I am pleased to write a health related content. It’s been a while and I have missed it.
I got to know about brachytherapy for the very first time last year.
Brachytherapy is a method of delivering radioactive treatment internally to a cancer site to maximize chances of cure.
Simply say, the introduction of treatment to the cancer in a person to increase cure rate.
It can be done alone or as a part of other treatment.
There are two types of Brachytherapy:
– High dose rate (HDR) : This can be done with the aid of a plastic Catheter inserted under general or spinal anaesthesia via the perineum to the prostate or through the vagina for delivering radioactive substances.
– Low dose rate (LDR): In this, a permanent implant is placed and only for prostate cancer.
Preparation
-Patient should be admitted a day before the surgery for enema administration
– Nil by mouth from midnight.
After care
– CT and MRI scans will be carried out. – Patient is nursed lying flat as the implant is in place. – Strong analgesics like morphine and the likes are administered. – Heads can be raised during feeding only.
Removal of catheter
– When removed, patient is monitored to ensure urine is passed freely prior to discharge.
I hope this gives you an idea of what brachytherapy is and what is involved.
On one occasion, the patient was very dependent on morphine and would scream in pain most of the time.
It is truly hard to see someone in pain all the time. However, I haven’t seen that much morphine given in a short while.
The Dr had to intervene and speak with the patient regarding so much morphine given and the risks. The patient still demanded for more.
Hi Friends, I hope you are all well. Amidst Covid-19 pandemic, I want to remind you of how amazing you are.
I am cognizant that a lot has happened this period. So many lives have been lost, some people fought for their lives while some lost their loved ones. We all look forward to a cure/vaccine for this killer virus while observing the obvious rules of social distancing and health policies applicable in different places.
I am aware that different nations have specific rules tailored for their citizens, do abide by them, please. While the scientists do their jobs, I pray God to heal all nations.
We live in a world full of uncertainties. I can liken this period of lockdown to a trying time. However, it can be a time to know your inner self the more, a time to liberate yourself from any animosity and a time to let go of any grudges.
In families, it can mean spending quality time together; you never know what the earth uncovers for you. In cases where either or both parents own businesses, bravo while the lockdown lasts.
It can mean spending greater time with your spouse too. It can be a time to strengthen your spiritual life, which is vital in families. The stronger person can pull the other. I can go on to elaborate on this.
It can simply mean plenty of time to ask God for clarity and direction in your life. Some people tend to live the easy life instead of having a focus and aiming at achieving it. It should not be so. I will leave that to another post. I digress.
This period can provide you with ample time to reach out to people you would not have spared time to contact. There are times we tend to think about certain people; it can be family, friends, or mates but do not reach out to them. They are just there, in an imaginary safe place in our thoughts. I have lots of people like that, I can only hope that they are happy and truly safe where they are.
Whatever you do this period, do not let the enemy steal your joy. Do stay alert and do the needful to stay safe and feed your soul with the scriptures.
“May no disaster overtake you,
May no plague come near your tent,
For the angels have been ordered to guard you wherever you go.” #Psalm 91*
Lastly, you are a special being. Do look after yourself and your soul.
If you like this post, please share with your friends and subscribe to my page. Feel free to share any recent encounter or your opinions in the comment section.
According to BBC (2017) Mental health problems are defined and classified to help experts refer people for the right care namely. They are namely: neurotic and psychotic.
Neurotic conditions are extreme forms of “normal” emotional experiences like depression, anxiety or obsessive-compulsive disorder while psychotic symptoms interfere with a person’s perception of reality and impair thoughts e.g. schizophrenia and bipolar disorder.
Mental illness is invisible to everyone but those experiencing them.
Majority of those affected suffer in silence
There are some helpful treatments options available.
Look after yourself
Look after your health
Your are control
There are stressors around
You don’t need to add to them
Learn how to deal with them
Your physical, mental and overall health should be your priority.
Do spare time to reach out to friends and relatives. You never know what others are passing through.
Hello Friends, I’m posting a health related post today. Hope you had a great weekend?
I will be taking about HIV and our perception of sufferers.
I cared for a man who was in his late fifties last week. He was diagnosed with HIV about eight years ago but over time deteriorated as he wasn’t taking his medications judiciously as required of him.
