Surgery and Infections: What to do/know before you go.

Having surgery? YOU should expect safe healthcare everywhere care is given, including doctor's offices, surgery centers, physical/occupational clinics, and other outpatient care practices.

Having any type of surgery can be both necessary and stressful. It can raise questions including: What is the recovery process? How long will I be out of work? What do I do after leaving the hospital or surgery center?
Another important question patients should consider is: How do I avoid getting a surgical site infection (SSI)?
An SSI is an infection patients can get during or after surgery. SSIs happen on any part of the body where surgery takes place. Surgical site infections can sometimes be infections involving the skin only. Other surgical site infections are more serious and can involve tissues under the skin, organs, or implanted material.
These infections can make recovery from surgery more difficult because they can cause additional illness, stress, and cost. Therefore, it is important that appropriate prevention efforts are taken.
To prevent surgical site infections, doctors, nurses and other healthcare providers will take several measures to ensure that the surgical site is as clean as possible, including:

• Cleaning their hands and arms up to the elbows with an antiseptic agent just before the surgery
• Wearing hair covers, masks, gowns, and gloves during surgery to keep the surgery area clean
• When indicated, giving you antibiotics before surgery starts
• Cleaning the skin at the surgery site with a special soap that kills germs

How can you and your loved ones safeguard against surgical site infections?

• Prior to your surgery, discuss other health problems, such as diabetes, with your doctor. These issues could affect your surgery and your treatment.
• If you smoke, quit. Patients who smoke get more infections.
• Follow your doctor's instructions for cleaning your skin before your surgery. For example, if your doctor recommends using a special soap before surgery, make sure you do so.
• Ask if you need to get antibiotics prior to surgery.

After surgery, be sure to follow the recommendations below to protect against surgical site infection.

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• Ask your healthcare provider to clean their hands with soap and water or an alcohol-based hand rub before they examine you or check your wound.
• Ensure family and friends clean their hands before and after visiting you.
• Do not allow visitors to touch the surgical wound or dressings.
• Make sure you understand how to care for your wound before you leave the medical facility.
• Always clean your hands before and after caring for your wound.
• If you have any symptoms of an infection, such as redness and pain at the surgery site, drainage, or fever, call your doctor immediately.

Tiles, hand made, for my future bathroom remodel

For the past 6 weeks I've been learning about making clay/ceramic tile for my bathroom remodel. Sparked by my building the wood fired oven in the front of the house. We've been talking about this for 2-3 years and are getting close. I've done all the research and know what I want. I'm planning to make tile that embodies all the flora and fauna of the forest we live in. Trees, frogs, birds, under story plants and yes....even the slugs who make me crazy. The tile research has been a LOT of fun and has sparked the ceramic neurons in my archival brain. I'm working at Open Arts Studio, just 5 blocks from work. They've been very nice and give me run of the place as long as someone's there when I'm working. I go in after work on Mondays and any other time I can get away. I took a ceramics class my senior year in college and then when I REALLY needed to get out of the house after all the boys were born (3 boys in 4.5 years). Haven't done any ceramics since but boy, has this stirred the creative juices!
Today Wayne and I took a field trip to Seattle Pottery Supply and then to Seattle Woodcraft in the SODO district of Seattle. I'm looking at a potting wheel (used) and Wayne is very interested in kilns - gas, electric and even wood fired (it's the engineer in him). He sat and read the books on Raku kilns while I wandered the store....drooling the whole time.
We have room and I even have a studio....it just needs heat. It's fine in the spring/summer/fall but it's 30 degrees here right now and pretty cold to work with clay.
I love losing myself in the creative process! When work sucks, I can go and play with art.....always a great mini vacation. MUCH better than doing bodily harm....don't you think?

Pic of the tile to follow.....soon.

Where are all the science majors?

The New York Times recently published an article titled:

Why Science Majors Change Their Minds (It’s Just So Darn Hard)

The article talks about how hard science is. It's not all fun and games and many either drop out or switch to something a bit easier.

For those of us who finished or are now a part of science I have to admit....it was not easy. It's STILL not always easy. Sometimes I actually had to read a chapter more than once....in fact 4,5, or even 10 times. 

