Cardiovascular System, Circulatory System, Digestive System, Ears, Nose and Throat, Healthy Living, Immune System, Muscular System, Nervous System, Reproductive System, Urinary System

What to Do If You Just Had a Surgery?

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Surgeries & Procedures

These past 2 months I’ve had a number of people ask me about what to do after a surgery so I’ve decided to post a blog to help others who might have similar questions that they asked.

Before I start, though, let me be clear that I am going to discuss uncomplicated surgeries like, appendectomy, excision, incision and drainage, mastectomy, biopsy, endoscopy and the like, but not limited to these. If you’re asking if a cesarean section is considered uncomplicated, the answer is – it depends. Childbirth in itself, no matter how painful the mechanism is, is considered a normal process. A good question though, is what the reason was for a cesarean procedure and how the delivery process took place, and then we can decide whether it is an uncomplicated or a complicated one. I will talk more about labor and delivery in a separate post in the future.

Now back to surgery – first of all, it will be the safest to ask your doctor if there is any ongoing or possible complication on your case. Some of the most common complications to consider include: site or wound infection, fever, embolism (lodging of a blood clot, air bubble or foreign material in the bloodstream) or worse collapsed lungs, and many others.

If it’s been determined that you have a complicated case, then the principles I will discuss may or may not not be appropriate for you.

What to Expect After Surgery:

First 24 Hours

Pain
The first 24 hours will depend on your tolerance to pain. Normally, people just sleep over this stage for the most part, but some people experience the pain sooner than expected. No worries though because you will be given pre-scheduled pain relievers during this period.

Diet
A “nothing by mouth” policy is strictly implemented to avoid sucking of food into the airway, and to wait for the digestive function to return to normal.

Activity
You will be placed flat on bed during the first few hours after surgery, and then will be turned from side to side with help after a few hours to promote blood circulation.

After 24 Hours

Pain
Here is usually the difficult part because the effects of anesthesia will begin to wear off; so be ready for moderate to severe pain. Again, pain sensation differs from person to person depending on an individual’s tolerance and threshold. Pain relievers are still on regular schedule. Your nurse or healthcare provider will be your best friend during this time.

Diet
Your diet regimen will start slowly from sips of water, liquid diet, soft diet before you return to full diet. You may find it weird whenever your nurse or healthcare provider asks you “Have you farted yet?” Surprisingly, your precious gas determines how soon your diet plan will return back to normal. Reason is, this signals the return of your bowel function.

Activity
READ THIS CAREFULLY. Contrary to common myths that you have to stay longer in bed to prevent your stitches to tear off; you actually need to ambulate early because it promotes blood circulation, and therefore, speeds up healing. But mind you, you cannot do this in haste or you might experience what is called spinal headache, dizziness or vomiting.

Ambulate by moving your arms and legs and then when you’re comfortable with it, move from side to side. After a while, add more pillows to your head to raise it up, and then move to the side of your bed to sit up and dangle your legs. Finally, try a few steps to your side chair and then your first trip to the bathroom. When you are able to do this without any symptoms of headache, dizziness, nausea or vomiting, then you are good to go.

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Early ambulation speeds up your healing.

Discharge Plan:

Medication
Be sure to follow your prescription up to the last dose especially your antibiotics because this will prevent infection. Pain relievers may now be taken as needed, meaning when in moderate to severe pain, take it. If it’s tolerable, you may just need a distraction.

Diet
Diet is usually as tolerated, but I suggest you take more proteins because this is important for body and organ repair and recovery. Have more fruits and vegetables too for additional boost on your immune system, plus it eases up your bowel movement. You may also take your nutritional supplements to feed your cells.

Activity
Just like your diet, activity needs to be slowed down. You can return to your activities of daily living like bathing and grooming, office working, and non-straining house chores like cooking and washing light dishes. Avoid heavy tasks like doing the laundry or lifting heavy objects like your big pans and pots; have someone do it for you.

Special Note on Fever after Surgery

Rule of Thumb: Fever within 24 hours is usually normal; it’s your body telling you it is adjusting to the trauma after the surgery. If the fever shows up after 24 hours, you have to inform your doctor because it might be a sign of an infection setting in.

