Honey – Oh let me count the ways that Honey is amazing and tasty! Honey seems to have it all. Honey is an anti-inflammatory, antimicrobial and moisturizing for the skin. Honey has been known to help treat acne, soothe a sunburn, and even lighten scars. Clinical research has actual shown Honey to be effective in healing wounds from burns. Honey has shown anti-carcinogenic effects In vitro in a model of melanoma – however more research is needed to its complete value in the dermatologic treat of melanoma.
Turmeric (Curcuma longa)– This simple spice from the cabinet contains antioxidant, antimicrobial, and anti-inflammatory components. Some use Turmeric orally to help with their anti-inflammatory diet. Please speak with your health care provider before ingesting Turmeric as it can have a blood thinning effect. Topically Turmeric has been known to keep its anti-inflammatory components. It has been shown to calm redness and reduction the appearance of scarring, fight acne and brighten the skin. There is even some research that show curcumin might help decrease UV damage and may even boost collagen production. There are some lab and clinical studies that are investigating how Turmeric may help with Psoriasis due to the down regulation of Interleukins and TNF-a (Tumor Necrosis Factor) Turmeric is commonly found in Indian dishes such as curry. https://pubmed.ncbi.nlm.nih.gov/29484027/
Hemp (Cannabis Sativa)has been all the rage lately.Hemp contains Omega Fatty Acids. These fatty acids can help reduce redness and inflammation. Those with eczema or Rosacea may find a benefit from this non-comedogenic oil.
“Evidence suggests that phyto-, endo-, and synthetic cannabinoids contain properties that aid in the treatment of the brain, prostate, breast, skin, pancreas, and colon cancer.”
Vitamin E oil is a fat-soluble antioxidant. It is commonly used on scars and other skin imperfections. It has been used in dermatology and cosmetic products for years by acting as a free-radial scavenger. Some studies have suggested Vitamin E has antitumorigenic and photoprotective properties. Vitamin E is made by plants and dietary sources, such as, nuts, spinach, olive oil, sunflower oil, and whole grains. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4976416/
Colloidal Oats is an old topical treatment for various skin conditions. The oil acts as a skin barrier, anti-inflammatory and antioxidant. Antibacterial is still up for debate. Avenanthramide are phenolic compounds in the oats that inhibit NF-kB activation and inhibits cytokines.
Activated Charcoal is activated Carbon that is highly absorbent. It is still used orally for medical overdoses due to its ability to absorb. It is not as commonly practiced as it once was due to the duration of certain toxins in the stomach. Activated Charcoal has natural antibacterial properties and when used topically may help lift bacteria and remove impurities from pores. Thus, may help reduce acne and improve overall skin health. Anecdotally some has said it helps with itching. While there is anecdotal evidence of the topical benefits there are limited studies. My personal experience has been – activated charcoal soap works best on hard to clean areas. Especially the hands of mechanics and painters. This works great on oils and permanent paints.
***Resources from the National Library of Medicine National Institutes of Health and Pubmed.***
Hmm, I’m not sure. But It seems to incorporate everything I like. Creativity, happiness, cleanliness, and it helps people. Soap can help everyone and washing with soap has been one of the greatest discoveries in medicine. Why not fight illness with something functional and creative?!
I also like to learn new things and I have always enjoyed chemistry, but never to its fullest. Now I understand things so much more. Detergents vs no detergents. How can I get oil and water to mix?! Scented vs non scented. Essential oils vs Fragrance oils. What can I use as a binding agent?
Growing up I almost never used soap to clean my body. I always seemed to experience more acne and never knew why. I’m 41 years old now and I finally know why. I have a sensitivity to Sodium Lauryl Sulfate, a commonly used detergent in soap, shampoos, cleaners, and laundry detergents. Is there anything wrong with Sodium Lauryl Sulfate (SLS). . . No. Unless it causes you are problem.
Did you know there is more than one type of soap?! There is water soluble and non-water soluble. Non water soluble is commonly made by Cold or Hot process and can take days to weeks before it can be used for cleaning the body. While Cold process CAN be purely vegan, it most commonly involves using animal fat (Tallow). So yes, you may be rubbing your body with animal lard every time you bath. There is NOTHING wrong with cleaning yourself with animal fat. I personally am of the mind that if an animal is to be killed (food), then the ENTIRE animal should be used. No, Im not a part of PETA but I do have a tender heart for animals.
Most of the soaps I work with are water soluble and do not involve tallow. Though, sometimes I dabble. I will say for the most part, I do not want to wait more than a week to use a bar of soap.
