Maybe it’s the era in which I was raised?

Maybe it was the household where I was lucky enough to spend my youth?

Maybe it’s just me being stubborn and bull headed? (most likely)

I just feel that we should allow our bodies to take the hit. We don’t grow stronger by living in a bubble. We grow stronger by learning to defend ourselves. I’m talking about our immunity to illness and disease. This conversation brushes shoulders with the ‘Antibiotic resistance’ debate. No I don’t believe every child should be place on an antibiotic every time the get the sniffles.

I also don’t think we need to start prescribing a medication that is intended to alleviate symptoms of COPD and Asthma exacerbation for the common cold ^**

It’s a runny nose people! C’mon.

Intranasal ipratropium bromide for the common cold.

Cochrane Database Syst Rev.  2011; (7):CD008231 (ISSN: 1469-493X)

Albalawi ZH; Othman SS; Alfaleh K
Sheikh Abdullah S. Bahamdan Research Chair for Evidence-Based Health Care and Knowledge Translation, College of Medicine, King Saud University, P.O. Box 68639, Riyadh, Central, Saudi Arabia, 11537.

BACKGROUND: The common cold is one of the most common illnesses in humans and constitutes an economic burden both in terms of productivity and expenditure for treatment. There is no proven cure for the common cold and symptomatic relief is the mainstay of treatment. The use of intranasal ipratropium bromide (IB) has been addressed in several studies and might prove an effective treatment for the common cold.

OBJECTIVES: To determine the effect of IB versus placebo or no treatment on severity of rhinorrhoea and nasal congestion in children and adults with the common cold. Subjective overall improvement was another primary outcome and side effects were reported as a secondary outcome.

SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL 2011, Issue 1) which contains the Acute Respiratory Infections Group’s Specialised Register, MEDLINE (1950 to January week 4, 2011), MEDLINE in-process and other non-indexed citations (February 2011), EMBASE (1974 to February 2011), AMED (1985 to February 2011), Biosis (1974 to February 2011) and LILACS (1985 to February 2011).

SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing IB to placebo or no treatment in children and adults with the common cold.

DATA COLLECTION AND ANALYSIS: Two review authors independently extracted data and assessed trial quality. We used a standardised form to extract relevant data and we contacted trial authors for additional information.

MAIN RESULTS: Seven trials with a total of 2144 participants were included. Four studies (1959 participants) addressed subjective change in severity of rhinorrhoea. All studies were consistent in reporting statistically significant changes in favour of IB. Nasal congestion was reported in four studies and was found to have no significant change between the two groups. Two studies found a positive response in the IB group for the global assessment of overall improvement. Side effects were more frequent in the IB group, odds ratio (OR) 2.09 (95% confidence interval (CI) 1.40 to 3.11). Commonly encountered side effects included nasal dryness, blood tinged mucus and epistaxis.

AUTHORS’ CONCLUSIONS: For people with the common cold, the existing evidence, which has some limitations, suggests that IB is likely to be effective in ameliorating rhinorrhoea. IB had no effect on nasal congestion and its use was associated with more side effects compared to placebo or no treatment although these appeared to be well-tolerated and self-limiting. There is a need for larger, high-quality trials to determine the effectiveness of IB in relieving common cold symptoms.

Intranasal ipratropium bromide for the common cold| Medscape Reference Online

**  = Sorry folks, if you want to read the full article you have to sign up for the free account on Medscape (I would highly recommend it)

Myth versus medicine

What a nice break from school. During my interim break between the spring and summer semester, we went on a nice Caribbean vacation. It was our first time in St. Thomas, and I must say it was breathtaking. If you ever get the chance or opportunity be sure to take the trip. The overall experience was beyond description.

During our trip we got to swim with the sea turtles as well as take a nice sunset cruise. Both were enjoyed via a Catamaran boat – another first. I, for one, have been on other boats, but my wife has not. This was quite the gamble since my wife can get nauseous quite easily (she has been known to get car sick).