The concepts are sometimes hard and rarely easy. What does this mean? Are American students lazy or simply unprepared? Is the science different or have we spawned a crop of whiners and weenies? Is it possibly have anything to do with the fact that academic science in general does NOT pay well and the number of positions are very limited?

The answer....just like when you took those multiple choice tests....it's "D" - all the above. (I hated those tests....A, B or C and then "D"-all the above, "E"-none of the above, "F"-A and B only, etc etc etc.)

(A) It's true, we are turning out high school grads that have no concept of what science does nor how it works. What little science they get is bland, blah and out of a book. The days of exciting science in high schools or - heaven forbid...junior high - has become a thing of the past. It's all about routine facts out of a book. Microscopes and telescopes are disappearing from the classroom.That's, of course, IF you don't get the "Creationist" version of biology when you get no real science at all. It's unimaginative and at least here in Washington State - the teachers MUST teach to the WASL test. The bottom line on this argument....kids are not getting a solid science education that will sustain them once they get to college. YES...the science in college is a lot harder! You need to actually study and that means not just reading the book/chapter/paper just once....it takes a lot of work to shove in all the info. The first year is the worst, before you can get to the fun stuff you need a foundation. It's designed to weed out the kids that can't cut it.

(B) Does science pay well? YES! BUT....you need to study something practical to get paid. Engineering? You bet....LOTS of jobs and good money. Advanced degrees are not necessary to work in industry. Is it hard? ABSOLUTELY! LOTS of math and physics. Botany? Not so much although just as hard. You need advanced degrees to get anywhere. Few jobs, not so much money. Interesting work? YES! Do we need botanists? YES. Microbiologists? Yes on the jobs but to get ahead you need advanced degrees or training. Money.....it depends. Do we need microbiologists or virologists? YES! Psychology...some would say this is not a real science - but that's my take on it. Jobs? Few and far between - advanced degrees are assumed.

(C) Academic jobs (post doctoral) jobs are very few and hard to come by. They do not pay well (at least to start) and forget it if there's someone in the job you want with tenure. This is after you've spent 4-6-8 or more years after your BS degree. The cost....starts at around $100K. You could be old before you pay off all your school loans.

So, yes...it's hard. Stop whining. It's cool work and sooooo stimulating...every day is a new day and those of us who do it love what we do. There ARE jobs out there but you need to be smart and pick a field where there are jobs to find. Otherwise....just do what you love and learn to do with less. Think of it this way...it's not that you're not making enough money....you're spending more than you need to. If you love what you do and feel you're making a difference that's enough. Marie Curie did not make enough to live in a 5000 square foot house on the beach with 4 TVs and 3 new cars with a motor home and quads. She lived simply but lived a significant life.

Buckle down and Buck up! READ that chapter over and over....don't give up, do the problems again and again until you get it right. We all will retire one day. Someone needs to be there to continue the work we've started.

 

10 Things to know about the seasonal flu vaccine - (WITH references)

Here are ten things to know about the seasonal trivalent influenza vaccine.

There is a new intradermal product in the mix. I actually got this along with my office mates. I LOVE it! No issues. Some of my office mate had some itching and swelling, just localized reactions. I had NO issues. I can see this would be a great alternative for those who had "needle phobia". It's just a little skin puncture. Easy.

(1) The H1N1 (derived from the pandemic 2009 influenza virus) and H3N2 A antigens and the B antigen are the same as last year. Essentially, it's the same vaccine we got last year.

(2) The Advisory Committee for Immunization Practices (ACIP) recommends vaccination for everyone six months of age and older, including pregnant women, without a specific contraindication.

(3) Protective serum antibody levels are reached in adults about 2 weeks post-vaccination and persist for at least 6-8 months.

(4) The vaccine should be offered as soon as it is available until the end of the flu season (May).

(5) FluMist is a cold-attenuated live virus vaccine approved only for healthy non-pregnant persons 2-49 years old.  FluMist seems to be more effective than the IM vaccine in children whereas the converse is generally true in adults.