Lavender. . . everyone loves lavender. I have always had such a headache with this smell. Why? How can that be? Isn’t it supposed to be calming? Well- essential oils come from the oil of the actual flower or herb, while fragrances are artificial. However, essential oils can actually cause more nasal and skin allergies, simply because it comes from the oils of nature. There are some flowers that we can not extract the oil from and we are forced to use an artificial Fragrance in order to replicate the scent we enjoy.
At some point I will be posting a little cheat sheet of what nature has given us to help us in this world- None of which will be medical advice. I can make no claims that any of the ingredients in soaps can treat an ailment. As nothing has been fully evaluated by the FDA.
This blog is to update those who are interested in the EU of the Covid 19 Vaccine Moderna.
A quick review of the 2 Emergency approved Vaccines: Pfizer and Moderna.
Quick review of Pfizer and Moderna Vaccine differences
2 shots – 21 days a part
2 shots – 28 days a part (+/- 2 days in each direction of 2nd Vac)
Ultra freezer storage
32 General freezer
30,000 participants – I know some personally
16 years old +
18 years old +
There are currently studies with enrolled children 16yrs old. Some are my colleagues children.
No- it does not inject genetic material into your body. It inserts instructions (a playbook, for the sports fans) to respond to a foreign invader (COVID-19 19). So, this kind of vaccine could actually be safer than other vaccines because it just teaches our cells HOW to fight rather than introducing an empty shell of an invader without instructions of how to fight them.
Why did I decide to get an Emergency Usage vaccine instead of waiting for one to be officially approved? Although not approved, they are deemed safe enough to be administered in an emergency. Initially, I wanted to wait about a year. While I believe in science, I am a natural skeptic. Then I began to think about the people I care about and who I know that CAN get the vaccine. Child- NO, Husband – No, Mom and Dad- Not for a long while (might not even given the option anyway), In laws (not for a while), closest friends – No, my friends children – No. Hmm, so really I was/ am the only one who can actually DO SOMETHING to help those I care about. My last ER shift was last week. Every headache, sore throat, sniffle, or food that seemed off made me concerned that I might have COVID-19. Because I chose a career that put me at risk also put my loved ones at risk. What if I gave my son MIS-C from COVID-19?! I could never live with myself if I gave anyone I care about COVID-19 and they died.
Day 0 Moderna Vaccination DAY!!
I received my Moderna vaccine in my left arm on 12/27 at 4:15pm. I received the vaccine at the hospital where I work. The vaccination was far less painful than any vaccine I have ever received before. No, it was not cold. The vaccine must thaw or warm before it can be given. While working in the ER the previous week I had a discussion with a patient, and they expressed how painful and difficult it must be to receive the vaccine because of the temperature. I’m not going to lie; this briefly crossed my mind as well in the prior months to approval. However, I am educated about vaccines and injections, so it was a fleeting thought. Sometimes it can be difficult to remember that what is common knowledge to me is not common knowledge to everyone else. And yes, I did get a photo for my “Gram” at Pa_moments.
Not everyone in my life has voiced support about getting the vaccine. Rather they have chosen silence, which is probably the most respectful. Though I have difficulty understanding how someone can be so overtly supportive of a soldier getting shot in service to our country and not support me in receiving a shot in service to the entire world.
I have not seen the amount or severity of COVID-19 that other providers have seen. Though I have and presently see the entire Emergency Room Full of admitted COVID-19 patients. Patients are lined up on the walls of the ER and down the Hallways that connect to the ER because the ER and ICU are full.
After the injection I had to wait for 15 minutes in the same room so I could be monitored for immediate reactions. None! So off I went to inform my friends and family and social media platforms, of course.
I had no arm soreness that evening. I did have a wave of fatigue around 7:30pm and I thought I would not have the energy to shower. BUT I took my shower and felt better. I slept very well last night. Maybe it was due to the vaccine or maybe it was due to the new 12lb weighted blanket I received for Christmas.
Day 1 PV (Post Vaccination) 12/28
I woke up with a sore Left arm. Worse with movement. There was no bruising noted. Otherwise, I went about my day without side effects that I could relate to the vaccine. Don’t forget to vote, Georgia! NOW at 2:00pm, 22 hours post injection my left arm still hurts but only when I touched. It is brutal when my son encounters my shoulder when we play. The arm no longer hurts when I move it.
Day 2 12/29
So far today has involved an intermittent sore throat. And as the day continues, I am a more and more fatigued and a bit weak. Not a normal daily tired, though. In fact I am currently in bed with my laptop typing this. My left arm is still sore but slowly improving. Some of the things that run through me mind are: Do I have COVID and just have mild symptoms? And If I do, did I get it during my last shift? How am I going to feel tomorrow? I am on shift in the ER tomorrow. Only time will tell.