“Vivien you always treat me very differently” he said to me. “People are always in a hurry to leave my room but you take your time”
I told him I was only doing what was required of me. This gentleman was so frail and needed lots of persuasion. In my opinion, it was quite draining especially emotionally, as he at times declined most nursing acts and I could see he was weak. He would tell me he wanted to be left alone.
Genuinely, I think anybody ill will want to get better and would comply with medical advice but when I come across patients like this I tend to believe that they are fighting a battle with their condition and even the tiniest acts can upset them. My first day with him was challenging but days went by and I had him again.
He was happy to see me this time, like old friends, we stayed friends all through that day. I felt fulfilled and better compared to the first day.
As a health personnel, we all become very protective and extremely cautious when we know patients have certain conditions. Please don’t blame us because no one would want to jeopardise their health in the course of saving the lives of others.
Nevertheless, I will urge my fellow nurses, doctors and other health staff to show love and affection to HIV/AIDS patients. With standard precaution measures; which ought to be part of our everyday practice, one should be able to practise safely.
The condition alone is a cross for them, let’s not make it any worse. They know what they have, they wake up every day and the condition is still same, any act to take their mind of it is much needed.
I don’t want to stress much in this post about the stigmatisation associated with HIV, it still exists regardless of the numerous awareness programmes. Unfortunately.
I have previously discussed HIV/AIDS in details. The post outlined what HIV/AIDS is, it’s symptoms, prevention and stigmatisation. It can be found here.
I will like you to read that too.
I have a soft spot for this condition, I’m happy to discuss and answer questions. Do leave a comment or contact me if you are affected by this post.
Other health posts can be found in the health category.
P.S: Confidentiality was strictly maintained throughout this post.
If you have asthma do endeavour to carry your inhaler regardless of the last time you had an attack. Some people say that the attack feels like one being strangulated or suffocated.
What is Asthma
National Institutes of Health (2014) defined asthma as a chronic lung disease which causes the inflammation and narrowing of the airways and presents with recurrent episodes of wheezing sound, chest tightness and coughing (mainly at night and early in the morning).
A popular definition by Global Initiative for Asthma (GINA, 2016) states that “Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. It is defined by the history of respiratory symptoms such as wheeze, shortness of breath, chest tightness and cough that vary over time and in intensity, together with variable expiratory airflow limitation”.
There are different definitions of asthma which incorporate other subtle signs and symptoms, therefore it is important that nurses and other health professionals are proficient in their knowledge of asthma and its management.
Pathophysiology
Asthma is marked by characteristic episodes of symptoms and variable obstruction of the airway which can occur spontaneously or triggered by environmental factors. Exposure to allergens or viruses causes increased inflammation and exacerbation of symptoms such as cough, wheezing, chest tightness and dyspnoea (difficulty in breathing).
The main characteristic of asthma is inflammation of the bronchi and bronchioles which is marked by the release of various cells and chemical mediators which consequently leads to bronchoconstriction, airway oedema, airway hyperresponsiveness and airway remodelling. Airway remodelling leads to hyperplasia of submucosal and goblet cells and cause hypersecretion of mucus. Mucus plugging of the alveoli is a key cause of asthma death.
Majority of deaths from acute asthma takes place outside the hospital. Asthma patients whose symptoms did not improve either at the emergency department or in the ward should be admitted to intensive care unit.
Therefore, it is paramount that the asthmatics are equipped with the necessary knowledge and support to enable them to manage themselves.
Some patients are known to have triggers such as viral infections and cold air.
Diagnosis
A well detailed history taking and good knowledge of differential diagnosis will ensure that asthma is diagnosed appropriately.
In the view of BTS/SIGN (2016), asthma diagnosis is based on the identification of the characteristic pattern of signs and symptoms and the lack of a different explanation for them.
Once asthma is diagnosed, the physician assesses the patient for the level of severity. The presence of intense symptoms indicates an asthma attack.
Management
The significance of treating asthma symptoms once they are detected cannot be overemphasized as it prevents the symptoms from worsening.
Pharmacological management of Asthma:
Inflammation of the airways is central to the pathogenesis of asthma, hence systemic corticosteroid forms part of the first-line treatments for acute asthma.
