June 17th, 2013 | The Blog
Summer is here and so are the stronger, harsher, potentially damaging ultraviolet rays (UV). It is important to be aware of the myths and truths about sunscreen so fun-in-the-sun is also safe in the long-term.
Sunscreen reflects the sun’s UV rays and helps to protect against sunburn. The American Cancer Society strongly recommends the regular use of sunscreen to help prevent the development of skin cancer, squamous cell carcinoma, basal cell carcinoma or melanoma, a more advanced skin cancer.
Sunscreens are ranked by their sun protection factor or SPF. It is important to know the facts about sunscreen, in order to get the best and safest protection this summer.
True or False
The higher the SPF, the better the protection
False. An SPF of 15 blocks 93% of the sun’s harmful rays and an SPF of 30 blocks 97%. Jumping up to an SPF of 100% barely changes the protection factor.
The most important factor is that there is sufficient skin coverage. Sunscreen should be applied 30 minutes before going outdoors so it is adequately absorbed and then every 2 hours thereafter.
True. Most brands of sunscreen have a two-year shelf life. After that time, sunscreen can lose its effectiveness.
Sunscreen need only be applied to exposed skin
False. Surprisingly, a t-shirt offers an SPF of about 7 but it is important to apply sunscreen to the entire body before getting dressed for the best protection.
There are clothing lines made from UV protective fabrics now available. They are treated with colorless, UV-absorbing dyes, which provide an ultraviolet protection factor (UPF) of 50. UPF blocks the harmful UVA and UVB rays.
A relatively new concept in sunscreen is a wash-in fabric protection, one of which is called Sun Guard. This laundry aid, according to the website,”Transforms Everyday Clothing into Sun-Protective Gear with a UPF Protection of 30.” The effects last up to twenty washings. The Skin Cancer Foundation (skincancer.org) approves this product.
Make-up containing SPF works as well as any sunscreen
False. This is not true because, eventually throughout the day, make-up applied to the skin cracks and allows UV rays to filter through onto the skin. Wearing make-up containing SPF is better than wearing no sunscreen at all but it does not provide adequate protection.
Sunscreen causes cancer
False. Sunscreen can be hazardous to a person’s health if it is absorbed into the body. This is unlikely. To be ultra-cautious, using a sunscreen that contains physical blocking ingredients like zinc oxide will assure that it is not absorbed. These physical blocking agents act as a protective barrier only, on the skin’s surface.
Waterproof sunscreen does not need to be reapplied
False. Be aware that sunscreens, according to the U.S. Food and Drug Administration (FDA), sunscreens are water-resistant, not waterproof.
Sunscreen should be reapplied every two to three hours, at minimum, and more often if swimming. The best advice is to reapply each time after getting out of the water.
Sunscreen prevents vitamin D absorption
False. A sufficient amount of vitamin D is absorbed through regularly applied sunscreen.
The daily recommended adult dose of vitamin D is 600 IU a day for the average person, according to the Institute of Medicine. This can be attained through sun exposure or with fortified foods an/or vitamin D supplements.
Sunscreen or Not?
Whether or not to wear sunscreen should not take much thought. It is the only safe protection from harmful, skin cancer causing UV rays, other than staying inside. Pick your poison.
June 10th, 2013 | The Blog
Energy drinks are overflowing with caffeine. A recent study supports the theory that ultra-caffeinated drinks negatively impact heart health, especially with regard to electrical conduction.
Daily Caffeine Intake
The recommended daily caffeine intake for adults is 200-300 mg a day. This is equivalent to two to four cups of coffee a day.
Children should have only 100 mg of caffeine a day, if they indulge at all.
Energy Drinks VS Coffee
The danger-causing difference in drinking one energy drink versus having three or four cups of coffee is all about the concentration of caffeine and the time frame in which it is consumed.
Given the allowance for safe daily caffeine intake, keep in mind that it is intended to be spread throughout the day, not consumed in one big gulp. With the caffeine dispersed over time, so are the potential physical side effects.
When drinking coffee, the caffeine is spread across time as the coffee is sipped and enjoyed. An energy drink delivers the same caffeine in one small drink, one gulp at a time.
One 8-ounce cup of brewed coffee contains about 106 mg of caffeine. Monster energy drink has 80 mg of caffeine in an 8-ounce can. A 2-ounce serving of 5-Hour Energy has 207 mg of caffeine, according to the Mayo Clinic.
Other Additions to Energy Drinks
In addition to caffeine, some energy drinks contain other stimulants including a few of the following:
When used in combination with caffeine, these stimulants have raised concern among medical professionals about causing even more physical effects.
