"Aging In Place"

Completely exhausted and don't see any sign of it letting up any time soon. This is the second job I've had that I've kept for more than about a year and a half but things around here get stupider every day thanks to the fact that my boss Alvin N. Chipmunkk really doesn't know jack shit about health care (he ran a failing landscaping business before one of his buddies hired him as an administrator here) and he kowtows to all the family members who insist that their falling-apart loved ones don't need more care.

We currently have one woman who fell a dozen times within a week. We're doing night checks on her. I don't know why the hell she isn't being assessed for neurological problems. She's o.k. if she is the one that calls us, but the idea of taking her to the bathroom at scheduled times is right out because she can be a real bitch if she hasn't called us.

This is supposed to be the "independent living" part of the facility. People who are here are supposed to either be able to handle most things on their own with a modicum of assistance, such as having medications delivered or a stand-by assist for a shower, things of that nature. Or they are supposed to have home care because in this part of the facility there is one aide 24 hours a day for some 200 apartments and a nurse for 8-10 hours. We aren't supposed to act in an assisted living or health care capacity--that's what assisted living and health care are for! But with Alvin, these rules aren't really enforced. He's more about telling the families what they want to hear and kissing ass to the CEO's, who also don't happen to know jack shit about health care, just about the bottom line.

I'm waiting for this woman who keeps falling to break her hip or such. Or for one of these people that keeps leaving the stove on to set the place on fire. And then there are people like the demented lady who takes off her Depends and then the inevitable happens. At least the family finally got a part time aide for her, but when the aide isn't here, she will do things like leave her stove on. She once got out a wine glass which she subsequently broke. She was found stark naked trying to clean up the pieces of glass. Its a miracle she didn't cut herself.

But CEO Gloria Bee thinks that "aging in place" sounds so very wonderful. And it does sound wonderful. And maybe it could even work--if she would listen to the people who have to deal with it! But that ain't gonna happen. Any more than junior CEO Agnes Tin-Horne is going to stop throwing her weight around or Alvin is going to grow a backbone when it comes to pushy family members. In the end they will lose frustrated staff (we're already a skeleton crew) and replace them with the kind of "crack crew" that the good workers at the casino where I used to work ended up being replaced with. In other words, some crackhead that walks in off the street. And beyond that, the residents will be the ones who end up suffering all for some paper-pusher's idea of something that sounds great in theory but in reality is far more complex than they can possibly imagine.

Breast Cancer Patient Protection Act

This is an email I got from a friend. Here is a post on her blog regarding a woman who endured a double mastectomy recently and was given the boot shortly after she woke up from anesthesia.

Something important for you to consider.

From a nurse:

I'll never forget the look in my patients eyes when I had to tell them they had to go home with the drains, new exercises and no breast.
I remember begging the Doctors to keep these women in the hospital longer, only to hear that they would, but their hands were tied by the insurance companies.
So there I sat with my patients, giving them the instructions they needed to take care of themselves, knowing full well they didn't grasp half of what I was saying, because the glazed, hopeless, frightened look spoke louder than the quiet 'Thank You' they muttered.

A mastectomy is when a woman's breast is removed in order to remove cancerous breast cells/tissue.
If you know anyone who has had a Mastectomy, you may know that there is a lot of discomfort and pain afterwards.
Insurance companies are trying to make mastectomies an outpatient procedure.
Let's give women the chance to recover properly in the hospital for 2 days after surgery.

It takes 2 seconds to do this and is very important .. Please take the time and do it really quick!
Please send this to everyone in your address book.
If there was ever a time when our voices and choices should be heard, this is one of those times.
If you're receiving this, it's because I think you will take the 30 seconds to go to vote on this issue and send it on to others.
You know who will do the same.

There's a bill called the Breast Cancer Patient Protection Act which will require Insurance Companies to cover a minimum 48-hour hospital stay for patients undergoing a mastectomy. It's about eliminating the 'drive-through mastectomy' where women are forced to go home just a
few hours after surgery, against the wishes of their doctor, still groggy from anesthesia and sometimes with drainage tubes still attached.

Lifetime Television has put this bill on their Web page with a petition drive to show your support. Last year over half the House signed on.

