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Alli, The First FDA approved Weight Loss Drug?! (I just pooped myself)

alli.jpgIt has recently come to my attention that there is a new diet pill on the market that is FDA approved. This is big news for pharmaceuticals, who make the most money in OTC sales via diet/weight loss supplements. What will happen in the pharmaceutical war for market coverage with this new drug? What I am really excited about is not the fact that this expensive diet supplement will help obese people to manage their weight issues. No, it's not that they will be able to have a healthy lifestyle again where walking down the stairs isn't a four hour adventure. It's that these people are going to actually have to practice self control. Will it work? Alli, yes; self control, who can say? As side note, I heard a commercial on the radio the other day that started out making me think it was about Asthma but it was really for obesity. It said something along the lines of "Do you have a hard time walking to the mail box? Are you out of breath before you get there? Do you know how hard it can be to do any strenuous activities? Do you want your life back?" Now, don't you feel that this is a good lead into an asthma commercial? I did. But they they said, if you or a family member are obese and know this feeling, we invite you to try a clinical study with lasers and acupuncture. So, there you go. I really do hate it when obesity is called a disease. It is something you can control. Next thing you know people are going to be saying that laziness is a disease. And it must be cause that is why there are so many fat people. I agree that some people are probably fat because of genetics, but if you are like this, shouldn't it be more incentive to eat right and get exercise? I mean, if you know it runs in your family and you are afraid to become fat, then just do something about it. What really gets me about this commercial is that they make it sound like something else for dramatic affect, false advertising for obesity. Anyway, i digress. What the point of my story today was supposed to be was that Alli has the best dieting support plan ever. It's called "side effects". See, the whole point of Alli is that it's supposed to help you lose weight, not lose the weight for you. There are all sorts of publications on Alli now and most of them say it's a completely safe way to lose 10-20 pounds as long as you follow the directions. Please tell me which people actually follow directions on the bottle of any drug? Doctors tell you not to share prescriptions. People do. It says right on the bottle of aspirin to only take two every four to six hours, but I see people pop 10 of those little white pills at once. So, I have high hopes for Alli. Mind you, these high hopes are not because I think people will overdose on Alli. Not at all. Nope, I have hopes that people will not follow the diet and exercise program that the Alli diet plan "suggests" and that they will deal with the horrible side effects. I can't wait for those people who think "it won't happen to me" to just try to eat a yummy french fry or hamburger or piece of cake. Here is what the official website has to say about the side effects.
alliâ„¢ works by preventing the absorption of some of the fat you eat. The fat passes out of your body, so you may have bowel changes, known as treatment effects. You may get:
  • gas with oily spotting
  • loose stools
  • more frequent stools that may be hard to control
Oh boy, I can't wait for uncontrollable stool! Just think of how much fun oily spotting could be. Continue reading for the alli people's description of what's to come!

What to expect

The excess fat that passes out of your body is not harmful. In fact, you may recognize it as something that looks like the oil on top of a pizza.
Oil from on top of the pizza I am not allowed to eat coming out of my butt and laying fresh in my underwear? Sweet.
You may feel an urgent need to go to the bathroom. Until you have a sense of any treatment effects, it's probably a smart idea to wear dark pants, and bring a change of clothes with you to work
CBS news tells us that it might possibly be the holy grail of dieting. I don't know if I would go that far, though. The holy grail of dieting would be a pill that made you look like a movie star without uncontrollable oily spotting and the occasional skid mark in dark pants. But, as long as people take this diet seriously and follow the diet plan as far as eating and exercise, they probably won't poop in their pants while riding the subway or waiting in line at the grocery. Maybe. In conclusion, Alli is a lot like Santa Claus. It knows if you've been cheating. It knows if you are bad or good, so be good for goodness sake. And the sake of all those around you who will definitely be able to smell if your bowels were uncontrollable again.

