Acute Respiratory Distress Syndrome (ARDS)

Acute Respiratory

Acute respiratory distress syndrome (ARDS) is a lung problem. It happens when fluid builds up in the lungs. This causes a failure to breathe which creates low oxygen levels in the blood. ARDS is life-threatening.As a matter of fact, ARDS keeps your vital organs like the brain and your kidneys from getting the proper amount of oxygen that they need to work.

In addition, this respiratory disease is usually a side effect for people who are being treated for another serious illness or possible injury. By the same token,  most of the time, people who get ARDS are already in the hospital for another reason.

Not to mention that ARDS is a very serious condition that often causes death in many people. Survival numbers are one-third of people who develop ARDS die.

What causes ARDS?

There are many possible causes for ARDS. Some possibilities can be.

An infection in the blood better known as sepsis, this is the most common cause of ARDS. Also, other possible causes are

  • A serious injury to the head or chest, as well as a severe bleeding caused by an injury.
  • An infection in the lungs (pneumonia).
  • Having many blood transfusions.
  • Inhaling vomit.
  • Breathing toxic fumes or smoke.

What are the possible symptoms?

ARDS can develop quickly. The main symptoms of ARDS are severe shortness of breath and rapid breathing.

How can ARDS be diagnosed?

Your doctor will diagnose ARDS based on the medical exam.  The Dr. will make you go through numerous tests to determine without a doubt whether you have ARDS or not.

An arterial blood gas test may be done. This is when arterial blood is removed to check oxygen levels in the blood.

Some other tests are:

  • A chest X-ray, to look for fluid in the lungs.
  • A chest CT scan, which can show problems with the lungs, such as pneumonia or a lung tumor.
ACUTE RESPIRATORY DISEASE, How is treated?

A Patient that has attracted ARDS is normally transferred immediately and treated in the intensive care unit. The main purpose of treatment is focused on getting oxygen to the lungs and other organs, and then treating the cause of ARDS.

Oxygen therapy may be given through a mask that fits over the mouth to keep the patient’s oxygenation level up to a safe level. If the patient still has trouble breathing, your doctor may intubate the patient by inserting a breathing tube that is connected to a machine called a ventilator. The breathing tube will be able to help the patient breathe until they can breathe on your own.

The doctor may also give you antibiotics, to help treat the infection if it is causing ARDS. A patient may also be given fluids through an IV to help them recover.

Acute Respiratory Distress Syndrome (ARDS)<http://www.lung.org/lung-health-and diseases/lung-disease-lookup/ards/>

Acute (or Adult)Respiratory distress syndrome <https://en.wikipedia.org/wiki/Acute_respiratory_distress_syndrome>

Lee W, Slutsky A (2010). Acute respiratory distress syndrome. In JF Murray, JA Nadel, eds., Textbook of Respiratory Medicine, 5th ed, vol. 2, pp. 2104-2129. Philadelphia: Saunders Elsevier.Acute Respiratory Distress Syndrome (ARDS) – Topic Overview <http://www.webmd.com/lung/tc/acute-respiratory-distress-syndrome-ards-topic-overview#1>

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Is Salt Really Good For You.

salt
Salt

Salt, also known as sodium chloride, is about 40 percent sodium and 60 percent chloride. It adds flavor to food. Also used as a preservative, binder, and stabilizer. The human body needs a very small amount of sodium – the primary element we get from salt – to conduct nerve impulses, contract and relax muscles, and maintain the proper balance of water and minerals. But too much sodium in the diet can lead to high blood pressure, heart disease, and stroke.

Sodium consumption high among those at risk of heart disease:

Excess sodium intake is a problem across gender, race, and health status. Some differences were seen:

  • Among adults, a larger proportion of men (98 percent) than women (80 percent) consume too much sodium.
  • About 90 percent of adult whites consume excess sodium compared with 85 percent of blacks.
  • Estimated sodium and calorie consumption peaks between the ages of 19 and 50.
  • Among people at greater risk of developing heart disease or stroke – such as people age 51 and older, African Americans and individuals with high blood pressure or pre-hypertension (blood pressure higher than normal but not in the “high” range) – more than three out of four exceed 2,300 mg per day.
  • Adults with hypertension consume slightly less sodium than other adults and may be trying to follow physicians’ advice to reduce sodium. However, 86 percent of adults with hypertension still consume too much.

At least that is what we were told.

Now we have a whole new outlook towards Sodium Chloride. What are we to do with salt. The government seems to change their position on everything sooner or later. Now, it seems to be Sodium Chloride turn. This phenomenon seems to happen fairly regularly when a new scientific research results come in. Now we understand that the facts of yesteryears were all wrong.  Sodium chloride is no longer a cause for alarm.

The research, published recently in two dense papers in The Journal of Clinical Investigation, reported in The New York Times.  Contradicts much of the conventional wisdom about how the body handles sodium chloride and suggests that high levels may play a role in weight loss.

