Nursing 101

Cancer Awareness and Support

2010-11-30T16:04:00.000-08:00

Mesothelioma

2010-11-30T15:12:00.000-08:00

Who is at risk for Mesothelioma?

The only recognized cause of mesothelioma is exposure to asbestos, though other factors such as smoking can make mesothelioma more or less likely in some individuals. Industrial laborers were widely subjected to asbestos exposure on the job, as the material was widely used throughout the 20th century. Few of these workers knew they were being exposed to asbestos and thus put at risk for mesothelioma, however, despite the fact that many manufacturers were aware the material was hazardous. In most cases, mesothelioma symptoms will not appear in an individual exposed to asbestos until many years after the exposure has occurred. Those who believe they may have been exposed to asbestos are at risk for mesothelioma and should fill out our form to receive a free mesothelioma information packet, detailing treatment options, emerging therapies, and jobsite exposure information.

Early Symptoms of Mesothelioma

Mesothelioma symptoms rarely arise at an early stage, which is why the disease is commonly diagnosed at a late stage of development. In the interest of early detection, those who were exposed to asbestos but have not yet exhibited symptoms should undergo regular chest X-rays or pulmonary function tests to monitor any signs of asbestos inhalation.

When a doctor informs a patient of a mesothelioma diagnosis, patients and their loved ones are often very confused since the cancer is relatively unknown. Asbestos.com provides a complimentary packet with comprehensive information about mesothelioma symptoms and next-step guidance following a diagnosis.

Pleural Mesothelioma SymptomsPleural mesothelioma is the most common form of the cancer, comprising approximately two-thirds of all mesothelioma cases.

Known symptoms of pleural mesothelioma include:

Persistent dry or raspy cough (typically non-productive, meaning there is little or no phlegm)

Coughing up blood (hemoptysis)

Difficulty in swallowing (dysphagia)

Night sweats or fever

Unexplained weight loss of 10 percent or more

Fatigue

Persistent pain in the chest or rib area, or painful breathing

Shortness of breath (dyspnea) that occurs even when at rest

The appearance of lumps under the skin on the chest

Symptoms of pleural mesothelioma occur as a result of thickening of the pleural membrane. This is caused by the rapid production of cancerous cells, which can lead to the buildup of fluid between membrane layers. Tissue thickening and fluid buildup place added pressure on the lungs, leading to reduced respiratory function.

Peritoneal Mesothelioma SymptomsPeritoneal mesothelioma accounts for approximately 25 to 30 percent of mesothelioma diagnoses. Symptoms of this type may include:

Night sweats or fever

Unexplained weight loss

Swelling or pain in the abdomen

Anemia

Fatigue

Diarrhea or constipation (in general, any change in bowel habits or regularity)

Nausea or vomiting

The appearance of lumps under the skin on the abdomen

Symptoms are caused by the thickening of the peritoneal membrane and the resulting buildup of fluid between membrane layers. These changes in membrane composition place pressure on the abdominal region and organs, causing a patient to demonstrate symptoms of the cancer.

Pericardial Mesothelioma SymptomsPericardial mesothelioma accounts for less than 5 percent of all mesothelioma. Symptoms are caused by thickening of the pericardial membrane and fluid buildup. Symptoms of this form of mesothelioma are known to include:

Heart palpitations or irregular heartbeat

Chest pain

Difficulty breathing, even when resting (dyspnea)

Fever or night sweats

Generalized fatigue

Pericardial mesothelioma is so rare that the recognized body of symptoms is not as well-developed as with more common types of mesothelioma. It is a particularly difficult type of mesothelioma to diagnose, and this correlates to a poor prognosis among pericardial mesothelioma patients.

Testicular Mesothelioma SymptomsTesticular mesothelioma is an extremely rare form of cancer, as less than 100 cases of testicular mesothelioma have been recorded in the last 60 years. With so few cases recorded, very little is known about the symptoms of this disease. The only known symptom of testicular mesothelioma is the appearance of testicular lumps, and the lumps may or may not be painful.

Mesothelioma Treatment

Once an individual has been diagnosed with mesothelioma, the next step is to discuss mesothelioma treatment options with his/her physician. Recent scientific research has produced significant breakthroughs with regard to treatment protocols for mesothelioma patients and more options are now available for managing mesothelioma and supporting improved quality of life. Newly diagnosed mesothelioma patients always have many questions about the treatment options that would be most effective for them, including those about new treatment therapies.

Asbestos Exposure

Asbestos exposure is the single known cause of mesothelioma. Inhaled or ingested asbestos fibers may cause an inflammation of internal tissue and disrupt organ function which leads to the development of mesothelioma. Asbestos products were used extensively throughout the 20th century in a wide variety of applications. Many of these products were responsible for asbestos exposure sustained by both the individuals who manufactured the products as well as those who used them at commercial and industrial jobsites including shipyards, refineries, power plants, steel plants and more. Several asbestos companies continued to produce these products even after they were known to be hazardous and harmful to workers and their families. Those who have become sick with mesothelioma because of exposure to these products may now be eligible for financial compensation if they were wrongfully exposed.

Signs Of Colon Cancer

2010-09-16T17:28:00.000-07:00

Signs and symptoms of colon cancer include:

A change in your bowel habits, including diarrhea or constipation or a change in the consistency of your stool for more than a couple of weeks

Rectal bleeding or blood in your stool

Persistent abdominal discomfort, such as cramps, gas or pain

A feeling that your bowel doesn't empty completely

Weakness or fatigue

Unexplained weight loss

Many people with colon cancer experience no symptoms in the early stages of the disease. When symptoms appear, they'll likely vary, depending on the cancer's size and location in your large intestine.

When to see a doctor

If you notice any symptoms of colon cancer, such as blood in your stool or a persistent change in bowel habits, make an appointment with your doctor.

Talk to your doctor about when you should begin screening for colon cancer. Guidelines generally recommend colon cancer screenings begin at age 50. Your doctor may recommend more frequent or earlier screening if you have other risk factors, such as a family history of the disease.

Causes:

It's not clear what causes colon cancer in most cases. Doctors know that colon cancer occurs when healthy cells in the colon become altered. Healthy cells grow and divide in an orderly way to keep your body functioning normally. But sometimes this growth gets out of control — cells continue dividing even when new cells aren't needed. In the colon and rectum, this exaggerated growth may cause precancerous cells to form in the lining of your intestine. Over a long period of time — spanning up to several years — some of these areas of abnormal cells may become cancerous.

Precancerous growths in the colon

Colon cancer most often begins as clumps of precancerous cells (polyps) on the inside lining of the colon. Polyps can appear mushroom-shaped. Precancerous growths can also be flat or recessed into the wall of the colon (nonpolypoid lesions). Nonpolypoid lesions are more difficult to detect, but are less common. Removing polyps and nonpolypoid lesions before they become cancerous can prevent colon cancer.

Inherited gene mutations that increase the risk of colon cancer

Inherited gene mutations that increase the risk of colon cancer can be passed through families, but these inherited genes are linked to only a small percentage of colon cancers. Inherited gene mutations don't make cancer inevitable, but they can increase an individual's risk of cancer significantly.
Factors that may increase your risk of colon cancer include:

Older age. About 90 percent of people diagnosed with colon cancer are older than 50. Colon cancer can occur in younger people, but it occurs much less frequently.

African-American race. African-Americans have a greater risk of colon cancer than do people of other races.

A personal history of colorectal cancer or polyps. If you've already had colon cancer or adenomatous polyps, you have a greater risk of colon cancer in the future.

Inflammatory intestinal conditions. Long-standing inflammatory diseases of the colon, such as ulcerative colitis and Crohn's disease, can increase your risk of colon cancer.

Inherited syndromes that increase colon cancer risk. Genetic syndromes passed through generations of your family can increase your risk of colon cancer. These syndromes include familial adenomatous polyposis and hereditary nonpolyposis colorectal cancer, which is also known as Lynch syndrome.

Family history of colon cancer and colon polyps. You're more likely to develop colon cancer if you have a parent, sibling or child with the disease. If more than one family member has colon cancer or rectal cancer, your risk is even greater. In some cases, this connection may not be hereditary or genetic. Instead, cancers within the same family may result from shared exposure to an environmental carcinogen or from diet or lifestyle factors.

Low-fiber, high-fat diet. Colon cancer and rectal cancer may be associated with a diet low in fiber and high in fat and calories. Research in this area has had mixed results. Some studies have found an increased risk of colon cancer in people who eat diets high in red meat and processed meats.

A sedentary lifestyle. If you're inactive, you're more likely to develop colon cancer. Getting regular physical activity may reduce your risk of colon cancer.

Diabetes. People with diabetes and insulin resistance may have an increased risk of colon cancer.

Obesity. People who are obese have an increased risk of colon cancer and an increased risk of dying of colon cancer when compared with people considered normal weight.

Smoking. People who smoke cigarettes may have an increased risk of colon cancer.

Alcohol. Heavy use of alcohol may increase your risk of colon cancer.

Radiation therapy for cancer. Radiation therapy directed at the abdomen to treat previous cancers may increase the risk of colon cancer.

If your doctor suspects you may have colon cancer, you'll likely be referred to specialists who treat colon cancer. You may meet with a number of specialists, including:

Doctors who treat digestive diseases (gastroenterologists)

Doctors who treat cancer (oncologists)

Doctors who remove colon cancer using surgery (surgeons)

Doctors who use radiation to treat cancer (radiation oncologists)

Because appointments can be brief, and because there's often a lot of ground to cover, it's a good idea to be well prepared for your appointment. Here's some information to help you get ready for your appointment, and what to expect from your doctor.

What you can do

Be aware of any pre-appointment restrictions. At the time you make the appointment, be sure to ask if there's anything you need to do in advance, such as restrict your diet.

Write down any symptoms you're experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.

Write down key personal information, including any major stresses or recent life changes.

Make a list of all medications, as well as any vitamins or supplements, that you're taking.

Take a family member or friend along, if possible. Sometimes it can be difficult to absorb all the information provided during an appointment. Someone who accompanies you may remember something that you missed or forgot.

Write down questions to ask your doctor.

Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For colon cancer, some basic questions to ask your doctor include:

Where is my colon cancer located in my colon?

What is the stage of my colon cancer?

Can you explain my pathology report to me?

Can I have a copy of my pathology report?

Has my colon cancer spread to other parts of my body?

Will I need more tests?

What are the treatment options for my colon cancer?

Will any of the treatments cure my colon cancer?