The irony of it all is that my wife is a fellow nurse. So you’d think she has the cast iron stomach that is pretty much a requirement to do our job. Somehow she only gets the ‘motion’ sickness. And like I said, the boat trips were a gamble.

It was recommended by the local staff that we seek out the boat crew to have her take some ginger (Ginger?? Really??). They claimed it calmed the stomach (we weren’t buying it).

We knew she needed medication. Some sort of anticholinergic would do the trick. We got lucky and found an OTC medication that had meclizine in it. We thought we were set. We had a plan: Take some before, take it right when she boards and then possibly during the trip. They were chewable which of course helped.

The trip out for the turtle swim went without incident. We got in the water and saw some amazing turtles and other marine life (honestly I’m really downplaying how truly amazing it was!). Once she got out of the water and back on the boat she got the ‘wave’ of nausea that everyone hates. She immediately took another dose of that OTC med.

She spent the next 15 minutes battling through it like a trooper — watching the land, keeping her eyes off the water and anything that moved. She did the purse-lip breathing. She did everything shy of standing on her head (as if that would have helped).

During the entire ‘wave of nausea’ episode the boat crew and captain wouldn’t stop talking about the darn ginger! Take the ginger ‘concoction’ — it’s the spice mixed in with some ginger ale (and up until I typed this sentence I never realized it was ‘ginger’ in ginger ale – go figure that one out?). They swore up and down it will get rid of the nausea.

Since her nausea was not going away, she caved in and took the ginger concoction. She had to ‘chug’ the stuff, which she tells me was not the most tasty.

Within 15-20 minutes her nausea disappeared…

…

…as if she never got nauseous in the first place!!

…

????

We were THE BIGGEST skeptics about this ‘natural’ remedy. And had I not seen it with my own two eyes and had it not been my wife, I probably would still tell you your full of it.

This trip made us believers.

Needless to say the next day when we took our sunset cruise, the boat crew had her ‘ginger’ waiting for her and she never once got nauseous.

This was one of those instances where all your education and experience don’t mean squat and you just have to go on faith and believe those who just ‘know better.’

We are both still laughing at how shocked we were at the results.

Anyone else have any mythical remedies that work better than our standard western medicine practices?

Myth versus medicine | Scrubs Magazine

(Follow the link )

I want a new drug

According to the IMS Institute for Healthcare Informatics:

April 20, 2011 — The 10 most prescribed drugs in the U.S. aren’t the drugs on which we spend the most, according to a report from the IMS Institute for Healthcare Informatics.

…

#1 most prescribed = Hydrocodone (combined with acetaminophen) — 131.2 million prescriptions

…

Out of the $307 billion we spent on drugs in 2010, we spent most of our money on the following:

• Lipitor, a cholesterol-lowering statin drug — $7.2 billion
• Nexium, an antacid drug — $6.3 billion
• Plavix, a blood thinner — $6.1 billion
• Advair Diskus, an asthma inhaler — $4.7 billion
• Abilify, an antipsychotic drug — $4.6 billion
• Seroquel, an antipsychotic drug — $4.4 billion
• Singulair, an oral asthma drug — $4.1 billion
• Crestor, a cholesterol-lowering statin drug — $3.8 billion
• Actos, a diabetes drug — $3.5 billion
• Epogen, an injectable anemia drug — $3.3 billion

So what does this information tell you about America?

It seems that a majority of Americans suffer from obesity & sedentary life style which can have a cause & effect relationship to:

• high cholesterol
• gastric reflux disease (need for antacids)
• diabetes type II
• lung deficiencies and inflammation (asthma and many other diseases)

And this is just me spit-balling here, but the above disease have seem to upset and possibly depress a good majority of the nation as well (need for anti-psychotic drugs = for depression).

Yes, yes, I know this is just scratching the surface of these disease states. No need to debate about the ba-zillion comorbidities that can or cannot be involved with these disease (and many others). I only bring these to light since most of these disease states mentioned above have been argued to be very preventable and/ or controllable without the use of medications.

Just more food for thought.

The 10 Most Prescribed Drugs | Medscape.com

FDA: Stop-smoking drugs Chantix, Zyban must carry suicide warning – USATODAY.com.

