This is a case of a 41-year-old male who came in for right atrial mass excision.
During his annual physical exam there was a noted mass in the right atrium of his heart and was advised to undergo surgery.
According to adam.com: A myxoma is a benign tumor in the heart. Right atrial myxomas occur less frequently than left atrial myxomas. Treatment is necessary to avoid metastasis and the formation of clots. In addition, untreated growth of the tumor can obstruct blood flow through the heart. Myxomas are curable with surgical removal.
During the endorsement from the Surgical ICU I was told that the patient’s case was taunted as one in a million as the most common site for myxoma is the left atrium. Checking on line at MedlinePlus, it says that about 75% of myxomas occur in the left atrium of the heart, usually beginning in the wall that divides the two upper chambers of the heart. The rest are in the right atrium. Right atrial myxomas are sometimes associated with tricuspid stenosis and atrial fibrillation.
Myxomas are more common in women. About 10% of myxomas are passed down through families (inherited). Such tumors are called familial myxomas. They tend to occur in more than one part of the heart at a time, and often cause symptoms at a younger age than other myxomas.
He presented with no symptoms as right atrial myxomas rarely produce symptoms until they have grown to be at least 13 cm (about 5 inches) wide. Common symptoms of such as disease are the following:
• Breathing difficulty when lying flat
• Breathing difficulty when asleep
• Chest pain or tightness
• Dizziness
• Fainting
• Sensation of feeling your heart beat (palpitations)
• Shortness of breath with activity

The operation which was done on his second hospitalization day was successful. Also, the biopsy performed on the excised mass turned out to be benign and non-cancerous. He continued to have normal vital signs and he was discharged the day before his birthday.

December is the perfect month for reunions.  There so many announcement and invites son facebook  about high school and college reunions. I myself has been invited to attend our high school reunion next month. There are class rings high school that will be given as memento of this rare occasion.  I am really excited to sit down with my former classmates and catch up with them.

This is a case of 56 year-old-female who was diagnosed to have diabetes mellitus for 38 years. Her uncontrolled diabetes has taken its toll on his other systems such as the urinary and cardiac systems. She has just underwent Coronary Artery Bypass Graft to treat her 3-vessel disease. Before that, she was diagnosed to have Chronic Kidney Disease secondary to Nephropathy and has not been urinating normally for years (anuric). She has been created with arteriovenous fistula (AVF) on her left antecubital area for hemodialysis about 1 ½ months ago. Right now she is on peritoneal dialysis for three years with her own dialyzer machine. Her caregiver is doing the peritoneal dialysis for her with the order she got directly from her nephrologist.
So what is the difference between peritoneal dialysis (PD) and hemodialysis (HD)?
Dialysis is the process of removing waste products and water from the bloodstream. Necessary elements include a semipermeable membrane, dialysate solution, and a surgically created access. Blood is separated from dialysate solution by a semipermeable membrane. Because the dialysate solution contains physiologic amounts of electrolytes and buffers, exposure to blood across the membrane allows diffusion to begin. Solutes dissolved in the blood, such as blood urea nitrogen (BUN) and creatinine, cross the membrane from an area of greater to an area of lesser concentration. Osmosis is the other process at work, whereby water moves across the membrane into the dialysate, which by virtue of its composition has a lesser concentration of water molecules. (Levy, Morgan, & Brown, 2001). Both HD and PD rely on these basic principles of osmosis and diffusion.
During hemodialysis, the blood is pumped into a machine to be filtered and then returned to the body. On the other hand, PD process include the infusion time, dwelling time and the drain time.
In PD, a soft tube called a catheter is used to fill the abdomen with a cleansing liquid called dialysis solution. The walls of the abdominal cavity are lined with a membrane called the peritoneum, which allows waste products and extra fluid to pass from the blood into the dialysis solution. The solution contains a sugar called dextrose that will pull wastes and extra fluid into the abdominal cavity. These wastes and fluid then leave the body when the dialysis solution is drained. The used solution, containing wastes and extra fluid, is then thrown away. The process of draining and filling is called an exchange and takes about 30 to 40 minutes. The period the dialysis solution is in the abdomen is called the dwell time. A typical schedule calls for four exchanges a day, each with a dwell time of 4 to 6 hours. Different types of PD have different schedules of daily exchanges.
Patients who are ambulatory, work, want independence, live a distance from the nearest dialysis unit, like to travel, and like to participate in their care are apt to choose PD. Often, patients who are severely limited in mobility or who live in a nursing home will opt for PD because someone else is available to perform the therapy. Medical reasons to use PD include failed vascular accesses and severely compromised cardiac function.
A particular advantage of PD is that because of its continuous nature, potassium is not nearly as restricted in the diet as it is on HD, nor is fluid. In fact, it is not uncommon to find hypokalemia and dehydration in certain PD patients.
In HD, a nurse or a technician cares for the patient during treatment. The PD patient performs self-care, with the support and encouragement of the PD team. (Source: Findarticles.com)
One of the biggest adjustments you must make when you start hemodialysis treatments is following a strict schedule. Most patients go to a clinic-a dialysis center-three times a week for 3 to 5 or more hours each visit.
One important step before starting hemodialysis is preparing a vascular access, a site on your body from which your blood is removed and returned. A vascular access should be prepared weeks or months before you start dialysis. It will allow easier and more efficient removal and replacement of your blood with fewer complications. (Source: National Kidney & Urologic Diseases Information Clearinghouse (NKUDIC))
In a nutshell, the PD can be performed anywhere by a person who was taught to perform it while HD is done in dialysis centers performed by a dialysis nurse or any trainged healthcare personnel.