Intravenous hydrocortisone 200mcg and Prednisone 4g should be given in accordance with BTS/SIGN (2016) guidelines. Other sources advocates the usage of oral and intravenous steroids in the management of severe asthma.
Ipratropium nebulizer 500mcg to be given every 20 minutes for 1 hr and later reduced to Qds. It is a bronchodilator that eases breathing by relaxing the air passages.
Salbutamol nebulizer 5mg Qds. β2-adrenergic agonists are the first-line treatment for smooth-muscle mediated bronchoconstriction and are most reliable for dilating the bronchioles (GINA, 2016).
Iv Magnesium sulphate 2g in cases of hypomagnesia. Studies showed that the administration of 2g of Magnesium sulphate increases the dilation of the bronchioles in patients with severe asthma regardless of normal magnesium levels.
Health education is vital in the management of Asthma as it ensure asthmatics are able to self-manage, monitor symptoms, adhere to written asthma care plan and attend review appointments as recommended by GINA (2016) to avoid hospital admissions.
The BTS/SIGN (2016) reported evidence in which self-management was considered to reduce emergency use of healthcare resources and improve markers of asthma control.
Ideally, there is an asthma care plan for all sufferers which should adhered to. Asthma UK (2016) stressed on the importance of patients adhering to their written asthma care and added that asthma patients are four times less likely to present in the hospital if they utilize their asthma care plan.
Conclusion
It is paramount that asthma patients are supported by healthcare professionals to make sure they confidently self-managed, experience lesser symptom and thus, require less hospital visits.
P.S.
I am a registered volunteer of Asthma UK. Detailed information about asthma, its management and events are on the website.
This post is adapted from an Asthma case study, to access the full study do not hesitate to contact me.
There are lots of cradle cap remedies online but I will tell you what worked for me. By the way, what does cradle cap look like?
Photo credit: Wikipedia
It is oily yellowish patches that appears on the scalp of babies. It is mostly common within 3 months of life and can last up to 1 year. It is not contagious and does not harm the baby.
In my experience, my little one had it and I was really worried but the GP said not to worry that it goes away before most babies one year birthday. However, that was not enough for me. I simply wanted it to go away as soon as possible.
I read a lot online, watched YouTube videos and was not happy with my findings. None seemed to be say what I wanted to hear.
Many sources recommended the usage of olive oil and combing it out after 15 mins. Meanwhile, that was my baby’s hair oil. Strangely, the front part of the scalp where I cover with lots of oil was coated with cradle cap.
I was convinced that ‘Olive oil’ was the culprit and cannot be my solution. This was further confirmed by an article I read too. The link to the article is available at the end of this post.
I searched for shampoos but was worried trying those chemicals on my little ones scalp. Then, a friend told me she had same issue but theirs was very little and gradually disappeared. She said her GP prescribed Capasal therapeutic shampoo for her baby but she never used it.
It was as if that was all I needed – something prescribed by a professional! I used it on my little one and it worked like magic. The first time, I was really careful both on application and on combing of the hair. It worked and I was happy. The second day, I was more confident in using it and most of it came off. On the third day, my baby’s scalp was neat, no traces of cradle cap.
I could not believe the past few weeks and all the time I had spent online reading lots of stuffs that amounted to nothing.
I hope this post gets to someone who needs remedy that I needed or to someone that knows someone. However, every baby is different. What worked for mine might not be suitable for yours.
Below are sites for further reading on the topic. I found them very informative.
Acute respiratory distress syndrome commonly known as ARDS is a life-threatening medical condition whereby the lungs cannot provide sufficient oxygen for the body. Causes This condition develops when the lungs has become infected or sustained an injury leading to inflammation. The inflammation causes fluid from nearby blood vessels to leak into the tiny air sacs in the lungs, making breathing increasingly difficult.
Inflammation can be caused by:
Sepsis
Pneumonia
Severe chest injury
Accidental inhalation of vomit, smoke or toxic chemicals
Acute pancreatitis
Blood transfusion reaction
Clinical Features Theses can occur within 24 to 48hrs of illness and can include:
Severe shortness of breath
Rapid, shallow breathing
Low blood pressure
Tiredness, drowsiness or confusion
Feeling faint
Organ failure
Normally, these patients are so sick that they cannot complain of symptoms.
