Morning Sniffles » Health and Fitness

Keeping my shape in shape

morning sniffles — Mon, 19 Jul 2010 07:44:59 +0000

I have been thinking about what the dressmaker has told me. Of course nothing beats the natural way of loosing weight like cutting on carbs, eating on moderation and getting up on my feet doing cardio workouts. Then again, with my erratic sked I came to considering popping some weight loss supplements to shed off some pounds.
I need to keep my shape in shape to fit in my clothes.

Into the fad

morning sniffles — Mon, 19 Jul 2010 07:30:45 +0000

I have asked the hospital’s official dressmaker to sew me another set of uniforms. Unfortunately my old uniforms are close to not fitting me anymore. Even with my erratic hospital sked and the toxic shifts which do not allow me to eat on time, I still continue to put on some pounds.
I have been giving the dressmaker my detailed instruction on how I would like her to sew my uniform and she has just jokingly told me to try clinicallix. I was surprised that at her age, she knows about these stuff. She told me that her daughters abroad are so obsessed with it.

Accidents happen

morning sniffles — Fri, 16 Jul 2010 15:32:51 +0000

Just before I capped off my night duty. I went into my patient’s room to take his capillary blood sugar (CBG). After that, I gave his pre-breakfast dose of Novomix via Flex Pen which is reusable. As I tried to recap the pen and secure the silicon cover, the needle went through the silicon cover piercing through my right finger. It bled. I was panicking I immediately rinsed my finger with alcohol.
I reported the matter to the supervisor on duty. She asked me to fill out the Needle Stick Injury form and submit it immediately and then to go to the infirmiary to see a doctor.
The doctor has requested for an HBsAb or Anti-HBs (hepatitis B surface antibody) test.
Not that I wanted but it is good to know that this kind of test is covered by the disability insurance of the hospital I work for.