What is the chance that my colon cancer will be cured?

How much does each treatment increase my chances that my colon cancer will be cured?

What are the potential side effects of each treatment?

How will each treatment affect my daily life?

Is there one treatment you feel is best for me?

What would you recommend to a family member or friend in my same situation?

How much time can I take to make my decision about treatment?

Should I seek a second opinion?

Should I see a specialist? What will that cost, and will my insurance cover seeing a specialist?

Are there any brochures or other printed material that I can take with me? What Web sites do you recommend?

In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.

Non-Hodgkin Lymphoma

2010-09-02T09:58:00.000-07:00

What is non-Hodgkin lymphoma?
Non-Hodgkin lymphoma (also known as non-Hodgkin's lymphoma, NHL, or sometimes just lymphoma) is a cancer that starts in cells called lymphocytes, which are part of the body's immune system. Lymphocytes are in the lymph nodes and other lymphoid tissues (such as the spleen and bone marrow). These will be described in more detail in the section "The lymph system and lymphoid tissue."

Some other types of cancer -- lung or colon cancers, for example -- can spread to lymph tissue such as the lymph nodes or bone marrow. But cancers that start in these places and then spread to the lymph tissue are not lymphomas.

There are 2 main types of lymphomas.

Hodgkin lymphoma (also known as Hodgkin's lymphoma, Hodgkin disease, or Hodgkin's disease) is named after Dr. Thomas Hodgkin, who first described it.
non-Hodgkin lymphoma
These 2 types of lymphomas differ in how they behave, spread, and respond to treatment.

Doctors can usually tell the difference between them by looking at the cancer cells under a microscope. In some cases, sensitive lab tests may be needed to tell them apart.
The lymph system and lymphoid tissue
To understand what lymphoma is, it helps to know about the body's lymph system.

The lymph system (also known as the lymphatic system) is composed mainly of lymphoid tissue, lymph vessels, and a clear fluid called lymph. Lymphoid tissue is made up of several types of immune system cells that work together to help the body fight infections. Lymphoid tissue is found in many places throughout the body (described below).

LymphocytesMost of the cells in lymphoid tissue are lymphocytes, a type of white blood cell. The 2 main types of lymphocytes are B lymphocytes (B cells) and T lymphocytes (T cells). Both types can develop into lymphoma cells, but B-cell lymphomas are much more common than T-cell lymphomas in the United States. Normal T cells and B cells do different jobs within the immune system.

B lymphocytes: B cells normally help protect the body against germs (bacteria or viruses) by making proteins called antibodies. The antibodies attach to the bacteria or viruses and attract other immune system cells that surround and digest the antibody-coated germs. Antibodies also attract certain blood proteins that can kill bacteria.

T lymphocytes: There are several types of T cells, each with a specialized job. Some T cells help protect the body against viruses, fungi, and some bacteria. For example, they recognize specific substances found in virus-infected cells and destroy these cells. T cells can also release substances called cytokines that attract certain other types of white blood cells, which then digest the infected cells. T cells are also thought to destroy some types of cancer cells. Some types of T cells play a role in either boosting or slowing the activity of other immune system cells.

Different types of lymphoma can develop from these different types of lymphocytes. Treatment for each lymphoma depends on which type it is, so determining the exact type of lymphoma is important.

Organs that contain lymphoid tissueBecause lymphoid tissue is in many parts of the body, lymphomas can start almost anywhere. The major sites of lymphoid tissue are:

Lymph nodes: Lymph nodes are bean-sized organs throughout the body that are connected by a system of lymphatic vessels. These vessels are like veins, except that instead of carrying blood, they carry lymph and immune system cells.

Lymph nodes get bigger when they fight infection. Lymph nodes that grow in reaction to infection are called reactive nodes or hyperplastic nodes and are often tender to the touch. An enlarged lymph node is not always a sign of a serious problem. Enlarged lymph nodes in the neck are often felt in people with sore throats or colds. But a large lymph node is also the most common sign of lymphoma. Lymph node enlargement is discussed more in the section, "How is non-Hodgkin lymphoma diagnosed?"

Spleen: The spleen is an organ under the lower part of the rib cage on the left side of the body. An average adult spleen weighs about 5 ounces. The spleen makes lymphocytes and other immune system cells to help fight infection. It also stores healthy blood cells and filters out damaged blood cells, bacteria, and cell waste.

Thymus gland: The thymus lies behind the upper part of the breastbone and in front of the heart. Before birth, the thymus plays a vital role in development of T lymphocytes. The thymus shrinks and becomes less important over the first 20 years of life. Despite this, it continues to play a role in immune system function.

Adenoids and tonsils: These are collections of lymphoid tissue located at the back of the throat. They help make antibodies against germs that are breathed in or swallowed. They are easy to see when they become enlarged during an infection or if they become cancerous.

Digestive tract: The stomach and intestines as well as many other organs also contain lymphoid tissue.

Bone marrow: The bone marrow (the soft inner part of certain bones) makes red blood cells, blood platelets, and white blood cells. Red blood cells carry oxygen from the lungs to the rest of the body. Platelets plug up small holes in blood vessels caused by cuts or scrapes. White blood cells' main job is fighting infections. The 2 main types of white blood cells are granulocytes and lymphocytes. Bone marrow lymphocytes are primarily B cells. Lymphomas sometimes start from bone marrow lymphocytes.

Types of non-Hodgkin lymphoma
Classifying non-Hodgkin lymphoma can be quite confusing (even for many doctors) because there are so many types and because several different systems have been used. The most recent system is the World Health Organization (WHO) classification. The WHO system groups lymphomas based on how they look under a microscope, the chromosome features of the lymphoma cells, and the presence of certain chemicals on the surface of the cells. (Older systems classified lymphomas based only on how they looked under a microscope.)

The more common types of lymphoma are listed below according to whether they are B-cell or T-cell lymphomas. Some rarer forms of non-Hodgkin lymphoma are not discussed here.

B-cell lymphomas
B-cell lymphomas make up most (about 85%) of non-Hodgkin lymphomas in the United States.

Diffuse large B-cell lymphoma This is one of the more common types of non-Hodgkin lymphoma in the United States, accounting for about 1 out of every 3 cases. The cells are fairly large when viewed under the microscope.

Diffuse large B-cell lymphoma (DLBCL) can affect any age group but occurs mostly in older people (the average age is mid-60s). It usually starts as a quickly growing mass in an internal lymph node, such as in the chest or abdomen or in a lymph node that you can feel, such as in the neck or armpit. Although this lymphoma usually starts in lymph nodes, it can grow in other areas such as the intestines, bone, or even the brain or spinal cord.

About 1 out of 3 of these lymphomas is confined to one part of the body (localized) when it is found. Localized lymphomas are easier to treat than when they have spread to other parts of the body. Genetic tests have shown that there are different subtypes of DLBCL, even though they look the same under the microscope. These subtypes seem to have different outlooks (prognoses) and responses to treatment.

This is a fast growing lymphoma, but it often responds well to treatment with chemotherapy. Overall, about 3 out of 4 people will have no signs of disease after initial treatment, and about half of all people with this lymphoma are cured with therapy.

Follicular lymphomaAbout 1 out of 5 lymphomas in the United States is follicular lymphoma. The term follicular is used because the cells tend to grow in a circular, or nodular, pattern in lymph nodes.

The average age for people with this lymphoma is about 60. It is rare in very young people. Most of the time, this lymphoma occurs in many lymph node sites in the body, as well as in the bone marrow.

Follicular lymphomas are often slow-growing, but they are hard to cure. The 5-year survival rate (the percentage of people surviving at least 5 years) is around 70%. Often these lymphomas are not treated when they are first diagnosed if the patient has no symptoms of the disease. Over time, about 1 out of 3 follicular lymphomas changes (transforms) into a fast-growing diffuse B-cell lymphoma.

Chronic lymphocytic leukemia /small lymphocytic lymphoma These are closely related diseases. In fact, many doctors consider them to be different versions of the same disease. The same type of cell (known as a small lymphocyte) is involved in both chronic lymphocytic leukemia (CLL) and small lymphocytic leukemia (SLL). The only difference is where the cancer occurs. In CLL it is mostly in the blood and bone marrow; in SLL, it is mainly in the lymph nodes. SLL accounts for about 5% to 10% of all lymphomas.

Both CLL and SLL are slow-growing diseases, although CLL, which is much more common, tends to grow slower. CLL and SLL are treated the same way. They are usually not considered curable with standard treatments, but depending on the stage and growth rate of the disease, most patients live longer than 10 years. Occasionally over time, these slow-growing lymphomas may transform into a more aggressive type of lymphoma.

For more detailed information, see our document, Leukemia -- Chronic Lymphocytic.

Mantle cell lymphomaOnly about 5% of lymphomas are of this type. The cells are small to medium in size.

Men are affected most often. The average age of patients is in the early 60s. The lymphoma is usually widespread when it is diagnosed, involving lymph nodes, bone marrow, and, very often, the spleen.

This isn't a very fast growing lymphoma, but it is hard to treat. Newer, more aggressive treatments may be more effective than those used in the past, and may offer a better chance for long-term survival for patients now being diagnosed.

Marginal zone B-cell lymphomasMarginal zone lymphomas account for about 5% to 10% of lymphomas. The cells in these lymphomas look small under the microscope. There are 3 main types of marginal zone lymphomas.

Extranodal marginal zone B-cell lymphomas, also known as mucosa-associated lymphoid tissue (MALT) lymphomas: These lymphomas start in places other than the lymph nodes (hence the name extranodal) and are the most common type. Most MALT lymphomas arise in the stomach and are thought to be related to an infection by the bacteria Helicobacter pylori, which is also the cause of stomach ulcers. Other possible sites of MALT lymphomas include the lung, skin, thyroid, salivary glands, and tissues surrounding the eye. Usually it is confined to the area where it begins and is not widespread. Many of these other MALT lymphomas have also been linked to infections with bacteria or viruses.

The average age of patients with MALT lymphoma is about 60. It is a slow-growing lymphoma and is often curable in its early stages. Doctors often use antibiotics as the first treatment for this type of lymphoma, especially MALT lymphoma of the stomach, as they may get rid of the Helicobacter pylori infection.

Nodal marginal zone B-cell lymphoma: This is a rare disease, found mainly in older women. Mostly lymph nodes are involved, although the lymphoma cells can also sometimes be found in the bone marrow.

This tends to be a slow-growing lymphoma (although not usually as slow as MALT lymphoma), and many patients are cured if they are diagnosed in the early stages.