*Ephedra was banned from being added to dietary supplements by the U.S. Food and Drug Administration (FDA) in 2004 because there was a direct connection to causing heart attacks.
The concentrated quick hit of caffeine in energy drinks acts as a stimulant. Stimulants can cause a rapid heartbeat or tachycardia. Tachycardia leads to several serious and concerning symptoms like shortness of breath and possible cardiac arrest.
Patients with pre-existing cardiac conditions are at an especially high risk of developing a cardiac problem. A pre-existing arrhythmia or irregular heartbeat can be dramatically worsened with the consumption and onslaught of highly concentrated caffeine.
It is important for patients with a known cardiac arrhythmia or a tendency to experience palpitations to avoid energy drinks.
Even patients with no underlying cardiac history should only indulge in an energy drink on an infrequent basis.
No one, regardless of age, physical prowess or medical history, should ever drink two or three high-energy drink at one time.
Those who have a documented cardiac arrhythmia should avoid energy drinks at all times.
Everything in moderation is the best advice for the general population to follow, when it comes to enjoying a popular concentrated energy drink.
June 3rd, 2013 | The Blog
Let us take a look at the life and times of a female patient, from one specific perspective. Menopause.
So, one decade a woman is worried about preventing an unplanned pregnancy. The next decade she is trying to conceive. Then, comes the time when every female no longer wants to think about it anymore. So, is this my last menstrual period?
Fret no more. According to the Journal of Clinical Endocrinology and Metabolism, there is a new model to potentially determine that final stop on the female timeline.
Knowing when a woman will stop having menstrual periods is an important healthcare marker. It is not just about the physical presence or absence of menstrual bleeding. It is the time when a primary care physician (PCP) should increase general health monitoring of a woman’s:
Researchers have determined that by predicting a woman’s final menstrual period (FMP), it will allow earlier medical intervention, a significant one or two years earlier. This information will help to prevent potential postmenopausal health problems, such as bone fractures and heart disease. Statistics show that bone loss related to menopause most often starts about one year before a woman’s last menstrual period. Therefore, the information is important.
Traditionally, menstrual cycle bleeding or lack thereof predicts a woman’s impending menopause. This is not a foolproof method of determining that timeline. About 60 percent of peri-menopausal women transition from slightly irregular periods to a full post-menopausal state without any significant change in their bleeding, except when it completely stops.
A recent study recommends that in order to fully assess a woman’s physical wellness and health status at the juncture of their final menstrual period, a series of specific lab tests should be done over the course of one to two years. These lab tests include:
What happens to these hormone levels during menopause?
These two hormone levels begin to change within two years before the FMP and continue for one year or beyond the final menstrual period.
The Bottom Line
To provide the best preventive health care, with regard to heart disease and bone loss for a woman who is approaching menopause, the first step is to accurately determine where she is on the menopause timeline. The findings of this recent research study are an important beginning in the assessment and subsequent care plan.
It is important for all women who are in the peri-menopausal stage of their life to have a frank discussion with their primary care physician or gynecologist to assess their personal situation and develop the most effective healthcare plan.
May 28th, 2013 | The Blog
What do you think about the age restrictions, or not, on the Plan B contraceptive pill?
A federal judge recently ordered the U.S. Food and Drug Administration (FDA) to make the emergency contraception pill available over-the-counter to women without any age restriction or prescription.
In a counter-response to that ruling, the FDA announced that it would approve one such product, Plan-B Step-One, to be sold over-the-counter with an amended age restriction. The FD wants to allow the drug to be sold to girls 15 years and older without a prescription.
Plan B One-Step Explained
It is important to understand the basics about the emergency contraception pill, Plan B One-Step or levonorgestrel. Here are some quick facts:
It contains high doses of progestin, a female hormone, and works in a similar way to traditional birth control pills. It prevents the release of an egg from the ovary, fertilization of an egg by sperm or the implantation of a woman’s egg in the uterus.
The pill must be taken within three days or 72 hours of having unprotected sex in order to prevent an unwanted pregnancy
This drug is not intended for routine birth control use to prevent pregnancy. It is a backup plan for emergency use only.
The medication does not prevent sexually transmitted diseases (STD).
Plan B One-Step does not terminate an existing pregnancy. At this time, there is no proof that the pill negatively affects an already developing fetus.
After taking Plan B One-Step, a woman will know that it worked if she gets her next menstrual period at or within a week of the expected time.
The research data shows that 7 out of 8 women who might have otherwise become pregnant after having unprotected sex have not.