Thymoma

morning sniffles — Tue, 13 Jul 2010 14:39:17 +0000

This is the case of a 27 year-old male who was diagnosed to have thymoma. Two months prior to admission, patient experienced on and off chest pain associated with occasional cough. Pain relievers prescribed by a doctor on private consult gave temporary relief for a month. The symptoms persisted accompanied with a gradual weight loss . He was confined in a private hospital in Manila where he had CT scan that revealed mediastinal mass. Biopsy revealed thymoma and was advised to have thoracic surgery hence the admission to our institution.
The contemplated surgery was put on hold as the attending wants clearance from the oncologist. The oncologist wants the patient to undergo chemotherapy.
Thymoma is a type of cancer that begins in the thymus. The thymus is located in the upper chest just below the neck. It is a small organ that produces certain white blood cells before birth and during childhood. These white blood cells are called lymphocytes and are an important part of the body’s immune system. Once released from the thymus, lymphocytes travel to lymph nodes where they help to fight infections. The thymus gland becomes smaller in adulthood and is gradually taken over by fat tissue.
Cancer begins when normal cells begin to change and grow uncontrollably, forming a mass called a tumor. A tumor can be benign (noncancerous) or malignant (cancerous, meaning it can spread to other parts of the body).
Although rare, thymomas are the most common type of thymic tumor. The term thymoma traditionally refers to a non-invasive, localized (only in the thymus) type of thymic tumor. Thymomas arise from thymic epithelial cells, which make up the covering of the thymus. Thymomas frequently contain lymphocytes, which are non-cancerous. Thymomas are classified as either noninvasive (previously called benign) or invasive (previously called malignant). Noninvasive thymomas are those in which the tumor is encapsulated and easy to remove. Invasive thymomas have spread to nearby structures (such as the lungs) and are difficult to remove. Approximately 30% to 40% of thymomas are of the invasive type. (Healthline.com)
Thymoma is generally a slow-growing tumor that does not usually spread outside of the thymus. Occasionally, it can spread to the lining of the lung, called the pleura. Less often, it can spread to other parts of the body. (Cancer.net)
The symptoms in 60% of patients with Thymoma are caused by pressure from the enlarged thymus on the windpipe (trachea) or blood vessels which explains the difficulty breathing or pain being experienced by the patient.
Other symptoms of thymoma may include:
• shortness of breath
• swelling of the face
• coughing
• chest pain
• muscle weakness (especially in the eyes, neck, and chest, causing problems with vision, swallowing, and breathing)
• weakness
• dizziness
• shortness of breath
• fatigue
Of these, Mr. P. only manifested the chest pain and coughing.
Thymoma is categorized into four stages (I, II, III, and IV) which may be further subdivided (A and B) based on the spread of cancerous tissue. The Masaoka staging system is as follows:
• Stage I. The thymoma lies completely within the thymus.
• Stage II. The thymoma has spread out of the thymus and invaded the outer layer of the lung (pleura) or nearby fatty tissue.
• Stage III. The thymoma has spread to other neighboring tissues of the upper chest including the outer layer of the heart (pericardium), the lungs, or the heart’s main blood vessels.
• Stage IVA. The thymoma has spread throughout the pericardium and/or the pleura.
• Stage IVB. The thymoma has spread to organs in other parts of the body.
• The treatment for thymoma cancer depends on the stage of cancer and the patient’s overall health. Because thymomas are so rare, there are no defined treatment plans. Options for treatment include surgery, radiation therapy, and/or chemotherapy. Surgical removal of the tumor is the preferred treatment. Surgery is often the only treatment required for stage I tumors. Treatment of thymoma often relieves the symptoms caused by paraneoplastic syndromes.
• A treatment that is intended to aid the primary treatment is called adjuvant therapy. For instance, chemotherapy may be used along with surgery to treat thymoma. Stages II, III, and IV thymomas are often treated with surgery and some form of adjuvant therapy. However, in the case of Mr. P, the oncologist prefers chemotherapy.
Also, since the patient is already immunocomprmised or has low level of immune system, I have advised the patient and the visitors to wear mask. The patient has been place on reverse isolation or protective environment.
Source: Healthline.com

What goes up must come down

morning sniffles — Fri, 09 Jul 2010 11:32:20 +0000

Most of Filipino men are ashamed to discuss about the decline in their sexual desires. I had one patient who has been treated for his depression due to impotence also know as erectile dysfunction or ED. ED according to NKUDIC, ED is the repeated inability to get or keep an erection firm enough for sexual intercourse. The word “impotence” may also be used to describe other problems that interfere with sexual intercourse and reproduction, such as lack of sexual desire and problems with ejaculation or orgasm.
Damage to nerves, arteries, smooth muscles, and fibrous tissues, often as a result of disease, is the most common cause of ED. Diseases—such as diabetes, kidney disease, chronic alcoholism, multiple sclerosis, atherosclerosis, vascular disease, and neurologic disease—account for about 70 percent of ED cases. Between 35 and 50 percent of men with diabetes experience ED.
Oral drugs such as Viagra, Levitra, and Cialis are being used to treat ED. Some use oral testosterone booster that can reduce ED in some men with low levels of natural testosterone, but it is often ineffective and may cause liver damage.
The patient is taking drugs to address his depression but according to NKUDIC, anti depression drugs may actually cause ED.

A natural way to be healthy

morning sniffles — Mon, 05 Jul 2010 13:43:59 +0000

After the whole night of binging on unhealthy food, I am a bit jumpy thinking about my cholesterol level. I have stopped taking simvastatin and fish oil for more than a week now. I want to continue with the fish oil thing and I want to try on other stuff like the grape seed and all but I have to look also for some other supplement reviews to know that will best work for me.