A double whammy. Now, not only does the habit itself cause mortal damage to your body, but some of the drugs that help you stop the filthy habit have a set of their own possible life-threatening damages. This time in the form of suicidal tendencies.

I continue to revisit the same theme: Smoking – Tell me something good about it?

Carpe Diem

Image Source: Bryan Christie Design

‘Do you have any allergies?’

This is something we nurses ask all our patients. It’s quite an important piece of your current and past medical history. It can determine the path of your plan of care in virtually everything that has to do with the maintenance of your health and wellness.

Here’s the problem:

‘No, I’m not allergic’ –

‘So you’re not allergic to anything? No allergies that you know of? (We ask this because it is clearly stated on the front and on every page of your chart’s order sheets that you in fact do have allergies)

‘No, I’m not allergic. I just can’t take Penicillin.’ –

‘Oh? You can’t take Penicillin? Why is that? What happens?’

‘Oh, I break out in some red rash thing. They tell me I also started havin’ trouble breathing’ –

‘They?’

‘Yeah, that doctor down at the other hospital’

Clearly you can see this can be and could have been a serious problem.

‘Do you have allergies?’ –

‘Oh yeah! Tons! Whew!”Don’t give me them pain meds. Pain meds make me nauseous. I get real sick to my stomach. I get dizzy and light-headed. My mouth gets real dry.’

‘If they give me that blood thinner stuff. I bruise real easy too.’

‘Oh, and once that doctor gave me Ibuprofen… or err.. That ant-eye-flamtry stuff. Boy did It make my stomach upset.’

(These are called side effects. These are not allergies.)

‘I see. We’ll be sure to let the doctor know about them.’ -

I saw my oral surgeon today for a wisdom tooth extraction. Only one of my 4 wisdom teeth are actually exposed, and on Christmas day (of all days) I broke it. There was quite the ‘crater-like’ hole in the back of my mouth.

I couldn’t get an appointment with my Dentist until January 5th, but when I did see him he had to refer me to the oral surgeon due to the location of the tooth and the actual tooth itself. (Lucky me)

I had an original appointment with another local surgeon who gave me some song and dance about two separate appointments. One for ‘consultation’, then another to actually remove the tooth. Can you say money, money, money…. MO-NAH!

So with the help of colleagues and friends, I got an appointment with another local oral surgeon. And ironically I was told he could x-ray the tooth, ‘consult’ me and remove the tooth all in one appointment! (Hmm.. )

So that’s where I was this morning. And of course you have the option of local anesthesia or moderate sedation. I chose the local so I could get in and get out. I didn’t need anyone driving me to the darn surgeon. I mean I was well prepared for the aftermath of pain.

So my visit was about the most expeditions, courteous and efficient dental visit I have ever had the ‘pleasure’ of enduring.

It took long for the prep and post procedure education than the actual removal! I don’t know why I’m surprised. I mean I work in surgery and see this every day. But being the patient puts a whole new twist on things.

Needless to say it was as enjoyable an experience as one could make out of x-rays, needles, pain and tooth removal.

So here is the point of my blog post – long story short longer.

I knew that once the local anesthetic wore off, that I’d be in some serious pain. I didn’t feel the tooth being removed but I could feel the amount of pressure he placed on my jaw/face. He also had to place one suture. And to boot I was biting down on a sterile gauze for about 45 minutes that was quite ‘colorful’ to say the least. So I knew what kind of ‘rush’ of pain was in store for me. I’m no stranger to pain. I live with ‘nerve’ pain, but jaw/tooth pain is not fun.

So knowing what I know, and having taken care of surgical patients of almost every type. I decided to practice what I preach, and ‘stay ahead of my pain’. Instead of waiting until the ‘numbness’ disappeared, I took my pain medication now. That way when the anesthetic wears off, I already got narcotics and anti-inflammatory medications doing there job.

I let my wife know what I did. And this was her reply:

‘Such a Nurse’

Why YES.  I am.

Carpe Diem