PLEASE!! Sign the petition by clicking on the Web site below. You need not give more than your name and zip code number.

http://www.lifetimetv.com/breastcancer/petition/signpetition.php

This takes about 2 seconds.
PLEASE PASS THIS ON to your friends and family, and on behalf of all women, THANKS!!! :-)

There isn't always a positive outcome

This is a piece of a response to a friend whose husband died of cancer in December. While at a parade, the American Cancer Society was tossing t-shirts and she happened to get one that said "survivor," and it infuriated her. Can't blame her there. The shirt actually served to remind her that her husband did not survive, but she did and now has to go on without him. This did not inspire Pollyanna "the sun will come out tomorrow" feelings, it inspired sorrow and hopelessness. Maybe "that which doesn't kill you makes you stronger," but like any cliche, it also pisses you off.

I did say more than is written below but this is the only part that's relevant to the point I want to make.

My father gets the Stroke Connection magazine and he feels about it's approach the way you felt about the t-shirt. Not everyone survives cancer, and not everyone who has a stroke makes a full recovery and is able to go back to a productive life. While giving hope these organizations should also not be forgetting about the reality, about the people grieving the loved ones lost to cancer, about people grieving the functions lost to stroke.

Stroke Connection tends to focus on stories of people who have made good recoveries, in order to give new survivors hope, I think. In 2004, my father had a hemorrhagic stroke that affected the basal ganglion area of his brain. He did make some recovery, but he still walks very slowly and must use a walker. He never did get much function back in his right hand. He feels very bitter and disappointed. He wrote to Stroke Connection and told them that they should include stories about the other half of the people who had a stroke and did not have a miraculous recovery, who are enduring day to day. And I agree with him. The magazine is basically a good thing and he likes reading it, but he'd like to hear about more people like him who have to deal with being permanently quite handicapped.

I'm not trying to condemn the good works done by the American Cancer Society and the American Heart Association, just imparting a thought.

Hemorrhages on the Sclera

This is what my eye looks like right now. This actually isn't my very own eye, but, interestingly, the picture I found is the same color as my eyes. So, this is what my eye looks like right now.

This can happen from trauma, even trauma such as a really forceful cough, but in my case it happens spontaneously when I am very exhausted and/or under a lot of stress.

Today I told my son that if it weren't for the fact that I take B vitamins and eat meat, I would think I was anemic as exhausted as I was feeling. I slept most of the day away. (well, I do work nights...) Tonight when I saw myself in the mirror, my eye looked like this. Ah hell...

As for stresses, well, the financial ones never end. It's on my mind constantly.

The Chubby Curmudgeon Strikes Back

Here was my forum response to this article. I liked what poured out of my slimy little brain, so I'll repeat it!
I am a 43 year old person who has, sadly, put on quite a bit of weight over the last 15 years, in part due to admittedly less than perfect eating habits, in part due to medication and health conditions such as hypothyroidism and polycystic ovarian syndrome. However, I am no less healthy than my slimmer co-workers. I have only called in sick twice in the past three years. I had to go to the emergency room once a little over a year ago--for ear wax that was pressing against the ear drum and caused me vertigo and also a frightening blood pressure spike. Hypertension runs in my family, but it doesn't seem to have anything to do with weight. My brother, who is now 39, had to start taking blood pressure medication in his early 30's, and he is not overweight. My blood pressure is on the borderline and I'm watching it. But I still don't have to take medication for it yet. The medications I take are lithium for bipolar disorder (which does cause weight gain) and thyroid medication. I am also fairly active, so the myth that all heavy people do is sit around eating is just that--a myth. Most of the big people I have known have been hard-working folk. Rather than engaging in prejudiced behavior against one segment of the population, let us try to find a solution that works for everybody.

Terrible and Funny Tales From The E.R.

For a good time click here.

How Low Can You Go?

Does it get any lower than stealing from the poor and the elderly?