Splenic marginal zone B-cell lymphoma: This is a rare lymphoma. Most often the lymphoma is found only in the spleen and bone marrow.

Patients are often elderly and male and have fatigue and discomfort caused by an enlarged spleen. Because the disease is slow-growing, treatment may not be needed unless the symptoms become troublesome.

Primary mediastinal B-cell lymphoma This type accounts for about 2% of all lymphomas. The cells are large and resemble those of diffuse large B-cell lymphomas.

This lymphoma starts in the mediastinum (the area around the heart and behind the chest bone). It usually is localized when it is found and rarely involves the bone marrow. It can cause trouble breathing because it often presses on the windpipe (trachea) leading into the lungs. It can also block the superior vena cava (the large vein that returns blood to the heart from the arms and head). This can cause the arms and face to swell.

About 2 out of 3 people with this lymphoma are women. Most are young -- in their 30s. It is a fast growing lymphoma but it is treatable. About half of patients can be cured.

Burkitt lymphomaThis type makes up about 1% to 2% of all lymphomas. It is named after the doctor who first described this disease in African children and young adults. The cells are medium sized. Another kind of lymphoma, called Burkitt-like lymphoma, has slightly larger cells. Because this second kind of lymphoma is hard to tell apart from Burkitt lymphoma, the WHO classification combines them.

This is a very fast-growing lymphoma. In the African variety, it often starts as tumors of the jaws or other facial bones. In the more common types seen in the United States, the lymphoma usually starts in the abdomen, where it forms a large tumor mass. It can also start in the ovaries, testes, or other organs, and can spread to the brain and spinal fluid.

Close to 90% of patients are male, and the average age is about 30. Although this is a fast-growing lymphoma, over half of patients can be cured by intensive chemotherapy.

Lymphoplasmacytic lymphoma (Waldenstrom macroglobulinemia)This type is not common, accounting for 1% to 2% of lymphomas. The cells are small and found mainly in the bone marrow, lymph nodes, and spleen.

Most of the time the lymphoma cells make an antibody called immunoglobulin M (IgM), which is a very large protein. This antibody circulates in the blood in large amounts, and causes the liquid part of the blood to thicken, like syrup. This can lead to decreased blood flow to many organs, which can cause problems with vision (because of poor circulation in blood vessels in the back of the eyes) and neurological problems (such as headache, dizziness, and confusion) caused by poor blood flow within the brain. Other symptoms can include feeling tired and weak, and a tendency to bleed easily.

This lymphoma is slow growing. Although it isn't usually considered to be curable, most patients live longer than 5 years.

For more information, see our document, Waldenstrom Macroglobulinemia.

Hairy cell leukemiaDespite the name, this is sometimes considered to be a type of lymphoma. Hairy cell leukemia (HCL) is rare -- about 1,000 people in the United States are diagnosed with it each year. The cells are small B lymphocytes with projections coming off them that give them a "hairy" appearance. They are typically found in the bone marrow and spleen and circulating in the blood.

Patients with HCL tend to be older in general. Hairy cell leukemia is slow-growing, and some patients may never need treatment. An enlarging spleen or dropping blood counts (due to cancer cells invading the bone marrow) are the usual reasons to begin treatment, which is highly effective. Hairy cell leukemia is also described in our document, Leukemia--Chronic Lymphocytic.

Primary central nervous system (CNS) lymphomaThis lymphoma usually involves the brain (called primary brain lymphoma), but it may also be found in the spinal cord and in tissues around the spinal cord and the eye. Over time, it tends to become widespread in the central nervous system. Primary CNS lymphoma is more common in people with immune system problems, such as those infected with HIV, the virus that causes AIDS. Most people develop headaches and confusion. They can also have vision problems, paralysis of some facial muscles, and even seizures in some cases.

The outlook for people with this condition has always been thought to be fairly poor, but about 30% to 50% of people can live at least 5 years with today's treatments.

T-cell lymphomas
T-cell lymphomas make up less than 15% of non-Hodgkin lymphomas in the United States.

Precursor T-lymphoblastic lymphoma/leukemiaThis disease accounts for about 1% of all lymphomas. It can be considered either a lymphoma or leukemia, depending on how much of the bone marrow is involved (leukemias have more bone marrow involvement). The cancer cells are small-to-medium sized immature T-cells.

It often starts in the thymus gland (where many T cells are made) and can develop into a large tumor in the mediastinum (the area around the heart and behind the breast bone). This can cause trouble breathing if it presses on the windpipe (trachea) leading into the lungs. It can also block the superior vena cava (the large vein that returns blood to the heart from the arms and head), which can cause the arms and face to swell.

Patients are most often young adults, with males being affected more often than females.

This lymphoma is fast-growing, but if it hasn't spread to the bone marrow when it is first diagnosed, the chance of cure with chemotherapy is quite good. Once it is in the bone marrow, only about 40% to 50% of patients can be cured.

Peripheral T-cell lymphomasThese types of lymphomas develop from more mature forms of T cells. They are rare, accounting for about 5% of all lymphomas.

Cutaneous T-cell lymphomas (mycosis fungoides, Sezary syndrome): These lymphomas start in the skin. They are described in our document, Lymphoma of the Skin.

Angioimmunoblastic T-cell lymphoma: This lymphoma tends to occur in the lymph nodes and may affect the spleen or liver. Patients usually have fever, weight loss, and skin rashes and often develop infections. This lymphoma often progresses quickly.

Extranodal natural killer/T-cell lymphoma, nasal type: This type often involves the upper airway passages, such as the nose and upper throat, but it can also invade the skin and digestive tract. It is much more common in parts of Asia and South America. All ages can be affected.

Enteropathy type T-cell lymphoma: This lymphoma occurs in people with sensitivity to gluten, the main protein in wheat flour. The disease, called gluten-sensitive enteropathy, can progress to this lymphoma, which typically invades the walls of the intestines.

Subcutaneous panniculitis-like T-cell lymphoma: This rare lymphoma invades the deep layers of the skin, where it causes nodules to form. It is described further in our document, Lymphoma of the Skin.

Anaplastic large cell lymphoma: About 1% to 2% of lymphomas are of this type. The cells appear large under the microscope. The type of lymphoma is more common in young people (including children), but it does occur in patients in their 50s and 60s. It usually starts in lymph nodes and can also spread to skin. This type of lymphoma tends to be fast-growing, but many patients with this lymphoma are cured.

Peripheral T-cell lymphoma, unspecified: This name is given to T-cell lymphomas that don't readily fit into any of the groups above. They make up about half of all T-cell lymphomas. The tumor cells can be small or large. Most patients are in their 60s. As a group, these lymphomas tend to be widespread and grow quickly. Some cases respond well to chemotherapy, but long-term survival is not common.

Bee Sting Signs And Symptoms

2010-08-16T11:03:00.000-07:00

Bee stings are a common outdoor nuisance. In most cases, bee stings are just annoying and pain and swelling go away quickly. Usually home treatment is all that's necessary to ease the pain of bee stings. But if you're allergic to bee stings or you get stung numerous times, you may have a more serious reaction that requires emergency treatment. You can take several steps to avoid bee stings — and find out how to treat them if you do get stung.

Bee sting symptoms include:

Instant, sharp burning pain at the sting site
A red welt at the sting area
A small, white spot where the stinger punctured the skin
Slight swelling around the sting area
In most people, swelling and pain go away within a few hours and only cause minor discomfort.

Allergic reactions

If you're allergic to bee stings, you'll have a more serious reaction. Symptoms can range from mild to severe. Most severe allergic reactions to bee stings develop within minutes of the sting, but in some cases, serious reactions around the bee sting area can take hours or even a few days to develop. Even if you've only had a minor reaction to bee stings in the past, it's possible to have a more serious allergic reaction the next time you get stung.

Signs and symptoms of an allergic reaction to bee stings can include:

A large area of swelling (edema) at the sting site
Itching or hives all over your body
Cough, chest tightness, wheezing or shortness of breath
A severe allergic reaction to bee stings can cause:

Lightheadedness
Loss of consciousness
Upset stomach, diarrhea, nausea, vomiting or other digestive issues
Anaphylaxis
A medical emergency, anaphylaxis is a full-blown allergy attack that can be life-threatening. If you have symptoms of anaphylaxis following a bee sting, seek emergency treatment immediately. Signs and symptoms include:

Skin reactions in parts of the body other than the sting area, including hives and itching and flushed or pale skin (almost always present with anaphylaxis)
Difficulty breathing
Swelling of the throat and tongue or other areas of the body
A weak and rapid pulse
Nausea, vomiting or diarrhea
Dizziness or fainting
Loss of consciousness
Multiple bee stings
Most honeybees or bumblebees aren't aggressive and only sting in self-defense. In most cases, this results in one or perhaps a few bee stings. However, in some cases a person will disrupt a hive or swarm of bees and get stung multiple times. Some types of bees — such as Africanized honeybees — are more likely than are other bees to swarm, stinging in a group.

Bee stings are rarely fatal, in spite of dramatic movie scenes that might make you believe otherwise. But if you get stung more than a dozen stings, you may feel quite sick. Multiple stings can be a medical emergency in children, older adults, and people who have heart or breathing problems.

When to see a doctor
In most cases, bee stings are a minor problem that gets better quickly with home treatment. However, if you have a serious reaction, you'll need medical attention.

Call 911 or other emergency services if you're having a serious reaction to a bee sting that includes dizziness, lightheadedness, loss of consciousness, trouble breathing, swelling of the throat or hives. If you were prescribed an emergency epinephrine autoinjector (EpiPen, Twinject), use it right away as your doctor directed.
Make an appointment to see your doctor if bee sting symptoms don't go away within a few days, or if you've had other symptoms of an allergic response following a bee sting.

Common Signs And Symptoms Of Heart Failure

2010-08-15T15:47:00.000-07:00

Sign or Symptom People with Heart Failure May Experience...