I admire people who know how to play around with coupons and end up getting tons and tons of merchandise for less than half its actual cost. Items are mostly food and household products but I recently come across Proflowers coupons which I think would give every couponer a whole new perspective in discount shopping. I hope that the coupon lady would device a strategy to turn things around in her favour.

Every person has physical attribute that he or she can be proud of. I am so thankful that I am blessed with long thick lashes, although they are not curled up, I can just pump them up with my eye lash curler. There are those who verbalize their words of appreciation of my lashes and they just wish that they could have the same. I always tell them that having long and beautiful lashes nowadays is not that as hard. I even told them to check eye-lashgrowthproducts.com to find something that would make the Kardashian sisters wear sunnies all the time.

Time is flying so fast.  A few years ago, I was excited to shop for my niece for her first birthday and next thing I know, she will be in high school next year. I caught them with her cousin who is in high school surfing for 2012 prom dresses online. Inspired by Hannah Montana and I-Carly, they are into contemporary fashion. I was really excited that I  joined them mixing and matching clothes, shoes and accessories. It just brings back my high school prom years.

This is a case of a 45-year old female who was referred by another hospital on her island with chief complaint of body weakness and pain while urinating or dysuria.
She was diagnosed with cervical cancer stage IIA with vaginal extension in a local hospital on her island. PAP smear in May 2010 showed HGSIL/CIS or High grade squamous intraepithelial lesion, or HGSIL for short, is a medical term given to a category of cervical dysplasia detected through a Pap smear. Cervical dysplasia is mild to severe abnormal changes that can occur in the lining of the cervix. Her biopsy then showed poorly differentiated squamous cell carcinoma.
A Pap smear is a test used to detect cervical cancer or abnormal changes in the cervical cell. It is done by taking sample of cells by the use of a small spatula.The cells are then placed in a tube with a preservative, or placed on a slide and sent to laboratory to tests.
If HGSIL is found through a Pap smear, a colposcopy is then done to confirm results. A colposcopy is an in-office procedure that allows a doctor to examine the cervix more in-depth. It is done by using a colposcope, a lighted microscope that magnifies the cervix.
Since we do not have that type of equipment, the patient procedure was done in another hospital.

During the colposcopy, the doctor may also do a cervical biopsy, the removal of small pieces of cervical tissue. The tissue samples are then sent to a lab for further examination.
Due to lack of resources in her place then, colposcopy was never performed. The OB –Gyne to whom she was referred to immediately requested for such.

A colposcopy is performed in the doctor’s office and normally takes less than an hour to perform. Results are available within two weeks, depending on the lab the doctor uses.
It was actually my first encounter with the OB-Gyne from another hospital and I was really impressed by his ability to show genuine concern with the patient who hardly understand English and took her time discussing the matter with the patient’s niece. I have learned from him that the patient’s condition is not actually cervical cancer but as he termed “pre-cancer”.
Although there are other procedures done to destroy the abnormal tissue formation that cause the vaginal extension, he chose to have the patient on Cryotherapy.
Cryotherapy is a technique used to destroy abnormal tissue by freezing it. It is also called crysosurgery. Since our hospital cater to operable clean cases, the patient had to be brought again to another hospital where the OB-Gyne could perform the surgery.
Cryosurgery is method of treatment used for cervical dysplasia, or abnormal cells on the cervix. It may also be performed in very early staged cervical cancer. If left untreated, these abnormal cells may develop into cervical cancer. Cryosurgery is also called cryotherapy. Cryosurgery kills pre-cancerous and cancerous cells by freezing them.
During cryosurgery, a doctor will insert a speculum into the vagina. A probe is inserted into the vagina that releases a gas that freezes the abnormal cells. It is left in for three minutes until ice crystals form on the cells. The process may be repeated after waiting for an additional three minutes. (Source: about.com)
It only took her half a day in that hospital and she was brought in our hospital again and she was already able to ambulate.
According to the doctor, she might have blood-tinged discharges that will go away after a couple of days.
The patient has been discharged and was then advised to come to an OB-Gyne in her place for follow up check up.
Also, it is important that every woman should get vaccinated to prevent cervical cancer.
It is just amazing how God sends his angels to heal those who are sick.

I am an advocate of one’s right to free air but I also have friends to really cannot control their urge to puff the cigarettes. I just smile at them when they try to sneak out of the office and exchange Padron with one another just to satisfy their cravings. I know that they are old enough to know the consequence of their actions and they are responsible enough limiting their smoke-intake.

Finally, after almost a month of getting drowned with the ward’s toxicity level, I came to get out with my colleagues to catch some movies. I felt guilty that I had to leave my practicing charge nurse completing her tasks but I already did my part lightening up her load. We need to run to catch the movie’s last full show. As we hit the escalators toward the cinema, I caught a glimpse of sony lcd tvs on a showcase in an appliance store. I just said to myself, I have been a Sony believer and one day, I will be getting that TV in my living room.

Christmas can now be felt everywhere and in these tough economic times, what is the best way to get through the season? Do not just splurge man, enjoy the season without breaking the bank. Tradeshow booth can be a good start in showcasing your crafts or products. It is like taking advantage of the holiday season and earning some extra bucks that you could use in turn in buying your loved ones the best gift for the holidays.