The people in the retirement community where I work like displaying decorations and knick-knacks on the doors and shelves outside their apartments. Usually nothing gets taken. But one lady likes to display wreaths on her door for various holidays. Her Valentine wreath had a bunch of tiny dolls among the decorative pink and white heart garland. Some lowlife clipped all the dolls from the wreath.
Why would anyone do that?
In another incident, a woman had been "working" retirement communities in the area. Our building is locked at night but during the day it is open. This woman came in, knocked on one of the residents' doors and pretended she was looking for someone, asking the resident if she could help. The perpetrator then said she was thirsty and asked for a glass of water. While the resident was getting the water, the woman stole her purse. She then proceeded to chat with the resident for a few more minutes before leaving. A few days later there were reports in the paper of similar incidents at other retirement homes.
None of this helped calm the unfortunate victim of this unsettling crime, who was an Austrian immigrant that had lived through the horrors of World War II. Her cognitive abilities were declining and that in itself was causing severe anxiety. The night after the incident she called me to her apartment. I talked to her for 20 minutes in an attempt to calm her but I fear I wasn't able to do much good. Then her abilities to care for herself at all began to decline. I'll never be sure how much of this was psychosomatic. She ended up in the hospital and from there was transferred to our facility's health care center. She never returned to her apartment, dying in the health care center a few months later. She completely shut down emotionally and her physical faculties followed.
Granted, "Gwenda's" short term memory was beginning to fail her, but before this incident she would walk around the building twice a day for exercise and every morning before I went home she would be there at the office for her medicines with a cheery "Gud Mornink, how are you?" After she was victimized, she became a terrified shell of herself. While she didn't say so, I'm sure that the invasion of her home brought back memories of a frightening time in her existence, perhaps some that she had repressed for years. Her drastic decline following her victimization was shocking and, I think, completely unnecessary.
Shame on those who victimize the most vulnerable so callously! But due to the fact that they have no conscience, I suppose that they feel no shame.

Virus Du Jour

There's some sort of ugly virus going around. It seems to mostly affect the upper respiratory system, particularly the throat, although there are signs that it might eventually move to the bronchi. I had an explosive, uncontrollable dry cough all day. I thought it was allergies. But tonight my throat became sore and I lost my voice. I also had a rasping wheeze for most of the night. When this disappeared it actually freaked me out a bit. I think this is due to the fact that 5.5 years ago I had pneumonia. The combination of the coughing and being on inhaled steroids for several months eventually caused a severe laryngospasm and I ended up in the emergency room with severe stridor. I tried to tell the ER attendants that my lungs were filling up just fine, it was my throat that was the problem (felt like breathing through a cocktail straw) but they treated as for asthma. The albuterol only made my throat tighten worse. I told them this was the case and they gave me epinephrine, which dilated the tissues and blood vessels, providing relief. It turns out that the tissues in my larynx were so irritated that the cold air caused my larynx to constrict. Although not as severe, tonight's sensations reminded me of that frightening incident and I started having a panic attack. Luckily I was able to to stop it using homeopathic and herbal means, in this case Hylands Calms Forte and Kava. I don't like to take Valium if at all possible. It makes me feel funny and kind of fuzzy. But I like going to the ER even less.
At this point I'm trying not to cough because it will only cause worse irritation to the tissues in my throat and unwanted choking sensations. At this point the cough is semi-productive although there isn't any discomfort in my lungs, i.e. bronchitis. So far I'm pretty sure this is a virus and not strep. My throat isn't that sore and I'm not running a fever.
If you find yourself having to cough constantly, particularly an explosive dry cough, do what I should have done and nip it in the bud with some cough syrup so your throat doesn't end up as irritated as I let mine become. Normally I let minor cold and cough run their course, but I would have been advised to stop this one. Now I need to allow my throat to heal and deal with the unsettling gagging sensations that come with having irritating the tissue with so much coughing.

Genetic mutation stuff--eyes

I will freely admit that this is a direct rip-off from this article on MSN. I can't be arsed to rephrase it. But I find the information interesting. I'm very fascinated by genetics, but they lose me at the point when you get into all the ACGTU's. It becomes too mathematical for my addled mind.

Genetic mutation makes those brown eyes blue
Scientists find that blue-eyed individuals have a single, common ancestor

Carolyn Kaster / AP file
By Jeanna Bryner

updated 12:01 p.m. MT, Thurs., Jan. 31, 2008

How did actress Reese Witherspoon get those big blue eyes? A team of scientists has found that blue eyes are linked to a genetic mutation that occurred between 6,000 and 10,000 years ago.