We’ve covered the most part and if you make it to the second week without any problem, then you are on your way towards full recovery.

Signs of Complication:
Watch out for the following and report it immediately to your doctor or healthcare provider:

1. Fever after 24 hours.
2. Increasing pain around the surgical area.
3. Swelling that does not subside.
4. Red discoloration around the surgical site.
5. Surgical site warm to the touch.
6. Presence of discharges around the surgical site.

Media Credits:
Surgery & Procedures: http://www.estermaneye.com/services/surgery-procedures/
WebMD: http://www.webmd.com

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Success in The Workplace

The Year that Was for Ask the Nurse

The WordPress.com stats helper monkeys prepared a 2015 annual report for this blog.

Here’s an excerpt:

A San Francisco cable car holds 60 people. This blog was viewed about 1,000 times in 2015. If it were a cable car, it would take about 17 trips to carry that many people.

Click here to see the complete report.

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Childhood Conditions, Mommy Diaries

When to Seek Professional Help When Your Child is Sick?

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A healthy child puts on a good smile on his face.

Would you believe if I’d say that my son at 18 had never been admitted in the hospital? Not once? Yes, not even once. It’s not to say that I am a perfect mom or that I did not have awful days for the past 18 years. Like most moms do, I went crazy calming Josh as he kept crying during his teething period, ran around giving sponge baths for his fever after his vaccine shots, and I definitely had bouts of losing my sense of reason when he had his asthma attacks. Name them, and I’d say yeah I endured them too, but there’s nothing compared to the feeling of nurturing a child no matter how difficult it may be.

As a nurse, I give credit to my nursing teachers who taught me well, and my colleagues who gave me an avenue to enjoy teaching and  learning at the same time. Then there were the hundreds of patients who gave me an opportunity to gather a wealth of priceless experiences. All these are well kept in my treasure box. Then, I salute my mother, sister, sisters in law, mother in law and mommy friends who all modeled to me how it is to be a great  “MOM”.

I’d have to say, God has blessed me with the knowledge I need, given me the experiences that I can handle, and gifted me with wisdom from all the moms I know. As I gathered all these, I was spared some sleepless nights and anxious days from the burden of a hospital admission. It also meant that we saved some amount of money as we stayed in the comforts of our home during those difficult days.

So having been a nurse for 24 years and a mom for 18, I thought it proper to share what I learned over the past 2 decades. So, I made a summary of the things (but they are not limited to these) that need your immediate attention, and which tells you that it’s time to seek professional help.

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Telltale Warning Signs:

Infants (0 to 12 months)

  • Fever that does not disappear after 24 hours or is not associated with teething or vaccination
  • Convulsions
  • Swollen Fontanelle (the soft spot at the top of the head)
  • Rashes
  • Vomiting or Diarrhea (if it’s more than 3 times, immediately seek professional help)
  • Appears limp, flushed or pale
  • Cries a lot, irritable and is inconsolable (this is usually a sign of pain)
  • Fast Breathing
  • Has trouble swallowing and does not feed well

Older Kids (1 year old and up)

  • Fever:
    • that does not disappear after 24 hours
    • that occurs when there is no obvious reason for it
    • that can be caused by seasonal illnesses like measles, hay fever, chicken pox or hand-foot-and-mouth disease (HFMD)
    • that is not associated with a previous vaccination.
    • that is accompanied by cough and cold, stomach flu, painful urination, sore throat or other unusual symptoms
  • Rashes
  • Vomiting or Diarrhea (if it’s more than 5 times, immediately seek professional help)
  • Keeps touching or scratching particular body parts like the eyes, ears or private areas
  • Unusual lack of interest to play
  • Lack of Appetite
  • Wheezing or crackling sound with breathing especially with a history of asthma

As a rule of thumb, I’d say timely response and immediate professional care should not be delayed when there is a need for it. You as a mom should know your child well, which means a slight change in physical signs or behavior tells you a lot about his or health condition. The old cliché, “an ounce of prevention is better than cure” will keep you from a lot of trouble.

