series of cross-sectional slices. These slices are digitally stacked to recreate a three-dimensional image of the patient, organ, or tissue. PET and CT both create these slices, but they use different technologies to do so, providing different medical information as a result.

CT uses x-ray radiation to image the inside of the body. In a CT scanner , the patient is flanked by an x-ray beam on one side, and a detector on the other. Unlike a conventional x-ray, CT is three-dimensional: the x-ray beam and detector rotate around the patient to capture the same section from different angles. The amount of x-ray radiation which reaches the detector depends upon the density of the body part it is passing through. By analysing the amount of radiation detected at different positions in the rotation around the patient, a computer programme can reconstruct an internal image of the body.

Like CT, PET is a three-dimensional scan. Instead of using energy from x-rays, a PET scanner detects tiny spikes of radiation produced by positrons . Positrons are small particles which are given off when an injected radioactive drug, called a radiotracer, decays over time. When these positrons collide with body tissue, they produce spikes of radiation. The scanner detects these spikes and converts them into an image showing where the radiotracer has accumulated.

PET radiotracers are often radioactive versions of substances used by the body, such as sugar, amino acids, or ammonia: this enables them to be taken up or used by different tissues. Different radiotracers are designed to accumulate in different tissues and cause them to become visible to the scanner.

The most commonly used radiotracer in oncology is a sugar called [ ¹⁸ F]-fluorodeoxyglucose , or [ ¹⁸ F]-FDG. Cells can take up natural sugars like glucose and break them down for energy, so they can take up [ ¹⁸ F]-FDG too. However, this sugar is chemically modified so that it cannot be broken down and accumulates in the cell. Very energy-intensive cells which use lots of glucose, like cancer cells, will also accumulate more [ ¹⁸ F]-FDG than other cells. This makes tumours appear as activity ‘hotspots’ on the PET scan.

What information can PET and CT tell us?

By using different radiotracers, PET can be tailored to show different information about the patient. We have talked about the tumor radiotracer [ ¹⁸ F]-FDG, but there are many others:

Choline is a nutrient which participates in the production of new cell membranes. Areas where many new cells are being produced, such as tumors, will therefore take up more choline than normal cells. Radiolabeled choline can be more accurate than [ ¹⁸ F]-FDG when imaging tumors in energy-intensive organs like the brain.
[ ⁸² Rb]-Rubidium chloride is absorbed from the blood very effectively by cells in the heart muscle (myocardium). It can therefore be used to identify areas of the heart which are not receiving enough blood; this is called a myocardial perfusion scan .
[ ¹⁸ F]-Sodium fluoride is a salt which is used to image bone diseases . It adheres to the outer layer of the bones, acting similarly to the protective coating that fluoride toothpaste forms on teeth.

CT is used to obtain realistic images of the internal organs. Unlike a normal two-dimensional x-ray, CT offers precise spatial information which may be required in certain cases. It offers a non-invasive way to identify sites of damage after a major traumatic injury, for example, and shows soft tissues better than a normal x-ray. CT can be combined with further contrast-enhancing agents, for example intravenous dyes which make blood vessels more visible in the scan; this can be used to locate abnormalities like aneurysms or blood clots.

In some cases, both PET and CT may contribute different useful information, and in this case a combined PET-CT may be used.

Who can have a CT or PET scan?

Unlike Magnetic Resonance Imaging (MRI), both PET and CT are safe for use in patients with pacemakers or metal implants. However, radiation dose is an important safety consideration.

Radiotracers are considered safe because they lose their radioactivity rather quickly; this is why they are injected into the patient no more than an hour before a PET scan. The radiotracer is degraded and flushed out of the body within a few hours.

Researchers have estimated that a whole-body combined PET/CT scan exposes the patient to a dose of around 12 millisieverts, which is three times the yearly radiation exposure of the average person (a useful visualisation of these doses can be found here ). Hence, the use of these procedures is not a decision to be taken lightly. The safety of PET and CT may be improved further using technologies which reduce the required radiation dose, such as machines with image enhancement algorithms.

Usually, PET and CT are avoided in pregnant women and babies as a precautionary measure. In some cases, however, they might be necessary , for example to locate a tumor for treatment which could negatively affect the pregnancy if left untreated. Locating the tumor by PET or CT exposes the fetus to radiation, but the risk to mother and child of leaving the tumor untreated might be far greater.

Summary

CT and PET are both types of tomography – an imaging method which constructs 3D images of the body from a series of "slices".
CT provides anatomical images of the body, whereas PET provides information about the activity and function of different tissues.
Each scan uses a form of radiation. CT uses external X-rays which are passed through the patient, whereas PET uses radiotracers which can be taken up by different tissues in the body.

Sources

CT Scan - National Health Service

How Does it Work? Positron Emission Tomography - British Medical Journal

PET Scan - National Health Service

Brain tumour imaging with carbon-11 choline: comparison with FDG PET and gadolinium-enhanced MR imaging - European Journal of Nuclear Medicine

Myocardial Perfusion Scan - StatPearls

Clinical PET Imaging in Prostate Cancer - RSNA Radiographics

Radiation Dose from Whole-Body F-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography: Nationwide Survey in Korea - Journal of Korean Medical Science

Radiation Dose Chart - xkcd

The use of PET/CT in pregnancy: A case report of malignant parathyroid carcinoma and a review of the literature - Obstetric Medicine

Katherine is currently completing a Masters by Research in Cancer Biology at Imperial College London. She is enthusiastic about science communication and is a contributor to both of the College’s science magazines, I, Science and Broadsheet , where further examples of her writing can be found. She can be contacted on LinkedIn .

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

All You Need to Know About Telehealth Services in 2022

Mon, 31 Oct 2022 23:17:07 GMT

All You Need to Know About Telehealth Services in 2022

Written by Dr. Lori Poston

You may have overheard people speaking about telehealth or you have read about it in healthcare journals or articles. Telehealth refers to the delivery of healthcare services to patients using technology.

To access telehealth care, you need a device that can access the internet and a healthcare facility with a working telehealth policy.

Telehealth services allow you to talk to your healthcare provider and have them monitor your progress remotely. Telehealth services, such as those provided by Telehealth Care Florida , keep improving, but there is still a long way to go in making it work.

Here is all you need to know about telehealth services in 2022.

History of Telehealth

Telehealth began in the 1940s when the first radiological images were sent via telephone. Doctors began using the telephone to communicate with their patients and other healthcare providers until the introduction of the internet in the 1990s.

As more people gain access to the internet, healthcare providers are now using various devices, such as computers and smartphones, to offer telehealth services.

Telehealth vs. Telemedicine

Sometimes telehealth is used interchangeably with telemedicine, but these two terms mean different things.

Telehealth is a broad policy that covers different healthcare services, including medical care provision, education, and self-care communication.

Telemedicine, on the other hand, refers to the remote treatment of patients using telecommunication technology.

Types of Telehealth Services

Patients can access several types of telehealth services depending on their health condition. Your doctor can use telehealth to monitor your condition and determine the next cause of action. They can also use telehealth to send information, such as your medical records, to other specialists.

Healthcare providers can also use telehealth to send you information regarding your condition and instructions on managing it. Telehealth can help contain and manage patients with infectious diseases, such as Covid-19.

Pros and Cons of Telehealth

The pros of telehealth services include reduced physical access to patients, reduced waiting periods, virtual healthcare visits, and easy access to specialists. Telehealth reduces unnecessary emergency room visits; hence healthcare providers only attend to people needing emergency treatment.

Telehealth is not perfect, and some of the disadvantages of telehealth include difficulties conducting physical examinations, few people having access to the internet, and too many regulations making healthcare providers hesitant to implement telehealth in their facilities.

Summary

Current and emerging technology can help improve telehealth services and improve access to healthcare. There are disadvantages to using telehealth, but the advantages outweigh them; hence telehealth is perfect for every healthcare system. If you have concerns about using telehealth, you can discuss it further with your healthcare provider.

Sources:

Telehealth: The advantages and disadvantages - Harvard Health

Why Should We Not Ignore Telehealth Care After The Covid 19 Pandemic? | Telehealth Care Florida

Dr. Lorie Poston is a nurse practitioner with over a decade of experience in medicine. She is a dual board certified as a Family and an Adult-Gerontology Acute Care nurse practitioner and now operates Telehealth Care Florida .

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Infertility and IVF

Mon, 24 Oct 2022 07:15:00 GMT

The Not so Conventional Forms of IVF

Written by: Madison Carpenter, RN, BSN, CCRN

Infertility is still a problem for many couples in the United States.

Both men and women can have identifiable infertility factors, but there are instances when reasons for infertility are not known. Depending on the causative factor, these couples may look into infertility services which can be as simple as taking certain medications to improve sperm count and ovulation, or more invasive procedures like intrauterine insemination (IUI), sperm retrieval, or undergoing corrective surgeries.

Another evolving invasive procedure is assisted reproductive technology (ART).

In vitro fertilization (IVF) is a form of ART. When you think of IVF you are most likely thinking of the conventional form of IVF.

The other less known forms of IVF that can still be an option are natural cycle IVF or minimal stimulation IVF, both of which have their pros and cons.

In all forms of IVF, the procedure remains relatively the same.

The mature eggs are retrieved from the woman’s ovaries and fertilized by the man’s sperm in a lab. This can be done by allowing the sperm to penetrate the egg or through intracytoplasmic sperm injection (ICSI).
Once at an embryo stage of development it is then transferred to the woman’s uterus in the hopes that it will implant.

The difference in these IVF options are the medications used, side effects, cost, and the goal of therapy.

Conventional IVF

In conventional IVF the goal of therapy is quantity.

More medications are used to induce the production of more eggs thus increasing the chance of ovarian hyper-stimulation syndrome (OHSS).

OHSS is characterized by abdominal pain, bloating, rapid weight gain, or shortness of breath due to fluid buildup in the abdomen and chest.

Other drawbacks of this form of IVF are that it is more costly because more medications are used and can be more invasive as more injections are needed. Since more eggs are produced using this form of IVF, sedation or general anesthesia is needed to retrieve the eggs, increasing the cost and side effects.

Minimal Stimulation IVF

In minimal stimulation IVF , the goal of therapy is quality. Less medication means fewer eggs are produced but with increased viability, or quality.

This form of IVF reduces the cost and the chances of having multiples (twins, triplets, etc.)

Since fewer eggs are produced, most clinicians can utilize local anesthetics instead of generalized sedation, keeping the cost lower.

One of the downsides of having fewer eggs is you may not have eggs to freeze for later implantation. This form of IVF can also take longer as it involves waiting for the next menstrual cycle for embryo transfer.

Natural Cycle IVF

Natural cycle IVF is a minimalistic approach and is the endogenous form of IVF, which utilizes the woman’s own hormones to develop a single egg. Although medications used to stimulate the ovary to produce multiple eggs are eliminated, some medications can be used to prevent early ovulation and support the maturation of the egg.

Pregnancy rates are lower than conventional IVF, but it is an alternative for some couples. These include couples with multiple failures attempting conventional IVF, couples with male factor infertility (low sperm count or quality), or women with predisposing factors that cannot tolerate the medications associated with conventional IVF, such as cancer. One other disadvantage is that the availability of only one egg eliminates the couple's option of gender preference selection.

While the use of minimal stimulation and natural cycle IVF has been a slow introduction into clinical practice, it’s good for couples to know there are other options.

Discussing the best treatment with your provider is recommended as each couple has differing factors contributing to their infertility or health.

References:

Infertility: Diagnosis & Treatment- (mayoclinic.org)

In vitro fertilization (IVF)- (medlineplus.gov)

MiST IVF offers less expensive, easier treatment for motivated parents- (mayoclinic.org)

Natural Cycle IVF- (uscfertility.org)

Author Bio:

Madison Carpenter, RN, BSN, CCRN is a nurse with nine years of bedside experience in a variety of settings. From medsurg/tele to ICU, ER, and now PACU. She hopes to now bring her extensive knowledge and love for patient and fellow nurse education through writing.

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Bell's Palsy

Thu, 20 Oct 2022 07:30:02 GMT

Bell’s Palsy: What you Need to Know

Written by Courtney Southwick, MS

What is Bell’s palsy?

Bell’s palsy is a type of temporary facial paralysis that comes on suddenly, usually on only one side of the face.

The symptoms are caused by dysfunction of the seventh cranial nerve, which controls upper and lower facial muscles. This can cause difficulty with smiling, blinking or closing the eyes, or making normal facial movements. Symptoms usually begin suddenly over the course of several hours up to a few days, and most people recover fully within one to three months. Some severe cases experience long term muscle weakness.

The exact cause of Bell’s palsy is unknown.

Medications can help lessen the symptoms of Bell’s palsy but should be started within 72 hours of the onset of symptoms.

What are the Symptoms of Bell’s palsy?

Because the cranial nerve is very complex and carries nerve impulses to many parts of the face, symptoms can vary.

The most common symptom is sudden weakness on one side of the face. It can be accompanied with

a slight fever
pain near the ear or jaw
inability to close the eye
drooping of the mouth,
drooling

It usually progresses rapidly over 48-72 hours and can range from mild weakness to total paralysis. Other symptoms may include:

headaches
loss of taste
hyperacusis (increased sound sensitivity)
decreased tear and saliva production
abnormal sensations

Severe cases may present the following:

affected nerves on both sides of the face
fully paralyzed muscles
complete inability to close the affected eye,
dysfunction of the corneal reflex (meaning the eye does not close when touched)

Bell’s palsy symptoms sometimes begin following a period of stress in a person’s life. Stress can lead to reduced immunity, which is thought to trigger the condition.

What causes Bell’s palsy?

While the specific cause is unknown, patients with Bell’s palsy show swelling and inflammation of the seventh cranial nerve. This nerve passes through a narrow bone corridor and controls the muscles of the face. The swelling of the nerve in the tight space leads to reduced blood supply.

The condition has been linked to viruses, such as herpes simplex . Many scientists believe that dormant viruses in the body may reactivate during times of impaired immunity , which may be caused by

stress
illness
autoimmune diseases
physical trauma
sleep deprivation

There may also be a possible genetic predisposition to Bell’s palsy.

What are the risk factors and complications?

Each year in the United States, 40,000 people are diagnosed with Bell’s palsy.

The condition affects males and females equally and it can happen at any age.

Certain conditions can increase the odds of developing Bell’s palsy:

pregnancy (especially third trimester)
diabetes, obesity
hypertension (high blood pressure)
upper respiratory illnesses

Recurrent attacks are uncommon and happen more often in people who have a family history of Bell’s palsy.

Most cases resolve within a month, but severe cases may lead to complications. These can include irreversible damage to the nerve and synkinesis (unwanted muscle contractions of the face). Other complications may arise from the inability to completely close and protect the eye, including cornea scratches or blindness.

How is Bell’s palsy diagnosed?

There are no specific tests available to diagnose Bell’s palsy, but some tests can be used to rule out other conditions.

A physician will examine the individual by looking at the face and asking the patient to perform movements such as lifting the brow, smiling, closing eyes, or showing teeth.

A test called electromyography may be used. This measures the electrical conductivity of the nerve to assess the damage.

Imaging, such as CT scans or MRIs may be ordered to rule out other causes, like fractures or tumors.

Blood tests may be ordered to rule out Lyme disease or other infections that may cause similar symptoms.

What treatments are available?

Most patients recover completely without any treatment. There is no one size fits all treatment; it will look different for each patient. Treatment options can include:

Medication:
Oral steroid drugs, such as prednisone, have been shown to be very successful, especially if started within 72 hours of onset of symptoms. This can increase the probability of fully restoring the function of the nerve..
Antiviral medications have been used, but their benefits have not been fully established.
Pain-relieving medications, like ibuprofen or acetaminophen, may help reduce pain levels.
Botulinum toxin (Botox) can reduce muscle overactivity.
Physical therapy:
Facial massage can help the muscles maintain mobility and nerve function.
Physical therapy exercises can work the muscles and prevent them from shortening and tightening as they heal.
Surgery:
Surgical options, where damaged nerves are connected to healthy nerves, are also available, but doctors suggest conservative measures be taken first.
In rare and severe cases, plastic surgery may be used. This can help correct lasting nerve issues, help reanimate the face, and sometimes even restore movement.
Support: Counseling or support groups can help patients deal with anxiety or feelings of social isolation. A physician’s office will have contact information for these groups.

For eye damage that results from Bell’s palsy, there are many treatments available. These include
eye drops
goggles
taping of the eye for protection

What is the prognosis for Bell’s palsy?

The prognosis is usually positive, with improvement seen within weeks in the majority of cases. Most individuals are able to regain full facial function, though some may continue to experience facial weakness.