Why It Happens
Shortness of breath (also called dyspnea) ...breathlessness during activity (most commonly), at rest, or while sleeping, which may come on suddenly and wake you up. You often have difficulty breathing while lying flat and may need to prop up the upper body and head on two pillows. You often complain of waking up tired or feeling anxious and restless. Blood "backs up" in the pulmonary veins (the vessels that return blood from the lungs to the heart) because the heart can't keep up with the supply. This causes fluid to leak into the lungs.
Persistent coughing or wheezing ...coughing that produces white or pink blood-tinged mucus. Fluid builds up in the lungs (see above).
Buildup of excess fluid in body tissues (edema) ...swelling in the feet, ankles, legs or abdomen or weight gain. You may find that your shoes feel tight. As blood flow out of the heart slows, blood returning to the heart through the veins backs up, causing fluid to build up in the tissues. The kidneys are less able to dispose of sodium and water, also causing fluid retention in the tissues.
Tiredness, fatigue ...a tired feeling all the time and difficulty with everyday activities, such as shopping, climbing stairs, carrying groceries or walking. The heart can't pump enough blood to meet the needs of body tissues. The body diverts blood away from less vital organs, particularly muscles in the limbs, and sends it to the heart and brain.
Lack of appetite, nausea ...a feeling of being full or sick to your stomach. The digestive system receives less blood, causing problems with digestion.
Confusion, impaired thinking ...memory loss and feelings of disorientation. A caregiver or relative may notice this first. Changing levels of certain substances in the blood, such as sodium, can cause confusion.
Increased heart rate ...heart palpitations, which feel like your heart is racing or throbbing. To "make up for" the loss in pumping capacity, the heart beats faster.

Congestive Heart Failure or CHF

2010-08-15T15:23:00.000-07:00

Congestive heart failure (CHF), or heart failure, is a condition in which the heart can't pump enough blood to the body's other organs. This can result from
narrowed arteries that supply blood to the heart muscle — coronary artery disease
past heart attack, or myocardial infarction, with scar tissue that interferes with the heart muscle's normal work
high blood pressure
heart valve disease due to past rheumatic fever or other causes
primary disease of the heart muscle itself, called cardiomyopathy.
heart defects present at birth — congenital heart defects.
infection of the heart valves and/or heart muscle itself — endocarditis and/or myocarditis
The "failing" heart keeps working but not as efficiently as it should. People with heart failure can't exert themselves because they become short of breath and tired.

As blood flow out of the heart slows, blood returning to the heart through the veins backs up, causing congestion in the tissues. Often swelling (edema) results. Most often there's swelling in the legs and ankles, but it can happen in other parts of the body, too. Sometimes fluid collects in the lungs and interferes with breathing, causing shortness of breath, especially when a person is lying down.

Heart failure also affects the kidneys' ability to dispose of sodium and water. The retained water increases the edema.

How do you diagnose and treat congestive heart failure?

Your doctor is the best person to make the diagnosis. The most common signs of congestive heart failure are swollen legs or ankles or difficulty breathing. Another symptom is weight gain when fluid builds up.

CHF usually requires a treatment program of:

rest
proper diet
modified daily activities
drugs such as

ACE (angiotensin-converting enzyme) inhibitors
beta blockers
digitalis
diuretics
vasodilators

Various drugs are used to treat congestive heart failure. They perform different functions. ACE inhibitors and vasodilators expand blood vessels and decrease resistance. This allows blood to flow more easily and makes the heart's work easier or more efficient. Beta blockers can improve how well the heart's left lower chamber (left ventricle) pumps. Digitalis increases the pumping action of the heart, while diuretics help the body eliminate excess salt and water.

When a specific cause of congestive heart failure is discovered, it should be treated or, if possible, corrected. For example, some cases of congestive heart failure can be treated by treating high blood pressure. If the heart failure is caused by an abnormal heart valve, the valve can be surgically replaced.

If the heart becomes so damaged that it can't be repaired, a more drastic approach should be considered. A heart transplant could be an option.

Most people with mild and moderate congestive heart failure can be treated.

Truth About Genital Herpes

2010-08-01T15:56:00.000-07:00

Genital Herpes

Herpes is a sexually transmitted disease (STD) caused by the herpes simplex virus (HSV).

Genital herpes infection is very common and on the increase in the United States. Nationwide 45 million people aged 12 and older (1 out of 5 of the total adolescent and adult population) are infected with HSV-2.

It is more common in women (1 out of 4) than in men (1 out of 5) possibly because male to female transmission is more efficient than female to male transmission.

HSV-2 infection is also more common in areas of high socio-economic disadvantage, facing fundamental issues of health such as:

access to quality health care

poverty

living in communities with a high prevalence of STDs

illicit drug use

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The Herpes Virus

HSV-type 1

causes fever blisters on the mouth or face (oral herpes)

HSV-type 2

typically affects the genital area (genital herpes)

Both viral types can:

be inactive or 'silent' causing no symptoms

cause either genital or oral infections

cause 'outbreaks' of blisters and ulcers

People can remain infected for life after the first initial episode

--------------------------------------------------------------------------------

Transmission

Herpes is spread by direct contact including:

Sexual contact

Anal sex

Oral sex

Vaginal sex

as well as

Kissing

Skin-to-skin contact which transmits HSV-1 and HSV-2

Genital herpes

Can be transmitted with or without the presence of sores or other symptoms

Is often transmitted by people who do not realize infection can be passed on even when there are no symptoms

Is often transmitted by people unaware they are infected

Statistics

An estimated 40 million people have genital herpes which is a chronic viral infection

About 500,000 new people get symptomatic herpes each year

There are even more people without symptoms

Genital herpes infection

has increased 30% in the U.S.

has increased most dramatically among young white teens (12-19 years old)

among whites is 5 times higher than 20 years ago

is twice as likely to infect 20-29 year old adults

--------------------------------------------------------------------------------

Questions

How serious is Herpes?

Mild symptoms can be experienced with HSV-2, but often no apparent symptoms are present.

HSV-2 may cause recurrent painful genital ulcers and can be severe in people with suppressed immune systems. Severe genital herpes frequently causes psychological and emotional stress.

If a woman with HSV-2 is pregnant, potentially fatal infections in infants can occur. A cesarean -section delivery is usually carried out if a woman has active genital herpes at time of giving birth.

People infected with herpes may be more susceptible to HIV infection, and HIV-infected individuals may be more infectious.

How do you know if you are infected with genital herpes?

Many people with HSV-2 are sometimes not aware that they are infected.

Some people infected with HSV-2 do not have lesions or may suffer only very mild, almost unnoticeable, symptoms which are sometimes mistaken for insect bites or a rash.

Symptoms of the primary episode can be quite pronounced. The primary episode usually occurs within two weeks after the virus is transmitted and lesions usually heal within 2-4 weeks of outbreak.

Other symptoms may include a second crop of lesions, or flu-like symptoms including:

fever

swollen glands

A primary episode of genital herpes can cause several symptomatic recurrences a year (average 4 or 5). Most recurrences occur more often within the first year following the primary episode.

Herpes simplex, a recurrent viral infection, caused by Herpes Virus hominis (HVH), is a widespread infectious agent, which is very hard to control. As well there are latent herpes associated infections.

--------------------------------------------------------------------------------

Symptoms

Symptoms vary, but often most people have no noticeable symptoms.

Early symptoms may include:

burning sensation in the genitals

flu-like symptoms

lower back pain

pain when urinating

Small red bumps may appear in the genital area after initial symptoms, which later develop into painful blisters.

The blisters usually:

crust over

form a scab

heal

GENITAL HERPES

The First Outbreak

Symptoms usually develop within 2-20 days after contact, but could continue up to 2 weeks.

The first infection may be so mild it goes unnoticed. In other cases, the first attack causes visible sores. Subsequent recurrences of the virus may cause an outbreak of blisters.

The virus retreats into the nerves and lies dormant. Even when there are no symptoms of herpes, transmitting the virus is still possible (asymptomatic viral shedding).

Healing of the skin does not normally leave scarring.

Typical Symptoms

When it gets into skin cells the virus reproduces itself and starts to multiply, making the skin red and sensitive.

Blisters or bumps may appear on the genital area, the blisters first opening and then healing with the regeneration of new skin tissue.

During the outbreak the infected area may:

be painful

burn

itch

tingle

Other symptoms include:

fever

headache

infection of the urethra causing a burning sensation when urinating

muscle ache

painful inflamed blisters which develop around the infected area

swollen lymph glands

vaginal or penis discharge

The first episode is the most severe, with most episodes lasting 10-21 days. A warning sign (prodrome) such as tingling is experienced by many people in recurring outbreaks.

Should any of these symptoms occur, consult your doctor or other health care provider immediately.

Genital herpes should be diagnosed and treated professionally.

--------------------------------------------------------------------------------

Diagnosis/Testing

Diagnosis can be made by:

Blood Test

A blood test for herpes is available only in a few research centers.

Microscopic Examination of Tissue Scrapings

In this process, scrapings from lesions are stained and then examined under a microscope.

This test is less accurate than viral cultures, as it is difficult to ascertain which type of HSV infection is present.

One common test is called a Tzanck smear.

Results of the tests take up to 2 weeks.

Viral Cell Culture Test

The test is a specific virus culture or assay for herpes virus.

The doctor or health consultant will obtain fluid from the sores and send it to a laboratory to see if the herpes virus is present.

A viral culture is a fluid sample taken from a lesion when it first appears. Highly accurate results can be given from a culture taken while the lesion is still in the clear blister stage, but the process takes a few days.

The test will not work if the sores have healed.

Immune Response Tests

These tests detect the body's immune response to the herpes virus and are slightly less reliable than viral cultures, but more reliable than tissue scrapings.

Results can sometimes be provided in two hours.

Other available tests:

Antigen test

Pap Smear

Identifying Your Type

Not everyone knows whether they have HSV-1 or 2 and in certain situations that information could be relevant.

In a situation where both partners have HSV-2 both are already infected so precautions to prevent the spread of the disease are optional.

If one partner has genital HSV-1 and the other has HSV-2, each might get infected with a second type unless precautions are used.

HSV- 1

Diagnosing genital HSV- 1 is difficult because the infection seldom recurs. Since many people have HSV-1 orally, a finding of HSV-1 by Western blot serology (blood test) would not positively identify genital infection.

A Western blot confirms if you have HSV-2. If you are seronegative (negative by blood test) for type 2, but positive for type 1, that gives you a strong clue as to the cause of your outbreaks, i.e. seropositive for type 1 but not type 2, with infrequent recurring genital herpes is probably genital HSV1.

Seek immediate professional help if genital herpes is suspected. Some of the available diagnostic procedures become less reliable the longer you wait.

Detox Your Body

2010-07-28T09:45:00.000-07:00

Detoxing the body is one of the primary steps towards a healthier being. If you don’t set time for detoxing then you are allowing for the build up of toxins in the body, which in turn can play havoc on your health and well being. Some of you can probably already recall some of the following symptoms – fatigue, minor aches and pains and a constant feeling of low energy and power.

