Jul
31
    
Posted (morning sniffles) in Celebrations on July-31-2011

There many promos circulating the net or just simple requests to like a particular page. There are time that I pass on to some requests but there are times that I give in. I checked out the happyeasterstore page on Facebook and I am surprised at the Easter favors that they offer. Easter is one of the most celebrated holidays of the year and being stress free yet keeping the personal touch in sending out your love and concern to everyone is really a big thing.


 
Jul
26
    
Posted (morning sniffles) in family on July-26-2011

I was really thrilled by the news I received from a friend. Her status on Facebook says” Bun in the oven” and everybody went crazy posting congratulatory comments. It is really nice how creative people are in terms of letting others know about their situation like baby announcements. I hope that I could think of better ways of making them when the right time comes.


 
Jul
19
    
Posted (morning sniffles) in career, Health and Fitness, nursing on July-19-2011

One of the seniors in our ward was so furious. He was apparently scolded by our headnurse during the grand endorsement. As the outgoing nurse, he needs to endorse all the patients to the incoming nurses and that includes the headnurse.
Our patient was a 22-year-old female who was diagnosed to have Ventricular Septal Defect or VSD who came in due to complaint of fatigability. VSD is a congenital disease or present at birth and is characterized by a hole or a shunt in the lower chambers (right and left) of the heart.
Anatomically, the blood flows from the superior and inferior vena cava to right atrium down to the right ventricle going to the pulmonary artery to the lungs for oxygenation then to the pulmonary vein to the left atrium down to the left ventricle then pumped out to the systemic circulation. With the VSD, the oxygenated blood coming from the left atrium leaks back to the right ventricle which mixing with unoxygenated blood then goes back to the lungs that cause too much blood pressure in the lungs that causes pulmonary hypertension. Also, the shunt allows for the poorly oxygenated blood to enter the left ventricle that causes the blood to circulate the system.
Our female patient was diagnosed to have Eisenmenger Syndrome which is associated with the high blood pressure in the lungs or the pulmonary hypertension caused by the VSD. The mean pulmonary artery pressure (mPAP) is ≥25 mmHg at rest or ≥30 mmHg with exercise (Barst et al 2004).
Eisenmenger’s Syndromes signs and symptoms include:
• Abnormal heart rhythm (arrhythmia)
• Bluish lips, fingers, toes, and skin (cyanosis)
• Chest pain
• Coughing up blood
• Dizziness
• Fainting
• Feeling tired
• Shortness of breath
• Stroke
• Swelling in the joints caused by too much uric acid (gout)
Complete blood count revealed increased levels which is common presentation of the syndrome. She underwent phlebotomy. Older children with symptoms may have blood removed from the body (phlebotomy) to reduce the number of red blood cells, and then receive fluids to replace the lost blood (volume replacement).
Heart murmur or an abnormal heart sound can also be heard and this was among the questions of our headnurse. I do not know but based on the feedback I received from my co-staff nurses, what our headnurse did was a bit out of bounds. The senior nurse felt belittled. It is one thing that she knows something that we do not know but it is another to guide us to learning the ropes of cardiac nursing.
Searching the internet, I landed on kidshealth.org. A heart murmur is a whooshing sound between the beats that a doctor hears through a stethoscope. The whoosh is just an extra noise that the blood makes as it flows through the heart. Normal heart sounds are called “lub-dub”.
The heart makes a “lub” sound with the closing of the valves that control blood flow from the upper chambers to the lower chambers. Then, as the valves controlling blood going out of the heart close, you will hear the sound “dub.”
Murmurs have grades. Grade 1 is the softest-sounding murmur, and Grade 6 is the loudest. A murmur graded 4, 5, or 6 is so loud you can actually feel a rumbling from it under the skin if you put your hand on the person’s chest.
There is no treatment for this type of condition and the treatment is palliative or based on the presenting complication. The pulmonary hypertension may be treated with prostacyclin and endothelin antagonists.
Viagra, which is the common form of Sildenafil is used to treat pulmonary hypertension that helps dilate the pulmonary arteries.
Prophylaxis against endocarditis is also recommended. Once developed, life expectancy for patients with Eisenmenger Syndrome depends on the type and severity of the underlying defect and right ventricular function, and ranges from 20 to 50 years.
According to Mayoclinic. Com, doctors do not recommended surgery once Eisenmenger syndrome has been developed although some may benefit from heart and lung transplantation or lung transplant with repair of the hole in the heart.
Next time that our headnurse will throw a big stone of a question at us, I will make sure that I have my armor.


 
Jul
13
    
Posted (morning sniffles) in career, nursing on July-13-2011

I did not notice how time flew so fast. Almost a year and seven months ago, I started as an orientee in this hospital. I was being guided by my preceptor, who actually, I did not regard as one. I remember that during that time, he just deflects or asks me back every question that I threw at him. He even sarcastically tells me to research on some questions that I ask and get back to him about it. So arrogant. He is brilliant as he was on the list of those who topped the critical care course.
I know for a fact that it is not the right way of mentoring a newbie or any person for that matter. Show them the tricks of the trade, teach him thing that he or she might not know or enhance the things that he already know.
Now that I am in line to be the next preceptor, I will assure that I will leave something for preceptee to cherish. Something good that is.
The preceptorship training will help me in becoming the best preceptor I could ever be.