Summary

Bell’s palsy is a rare condition that causes temporary facial paralysis. It may have viral or genetic origins, and possibly be brought on by increased stress. Symptoms vary widely, but all include facial weakness. If medical care is sought quickly, the outcome is usually positive.

The National Institute of Neurological Disorders and Stroke (NINDS) is currently studying the circumstances and conditions that lead to nerve damage. Scientists and researchers are also looking into genes that may be involved. More information about research and funding may be found here .

References:

https://rarediseases.org/rare-diseases/bells-palsy/

https://www.mayoclinic.org/diseases-conditions/bells-palsy/symptoms-causes/syc-20370028

https://www.ninds.nih.gov/bells-palsy-fact-sheet

https://pubmed.ncbi.nlm.nih.gov/12218634/

https://www.nature.com/articles/s41598-021-82736-w

https://www.sciencedirect.com/science/article/pii/S1568997212001152

Courtney Southwick is a freelance writer focusing on health, nutrition, and disease. She holds a Master of Science in Health Science and has been writing since she was a child. She is available for freelance writing assignments. Visit her at CourtneySouthwick.com or on LinkedIn .

Thank you for reading the Write Shift RN blog.

Are Supplements good for You?

Mon, 17 Oct 2022 07:30:00 GMT

How healthy are supplements?

Written by Kopy Klinic .

According to Penn Medicine , based on legal claims, it is wrong for companies to state that their products can heal, treat, or cure any disease.

More than ¾ of Americans take dietary supplements .

What is a supplement?

The word supplement means something that enhances or boosts the performance of another thing.

Dietary supplements come from food sources to enhance the quality of human health when consumed. They may come in different forms like tablets, liquids, or capsules.

What you should know about supplements.

The average citizen of any country feels they are healthy when they take supplements. A lot of individuals have tons of them in their homes. Not because they feel any illness, but because they believe taking them makes them healthy. Which is not bad because most individuals do not receive all the necessary nutrients from their meals.

To some degree these dietary supplements are very effective, and most of them may provide the results their manufacturers have claimed.

However, most of these supplements may have negative effects on your body, probably because you took more than your body can absorb or not enough to make a difference. For example, too much vitamin A can cause headaches or damage to your liver and other vital organs.

Some vitamins could lead to an increase in bleeding from a little wound or change a person's response to anesthesia if taken before surgery . O ther supplements, such as St. John’s Wort, may reduce the effectiveness of certain medications. Antioxidant supplements, like vitamin C and E, reduce the effectiveness some cancer chemotherapy.

Should supplements replace drugs?

If you take prescription medications, always talk to your doctor before stopping the medication or taking a new supplement. These practices have led to increased health risk for many people.

Everyone has different health needs and health conditions, which can make balancing prescription medications and supplements very challenging for some.

Therefore, before you are given any medication, your healthcare provider should ask you some questions. They need to be sure a medication meant to treat you doesn't harm you. Some supplements manufacturers may not acknowledge this because they want to make sales.

How important is my doctor's advice on the supplement to use?

A doctor's advice is very important.

As a personal example, one time I was spending a holiday with my aunt. Her neighbor heard of a certain supplement, and without much research she got some for herself. My aunt suggested she speak with her antenatal healthcare provider before taking the supplement. But she didn't listen. After three days she lost her baby.

Was the supplement bad?

Not necessarily. But in this situation, it may have contributed to the death of her unborn baby.

Some supplements can be harmful in certain situations and health conditions. This unfortunate situation may have been avoided if the neighbor had spoken to health practitioners before starting a new supplement.

Can supplements replace a healthy diet?

If you can get the necessary essential minerals and vitamins from a natural healthy diet , taking supplements isn’t necessary.

No matter the benefits you feel you are getting from a particular supplement, it is always better to get your nutrients from you diet. Nothing can replace a nutritious, natural, non-processed foods diet.

This does not mean that supplements are bad. But too many individuals now focus their attention on supplements instead of eating healthy foods.

Conclusion

Supplements claim to help you get the nutrition that you need, but it is always better to get the vitamins and minerals your body needs from your meals if possible. Getting proper nutrition can be a challenge. Juggling medications and supplements can make this even more difficult.

Here are some tips that may help you:

Eat a healthy diet.
Take supplements as recommended by your doctor to fill in the gaps in your diet.
Research the supplement brands, some are a better quality than others.
Never replace your prescription medications with supplements without talking to your doctor first.
Never start a new supplement without talking to your doctor if you have been diagnosed with a medical condition or are pregnant or plan to become pregnant.
Talk to your doctor if you have questions regarding the supplements you are currently taking.
Make a list of all of the medications and supplements you take, how much you take, and why you take them. Keep a copy of this list at home with your other health information and another copy with you in your purse or wallet. Update the list every time a change is made to your medications or supplements. Give the list to your doctor every time you see them or are admitted to the hospital for any reason.

Sources

https://www.pennmedicine.org/updates/blogs/health-and-wellness/2020/february/the-truth-about-supplements

https://ods.od.nih.gov/pubs/DS_WhatYouNeedToKnow.pdf

Thank you for reading the Write Shift RN blog.

Wound Care: Pressure Injuries, Chronic Wounds, and Traumatic Wounds

Thu, 13 Oct 2022 08:00:00 GMT

Wound Care: Pressure Injuries, Chronic Wounds, and Traumatic Wounds

Written by Meagan De Carlo BSN, RN, CWS

In the previous blog posts, Why YOU Might Need Advanced Wound Care and Wound Care: Diabetic Ulcers, Venous Ulcers, and Arterial Ulcers , we addressed what a visit looks like at an Advanced Wound Care Clinic and then dove deep into specific treatments for diabetic, venous, and arterial ulcers.

This post will focus on Pressure Injuries, Chronic Wounds, and Traumatic Wounds.

Pressure Injuries

Pressure injuries usually occur when someone is immobile, either in bed or in a wheelchair. Often, these people will also have poor nutrition and low pre-albumin levels, an indicator of insufficient protein intake.

How can advanced wound care help pressure injuries?

Relieving pressure, improving nutrition, and proper wound care can help to heal pressure injuries.

Registered Dieticians play a critical role in the team management of these types of wounds.

Wound healing requires 1.25-1.5 grams of protein per kilogram of body weight per day compared to approximately 0.8 grams of protein/kilogram/day for a healthy adult without a wound.

Let me illustrate with some math for you, using a 130-pound person as an example. 130 pounds = 58.9 kg, so this person would need to eat a minimum of 73 grams of protein per day for wound healing. What does that look like? Well, 1 egg has 6 gm of protein, a 3oz hamburger has ~22 grams protein, and lentils have ~ 18 grams per cup.

Often, supplementation with a protein shake is recommended .

Chronic Wounds

Chronic wounds are often mismanaged wounds or related to other pathologies such as auto-immune diseases.

Often, people with chronic wounds come to wound centers to find ways to best manage their wounds, without the goal of healing their wound.

How can advanced wound care help chronic wounds?

For people with wounds that have a low likelihood of healing, wound care becomes wound management.

Special absorbent dressings can be ordered to help with excessive drainage, medicine can be ordered to help with pain and any foul smells that might occur when there are a lot of bacteria present.

Often patients with chronic wounds will meet with a Medical Social Worker who can help find any resources they may need, whether it is assistance with State Disability or emotional support.

Traumatic Wounds

Traumatic wounds sometimes need help from the wound care experts because the general physicians don’t have the advanced training that the wound care team has.

Wound healing involves many complex responses from the body and there are many wound care products that can help to move the body’s wound healing in the right direction.

Healing wounds is a complex process, so much of the healing takes place “behind the scenes."

Summary

If you have a wound that is not showing signs of healing after 2 weeks, or is not completely healed after 6 weeks, YOU may need Advanced Wound Care.

To be sure that you will receive the best care possible, look for a wound center that has the Joint Commission Gold Seal of Approval and/or Healogics National Award of Excellence and Center of Distinction. The wound center should have board certified physicians and wound care nurses that are certified in wound care, deeming them experts in their field.

Sources

https://www.cdc.gov/diabetes/basics/type2.html

https://www.cottagehealth.org/locations/goleta-valley-cottage-hospital/wound-care/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8539411/

Meagan is a Registered Nurse with 17+ years working at the bedside. She has worked extensively with mothers and their newborn babies, all medical-surgical floors in the hospital and, most recently at the Ridley-Tree Center for Wound Management, one of only three centers in California and one of 21 in the nation to earn the Joint Commission Gold Seal of Approval. Meagan is a Certified Wound Specialist.

Meagan can be found on LinkedIn

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

What is the Treatment for Heart Failure?

Mon, 10 Oct 2022 07:15:00 GMT

What is the treatment for heart failure?

Written by Rachael Mooney

Heart failure occurs when the heart is not able to pump enough blood out to the body. This can cause symptoms such as swelling, coughing, or shortness of breath.

If your doctor determines you have heart failure, they will discuss the proper treatment for your heart failure with you.

Treatment for heart failure may include a combination of lifestyle changes, medications, or surgery.

Lifestyle changes that you can make to help better manage your symptoms of heart failure include:

quitting smoking
losing weight
tracking your fluid intake
avoiding alcohol
avoiding or limiting caffeine
exercising
decreasing your stress
monitoring your blood pressure
getting adequate rest
eating a heart healthy diet
avoiding other illnesses such as the flu or pneumonia with vaccinations

Your provider may also manage your heart failure with medications. Studies have shown several classes of drugs are best to treat heart failure, help prolong life, and improve heart function. Below is a list of drugs commonly prescribed to treat heart failure.

Angiotensin-converting enzyme inhibitors (ACE)
Captopril (Capoten)
Enalapril (Vasotec)
Fosinopril (Monopril)
Lisinopril (Prinivil, Zestril)
Perindopril (Aceon)
Quinapril (Accupril)
Ramipril (Altace)
Trandolapril (Mavik)

Angiotensin II Receptor Blockers
Candesartan (Atacand)
Losartan (Cozaar)
Valsartan (Diovan)

Beta Blockers
Bisoprolol (Zebeta)
Metoprolol succinate (Toprol XL)
Carvedilol (Coreg)
Carvedilol CR (Coreg CR) Toprol XL

Aldosterone Antagonists
Spironolactone (Aldactone)
Eplerenone (Inspra)

Hydralazine and Isosorbide Dinitrate
Hydralazine and isosorbide dinitrate (combination drug) - (Bidil)

Diuretics (Water pills)
Furosemide (Lasix)
Bumetanide (Bumex)
Torsemide (Demadex)
Chlorothiazide (Diuril)
Amiloride (Midamor Chlorthalidone (Hygroton)
Hydrochlorothiazide or HCTZ (Esidrix, Hydrodiuril)
Indapamide (Lozol)
Metolazone (Zaroxolyn)
Triamterene (Dyrenium)

Your doctor will talk to you about what medications are best for you to treat your heart failure.

Surgery: If your heart failure is more severe, your doctor may recommend a heart procedure or surgery.

Below is a list of heart procedures and surgeries that may be done for your heart failure.

Implantable Cardioverter Defibrillator (ICD): This is a device that is surgically placed that will deliver a shock to your heart if it detects any life-threatening abnormal rhythms. This may be recommended if you have severe heart failure or a serious abnormal heart rhythm.

Cardiac Resynchronization Therapy (CRT): Heart failure can lead to the development of an abnormal conduction of the heart’s electrical system, which changes how efficiently and effectively the heart beats. If this happens, your doctor may recommend CRT. In this procedure, a pacemaker is inserted that makes the ventricles contract more normally which has shown to improve the heart function and reduce hospitalizations.

Left Ventricular Assist Device (LVAD): A LVAD is a battery-operated mechanical pump-like device that is surgically implanted to help maintain the pumping ability of your heart. This device is used for patients whose hearts can no longer effectively work on their own. Previously, these were used primarily for patients who were waiting for a heart transplant but are now also being used more long-term in end-stage heart failure patients when a heart transplant is not an option.

Heart Transplant: A heart transplant may be recommended for patients who have severe heart failure that can no longer be managed with medications and lifestyle changes. In this surgery, surgeons replace the patients damaged heart with a healthy heart from a donor who has been declared brain dead.

Percutaneous Coronary Intervention (Angioplasty): If heart failure was caused by blockages in the coronary arteries, your doctor may recommend an angioplasty. During this procedure, the blockages are removed, which reopens the blocked blood vessels to improve or resolve heart failure.

Coronary Artery Bypass: If a blockage that is causing your heart failure is so severe that it cannot be removed, your doctor may recommend a coronary artery bypass surgery. During this procedure, the surgeon removes healthy blood vessels from another part of your body and surgically attaches them to the diseased artery so that blood can flow around the blocked section.

Valve Replacement: If your heart failure is caused by a diseased or defective heart valve, your doctor may recommend a valve replacement. This involves replacing the diseased or defective valve with a metal or plastic valve, or with a valve made from human or animal tissue.

When should I contact my doctor?

If you are diagnosed with heart failure, your doctor will give you instructions on when you should notify him or her regarding worsening symptoms. Here are some things you should watch for or ask your doctor about:

Rapid weight gain: Make sure you talk to your doctor about the amount of weight that you should report gaining. People with heart failure should weigh themselves daily, typically every morning before they’ve eaten breakfast. You should weigh yourself with the same amount of clothes on every day and use the same scale.

Shortness of breath: If you have had an increase of shortness of breath, you should notify your doctor. Your doctor will want to know if you are shorter of breath at rest or with activity and if you need to sleep sitting up and are unable to breath if you are lying flat.

Increased swelling: Notify your doctor if you have increased swelling in your legs, ankles, and feet or if your abdomen is more swollen or bloated than normal. This may be noticeable to you if your shoes and pants are fitting tighter than normal and is a sign that you are retaining more fluid.

Other symptoms to report: You should also notify your doctor if you have a new cough, loss of appetite, increased fatigue, or are feeling sad or depressed.

References

Brown, D., Edwards, H., Buckley, T., & Aitken, R. L. (2020). Lewis's medical-surgical nursing:

Assessment and management of clinical problems. Elsevier.

Diastolic heart failure: HFPEF, left-sided heart failure, symptoms. Cleveland Clinic. (n.d.).

Retrieved September 27, 2022, from https://my.clevelandclinic.org/health/diseases/22950-

diastolic-heart-failure

Systolic heart failure. Johns Hopkins Medicine. (2022, July 11). Retrieved September 27, 2022,

from https://www.Hopkinsmedicine.org/health/conditions-and-diseases/systolic-heart-

failure

Treatment options for heart failure. www.heart.org. (2022, August 10). Retrieved September 27,

2022, from https://www.heart.org/en/health-topics/heart-failure/treatment-options-for-

heart-failure

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Wound Care: Diabetic Ulcers, Venous Ulcers, and Arterial Ulcers

Thu, 06 Oct 2022 08:00:02 GMT

Wound Care: Diabetic Ulcers, Venous Ulcers, and Arterial Ulcers

Written by Meagan De Carlo BSN, RN, CWS

Different types of wounds require different care.

Most wounds will require the basic cleaning, measuring and debridement mentioned in the blog post, Why YOU Might Need Advanced Wound Care . Beyond that, the primary etiology of the wound must be understood and addressed. Below are 3 different types of wounds requiring their own unique treatments

Diabetic Ulcers

More than 37 million Americans have Diabetes Mellitus. It is estimated that between 20-30% will develop a chronic, non-healing wound, like a Diabetic Foot Ulcer.

People with Diabetes Mellitus (DM), and uncontrolled blood glucose levels (A1C level 7% or greater), are at greater risk for developing neuropathy and microvascular disease, along with cracks and fissures in their feet due to decreased sweat gland activity, a product of autonomic neuropathy.

Neuropathy is damage of the nerves, which can lead to numbness in the feet. Our sensory perceptions are what keep us safe. A person with nerve damage to the feet, will not feel the protective sensation of pain, and will therefore not respond to usually painful events such as walking with a small pebble in the shoe or feeling the heat of a bonfire when camping. Walking with a small pebble in your shoe, for hours at a time, will wear down your tissue and cause a foot ulcer, possibly penetrating to the bone. Thermal damage will occur when a person with neuropathy has their feet up close to a fire and does not have the sensation alerting them that their feet are hot, thus causing significant burns to the soles of their feet.

Autonomic neuropathy results in decreased moisture in the feet, which can cause cracks and fissures, allowing bacteria an entry way through the damaged skin barrier, leading to infection.

Microvascular disease occurs overtime with elevated blood glucose. The tiny blood vessels that transport oxygen and other nutrients to cells, become damaged, thus decreasing the supply of these vital nutrients. Wounds need oxygen to heal, and some diabetics don’t have sufficient supplies to heal wounds, leading to diabetic foot ulcers (DFU).