Media Credits:
Child Health: http://www.emmasdiary.co.uk/images/default-source/toddler/child-healtha43ddf84491d6e5b9e79ff0000427a78.jpg?sfvrsn=0
Childhood Diseases: http://www.newagepregnancy.com/wp-content/uploads/2014/04/Childhood-diseases.jpg
Keep me Home: https://littletulipsfamilychildcare.files.wordpress.com/2014/09/sick.jpg
Suddenly Ill: http://www.cobbk12.org/mccleskey/sick.jpg
Crying baby: http://www.healthyhappysleep.com/wp-content/uploads/2015/03/crying-baby-girl.jpg
Baby is Sick: http://www.eurotrauma.org/wp-content/uploads/2015/09/baby-sick.jpg

Resources:
School Children: https://www.healthychildren.org/English/tips-tools/Symptom-Checker/Pages/default.aspx

atnurse
Ears, Nose and Throat, Healthy Living, Immune System

Did You Know that You Can Develop Allergies even When You Didn’t Have them as a Child?

A few months ago, two cases of allergy were brought to my attention from two women who both said they were unexpected – the reason being for this blog, which is by the way long overdue.

One of the two women had a bothersome itch on her neck, while the other had a near death experience with her husband who was rushed to the hospital due to anaphylactic shock. In both instances though, one thing was common – both individuals never had any history of allergy in the past. So, what just happened?

Upon probing, it turned out that the first woman vacuumed her house in the middle of a hot summer day, and only after a few hours, she developed red rashes on her neck that felt itchy. My analysis: the vacuuming stirred up the dust particles into the air making its way to her nostrils. This gave easy access for the allergens found in the waste products of the dust mites to enter her body, leading to an unexpected allergic reaction.

The husband, on the other hand, ate mackerel sushi for dinner that the wife bought from a local supermarket and prepared personally. This fish according to her is a usual viand in their home, so she had the slightest idea that this would cause her husband’s near death experience. Imagine her shock when after a few hours, her husband suddenly lost consciousness while preparing for bed that night. She recalled feeling so scared and confused while calling for the emergency services. My analysis: her husband had what is called, Scombroid Fish Poisoning. Here is a detailed explanation of this condition:

“This is an allergy like reaction that occurs after eating fish that have been improperly refrigerated after capture. Bacteria in and on the fish break down proteins into histamine, one of the major mediators of allergic reactions. Fish with a high content of red meat, which turns brown upon cooking are commonly involved such as mackerel, tuna, king fish, herring, sardines, marlin, anchovies and bluefish. Affected fish often have a metallic or peppery taste. Symptoms usually commence within 30 minutes of eating, and include flushing, itch, hives (urticaria), nausea, vomiting, stomach cramps, dizziness, palpitations and headache. Severe episodes may result in wheezing and dizziness or a drop in blood pressure.” Australian Society of Clinical Immunology and Allergy

Factors that Trigger Adult Onset Allergy:

Genetic History

An allergy can occur anytime during your lifetime if you have the dormant antibodies in your body, and yes, even if you didn’t have them during your childhood.

Exposure to High Levels of the Allergen

Sometimes, exposure to small levels of an allergen does not cause any reaction, but high titers of the same will cause moderate to severe allergic reactions.

Compromised Immune System

A poor immune system is not a very good defense in combating the effects of allergens during an allergic reaction process.

Allergies are common occurrences that can manifest in many ways such as rhinitis, asthma, skin rashes, dermatitis or in more serious cases anaphylaxis. Whatever the cause, however, points to a particular allergen as the culprit. In the medical community we call it “antigen-antibody reaction” where a foreign object or allergen, referred to as the “antigen” triggers an attack to a person who has a dormant antibody.  Once triggered, the “antibody” cascades a host of reactions in response to the “antigen”, which can vary from a simple rash to a fatal anaphylactic shock.

“The term atopic allergy implies a familial tendency to manifest such conditions as asthma, rhinitis, urticaria, and eczematous dermatitis (atopic dermatitis) alone or in combination. However, individuals without an atopic background may also develop hypersensitivity reactions, particularly urticaria and anaphylaxis, associated with the same class of antibody, IgE, found in atopic individuals. Inasmuch as the mast cell is the key effector cell of the biologic response in allergic rhinitis, urticaria, anaphylaxis, and systemic mastocytosis, the introduction to these clinical problems will consider the developmental biology, activation pathway, product profile, and target tissues for this cell type.” Harrison’s Principles of Internal Medicine, 17th Edition

atnurse
Know your “Asthma Triggers”

What should be done to avoid such fateful episodes?