Diagnosis
A full assessment is carried out and include the following:
Physical examination
Blood test to ascertain oxygen saturation and check for signs of infection
Arterial blood gases(ABG) for continous monitoring of respiratory state, blood volume and electrolytes.
Blood and urine culture
Pulse oximetry test for continuous monitoring of oxygen saturation
Chest X-ray and a computerised tomography (CT) scan – to look for evidence of ARDS
Echocardiogram to picture the heart ; to rule out heart failure.
Sputum culture and analysis
Broncoscopy can be carried out in certain cases.
Treatment -Admission into intensive care unit for breathing support via Ventilator. -Antibiotic administration to fight infection.
*Prone position have been found to be appropriate in the management of ARDS.
My Encounter with ARDS patient I had to look after after a Mr. X diagnosed with ARDS and Intracranial hyperosmolar. It turned out to be a very busy and interesting shift.
Cardiovascular: Blood pressure was initially high but was supported with Noradrenaline infusion and it was managed. –
Respiratory: Was intubated and ventilated. Settings include: pressure control mode of 24, peep 14, FiO2 70%, respiratory rate 15, peak 38. The above high settings were changed slightly throughout the day. ABG revealed; high PCO2, low O2, high hydrogenbicarbonate, high base excess, high sodium, low potassium and high glucose. All electrolytes were replaced and a slidiing scale was in place to control his blood glucose level.
Neurologically, he was sedated and paralysed using Propofol and Actracurium infusions. Fentanyl was given for pain. Pupils were 2 and nonreactive. Richmond sedation agitation score was -5(deeply sedated and unarousable)
Nutrition: on nasogastric feed- Nutrison and ng water at 40ml and 30ml respectively
Elimination: Good bowel movement and urine output. However, furosemide was given to push more fluid out of the lungs.
I hope you are getting the gist? I am not going to bore you with my nursing care bits. So, let me wrap it up by telling you the issues and plan for that day. Problems:
ARD
Septic shock
Neutral fluid balance(off target)
Electrolyte abnormalities
Permissive hypercapnia
Plan:
PC Ventilator settings – sedated and paralysis
Manual recruitment post sunctioning
No nebs – Suction 6hrly
Ng water @ 30ml/hr
Furosemide infusion Urine output greater than 100ml/hr
Continue antibiotics Meropenem and Teicoplanin
Discuss with microbiology daily.
Lastly, ARDS is a killer illness. I was practically on my feet throughout the shift as Mr. X was unstable and I had lots of infusions that were running out at different times amongst other tasks. Suctioning was quite scary that day as Mr. X could desaturate within secs. Oh! I ended up staying 45mins extra to do my documentations.
References NHS Choices (2015)
P.S. Thanks for reading. Sorry for the medical jargons- I tried to minimse them. When your loved ones or friends are sick or look unwell, please encourage them to go the hospital to get a medical assistance.Ours lives are so precious.
Disclaimer: This cannot substitute for a professional medical advice and treatment.
I have come across lots of articles and case studies on liver diseases and the rapid health decline of most sufferers. So, I will like to share some of my knowledge of the liver and liver diseases. I will tell it like a story and cite where necessary.
Before I start, what melted my heart the other day was when I met a very young girl who has undergone two liver transplants. In this girl’s case, her former transplant failed because her body system rejected the organ. The later transplant is pretty new and she complained of so much pain and discomfort. As I write this, my heart reaches to her, I wish her a speedy recovery and hope this is her last organ transplant.
The liveris the second largest organ in the body and the biggest reservoir for blood. It serves as the body factory and plays lots of significant roles that are vital to life. The liver islocated in the upper right side of the abdomen, beneath the diaphragm and on the top of the right kidney.
The mainfunctions of the liver include;
Filtration and cleansing of the blood
Fights against infections and diseases
Production of proteins that makes blood clot( i.e when you bleed)
Aids in digestion
Destroys and deals with poisons and drugs
Excretion of wastes.
There are lots of other roles the liver play in the body. It is a very powerful organ than we think.
Onset of liver disease:- Acute- Whereby it happens over a short period of time
-Chronic- Here, the disease manifests after couple of years e.g 5-8 years
Main causes: -Heavy alcohol consumption or alcohol misuse (the commonest)
-Undiagnosed hepatitis
-Obesity
Typesof Liver diseases
-Alcohol related liver diseases- Liver damage occurs due to years of heavy alcohol consumption.