(6) FluMist recipients may shed virus for a few days after vaccination, but person-to-person transmission has been rare and vaccine virus is unlikely to cause serious disease (which has never been reported) since it cannot replicate above 37 degrees C.  Nonetheless, FluMist recipients should avoid close contact with severely immunocompromised persons for 7 days after vaccination.

(7) Intradermal administration theoretically improves immunogenicity because of the high vascularity and large concentration of antigen-presenting cells in the dermis.  Fluzone Intradermal is 0.1 ml (not 0.5 ml) per dose, is injected through a shorter needle, and only has 9 mcg of influenza hemagglutinin antigen from each strain (the usual is 15 mcg).  Limited data indicate immune response comparable to the IM vaccine, but no published studies on the clinical efficacy of the vaccine against infection or illness are available. (we'll see how I do). The last time I had the REAL flu I felt like I was going to die....my skin hurt, my hair hurt. After that learning experience....I always get the shot.

(8) Fluzone High-Dose, an alternative to the standard IM vaccine for patients 65 and older, contains 60 mcg of hemagglutinin antigen from each strain (4x the usual).  It causes more injection-site reactions than the standard vaccine (as does Fluzone Intradermal, by the way).

(9) Influenza vaccination has very rarely been associated with Guillain-Barre syndrome, but so has influenza infection itself.

(10) Dosing of IM vaccine: 0.5 ml x1 if 3 years or older, 0.25 ml x1 if 6-35 months old.  Children <9 years old being vaccinated for the first time should receive two doses separated by at least 4 weeks (second dose given before December if possible).  Since this year's vaccine is the same as last year, children <9 who received only one dose of vaccine last year require only one dose this year (normally they would receive two).  Dosing of FluMist: 0.1 ml in each nostril x1; children 2-8 years being vaccinated for the first time should do this twice (separated by at least 4 weeks).

(11) BOTTOM LINE....GO GET YOUR FLU SHOT/INTERDERMAL INJECTION.  

REFERENCE

Influenza vaccine for 2011-2012.  Med Letter Drugs Ther 2011; 53: 81-83.

Turkey leftovers? My favorite = Turkey pot pie

I grew up (as many of us did) with frozen chicken/turkey pot pies from Swanson. I know, I know.....we really don't like to admit it....but we did. I can remember buying several while in college and eating them during finals week. Very comforting but.....NOT very good for me dietary wise.
I STILL love pot pies. The good news is that they are very easy to make and now with leftovers of the turkey kind.....all the ingredients are just waiting. Here's my recipe:
First - decide what kind of crust you want. Do you have flour, fat (butter, shortening, etc) and water....pie crust works wonderfully. If you have a sheet of puff pastry in your freezer (who doesn't, right?) use this. Do you have leftover potatoes? These are made to order! Since this is about leftovers...lets assume this is what we'll use.
For the filling:
Saute onion, celery, and any vegetable you have in a bit of olive oil until just brown. I love carrots so add these, diced. Have any leftover vegetables? (Squash, peas, beans, etc) add them now. Add cubed turkey and heat through. Leftover gravy? Add this now. No leftover gravy? Don't let this stop you....use chicken stock. White wine is awesome too!
Thin a bit or cook down to a nice sauce. If you want to add any frozen vegis....now is the time. Have leftover cream or half and half....add if you want, depending on your cholesterol tolerance.
When it's nice and bubbly, add to ramekins for small pies or a baking dish appropriate to how much filling you have.
Top with your topping, puff pastry, mashed potatoes, crust. I like to sprinkle with cheese, just a bit. Use what you have. Tuck in the edges. Cut slits in the top if using crust to let the steam out.
Pop into a 375 degree oven and bake until the top is golden brown. The filling is already cooked so it just needs to bubble to be ready. DON'T forget to put them on a baking sheet to collect the bubbled over filling. They can make a HUGE mess in your oven.

The best part of leftovers!

Let it cool so you can eat it. Add a salad......probably leftover too, right? Mmmmmmm!
 So, these are soooo much better than those frozen pies you have NO idea! Here's something good too......more than you can eat at one sitting? FREEZE THEM! Wrap in foil and plastic wrap and then in a zip-lock bag. JUST the thing during finals week-----again!