During an experiment, they recorded that the cosmonauts ate a diet containing 12 grams of salt daily, followed by nine grams daily. In addition, the cosmonauts then ate a low-salt diet of six grams daily, each for a 28-day period. In like manner, in a longer mission, the cosmonauts ate an additional cycle of 12 grams of salt daily.

The Real Shocker for Salt

The real shocker came when Dr. Titze measured the amount of sodium excreted in the crew’s urine, the volume of their urine, and the amount of sodium in their blood.

When the crew ate more salt, they excreted more salt; the amount of sodium in their blood remained constant, and their urine volume increased.

Instead of drinking more, the crew was drinking less in the long run when getting more sodium chloride. So where was the excreted water coming from? More tests need to be made to answer all the questions.

So many new questions with so many new answers to come. This study by Dr. Titze made us look at Sodium Chloride in a new way. Are the findings decisive? Time will tell.

 

Gina Kolata “Why Everything We Know About Salt May Be Wrong” May 2017,<www.nytimes.com/2017/05/08/health/salt-health-effects.html>

“New Research: Excess Sodium Intake Remains Common in the United States” May 2017<https://www.cdc.gov/media/releases/2016/p0106-sodium-intake.html>

 

 

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Sunscreen Or Not To Sunscreen

 

SunscreenSunscreen Or Not To Sunscreen? You spend your day at the beach, working on that beautiful healthy color that can only come from spending time in the sun. Your summer fashion looks great against your sun-kissed bronze skin. Really? Is that tan really a healthy look? Here are some facts to consider, that sun-kissed look you are working on could, in reality, be the kiss of death.

That color that so many people work so hard to achieve is actually the symptom of damage caused to the skin by UV rays. Your skin in the largest living organ of your body, your skin provides protection. Your skin assists to cool the body, when you become hot you perspire, the perspiration evaporates on your skin and cools your body. This is just one example of the many functions of your skin.

Do not forget there is no such thing as a base tan or safe tan. When your skin is exposed to the sun your cells produce melanin, it is the melanin that produces the color of your tan. When your cells are producing extra melanin it is a sign that they have suffered damage from exposure to UV light. And the damage from UV light causes skin cancer and premature aging of the skin.

What To Do, Sunscreen?

So what is a person to do? Well to start, stay away from tanning beds, then limit exposure to the sun’s damaging rays. When you are going to be in the sun wear a sunscreen rated SPF 30 or higher. Reapply your sunscreen every two hours, more often if you have been swimming.

There are two kinds of sunscreen, “chemical and physical. Chemical ingredients such as avobenzone and benzophenone, work by absorbing UV, reducing its penetration into the skin, whereas physical ingredients such as titanium dioxide and zinc oxide stay on top of the skin and deflect UV rays. Many sunscreens available today combine chemical and physical ingredients.”

The best type

The best type of sunscreen is one that offers protection against UVA and UVB rays, these are the solar light waves that have been proven to cause damage. SPF stands for “Sun Protection Factor” and the school of thought that anything over an SPF 15 is a waste is just wrong. The fact is that most people do not apply sunscreen in the most effective way to receive the benefits, so don’t be afraid to use an SPF of 30 or higher.

For more information on sunscreen visit the Skin Cancer Foundation’s website at,  http://www.skincancer.org/publications/sun-and-skin-news/

Skin cancer is nothing to take lightly, it is at best disfiguring, and at worse a killer. The way to prevent skin cancer is to protect yourself from the damaging rays of the sun. It is also important to learn to recognize the signs of skin cancer and to go to your dermatologist with anything that you find questionable.

4 types of skin cancer

There are 4 types of skin cancer, melanoma, basal cell carcinoma, squamous cell carcinoma and Merkel cell carcinoma. Remember that skin cancer can develop in any area of your body that the sun touches. Consult your dermatologist if your notice a suspicious mole. In addition, a mole that has changed or is bleeding.

this is an image of melanoma, the most dangerous type of skin cancer, notice the irregular borders.

Sunscreen, melanoma
Melanoma

For more information visit the Skin Cancer Foundation at,

http://www.skincancer.org/skin-cancer-information

Squamous Cell Carcinoma, the most common type of skin cancer.

Sunscreen, Squamous_Cell_Carcinoma
Squamous_Cell_Carcinoma

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What is Medicare “Observation Status” and what does it mean to me?

 

Medicare

 

You wake up not feeling well, you call your primary care physician and she directs you to go to your local emergency room. So with your Medicare card in hand you present to the nearest emergency room trusting in the care you are about to receive and that the Medicare insurance that you paid for all your working years will take care of the cost.

The staff in the emergency room is kind and concerned, the ER doctor orders some blood test and perhaps a chest x-ray, you can see him pondering over the results on the computer across the room. When the doctor comes to speak with you, he tells you that the test is inconclusive but you do have a fever and he believes that you should stay in the hospital at least overnight so more test can be conducted.

