Nothing fancy, Just Thanks Giving…

Happy Thanksgiving to anybody that happens to come across this post. I have certainly been slacking in my blogging, so I figured I would switch it up from putting a bunch of health mambo jumbo, and write out some thoughts from lately. Well first off, I had a wonderful Thanksgiving with my amazing family and boyfriend. We went out to the boonies of Plant City, where my aunt has a little farm. It was a great vacation, with some much-needed rest and relaxation. I often find myself unable to really let people in my life know how I feel about them. Sure, I say “I love you” and whatnot, but truly expressing feelings has not necessarily been a significant quality in our family. We know we all love each other, and typically express it through enjoying our time with one another when we can. So here is my post to really let those people I love know how I REALLY feel….

To my Mother…with so many roles you play in my life, I don’t know where to begin…my giver of life, my guardian, my nurse, my comfort, and my best friend. My world would be upside down if I didn’t have you. Although Dad is my hero, you are my angel. After 22 years, one of my favorite places in the world is still in your arms. Some of my greatest struggles in life, I had you by my side to give me strength. Even at my greatest successes in life, I still credit you for giving me strength. I admire everything about you mother, your wisdom, your courage, your beauty…the list goes on and on. You are my rock, my conscience, my guidance, my primary support in everything I do. There is nothing I feel I can’t tell you, and I am so fortunate to have such an incredible bond with you. I feel there is no better friend for a woman than her mother, and I am blessed beyond words to have such a beautiful, amazing woman in my life.

To my Father…My hero, my superman. I think you are one of the most brilliant people I have ever met. When asked who my heroes are, without a doubt, the first person that comes to mind is you. It never ceases to amaze me your clever skills, ideas, and overall use of common sense. Whenever I am faced with a tough situation, I step aside and think “Well how would my Dad handle this?” and most of the time, problem solved. I look up to you in ways that you could never imagine; I can only hope to be as awesome as you are. Not only are you so multi-talented, Dad, but I always know how much you love our family. You have provided us with extraordinary love, and a sense of comfort in knowing that you will always be there to do whatever you can to make our lives better. Little do you know, that just having you in our lives is one of the best things anyone could ever ask for.

To my Alan…my incredible boyfriend. The love of my life. It has only been 7 years, but I feel like I have known you forever. You know everything about me, from what I will order on a menu to the way I react to things. We have been through so much in our relationship, I feel that nothing can tear us apart. I could not think of a better definition of a soul mate than the relationship I have with you, and it is a bond that I hope we share forever. I know how much you hate corny things like this, so I’m keeping it short, but I wanted you to know that I could go on forever telling you how much I love you, and what a special person you are in my life.

To my sister Kimberly…you are a musical masterpiece in and of itself. I love telling people that my little sister is a musical genius, and counting off the impressive list of instruments you play. Your passion for music is so admirable, and listening to you playing flute is one of my favorite past times, in particular, one of your first performances, playing A Whole New World. Although as sisters, we could not be more different, I hope you know how proud I am of you and all that you do. Growing up, I could not have asked for a better companion and best friend. As adults, I love watching as our futures unfold, and though our journey through life takes very different paths, I know that they will forever be alongside each other, and will always lead back to our home.

To my brother Dominick…my little baby brother, all big and grown up, literally! I can remember how easily you could play the role of my baby doll, and competing with Kim for who got to hold you. Now you tower over me, and the days when I could tickle you and beat you up are long gone. Not only have you grown physically, but you have developed a personality and character that cracks me up and I really enjoy hanging out with you. Although I miss the days when we knew everything there was to know about Pokemon, Dragon Ball Z, and laughed at silly parts from the Jungle Book, I really love watching you rock out on your drum, and making such smooth music with your sax. Like Kim, you have such a great skill at making music that is not only a pleasure to listen to, but so impressive to watch as you fuel your tunes with passion.

My best friend, my AlliMama. I can still remember back to the days of freshman year of college, going to Starbucks with you, looking like a total New Yorker, with the coolest hats, scarves, gloves, sunglasses, EVERYTHING! Obviously if I can find another person with illegal Argentinian documentation, we were meant to be best friends. Fast forward to the days of delicious brownies, broken hearts, and David Guetta. Junior year brought new faces, new romances, new career goals, and the mysteries of the Ouija board. Come Senior year…well. Let’s not even get started on that madness. How was it that I got through 18 years of my life without you in it? I can’t even begin to tell you how incredibly blessed I feel for having such a loving, caring, overwhelming burst of a best friend like you. I hate how our lives have brought us to different parts of the state, and our schedules are so hectic that we have no catch up time, but regardless, I have never once felt like we were growing apart in our friendship, and I feel that is what takes people beyond the level of friendship, and making them more like sisters.