How can advanced wound care help a diabetic a foot ulcer?

The gold-standard for diabetic foot ulcers is the total contact cast (TCC).

The TCC is used for off-loading of the ulcer, for removing any pressure on the wound that can occur with ambulation. Pressure is a wound’s worst nightmare, so relieving pressure is a must. A TCC looks just like a typical cast, is made of fiberglass or a plaster shell, and has a rubber bar that runs the width of your foot. The cast starts at the base of the toes and goes just below the knee. It is typically changed once a week and is used until the wound shows significant improvement.

Another treatment for DFU is the hyperbaric chamber. A hyperbaric chamber is a clear tube that the patient is wheeled into from a gurney. The patient may be in the chamber for up to 2 hours and needs 20-60 sessions, sessions are 5-days per week. This therapy is effective but a big time commitment.

In addition to the wound care, diabetes education may be provided during the visits.

Venous Ulcers

Venous ulcers account for a large percentage of advanced wound care visits.

As people age, the valves in their veins often fail. Veins are the vessels that return blood to the heart. The blood needs to travel against gravity to get to the heart. As the heart pumps, blood is moved upwards in the veins, and when the heart relaxes, one-way valves in the veins prevent the blood from backflowing. When the valves are failing, blood and other fluids start to accumulate in the lower legs, around the calves and the feet, this results in edema, or swelling of the lower extremities. With the build-up of pressure from the fluid, the tissue often breaks down, resulting in a venous ulcer.

Venous ulcers typically have large amounts of exudate, or leaking fluid. The wounds often leak through the dressings that are applied.

How can advanced wound care help venous ulcers?

Compression, compression, compression.

After the wound has been cleaned and debrided, the physician orders a primary dressing that is designed to absorb copious amounts of drainage and then a secondary dressing that will also absorb drainage. Once the primary and secondary dressings are applied, the nurse will either apply compression stockings or a 4-layer compression wrap.

Dressings are changed three times per week.

Arterial Ulcers

Arterial ulcers are due to a lack of oxygen to the tissue and usually occur in the lower extremities, especially around the ankles.

Arterial ulcers are typically round and have a punched-out appearance. Often, they are deep wounds with exposed secondary structures like tendon.

They are very painful.

The nurse and physician will ask you

Do you ever stop walking half-way down the grocery store aisle due to pain in your legs?
Does the pain resolves with rest?
Do you ever have leg pain at night that is resolved by hanging your legs over the bed ?

Some risks for developing arterial ulcers include smoking , diabetes, and renal disease.

How can advanced wound care help arterial ulcers?

If it is determined that there is decreased blood flow to the wound, a consult with a vascular surgeon will be ordered.

Wounds are extremely difficult, and sometimes impossible, to heal if there is limited blood flow.

Until revascularization can be achieved, the wound will be managed by adding moisture to the wound bed and keeping infection at bay.

Summary

Because different types of wounds are treated in different ways, it is important to have that first comprehensive visit to determine what the underlaying factors are in the delayed wound healing.

Talk to your doctor if you think you have a wound that will not heal.

Sources:

https://www.cdc.gov/diabetes/basics/type2.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8539411/

Meagan can be found on LinkedIn

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

What is Heart Failure?

Mon, 03 Oct 2022 08:45:00 GMT

What is Heart Failure?

Written by Rachael Mooney

Heart failure is a condition where your heart is no longer able to pump sufficient blood and oxygen to the other tissues and organs of your body. This is often the result of an injury to your heart, which can occur from things like high blood pressure, coronary artery disease , or a myocardial infarction ( heart attack ), among other heart conditions.

There are four different types of heart failure: Left-sided, right-sided, diastolic, and systolic.

Left Sided Heart Failure: This is the most common type of heart failure. There are two forms of left sided heart failure: systolic failure and diastolic failure.

In systolic heart failure , the heart is unable to pump blood effectively. This results in a decreased ejection fraction, which measures the amount of blood ejected from the heart with each contraction. A normal ejection fraction is 55-65%. When a person has systolic heart failure, their ejection fraction is less than 40%.

With diastolic heart failure , the ventricles of the heart are unable to relax between heart beats. Because the heart is unable to relax, it doesn’t fill the heart chambers with blood during diastole, or this rest period. When this happens, the pressure inside the heart ventricles must increase to fill it, causing blood to build up inside of the left atrium and the lungs. This can lead to symptoms of fluid congestion and heart failure. A person with diastolic heart failure will have a normal ejection fraction.

Right-Sided Heart Failure: Right sided heart failure is when the right ventricle of the heart does not pump effectively. When this happens, fluid backs up into the venous system, which is a system of blood vessels that carry blood throughout your body. This causes fluid to move into the tissues of other organs which causes swelling in the face, neck, stomach, and legs.

What are some signs and symptoms of heart failure?

The symptoms of heart failure vary between people, but the most common symptoms are

shortness of breath
swelling
weight gain, fatigue
frequent coughing
lack of appetite
chest pain
inability to lie flat
decreased exercise tolerance

How is heart failure diagnosed?

Heart failure can be challenging to diagnose since the signs and symptoms of heart failure are similar to other medical conditions.

If your doctor suspects your symptoms are related to your heart, you will need to have an echocardiogram of your heart. This will give your doctor information about the heart chamber size, ejection fraction, heart valve function, wall thickness, and will also measure the pressure inside your heart and check for any blood clots in your heart.

You may also need to have tests such as an:

EKG
heart monitor
stress test
cardiac MRI
cardiac catheterization.

Your doctor may also check your BNP level, which will be elevated if you have heart failure.

Summary

Heart failure occurs when your heart is no longer able to pump enough blood to your body and brain. There are several types of heart failure and treatment will be based on the type of heart failure you have and your symptoms.

Talk to your doctor about what heart failure treatments are right for you.

References:

Brown, D., Edwards, H., Buckley, T., & Aitken, R. L. (2020). Lewis's medical-surgical nursing:

Assessment and management of clinical problems. Elsevier.

Diastolic heart failure: HFPEF, left-sided heart failure, symptoms. Cleveland Clinic. (n.d.).

Retrieved September 27, 2022, from https://my.clevelandclinic.org/health/diseases/22950-

diastolic-heart-failure

Systolic heart failure. Johns Hopkins Medicine. (2022, July 11). Retrieved September 27, 2022,

from https://www.Hopkinsmedicine.org/health/conditions-and-diseases/systolic-heart-

failure

Treatment options for heart failure. www.heart.org. (2022, August 10). Retrieved September 27,

2022, from https://www.heart.org/en/health-topics/heart-failure/treatment-options-for-

heart-failure

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Understanding MRI

Fri, 30 Sep 2022 19:56:35 GMT

Understanding MRI

Written by Thandiwe Chavula, MBBS, MSc

What is an MRI?

Magnetic Resonance Imaging (MRI) is a common procedure used in hospitals to examine your body organs and tissues. An MRI assists doctors in making a diagnosis or monitoring treatment for different conditions.

The MRI machine is a large tube-shaped structure that produces a strong magnetic field and generates radio waves to create images of body organs and tissues on a computer. The images produced by an MRI are cross-sectional, therefore providing more internal detail especially in solid organs like the heart, kidneys, or liver. MRI images can also be 3-dimensional (3D) in nature, which allows for viewing the tissues from different angles.

Is an MRI Safe?

Unlike other imaging techniques, such as an x-ray or CT scan, an MRI does not use radiation. This makes it a safe procedure with minimal risk of cancer-inducing effects usually associated with radiation. This also makes an MRI safe for pregnant women or children. In addition, an MRI is better at telling the difference between normal and diseased tissue compared to a CT scan or x-ray.

Why do I need an MRI?

There are different reasons that your doctor will request an MRI. Most commonly, an MRI will be used to detect or monitor the presence of disease or tissue injury including the following:

Brain – Hemorrhage (bleeding) due to injury or trauma, brain tumors and masses, infection, inflammation, brain specific changes associated with diseases such as Alzheimer’s disease .
Spine – Deformities, inflammation, collapsed discs, Multiple Sclerosis , injury from trauma
Bones and joints- fractures, inflammation, infection
Abdomen and pelvis – soft tissue inflammation, tumors or masses in the liver, kidney, intestines, bladder, and uterus. Conditions such as fibroids and endometriosis are also detected.
Heart – ischemia, tumors, cardiomyopathy, chest wall abnormalities

MRI is also used for treating certain cancers in a procedure known as MRI-guided radiation therapy.

How do I prepare for an MRI?

In general, an MRI does not require specific or extensive preparation. Unless specified by your doctor, you do not need to fast the day before or day of the procedure, as is sometimes the case before an ultrasound or abdominal x-ray.

Because of the strong magnetic fields produced by the MRI machine, no metal objects or electronic devices should be brought into the room as these will interfere with the images produced and can also be a safety hazard. Objects such as rings, jewelry, watches, and glasses should be removed.

It is important to inform your doctor before the procedure of any metal objects inside your body that could make having an MRI dangerous. Some of these include:

electrical devices such as pacemakers, cochlear implants, insulin pumps
foreign bodies like shrapnel, bone plates and screws, metal prosthetics, metal tooth fillings or implants

What else should I know?

An MRI requires you to lie on a padded table, which then moves into the center of a large enclosed tube-shaped space. If you have issues with claustrophobia, inform your doctor or radiologic technologist so that consideration can be made for mild sedatives.

While the procedure is not painful, you may experience some discomfort if you have some pre-existing back conditions. You will be required to lie still as the images are being taken.

The MRI will produce loud noises, which can be uncomfortable, and you will usually be given earplugs.

To aid with visualizing the images and depending on the reason for the MRI, you may be given an intravenous (IV) contrast dye containing gadolinium . While direct side effects to the dye are minimal, the dye can cause problems if you already have kidney failure or some form of kidney injury. The only scientifically proven adverse effect according to the FDA is a rare condition called nephrogenic systemic fibrosis , which was associated with receiving very high doses of gadolinium in the early 1980-90s.

After the images are taken, the IV will be removed and you will be able to go home right away if the MRI is an outpatient procedure.

Summary

An MRI is a widely used, safe procedure for imaging different tissues and organs that helps your doctor to screen and accurately diagnose conditions such as tumors, infection, or tissue injury.

During the procedure, you will lie still on a table inside a tunnel shaped machine. The scan is not painful, but the MRI machine makes a lot of noise.

Before the MRI, inform your doctor if you have any metal objects or electronic devices in your body such as shrapnel, tooth fillings, pacemakers, or artificial joints. Be sure to remove all metal accessories like jewelry, rings, watches, and glasses.

Sources:

Risk Factors: Radiation - NCI (cancer.gov)

Alzheimer's Disease Fact Sheet | National Institute on Aging (nih.gov)

Nephrogenic Systemic Fibrosis - StatPearls - NCBI Bookshelf (nih.gov)

Gadolinium Side Effects: Toxicity & Nephrogenic Systemic Fibrosis (drugwatch.com)

Gadolinium Contrast Medium (MRI Contrast agents) - InsideRadiology

MRI-LINAC: Magnetic Resonance Imaging Guided Linear Accelerator – Brigham and Women’s Hospital (brighamandwomens.org)

Endometriosis | NICHD - Eunice Kennedy Shriver National Institute of Child Health and Human Development (nih.gov)

Multiple Sclerosis | National Institute of Neurological Disorders and Stroke (nih.gov)

Author Bio:

Thandiwe Chavula, MBBS, MSc is a medical doctor and an Immunologist, currently training for a PhD at Baylor College of Medicine in Houston, TX. Her background is in clinical medicine in her home country Malawi. Over the last 6-7 years, her focus and interest has been on translational medical research in autoimmune diseases like Lupus. She works with patient samples and animal models of lupus to further understand disease pathogenesis and discover new treatment targets.

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

What is a WATCHMAN Device? Why do I need it?

Thu, 29 Sep 2022 18:08:13 GMT

What is a WATCHMAN Device? Why do I need it?

Written by Idrees Agha

The WATCHMAN device has been introduced as an alternative to anticoagulant drugs (blood thinners) in patients with atrial fibrillation (AF). It has reduced the bleeding complications associated with blood thinners and is used in AF patients with normal heart valves. AF causes the atria (smaller chambers of the heart) to beat at a very rapid rate which impairs the normal contractile power of the atria leading to blood stasis and clot formation. Clots can dislodge and cause complications like stroke .

The left atrium is the most common site of clot formation because it has an extra communicating small cavitary structure called the left atrial appendage (LAA). The WATCHMAN device is implanted in the LAA to seal it permanently from the main atrial cavity. It is a self-expanding device designed in a parachute shape containing numerous anchors at one end and a fabric cap at the other end. The fabric end faces the main atrial cavity. The heart’s inner layer—the endocardium—grows over the fabric cap after implantation and seals the LAA from the main atrial cavity.

Images of a WATCHMAN device are available here .

When Do I Need a WATCHMAN Device?

If you have AF with normal heart valves and you need to take blood thinners plus any of the following:

· Previous history or future risk of bleeding.

· Occupation or lifestyle that increases the risk of bleeding e.g., Contact sports.

· Noncompliance with medications.

· Intake of other drugs that have possible interactions with blood thinners, therefore, increasing the risk of bleeding. ¹

Are There Preprocedural Requirements?

Your doctor will assess you through a detailed history, examination, and certain blood and imaging tests. These are necessary to determine the indications or contraindications, and the size of the device. One important imaging test of the heart is transesophageal echocardiography (TEE). It is an invasive test in which a probe is inserted into the esophagus.

What are the Contraindications for WATCHMAN Device Implantation?

The device is not recommended if you have:

· A low risk of stroke based on a scoring system, which considers certain health conditions.

· A disease related to heart valves.

· An active infection.

· Left atrial clot or tumor.

· Presence of a defect or a device in the septum between the right and left atria.

· Left atrial appendage with significantly short depth.

· Another health condition that necessitates the need for blood thinners.

· High risk of bleeding with short-term therapy of blood thinners.

How is The Procedure Performed and what are possible complications?

You will be moved to a special room—the catheterization laboratory—where different procedures are performed on blood vessels and the heart through the insertion of a catheter into blood vessels. You will probably be sent back home the same or the next day. During the procedure:

· You will be deeply sedated to avoid complications caused by movement.

· You will be given the antibiotic drug for the prevention of infection.

· You will be given a dose of blood thinning drug directly into your veins via an IV.

· A catheter will be inserted into the major vessel of the thigh and directed to the heart through continuous imaging.

· WATCHMAN device will be inserted into the LAA.

Various complications can occur during or after the procedure, but the most dangerous complications are:

· Fluid accumulation in the cavity around the heart.

· Perforation of heart tissue.

· Dislocation of the device.

· Clot formation due to the device.

· Persistence of the defect in the septum between atria due to catheter. penetration.

· Stroke. ²

Will I need Follow-up visits and Medications?

You need to take a blood thinning drug and aspirin for at least six weeks to prevent the complication of device-related clot formation.

After six weeks, the doctor will assess the status of the device implantation. If implantation is successful, the blood thinning drug will be stopped. It will be replaced by another drug with less potential for bleeding complications.

After six months, aspirin must be continued indefinitely.

Has WATCHMAN Device Proved to Replace Blood Thinners?

Thousands of patients with WATCHMAN device implant were followed up for years. The results showed that the device was almost equivalent to blood thinners in the prevention of stroke, and the bleeding risk was significantly lower than those of blood thinners. Hence, WATCHMAN device has been accepted as an alternative to blood thinners in AF patients with normal valves. ³

Ask your doctor if a WATCHMAN device would be beneficial in your situation.

References:

1. Akinapelli A, Bansal O, Chen JP, et al. Left Atrial Appendage Closure – The WATCHMAN Device. Curr Cardiol Rev. 2015;11(4):334-340. doi:10.2174/1573403X11666150805115822

2. Agasthi P, Arsanjani R. Catheter Management Of Left Atrial Appendage Closure Devices. In: StatPearls. StatPearls Publishing; 2022. Accessed September 24, 2022. http://www.ncbi.nlm.nih.gov/books/NBK557458/

3. Magdi M, Renjithal SLM, Mubasher M, et al. The WATCHMAN device and post-implantation anticoagulation management. A review of key studies and the risk of device-related thrombosis. Am J Cardiovasc Dis. 2021;11(6):714-722.

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Why YOU Might Need Advanced Wound Care

Wed, 28 Sep 2022 16:48:49 GMT

Why YOU Might Need Advanced Wound Care

Written by Meagan De Carlo BSN, RN, CWS

When should you seek Advanced Wound Care?

If you have had a wound for more than 2 weeks which hasn’t shown signs of improving, or if your wound has not fully healed in 6 weeks. Any of the wound etiologies below would also indicate the need for advance wound care.