 
Jul
10
    
Posted (morning sniffles) in Technology on July-10-2011

I have been to Singapore once and the experience was good . I have been wanting to get another opportunity to get there and I think this time of the year is the most perfect timing as it is the grand Singapore sale. I really wanted to check out their electronics sale especially the computers. I think having this laptop around for more than two years is enough to let it go. I need to keep up with the demands of my work and with my lifestyle. Geez, I need to get a very good deal.


 
Jul
10
    
Posted (morning sniffles) in Finance on July-10-2011

I finally get to hang out with my friend right after our duty. We went to the mall to register to the Milo Marathon. On the way there, we discussed how we should continue making voluntary contribution to our government-funded insurance. We understand that no matter how hard it is for us to cope with the increasing a href=”http://www.wholesaleinsurance.net/”>life insurance rate we should still be thinking that little sacrifices everyday will just be a delayed gratification. That it will benefit us in the long run.


 
Jul
01
    
Posted (morning sniffles) in Entertainment, Health and Fitness on July-1-2011

In my quest to catch my elusive sleep last night, I chanced upon a documentary show on Bio channel titled Obsessed. It featured two individuals who are battling a mental condition called Obsessive-compulsive disorder or OCD.
The first case was a married woman in her early 30s. She has been suffering from OCD since 5 years old. The problem according to her has stemmed, when she was abused on a school bus at that age. She felt dirty in the inside and she channelled her hunger to clean her innerself by obsessing with having clean surroundings. The OCD got worse when contracted MRSA or the methicillin-resistant Staphylococcus aureus (S. aureus) bacteria putting her quest for perpetual cleanliness into a great hype.
She caves into her obsession making her compulsive and cleaning every inch of her household. She wakes up so early cleaning up everything in their home repetitively. She straightens out the fringes on her carpet rug using a fork and cleans every corner of their furniture pieces using Q-Tips. Although she feels tired and she knows that everything is already clean and in order, she just cannot fight the urge forcing her to stay up until wee hours in the morning scrubbing everything she sees and thinks dirty.
While in Florida, a 26-year old man is also suffering from OCD obsessed in checking and ensuring that every faucet, door, stove and electric appliance is properly shut down. He uses a checklist doing the routine of checking every piece of it not one, not twice but at least four times before tucking himself at night. However, the obsession does not end when he hits the bed, he still tosses and turns in bed being bugged by the thought that he might have forgotten to shut down something completely. The obsession stems from his childhood experience when he left the faucet at home open and left. He was traumatized by the thought that their house flooded. Although no one blamed him for the accident, the event kept traumatizing him until today. He has lost a good music deal while in Switzerland due to his OCD when he kept on checking the hotel door’s every so often that the band was not able to finish recording.
It was really painful watching them struggle to fight their obsessions. The woman’s relationship with her family has been greatly affected. She cannot even sit down with them at the dinner table as she tries to finish scrubbing the sink. She really felt exhausted but her obsession keeps on pulsating in her mind. She even had to ask her kids to clean objects and places again and again even if they were not dirty at all.
On the other hand, the man’s partner does not get good night sleep as she gets awakened by the man’s constant trip to the kitchen and living room to check on doors, plugs and switches.
According to medicine.net

An obsession is defined as a thought, impulse, or image that either recurs or persists and causes severe anxiety. These thoughts are irresistible to the OCD sufferer despite the person’s realizing that these thoughts are irrational. Examples of obsessions include worries about germs/cleanliness or about safety or order. A compulsion is a ritual/behavior that the individual with OCD engages in repeatedly, either because of their obsessions or according to a rigid set of rules.

Being physically exhausted thinking and doing things repeatedly, affecting their relationship with their significant others and their performance of activities of daily living, they have agreed to undergo intervention therapy that involves OCD therapists. They were asked to face their fears by exposing them to the things that increases their anxiety.
The woman was brought out to a public toilet where she was asked to touch the toilet seat for 15 seconds and she was not allowed to wash her hand for 5 minutes. Her anxiety grew as she rated upto 8 out of 10. She survived the day but she was really in tears. After 8 weeks of continuous therapy sessions, she was asked to do a, yet, major challenge. She was asked to go out in an amusement park and spend the whole day with the family. At first, she was jittery, but as she tried on conquering her obsession, it turned out well. She had a blast and she was really up on her feet to overcome the major challenges her disorders is going to put on the table.
On the other hand, the man was exposed to things that make him jitter. The OCD therapist opened the faucet and let the water fall in the sink and he opened the gas stove while they are sitting in the living room. After a few attempts the man succeeded in overcoming his obsession to come into the kitchen and switch all the things off.
The next step was keeping all the same stuff open all throughout the night as the man was trying to sleep in his room with his partner at night. The first few nights were a struggle as night vision camera placed in his room and kitchen showed that he kept tossing and turningfighting his obsession but in the end he caved in. It took him a while to control his anxiety.
After 3 weeks of intervention and close monitoring, his OCD therapist has decided to take the exposure to its highest limit. He kept the faucet in the patient’s house open and they went out with his family to see him play his music. He succeeded.
The treatment, according to the OCD therapists, is a life long process and the person affected needs a strong support system to win the battle.
I am now hooked on the show as I want to explore the different sides of OCD.