Registration Under Medicare

The next person to visit you is the registration person, this person presents you with “Medicare Outpatient Observation Notice” MOON for short. This person explains that you will be staying in the hospital as an outpatient for further medical observation, and you may incur higher out of pocket costs and fewer Medicare benefits related to your care.  Why are they giving you this notice, and how does it all impact you?

When hospital patients are classified as outpatients on Observation Status, they may be charged for services that Medicare would have paid if they were admitted as inpatients. For example, patients may be charged for their medications. Because Medicare part A pays for inpatient hospitalization only, Medicare part B will be charged and the patient will incur the cost of co-pays for the doctor and any tests that are performed.

Outpatient Observation Status

Outpatient Observation Status is paid by Part B, while inpatient hospital admissions are paid by Part A.  Thus, Medicare beneficiaries who are enrolled in Part A, but not Part B, will be responsible for their entire hospital bill if they are classified as Observation Status.

Most significantly, patients will not be able to obtain any Medicare coverage if they need nursing home care after their hospital stay. Medicare only covers nursing home care for patients who have a 3-day inpatient hospital stay – Observation Status doesn’t count towards the 3-day stay.

Hospitals provide observation care for patients who are not well enough to go home but not sick enough to be admitted.  This care requires a doctor’s order and is considered an outpatient service. The hospitalization can include short-term treatment and tests to help doctors decide whether the patient meets the medical criteria for admission.

Two-Midnight Rule

Medicare officials have issued the so-called “two-midnight rule” Patients whose doctors expect them to stay in the hospital through two midnights should be admitted. Patients expected to stay for less time should be kept in observation.

By now you are asking why the hospital does not just admit you as an inpatient and save everyone a lot of trouble. The answer goes back to the “two-midnight rule”, if the hospital admits patients as inpatients and they are discharged within 48 hours, the hospital may not get reimbursed by Medicare.

Medicare reviews the hospitals discharge on a regular basis and a hospital that is found to be in violation of the “two-midnight rule” can face not only not being reimbursed for care provided but also face stiff fines.

Strict Criteria

Medicare has strict criteria for admissions as an inpatient and usually won’t pay anything for admitted patients who should have been in observation care. Partly in response to stepped up enforcement of these rules, hospitals in recent years have been placing more patients in observation.

Know your rights and to find more answers to your questions, visit www.medicare.gov.

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Mouth Damages To Be Aware Of When Playing Sport

Mouth damages

Mouth damages have become the leading injury with anyone that has been in any sports activity. According to Academy of Pediatric Dentistry (AAPD), the majority of the injuries are to the mouth, also to the lips, upper jaw(maxilla and the maxillary incisors. The ages of 15 – to 18 years old students that play sports are the main victims.

LIP INJURIES

Your lips are made up of three major layers: skin, muscle, and oral mucosa The latter being the mucous membrane, which lines the inside of the mouth and may need stitches. When there is trauma to the lips there is usually a significant amount of blood loss. It requires pressure applied to the area to be able to stop the bleeding until the bleeding stops. Usually around 10 minutes.

Even though these injuries are more common in sports activities and especially in our youth, mouth damages can happen to anyone of any age or sex.

The American Academy of Otolaryngology-Head and Neck Surgery says many cuts and scrapes are the results of high-contact sports such as boxing, football, soccer, ice hockey, bicycling, skiing and similar winter sports.

Some of the symptoms of mouth damages that you might find are:

  1. Pain or numbness in the lips
  2. Swelling, which can hide or cover up any more serious injuries underneath.
  3. Bruising, which indicates some bleeding underneath the skin surface that usually goes away in a week or two.
MUCOSAL LACERATIONS

Mouth damages injuries can sometimes be minor, it can easily be a more serious lip injuries that aren’t simply facial lacerations, but instead, the damage may be internal. Mucosal lacerations happen when there is a cut into the mucous membrane inside your mouth, which can create a flap that impedes your ability to chew. It can also trap food particles that are in your mouth. With an internal mouth injury that’s longer than two centimeters most likely needs advanced treatment by a dental specialist.

Treatments for this could range from conservative care (wound cleaning and bandaging), possible stitching, internally and externally, antibiotics, Tetanus shot and even conscious sedation in some more serious damage.

It is very important to get a professional medical opinion if the laceration is profound (2 cm or greater) or you are unable to stop the bleeding.

Tricia Mool “Lip Injury From Sports: Types And Treatments”  Feb.2017 <http://www.colgate.com/en/us/oc/oral-health/life-stages/adult-oral-care/article/lip-injury-from-sports-types-and-treatments-1115>

“Mouth and Dental Injuries-Topic Overview”  Feb. 2017 <http://www.webmd.com/oral-health/tc/mouth-and-dental-injuries-topic-overview>

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