Different wound etiologies typically treated at a wound center include:

What should you expect during the first visit?

The first visit to an advanced wound care center will entail a lengthy and involved visit, usually around 90 minutes.

A detailed patient history will be taken, some questions that will be asked are the following:

Are you a smoker?
Do you have diabetes?
What is the state of your general health?
Do you have any diagnosed heart problems?

Labs will be drawn to see your state of nutrition, as protein plays a major role in wound healing. A hemoglobin A1C will be taken to determine if you are diabetic, or how well your diabetes is controlled. Calf and ankle measurements will be taken to determine a baseline for swelling, or edema. A non-invasive arterial assessment will be done to measure blood flow to the area of the wound and to the extremities. And pictures of the wound or wounds will be taken.

Usually, a visit with a Registered Dietician will be arranged for the second visit.

What should you expect during the next visits?

After the initial visit, a typical advanced wound care appointment can range from 45-90 minutes, depending on the severity of the wound and which treatments are used.

An RN or LVN (licensed vocational nurse) will take down the dressing (the bandage) and clean the wound using a saline solution and a small amount of pressure from the saline tube. They will then gently wipe the wound and take measurements and pictures to track the wound improvement over time. The nurse will also take calf measurements to measure for any edema or swelling. If the patient does not have a lidocaine allergy, the nurse will usually apply a lidocaine cream to help numb the wound.

The physician will then come into the exam room and debride the wound. The wound is debrided with a sharp, sterile instrument that resembles a tiny ice-cream scoop, called a curette. Debridement is a type of scraping; it removes dead tissue and any bacterial build-up. Dead tissue is removed to remind the body to wake up and initiate/resume wound healing, it also removes bacteria from the wound which can lead to infection If callus has built up, the physician will remove it with a sterile blade.

At this point in the visit, the physician will review the wound care orders with the nurse, and the nurse will then apply the primary dressing and secondary dressings and any compression stockings or wraps as ordered.

Wound care is typically done 3 times per week, once at the wound care clinic and twice at home, either with the help of family or a home health agency nurse.

Sources:

https://www.cottagehealth.org/locations/goleta-valley-cottage-hospital/wound-care/

Meagan can be found on LinkedIn.

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Stress Management: Can your imagination cause stress?

Tue, 20 Sep 2022 19:19:25 GMT

Discover what to do when stressed.

Written by Kopy Klinic .

After the day's work, I went to see a friend who had her first baby. By the time I was done with my activities, it was 8 pm. When I got to my apartment, I saw an object staring at me. I was still trying to turn on the light when I saw the image moving toward me. I was frightened. I wanted to call my neighbor but remembered he told me he would be traveling. I positioned myself to hit the object forcefully. Just when I grabbed the area I thought was the neck, I discovered it was my cotton that the wind was blowing gently.

Thankfully I didn't allow the experience to overwhelm me.

When you have experiences that overwhelm you, you can be stressed out. However, stress doesn't have to be always negative.

Did you know your body can be productive when you are stressed?

What is Stress?

Stress is the reaction your body displays when there is an unplanned occurrence. The response may occur either immediately or afterward. According to the World Health Organization (WHO), stress can lead to emotional, physical, or psychological reactions. How your body reacts to seen or imagined actions can lead to stress.

Truth be told, everyone experiences stress in one way or another. However, while some react to it mildly, others may not.

How we react matters.

Nevertheless, our genetic makeup and the experiences that made up our childhood play a role in how we react to stress.

How does your body react to stress?

When faced with real or perceived danger, your body has a way it protects itself from attack. Your body releases hormones (Adrenaline and Cortisol) that keep you alert, ready, and thinking fast on how to handle the present situation. When there is a need to react in defense to unplanned situations, your concentration is heightened, your brain is sharp, and your heart rate increases. After the problem has been handled, your body returns to its previous state.

Types of Stress

Acute stress: This is otherwise known as short-term stress, which happens when you must react to a sudden situation that makes your body tense. However, a few minutes after the situation has been dealt with, your body becomes calm, and your heart rate and your blood pressure normalize.

Chronic stress: This is popularly known as long-term stress and is the opposite of acute stress. Your body doesn't seem to recover from the incident. What causes the stress is often repeated. It can be from domestic violence, child abuse, or constant fights. This can result in constant tiredness, low self-esteem, or hypertension.

Stress and Imagination

In our world, is it possible to live 24 hours without an imagination?

We live in a world where our imagination can influence our decisions in the workplace, career, social life, or family life. How we react to any situation, whether good or bad, can cause stress.

Our imagination may often go wild, moving beyond the actual incident. When nursed over time, this may pose health problems.

Positive stress can:

Make you alert: When faced with an uncertain situation, your body is alert. You can quickly hit the brakes of your car to escape an accident.
Bring your creativity alive: I have had to improvise some items during service. I wasn't taught what to do, but your creativity heightens when you have a task and a deadline to meet. You might even begin to see options that can help you achieve what you want.
Your muscles are heightened. I have had to lift very heavy objects that I wouldn't have been able to without being stressed.

How to handle long-term stress

Know what triggers stress in your body. Our bodies are different in the ways they react to stress. So, it is better to know what causes you stress and avoid it if possible.

Set up a healthy exercise routine. The power of exercise cannot be overemphasized. Mayo Clinic states that it is difficult to ignore the benefits of regular exercise and physical activity. Exercise doesn't care about sex, age, or race. Having an exercise routine helps relieve long-term stress by:
Boosting your energy
Lightening your mood
Controlling your weight
And more

Get enough sleep. Your body shouldn't have less than seven or eight hours of sleep each night.

Build positive connections. There are some problems you can't figure out all by yourself. Sometimes, a little talk with a trusted colleague can ease your stress.

Engage in your hobbies often. What are the things that bring you relief? Games, hanging out, shopping, watching movies, reading, or even traveling. Engage in them often so your body can revitalize.

Positive imagination. Some people never see good in themselves. They always think of negative things happening to them, so they are never fulfilled. They may always appear sick or always be hospitalized. This can result in low self-esteem. So, learn to see the good in yourself and give yourself a pat on the back whenever you achieve a feat or even attempt one.

Final thoughts

Stress happens to everyone who is alive and has goals to reach. However, you can determine to take advantage of the positive effects of stress.

When you feel stress is taking a toll on your body, rest so you can perform maximally.

Sources:

www.4woman.gov/faq/stress

https://www.sutterhealth.org/health/mind-body/10-simple-ways-to-cope-with-stress

https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/exercise/art-20048389

What Causes a Stroke?

kristina.a.vw@gmail.com (Kristina Van Winkle) — Tue, 06 Sep 2022 07:45:00 GMT

What Causes a Stroke?

Stroke is the most common symptom of cerebrovascular disease.

Cerebrovascular disease is a term used to refer to any "disease" affecting the brain's blood vessels. It includes all conditions in which any part of the brain is deprived of blood (and oxygen) either temporarily or permanently. The blood vessels may be malformed, weakened, narrowed, or blocked.

When any disease process leads to the complete blockage of a blood vessel in the brain, a stroke (also called a cerebrovascular accident or CVA) occurs.

Strokes are the fifth leading cause of death in the United States and the leading cause of disability in adults.

As with cerebrovascular diseases, scientists and doctors classify strokes as either ischemic or hemorrhagic.

Ischemic Strokes

An ischemic stroke occurs when blood flow is temporarily or permanently blocked in the brain.

Approximately 85% of all strokes are ischemic .

Things that may cause a narrowing or complete blockage include:

Atherosclerosis: plaque build-up on the walls of the blood vessels
Clots: blood clots form and block the blood vessel
Embolism: a piece of plaque breaks off from somewhere else and travels to a new location where it blocks the blood vessel
Thrombosis: a blood clot forms and blocks the blood vessel
High blood pressure
Clotting disorders
Illegal drug use: this is a common cause of stroke in young people
Moyamoya disease: can cause strokes in children and young people
Malformations of the blood vessels

Hemorrhagic Strokes

Hemorrhagic strokes are less common than ischemic strokes and occur when a blood vessel ruptures and blood leaks into the brain tissue. These can be caused by:

Uncontrolled high blood pressure
An aneurysm that ruptures
Malformations of the blood vessels
Medication used to prevent blood clots
Illicit drug use, especially cocaine
Amyloid angiopathy
Cancer that spreads to the brain

Tranischemic Attack

A trans ischemic attack (TIA) is a temporary stroke. The blood flow is stopped long enough for damage to begin but restored without permanent damage.

Causes and symptoms are the same as those for strokes, but the symptoms clear up with no lasting problems. Treat TIAs like strokes; you should go to a hospital even if symptoms clear up.

A stroke is a medical emergency.

It is critical to recognize and treat stroke quickly as possible to reduce disability or death. Call 9-1-1 immediately if you or someone around you is experiencing symptoms of a stroke.

Remember: FAST

F ace droops, or their smile is uneven
A rm numbness or weakness that occurs suddenly
S peech problems, such as sudden difficulty speaking or understanding someone else
T ime to call 9-1-1!

Do not try to bring the person to the hospital, and DO NOT attempt to drive yourself to the hospital if you have any of these symptoms. Strokes can get worse very quickly; call 9-1-1, and emergency medical personnel will be able to care for you and monitor your situation on the way to the hospital.

Even if the symptoms stop before an ambulance arrives, the person should still go to a hospital. A TIA is a sign that a stroke could happen at any time.

Need a medical writer?

Contact me!

Thank you for reading my blog!

Sources:

American Association of Neurological Surgeons. (n.d.). Cerebrovascular Disease. https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Cerebrovascular-Disease

Khaku, A. S. (2021). Cerebrovascular Disease. https://www.ncbi.nlm.nih.gov/books/NBK430927/

Khaku, A. S. (2021). Cerebral Vascular Disease (Nursing). https://www.ncbi.nlm.nih.gov/books/NBK568674/

Northwestern Medicine. (n.d.) Understanding Stroke and Cerebrovascular Disease. https://www.nm.org/conditions-and-care-areas/neurosciences/comprehensive-stroke-centers/understanding-stroke-and-cerebrovascular-disease

What is Cerebrovascular Disease?

kristina.a.vw@gmail.com (Kristina Van Winkle) — Tue, 30 Aug 2022 07:30:00 GMT

Cerebrovascular Disease vs. Stroke

These conditions frequently lead to brain damage and stroke symptoms. The brain damage and symptoms may be temporary or permanent.

Cerebrovascular disease is the most common life-threatening neurological event in the U.S.

Although a stroke is what most people think of when they hear "cerebrovascular disease," a stroke is often the result of cerebrovascular disease; meaning stroke is a symptom of cerebrovascular disease . When any disease process leads to the complete blockage of a blood vessel in the brain, a stroke (also called a cerebrovascular accident or CVA) occurs.

Cerebrovascular diseases can be either ischemic (a narrowing or blockage blocks blood flow) or hemorrhagic (bleeding into the brain).

Ischemic diseases include:

Atherosclerosis is plaque formation on the blood vessel wall that narrows the opening and reduces blood flow, this can also be one cause of cerebral stenosis.
Cerebral Stenosis is a narrowing of a blood vessel leading to less blood flow.
Some Vascular Malformations can result in narrowed blood vessels.

Hemorrhagic diseases include:

Aneurysms are weakened areas of the blood vessel wall that begin to balloon out or bulge and can eventually burst and blood leaks out into the brain.
Some Vascular Malformations can result in bleeding into the brain.

Any cerebrovascular disease can result in a stroke or symptoms resembling a stroke.

Symptoms of Cerebrovascular Disease or a Stroke

Symptoms of a cerebrovascular disease or stroke may include:

Stiff neck
Sensation loss
Sensitivity to light
Sudden Confusion
Sudden weakness
Sudden Numbness
Nausea and vomiting
Blurry or double vision
Sudden Trouble Seeing
Sudden Trouble Walking
Sudden Severe Headache
Facial droop or uneven smile
Difficulty speaking or slurred speech
Difficulty understanding someone else

Any of these symptoms, mainly if occurring abruptly or without any other apparent cause, may indicate a stroke or other life-threatening condition and is a Medical Emergency.

Call 9-1-1 immediately if you or someone around you is experiencing any of these symptoms.

Remember: FAST is the key to a possible stroke:

F ace droops, or their smile is uneven
A rm numbness or weakness that occurs suddenly
S peech problems, such as sudden difficulty speaking or understanding what they are hearing
T ime to call 9-1-1!

Do not try to bring the person to the hospital, and DO NOT attempt to drive yourself to the hospital if you have any of these symptoms.

Strokes and other brain conditions can get worse very quickly; call 9-1-1 , and emergency medical personnel will be able to care for you and monitor your situation on the way to the hospital.

Future blog posts will cover stroke and specific cerebrovascular diseases in more detail.

In the meantime, if you need a medical writer, contact me !

Thank you for reading my blog!

Sources:

American Association of Neurological Surgeons. (n.d.). Cerebrovascular Disease. https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Cerebrovascular-Disease

Khaku, A. S. (2021). Cerebrovascular Disease. https://www.ncbi.nlm.nih.gov/books/NBK430927/

Khaku, A. S. (2021). Cerebral Vascular Disease (Nursing). https://www.ncbi.nlm.nih.gov/books/NBK568674/

https://www.nm.org/conditions-and-care-areas/neurosciences/comprehensive-stroke-centers/understanding-stroke-and-cerebrovascular-disease

How Do I Stop Smoking?

kristina.a.vw@gmail.com (Kristina Van Winkle) — Tue, 23 Aug 2022 07:15:01 GMT

Tips to help you kick the habit.

Smoking cigarettes is a form of recreational drug use and the leading cause of preventable early death in the US.

When you smoke tobacco, you inhale harmful chemicals and smoke into your lungs; these quickly absorb into the bloodstream, leading to multiple health conditions. In addition, the nicotine in tobacco is highly addictive; your body becomes accustomed to the drug, making it challenging to quit ingesting it without withdrawal symptoms.

Smoking also puts the people around you at risk. People who are frequently exposed to second-hand smoke have the same health concerns as those who smoke themselves.

Any form of tobacco is unsafe, including cigarettes, cigars, pipes, hookahs, chewing tobacco, snuff, and vaping.

Quitting smoking is one of the best ways to improve your health and the health of those around you.

How do I quit smoking?

Most people who smoke struggle with the addiction. It is challenging for many people to give it up.

You will be more likely to quit if you know what to expect and prepare for it. When you give up smoking, you may notice

irritability
hunger
fatigue
headaches
depression
difficulty sleeping
difficulty concentrating

To stop smoking, you need a reason, a plan (and maybe a backup plan or two), and some support before you begin.

Try these tips for smoking cessation:

Identify your reasons and motivations for quitting. Why do you want to quit smoking? Your health? Your family's health? Improve your finances? Figure out your motivation and write it down. What can you do with the money or time you save by not smoking?
Find some self-help books and other information before you begin. Keeping your resolve when the cravings start will be easier if you know what you are getting into.
Look for support groups, smoking cessation counseling, or even apps that can give you some support and advice along the way. Smokers who use proven smoking cessation therapies, such as behavioral counseling or medication, are more likely to succeed .
Tell someone about your pledge. Tell your family or friends you will quit smoking and let them hold you accountable.
Find your triggers and make a plan for them. Do you usually want to smoke after a meal? Make different plans for what you will do after meals. Do you smoke before bed? Plan another activity. What will you do when you are stressed instead of smoking? Make plans for when you know you will feel the urge to smoke.
Think about past attempts and learn from them.
Choose a method. Go "cold turkey, or slowly cut back on the number of cigarettes per day, the time you spend smoking, or the number of puffs you take each time you smoke until the official "Quit Day."
Set a "Quit Day' and stick with it. Pick a relatively stress-free time to quit smoking and ensure you are mentally ready.
Get rid of cigarettes, cigars, ashtrays, lighters, or other smoking paraphernalia.
Ask friends and family members not to smoke around you and avoid places that sell cigarettes or where people are smoking.
Find ways to fill your time, mouth, and hands. Suck on hard candies or suckers, chew on a straw or cinnamon sticks, keep a Rubics cube handy, doodle, or take up a hobby.
Ask your doctor about medicines, gums, or patches that may help.
Eat a healthy, balanced diet .
Have healthy snacks on hand to combat cravings.
Drink plenty of water.
Avoid alcohol and caffeine. People who drink are more likely to start smoking again after quitting.
Exercise regularly.
Get plenty of sleep.
Celebrate small victories. Keep a stock of your favorite candies or ice cream to celebrate when you go a whole day without smoking, or maybe even after you successfully get through a particularly difficult craving. Call up a friend and celebrate. Allow yourself a Starbucks coffee each morning if you did not smoke the day before.
Set up a reward system for yourself. Put the money you would have spent on cigarettes into a piggy bank to save for a vacation or some other goal or use the extra time to learn a hobby you have always wanted to try.
Try complementary health options, such as yoga, mindfulness meditation, relaxation techniques, acupuncture, and hypnosis. Even though there is not much medical proof that these things work, they may be helpful for some people.
Look into natural supplements which may help reduce cravings. But do your research; "natural" does not always mean safe.
Prepare for relapse; determine that you will keep going, even if you slip and have another cigarette. Use relapses as opportunities to learn and grow. Why did I slip up? How can I be more prepared next time?
Take urges and days one at a time.
Be prepared for the urges:
Have something readily available to occupy your hands or mouth when the urge to smoke comes.
Wait for several minutes for the urge to pass, and then wait for a few more. For most people, the craving will go away within a few minutes.
Remind yourself of why you are quitting and the benefits of quitting.
Talk to your doctor if you need help and support. They may be able to help you find nicotine replacements (medications, gums, patches, etc.), support groups, or counselors that can help you.