Things Every Nursing Student Should Have: Part II, Palm Pilots and Programs

I left a cliffhanger of a post in Part I of this article. This section of the article will focus more on things to help you be successful and knowledgeable in your clinical skills as a student nurse, even if you do decide to go further for your master's or doctorate degree in nursing. Palm Pilots As I mentioned in the previous article, buying a palm pilot was the smartest thing that I ever did. Going on many websites, your head may swoon when thinking of all that you have to consider when buying a Palm Pilot. There are only three things that you need to worry about: price, compatibility, and memory. Price Most good palm pilots (PDAs) start at a range of $199 and can go as far as $499 or higher. I am not a rich person at all. The Palm Pilots (yes, plural...see below) I have bought took months for me to save up for. In my humble opinion, I would have to say that a PDA for $199-299 might be all that you need. Before you tsk, tsk me, there are several things working for you as a student nurse. The first is that you're a student, a poor, poor student who needs help financially. Most companies offer some kind of student discount if you order PDAs from their website like Skyscape and Epocrates. These two websites offer bundles in which you buy PDAs and medical programs together at a discounted price. There might be more sites out there, but these are the two big sites that I deal with when shopping for medical stuff for my PDA. Secondly, as I said in the last section of this article, you can always hit all of the relatives up for some palm pilot lovin' during Christmas/Hanukkah/birthday or whatever time. Compatibility I have had 4 Palm Pilots in my whole life. The first was lost by family members. Number two was tossed out due to the power button breaking...that was the Tungsten E, which I guess was on the list of many repairs and updates leading to Tungsten E2. The third was a Tungsten E2 that ran out of memory. Epocrates is a memory hog...more on this below. Currently I have a Palm TX, one of the few loves of my life. I only know Palm OS (operating system) as opposed to Windows Mobile. Most of the PDA programs that you're going to buy are going to be Palm OS compatible, so it can work on both a Mac or a PC. The PDAs that are only Windows Mobile compatible can only work with programs built for Windows, not for Macs. There are not many Windows only programs, so you're best bet is buying a PDA that is Palm OS compatible. Memory You want to have at least 32 megabytes of memory on the actual device. Palm's Tungsten E2 has this much memory and did very well for me. Most nurse practitioners (and nurses) who I have seen with a PDA have a Tungsten E2. If you choose to shower your palm with a good reference guide, medical dictionary, and drug book, then you will definitely need a memory card. A memory card with 1 gigabyte should be enough. I'm kind of obsessive about new and cool medical books available on PDAs, and I have a 1 gigabyte memory card. Be sure to know which major programs you would want to buy before buying a PDA. Some software requires a certain amount of memory to be on the actual PDA device, even if you have a huge amount of memory on your memory card. Programs Here's the fun part. The inner nerd in me loves nothing more than to break open a new PDA box or play with a new medical e-book found on the internet. You will find this to be true, too,or maybe I am a freak. Student Nurse Must Haves: 1. Epocrates Essentials Pros:
  • Keeps you up to date on current research (depending on how much you update Epocrates)
  • A 5-minute Clinical Consult in which you type in symptoms and it gives you the most likely diagnoses and treatment modalities
  • You can look up different labs and what they mean, different medical diagnoses/diseases, different drugs different medical math formulas i.e. body mass index, creatinine clearance, and pediatric maintenance fluids.
Cons:
  • Epocrates = memory hog. Get a memory card to save you the trouble and heartache
  • It sometimes has trouble updating and gives you corrupt files. If you have a PDA with WiFi, like the Palm TX, then do the auto update wirelessly instead of using your hotsync cable. This will save you 5 months of constantly calling Epocrates tech support. You'll know exactly what all this mumbo-jumbo is when you actually have a PDA, I promise.
2. Taber's Cyclopedic Medical Dictionary Pros:
  • A full 2439 pages all wrapped up in 10966 kilobytes of memory.  It may sound like a lot of memory, but it's still not as much as Epocrates.
  • web access to the dictionary with illustrations.
Cons:
  • No illustrations for the PDA version.
3. Lexi Comp Drugs International Pros:
  • In-depth description of tons of drugs...far better than Epocrates.
  • Many international drugs used in Canada and Europe listed.
  • Patient education and monitoring parameters are really spelled out well.
Cons:
  • It is a bear to download and update. They are based in Hudson, OH, but their books are used all over. I'm really surprised that they haven't made their website more user-friendly.
Grad Nursing Student Must Haves: 1. Washington Manual Outpatient Medical Survival Guide 2. Washington Manual Internship Survival Guide These two books saved my life a few times when doing my clinical rotations. As student NP, you are basically treated as a resident because many people don't know what your training exactly is. This experience was bittersweet...maybe more sweet in hindsight, because I trained myself to not only think on an advance practice nurse's level, but also on medical level along with all of the residents and docs. Studying many sections of these two books also had prepared me for seeing common problems in all of my rotations that NPs and docs have to deal with all the time. I know it is the end of the school year for many and maybe soon to be the beginning of the school year for some. I get asked these questions all the time from classmates, so I figured if that many people wanted to know about PDAs and medical software, then there has to be hundreds more people out there who haven't even started nursing school, yet. I hope this article has helped you. If you have any questions, post them in the comments section below and I will try to answer or add additional parts to this article. Feedback is always greatly appreciated. Good luck in your future studies!