-Non-alcoholic fatty liver diseases-
-Hepatitis- Inflammation of the liver
-Haemochromatosis i.e an inherited disorder whereby there is iron overload in the body
-Primary biliary cirrhosis
All these types of liver diseases can cause scarring of the liver, which is called Cirrhosis (www.nhs.uk)
Pathophysiology
Photo credit: Youtube images
The liver responds to injury by becoming inflamed. Any form of inflammation of the liver is known as hepatitis. This can happen suddenly (acute) or over a long period of time (chronic). Repeated injuries cause the liver cell not to regenerate any more,fibrosis gradually forms.
When the fibrosis spreads out due to persistent harm not been addressed, the liver shape and function is disrupted.and is known ascompensated cirrhosis. As damage progresses, the liver is unable to function effectively (decompensated) and begins to fail. This stage is termedend stage liver diseasethis allows toxic chemicals and wastes to build up in the body causing jaundice, ascites and hepatic encephalopathy (i.e. a brain disorder due to toxins in the brain). Further deterioration may lead to multiple organ failure anddeath.
Signs and Symptoms: It is important to know that liver diseases can go on for a long time before the clinical manifestations sets in. They include:
Loss of appetite
Weight loss or sudden weight gain
Jaundice i.e yellowing of the skin
Itchy skin and bruises
Fluid retention (oedema)
Brownish or orange tint in the urine
Light coloured stools
Confusion, disorientation, personality changes
Treatment and Management This can achieved mainly the use of drugs or surgery –Diet control; Avoiding too much or little protein. –Drugs:-Lactulose;This works by changing the stool acidity which prevents bacterial growth and reduces ammonia production. -Neomycin; An antibiotic which kills intestinal bacteria and minimises ammonia production. -Rifaxiimin; An antibiotic used in reducing the recurrence of hepatic encephalopathy. –Surgery: –Paracentesis: This is the removal of fluid that has accumulated in the liver due to ascites –Liver transplant: This occurs in cases where liver transplant is inevitable.
Prevention
The commonest type of liver diseases is the Alcohol liver disease, which means we can make liver diseases unpopular.
Avoidance or minimal alcohol intake (you need to know your limit: Ask)
Diet: reduced protein intake is advised to minimise ammonia(waste) production
Exercise- This is good for you to stay fit. Being overweight or obese can affect the progress or treatment your liver condition. Thus, avoid sendatary lifestyles.
Get vaccinated against hepatitis B.
Health education about liver and causes of liver disease: Equip yourself by reading or watching videos or discussing with health professional about the liver.
Having been already informed about his condition, I knew I was going to be very careful and most times repeat myself to him.
On reaching there, he was dressed in an outing attire and was so full of life. Few minutes later, whistling by a bird at the corner drew our attention. One of my colleagues who seem to know more about birds went closer and I followed her just for curiosity sake. She was asking him for the species, who gave it to him, how long he has had it and what he had named the little creature.
We all got chatty. .He said, it was a Christmas present from his son and he can’t think of a name yet and simply calls it baby. Mmm… How am I supposed to know a mere bird can be called baby as well. We all laughed. I admired his sense of humour.
It struck me that it was a present. I thought to myself, won’t he be doing some more cleaning because of this bird, so much noise and distractions but then I viewed it in a more positive and healthy perspective and concluded that his brilliant son has bought that to make him more attentive, keep him busy and also keep him company or for some other reasons.
He was pleased to have us around. He talked about his housing issues and how he called an ambulance three days ago when he felt so unwell. He looked much stronger and said he felt much better. If my guess was right, he enjoyed our company and wanted us to come more often. I can tell because loneliness is friend of no man.
When we were about leaving, we mentioned our names to him once more and made sure he locked the door before we headed for the stairs.
The next day, I ran into him in an event and he recognised me, I was impressed though he didn’t remember my name, which I reminded him of.
At this juncture, I want to get us acquainted with the condition.
Photo credit: Daily mail.
Dementia is a syndrome associated with an ongoing decline of the brain and its abilities. This includes problems with:memory loss,thinking speed,mental agility, language,understanding and judgement.
It usually affect people above the age of 65, though on fewer occasions could have an early onset.