People with blue eyes have a single, common ancestor, according to new research.

A team of scientists has tracked down a genetic mutation that leads to blue eyes. The mutation occurred between 6,000 and 10,000 years ago, so before then, there were no blue eyes.

"Originally, we all had brown eyes," said Hans Eiberg from the Department of Cellular and Molecular Medicine at the University of Copenhagen.

The mutation affected the so-called OCA2 gene, which is involved in the production of melanin, the pigment that gives color to our hair, eyes and skin.

"A genetic mutation affecting the OCA2 gene in our chromosomes resulted in the creation of a 'switch,' which literally 'turned off' the ability to produce brown eyes," Eiberg said.

The genetic switch is located in the gene adjacent to OCA2 and rather than completely turning off the gene, the switch limits its action, which reduces the production of melanin in the iris. In effect, the turned-down switch diluted brown eyes to blue.

If the OCA2 gene had been completely shut down, our hair, eyes and skin would be melanin-less, a condition known as albinism.

"It's exactly what I sort of expected to see from what we know about selection around this area," said John Hawks of the University of Wisconsin-Madison, referring to the study results regarding the OCA2 gene. Hawks was not involved in the current study.

Baby blues
Eiberg and his team examined DNA from mitochondria, the cells' energy-making structures, of blue-eyed individuals in countries including Jordan, Denmark and Turkey. This genetic material comes from females, so it can trace maternal lineages.

They specifically looked at sequences of DNA on the OCA2 gene and the genetic mutation associated with turning down melanin production.

Over the course of several generations, segments of ancestral DNA get shuffled so that individuals have varying sequences. Some of these segments, however, that haven't been reshuffled are called haplotypes. If a group of individuals shares long haplotypes, that means the sequence arose relatively recently in our human ancestors. The DNA sequence didn't have enough time to get mixed up.

"What they were able to show is that the people who have blue eyes in Denmark, as far as Jordan, these people all have this same haplotype, they all have exactly the same gene changes that are all linked to this one mutation that makes eyes blue," Hawks said in a telephone interview.

Melanin switch
The mutation is what regulates the OCA2 switch for melanin production. And depending on the amount of melanin in the iris, a person can end up with eye color ranging from brown to green. Brown-eyed individuals have considerable individual variation in the area of their DNA that controls melanin production. But they found that blue-eyed individuals only have a small degree of variation in the amount of melanin in their eyes.

"Out of 800 persons we have only found one person which didn't fit — but his eye color was blue with a single brown spot," Eiberg told LiveScience, referring to the finding that blue-eyed individuals all had the same sequence of DNA linked with melanin production.

"From this we can conclude that all blue-eyed individuals are linked to the same ancestor," Eiberg said. "They have all inherited the same switch at exactly the same spot in their DNA." Eiberg and his colleagues detailed their study in the Jan. 3 online edition of the journal Human Genetics.

That genetic switch somehow spread throughout Europe and now other parts of the world.

"The question really is, 'Why did we go from having nobody on Earth with blue eyes 10,000 years ago to having 20 or 40 percent of Europeans having blue eyes now?" Hawks said. "This gene does something good for people. It makes them have more kids."

New Changes

Once again I've decided it's best to combine the Medical Hodgepodge and Gerri Atrik Retirement Community blogs into one. Anecdotes about work and school as well as interesting things I learn will go here. All in one place. I like diversity, but enough's enough already.

World's Shortest Wedding

Wow, even Britney Spears' 10 hour wedding lasted longer than this! I decided to keep this the Medical Hodgepodge blog. I kind of like posting about my studies all on their own. My battle stories about the retirement community will now merge with the Strange Daze blog. Yeah, I know...who gives shit? Probably besides me, nobody. But I like to keep track.

It's A Nice Day for a Blog Wedding

Now hear this! The Medical Hodgepodge blog and the Gerri Atrik Retirement Community Blog have merged and become one for the sake of simplicity. The blog is now Caretaker's Hell. Read it and weep.

Genetically Modified Foods

This is from a biology class discussion on genetically modified foods.