The proposed new guidelines for the drug make it easier to obtain. Here is why:
Federal judge proposal:
The FDA ruling applies to the brand name drug only, the Plan B One-Step manufactured by Teva. It does not apply to the generic versions of the drug, which require that two doses are taken, 12-hours apart. The generic brands will remain in the pharmacy-controlled location of the store.
Problems Along the Way
While women’s health advocates approve the overall increased access to the medication, there are some issues to clarify to make it more readily available under the proposed FDA guidelines. This is one of the issues to resolve:
Teens will be required to show proof of their age in order to make the purchase. Girls under the age of 15, even some 17 year olds, might not have a photo ID if they do not have a driver’s license. Then what?
The Continuing Saga
The intent of this discussion between the federal government and the FDA is to make a safe emergency contraception drug readily available to the female population. There remain many questions and concerns to clarify.
May 20th, 2013 | The Blog
While it is important to stay hydrated throughout the year, with summer fast approaching, it is even more critical. Water loss is naturally higher during the hot summer months due to the general heat index and increased natural sweating.
The human body is mostly water, 55%-75%. It contains 10 to 12 gallons of water at any given time. Here are a few interesting statistics to put those numbers in perspective. Water composes:
Water has a myriad of health purposes for the human body. It impacts the following bodily functions:
Common Facts or Fiction
8 glasses of water?
Most Americans think that they need to drink eight 8-ounce glasses of water a day. This is not necessarily the correct answer.
The Institute of Medicine recommends that males consume 125 ounces and females consume 91 ounces of fluid a day. These totals include the total fluid intake from water, food and other beverages.
Food contains water so dietary intake must be taken into account in the daily fluid intake total. Here are a few examples of some surprising water content in solid food:
A General Set of Guidelines
Other professionals suggest a compilation of following general guidelines to determine daily fluid needs for the general population: age, gender, weight, general health and environment.
Keep in mind that the human body loses ten or more cups of water a day just through normal bodily functions like breathing, sweating, urinating and defecating.
Too Much Water
On the flip side, yes, a person can drink too much water. Normally functioning adult kidneys effectively process 20-1000 ml of fluid per hour. While it is not an easy task to overload them, in extreme cases, it can be done. Drinking an excessive amount of water in a short time period can be life-threatening.
Too much water consumption can lead to bloating, nausea, vomiting and, in acute situations, a low blood sodium level. A low sodium level can evolve into headaches, confusion, seizures or coma and death. This is the extreme case, not the norm.
The International Marathon Medical Directors Association guidelines suggest that during prolonged exercise, an athlete should consume no more than 31 ounces of water per hour.
So grab a glass or a bottle of water and drink up, for so many important and life changing reasons. Cheers!
May 14th, 2013 | The Blog
Is it Worth the Risk for Pretty Nails?
Millions and millions of women around the world enjoy having a manicure.Everyone loves wearing well-groomed, polished fingernails with no visible chips. The creation of a newly popular gel manicure allows that dream to become a reality.
A gel manicure prevents nail polish from chipping. Gel manicures last twice as long as a manicure done with regular nail polish. They cost more than a regular nail polish manicure; a gel manicure costs $25-$45.
It is estimated that millions of women in the United States wear gel manicures and have them filled and maintained on a regular basis.
What is the Problem?
There is prolonged exposure to the UV light to properly dry the gel application. The exposure to the ultraviolet (UV) light used to dry the gel is causing damage to skin cells on the back of the hand. This UV exposure and subsequent damage is being likened to the cell damage done by a tanning bed.
Here is the real health issue:
Women who have regularly scheduled gel manicures are at a risk of developing skin cancer on the backs of their hands, according to the Journal of the American Academy of Dermatology.
It is important to note that the lamps used to dry regular nail polish are LED (light-emitting diode) and do not pose any health risk to the user. They do not emit any ultraviolet radiation.
Protection is Important
A dermatologist, recently featured on the Today Show, made several practical suggestions to offer protection from the UV light used to harden a gel manicure. They include these easy-to-follow ideas:
If a regular nail polish manicure does not seem to last long enough, silk wraps might be an option to investigate. They do not require the use of an ultraviolet drying lamp.
Having regularly scheduled gel manicures causes exposure to harmful UV light during the drying process. The risk of developing skin cancer on the back of the hands is real and needs to be weighed against the benefits of a long-lasting manicure.
May 10th, 2013 | The Blog
As National Nurses Week comes to a close on May 12th, it is also a day to mark the birth of Florence Nightingale, fondly called the Lady with the Lamp by those for whom she cared and also by historians as the years of history move forward.