  1. Dig in your family’s health history. If you have anyone among your relatives from (at least) the past two generations who had a history of allergy in any form, chances are, you might also have this dormant antibody genotype.
  2. Take a mental note of any incidence that caused you symptoms like rashes, sneezing, stomach upset, eye irritation and other unusual episodes that are not directly related to any bacterial or viral exposure. These incidents might give you a clue of possible antigens or “trigger allergens“.
  3. Avoid exposure to your “trigger allergens” at all cost.
  4. Invest in your health and keep your immune system in constant optimal condition. You can do this by eating healthy, exercising regularly, sleeping sufficiently, hydrating adequately, avoiding stress and keeping well-nourished cells.

It’s difficult to say when an allergy will hit just like what these two women experienced; especially when the cause or trigger is unknown. In these cases, however, both persons probably have the dormant antibody that reacted instantly upon exposure to the allergen. So, I’d say that the best way to avoid an allergic reaction is to be informed of your health exposure and risk factors.

The prudent understand where they are going and they carefully consider their steps. Proverbs 14: 8, 15 (NLT)

Resources:
Anaphylaxis: http://www.aaaai.org/conditions-and-treatments/allergies/anaphylaxis.aspx
Dust Mites: https://www.aafa.org/display.cfm?id=9&sub=18&cont=228
Allergic and toxic reactions to seafood: http://www.allergy.org.au/patients/food-allergy/allergic-and-toxic-reactions-to-seafood

Media Credits:
Dust Mites: http://www.pestfreeliving.ca/blog/wp-content/uploads/2015/04/7020081293_00a1f35a2a.jpg
Dust Mite Allergy: http://www.aamfoundation.com/wp-content/uploads/2014/03/girl-with-back-rash.jpg
Scombroid Poisoning: http://image.slidesharecdn.com/foodpoisoning-120213022212-phpapp01/95/food-poisoning-21-728.jpg?cb=1329101316
Mackerel: http://paleodiet.co.uk/wp-content/uploads/2013/09/mackerel.jpg
Asthma Triggers: http://www.smerete.com/wp-content/uploads/2013/06/Smerete_Types_Of_Asthma.png

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Basal Metabolic Rate, Calorie Counter, Healthy Living, Hope for You, Successful Living, You are Loved

We’ve Got a Makeover!

Last month marked the first year when I started blogging on this site. I remember my first post – it was in a depressing tone as it featured the passing of one of the most bubbly personalities in Hollywood, Robin Williams. It was so relevant at that time as I remembered some people who were in challenging situations in life.

This year, however, I decided to do a complete makeover as suggested by my son, Josh. We started to work on the theme to set aside the gloom of last year and to welcome the new season of life and new beginnings. From the very dense logo and “hospital-ish” feel of the website, Josh decided to do a little bit of experiment with the theme and it’s colors.

He suggested that it should be simple yet stylish, so we played with only three colors: green, blue and red. Green speaks of life, harmony, healing and safety. Blue, on the other hand, talks about clarity, wisdom, tranquility and stability. To strike a balance and a contrast with the other two colors, we used red to display energy, leadership, passion and love.

Also, and surprisingly, the past year has earned us an audience from different parts of the globe from Japan, India, Macau, South Korea, United States, United Kingdom, Saudi Arabia, Russia, Canada, Australia and more. Reason why we decided to put the world map as it’s base.

After several weeks of brainstorming, here now is the finished product!

Hopefully, I would be able to reach more people to help transform their lifestyles in the coming years. So as an added treat, I am giving you a free “Health Assessment Test” for you to know where you are in your health condition and what can be done to meet your wellness needs. Answer the question: Are You as Healthy as You feel?

A peaceful heart leads to a healthy body. Proverbs 14:30 (NLT)

atnurse
Healthy Living, Reproductive System, Urinary System

Do You Have Frequent Urinary Tract Infections?