Don't be discouraged if quitting is difficult for you; most people who quit smoking need a few attempts before they are successful.

The key is not to quit trying to quit! Instead, learn from your mistakes, recommit, and keep up the good work.

Do you need content that will educate your patients and improve their engagement?

Contact me!

Sources:

America Heart Association. (2018). 5 Steps to Quit Smoking and Vaping | American Heart Association

CDC. (2022). Tips For Quitting | Quit Smoking | Tips From Former Smokers | CDC

Johns Hopkins Medicine. (n.d.). Smoking and Cardiovascular Disease | Johns Hopkins Medicine

National Institute on Aging. (2019). Quitting Smoking for Older Adults | National Institute on Aging (nih.gov)

NCCIH. (2021). Quitting Smoking | NCCIH (nih.gov)

NIH. (2022). Smoking and Your Heart - Strategies To Quit Smoking | NHLBI, NIH

Dangers of Smoking

kristina.a.vw@gmail.com (Kristina Van Winkle) — Tue, 09 Aug 2022 09:15:00 GMT

Why Should I Stop Smoking?

Smoking cigarettes is a form of recreational drug use and the leading cause of preventable early death in the US.

Any form of tobacco is unsafe, including cigarettes, cigars, pipes, hookahs, chewing tobacco, snuff, and vaping.

Quitting smoking is one of the best ways to improve your health and the health of those around you.

Why should I quit smoking?

When you smoke, smoke and aerosolized drugs in the tobacco enter your lungs, absorb into the bloodstream, and continue throughout your body via your blood. For this reason, smoking has far-reaching effects on not only your lungs, but your whole body.

Smoking can cause:

inflammation
atherosclerosis (fatty build-up on the walls of blood vessels)
heart disease
heart attacks
coronary artery disease
peripheral artery disease
blood clots
abnormal heart rhythms
increased workload on the heart
decreased HDL (good cholesterol)
increased LDL (bad cholesterol) and triglycerides
thickened blood, making it harder to carry oxygen to the body's cells
lung disease, such as emphysema
lung cancer
stroke
high blood pressure
rapid heart rate
blood vessel damage

Cigarettes are not the only tobacco product you should avoid; cigars, pipes, hookahs, chewing tobacco, snuff, and vaping are also harmful.

Smokeless tobacco, or chewing tobacco, can cause cancer of the mouth and pancreas, precancerous lesions, gum problems, and nicotine addiction.
Pipes and cigars can cause mouth, lip, larynx, esophagus, and bladder cancer.
Hookahs used with tobacco can cause many health issues similar to cigarettes.
Vaping with e-cigs, e-hookahs, mods, vape pens, vapes, or tank systems can also lead to health problems. They contain harmful substances like lead, cancer-causing chemicals, and nicotine which is addictive, and some flavorings may have links to lung disease. There is also limited evidence they are adequate to help you quit smoking.

You are 2 to 4 times more likely to get heart disease if you smoke and double your stroke risk. Unfortunately, those around you may suffer the same health conditions as you due to second-hand smoke inhalation.

We will discuss the dangers of second-hand smoke in my next blog post.

Stay tuned!

Do you need content that will educate your patients and improve their engagement?

Contact me!

Sources:

America Heart Association. (2018). 5 Steps to Quit Smoking and Vaping | American Heart Association

CDC. (2022). Tips For Quitting | Quit Smoking | Tips From Former Smokers | CDC

Johns Hopkins Medicine. (n.d.). Smoking and Cardiovascular Disease | Johns Hopkins Medicine

National Institute on Aging. (2019). Quitting Smoking for Older Adults | National Institute on Aging (nih.gov)

NCCIH. (2021). Quitting Smoking | NCCIH (nih.gov)

NIH. (2022). Smoking and Your Heart - Strategies To Quit Smoking | NHLBI, NIH

Dangers of Second-hand Smoke

kristina.a.vw@gmail.com (Kristina Van Winkle) — Mon, 08 Aug 2022 21:05:28 GMT

How Dangerous is Second-hand Smoke?

Smoking cigarettes is a form of recreational drug use and the leading cause of preventable early death in the US.

Smoking also puts the people around you at risk. People who are frequently exposed to second-hand smoke have the same health concerns as those who smoke themselves.

Any form of tobacco is unsafe, including cigarettes, cigars, pipes, hookahs, chewing tobacco, snuff, and vaping.

Quitting smoking is one of the best ways to improve your health and the health of those around you.

Second-Hand Smoke puts your loved ones at risk.

When smokers exhale from a lit cigarette, cigar, or other tobacco product, those around them inhale the smoke and chemicals, causing the same damage to their systems as those who smoke.

Approximately 34,000 non-smokers die from heart disease each year from exposure to second-hand tobacco smoke.

The health hazards of second-hand smoke are even more detrimental to infants, children, and pregnant women. It increases the chances of ear infections and asthma in children and sudden infant death syndrome (SIDS) in infants.

People exposed to second hand-smoke may experience:

Coughing
Irritated eyes, nose, or throat
Excessive mucous
Chest discomfort or pain
Bronchitis

Symptoms of second-hand smoke inhalation can mimic those of other health conditions. Call your doctor if you or a loved one has these symptoms, as they could also be symptoms of a more severe illness.

Smoking increases the risk of strokes, heart attacks, and other medical problems, but quitting lowers your risk of heart disease and stroke. In many studies quitting smoking has cut the risk by half or even more. Studies have revealed the number of heart attacks drop in areas where smoking is banned.

Do you need content that will educate your patients and improve their engagement?

Contact me!

Sources:

America Heart Association. (2018). 5 Steps to Quit Smoking and Vaping | American Heart Association

CDC. (2022). Tips For Quitting | Quit Smoking | Tips From Former Smokers | CDC

Johns Hopkins Medicine. (n.d.). Smoking and Cardiovascular Disease | Johns Hopkins Medicine

National Institute on Aging. (2019). Quitting Smoking for Older Adults | National Institute on Aging (nih.gov)

NCCIH. (2021). Quitting Smoking | NCCIH (nih.gov)

NIH. (2022). Smoking and Your Heart - Strategies To Quit Smoking | NHLBI, NIH

Peripheral Artery Disease: Complications and Prevention

kristina.a.vw@gmail.com (Kristina Van Winkle) — Tue, 02 Aug 2022 07:30:00 GMT

Peripheral Artery Disease (PAD), Part 3

Peripheral artery disease (PAD) is a narrowing of the arteries supplying blood to the arms, legs, or abdomen. The narrowing is usually caused by the accumulation of plaque along the walls of the blood vessels.

We saw the causes and symptoms of PAD in the blog post, Peripheral Artery Disease, Part 1.

In part 2, we discussed the risk factors and how it is diagnosed and treated.

Part 3 will include possible complications, prevention, and an overview of the condition.

Complications

Peripheral artery disease puts you at a higher risk for coronary artery disease , heart attack , and strokes.

Other complications that may result from PAD include:

Chronic poor blood flow
Trouble performing daily activities
Sores, if left untreated, can lead to infection, gangrene, and possibly amputation.
Acute limb ischemia (decreased oxygen from lack of blood): This is a medical emergency. Call 9-1-1 if you suddenly lose feeling in your foot or leg, cannot move it, or it becomes blue or pale and grows colder than the other foot or leg.

Prevention

You can prevent peripheral artery disease or reduce symptoms with some simple lifestyle changes.

Get regular exercise
Eat a heart-healthy diet , low in saturated fats.
Quit smoking.
Maintain a healthy weight.
Manage your blood pressure and cholesterol.
Manage your stress.
Manage your diabetes.
Go for regular check-ups for your blood pressure and other risk factors.
Keep a close eye on your legs and feet for sores.
Avoid over-the-counter medications that contain pseudoephedrine , which constricts blood vessels.

Take Away

Peripheral artery disease is the narrowing of the arteries in the arms, legs, or abdomen due to plaque build-up on the lining of the vessels.

Symptoms and risk factors are similar to those of coronary artery disease .

Treatment may be lifestyle changes, medication, angiograms with possible stents, or possibly a bypass graph.

Call your doctor if leg pain does not go away within 5 minutes of resting, your symptoms change or get worse, or you contract cellulitis or other infections. Call 9-1-1 for acute limb ischemia, as mentioned above.

Contact me for health articles or blog posts to educate your readers.

Thank you for reading my blog!

Sources:

Mayo Clinic. (2022). Peripheral artery disease (PAD) - Symptoms and causes - Mayo Clinic

CDC. (2021). Peripheral Arterial Disease (PAD) | cdc.gov

AHA. (2021). About Peripheral Artery Disease (PAD) | American Heart Association

NIH. (2022). Peripheral Artery Disease - What Is Peripheral Artery Disease? | NHLBI, NIH

Peripheral Artery Disease: Risk Factors, Diagnosis, and Treatment

kristina.a.vw@gmail.com (Kristina Van Winkle) — Tue, 26 Jul 2022 08:45:00 GMT

Peripheral Artery Disease (PAD), Risk Factors, Diagnosis, and Treatments

Risk Factors

Risk factors for peripheral artery disease are the same as for coronary artery disease (narrowing of the arteries bringing blood to the heart muscle):

Stress
Obesity
Smoking
Increasing age
Sedentary lifestyle
Family history of PAD
Diet high in saturated fats and other unhealthy diet choices

Certain other medical conditions can also add to your risk of developing PAD.

A fib
Obesity
Diabetes
Sleep apnea
Heart failure
Vascular dementia
High blood pressure
Chronic kidney disease
High homocysteine levels
High cholesterol or triglycerides
Conditions that cause blood clots

Preeclampsia or gestational diabetes during pregnancy will also increase your risk of developing peripheral artery disease.

Diagnosis

Talk to your doctor if you have any peripheral artery disease symptoms.

Your doctor will

ask questions about your medical history, family history, risk factors, and symptoms
perform a physical assessment
check the pulses in your arms and legs
listen to the blood flow with a stethoscope
examine your legs and feet for sores, swelling, or discoloration
perform an ankle-brachial index (ABI) test to compare your blood pressure in your upper and lower extremities using a blood pressure cuff and an ultrasound machine
draw blood samples for tests

Your doctor may also order tests and scans such as

an exercise ABI test after exercising on a treadmill
a 6-minute walking test
An angiogram
doppler tests
an MRA
a CTA

Treatment

Ask your doctor about getting tested for peripheral artery disease if you have symptoms. If you are diagnosed with PAD, your doctor may recommend treatments such as:

Medicine to prevent blood clots, lower cholesterol, lower blood pressure or blood sugar, and prevent the arteries from narrowing
Thrombolytic therapy to prevent blood clots
Medicine for the pain
Angioplasty to open arteries, possibly stents
Bypass surgery to circumvent a blocked artery and restore circulation to the leg

Your doctor may recommend lifestyle changes that can reduce your risk of developing PAD, prevent complications or reduce symptoms.

Exercise to help increase movement and circulation, increase your ability to perform daily tasks, and improve your quality of life.
Eat a heart-healthy diet .
Quit smoking .

Contact me for health articles or blog posts to educate your readers.

Thank you for reading!

Sources:

Mayo Clinic. (2022). Peripheral artery disease (PAD) - Symptoms and causes - Mayo Clinic

CDC. (2021). Peripheral Arterial Disease (PAD) | cdc.gov

AHA. (2021). About Peripheral Artery Disease (PAD) | American Heart Association

NIH. (2022). Peripheral Artery Disease - What Is Peripheral Artery Disease? | NHLBI, NIH

Peripheral Artery Disease: Causes and Symptoms

kristina.a.vw@gmail.com (Kristina Van Winkle) — Tue, 19 Jul 2022 09:45:00 GMT

Peripheral Artery Disease (PAD)

Peripheral artery disease is the narrowing of the peripheral arteries , the arteries leading away from the heart to the body.

The term "peripheral artery disease" (PAD) usually refers to narrowing of the arteries and reduced blood flow in the legs and feet, but PAD can be anywhere in the arms, abdomen, or legs.

PAD can be challenging to recognize, and many people mistake it for something else, and it often goes undiagnosed. But it is important to know if you have PAD because you have a higher risk of coronary artery disease , heart attack , and stroke if you have peripheral artery disease.

Causes

Peripheral artery disease, like coronary artery disease , is often caused by atherosclerosis, a waxy build-up of plaque (fat, calcium, and cholesterol) in the lining of the arteries, which causes narrowing and decreased blood flow through the arteries.

Atherosclerosis is not the only cause of PAD; less common causes include:

Blood vessel inflammation
Injury to the arms and legs
Changes to the muscles or ligaments
Exposure to radiation

Symptoms

Symptoms of peripheral artery disease are similar to symptoms of coronary artery disease :

Pain or discomfort ranging from mild to severe in the legs or feet during walking or stair climbing, in the arms while moving them, and the pain goes away after a few minutes of rest
Weakness, cramping, fatigue, or heaviness in the limb
Aching in the limb

With severe PAD, you may have pain even during rest.

About 1 out of every four people with PAD will have these common symptoms; some will have different or none. 4 out of 10 people will not have leg pain.

More than half of people with PAD will have non-typical symptoms, including:

Toenails and leg hair stop growing
Hair loss on the legs
Smooth, shiny skin
Skin that is cool to the touch
Cold or numb toes
One foot feels colder than the other
Pale, discolored, or blue limb
Numbness
Feeling of pins and needles in your feet or legs
Sores that do not heal or heal very slowly
Weak or no pulses in the extremity
Erectile dysfunction

One in 5 people will not have any symptoms.

No matter your symptoms, you have an increased risk for heart disease , heart attack , and stroke with PAD.

Contact me for health articles or blog posts to educate your readers.

Thank you for reading!

Sources:

Mayo Clinic. (2022). Peripheral artery disease (PAD) - Symptoms and causes - Mayo Clinic

CDC. (2021). Peripheral Arterial Disease (PAD) | cdc.gov

AHA. (2021). About Peripheral Artery Disease (PAD) | American Heart Association

NIH. (2022). Peripheral Artery Disease - What Is Peripheral Artery Disease? | NHLBI, NIH

Coronary Artery Disease: Treatments, Complications, and Prevention

kristina.a.vw@gmail.com (Kristina Van Winkle) — Tue, 12 Jul 2022 08:00:00 GMT

Coronary Artery Disease, Part 3

We have already learned about the basics of CAD , symptoms , when to call your doctor, and how CAD is diagnosed in parts 1 and 2.

Here's a quick review:

Coronary artery disease is a condition that occurs when the major blood vessels that provide blood and oxygen to the heart become blocked due to plaque build-up or inflammation.

Coronary artery disease (CAD) is also known as coronary heart disease or ischemic heart disease and is the most common type of heart disease in the United States .

CAD is the leading cause of death in the United States .

Coronary artery disease is also called "atherosclerosis" or "hardening of the arteries.

How is coronary artery disease treated?

Your doctor may order medication to prevent or treat the symptoms of CAD , including:

Medication to lower your cholesterol
Aspirin or some other pill to reduce your risk for blood clots
Medications to control your heart rate, heart rhythm, or blood pressure
Nitroglycerine as needed to widen the coronary arteries and restore blood flow during chest pain
Ranolazine for chest pain

Your doctor may want to perform a cardiac catheterization or an angiogram if they suspect your CAD could lead to a heart attack or other complications; they may be able to place a stent during the procedure to open up the artery and restore blood flow.

If your condition warrants it, your doctor may want you to have coronary artery bypass graph surgery (CABG) to restore blood flow to your coronary arteries.

What are the complications of coronary artery disease?