It is appropriate that the weeklong celebration to acknowledge the compassionate and lifesaving care in nursing begins each year on May 6th and ends on May 12th, the day that the most recognized nurse in history was born in 1820 in Florence, Italy.
Florence Nightingale worked to improve the unsanitary hospital conditions during the Crimean War by organizing and guiding a team of nurses to deliver care to the wounded soldiers. At the time of her arrival on the scene in 1854, more solders were dying from infectious diseases, especially cholera and typhoid, than from actual war wounds.
She worked tirelessly to clean up the horrific physical conditions of the hospital and care for the fallen soldiers by day and into the night. Hence, she became known as the Lady with the Lamp as she made her rounds throughout the dark of the night. Florence’s scrupulous cleaning efforts and tender physical care of the wounded reduced the death toll in the British base hospital where she worked by two-thirds.
Florence contributed to what we recognize as worldwide health care reform by not only administering direct patient care but by creating and changing other heath care standards at the hospital, such as:
Florence was committed to training future nurses to care for patients in a hospital as well as at home, which is interestingly the foundation of the home care standard that is flourishing in our society and healthcare footprint today.
In 1860, she established the St. Thomas’ Hospital and the Nightingale Training School for Nurses, the first official nursing school, by using the significant financial prize that she received from the British government in recognition of her own outstanding work.
To this day, in the medical profession, Florence Nightingale is recognized as the pioneer of modern nursing.
A Celebration of the Nursing Profession
National Nurses Week is celebrated annually from May 6th through Florence Nightingale’s birthday on May 12th. There are designated days throughout the week to recognize certain specialties within the profession; May 8th is the official National Student Nurses Day and the Wednesday of the week is National School Nurses Day each year.
Celebrating the life and legacy of Florence Nightingale confirms the outstanding patient care standards set by this incredibly compassionate and skilled nurse of years gone by. It also acknowledges the scrupulous health care delivered to patients today by the nursing profession as a whole.
May 6th, 2013 | The Blog
Since the 2012-2013 flu season is pretty much over, now is the time to take a retrospective look at how it went, overall. What worked and what did not? Who got the flu and who didn’t?
A General Review
The 2012-2013 influenza vaccine was declared to be a good match for the most common flu viruses this year, before the season started. The flu vaccine is revised every year to target the circulating strains of influenza. This year, that included three strains, H3N2, H1N1 and influenza B.
The vaccine ended up delivering only 47% protection from the primary circulating flu virus, H3N2.
Overall, the flu shot prevented the flu in 56% of adults and children. Specifically, here are the categorized numbers of efficacy according to age groups for the 2012-2013 flu season:
Other Contributing Factors
The early onset of the flu season worsened the statistics. The U.S. Centers for Disease Control and Prevention report that the 2012-2013 flu season peaked during the third week of January. The annual flu actually circulates through May. Interestingly, a second set of flu virus called influenza B can spread after influenza A viruses like H3N2 passes.
One important efficacy fact is that the 2012-2013 influenza vaccine was 47% effective against influenza A or H3N2 and 67% effective against the influenza B strain.
High Risk Group, the Elderly
Flu vaccine did not work well to protect the elderly. The vaccine prevented the flu in only 9% of patients over 65 years old, according to the U.S. Centers for Disease Control and Prevention (CDC).
A higher number of the elderly population was sickened:
Recent studies suggest that the flu shot is less effective in patients over 65 years old, possibly, because the natural immune system response slows with aging.
In the Event of Illness
If a patient, especially someone over 65, contracts the flu, it is important to be treated. Tamiflu, a pill, and Relenza, an inhaled powder, can help to shorten the duration of the illness, if taken as soon as symptoms start.
Death Tally From the Flu
There were 64 children who died during the current flu season, compared with 34 children during the prior season. Childhood death from the flu has a strong history. During a very active 2010-2011 flu season, there were 122 pediatric deaths and an alarming 282 deaths during the initial outbreak of the H1N1 swine flu pandemic.
The CDC is unable to keep an accurate tally of adult deaths from the flu. They estimate the number to be somewhere between 4,000 and 49,000 each year.
The Final Recommendation
The CDC strongly recommends that everyone get an annual flu shot, regardless of a low efficacy rate in any given year. This year, according to the CDC, 145 million doses of vaccine were available and 138 million doses were administered.
The flu shot helps to keep patients out of the hospital and from developing a more serious form of the illness. It is the most important preventive measure a patient can take against the flu.