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Love Your Kidneys

I at least know five people in my life who had trouble with their kidneys; these excluding hundreds of my patient encounters back when I was in the hospital. Whether it is a simple upper or lower urinary tract infection (UTI), kidney stone or chronic kidney failure, there is a common denominator that would signal the problem, which is a simple urine test (urinalysis). This is exactly the reason why it is made part of a simple annual exam to a more complicated executive check up. Now, this article is not meant to diagnose your illness, but to simply give you something to consider and the actions you can take.

Here is a checklist of the symptoms you might be experiencing now, which is telling you, it is time to have your most dreaded visit to your doctor:

Are you experiencing any of the following?

  • painful urination
  • burning sensation on urination
  • urinary frequency
  • urinary urgency
  • pain or spasm in the area of your bladder
  • frequent waking up at night to urinate
  • pressure on the lower abdomen when bladder fills up
  • pain radiating to the groin or back
  • incomplete emptying of the bladder or inability to urinate
  • involuntary urination
  • presence of blood in the urine
  • cloudy, foul odor urine
  • stones or sand like in urine
  • flank pain (refers to a feeling of discomfort or pain from the sides below the rib cage that extends to the back)
  • fever and chills
  • in some cases nausea and vomiting, and diarrhea
  • purulent urethral discharge
  • Red Blood Cells (RBC) in the urine even without an infection

These are only some of the symptoms you might be experiencing, but have been ignoring for a long time. My advice for you is to visit your healthcare provider for a thorough medical examination. You should know that a simple UTI is easy to treat with the use of specific antibiotics – with the right dosage and frequency, you are good to go. Or better yet, a change in lifestyle like full hydration, healthy eating choices, regular exercise, enough rest and sleep, take potent nutritional supplements and most importantly – get married and have an exclusive sexual partner.

If, however, you are already in an advanced urinary or kidney problem, which I hope is not the case, you may already have the following symptoms:

  • persistent UTIs of not less than three times a year
  • frequent and consistent Red Blood Cells found in the urine even without an infection
  • presence of protein in the urine
  • pain that can be dull to a sharp stabbing pain from the flank area that may radiate to the groin
  • increase in blood urea nitrogen and serum creatinine

If you have any of these symptoms, do not delay your visit to your healthcare provider as it may save your kidneys. It is the same health advice I give to a relative who has had more than three urine examinations that shows a consistent RBC, a friend who had a history of 20 years of stressful work with no time to go to the bathroom or to drink enough water during her working hours. Sadly, she now has eye, liver and kidney complications, which could have been avoided (except if it is something genetic) had she modified her lifestyle early on.

Now, it is up to you to decide whether you are taking your health in your hands or simply wait for the symptoms to worsen until you seek professional help.

Resource: Harrison’s Principles of Internal Medicine, 17th Edition

Media Credits:
Love Your Kidneys: https://www.flickr.com/photos/50192211@N07/5609998909/in/album-72157626086513845/

atnurse
Ears, Nose and Throat, Healthy Living, Immune System, Infectious Diseases

Warning: Cold and Flu Season Ahead

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Flu Pandemic in the Philippines in 2009

It’s the rainy season again, which also marks the cold and flu season in the Philippines. There is no better way to beat these viruses than an ounce of prevention, so I chose to re-post an informative article written by Nick Peterson on “Scientifically Speaking: What’s the Cold Got to Do with It?”. I did a few editing to make the article appropriate for a tropical country setting.

Although, there is no winter in the Philippines and the viruses do not reach their gel state, flu spreads fast during the rainy season because of the cooler temperature, and the increased humidity and moisture of the air. Therefore, the air droplets easily carry viruses and transfers them from person to person. Another obvious reason is that the cooler season tends to dry up the mucosal cavities of the mouth and nose, making them a good breeding ground for viruses or bacteria for that matter.

On another note, if you ask me what is my position on whether to stay at home or to go out during the cold and flu season? I’d say, I had better stay at home, as long as, I am sure there is no carrier of the virus in our household.

“People with flu can spread it to others up to about 6 feet away. Most experts think that flu viruses are spread mainly by droplets made when people with flu cough, sneeze or talk. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. Less often, a person might also get flu by touching a surface or object that has flu virus on it and then touching their own mouth or nose.” – Centers for Disease Control and Prevention

An article by Nick Peterson, which was originally posted at What’s Up, Usana?