Right now, I don’t even know what shifts I can pick up next week because there has been no announcement about school next week. Will it be Face 2 Face or virtual? Time for either a nap or coffee, while my child continues to watch TV.
Day 6 1/2/2021
HAPPY NEW YEAR EVERYONE!
Yes, Last year was hard. 2021 will also be hard. For some it will be much harder than 2020. The difference is 2021 seems to have light at the end of the tunnel.
At 6 days post Vaccination I have had some occasional headaches with nausea and dizziness. This seems to resolve pretty quickly AND it may be from the lack of food. The first event happened while I was in the ER on day 3 post vaccination, yesterday on day 5 also while working in the ED and then on my day off. My arm pain has completely resolved.
I am still waiting to see if I get full-blown COVID symptoms. In the last 2 days I have been in close contact with at least 100 COVID + patients. Yes, I was always wearing my itchy N-95 mask, plus a surgical mask, goggles, gloves and a gown. The Emergency rooms really are at capacity and then some. There are tents outside of the ER. COVID patients that require admission usually stay a few days and right now their stay is in an ER room and not a different room in the hospital because those beds are full too. It really is a sight to be seen in order to be understood. Please, only go the the Emergency Room if it is a true Emergency. My personal wait time to be expected at the Emergency room is 3 hours. The wait on Wednesday was 5-6 hours. Most were COVID patients.
Day 17 (1/13/21) post 1st Vaccination
I had my annual physical yesterday and besides the typical COVID weight gain that seems to have effected everyone, I am healthy. In hindsight I realize, the nausea and fatigue was definitely from the vaccination. They are completely normal post vaccination symptoms that can happen with ANY vaccination, including the yearly flu vaccination and the vaccines that are given to multiple children daily. What have I learned after personally speaking with those who are tracking these post COVID reactions? IF you have had COVID previously, then the post vaccination might be a little harder on you than someone who has not previously had COVID. Why? Now your body knows the correct response to this foreign invader. While you reaction may be a little worse post vaccine it will not last as long as your prior encounter with the REAL invader.
In other news, there is a possibility I will be transferring to the ICU to help the staff take care of the overflowing COVID Floor. YES. . . COVID FLOOR. There is no longer just an ICU – there is an entire floor of Intubated patients with COVID and there are more and more that are intubated and staying in the ER because their is no room on the COVID ICU floor. What you see on the TV and hear on the radio about the healthcare system being overburdened is true. There is NO room for Non-COVID emergencies. There are less providers available to take care of them and there is no where to put them. Please stay safe and be responsible. I am hopeful to receive my second COVID Vaccine (1/22- 1/26) before I begin my time in the ICU.
Day 26 (1/22/2021) post 1st vaccination
This past week we had a little scare with our son having a low grade fever 100.5 to a max of 102 once. He Vomited as well with minimal appetite. The only exception was ice-cream, of course. It last for one day. No nasal congestion or cough. If the pandemic was not going on he would not have seen a provider. None the less we had him test via a Rapid nasal swab for CoVid. Both strep and Covid swab were negative and he is back to his rambunctious stir crazy self.
Now I am 2 days away from my second CoVid vaccine and I am nervous because a lot of my colleagues are having reactions (similar to having the flu). We are planning our work and our sons school schedule around the potential reaction I may have.
***Check out my next Moderna Vaccination Daily experience post 2nd Vaccination!
**If there is anything specific you would like to inquire about or have me address please contact me via the contact page.
** Also, if interested – There will be some fun soaps for sale in my shop shortly. This is a great way to help 1. Stay healthy by washing more frequently 2. Helping a stressed medical provider keep everyone a little safer with a stress reliever 3. Know your purchase is not mass produced. 4. Practicing a little self care. Some are great purchases for Children who hate to wash their hands. LIKE MINE!
Former Associate Director of Clinical Education of Physician Assistant Studies
Corona virus 19 (COVID-19) first entered the US via social and mainstream media by demonstrating its initial effects on Wuhan, China. Most educators or providers first thoughts were surprise and intrigue, but not necessarily fear. Then Covid-19 completely shut down China. There were news reports on how their citizens were coping with isolation and a decreased food supply. Not to mention the fear Citizens had when leaving their homes. This was startling and surreal to many medical providers even though they were not yet affected. The virus progressed to Italy with devastating effects. Now it is in the United states. Months have come and gone with COVID 19 in our daily lives. COVID 19 was not something educators, practitioners or students had anticipated. Clinical rotations came to a screeching halt, along with outpatient clinics and elective procedures. As re-opening cautiously takes shape, we now look at how to adapt to our new world. Below are 7 Strategies PA and ARNP programs can employ to help ready their students in preparation for Clinical rotations and beyond. These strategies can not only benefit PA and ARNP program educators but can also guide APP applicants when choosing a program. Current Physician Assistant and Nurse Practitioners students should query their programs on these strategies to help relieve some anxiety about COVID-19 and their future as providers.