May 1st, 2013 | The Blog
Spending time away from your loved ones can be difficult at best. But for the life of a travel nurse, traveling comes with the territory. With assignments that can last anywhere from a few months to a year, the periodic comings and goings are just another facet of the job. Yet, for the novice travel nurse, returning home after a lengthy assignment can be full of ups and downs. Paradoxically, you may be bursting with excitement to share all of the stories and experiences you encountered during your time away and also feel out of place with your surroundings and the people with whom you used to spend an inordinate amount of time with. It’s important to recognize that these feelings are completely normal for someone who has been away for a significant amount of time. Understanding and anticipating these changes can be the most important thing you can do to prepare for a smooth transition back home.
I don’t seem to fit in anywhere anymore. Vs. I am adaptable and flexible.
I feel bored with these surroundings. Vs. I feel empowered by my new experiences.
I feel depressed and miss my old connections. Vs. I am excited to bolster my old relationships and make new friends.
Understanding and expecting the changes that await when returning home is a key step to making the smoothest transition possible. Don’t be afraid to reach out and ask others who have taken travel nursing assignments about what worked for them. The internet is alive with testimonials, blogs and advice for people in your exact situation.
Take a deep breath and relax, traveling nursing isn’t for everyone, but for those who heed the call, may find that their road in life was indeed, the one less taken, and of course, in the immortal words of Robert Frost, it has made all the difference.
Kathryn Norcutt can often be found researching and reading about the newest innovations in the health care field. In her free time, she loves to work at perfecting her strength and fluidity in her Vinyasa yoga. Kathryn currently writes and blogs for RN Network.
April 29th, 2013 | The Blog
The spring allergy season is in full swing. One in every five American suffers from some type of allergy. Here are a few basics about nagging allergies:
When oral anti-histamines do not effectively work, many patients have turned to the tedious and weekly protocol of an allergy shot regime.
Another alternative measure to treat seasonal and allergic asthma allergies is sublingual immunotherapy or under-the-tongue allergy drops, according to a recent report published in the Journal of the American Medical Association (JAMA).
Allergy drops are widely used in European countries. The U.S Food and Drug Administration (FDA) has not yet approved their use. U.S. physicians can legally order the drops off-label.
Traditionally, allergy shots are administered in a medical office or clinic where the patient is monitored for an allergic reaction.
The patient administers allergy drops, at home since they are not yet FDA approved. This heeds the need for the patient to be on high alert for an adverse reaction. These patients need to be educated in what to do if they have a systemic reaction, according to the American College of Asthma, Allergy and Immunology (ACAAI). There have not been any reported cases of life-threatening reactions or death related to allergy drops.
The intent of allergy shots or the new found drops is to boost a patient’s immunity. Effective dosing remains an educated guess at this point in time. Physicians are working to determine the best dose to help patients accrue a long-term tolerance to their allergens.
Minute amounts of an inhaled allergen like mold or pollen is placed under the tongue in liquid drop form. In traditional allergy shots, a patient can be treated for multiple, eight or more, allergies at the same time. Allergy drops, at this time, have been tested on only one allergen at a time.
Are there any side effects to the drops? Yes, reports of lip and cheek swelling and a rare case of systemic hives mimic the reactions seen after traditional allergy shots.
Johns Hopkins University researchers found that allergy drops are safe and effective.
According to several studies, allergy drop treatments in adults resulted in a 40% improvement in asthma symptoms like chest tightness, coughing and wheezing than alterative allergy treatments. Similar results were found in reducing nasal congestion and itchy eyes associated with seasonal allergies.
This treatment option is considered to be moderately effective. The effectiveness in pediatric patients is reportedly stronger than in the adult population.
The Treatment Plan and Cost
Some physicians estimate that five years of daily dosing might be necessary. Without FDA approval, allergy drops are not covered by medical insurance.
The estimated cost is $1.50 a day for the first year and then $1.00 for the remainder of the treatment period. This cost is less than traditional allergy shots but one caveat is that allergy shots are usually covered by medical insurance plans.
Allergy drops negate the need for patients to travel to a physician’s office for weekly allergy shots. This saves a dramatic amount of precious time over the course of treatment, usually two to four years, for the allergy-ridden patient population. Patients using sublingual immunotherapy need to check in with their immunologist about every six months.
On the Horizon
Similar studies with regard to allergy drops are being done to treat anaphylactic or life-threatening peanut allergies.
While this sublingual immunotherapy treatment is proving effective for a limited number of patients who are using it, some questions remain. Further studies need to be conducted and the majority of patients await the approval of the FDA before undergoing treatment. It is a promising development in the world of effective allergy and immunology treatment.