Early recognition, diagnosis, and treatment for coronary artery disease are vital to preventing life-threatening complications. These can include:

Angina (chest pain)
Heart attack
Heart failure
Heart arrhythmias
Sudden cardiac arrest

Can coronary artery disease be prevented?

A heart-healthy lifestyle can prevent or help you recover from coronary artery disease.

Quit smoking.

Eat a heart-healthy diet , including fish and fish oil (Omega-3 fatty acids), flax and flaxseed oil, and alpha-linolenic acid (found in canola oil, soybeans, and soybean oil).

Exercise regularly .

Lose weight or maintain a healthy weight.

Practice stress management.

Get enough sleep.

Control your blood pressure through diet, exercise, and the medications your doctor prescribes.

Decrease or control your cholesterol levels with diet, exercise, and the medications your doctor prescribes.

Manage your blood sugar carefully if you have diabetes.

Limit alcohol consumption

Schedule regular medical check-ups and health screenings.

Take away

Coronary artery disease is a common type of heart disease and can lead to a heart attack and death if not recognized and treated early.

Eating a heart-healthy diet, regular exercise, and other heart-healthy lifestyle changes can decrease your chances of developing CAD or help your body heal from it.

Contact your doctor if you have risk factors or symptoms of CAD .

Call 9-1-1 if you or someone close to you starts to show signs of a heart attack.

Do you need help with the medical content on your blog or website?

Send me an email or contact me on my website!

Thank you for taking the time to read my blog.

Sources:

Coronary artery disease - Symptoms and causes - Mayo Clinic

Coronary artery disease - Diagnosis and treatment - Mayo Clinic

Coronary Artery Disease | cdc.gov

Coronary Heart Disease - What Is Coronary Heart Disease? | NHLBI, NIH

Coronary Heart Disease - Causes and Risk Factors | NHLBI, NIH

Coronary Artery Disease: Symptoms and Diagnoses

kristina.a.vw@gmail.com (Kristina Van Winkle) — Tue, 05 Jul 2022 08:15:00 GMT

Coronary Artery Disease Symptoms and Diagnosis

Coronary artery disease is a condition that occurs when the major blood vessels that provide blood and oxygen to the heart become blocked due to plaque build-up or inflammation.

Coronary artery disease (CAD) is also known as coronary heart disease or ischemic heart disease and is the most common type of heart disease in the United States .

CAD is the leading cause of death in the United States .

Coronary artery disease is also called "atherosclerosis" or "hardening of the arteries."

What are the symptoms of CAD?

When should you call your doctor?

How is CAD diagnosed?

Read on for the answers.....

What are the symptoms of coronary artery disease?

Symptoms appear when the heart muscle does not receive the oxygen and nutrients it needs due to the blockage in the heart.

You may not even notice them, or they may only occur during strenuous activity.

Symptoms may increase in frequency and severity as the arteries become more and more blocked over time, or sometimes the first symptom is a heart attack.

Some symptoms you might notice include:

Chest pain (angina), pressure, or discomfort is the most common symptom
Tightness or burning in the chest
Cold sweats
Pain or discomfort in shoulders or arms, throat, neck, back, or jaw
Indigestion
Nausea
Shortness of breath
Fatigue
Weakness
Lightheadedness
Sleep disturbances
Heart attack

Women are less likely to have pain; but may instead experience dizziness,

extreme fatigue, chest tightness or pressure, stomach pain, or nausea.

Chest pain that does not go away with rest or becomes more frequent might be a heart attack . A heart attack is a medical emergency: call 9-1-1 if you or someone you are close to is experiencing heart attack symptoms .

When should I call my doctor?

Call your doctor if you are experiencing symptoms of coronary artery disease, especially if you have any of the risk factors for CAD .

Call 9-1-1 if you or someone close to you has symptoms of a heart attack (chest pain, shortness of breath, excessive sweating, or nausea).

Do not try to drive yourself or someone else to the hospital unless necessary. The ambulance crew will have the equipment to start treating you on the way to the hospital; this early treatment can mean the difference between life and death.

How is coronary artery disease diagnosed?

Your doctor will ask you questions about your symptoms, family medical history, and CAD risk factors .

They will check your blood pressure, cholesterol, blood sugar, and other blood tests.

If they suspect that you have coronary artery disease or may have had a heart attack, they may order tests to check your heart's function.

Tests may include:

Chest x-ray
Electrocardiogram (ECG or EKG)
Echocardiogram (ultrasound of your heart)
Exercise stress test (exercise while hooked to an ECG)
Nuclear stress test (similar to an exercise stress test, but also takes pictures of your heart's function)
Cardiac CT scan
Heart catheterization
Angiogram

Take away

Coronary artery disease is a common type of heart disease and can lead to a heart attack and death if not recognized and treated early.

Eating a heart-healthy diet , regular exercise , and other heart-healthy lifestyle changes (such as smoking cessation ) can decrease your chances of developing CAD or help your body heal from it.

Contact your doctor if you have risk factors or symptoms of CAD.

Call 9-1-1 if you or someone close to you starts to show signs of a heart attack.

Do you need help with medical content on your blog or website?

Send me an email or contact me on my website!

Thank you for reading!

Sources:

Coronary artery disease - Symptoms and causes - Mayo Clinic

Coronary artery disease - Diagnosis and treatment - Mayo Clinic

Coronary Artery Disease | cdc.gov

Coronary Heart Disease - What Is Coronary Heart Disease? | NHLBI, NIH

Coronary Heart Disease - Causes and Risk Factors | NHLBI, NIH

Coronary Artery Disease: Overview

kristina.a.vw@gmail.com (Kristina Van Winkle) — Tue, 28 Jun 2022 08:00:04 GMT

What is Coronary Artery Disease?

Coronary artery disease is a condition that occurs when the major blood vessels that provide blood and oxygen to the heart become blocked due to plaque build-up or inflammation.

Coronary artery disease (CAD) is also known as coronary heart disease or ischemic heart disease and is the most common type of heart disease in the United States .

CAD is the leading cause of death in the United States .

Coronary artery disease is also called "atherosclerosis" or "hardening of the arteries".

What is coronary artery disease?

In coronary artery disease, the blood vessels that provide blood to the heart muscle become blocked; blood cannot get to the heart muscle to provide it with the oxygen it needs, leading to complications like a heart attack.

What causes coronary artery disease?

Usually, CAD occurs when fat, cholesterol, or other substances form a "plaque" on the inside wall of your coronary arteries, the blood vessels providing your heart muscle with blood, nutrients, and oxygen. These substances may partially block the blood flow in the heart, or the plaque may break away and form a blood clot.

This leads to narrowing in the blood vessels. If the blood vessel becomes completely blocked by plaque or a blood clot, the heart muscle will begin to die without oxygen, and a heart attack may result.

Diabetes, high blood pressure, not getting enough exercise, smoking, or tobacco use can also cause damage to the coronary arteries and result in CAD.

What are my risk factors for coronary artery disease?

Sometimes CAD develops without any of the usual risk factors, but generally, at least one risk factor is present.

Some of the most common risk factors for CAD include:

Advancing age: the older you get, the greater your risk of developing CAD
Alcohol use
An unhealthy diet
Chronic kidney disease
Diabetes
Family history: especially if a close family member was diagnosed with CAD before the age of 50
Gender: men have a higher risk of developing CAD, but women increase their risk after menopause
High blood pressure can make the arteries harden and become stiff, making it difficult for blood to flow
High cholesterol
High levels of stress
Metabolic syndrome: a combination of several of the above risk factors which, occurring together, increase your risk for CAD even more
Not getting enough exercise
Not getting enough sleep
Smoking
Some autoimmune diseases
Working long shifts, irregular shifts, or night shifts that affect your sleep patterns

Talk to your doctor if you have any of these risk factors, especially if you have symptoms of CAD.

Take away

Coronary artery disease is a common type of heart disease and can lead to a heart attack and death if not recognized and treated early.

Eating a heart-healthy diet , regular exercise , and other heart-healthy lifestyle changes can decrease your chances of developing CAD or help your body heal from it.

Call 9-1-1 if you or someone close to you starts to show signs of a heart attack .

What are the signs and symptoms of CAD?

Do you need help with the medical content on your blog or website?

Send me an email or contact me on my website!

Thank you for taking the time to read my blog.

Sources:

Coronary artery disease - Symptoms and causes - Mayo Clinic

Coronary artery disease - Diagnosis and treatment - Mayo Clinic

Coronary Artery Disease | cdc.gov

Coronary Heart Disease - What Is Coronary Heart Disease? | NHLBI, NIH

Coronary Heart Disease - Causes and Risk Factors | NHLBI, NIH

Cardiac Arrest: Treatment and Prevention

kristina.a.vw@gmail.com (Kristina Van Winkle) — Tue, 21 Jun 2022 08:30:11 GMT

Cardiac Arrest, Part 3

The terms "cardiac arrest" and "heart attack" are often used interchangeably, but they are not the same thing.

A cardiac arrest is when the heart stops working abruptly.

A cardiac arrest is an electrical conduction problem. The heart's electrical system stops working as it should and can either go into an ineffective rhythm (the heart is quivering instead of pumping effectively), or the electrical impulses may stop entirely.

It can occur in an otherwise healthy person, or you may have noticed warning signs.

In a heart attack, a blockage in the coronary arteries (the arteries that supply blood to the heart) prevents oxygen from reaching the heart muscle, leading to muscle death if not treated.

The heart muscle begins to die without oxygen, but the heart has not quit working.

A heart attack is a circulation problem.

A heart attack can lead to a cardiac arrest, but they are not the same thing.

My first cardiac arrest post covered the causes and risk factors of cardiac arrest.

Read this post covered triggers, signs and symptoms, and what to do if you witness a cardiac arrest.

This post will cover cardiac arrest treatments and prevention

How is a cardiac arrest treated?

If you survive a heart attack outside of the hospital, run to determine what caused your cardiac arrest. Your doctor will admit you to the hospital, run tests to determine the cause of your cardiac arrest, and treat you based on the test results. This may include oxygen, an angioplasty, heart surgery, or an implanted defibrillator devise (similar to a pacemaker) to prevent another cardiac arrest.

How can I prevent a cardiac arrest?

Coronary artery disease is the most common cause of cardiac arrest.

Decreasing your risk for coronary artery disease will lessen your chances of cardiac arrest.

Control your diabetes.
Don't smoke or use tobacco.
Eat a balanced, heart-healthy diet .
Exercise regularly.
Get plenty of sleep.
Go to your doctor's appointments and health screenings.
Maintain a healthy weight.
Practice stress management.
Take any medication as prescribed by your doctor.

Take away

Witnessing a cardiac arrest can be a frightening thing; arming yourself with the knowledge and skills to recognize and respond to this medical emergency.

Learn the signs and symptoms of cardiac arrest.

Take a CPR class.

Take note of the AEDs around you, just in case.

Always call 9-1-1 if you witness a collapse, especially if you suspect cardiac arrest.

Coming up next on the blog: Hypertension! AKA, High Blood Pressure....

Questions, comments, or suggestions?

Leave a message or send an email .

Need a medical writer, editor, or proofreader?

Contact me or send me an email .

Thank you for taking the time to read my blog.

Sources:

About Cardiac Arrest | American Heart Association

Causes of Cardiac Arrest | American Heart Association

Cardiac Arrest - Symptoms | NHLBI, NIH

Cardiac Arrest - Causes and Risk Factors | NHLBI, NIH

Cardiac Arrest - Treatment | NHLBI, NIH

Heart disease prevention: Strategies to keep your heart healthy - Mayo Clinic

Cardiac Arrest: Signs and Symptoms, and What should I do?

kristina.a.vw@gmail.com (Kristina Van Winkle) — Tue, 14 Jun 2022 08:00:02 GMT

Cardiac Arrest: Signs and Symptoms, and What should I do?

In my last blog post , I covered the causes and risk factors for cardiac arrest. This post will cover triggers, symptoms, how to recognize a cardiac arrest, and what you can do if you ever witness a cardiac arrest.

Just a quick review:

The terms "cardiac arrest" and "heart attack" are often used interchangeably, but they are not the same thing.

A cardiac arrest is when the heart stops working abruptly.

It can occur in an otherwise healthy person, or you may have noticed warning signs.

In a heart attack, a blockage in the coronary arteries (the arteries that supply blood to the heart) prevents oxygen from reaching the heart muscle, leading to muscle death if not treated.

The heart muscle begins to die without oxygen, but the heart has not quit working.

A heart attack is a circulation problem.

A heart attack can lead to a cardiac arrest, but they are not the same thing.

What can trigger a cardiac arrest?

If you have one or more of the risk factors that lead to cardiac arrest, this can lead to changes in the heart's electrical system, triggering a cardiac arrest under certain conditions.

These conditions include:

Extreme physical exertion or stress
Flue infection in the past month
Heavy drinking or binge drinking
Severe emotional distress
Too much coffee or other stimulants, such as energy drinks

The use of cocaine, amphetamine, or marijuana can lead to sudden cardiac arrest even in an otherwise healthy individual.

What are the symptoms of a cardiac arrest?

Cardiac arrest is a medical emergency.

Call 9-1-1 immediately and start CPR if someone around you has symptoms of a heart attack and get an AED as quickly as possible.

A person having a cardiac arrest will:

Lose consciousness; a person having a cardiac arrest will not be awake.
Stop breathing or begin gasping for air; no blood is reaching their lungs, so they will not be able to breathe effectively.
Be unresponsive to shaking or shouting; no blood is reaching their brain, so they will be unable to respond.
Not have a pulse; the heart is not pumping effectively, so you will not be able to find a pulse.

Will there be any signs before the cardiac arrest?

Sometimes a cardiac arrest will occur without any prior warning.

Most of the time, you will have warning symptoms for an hour to a few weeks before the cardiac arrest. These symptoms might include:

Abdominal pain, nausea, and vomiting
Back pain
Chest pain
Extreme fatigue
Flu-like symptoms
Frequent dizziness or fainting
Heart palpitations (your heart flutters, races, or skips a beat)
Shortness of breath

Call your doctor if you have any of these signs or symptoms as they could be warning signs of a cardiac arrest.

What should I do if I witness a cardiac arrest?

A cardiac arrest is fatal unless treatment begins immediately.

Call 9-1-1

Get an AED (Automated External Defibrillator) on the scene as soon as possible . These devices are usually located in public places and "talk" to you to tell you how to work them; turn on the machine and follow the instructions given to you by the AED until more advanced medical help arrives or you are too tired to continue CPR.

Start CPR if you have training in CPR methods.

Once advanced medical help arrives, they will continue treatment and transport the person to the hospital. Once there, the person will receive specialized treatment based on what caused the cardiac arrest.

Questions, comments, or suggestions?

Leave a message or send me an email .

Need a medical writer, editor, or proofreader?

Contact me or send me an email .

Thank you for taking the time to read my blog.

Sources:

About Cardiac Arrest | American Heart Association

Causes of Cardiac Arrest | American Heart Association

Cardiac Arrest - Symptoms | NHLBI, NIH

Cardiac Arrest - Causes and Risk Factors | NHLBI, NIH

Cardiac Arrest - Treatment | NHLBI, NIH

Heart disease prevention: Strategies to keep your heart healthy - Mayo Clini c
What is CPR | American Heart Association CPR & First Aid

Cardiac Arrest: Causes and Risk Factors

kristina.a.vw@gmail.com (Kristina Van Winkle) — Tue, 07 Jun 2022 09:00:00 GMT

Cardiac Arrest, part 1

The terms "cardiac arrest" and "heart attack" are often used interchangeably, but they are not the same thing.

A cardiac arrest is when the heart stops working abruptly.

It can occur in an otherwise healthy person, or you may have noticed warning signs.

In a heart attack, a blockage in the coronary arteries (the arteries that supply blood to the heart) prevents oxygen from reaching the heart muscle, leading to muscle death if not treated.

The heart muscle begins to die without oxygen, but the heart has not quit working.

A heart attack is a circulation problem.

A cardiac arrest is an electrical problem.

A heart attack can lead to a cardiac arrest, but they are not the same thing.

What causes a cardiac arrest?

During a cardiac arrest, the electrical system in the heart stops functioning properly. The heart's pumping action stops: the heart is "arrested."

This can be caused by :

Scarring of the heart tissue (heart attacks or other damage to the heart can lead to the risk of heart arrhythmias and cardiac arrest)

Heart Arrhythmias (irregular beating patterns in the heart)

Bradycardic rhythms (very slow heart rate)

Electrical abnormalities in the heart

Cardiomyopathy (thickened heart muscle caused by damage sustained to the heart)

Certain heart medications

Electrolyte imbalances (specifically, magnesium and potassium)

Abnormalities of the blood vessels (rarely, defects in the coronary arteries or aortic artery lead to sudden cardiac arrest during intense physical activity)

Drug use (even in healthy people, drug use can lead to sudden cardiac arrest)

What are the risk factors for a cardiac arrest?