During the Clinical Year
Ensure all clinical students have been appropriately fitted for an N-95 mask and make sure each student is supplied with at least one mask before going out on rotations. Some Facilities require the students to have appropriate PPE before they can rotate. Applying students and current students should ask their program who will be incurring this cost. Will the appropriate fitting be scheduled and payed for by the school or will this be the student’s responsibility? Correct N-95 fit is an OSHA requirement for those taking care of COVID patients.
Have a discussion with the students about potential COVID testing and Quarantining prior to certain rotations. Some Facilities require Negative COVID Testing or have a Quarantining protocol. There are currently rapid tests and PCR tests available. Who will pay for these required tests? The student, the program or the facility? See appropriate facility for individual requirements.
Focus on more rural areas for finding clinical rotations. Individually run clinics are more likely to accept students because there is less red tape. These providers also tend to enjoy the helping hand of a student.
Discuss the possibility of Telemedicine rotations with potential Preceptors. These discussions could decrease the clinical students housing costs. They can be done as a 3-way virtual call, which works best for Behavioral Health rotations. However, there are many strategies to assess patients across many different specialties and complaints.
During the Didactic year
Train and make sure the students are comfortable with Telemedicine. Teach the students how to evaluate patients via video. A good example would be to instruct the student on telling their patient to pull down the lower eye lid to help evaluate for anemia. This not only comes in handy for clinical rotations, but this will expand the student knowledge of Telemedicine, which will be a growing industry moving forward.
Put more emphasis on ICD 10 coding during the didactic year. Why? Clinical students must be exposed to a minimum amount of a different type of patients to meet graduation requirements. Benchmarks can vary per program. These are monitored by ARC-PA. If the students are more familiar with coding – they can input more appropriate patient contacts during each rotation, regardless of the tracking system the programs use. For example, a student could code for pregnancy AND anxiety. This will help a student and the program with meeting the minimum requirements for both Women and Behavioral health rotations. In September, ARC- PA updated their standards to include ICD 10 coding.
Appropriate staffing for all portions of the program. Didactic and Clinical. Anyone can get COVID regardless of appropriate protection. One sick person adds a lot of work to other colleagues’ plates, even if equally divided. More Clinicians than ever are feeling burn out from all the changes COVID has brought to both personal and professional lives. The burn out is not isolated to those practicing clinically, but academically as well. Heavy redundancy with regards to clinical preceptors as well as academic staff and faculty can help share the burden and reduce the mental fatigue from the pandemic.
These 2 images are from the same patient who had a FOOSH event. This patient Fell On Out Stretched Hands. A FOOSH event commonly results a Distal radius fracture. This is also known as a Colle’s Fracture. The image also shows angulation and a small ulnar styloid fracture. Obvious Deformity was observed. When evaluating these patients always ensure Cap refill and pulses are present as well as Range of Motion. This particular patient had cool fingertips with a delayed cap refill. Then I compared the temperature and cap refill to the other hand. It was the same. Always make sure to compare both extremities when evaluating a patient. The patient did have a strong pulse, but was just cold. Range of motion was obviously decreased but the patient did very well regardless of pain.
Reduce the deformity and splint via a sugar tong and sent to ortho the next day. Ortho might appreciate a heads up though. If you suspect a vascular injury or compromise – immediate ortho consult is required.
You can either perform a Hematoma block for pain with oral/ IV medication or you can chose Conscious sedation. I prefer a Hematoma block as it is relatively less invasive than sedation and an easy procedure to perform. Once the patients pain is under control you can manipulate (usually with your finger on the dorsal surface of the hand where you feel the step off) the injury back in place.
Prior to reduction make sure you have a tech or someone with you who has appropriately measured the length of the patients arm and all the splint supplies ready to be applied after you have reduced the injury. You will have to hold the reduction in place until the splint has been applied appropriately.
Some providers prefer to use finger traps to help with placement of the bones post hematoma block. This is a providers preference. I personally find it helps with the reduction and sometimes the break will reduce on its own without manipulation.
The pictured wound is post biopsy. 67 year old Female previously had an injury that healed. About a month later, this growth occurred. It itched with mild discomfort. Present for about 4-6 month prior to biopsy. Biopsy results: Squamous Cell Carcinoma. Patient treated with the Mohs surgery and doing well. Squamous Cell Carcinoma (SCC) is an overgrowth of abnormal Squamous cells. Usually progresses quickly but curable with appropriate treatment. SCC can metastasize to other organs.
Good company in a journey makes the way seem shorter. — Izaak Walton