The return of my sniffles

morning sniffles — Sat, 03 Jul 2010 05:21:56 +0000

For more than two months now, I am having 5mg steroids every Monday, Wednesday, Friday and Sunday. I have not gotten back to my doctor yet to adjust the roids dosage but I now that its effect is already wearing off. Ever since I gotten this anti-inflammatory full dose, I think for more than a year already, my sniffles have vanished. There were only very rare incidents that I sneezed. While the steroids were indicated to treat my other disease, its anti-inflammatory effect has extended to suppressing my allergic reaction to certain allergents.
Last week, I noticed that once in a while, I was having spells of sneezes. Yesterday was entirely different. I got up from bed already sneezing occasionally and I had sniffles until were had our endorsement in the ward.
Right after I made my rounds, the continuous sneezing became uncontrollable. It occurred to me that my allergic rhinitis has come back. The steroids has given way. I do not know if I will feel glad that my old self is back.
I just do not know.

Getting enlightened

morning sniffles — Sat, 03 Jul 2010 03:35:51 +0000

I was the charge nurse in the morning shift yesterday and as I expected, doctors’ order has drowned me. To prevent delay in carrying out orders, I immediately browsed on what the doctors have written and point blank shoot the one who ordered it a question about things I was unfamiliar of or I coordinate with concerned department regarding preparations for certain procedures.
Like when the doctor ordered for a hydroxycut on a patient, I immediately asked my headnurse about it and she asked me to call a certain department on proper charging and preparations.

Pleural effusion versus mesothelioma

morning sniffles — Thu, 01 Jul 2010 10:04:05 +0000

Ms. S who was admitted due to interstitial lung disease has just undergone minithoracotomy was placed on mechanical ventilator due to deteriorating oxygenation in her body. The surgeon suspects pleural effusion or accumulation of fluid in the interstitial space in the lungs. They are considering pleurodesis. A procedure that causes the membranes around the lung to stick together and prevents the build up of fluid in the space between the membranes. This procedure is done in cases of severe recurrent pleural effusion (fluid around the lungs), as from cancer, to prevent the reaccumulation of fluid. The doctors want to rule out Mesothelioma also known as Malignant mesothelioma (Source: Medlineplus) According to National Cancer Institute, The tissue that lines your lungs, stomach, heart and other organs is called mesothelium. Mesothelioma is cancer of that tissue. It is a rare but serious type of cancer. It usually starts in the lungs, but can also start in the abdomen or other organs. Most people who develop mesothelioma have worked on jobs where they inhaled asbestos particles. It can take a long time – 30 to 50 years – between being around asbestos and getting the disease. Treatment includes surgery, radiation, chemotherapy or all three.
I hope that pleurodesis will work for her.

Beyond the chart

morning sniffles — Tue, 29 Jun 2010 07:41:59 +0000

After my long three days off, I am back on track.
I was pleasantly surprised that the young Micronesian girl has been brought back to a regular room. The girls was the one who undergone MVR, AVR left thromboeectomy and IOTEE.
She is no longer on mechanical ventilator. She is now on oxygen per nasal cannula and she has a nasogastric tube for feeding. Her Glascow coma scale (GCS) is 10. She opens her eyes spontaneously, no verbal response and only withdraws to pain.
Since she cannot move on her own, frequent turning is required. Also she needs frequent suctioning of oral and nasal secretions.
Her mom, in broken English continuously expresses her gratitude to the ward nurses as she feels our care for her daughter.
The bedside rehabilitation is ongoing and at the moment, her legs seem to be powerless.
As I browsed through her chart, I saw that she has had subdural hematoma and they also performed emergency by pass on her.
According to Medline Plus Subdural hematomas are usually the result of a serious head injury. When one occurs in this way, it is called an “acute” subdural hematoma. Acute subdural hematomas are among the deadliest of all head injuries. The bleeding fills the brain area very rapidly, compressing brain tissue. This often results in brain injury.
I remembered the neurosurgeon telling the mother before that the fluid accumulated in the brain was negligible and does not require surgery.
What puzzles me is that the girl was ambulatory before the operation and now, her GCS is only 10. I also wanted to know why there was a need for emergency by pass.
Nancy Drew investigates