Several things can increase your risk for cardiac arrest :

Coronary artery disease , also known as atherosclerosis or hardening of the arteries, occurs when plaque builds up in the arteries that supply the heart with blood, narrowing the arteries and preventing normal blood flow.

Complications of coronary artery disease , such as a heart attack, can cause damage to the heart muscle.

Certain heart arrhythmias may progress until they present a risk for cardiac arrest.

Problems with the heart's structure can also increase your chances of cardiac arrest, such as congenital heart disease (structural malformations present at birth) or other conditions that affect the structure of your heart.

Damage to the heart, such as inflammation due to an infection, can cause an increased risk for cardiac arrest.

Heart failure can also lead to cardiac arrest.

Advanced age will increase your risk for cardiac arrest; the older you get, the higher your risk of cardiac arrest

Gender affects your risk for cardiac arrest. Cardiac arrest is more frequent in men, but they become more frequent in women after menopause.

Family history and genetics also play a role in your risk for heart disease. If a close family member has had a cardiac arrest, you have a higher chance of having one yourself. If a child or a young person has a cardiac arrest, it is usually the result of a genetic disorder.

Respiratory arrest (the person stops breathing) will lead to cardiac arrest if not treated immediately.

Diabetes increases your risk of cardiac arrest.

Electrolyte imbalances, especially potassium, magnesium, and calcium, can lead to cardiac arrest.

Certain medications can increase your chances of a heart arrhythmia which can, in turn, lead to cardiac arrest.

A hard blow to the chest, directly over the heart, can lead to cardiac arrest in rare cases.

If you have had a cardiac arrest in the past, you have a higher chance of having another one.

Would you recognize a cardiac arrest if you saw one? Would you know what to do?

Can you prevent a cardiac arrest?

Stay Tuned!

Questions, comments, or suggestions?

Leave a messag e or send me an email .

Need a medical writer or proofreader?

Contact me or send me an email .

Thank you for taking the time to read my blog.

Sources:

About Cardiac Arrest | American Heart Association

Causes of Cardiac Arrest | American Heart Association

Cardiac Arrest - Symptoms | NHLBI, NIH

Cardiac Arrest - Causes and Risk Factors | NHLBI, NIH

Cardiac Arrest - Treatment | NHLBI, NIH

Heart disease prevention: Strategies to keep your heart healthy - Mayo Clini c

Heart Attack, Part 2

Tue, 31 May 2022 07:30:00 GMT

Heart Attack vs. Cardiac Arrest: What you need to know about them, part 2

What is the difference between a heart attack and a cardiac arrest ?

A heart attack can lead to a cardiac arrest, but they are not the same thing.

A heart attack, or myocardial infarction, occurs when one of the blood vessels (coronary arteries) supplying blood to your heart muscle is blocked, oxygen can no longer reach the area, and the heart muscle begins to die; but the heart has not stopped beating yet. A heart attack can lead to a cardiac arrest (the heart stops beating).

Most heart attacks are caused by coronary artery disease (CAD), also known as "atherosclerosis" or "hardening of the arteries."

Both of these conditions are life-threatening emergencies. Call 9-1-1 immediately if you are someone around you is having symptoms of a heart attack. Do not attempt to drive to the hospital yourself; it is always better to call for an ambulance.

Become familiar with the risk factors and symptoms of a heart attack so you can act quickly if you or someone near you has a heart attack.

This article will continue to discuss heart attacks:

How is a heart attack diagnosed?

How is a heart attack treated?

What complications can result from a heart attack?

How is a heart attack diagnosed?

If you arrive at the hospital with symptoms of a heart attack, your doctor will order blood tests and an electrocardiogram (ECG or EKG). These tests will tell your doctor if you have had a heart attack in the past, or if you are currently having one.

They might also order a test called an angiogram to see if you have any clogged blood vessels in your heart. They may place a stent during the test if they do find a narrowed area.

They may also perform an ultrasound of your heart to visualize any damage to the muscle or valves in your heart.

How is a heart attack treated?

If it is determined that you have had a heart attack, or one is in progress, you will be put on a heart monitor and will probably be admitted to the hospital for a few days. Some of the treatments you may receive include:

Morphine to control the pain and dilate the blood vessels in your heart.
Aspirin or a clot "clot-busting" IV medication to break up any clots that have blocked the arteries in your heart.
Medications to open up the blood vessels in your heart and restore blood flow.
Medications to control your heart's rhythm or speed.
Medication to control your cholesterol.
An angioplasty: a procedure that opens up the blood vessels in the heart; one or more stents may be placed to keep the artery open.
You may even need Coronary Artery Bypass Surgery if the blockage is severe enough.

What complications can a heart attack lead to?

A heart attack can lead to several complications :

Arrhythmias

The damage done to the heart muscle during a heart attack can prevent the electrical impulses from flowing through the heart as they should. This is called an arrhythmia. The heart rate can be too fast, too slow, or irregular. You may not have any symptoms of these arrhythmias, or you may feel chest pain, dizziness, palpitations, fatigue, or shortness of breath. Some arrhythmias can lead to cardiac arrest.

Cardiac arrest

Certain arrhythmias can cause your heart to stop pumping effectively. This is called cardiac arrest . This condition is fatal within minutes if not treated. An AED can be used if a person is found unconscious outside of a hospital and a cardiac arrest is suspected. It is a life-threatening emergency. Call 9-1-1 immediately.

Heart failure

This happens when your heart is unable to effectively pump blood throughout your body. Symptoms of this include difficulty breathing, fatigue, and swelling in your arms and legs.

Cardiogenic shock

This happens when your heart can no longer pump enough blood to maintain your body's normal functions. Symptoms include difficulty breathing, not producing much urine, rapid heart rate, pale skin, cold extremities, and confusion.

Heart rupture

This is an uncommon but very serious complication of a heart attack. Part of the heart muscle or valves split apart. The symptoms are the same for cardiogenic shock and the treatment is open heart surgery.

Take away

A heart attack is a medical emergency. Call 9-1-1 if you or someone near you is experiencing symptoms of a heart attack. Do not attempt to drive to the hospital yourself; the ambulance crew will be able to start treating you on the way to the hospital and they will be able to perform life-saving measures if necessary. A heart attack can lead to some very serious, life-threatening complications including cardiac arrest.

Questions, comments, or suggestions?

Contact me here or on LinkedIn.

Do you need a medical writer for your online publication or blog?

Send me an email or contact me on my website .

Thank you for taking the time to read today!

Sources:

Cardiac Arrest - What Is Cardiac Arrest? | NHLBI, NIH

complications of a heart attack - NHS (www.nhs.uk)

Eat Your Way to a Healthy Heart | LinkedIn

Heart Attack - What Is a Heart Attack? | NHLBI, NIH

Understanding Heart Attack (webmd.com)

Understand Your Risks to Prevent a Heart Attack | American Heart Association

Warning Signs of a Heart Attack | American Heart Association

What is a heart attack?

Tue, 24 May 2022 08:00:10 GMT

Heart Attack vs. Cardiac Arrest: What you need to know about them, part 1

As a nurse on a cardiac floor, I have frequently been asked (or had to explain) the difference between a heart attack and a cardiac arrest . People often assume they are the same thing.

A heart attack can lead to a cardiac arrest, but they are not the same thing.

This post will deal with heart attacks.

What is a heart attack?

Are you at risk for a heart attack?

What are the symptoms of a heart attack?

What can you do to prevent a heart attack?

A heart attack occurs when one of the blood vessels (coronary arteries) supplying blood to your heart muscle is blocked, oxygen can no longer reach the area, and the heart muscle begins to die; but the heart has not stopped beating. A heart attack can lead to a cardiac arrest, when the heart stops beating entirely.

What causes a heart attack?

Most heart attacks are caused by coronary artery disease (CAD), a condition that causes fatty plaque build-up in the arteries. CAD is also called atherosclerosis or "hardening of the arteries." When this plaque leads to a blockage in the artery, a heart attack may result.

Rarely, a heart attack can happen when one of the coronary arteries is blocked by a spasm.

Risk Factors for a heart attack

Some risk factors for a heart attack can be controlled. These include:

High blood pressure
High cholesterol
Obesity
Lack of exercise
Smoking
Drinking too much alcohol
Diabetes

Other factors cannot be controlled. These include:

Age
Family history
Male gender

Symptoms of a heart attack

Symptoms of a heart attack can include:

Chest pain
Heartburn or indigestion
Pain in your chest that radiates to your jaw or arm
Dizziness or lightheadedness
A "cold sweat"
Nausea
Shortness of breath
Irregular heart rate or palpitations
Weakness

How can I prevent a heart attack?

As mentioned above, not all risk factors for a heart attack can be controlled, but a heart-healthy diet and exercise can help prevent or postpone heart attacks for most people.

Here are some practical ways to lower your risk of having a heart attack:

Eat a heart-healthy diet.
Get in at least 150 minutes of moderate intensity exercise every week, 30 minutes most days is a good goal to shoot for.
Stop smoking.
Avoid alcohol.
Lose excess weight by modifying your diet and exercise routine.
Take all your heart and blood pressure medications as prescribed by your doctor.
Control your diabetes by diet modification, exercise, and taking your medications as prescribed.

What should I take away from this article?

A heart attack is a life-threatening emergency. Call9-1-1 if you are someone near you is experiencing symptoms of a heart attack.

Learning the risk factors and symptoms of a heart attack can help you react quickly if you ever encounter someone having a heart attack.

Eating a healthy diet and exercising most days a week will go a long way in the prevention of a heart attack.

Making lifestyle changes today can lead to a much better life in the future.

The post next will continue to discuss heart attacks:

How is a heart attack diagnosed?

How is a heart attack treated?

What complications can result from a heart attack?

Then we will dig into cardiac arrests in some detail.

Sources:

Cardiac Arrest - What Is Cardiac Arrest? | NHLBI, NIH

Eat Your Way to a Healthy Heart | LinkedIn

Heart Attack - What Is a Heart Attack? | NHLBI, NIH

Understanding Heart Attack (webmd.com)

Understand Your Risks to Prevent a Heart Attack | American Heart Association

Warning Signs of a Heart Attack | American Heart Association

Questions, comments, or suggestions?

Contact me here or on LinkedIn .

Do you need a medical writer for your online publication or blog?

Send me an email or contact me on my website .

Thank you for taking the time to read my blog!

What is Heart Disease?

Mon, 16 May 2022 17:46:12 GMT

Or is it Cardiovascular Disease?

What is heart disease?

Or is it cardiovascular disease?

Do you have a structural heart problem or a conduction problem?

When it comes to your heart, things can become confusing very quickly.

Heart disease is a broad term referring to a variety of heart conditions.

These conditions can be grouped into several different categories, and these categories can overlap at times:

Cardiovascular disease
Congenital structural conditions
Acquired structural conditions
Arrhythmias

Cardiovascular disease

Cardiovascular disease is a term referring to conditions that affect the blood vessels.

Coronary artery disease (CAD) is the blocking or narrowing of the blood vessels supplying blood to your heart . This "hardening" of the vessels can also be called atherosclerosis . CAD can lead to chest pain and heart attacks.
Peripheral artery disease (PAD) is the blocking or narrowing of the blood vessels supplying blood to your body . PAD can lead to coldness, numbness, weakness, or pain in the hands and feet.
Stroke is also a form of cardiovascular disease. Blood vessels in your brain either become blocked or burst, leading to a stroke.

Congenital Heart Disease

Congenital heart disease (CHG) refers to problems with the structure of the heart that begins during fetal development. CHD conditions are numerous and include:

Coarctation of the aorta
Patent ductus arteriosus (PDA)
Pulmonary atresia
Patent foramen ovale
and many others

Symptoms of congenital heart disease may be present at birth, show up later, or you may never know about them at all.

Acquired Heart Disease

Acquired heart disease refers to problems with the structure of the heart that occur after birth. This term applies to all heart conditions that begin after birth. Because they are developed later in life, cardiovascular diseases are included in this category.

Some more examples of acquired heart disease are:

High blood pressure (hypertension)
Rheumatic heart disease
Endocarditis (an infection of the heart)
Cardiomyopathy (damage to the muscle of the heart)

Arrhythmias

Arrhythmias are caused by problems with the electrical conduction pathways in your heart. These electrical pathways cause your heart to beat and control the rhythm of your heart. When something blocks the electrical pathways in your heart or causes an extra impulse in the wrong place or at the wrong time, an arrythmia is the result.

An electrocardiogram (ECG or EKG) is the test used to diagnose an arrhythmia. An EKG detects the electrical impulses in your heart and graphs them.

Arrhythmias include:

Atrial fibrillation (Afib)
Atrial flutter
Heart blocks
Ventricular fibrillation

Summary

The terms heart disease and cardiovascular disease are sometimes used interchangeably, which can lead to confusion. It can be very difficult to keep track of all the terminology associated with heart disease.

Learning more about how your heart normally functions can give you a better understanding of what is going on when you or a loved one receive a heart-related diagnosis.

Eating a heart-healthy diet , exercising for at least 30 minutes most days, and taking your heart medications as prescribed can help you maintain or rebuild your heart's health.

Talk to your cardiologist if you have any questions or concerns about your heart.

Call 9-1-1 if you have chest pain, shortness of breath, dizziness, or fainting. These may be symptoms of a heart attack or some other heart-related condition.

The more you learn about your heart and your heart’s health the more you will be able to maintain a healthy, active life.

Do you have any questions or comments?

Send me an email!

Want more information about the services I provide?

Check out my website or my LinkedIn profile!

Need a medical writer?

Contact me!

Thank you for taking your time to read my blog!

Sources:

Heart Disease: Risk Factors, Prevention, and More (healthline.com

Types of heart disease | Heart and Stroke Foundation

Peripheral Arterial Disease (PAD) | cdc.gov

Heart disease and stroke - Better Health Channel \

Congenital heart disease in adults - Symptoms and causes - Mayo Clinic

Acquired Heart Disease | Boston Medical Center (bmc.org)

Structural Heart Disease > Fact Sheets > Yale Medicine

Heart Conduction Disorders | American Heart Association

Heart arrhythmia - Symptoms and causes - Mayo Clinic

Can Exercise Help my Heart?

Tue, 10 May 2022 17:46:10 GMT

Exercise and Heart Health

A heart-healthy diet and exercise are the best things you can do to maintain and improve your heart's health.

Exercise is crucial whether you want to keep your heart functioning as it should , prevent heart problems, or build your heart health back up to where it needs to be.

Exercise doesn't have to be strenuous or monotonous to be effective.

Increase your activity level.

One of the best things you can do if you are just getting started with exercising is to simply move more.

Get up and walk.

Buy a step tracker (pedometer) or fitness tracker, set a goal, and find ways to walk more. When you reach that goal, set another one and work on that.

Some consider 10,000 steps a day the gold standard for maintaining your health. Wear a step counter for a week and see what your average daily step count is. Whatever that is, start there and gradually build up to 10,000 steps a day.

Here are some ideas for increasing your step count every day:

Park farther away from the store.
Take the stairs.
Take a walk around the store before you start shopping.
Place a mini trampoline by the bathroom door and jump 100 times after you come out.
Place a mini trampoline in front of your refrigerator and jump 100 times before grabbing a snack.
Do an aerobic exercise you enjoy.
Adopt a hyper dog.
Borrow a friend's toddler.

Aerobics

Aerobics is a great way to add to your step count each day and the best way to exercise your heart.

Your heart is a muscle, and just like any muscle, it needs to be pushed to its limits to reach its peak performance. Aerobics works the heart muscle and improves circulation and blood pressure.

Aerobics doesn't necessarily mean running a marathon. Many exercises can get your heart pumping and raise your heart rate without spending hours pounding the pavement. Find an aerobic activity that fits your lifestyle and do it consistently, or pick several that you enjoy and mix them up.

Just get up and do some form of aerobics every day.

If you enjoy running or other vigorous exercises, try to fit in at least 75 minutes of exercise every week. That comes out to only about 15 minutes 5 days a week!

Vigorous exercise can include:

Running
Jumping rope
Stair climbing
Bicycling
Dancing
Jumping jacks
Jumping on a trampoline ( rebounding )

If you cannot do these vigorous activities, you can opt for at least 150 minutes of moderate-intensity exercise each week; that's only 30 minutes 5 days a week! Some suggestions for moderate-intensity activities include:

Walking
Gardening
Raking leaves
Shoveling snow
Gentle bouncing or jogging on a mini trampoline

You don't need to do all your exercises at the same time, either.