With no less love and tenderness, but getting tired of being so sappy for one post….I have been so fortunate to be blessed with wonderful friends throughout the years that I have shared some crazy awesome moments with. Through thick and thin, you know I gotcha back!! A great saying by Bernard Meltzer pretty much sums up the fantastic group of friends I have: “A true friend is someone who thinks that you are a good egg even though he knows that you are slightly cracked.”

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Save Your Cervix….Stop Smoking NOW!

For more information on smoking addiction and how to quit, visit: http://www.drugabuse.gov/PDF/TobaccoRRS_v16.pdf

With the transmission of HPV and subsequent development of cervical neoplasias on the rise, it is critical to assess possible risk factors to promote early detection and treatment of problems. Due to the variety of medical complications that have been associated with tobacco smoking, it is no wonder the study conducted by Sierra-Torres, Tyring, and Au (2003) sought to investigate the link between smoking and cervical abnormalities. Past studies have similarly examined this relationship, and chemical components of cigarettes, such as nicotine, cotinine, and N-nitrosamines were identified in the cervical mucosa of smokers (McCann, Irwin, & Walton, 1992). In the case controlled study by Sierra-Torres et al. (2003), women were interviewed who were seeking dysplasia evaluation for abnormal pap results via colposcopy to collect demographic data, such as age, sexual history, history of smoking, and family histories. Out of 272 women, 114 had a biopsy that showed cervical intraepithelial neoplasia or invasive cervical carcinoma, and were thus assigned to the case group, and the remainder assigned to the healthy control group. When assessing the HPV status of all the subjects, investigators found 92% of women in the case group were infected with HPV, and 13% of women in the control group. This finding strongly emphasizes the link between HPV infection and cervical dysplasia.

When investigators examined the correlation of cigarette smoking between the two groups, they found that having past history of smoking increased the risk of cervical cancer two fold. Further data revealed that women with a history of at least 15 years of smoking were nearly 4 times more likely to develop cervical cancer than the non-smoking counterparts (Sierra-Torres et al., 2003). The basis for the rationale for smoking’s contribution to cervical cancer relies on the presence of cigarette chemical components in the cervix. The belief is that these carcinogenic chemicals produce a decreased immune surveillance and subsequent predisposition for infections and abnormal cell proliferation (Prokopczyk, Cox, & Hoffmann, 1997).  This information is critical to health promotion and prevention tactics by informing women of the necessity for smoking cessation, especially in the presence of other risk factors, to reduce the risk for cervical cancer.

Similarly, smoking also markedly increases the risk for breast cancer.

Looking at the effects of smoking on the vascular components of the body, it’s not surprising to know that smoking can give you softies.

To sum it all up…by smoking cigarettes, we risk losing vaginas, losing boobies, and losing erections. If there is no other better reason to quit smoking…. For more information on smoking addiction and how to quit, visit: http://www.drugabuse.gov/PDF/TobaccoRRS_v16.pdf

Feeling tired lately?

Chronic fatigue syndrome is a debilitating disorder in which the individual experiences prolonged weakness and fatigue, that is not relieved with rest. This disorder primarily affects women, predominantly of ages 40-59, often occurring in cycles of relapses and remission (Center for Disease Control [CDC], 2010). Up until recent years, the has been a widespread misunderstanding of chronic fatigue syndrome, often being thought of as a mental impingement, or symptom of depression, limiting the extent of accurate diagnosis and treatment (Rosati, 2008). The International Chronic Fatigue Study Group ([ICFSG] 1994) standardized a case definition of diagnostic criteria, stating:

All people suffering from CFS experience severe, all-consuming mental and physical fatigue that is not relieved by rest. The fatigue can be worsened by minimal physical or mental exertion. Although the formal diagnosis of CFS requires fatigue of at least 6 months’ duration.

Treatment of CFS is often through supportive management of symptoms, however many research studies are currently in effect to evaluate pharmacologic interventions (Rosati, 2008).

Because this disease is so complex, and being seen increasing in incidence with medical advancement, health care providers need to have knowledge of therapeutic modalities to individualize care according to the many unique presentations of the disorder. This further exemplifies the need for adequate review of systems, and obtaining a thorough history of present illness to determine what specific problems the patient is experiencing, and being able to tailor treatment and management to their specific needs.