Symptoms include:
Increasing difficulties with tasks and activities that require concentration and planning
Depression
Changes in personality and mood
Periods of mental confusion
Difficulty finding the right words
Hallucinations i.e they may see or hear things that other people do not or they may make false claims or statements.
A catastrophic reaction i.e when put in circumstances beyond their abilities, there may be a sudden change to tears or anger .A common symptom of dementia is for dementia sufferers to deny that relatives, even relatives in their immediate family, are their own relatives.
Disorientation- this occurs in the later stages of the condition, whereby subjects may be disoriented in time (not knowing the day, week, or even year), in place (not knowing where they are), and in person (not knowing who they and/or others around them are).
On the contrary, with appropriate management and care, they lead an active and fulfilled live.
Photo credit: NL Group
Conclusion Aging do come with certain conditions and dementia seems to be very popular among them. Do try and treat the elderly with much care and concern, you never can tell what condition(s) they are battling with.
I am writing this post in regards to the previous one. There were many biased responses and questions from people. Well, I have always liked discussing or writing on HIV and related topics, so that was the kind of go-ahead I have always waited for to write again. Don’t worry it’s not going to be an easy-read.
Human immunodeficiency virus (HIV) is a special kind of virus that causes acquired immunodeficiency syndrome(AIDS). AIDS is a condition where progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive.
HIV infection occurs when there is transfer of an already contaminated blood, semen, vaginal fluid, pre-ejaculate, or breast milk between people. Within these body fluids, HIV is present as both free virus particles and virus within infected immune cells. Hence, extreme care should be taken in all procedures or acts that entails coming in contact with any of those fluids.
HIV infects vital cells in the human immune system such as helper T cells (specifically CD4+ T cells) and as a result leads to low levels of CD4+ T cells. This occurs through a number of mechanisms including: apoptosis of uninfected bystander cells, direct viral killing of infected cells, and killing of infected CD4+T cells by CD8 cytotoxic lymphocytes that recognize infected cells. When CD4+ T cell numbers decline below a critical level, cell-mediated immunity is lost, and the body becomes progressively more susceptible to opportunistic infections.
Having known the different ways HIV can be transmitted it is equally important that we stay abreast with its preventive measures and stick to them. Always bear in mind that it can be contacted through different means.
Actually, amazes me is the stigmatization that comes with this condition. Obviously, when allowed to get to the stage of full blown AIDS, it gives one the ghost-like and lifeless image but a lot can be done to avoid that stage.
HIV testing is very important and should be done as often as possible. It always comes with counselling, which would look into ones health and sexual history including other important aspects as well.
Thanks to free medication which is now available for its management. I would encourage anyone who is affected to stick to their drug- take your drug judiciously. In the HIV clinic, prior to the commencement of the drug they are classes to ascertain that sufferers are fully aware of their condition and how to live positively with it and to take their drugs judiciously. It implies that they take their drugs for the rest of their lives just like in the cases of diabetes and hypertension.
However, early detection and prompt commencement of drug makes a great health difference. The condition has become quite common lately. It’s not written on anyone’s forehead but it is how they manage themselves that matters.
Meanwhile, I would like us all to treat everyone with equal respect. For some that loses much weight in a short time and feel lots more sick, it’s not just the condition that takes them that fast but the way we treat them and the already assumed perception they have. They feel like they are mere shadows of themselves while they are still living. I know it can be difficult for us to see these people differently but we should try and be the reason they smile and find the strength and more reasons to live. All we need to do is to make sure we are always safe while dealing with them. It’s neither airborne nor can be gotten by mere touch.
Thank Goodness!
Fortunately with proper antenatal clinic visits, infected mothers can give birth to HIV- negative babies. Awesome! Isn’t that great? I mean there are so many instances in life where innocent children become victims but here, there is hope for them.
Having cared for some affected individuals warms my heart. There was a time I cared for an infected man, who already was critically ill. Beside him, was always his kind-hearted pregnant wife, each time I came we prayd together. I couldn’t help but thought the woman, her hope, future and that of their unborn baby.
Finally, it is not like they have lost their personalities or no longer have a life, they still do and need love and affection like everyone else. Their situation should not be treated with so much isolation because I do not think they are guilty of a certain abominable crime. Anyone can be a victim.