It is unfortunate, but even the healthiest amongst us can not avoid the intake of toxins found in abundance in foods and the air in which we breathe. Studies are beginning to show the extent of toxin build-up in the body and many medical professionals and scientists claim a link to serious diseases such as cancers and heart disease. Don’t let things get this far and begin your detoxifying journey before things cannot be reversed. It doesn’t have to be a huge effort and after the first few times it will just be a part of your normal routine. Besides, that little extra thought and care for your health can go along way in improving your life.

Some of the foods and drinks that are high in toxins and should be eradicated or consumed moderately are coffee, alcohol, sugar and saturated fats. Then there is smoking – quit that dirty habit! Vegetables and fruits on the other hand are (surprisingly) also laden with pesticides and toxins unless they are grown organically. One of the worst things for toxins though is the air that we breathe – something we cannot always avoid. Have a moment to think about which toxins might be existing in your current lifestyle and try to eliminate them the best you can.

To All The Nurses: Words Of Inspiration

2010-07-20T15:11:00.000-07:00

A Nurse's Prayer

Give to my heart, Lord...
compassion and understanding.
Give to my hands,
skill and tenderness.
Give to my ears
the ability to listen.
Give to my lips
words of comfort.
Give to me, Lord...
strength for this selfless service
and enable me to give hope
to those I am called to serve.
Author unknown

Nurse's Prayer

Be me in the world.
Be my voice to the deaf.
Be my faith where there is doubt.
Be my hope where there is despair.
Be my light where there is darkness.
Be my joy where there is sadness.
Be me in the world.

Be my eyes to the blind.
Be my consolation to those who need to be consoled.
Be my understanding to those who need to be understood.
Be my healing to those who need to healed.
Be my love to those who need love.
Be my forgiveness to those who need to be forgiven.
Be my death to those who need me.
Be me in the world.
- author unknown -

Well I am finally on vacation this week, thank God. It has been a very long time for me since my last vacation. I definitely needed one. I work in long term care at a nursing home. I love my residents, they are family to me. And for the most part the staff is great also. I missed the state survey this year because of my days off, can't say that it hurt my feelings too much. I take care of 25 residents that all require different levels of care. I have been a dedicated nurse since December 2007. I know to all of you experienced nurses out there I am still wet behind the ears. I love my job this is definitely my nitch in life. There is so much I learn everyday, and somethings I can't believe that happens in one shift. Well if anyone is having a bad day hopefully the poems will put a smile on your face. That's all for now, I feel like I am rambling, drop me a line or a shout out if you want. GOD BLESS..........

What Is Macular Dystrophy?

2010-07-19T17:35:00.000-07:00

Age related macular degeneration is a medical condition which usually affects older adults that results in a loss of vision in the center of the visual field (the macula) because of damage to the retina. It occurs in “dry” and “wet” forms. It is a major cause of visual impairment in older adults (>50 years).Macular degeneration can make it difficult or impossible to read or recognize faces, although enough peripheral vision remains to allow other activities of daily life.

Macular degeneration by itself will not lead to total blindness. For that matter, only a very small number of people with visual impairment are totally blind. In almost all cases, some vision remains.

The loss of central vision profoundly affects visual functioning. It is not possible, for example, to read without central vision. Pictures that attempt to depict the central visual loss of macular degeneration with a black spot do not really do justice to the devastating nature of the visual loss. This can be demonstrated by printing letters 6 inches high on a piece of paper and attempting to identify them while looking straight ahead and holding the paper slightly to the side. Most people find this difficult to do.

Macular degeneration is caused when part of the retina deteriorates. The retina is the interior layer of the eye consisting of the receptors and nerves that collect and transmit light signals from the eye into the optic nerve, then to the brain for interpretation as our sense of vision.

There are two types of degeneration wet and dry:
_Dry form_:

This type results from the gradual breakdown of cells in the macula, resulting in a gradual blurring of central vision.

_Wet form_:

In the wet form of macular degeneration, newly created abnormal blood vessels grow under the center of the retina. These blood vessels leak, bleed, and scar the retina, distorting or destroying central vision.
HOPE THIS INFO WAS HELPFUL.......

Breast Cancer Awareness

2010-07-18T16:08:00.000-07:00

If you or a loved one has been diagnosed with breast cancer, it's important to understand some basics: What is breast cancer and how does it happen?

In this section, you can learn about how breast cancer develops, how many people get breast cancer, and what factors can increase risk for getting breast cancer. You also can learn more about signs and symptoms to watch for and how to manage any fears you may have about breast cancer.

Breast cancer is an uncontrolled growth of breast cells. To better understand breast cancer, it helps to understand how any cancer can develop.

Cancer occurs as a result of mutations, or abnormal changes, in the genes responsible for regulating the growth of cells and keeping them healthy. The genes are in each cell’s nucleus, which acts as the “control room” of each cell. Normally, the cells in our bodies replace themselves through an orderly process of cell growth: healthy new cells take over as old ones die out. But over time, mutations can “turn on” certain genes and “turn off” others in a cell. That changed cell gains the ability to keep dividing without control or order, producing more cells just like it and forming a tumor.

A tumor can be benign (not dangerous to health) or malignant (has the potential to be dangerous). Benign tumors are not considered cancerous: their cells are close to normal in appearance, they grow slowly, and they do not invade nearby tissues or spread to other parts of the body. Malignant tumors are cancerous. Left unchecked, malignant cells eventually can spread beyond the original tumor to other parts of the body.

The term “breast cancer” refers to a malignant tumor that has developed from cells in the breast. Usually breast cancer either begins in the cells of the lobules, which are the milk-producing glands, or the ducts, the passages that drain milk from the lobules to the nipple. Less commonly, breast cancer can begin in the stromal tissues, which include the fatty and fibrous connective tissues of the breast.Over time, cancer cells can invade nearby healthy breast tissue and make their way into the underarm lymph nodes, small organs that filter out foreign substances in the body. If cancer cells get into the lymph nodes, they then have a pathway into other parts of the body. The breast cancer’s stage refers to how far the cancer cells have spread beyond the original tumor.

Breast cancer is always caused by a genetic abnormality (a “mistake” in the genetic material). However, only 5-10% of cancers are due to an abnormality inherited from your mother or father. About 90% of breast cancers are due to genetic abnormalities that happen as a result of the aging process and the “wear and tear” of life in general.

While there are steps every person can take to help the body stay as healthy as possible (such as eating a balanced diet, not smoking, limiting alcohol, and exercising regularly), breast cancer is never anyone's fault. Feeling guilty, or telling yourself that breast cancer happened because of something you or anyone else did, is not productive.

Initially, breast cancer may not cause any symptoms. A lump may be too small for you to feel or to cause any unusual changes you can notice on your own. Often, an abnormal area turns up on a screening mammogram (x-ray of the breast), which leads to further testing.

In some cases, however, the first sign of breast cancer is a new lump or mass in the breast that you or your doctor can feel. A lump that is painless, hard, and has uneven edges is more likely to be cancer. But sometimes cancers can be tender, soft, and rounded. So it's important to have anything unusual checked by your doctor.

According to the American Cancer Society, any of the following unusual changes in the breast can be a symptom of breast cancer:

* swelling of all or part of the breast
* skin irritation or dimpling
* breast pain
* nipple pain or the nipple turning inward
* redness, scaliness, or thickening of the nipple or breast skin
* a nipple discharge other than breast milk
* a lump in the underarm area

These changes also can be signs of less serious conditions that are not cancerous, such as an infection or a cyst. It’s important to get any breast changes checked out promptly by a doctor.

So many women you know may have had breast cancer — friends and neighbors, coworkers, relatives. It seems as if every time you turn around, breast cancer is being talked about in the newspaper or on TV. You may be fearful of developing breast cancer for the first time or of receiving a diagnosis after a mammogram or other testing. If you’ve had breast cancer, you may be fearful of a possible recurrence or even of the possibility that breast cancer could take your life.

Even though you may have some of these fears, you are not necessarily going to get breast cancer. If you have had breast cancer before, it doesn’t mean that the cancer will recur. Still, it's normal to have concerns about a disease that you hear about and see around you relatively often — and that you may have experienced yourself or through a loved one. Don't let the discussion of fear in this section feed into your own fears.

Just remember knowledge is power!

Reference:breastcancer.org research news

GOD BLESS!!!!!!!!!!!!!

T8MSW9QF949V

Signs Of Arthritis

2010-07-18T14:15:00.000-07:00

Have you ever wondered if you really have arthritis, or is it just pain because of over doing it in the yard or the gym.Well here are some signs and symptoms to help you better understand arthritis.
Arthritis is a joint disorder featuring inflammation. A joint is an area of the body where two bones meet. A joint functions to allow movement of the body parts it connects. Arthritis literally means inflammation of one or more joints. Arthritis is frequently accompanied by joint pain.Arthritis can affect any joint. Certain types of arthritis are associated with a specific pattern of joint disease. For example, rheumatoid arthritis is usually symmetric -- affecting the same joint on both sides of the body. Other types of arthritis typically affect a single joint. It's important to tell the doctor about all of your symptoms and every joint that hurts.Doctors play an essential role in the diagnosis and treatment of arthritis. Good communication between a doctor and patient is essential. It's important to know what to expect from your doctor and what your doctor expects from you. It's your doctor's job to assess your symptoms, gain more information from your medical history and a current physical examination, order diagnostic tests, and put together a treatment plan. It's your job to provide your doctor with as much pertinent information as possible. The goal is mutual - to improve your health.
The most common form of arthritis is osteoarthritis, sometimes referred to as wear-and-tear arthritis or degenerative joint disease. Osteoarthritis affects more than 20 million people in the United States. The primary form of osteoarthritis is usually related to aging, but osteoarthritis can also result from injury (athletes) or obesity.
Unfortunately there is no cure for arthritis. There are various treatment options that can help with managing pain and reducing deformity and disability. Early diagnosis and an aggressive treatment plan are recognized as two very important factors in getting arthritis under control.

Learn Human Anatomy And Physiology In 3 Days!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

2010-07-16T17:19:00.000-07:00

THAT'S THE TRUTH, LEARN ANATOMY AND PHYSIOLOGY IN 3 DAYS.............WHAT ARE YOU WAITING FOR...........FOLLOW THE LINK..........

Click Here!