 

Reference:

Center for Disease Control [CDC], (2010). Chronic fatigue syndrome. Retrieved from:

http://www.cdc.gov/cfs/general/treatment/index.html.

International Chronic Fatigue Study Group, (1994). The chronic fatigue syndrome: A

comprehensive approach to its definition and study. Annual International Medicine, 121: 953-958.

Rosati, P (2008). Chronic fatigue syndrome: Implications for women and their health care

providers during the childbearing years. Journal of Midwifery & Women’s Health

53(4): 289-301

 

Infectious Diabetes

Love this illustration!!

Diabetes is a chronic disease that affects the way glucose is utilized in the body. The necessary mediator for glucose uptake and utilization is via a substance produced in the pancreas called insulin. Although factors associated with insulin are the primary causes of diabetes, the two types have very different pathologies in relation to insulin. Type one, known as insulin dependant, results from an insufficient insulin production, where the cells need glucose from the blood, but there is no insulin production to facilitate glucose transport into the cell. Type two is non-insulin dependant, and is associated with normal insulin production, with cellular resistance (Kumar, 2010).

Although there have been many hypotheses developed to describe the etiology of diabetes mellitus, one study by Barbeau, Bassaganya-Riera, and Hontecillas (2007) suggests that hygiene may be a significant factor in the development of type 1 diabetes, in what they refer to as a “hygiene hypothesis.” In this hypothesis, it is thought that individuals with a predisposition to diabetes that are more frequently exposed to infections have a lesser incidence of developing the disease. Epidemiological statistics supporting this theory show that there are significantly lower prevalence rates of diabetes type one in areas that are prone to infections, such as the tropics, as well as in highly populated areas, where infections can be spread easily and children are exposed at an early age (Barbeau et al., 2007). Furthermore, Barbeau et al. (2007) explains that, in an experiment involving mice with a genetic predisposition for diabetes, mice that were raised in a pathogen free environment had higher rates of diabetes development than other genetically predisposed mice raised in normal conditions with exposure to various pathogens such as viruses and parasites. The rational for then phenomenon is linked to the idea that diabetes is a disease of autoimmunity. Barbeau et al. (2007) advocates that “the protective role of infections observed in human autoimmune diseases may be due in part to “antigen competition (Bach, 2001),” in which, theoretically, if the immune system is preoccupied with infectious agents and inflammation, there would be a “down-regulation” in the development of diabetes (Barbeau et al., 2007). In addition, identical twin studies showed that the numbers of CD45RO+ CD4+ lymphocytes (immune cells involved in the inflammatory response) are higher in the twin without diabetes, than in the twin that does have diabetes, with a concordance rate of at least 50% (Wu, 2005).

These finding present many aspects of controversy to health care providers. When assessing a client with a family history of diabetes, it is important to consider these findings in educating our patients. Generally, when managing diabetes, it is beneficial to advise clients to avoid potential situations that promote exposure to pathogens, due to the increased susceptibility for infections that diabetics typically acquire (Kumar, 2010). When discussing with patients with a genetic predisposition, it might be beneficial to suggest the idea of early exposure to benign pathogens that might be a possible strategy for prevention. Furthermore, this provides a foundation for health care providers to seek more information through conducting more research on the subject in order to better accommodate or decline this theory.

References

Bach, J. (2001) Protective role of infections and vaccinations on autoimmune diseases,

Journal of Autoimmunity, 16: p. 347–353.

Barbeau, W., Bassaganya-Riera, J., & Hontecillas, R. (2007). Putting the pieces of the puzzle

together – a series of hypotheses on the etiology and pathogenesis of type 1diabetes.

Medical Hypotheses, 68(3): 607-619.

Kumar, V., (2010) Endocrine disease: Diabetes mellitus. Robbins and Cotran:

Pathologic basis of disease, 8th Ed. Online Case Studies. Philadelphia: Elsevier

Wu, D. (2005). Bacterial glycolipids and analogs as antigens for CD1d-restricted NKT cells,

Proceedings of the National Academy of Sciences of the United States of America, 102:

p.1351–1356

 

Sexuality….and what??

As my professor quoted today in class:

“Sexuality is the birth of self awareness.”

