Barb's Daily Dose

How Elbows can prevent the flu

I learned this nifty trick from some pretty astute and experienced pre-school teachers. Instead of teaching children to cough and sneeze into their hands, teach them to turn their heads and sneeze or cough into the inside of their elbows. 

Brilliant! 

This helps prevent them from spreading germs to their hands which they’re much more likely to use to swipe across other people or other surfaces than their elbows. 

There’s also a nifty soap out there, Squid Soap that helps teach children and grown ups how to wash their hands for 90 seconds. Here’s a video.

A Glimpse into a Cardiac Cath lab part 2

A few days ago, my friend and NP colleague Jenny Jin began writing about what it's like to work in a Cardiac Cath lab.  Here's part 2.

Healthy arteries look like a large wide river flowing down briskly, tapering down to more and more narrow streams with a smaller diameter. Along these 3 major arteries, there are little side branches of other vessels branching off them. Arteries are usually a little curvy but sometimes we see people with arteries that curve and turn a lot. 

If there is narrowing of the artery, it appears as if it’s being pinched. We might see pinching in one or multiple areas of the same artery. Sometimes we can see a little haziness, which means that there might be a blood clot present. If there is a complete blockage, the blood flow stops abruptly without gradually tapering and narrowing. It’s almost as if there’s a stop sign holding up the flow of blood. 

A Glimpse into a Cardiac Cath lab

This is a guest blog by my friend and fellow nurse practitioner, Jenny Jin.

It is 7AM in the Kaiser Santa Clara Cardiac Procedure Unit. This is the place where people have Coronary Angiography. A scary sounding procedure that helps diagnose heart disease and look for clogging in the coronary arteries. These are the tiny blood vessels that bring oxygen and nutrients to the heart muscle. If they don’t work right, the heart doesn’t work right. 

During the test, if there’s life-threatening obstruction, we can intervene with various tools to dilate and open up arteries that may have been blocked, allowing more blood flow to the heart. The nurses are bustling to get their anxious patients ready for their upcoming procedures. This is where I come in, to help prepare patients and their families for the procedure. I wind my way through the unit, talking to each patient, obtaining a thorough history and then performing a physical exam. This is the time I can answer questions from the patients and their families. After a while, patients are relaxed enough to joke around a little bit, some even to call us “plumbers of the heart”. 

Dipstick for Bladder Infections

Most women will have at least 1 bladder infection some time during their lifetime. They can occur from the teen years to well past menopause. With the uncomplicated bladder infection or urinary tract infection, the symptoms might be:

• Feeling that you have to get to the bathroom every 10 minutes
• Only having a tiny amount of urine 
• Intense burning
• Pain in the lower abdomen

The Dipstick

When a women with symptoms sees their health care provider, they'll ask for a urine specimen. 

It's easy to get the flu

Researchers have found that the germs that cause colds and flu can live for 2 days on various things like toys, refrigerator doors, phones, light switches, counters and TV remotes. It's a wonder more people don't get sick. We used to think that if it was a dry surface, then the germs would die shortly and now we know that they can live a lot longer than previously thought. 

Information on the Flu Vaccine

Pregnant women and the Flu Vaccine

Preventing the Flu

• Good handwashing and using a hand sanitizer is helpful.  

• Carry hand sanitizers and wipes in your bag and wipe down toys and other surfaces.

• Get the Flu Vaccination, especially if you're at risk.

• Ask your health care provider about Tamiflu.

I'll be posting more on treatments this week and next. Stay tuned

Migraine or Sinusitis

Many people who have chronic sinusitis may actually have Migraine headaches. Often the symptoms are the same:

• Headache

• Feeling pressure along the forehead, under the eyes, the cheeks and around the nose,

(over the sinus cavities) 

• Pain behind the eyes

Unless you experience a nasal discharge and a fever, what you may have thought was another case of sinusitis, may actually be a migraine.

Many times, migraines start with pain in the forehead or back of the neck. 

Treatment options

Nip it in the bud, treat the symptoms as soon as you think it's possible that a headache is starting, before it becomes a full-fledged migraine.

• Check with your health care provider about which treatments are best for you.

• Over the counter remedies will often work if taken as soon as you suspect a migraine.

• Ask your provider about prescription medication, known as triptans that are highly effective.

– These help decrease swelling and constrict blood vessels in the brain, relieving pain.

In any case, if you think you have recurrent sinusitis, see your provider.

The Great Pumpkin

When Halloween Candy Magically Disappears

For little ones, most of the fun of Halloween is the delight of dressing up, knocking on doors and begging for candy. Ever notice how fast they run from house to house? Amazing what a child will do for a small treat. I love Halloween, kids love dressing up, and they love seeing grown ups be more playful than usual when they comment and make a fuss about how adorable and scary they look in their costumes. 

The candy is secondary, it's really all about the experience of gathering the Pirate's booty of treasure,

Economic Depression

It's not just the stock market that has hit bottom, so have a lot of peoples' emotional well being.  Last week, I heard from many people who felt:

• That the rug had been pulled out from under them
• That they had no real control over their lives
• Why me?  Why now? 