Heart Attack Warning Signs

2010-07-14T17:00:00.000-07:00

Each year over a million people in the U.S. have a heart attack. About half of them die. Many people have permanent heart damage or die because they don't get help immediately. It's important to know the symptoms of a heart attack and call 9-1-1 if someone is having them. Those symptoms include

Chest discomfort - pressure, squeezing, or pain
Shortness of breath
Discomfort in the upper body - arms, shoulder, neck, back
Nausea, vomiting, dizziness, lightheadedness, sweating

These symptoms can sometimes be different in women.

What exactly is a heart attack?
Most heart attacks happen when a clot in the coronary artery blocks the supply of blood and oxygen to the heart. Often this leads to an irregular heartbeat – called an arrhythmia - that causes a severe decrease in the pumping function of the heart. A blockage that is not treated within a few hours causes the affected heart muscle to die.

Some heart attacks are sudden and intense — the "movie heart attack," where no one doubts what's happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren't sure what's wrong and wait too long before getting help. Here are signs that can mean a heart attack is happening:

Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.
Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach.
Shortness of breath with or without chest discomfort.
Other signs may include breaking out in a cold sweat, nausea or lightheadedness.
As with men, women's most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.

Learn the signs, but remember this: Even if you're not sure it's a heart attack, have it checked out (tell a doctor about your symptoms). Minutes matter! Fast action can save lives — maybe your own. Don't wait more than five minutes to call 9-1-1 or your emergency response number.

Calling 9-1-1 is almost always the fastest way to get lifesaving treatment. Emergency medical services (EMS) staff can begin treatment when they arrive — up to an hour sooner than if someone gets to the hospital by car. EMS staff are also trained to revive someone whose heart has stopped. Patients with chest pain who arrive by ambulance usually receive faster treatment at the hospital, too. It is best to call EMS for rapid transport to the emergency room.

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Nursing Jewelry Great Gifts

2010-07-14T16:17:00.000-07:00

Here's a link to getting some cool nursing gifts for that special someone in your life. Click on the highlighted nursing gifts, for pictures and cost..........

Nursing Gifts

Cervical Cancer

2010-07-14T15:43:00.000-07:00

Signs and Symptoms:

Cervical cancers start as an abnormality of cells on the surface of the cervix. These abnormalities are not cancerous. They include dysplasia, squamous intraepithelial lesions (SIL) and carcinoma in situ. If undetected or untreated, these pre-invasive abnormalities eventually may invade normal cells of the cervix. As a result, cancer may develop, invading surrounding tissues or lymph nodes and possibly spreading to other parts of the body.

If these lesions have not invaded normal cells of the cervix, treatments may be relatively simple and straightforward.

Pre-cancerous changes of the cervix usually don't cause pain. In fact, they generally don't cause symptoms and aren't detected unless a woman has a pelvic exam and a Pap test.

Symptoms usually don't appear until abnormal cervical cells become cancerous and invade nearby tissue. When this happens, the most common symptom is abnormal bleeding, which may start and stop between regular menstrual periods or may occur after sexual intercourse, douching or a pelvic exam. Menstrual bleeding may last longer and be heavier than usual.

Bleeding after menopause also may be a symptom of cervical cancer. Increased vaginal discharge is another symptom of cervical cancer.

Diagnosis:

Cervical cancer is diagnosed by having a pelvic exam and a Pap test.

A pelvic exam is done to check a woman's vagina, uterus, bladder and rectum. The doctor feels these organs for any lumps or changes in their shape or size. To see the upper part of the vagina and the cervix, the doctor inserts an instrument called a speculum into the vagina.

A Pap test is when the doctor collects cells from the cervix and upper vagina. A medical laboratory checks for abnormal cells.

Treatment:

There are a number of ways to treat cervical cancer.

Loop Electrosurgical Excision Procedure (LEEP) -- This simple procedure can be performed in the doctor's office under local anesthetic. An electrically charged wire loop is used to remove the outer portion of the cervix containing the abnormal tissue, which then can be examined under a microscope to confirm that no cancer remains. In the great majority of cases, women are cured after one LEEP procedure and are able to return to full activity shortly thereafter.

Cryosurgery -- This is a procedure that freezes and kills the abnormal cells on the cervix. In this procedure, which is performed in the doctor's office and usually does not require an anesthetic, a silver probe that has been cooled with liquid nitrogen is placed against the cervix. This freezing kills the outer layer of cells that are abnormal on the cervix.

Cryosurgery Hysterectomy -- The removal of the uterus through the abdomen or vagina is a major surgical procedure requiring at least an overnight stay in the hospital. There are very few reasons to perform a hysterectomy for pre-invasive lesions. It is sometimes used for women who have had more than one relapse and no longer have enough tissue to perform another LEEP.

Treatment of Invasive Cancer:

The treatment of invasive cancer depends upon the extent of tumor growth. In cases where the tumor is small and confined to the cervix, a woman may be treated with either a radical hysterectomy or with radiation therapy. When tumors are large or extend to adjacent tissues or lymph nodes more intensive therapy is required, such as radiation therapy, sometimes with the addition of chemotherapy drugs.

Radical Hysterectomy -- This is the surgical removal of the uterus, the upper portion of the vagina, and the ligaments and connective tissues that hold the uterus in place. During a radical hysterectomy, it also is common to remove the lymph nodes in the pelvic area, for microscopic cancer cells can spread to those lymph nodes and into the ligaments that hold the uterus in place.

It is not necessary to remove the ovaries in a radical hysterectomy and the preservation of ovarian function is one of the benefits of this approach. This is important for younger women. Following a radical hysterectomy, a woman will no longer have menstrual periods and will not be able to bear children. However, she will continue to have the female hormone estrogen in her body. When patients are properly selected for this procedure, the cure rate of cervical cancer is between 85 percent and 95 percent.

Radiation Therapy -- This treatment uses high-energy rays to damage cancer cells and stop them from growing. It is a localized treatment, which means that it works to attack cancer cells in one area. The radiation may come from a large machine, called external radiation, or from radioactive materials placed directly into the cervix, called implant radiation. Some patients receive both types of radiation therapy.

Chemotherapy -- The use of drugs to kill cancer cells is most often used when cervical cancer has spread to other parts of the body. A patient may receive just one drug or a combination of drugs in cycles. Chemotherapy may be given by injection into a vein or by mouth. It is a systematic treatment, meaning that the drugs flow through the body in the bloodstream.

Biological Therapy -- This treatment uses substances to strengthen a woman's immune system to better fight her cancer. It may be used to treat cancer that has spread from the cervix to other parts of the body. Interferon is the most common form of biological therapy for cervical cancer and may be used in combination with chemotherapy. Most patients who receive interferon do so on an outpatient basis.

Hay Fever / Allergic Rhinitis

2010-07-14T08:50:00.000-07:00

Allergic rhinitis is a collection of symptoms, mostly in the nose and eyes, which occur when you breathe in something you are allergic to, such as dust, dander, or pollen.

This article focuses on allergic rhinitis due to outdoor triggers, such as plant pollen. This type of allergic rhinitis is commonly called hay fever.

Causes

An allergen is something that triggers an allergy. When a person with allergic rhinitis breathes in an allergen such as pollen or dust, the body releases chemicals, including histamine. This causes allergy symptoms such as itching, swelling, and mucus production.
Hay fever involves an allergic reaction to pollen. (A similar reaction occurs with allergy to mold, animal dander, dust, and similar inhaled allergens.)
The pollens that cause hay fever vary from person to person and from region to region. Large, visible pollens are seldom responsible for hay fever. Tiny, hard to see pollens more often cause hay fever. Examples of plants commonly responsible for hay fever include:

Trees (deciduous and evergreen)
Grasses
Ragweed

The amount of pollen in the air can play a role in whether hay fever symptoms develop. Hot, dry, windy days are more likely to have increased amounts of pollen in the air than cool, damp, rainy days when most pollen is washed to the ground.
Some disorders may be associated with allergies. These include eczema and asthma.
Allergies are common. Your genes and environment may make you more prone to allergies.
Whether or not you are likely to develop allergies is often passed down through families. If both your parents have allergies, you are likely to have allergies. The chance is greater if your mother has allergies.

Symptoms

Symptoms that occur shortly after you come into contact with the substance you are allergic to may include:

Itchy nose, mouth, eyes, throat, skin, or any area
Problems with smell
Runny nose
Sneezing
Tearing eyes

Symptoms that may develop later include:

Stuffy nose (nasal congestion)
Coughing
Clogged ears and decreased sense of smell
Sore throat
Dark circles under the eyes
Puffiness under the eyes
Fatigue and irritability
Headache
Memory problems and slowed thinking

Exams and Tests

The health care provider will perform a physical exam and ask you questions about your symptoms. Your history of symptoms is important in diagnosing allergic rhinitis, including whether the symptoms vary according to time of day or the season, exposure to pets or other allergens, and diet changes.
Allergy testing may reveal the specific substances that trigger your symptoms. Skin testing is the most common method of allergy testing. See the article on allergy testing for detailed information.
If your doctor determines you cannot undergo skin testing, special blood tests may help with the diagnosis. These tests can measure the levels of specific allergy-related substances, especially one called immunoglobulin E (IgE).
A complete blood count (CBC), specifically the eosinophil white blood cell count, may also help reveal allergies.

Treatment

The best treatment is to avoid what causes your allergic symptoms in the first place. It may be impossible to completely avoid all your triggers, but you can often take steps to reduce exposure.
There are many different medications available to treat allergic rhinitis. Which one your doctor prescribes depends on the type and severity of your symptoms, your age, and whether you have other medical conditions (such as asthma).
For mild allergic rhinitis, a nasal wash can be helpful for removing mucus from the nose. You can purchase a saline solution at a drug store or make one at home using one cup of warm water, half a teaspoon of salt, and pinch of baking soda.
Treatments for allergic rhinitis include:
ANTIHISTAMINES
Antihistamines work well for treating allergy symptoms, especially when symptoms do not happen very often or do not last very long.

Antihistamines taken by mouth can relieve mild to moderate symptoms, but can cause sleepiness. Many may be bought without a prescription. Talk to your doctor before giving these medicines to a child, as they may affect learning.
Newer antihistamines cause little or no sleepiness. Some are available over the counter. They usually do not interfere with learning. These medications include fexofenadine (Allegra), and cetirizine (Zyrtec).
Azelastine (Astelin) is a antihistamine nasal spray that is used to treat allergic rhinitis.

CORTICOSTEROIDS

Nasal corticosteroid sprays are the most effective treatment for allergic rhinitis.
They work best when used nonstop, but they can also be helpful when used for shorter periods of time.
Many brands are available. They are safe for children and adults.