Walking for 10 minutes 3 times a day counts for your 30 minutes. You can mix it up any way you like. Jump rope for 15 minutes in the morning and then walk your dog for 15 minutes in the evening. The key is the consistency of aerobic exercise, not necessarily your specific activity.

Remember to start slowly and build. Talk to your doctor before starting any new exercise, especially one considered vigorous, or if you have any questions.

Stretching

Stretching should be the starting point for any exercise you do.

In and of itself, it doesn't help your heart muscle, but it does help to build the other muscles in your body and prevent injuries.

Always stretch before and after aerobic activities.

Strength Training

Strength training , either with free weights at home or with machines at a gym, can help maintain a healthy weight, lower your bad cholesterol (LDL), and raise your good cholesterol (HDL), which are vital to keeping your heart healthy.

Try to fit at least two strength-training sessions into your week. Always skip a day between strength training sessions; this gives your muscles a chance to heal and build up properly.

Summary

Eating a nutritious heart-healthy diet and increasing your activity level, especially aerobic activity, are the keys to maintaining and improving your heart's health.

Remember to stretch before and after any aerobic exercise.

Add strength training exercises if you can.

Always talk to your doctor before starting a new exercise, especially one considered vigorous.

Do you have any questions or comments?

Email me or leave a comment!

You can learn more about me and my services on my website or LinkedIn .

Do you need a medical/legal writer?

Contact me!

And thank you for reading my blog.

Sources:

3 Kinds of Exercise That Boost Heart Health | Johns Hopkins Medicine

What Are the Best Exercises for Heart Health? (verywellhealth.com)

10,000 steps a day: Too low? Too high? - Mayo Clinic

Diet and Exercise | Cardiac Healt h

Rebounding: Science Behind the 7 Major Health Benefits of Rebound Exercise - Cancer Tutor

Can a Healthy Diet Prevent Heart Problems?

Tue, 03 May 2022 17:46:09 GMT

Eating your way to better heart health.

You are what you eat!

Junk in, junk out!

We've all heard these expressions.

Both are true.

What you eat makes a huge difference in your health and well-being. Nutrition is critical to your heart's health. A nutritious, balanced diet can help you maintain your heart health, keep your heart running the way it should , and avoid heart disease and other diseases .

To eat...

Most heart health advice focuses on what NOT to eat, which can be discouraging!

Focusing on what you CAN and should eat is a much better approach to any diet. Eating your way to heart health is delicious!

Here is a partial list of foods that may improve your heart health. Try to eat more:

Almonds
Apples
Avocados
Beans
Beets
Berries (especially blueberries)
Black pepper
Broccoli
Brussels sprouts
Cherries
Chili peppers
Cinnamon
Coriander
Dark chocolate
Fatty fish or fish oil (especially salmon)
Garbanzo beans
Garlic
Ginger
Green tea
Leafy, green vegetables
Oatmeal (and other whole grains)
Olives and olive oil
Seeds (especially pumpkin seeds)
Soybeans (tofu, edamame)
Turmeric
Tomatoes
Walnuts
Whole grains

Fresh or frozen vegetables and fruit , in general, are great for your heart health. If your plate is primarily vegetables and healthy grains, you are well on your way to maintaining or improving your heart health.

If you use canned vegetables, pick a low-sodium variety.

If you use canned fruit, buy it packed in water or juice instead of syrup.

And don't worry! Salmon and beans are not the only proteins you can enjoy on a heart-healthy diet. Low-fat proteins such as eggs, yogurt, cheese, and skinless poultry are also an option; just try to eat them in moderation.

If you eat red meats, try to find the leanest cut available. Again, moderation is your friend where red meats are concerned.

...or not to eat.

As with any diet, there are some foods that you should avoid.

This is not to say you can never eat these things, but you should eat them only occasionally and in small portions.

Fortunately, the list of things you should avoid is much shorter than the "do eat" list:

Added salt
Coconut oil
Processed meats
Processed snacks (packaged snacks, chips, etc.)
Energy drinks
Fast food
Organ meats (liver, kidneys)
Refined or processed grains and carbohydrates (white bread and pasta)
Soda and other sugary drinks
Too many desserts (you can splurge on occasion, but not too often)
Too much protein (most of your plate should be vegetables and healthy grains)

More tips

There are other small things you can do that impact your diet.

Smaller portions

Smaller portions should apply to both the "good" and the "bad" food. You can still eat that hot dog at that birthday party! Just stop at one hot dog and then head over to the veggie tray. Most of your plate should be vegetables, fruits, and healthy grains.

Splurge on occasion

That's right. You can eat that piece of cake at the party. If you are eating healthy and nutritious food most of the time, don't beat yourself up over a dessert or some other splurge on occasion.

Maintaining a healthy, nutrient-dense, heart health-promoting diet is easy when you focus on what you CAN have instead of what you cannot have. Fill your plate with vegetables, beans, and healthy grains; then add some healthy proteins and fruit salad for dessert.

Enjoy all the delicious foods that can help you eat your way to heart health!

Questions? Comments? Suggestions?

Send me an email or drop a comment in the comment box!

Need a medical writer?

Contact me!

You can learn more about me and my services on my website or connect with me on LinkedIn .

Thank you for taking the time to read my blog!

Sources

10 Top Foods for Heart Health (aarp.org)

15 Incredibly Heart-Healthy Foods (healthline.com)

Heart-Healthy Foods: 15 Foods to Eat for a Healthy Heart (foodrevolution.org)

Heart-healthy diet: 8 steps to prevent heart disease - Mayo Clinic

Avoid these foods for a healthier heart - Harvard Health

Heart health tips: 8 foods cardiologists try to avoid (today.com)

7 Impressive Health Benefits of Cherries (healthline.com)

Whole grains: Hearty options for a healthy diet - Mayo Clinic

Mayo Clinic Minute: Why coconut oil is bad for your heart - Mayo Clinic News Network

Normal Healthy Heart Function

Wed, 27 Apr 2022 16:32:54 GMT

How does a Healthy Heart Work?

How should a normal, healthy heart function?

Your heart is an amazing work of engineering!

When it functions as designed, you hardly ever think about it. It does its job all day, and you don't even need to think about it.

But when something does go wrong with it, you are usually quick to notice that something is wrong, even if you can't put your finger on exactly what that is.

When you hear a cardiologist or other medical provider explain what is wrong with your heart, you can get confused by all the terms and jargon.

It helps to understand the way your heart should be functioning. To understand what is wrong with your heart, you must first understand how a normal, healthy heart functions.

Let's get to it!

We'll start with the top part of your heart: your atria.

Atrial function

The heart's atria are small sack-like muscles located at the top of your heart. They hold blood before they pump it into the coronary arteries (the arteries supplying blood to your heart muscle) and the ventricles, the lower chambers of your heart.

The right atrium ("atrium" is the singular form of the plural "atria") receives deoxygenated blood (blood that has had much of the oxygen removed) from your body and pumps it to the right coronary artery and the right ventricle. From the right ventricle, the blood flows to your lungs.

The left atria receive oxygenated blood (blood that is full of oxygen) from your lungs and pump it to the left coronary artery and then to the rest of your body.

Circulation of blood in the heart

Your heart is a muscle that needs blood flow like any other muscle or organ. The arteries responsible for providing this blood flow are called the coronary arteries .

To keep it simple, the blood flow to the right side of your heart starts in the right atrium, and the blood flow to the left side of your heart starts in the left atrium. Coronary circulation , the blood flow to the heart muscle, is a bit more complicated than that, but that is the general idea.

Ventricular function

The ventricles are the larger sack-like parts of the heart muscle at the bottom of your heart.

The right ventricle receives blood from the right atrium through the tricuspid valve and then pumps this blood to the lungs. The blood picks up oxygen in the lungs and then returns to the heart. The left atrium receives this oxygen-rich blood from your lungs.

The left ventricle receives the blood from the left atrium through the bicuspid valve (also called the mitral valve). Then, the left ventricle pumps the blood throughout the rest of your body, where the oxygen is delivered to your body's muscles, organs, tissues, and cells. The oxygen-deficient blood then enters the right atrium, where the cycle begins all over again.

Circulation of blood throughout the body

Your blood keeps circulating in this figure-8 type circuit throughout your body night and day, sleeping and awake.

Oxygenated blood in the lungs enters the left atrium.
It enters the left coronary arteries.
It passes through the mitral valve into the left ventricle.
It goes to the entire body, and oxygen and nutrients reach the body's tissues.
Deoxygenated blood enters the right atrium.
It flows into the coronary arteries.
It passes through the tricuspid valve into the right ventricle.
It is pumped into the lungs to receive more oxygen.
The whole process starts all over again.

Heart Facts

A healthy heart will typically beat 60-100 beats per minute in adults.

Some factors that affect your heart rate include:

Your fitness levels
Your age
Your position (lying, sitting, or standing)
Your underlying medical conditions

So, at 60-100 beats per minute, that's an average of 100,000 times per day and 2.5 billion times throughout an average lifetime!

Almost the entire blood volume in your body is pumped through your heart every minute. That's about 5-6 quarts of blood every minute.

Every day, your heart pumps approximately 2,000 gallons of blood throughout your body.

Your heart is an incredible organ that works your entire life to provide oxygen, nutrients, and waste removal services. Do your best to care for your heart. Learn all you can about it and how you can keep it healthy and functioning up to and beyond that 2.5 billionth beat!

Sources:

AHA Journals. (2006). Right Ventricular Function and Failure | Circulation (ahajournals.org)

Beckerman, James, MD, FACC. (2020). How the Heart Works & Pumps Blood Through The Human Body (webmd.com)

Cleveland Clinic. (2019). Coronary Arteries: How It Works & Images (clevelandclinic.org)

CSG Network. (2022). Heart Blood Volume Calculator (csgnetwork.com)

Healthline Medical Network. (2018). Left Ventricle Function, Definition & Anatomy | Body Maps (healthline.com)

Healthline Medical Network. (2018). Right Atrium Function, Definition & Anatomy | Body Maps (healthline.com)

Healthline Medical Network. (2019). Left Atrium Function, Definition & Anatomy | Body Maps (healthline.com)

Joshi, Subhash D, Joshi Sharda S., Athavale, Sunita Arvind. (2010). Origins of the Coronary Arteries and Their Significance (nih.gov)

Laskowski, Edward R., M.D. (2020). Heart rate: What's normal? - Mayo Clinic

MedlinePlus. (2022). Circulation of blood through the heart: MedlinePlus Medical Encyclopedia Image

NOVA. (1997). NOVA Online | Cut to the Heart | Map of the Human Heart | Amazing Heart Facts (pbs.org)

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

What is Cardiology?

Wed, 02 Mar 2022 12:30:04 GMT

What does the word "Cardiology" mean? And what is a Cardiologist?

I LOVE cardiology!

Especially pediatric cardiology!

I had heart surgery when I was six months old, and I still occasionally have issues with my heart. So, it's easy to see why this subject is so close to my heart.

Get it?

Anyway...moving on!

What does Cardiac mean?

The word cardiac means "pertaining to the heart."

Cardiology, cardiac arrhythmias, cardio workout, cardiac arrest: all these things contain the word or a part of the word cardiac, so you know it has to do with your heart.

What is a Cardiologist?

A cardiologist is a doctor who specializes in treating hearts and heart problems. They also care for your vascular system, your arteries, and veins.

They specialize in cardiology, meaning they know A LOT about your heart and vascular system. But they may only be able to answer some of your questions about the other things you have going on.

Sometimes, patients will be upset because their cardiologist would not look at the rash on the back of their arm.

Aren't they a doctor?

Yes! Yes, they are a doctor.

They are a doctor who specializes in heart problems. They probably would not have the first clue about what was causing your arm rash. They think hearts, and that's about it!

Doctors, and even nurses, tend to specialize in a field. They get specific certifications and training and enjoy looking at, assessing, and playing detective in THAT PARTICULAR FIELD, not so much any of the others.

Your cardiologist will know about your kidneys only to the extent that they relate to your heart.

Even as a nurse specializing in cardiology, I groan inside when someone wants me to look at a rash or give them my ideas on the hormonal changes they are going through.

I don't know anything about those things. Nursing school covered the basics. Then, I started my career and promptly "forgot" everything I didn't use every day.

Well, I didn't forget, forget. All those facts are still floating around in my head. But I don't use them often, so I might need to look stuff like that up.

Your cardiologist and other specialists are the same way.

This is one reason it is crucial to keep track of all the medications and supplements you are taking. Your cardiologist will assess your heart, treat your heart, and prescribe medications for your heart. If your dermatologist prescribed something for you last week, your cardiologist would not know that. It would be up to you to mention that you started a new medication. Then, your doctor can make an informed decision about your best treatment options.

What am I trying to say?

Cardiology is the study of the heart and the vascular (arteries and veins) system .

Your cardiologist is an expert on everything related to your heart, arteries, and veins. They may be unable to answer all your other medical questions, but they are the go-to person for your heart questions.

Call your cardiologist for any issues you may be having with your heart.

Call 9-1-1 if you have chest pain or difficulty breathing. The hospital will contact your cardiologist, who can meet you at the hospital if necessary.

Contact me if you need a medical writer or editor!

Sources:

What Is a Cardiologist? What They Do and When to See One (clevelandclinic.org)

Cardiac | definition of cardiac by Medical dictionary (thefreedictionary.com)

Thank you for reading Patient Education Essentials, the Write Shift RN blog.

Disclaimer: This information is not intended as medical advice. It is for informational and educational purposes only. Always talk to your doctor or other qualified healthcare providers about any questions or concerns regarding medical conditions.

Patient Education Essentials

The Science of Stress Recovery

The Science of Stress Recovery: How Healthcare Workers Can Protect Their Health

﻿

Introduction: Stress Is Built Into the Job

Why Recovery Matters in Healthcare

The Physiology of Stress and Recovery

Evidence-Based Recovery Strategies for Healthcare Workers

1. Breathing Techniques to Reset the Nervous System

2. Micro-Recovery Breaks During Shifts

3. Protecting Sleep in Shift Work

4. Nutrition as a Stress Buffer

5. Movement and Posture Resets

6. Building Peer Support and Emotional Recovery

Putting It All Together

Conclusion: Protecting the Protector

About the Author

References

Salt and High Blood Pressure: Myth or Truth?

Salt and High Blood Pressure: Myth or Truth?

Understanding High Blood Pressure

The Role of Salt in the Body

The Connection Between Salt and the Development of High Blood Pressure

Debunking the Myth: Does Salt Directly Cause High Blood Pressure?

The Impact of Other Factors on Blood Pressure

Alternative Seasonings and Flavor Enhancers to Replace Salt

Tips for Reducing Your Salt Consumption

The dog days of summer have come and gone....Are you hydrated?

The dog days of summer have come and gone....Are you hydrated?

﻿

What is a healthy hydration zone?

What is dehydration?

Benefits of Exercise for Women

Benefits Of Exercise For Women

Why should you exercise?

How to support your loved one through their first year of nursing.

Support your loved one through their first year of nursing.

Shift Work

Imposter Syndrome

How to support your loved one

Summary

How to Enjoy Life After a Mastectomy

How to Enjoy Life After a Mastectomy

Breast Cancer Caused the Mastectomy

A Mastectomy Changes Your Life

Needs to Address After a Mastectomy

Final Thoughts

Is Sitting the New Smoking?

Is Sitting the New Smoking?

What is the opposite of inactivity?

Tips to help get you up and moving.

Summary

BMI and Health: Should we still bother about the number?

BMI and Health: Should we still bother about the number?

What does BMI mean?

Should we still rely on BMI? Experts weigh in.

Experts Identify some limitations.

How should we use BMI?

Conclusion

Bipolar Disorder and Light Therapy: What You Need to Know.

Bipolar Disorder and Light Therapy: What You Need to Know.

What is bipolar disorder?

What are the symptoms of bipolar disorder?

What causes bipolar disorder?

How does genetics affect bipolar disorder?

Does the brain structure have a link?

What's the role of neurotransmitters?

Norepinephrine (NE)

Light therapy offers some prospects for the treatment of bipolar therapy.

The bottom line

What are Herbal Supplements?

What are Herbal Supplements?

What are some of the most common herbal supplements?

Benefits of Taking Herbs and Supplements

Potential Risks and Side Effects

Safe use of Herbs and Supplements

Could Breast Cancer Screening be Improved with the Help of Artificial Intelligence?

Could Breast Cancer Screening be Improved with the Help of Artificial Intelligence?

﻿

Immune Checkpoint Inhibitors

How Immune Checkpoint Inhibitors (ICI) work:
or what happens when Checkpoint Inhibitors crash the T-Cell and cancer cell dance party?