5 stages of grief:

• Denial - this can't happening to me. My 401 K will be fine. My job is secure. I'm going shopping.

• Anger - why is this happening to me? I followed the rules.  I saved, I invested.

• Bargaining - If I just play the lottery, don't look at my on-line bank statement, then it will get better. 

• Depression - I don't care anymore, I'm going to melt down.  

• Acceptance - I'm ready for whatever comes. I have my health, my family, friends and the skills I need to get past this.  Money isn't everything. If my grandparents could do it, so can I. 

Loss of control

This is a crisis, and it has both long and short term implications for all of us. Many americans have always felt in control of their futures and their happiness. This may be the first time ever that external events, that are completely out of their control, have profoundly affected and will continue to affect their lives.

When events that are outside of our control intrude on our lives and cause turmoil, the psychological effects are profound. Just ask the folks in the Gulf coast areas that have seen their lives turn upside down from events (Hurricanes) out of their control. It's an incredible trauma.

What to do

• It's normal to feel anxious and worried about the future.
• There is comfort in sharing your worries with others and drawing strength from seeing how other people are coping. 
• If you're really anxious and depressed, get information from a professional, whether it's a financial expert, Suze Orman or a therapist.
• Mobilize your energy for a contingency plan and strategies for decreasing expenses 

We'll be coming back to this topic frequently.  I want to hear from you how you're coping with the financial meltdown.

Flu Vaccine

It's that time of year again when the flu is going to start spreading. As a health care provider, I reluctantly undergo the vaccination.  (I'm a big baby and hate getting injections. Eyes slammed shut, gripping whatever is closest, holding my breath, and enduring the few seconds of pain, that's never as bad as I anticipate.)

There are recommendations from the CDC (Centers for Disease Control) that may have you scratching your head.  Is it really necessary?  You're right to be concerned and to ask questions about any treatment or medication before agreeing to it.

My bias

I've been a nurse for a long time, more than 28 years. This means that I've seen way too many serious pneumonias that could have been prevented that lead to terrible consequences, even, death.  In fact 40,000 to 70,000 people in the US die from flu-related pneumonia each year.  

Fortunately, most people who acquire the flu are able to recover in about a week, but for the people who are most vulnerable, the flu is dangerous. If their immune systems are weakened, they have less ability to fight off the infection.

Who should be vaccinated: 

• Children from 6 months to 19
• Anyone caring for children less than 6 months of age, as these children are too young to be vaccinated.
• Pregnant women
• People who are 50 and older
• People of any age with certain chronic medical conditions
• People who live in nursing homes and other long-term care facilities
• Health care workers
• Anyone living with or caring for people at high risk for complications from the flu, which means that their immune function is not optimal and if they develop the flu, it could lead to a serious pneumonia:

Children with Asthma
Premature Babies
People with a recent bone marrow transplant
People with cancers or kidney cisease who need dialysis
People with  HIV/AIDs.

Election Obsession

OCED

I'm coining a new acronym. You read it here FIRST! OCED, Obsessive Compulsive Election Disorder. In this particular psychological response to variables, the person is unable or unwilling to tear themselves away from media coverage of the upcoming election.

Reports are flooding in from every corner of the country, red, blue, purple and green states alike. Ordinary people with no previous history of repetitive behaviors are suddenly checking polling websites every 1/2 hour.  The words Zogby, Gallup, Fivethirtyeight, Rasmussen are now sprinkled in to conversations at playgrounds, coffee shops, parties and after the workout at the Y. 

Others find themselves unable to relinquish the remote as they leap-frog between CNN, MSNBC, FOX, CBS, PBS & ABC, looking for the pundits, experts and talking heads with the latest updates on undecided voters from battleground states.

The symptoms of an informed electorate

More informed electorate for sure, and for some, it's extreme, thus the name OCED, Obsessive Compulsive Election Disorder.  Here's some signs that you might be afflicted:

•  You check and re-check your favorite post more than twice a day hoping for an update
•  You have commented on articles and blog posts using a clever pseudonym
•  You can't sleep, worried about the how voters in West Virginia are going to decide
•  You've watched Tina Fey more this week than in the past few years on 30 Rock
•  You find yourself forwarding emails to every casual acquaintance  who expresses even a mild like-minded opinion on the issues
•  For the first time ever you understand the term Margin of Error
•  You bounce between Huffington, National Review, The Atlantic & DrudgeReport  

The side effects:

1. Nausea as events beyond your control unfold before your eyes
2. Headache as you try to understand Confidence intervals and Margin of error statistics
3. Upset stomach from too many Advil® and Tylenol® swallowed for #1 & #2 above
4. Putting off work related projects to check latest polling numbers from Missouri

Treatment

• Besides Electric Shock Therapy, most people have found that the best thing to do is to shut down the computer and hide the remote.  
• Get out of the house and go for a walk.  
• Avoid counting and comparing the number of political yard signs.
• Research shows that when people with OCED volunteer for their candidate, get involved and direct that energy outward instead of inward, they sleep better at night without medication or alcohol
• Optimal treatment is, drumroll here , please:   Vote

Be well.