DECONGESTANTS

Decongestants may also be helpful in reducing symptoms such as nasal congestion.
Nasal spray decongestants should not be used for more than 3 days.
Be careful when using over-the-counter saline nasal sprays that contain benzalkonium chloride. These may actually worsen symptoms and cause infection.

OTHER TREATMENTS

The leukotriene inhibitor Singulair is a prescription medicine approved to help control asthma and to help relieve the symptoms of seasonal allergies.

Specific illnesses that are caused by allergies (such as asthma and eczema) may require other treatments.
ALLERGY SHOTS
Allergy shots (immunotherapy) are occasionally recommended if the allergen cannot be avoided and if symptoms are hard to control. This includes regular injections of the allergen, given in increasing doses (each dose is slightly larger than the previous dose) that may help the body adjust to the antigen.

References

Updated by: A.D.A.M. Editorial Team: David Zieve, MD, MHA, Greg Juhn, MTPW, David R. Eltz. Previously reviewed by Stuart I. Henochowicz, MD, FACP, Associate Clinical Professor of Medicine, Division of Allergy, Immunology, and Rheumatology, Georgetown University Medical School (5/25/2009).

References

Wallace DV, Dykewicz MS, Bernstein DI, Blessing-Moore J, Cox L, Khan DA, et al. The diagnosis and management of rhinitis: an updated practice parameter. J Allergy Clin Immunol. 2008 Aug:122(2).

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Traveling Nurses

2010-07-13T11:52:00.000-07:00

Short-term positions across the country. As a licensed nurse in time with a big nursing shortage you are in demand. Hospitals and clinics are willing to pay top dollar for nurses to fill in for short periods.

These nursing positions usually span 3 months to a year. Depending on the duration and distance from your home, the employer will often supply housing, or alternatively, a housing subsidy.

Some travel nursing jobs are meant to span just a short period where a full-time nurse has left and a replacement has not yet been found. However, a lot of hospitals will try to recruit a traveling nurse into a full-time position if they are happy with performance.
This puts the traveling nurse in the driver's seat - you get a guaranteed short term position, with a good likelyhood that you can turn it into a long-term position if you are happy with the position.

Nursing salaries, like physician salaries vary by experience, location and specialty. Travel nursing usually pays $24-$35 per hour, with an additional housing subsidy. Pay is higher in regions of the country with the highest cost-of-living: New York, San Francisco, Chicago, and other major metropolitan areas. California Nursing Jobs are in high demand because of the location, and it turns out that there are many open travel nursing positions in the sate.

Large medical facilities advertise directly for nurses. However, the easiest way of finding a position is to sign up with a nursing recruiter. The big benefit is that you can get several, well-targeted options and a guaranteed minimum quality of living conditions. The recruiter takes a good-sized fee, so your compensation might be lower than it otherwise would be, but it is usually worth it to get the best nursing job opportunities with very little searching.

CPR Basics

2010-07-13T11:07:00.000-07:00

CPR is typically administered in cases of cardiac arrest. Signs of cardiac arrest include an absence of heartbeats, blood flow and pulse. When blood stops flowing to the brain, the person becomes unconscious and stops regular breathing.
The ABCs of CPR are Airway, Breathing, and Circulation. This acronym is used to help you remember the steps to take when performing CPR.
Airway

If a person has collapsed, determine if the person is unconscious. Gently prod the victim and shout, “Are you okay?” If there is no response, shout for help. Call 911 or your local emergency number.
If the person is not lying flat on his or her back, roll him or her over, moving the entire body at one time.
Open the person’s airway. Lift up the chin gently with one hand while pushing down on the forehead with the other to tilt the head back. (Do not try to open the airway using a jaw thrust for injured victims. Be sure to employ this head tilt-chin lift for all victims, even if the person is injured.)
If the person may have suffered a neck injury, in a diving or automobile accident, for example, open the airway using the chin-lift without tilting the head back. If the airway remains blocked, tilt the head slowly and gently until the airway is open.
Once the airway is open, check to see if the person is breathing.
Take five to 10 seconds (no more than 10 seconds) to verify normal breathing in an unconscious adult, or for the existence or absence of breathing in an infant or child who is not responding.
If opening the airway does not cause the person to begin to breathe, it is advised that you begin providing rescue breathing (or, minimally, begin providing chest compressions).

Breathing (Rescue Breathing)
Pinch the person’s nose shut using your thumb and forefinger. Keep the heel of your hand on the person’s forehead to maintain the head tilt. Your other hand should remain under the person’s chin, lifting up.

Inhale normally (not deeply) before giving a rescue breath to a victim.
Immediately give two full breaths while maintaining an air-tight seal with your mouth on the person’s mouth. Each breath should be one second in duration and should make the victim’s chest rise. (If the chest does not rise after the first breath is delivered, perform the head tilt-chin lift a second time before administering the second breath.) Avoid giving too many breaths or breaths that are too large or forceful.

Circulation (Chest Compressions)
After giving two full breaths, immediately begin chest compressions (and cycles of compressions and rescue breaths). Do not take the time to locate the person’s pulse to check for signs of blood circulation.

Kneel at the person’s side, near his or her chest.
With the middle and forefingers of the hand nearest the legs, locate the notch where the bottom rims of the rib cage meet in the middle of the chest.
Place the heel of the hand on the breastbone (sternum) next to the notch, which is located in the center of the chest, between the nipples. Place your other hand on top of the one that is in position. Be sure to keep your fingers up off the chest wall. You may find it easier to do this if you interlock your fingers.
Bring your shoulders directly over the person’s sternum. Press downward, keeping your arms straight. Push hard and fast. For an adult, depress the sternum about a third to a half the depth of the chest. Then, relax pressure on the sternum completely. Do not remove your hands from the person’s sternum, but do allow the chest to return to its normal position between compressions. Relaxation and compression should be of equal duration. Avoid interruptions in chest compressions (to prevent stoppage of blood flow).
Use 30 chest compressions to every two breaths (or about five cycles of 30:2 compressions and ventilations every two minutes) for all victims (excluding newborns). You must compress at the rate of about 100 times per minute.
Continue CPR until advanced life support is available.

Heat Stroke And Heat Exhaustion Signs And Symptoms

2010-07-05T16:56:00.000-07:00

Introduction to heat exhaustion

Heat exhaustion is a milder form of heat-related illness that can develop after several days of exposure to high temperatures and inadequate or unbalanced replacement of fluids. Those most prone to heat exhaustion are elderly people, people with high blood pressure, and people working or exercising in a hot environment.

Heat exhaustion symptoms

Warning signs of heat exhaustion include:

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

The skin may be cool and moist. The victim's pulse rate will be fast and weak, and breathing will be fast and shallow. If heat exhaustion is untreated, it may progress to heat stroke, which is a medical emergency. Seek medical attention and call 911 immediately if:

symptoms are severe, or
the victim has heart problems or high blood pressure.

Otherwise, help the victim to cool off, and seek medical attention if symptoms worsen or last longer than 1 hour.

Heat exhaustion treatment

Cooling measures that may be effective include:

cool, non-alcoholic beverages, as directed by your physician
rest
cool shower, bath, or sponge bath
an air-conditioned environment
Lightweight clothing

Heat stroke occurs when heat exhaustion is left untreated and the victim's core body temperature continues to rise. Heat stroke is a severe emergency that can lead to coma, irreversible brain damage and death. Learn to recognize heat stroke and treat the victim aggressively to prevent further injury. Signs and symptoms of heat stroke:

coma or confusion
hot, flushed, dry skin
deep, rapid breathing
possibly seizures

Difficulty: Easy

Time Required: Less than a minute

Here's How:

Stay safe! If the environment is hot enough for the victim to get overheated, then it's hot enough for the rescuers. Follow universal precautions and wear personal protective equipment if you have it. There are also several other causes of coma that may affect the victim.
Call 911 immediately!
Assure that the victim has an airway and is breathing. Follow the ABC's {airway,breathing,and circulation}.
Move the victim to a cooler environment immediately. Shade is better than sun, air conditioning is better than outside, etc. The cooler the better.
Remove the victim's clothing to encourage heat loss.
Put ice on the armpits, groin, and neck area. Cool the victim as aggressively as possible.

Tips:

Strip the victim completely to facilitate cooling.
Cover the victim with a sheet soaked with water to cool the victim's body.
Use ice at the victim's armpits, neck, and groin.
DO NOT give the victim of heat stroke anything to drink.
A victim conscious enough to follow commands may be suffering heat exhaustion.

Stroke: Know The Warning Signs

2010-07-05T16:28:00.000-07:00

Watch for these signs and symptoms if you think you or someone else may be having a stroke. Note when signs and symptoms begin, because the length of time they have been present may guide treatment decisions.

Trouble with walking. You may stumble or experience sudden dizziness, loss of balance or loss of coordination.
Trouble with speaking and understanding. You may experience confusion. You may slur your words or be unable to find the right words to explain what is happening to you (aphasia). Try to repeat a simple sentence. If you can't, you may be having a stroke.
Paralysis or numbness on one side of your body or face. You may develop sudden numbness, weakness or paralysis on one side of your body. Try to raise both your arms over your head at the same time. If one arm begins to fall, you may be having a stroke. Similarly, one side of your mouth may droop when you try to smile.
Trouble with seeing in one or both eyes. You may suddenly have blurred or blackened vision, or you may see double.
Headache. A sudden, severe "bolt out of the blue" headache, which may be accompanied by vomiting, dizziness or altered consciousness, may indicate you're having a stroke.

When to see a doctorSeek immediate medical attention if you notice any signs or symptoms of a stroke, even if they seem to fluctuate or disappear. Call 911 or your local emergency number right away. Every minute counts. Don't wait to see if symptoms go away. The longer a stroke goes untreated, the greater the potential for brain damage and disability. To maximize the effectiveness of evaluation and treatment, it's best that you get to the emergency room within 60 minutes of your first symptoms.
If you're with someone you suspect is having a stroke, watch the person carefully while waiting for emergency assistance. You may need to:

Begin mouth-to-mouth resuscitation if the person stops breathing
Turn the person's head to the side if vomiting occurs, which can prevent choking
Keep the person from eating or drinking

If you have symptoms of a stroke, seek emergency medical care. Symptoms may include:

Sudden numbness, tingling, weakness, or paralysis in your face, arm, or leg, especially on only one side of your body.
Sudden vision changes.
Sudden trouble speaking.
Sudden confusion or trouble understanding simple statements.
Sudden problems with walking or balance.
A sudden, severe headache that is different from past headaches.