While there might be advantages to having crops that are pest resistant, would the same mutations that make them pest resistant also produce negative effects in humans? For instance, might these foods take on qualities that may be carcinogenic? While there is no problem with creating hybrid foods that are already eaten by humans, for instance an apple with mixed qualities of two different apples or if the aspects of an orange and a grapefruit were combined, I personally don't wish to eat foods that have been altered in ways that might be detrimental and until the products of an insect-resistant super-crop are proved not to be detrimental to humans and domestic animals, I don't want to be consuming it.
I personally don't use products such as milk containing BGH. Maybe there is nil negative effect, but maybe not. Wherever possible, when it comes to food, I prefer not to mess with Mother Nature.

allelic frequency

This is from a discussion of genotype variation in the biology class that I have been taking. Today was the last day of the class. I didn't expect to feel this way but I'm kind of sorry its over. The subject matter was actually starting to become interesting to me.

The allelic frequencies in a population such as the US will have greater shifts than a country such as China due to the greater range of genetic variation. Persons of various racial backgrounds reside in a country such as the United States whereas a country such as China is reasonably homogenous for phenotype and thus presumably also fairly homogenous in it range of genotypes. If there were an influx of immigrants of other racial types to China over the next 25 years, there would be new alleles introduced into the offspring of couples of mixed racial types. This would cause a greater variation in alleles.

Mitosis and Meiosis

In MITOSIS, the 2 daughter cells formed in the division have the same in genetic makeup as the parent cell. They have the same DNA and thus make the same proteins and behave the same.
In MEIOSIS the cells are not identical. The gametes, eggs and sperm, are products of meiosis. There is a blend of genetic material from the mother via the egg and father via the sperm. Meiosis is necessary for genetic diversity. It also explains why an individual may have traits from a grandparent. The parent may not have that trait but carries it in their genes.
Meiosis can be a complicated subject because we have 2 of every chromosome and therefore 2 of every gene even before the DNA replication that preceeds mitosis. As well, there's a chance that 2 copies of the same gene are different. An example is a trait which appears in both a grandparent and a grandchild although the parent does not have the same trait. The parent was a carrier of said trait although he or she does not present with it.
The mixing of genetic material comes about after the DNA replicates in preparation for cell division. This involves chromosomes breaking apart and joining back together.
Here is an animated movie of meiosis at http://www.biology.yale.edu/animatedMeiosis.nclk Note the red and green chromosomes at the beginning and the mixed ones at the end.

Medical Genius

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cellular respiration

This site breaks down the process of cellular respiration. It is written in a way that a person with some understanding of biology will be able to learn the process. I appreciated it because the chapter in my textbook was a bit convoluted.

Exciting Info about Reproduction

Sexual reproduction provides genetic diversity through recombination. This genetic diversity may serve the population well as the environment changes or as the population expands into new environments. The adaptability resulting from genetic diversity is the major advantage of sexual reproduction over asexual reproduction, although sexual reproduction can also break up well-adapted combinations of alleles through the same process of recombination.
Asexual reproduction is the only way of raising plants such as navel oranges, all of which have been reproduced from a single tree found in on a plantation on the Brazilian coast in the early 19th century.
http://www.filefarmer.com/2/successus/Books/Ch39.pdf

Alkalinity and acidosis of the blood

In humans, a normal pH of all tissues and fluids of the body is slightly alkaline. The most critical pH is in the blood. All other organs and fluids fluctuate in their range in order to keep the blood at between 4.35 and 7.45 pH

If the blood becomes too acidic then it robs some of the alkaline forming elements from the enzymes in the small intestine to maintain homeostasis. The small intestine then becomes to acidic to digest foods properly. The pancreas, gallbladder and liver must then work harder to make up for this deficiency in order to metabolize foods properly. This negatively impacts metabolic enzyme production, resulting in lowered immune function, fatigue, hormonal imbalances and absorption and digestive problems.

The bones begin to leach calcium when pH is too acidic, resulting in bone density problems.

Insulin levels increase and fat is stored rather than being metabolized.

Electrolyte imbalances occur that can negatively impact the nerve, heart and muscle cells.

A hyperalkaline state can cause muscle cramps and weakness.

Amoebas

Come look at some excellent photographs of the most famous one-celled animal.