March 2013
Blog

March 2013 posts

What is Gastroenteritis?

This past week, Britain’s Queen Elizabeth II was hospitalized with a “stomach bug”. Gastroenteritis (also called the “stomach flu”) is the second most common illness in the United States. So, chances are good that your family has been affected by gastroenteritis already this year!

What are the symptoms of gastroenteritis?
Gastroenteritis is inflammation of the stomach and intestines causing symptoms of diarrhea, vomiting, cramping, and fever. If a person is not able to keep up with fluid losses from diarrhea and vomiting, then they can become dehydrated. Gastroenteritis occurs year-round and affects people of all ages. Those who are young, old, or have a suppressed immune system are more susceptible to severe gastroenteritis and to dehydration.

What causes gastroenteritis?
The majority of cases are caused by a viral infection (occasionally, a bacterial infection) transmitted through contact with another sick person or contaminated food/drink.

I have gastroenteritis, how can I feel better?
Rest and fluids! Staying hydrated is the most important step to controlling gastroenteritis. Some good options for staying hydrated include sports drinks or oral rehydration solutions (such as Pedialyte in drug and grocery stores).

I typically do not recommend any anti-diarrheal medications as this may even prolong the illness. In addition, antibiotic therapy is not helpful unless a specific bacterial cause is identified.

When should I call my doctor?
If you have questions or concerns you should always call your provider. However, things to watch for if you have gastroenteritis include:

Clinical Trials and Personalized Medicine - Interpreting Studies

Medicine does not search for truth. It searches for cure. It does not look for the universal, it tries to create exceptions.

Medicine emerged from witchcraft. It has always utilized the most advanced technology of its day. Medical models and reasoning always evolve and that evolution makes the previous model obsolete. One of the foundation models of modern medicine is the randomized controlled clinical trial.

The principal of the randomized controlled clinical trial is that a single observation needs to be validated and reproduced. The clinical trial provides an estimate of how often a particular observation will occur. It tells us that chemotherapy improves survival for patients with non-small cell lung cancer at one year from 20% to 29%. It tells us that FOLFOX treatment for advanced colon cancer gives a median time to progression of 8.7 months, response rate of 45%, and median survival time of 19.5 Months. This is accurate information about populations. It's use for the individual is a difficult problem.

Every person is a unit, no one is 20% or 29% or 45%. The question is...

The Art of Nursing Complements the Science of Medicine

I first had the opportunity to speak with Sue Averill, one of Swedish's many incredible nurses, last year. As you may have read in her prior post, she's doing incredible work to serve in communities around the world, and shared a story from her recent work in Haiti that illustrates the art of nursing:

Last month I traveled with other nurses and doctors to Port Au Prince, Haiti, with Project Medishare, working at Bernard Mevs, the only neuro-surgical and trauma facility in the region. Project Medishare’s goal is to train Haitian doctors and nurses and to establish sustainable programs so the facility can function independently beyond the departure of expats. Among my role as ER and Triage nurse, I was anointed “The Hysteric Whisperer."

Many teenage girls and young women came to the hospital via ambulance or private vehicle presenting in catatonic states, hyperventilating or as “post-ictal seizure” patients. We soon learned that these were anxiety/panic attacks. One teenage girl was brought with ambulance lights blazing and sirens blaring for "seizures" – but made eye contact and was purposefully moving around in the gurney - not in a post-ictal state. The doctor approached the patient and shouted, "Prepare to intubate!"

Intubation was certainly not necessary. Three minutes later, I held the girl’s hands and helped her off the gurney and onto a chair.

With an astounded look on his face, the doctor asked “How did you do that? That was magic!” I ...

Results 22-24 of 24