A stroke usually happens suddenly but may occur over hours. For example, you may have mild weakness at first. Over time, you may not be able to move the arm and leg on one side of your body.

Ischemic stroke

Symptoms of an ischemic stroke (caused by a blood clot) vary from one person to another. But symptoms usually occur in the side of the body opposite from the side of the brain where the clot occurred. For example, a stroke in the right side of the brain affects the left side of the body.
Symptoms of a stroke may be so minor that they are ignored or go unnoticed. Some people have symptoms that go away after a short time. This could be caused by a transient ischemic attack , or TIA. A TIA is a warning sign that a stroke may soon follow.

Hemorrhagic stroke

The symptoms of a hemorrhagic stroke (caused by bleeding in the brain) are usually the same as those from a blood clot. But you also may have other symptoms, such as:

Severe headache, sometimes in a specific area.
Nausea and vomiting.
Neck stiffness.
Dizziness, seizures, or changes in mental state, such as irritability, confusion, and possibly unconsciousness.

Hemorrhagic strokes usually occur during the daytime and during physical activity. Symptoms of a hemorrhagic stroke usually begin very suddenly (within seconds) and get worse over several hours.

Summer Brings Risk Of Tick Bites

2010-07-05T16:04:00.000-07:00

If you live out in the boonies like me, then you need to be aware of ticks. I always do a body check when i come in from the garden or from hiking in the woods, and especially after fishing. Here are somethings to keep in mind..

Some ticks transmit bacteria that cause illnesses such as Lyme disease or Rocky Mountain spotted fever. Your risk of contracting one of these diseases depends on what part of the United States you live in, how much time you spend in wooded areas and how well you protect yourself.
If you've received a tick bite:

Remove the tick promptly and carefully. Use tweezers to grasp the tick near its head or mouth and pull gently to remove the whole tick without crushing it.
If possible, seal the tick in a jar. Your doctor may want to see the tick if you develop signs or symptoms of illness after a tick bite.
Use soap and water to wash your hands and the area around the tick bite after handling the tick.
Call your doctor if you aren't able to completely remove the tick.

See your doctor if you develop:

A rash
A fever
A stiff neck
Muscle aches
Joint pain and inflammation
Swollen lymph nodes
Flu-like symptoms

If possible, bring the tick with you to your doctor's appointment.
Call 911 or your local emergency number if you develop:

A severe headache
Difficulty breathing
Paralysis
Chest pain or heart palpitations

Reviewing The Basics Of Nursing

2010-07-05T11:25:00.000-07:00

5 Rights of medication administration
*Right patient
*Right dose
*Right time
*Right route
*Right drug

Drug dose calculation:

desired dose
____________ x Quantity

on-hand strength

Patient care is part of a nurse's role. Nurses use the nursing process to assess, plan, implement and evaluate patient care. Patient care is founded in critical thinking and caring in a holistic framework. Nursing care is increasingly framed in best practice, which is the application of evidence-based concepts to patient problems in a particular setting. Florence Nightingale is recognized as the first nurse researcher.

Infection control

Nurses must observe the principles of asepsis at all times to prevent the spread of infection. They wash their hands thoroughly with soap and warm water before and after caring for patients, after handling any waste, before and after eating and drinking, after smoking, coughing, touching clothes, and after wearing gloves. Alcohol gel has come into common use to sanitize the hands in place of washing hands that are not visibly soiled. Infection control regulations state that hand washing must be done after the third instance of using hand sanitizer. Gloves are generally worn when patient care is given, especially when exposure to patient bodily fluids is likely.
Nurses also observe aseptic technique. This specialty is used for procedures such as wound cleaning and any insertion or removal of appliances into or out of the patient's body. Examples are insertion of an intravenous or urinary catheter, or feeding (nasogastric) tube.
Surgical scrub techniques are also taught to nurses. This specialty is used for operating room technique, where nurses are an important part of any procedure.

Records

Nurses keep accurate records of all care and observations for many purposes. The patient's record is how the different members of the health care team communicate with each other. The chart is a legal document that serves as evidence of care provided. Since the maintenance of records is a legal responsibility, the charts have to meet certain standards, e.g. records must be permanent, accurate, complete, and kept for years after the care was given.

Vital signs

Nurses may take a person's vital signs several times a day. Vital signs include taking and recording a patient's temperature, blood pressure, respiration, pulse, and pain level. Other things recorded in vital signs may be weight (especially for renal patients), bowel movements, and blood pressure measurements which are taking in different positions (in heart patients, for example, it is common to do a lying then standing measurement to assess the cardiovascular system's ability to compensate).
Vital signs are usually done with an electronic machine (commonly called a Dynamap) in modern first world countries, however nurses are usually trained to also use manual equipment. These include a sphygmomanometer for blood pressure and a thermometer for temperature. Nurses are also trained in use of a stethoscope to hear heart, lung and bowel sounds on patients of all ages group.

Medication

Medications are typically dispensed during nursing care. In some countries a nurse is only responsible to administer medication as prescribed by a doctor. In other countries nurses are legally responsible to ensure that the medication is appropriate for the patient and have the authority to interpret the order. Administration of medication by nurses generally requires the nurse to apply advanced knowledge and critical thinking to determine the safety of the administered medication. Advanced practice nurses (Nurse Practitioners, Nurse Midwives, Clinical Nurse Specialists and Certified Registered Nurse Anesthetists) prescribe medications as regulated by the state boards of nursing. Advanced practice nursing requires additional education, generally at the master's level. Advanced practice nurses, depending on specialty and state regulations may assess, order and interpret diagnostic tests, diagnose and treat medical conditions and evaluate the results. Advance practice varies in the different states from supervised (by a physician) to completely independent practice. Multiple research studies indicate patients treated by advanced practice nurses have the same outcomes as patients treated by physicians. Patient satisfaction has been equal to treatment by physicians. Advanced practice nurses may be part of the solution to an overburdened and costly health care system. Advanced practice nurses retain the holistic and preventative framework of nursing, and are ideally suited to wellness care.

Diet

Diet is important for people to stay healthy. A dietitian, or physician may place the patient on a regular, light, soft, or liquid diet. A person on a regular diet can eat any type of food; on a light diet the patient may have such foods as ground meat, chicken, fish, potatoes, rice, strained vegetables, custards, and puddings. Raw fruit and vegetables, rich, spicy or fried foods are not allowed on this diet. A soft diet includes such foods as bread, cereal, eggs, potatoes, custards, and ice cream. A liquid diet may consist only of clear liquids, such as soup, tea, and juices. People with certain illnesses may have other diet restrictions for example people with diabetes or on dialysis.

Safe patient handling

Injury is a major factor of the shortage of nurses today. With an overweight society, moving patients is often difficult. Not only is this risky for the patient, especially if the nurse is older, it is also risky for the nurse. Many nurses quit work every year just because they were injured while working.
American Nursing Association (ANA) works to implement systems to avoid these injuries. If nurses know best practices and have proper supplies and equipment, it is safer for both the patient and nurse. ANA promotes nurses using best practices to increase safe patient care and comfort, as well as keeping the medical professionals safe from injury and physical stress.

Charting....Just The Facts!!!!!!!!!!

2010-07-05T10:45:00.000-07:00

"The best offense is a good defense: ' In the world of nursing and malpractice, the best way to avoid having to defend yourself in court is to chart factually and defensively. This involves knowing:
*how to chart
* what to chart
* when to chart
* who should chart.

HOW to chart:

A skilled nurse charts with a jury in mind and knows that how she charts is just as important as what she charts.
Rule #1: Stick to the facts.
Record only what you see, hear, smell, feel, measure, and count not what you infer or assume. For example, if a patient pulled out his LV. line, but you didn't witness him doing so, write: Found pt., arm-board, and bed linens covered with blood. 1. V. line and venipuncture device were untaped and hanging free. If the patient says he pulled out his LV. line, record that.

Don't chart your opinions. If the chart is used as evidence in court, the plaintiff's lawyer might attack your credibility and the medical record's reliability. Chart subjective information only when it's supported by documented facts.

Rule #2: Avoid labeling. Objectively describe the patient's behavior instead of subjectively labeling it. Expressions such as exhibiting bizarre behavior or using obscenities mean different things to different people. Could you define these terms in court?

Rule #3: Be specific. Your charting goal is to present the facts clearly and concisely. Use only approved abbreviations and express your observations in quantifiable terms. For example, writing output adequate isn't as helpful as writing output 1,200 ml. And Pt. appears to be in pain is vague compared with Pt. requested pain medication after complaining of severe lower back pain radiating to his right leg. Also avoid catchall phrases, such as Pt. comfortable. Instead, describe how you know this. For instance, is the patient resting, reading, or sleeping?

Rule #4: Use neutral language. Using inappropriate comments or language is unprofessional and can cause legal problems. In one case, an elderly patient developed pressure ulcers, and his family complained that he wasn't getting adequate care. The patient later died, probably of natural causes. Because his relatives were dissatisfied with the patient's care, they sued. The insurance company questioned the abbreviation PBBB, which the physician had written in the chart under prognosis. After learning that this stood for "pine box by bedside," the jury awarded the family a significant sum.

Rule #5: Eliminate bias. Don't use language that suggests a negative attitude toward the patient, such as obstinate, drunk, obnoxious, bizarre, or abusive. The same goes for what you say out loud and then document. Disparaging remarks, accusations, arguments, or namecalling could lead to a defamation of character or libel suit. In court, the plaintiff's lawyer might say, "This nurse called my client `rude, difficult, and uncooperative.' It's right here in her own handwriting! No wonder she didn't take good care of him." Remember, the patient has a legal right to see his chart. If he spots a derogatory reference, he'll be angry and more likely to sue.
If a patient is difficult or uncooperative, document the behavior objectively and let the jurors draw their own conclusions.

Rule #6: Keep the record intact. Discarding pages, even for innocent reasons, raises doubt in a lawyer's mind.
Let's say that you spill coffee on a page, blurring several entries. Don't discard the original. Rewrite it and put both pages in the chart. Then cross-reference them by writing Recopied from page on the copy and Recopied on page on the original.

WHAT to chart:

Caring for patients seems more important than documenting every detail, doesn't it? But legally speaking, an incomplete chart reflects incomplete nursing care. Leaving out details is such a serious and common charting error that malpractice lawyers have coined the expression, "Not charted, not done." This doesn't mean that you have to document everything. Some information, such as staffing shortages and staff conflicts, is definitely off-limits.