This statement is in regards to sexuality as being a normal, natural way of life. As ARNP’s, we are being taught that it is important to make our clients feel comfortable discussing their sexuality; not only is it an important physiologic aspect relating to reproduction and other body systems, but sexuality is a big contributor to quality of life. It is important to provide people the opportunity to explore their naturally sexual nature, and offer help and insight to improving sexual health. Our society has allowed individuals to take the role of passive  acceptance in regards to sexual dysfunction and decreased sexual satisfaction. We want to let people know, that sexuality is an important way of life. Humans were created to be sexual beings, and people should not feel ashamed, or embarrassed to discuss sexual function to improve not only quality of interpersonal relationships, but also enhancing quality of life.
This website has some great information about the importance of sexual health in older adults: http://www.nursingcenter.com/pdf.asp?AID=800532

Furthermore, it has been a few years since I have been in high school, but our discussion today involved the fact that schools in Florida today are now required to teach abstinence, rather than sexual education. Because all of the students in my class have not been in grade school for a while, we all had a big WTF?! response. Is the belief among the school board members really that NOT providing information about practicing sex really going to prevent kids from having sex?? Let’s look at the potential consequences here…

“Sex is bad. Sex is bad. Sex is BAD!!” Not only are we avoiding the the issue of sexual practices, and not providing information about safe sex and protection, but we are also instilling the belief that, what? “Sex is bad!” By putting this influence on teenagers (who are going to have sex regardless of what we do, and do not tell them), we are also passing judgement on those that have sex, which may lead them to feel afraid, and not seek help or guidance from adults and peers if they do have problems or questions. Furthermore, without providing sexual education in the school system, we are allowing myths about sex to circulate with ignorance about sexual safety.

Lets cut the conservative nonsense about promoting abstinence, and lets be freaking realistic here. Teenagers are going to have sex!! Instead of lecturing them and telling them not to, lets educate them about how to go about it safely! Here is a link to a great study from the Center for Disease Control and Prevention that has looked at the realistic side of adolescent lifestyles and behaviors. Enjoy. http://www.cdc.gov/mmwr/pdf/ss/ss5905.pdf

In conclusion, to those reading this that serve as a role model for today’s youth, whether being a health care provider, nurse, teacher, or parent, keep in mind the suggestion of making yourself as an available source to give information and education about safe sex and protection. As these kids go through puberty and adolescence, the are going to be curious, they are going to have questions. Keep an open mind and make yourself available to them, so they can come to you with out feeling like they will be judged or penalized, so they can get the correct information, as opposed to seeking help from the wrong sources.

Have a Blessed day!! ❤

Breast Cancer and Oral Contraceptives

Just another Mini Paper with some interesting information….

For many years, there has always been a great debate over whether the use of oral contraceptives (OC) plays a role in the development of breast cancer. Most researchers have conducted that generally, there is no significant correlation between the two. Recently, a study by Ursin et al. (1998) set to investigate the specifics of oral contraceptive use in breast cancer cases. Their findings were remarkable in that significantly higher incidences of breast cancer were associated with age of starting OCs, length of time of OC use, and length of time between last OC use and cancer development (Ursin et al., 1998). They determined that the greatest numbers of cases were seen in women who had started taking OC only after the age of 18, and specifically between the ages of 20-24 years. Additionally, the highest numbers of breast cancer cases were in women that had used OC for 1-48 months, specifically in 1-11 months, with a significant decline in the number of cases where the women used OC for longer than 48 months. Furthermore, other than the category of cases of women who had last used OC more than 60 months before breast cancer (420 cases), the next greatest numbers of cases of breast cancer were in the women who had last used OC in 0-11 months (Ursin et al., 1998).

These finding suggest that contrary to prior belief, there is some amount of association between oral contraceptives and breast cancer development in women under 40. When looking at the statistics from this study, it is apparent that women who begun their birth control in their early 20’s (ideal child bearing age), appear significantly more at risk than older or younger age groups. There is also the possibility that short-term use is more associated with breast cancer development, because we can see by the numbers that as OC use became more long term, there was significant decline in cases of breast cancer. Finally, we also see that there appears to be a link between women that are or were currently taking OC when they were diagnosed with breast cancer, as opposed to those who had discontinued use in months prior to diagnosis.

This study has a huge impact to health care providers that prescribe oral contraceptives frequently in their practice. Even more significant is to those that are frequently dealing with a younger population. These are important factors to keep in mind when prescribing OCs, and especially using this information to further encourage women using OC to perform monthly self breast exams and breast cancer screenings. Furthermore, these statistics should be especially of concern to women that have a significant family history of breast cancer, and in using better clinical judgments in when to seek alternative methods of contraception for these clients.

Reference:

Ursin G., Ross, R., Sullivan-Halley, J., Hanisch, R., Henderson, B., & Bernstein, L., (1998). Use

of oral contraceptives and risk of breast cancer in young women. Breast Cancer Research and Treatment, 50(2): 175-184