This month’s edition of Scientifically Speaking goes out to all the moms and dads who’ve warned their children throughout the years about exposure to the cold weather, which will inevitably lead to “catching a cold,” right?

Seriously though, as I’ve gotten older, I’ve started to wonder if my mom was just duping me the whole time. Both a cold and the flu are caused by viral infections, so what in the heck does cold weather have to do with anything?

It looks like we’ve stumbled across a great topic for Scientifically Speaking. I did a little digging and — as always — got a few leads from our expert scientists. I’d like to say I’ve got a solid answer for you guys, but there seems to be some difference of opinion within the medical community. Let’s break down my findings, shall we?

 

Cold vs. Flu

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Cold versus Flu

Before we dive into all the cold weather talk, let’s discuss what a cold actually is. With more than 200 viruses causing it, the common cold is a viral infectious disease that usually leads to symptoms such as coughing, sore throat, runny nose, and sneezing.

The most common virus strands that cause a cold are rhinoviruses, and all of those nasty symptoms you experience are actually a result of your body’s immune response to the infection rather than the deterioration of tissue that the actual virus causes. In more extreme cases, the virus causing your cold can lead to viral or bacterial pneumonia.

The flu, or influenza, is also a respiratory infection, but it’s caused specifically by influenza viruses and usually leads to more severe symptoms such as fever, body aches, chills and headaches. There are three different types of flu viruses, all of which humans are susceptible to.

What the Experts Say

The National Institutes of Health uncovered some evidence that might back up your parent’s argument to keep warm during the cold season. These findings are specifically associated with the flu virus and its outer covering, or envelope.

The study showed that colder temperatures (in case of areas with winter – near or below freezing), cause the flu virus to form a rubbery, gel-like covering that shields the virus, allowing for easier transfer from person to person. Once the virus enters the body, usually through mucus membranes in the mouth, nose or eyes, it reaches warmer temperatures in the respiratory tract and causes the covering to melt. The virus’ outer covering then reaches a liquid phase, allowing it to infect the cells of its new host.

On the flip side, during warmer seasons the temperature is too high for the viral membrane to enter its gel state. Because of this, flu viruses often can’t withstand the elements and will dry out and weaken, leading to the end of “flu season.” This led the scientists to wonder whether people might better protect themselves against the flu by remaining indoors at warmer temperatures than usual.

What the Other Experts Say

According to other experts, staying indoors might be the worst thing you can do for yourself throughout the colder season. A leading theory is that confinement breeds infection.

“In winter, we spend more time indoors, in rooms that may not get a lot of circulation, giving us more opportunities to be exposed to respiratory viruses,” says William Schaffner, M.D., chairman of the department of preventive medicine at the Vanderbilt University School of Medicine in Nashville, in this Real Simple article.

Additionally, Schaffner adds, the winter air, inside and outside, also tends to be less humid, drying nasal passages and making them more vulnerable to viral invasion.

What You Can Do

atnurse
Flu Prevention Tips

These are only two opinions on the subject, but there’s a lot of information out there. Do some investigating yourself to see what the research tells us.

In the meantime, the best thing you can do to fight that cold or flu virus is take preventative measures that support a healthy immune system. Evidence suggests that a healthy dose of both vitamin C and zinc may help. Deficiency in either of these may make individuals more susceptible to impaired immune response. Healthy adults generally need at least 75–90 mg of vitamin C and 8–11 mg of zinc per day to avoid severe deficiency.

Another important way to protect yourself from a virus is to avoid any kind of hand-to-face contact. Typically, a virus enters through hand-to-eye, -nose, or -mouth transmission. And of course, don’t forget to take the obvious precautions: healthy diet and exercise, sufficient amounts of sleep, disinfecting germ-susceptible areas, and regularly washing hands.

Media Credits:
Flu Season Ahead: http://greenprescription.net/home-remedies/8-home-remedies-for-flu/
Monsoon Rains: http://newsinfo.inquirer.net/694214/dry-winds-giving-way-to-monsoon
Woman with Flu: https://www.lloydspharmacy.com/en/info/Flu
Flu Prevention Tips: http://www.aboutflusymptoms.com/wp-content/uploads/2015/01/Flu-Prevention-Tips.png
Cold versus Flu: http://www.codral.com.au/cold-and-flu-symptoms