Things Every Nursing Student Should Have…Even Through Grad School: Part I

I have stewed over this topic for several months as I am finishing up my second to last semester of my Family Nurse Practitioner (FNP) program. I do not consider myself an expert on this issue; however, there were several things that got me through nursing school that I could not survive without. The following stuff is mainly for an undergrad nursing student. Part II (coming soon) will be more for a nursing student in grad school. 1. A cheap watch that tells military time I am a cheap watch girl because, working with the pediatric population ( & going through 6 watches in 5 years), I have learned that it is not worth it to get an expensive watch. Also, the amount of lifting, moving, bending, carrying, etc. that a nurse (especially the average nursing student, since the nurses on the floors are happy to have students do the grunt work) does makes for a broken watch every 5 months or so. These watches are so cheap, too...like $9.99 at Target. Military time watches saved my life. My husband always makes fun of me for having a military time watch, but it's truly a lifesaver. I never got used to adding or subtracting twelve hours to regular time. This watch made my life so much easier and my documentation much more accurate as a student and nurse. The first time I was truly grateful for having a military time watch was during my first job straight out of nursing school in the PICU (pediatric intensive care unit). It was during my first real code (code blue) ever and I was the recorder. When you watch ER or something, it amazes me that they never show the recorder who has to write down every single thing done to a patient during a code. 2. A good stethoscope I started out with a Prestige Medical sprague stethoscope. I remember an instructor telling us that we should buy a stethoscope with both a diaphragm and a bell in order to hear both high and low pitched sounds. This will be helpful for you distinguishing different breath sounds (rales, rhonchi, wheezing) and heart sounds (gallops, rubs, murmurs). I also (vaguely) remember being told that the shorter the tubing for the stethoscope, the better. This basically has to do with the physics of it all. You'll be able to hear the sound more clear the shorter the tubing is. My prestige stethoscope was a great starter. Once I was able to save up enough money, I got the a Littmann stethoscope. I made the upgrade to the Cardiology II because the difference in my ability to auscultate faint adventitious sounds of the body and checking NG (nasogastric) placement improved 20 times. Well, I was unable to actually measure the difference, but there was a definite difference. If you're the kind of student who feels that you need to have something like this early on (like now), hit those loved ones up, all of them at the same time. My Littmann is approximately 4 years old and still working very well. This is another very good investment for nursing school. 3. Comfortable nursing shoes I was never a trendy "croc" aficionado. Many hospitals don't even let you wear them. I'm a New Balance girl, myself. From working anywhere from 4 to 16-hour shifts, these babies keep you comfy. 4. Pocket protector filled with bandage scissors, many packets of rubbing alcohol, a permanent marker, a highlighter, and (at least) two 4-colored pens This is also something my husband makes fun of me about. It may seem nerdy, but it's going to save you the ink stains. Plus, it acts as a very handy storage area in your pocket. You'll learn to stuff unimaginable things in your pocket just to avoid an extra bag or trip. It's all about the multi-tasking. highlighter- Just highlight the important stuff for patient/family education. The patient is already overloaded. bandage scissors- I'm asked every single day for my scissors. rubbing alcohol- This is for a quick clean of almost any surface...also, those bandage scissors are going to end up in some pretty gross places permanent marker- Labeling meds/IV bags/anything really two 4-colored pens- You'll be surprised how much you might need red ink for taking off orders...depending on your institution. You'll learn that the piece of paper that you have all of your activities recorded for the day (tube feeds vs. PO meds vs. IV meds vs. I's & O's ) will need some color coding. This is pretty anal, but it helps map out your day. I've done this ever since junior high, and it has made me more organized in my thought process. You'll need at least two pens because us nurses are all filthy pen thieves. 5. Mosby's Drug Guide This book was a good starter for me. It has all the info that you will need for when your instructor grills you. The language is easy to understand. The part of the book that I really like (I'm sure it's even better now because I only have the 4th edition from 2002) were the pictures of how to give different kinds of injections. It also gave pictures of different common drugs used in the general population. This is helpful for that those cute little old people taking 15 different kinds of medications per day, don't know what they're for, but can tell you the color of the pill. 6. A PDA Know these initials and know them well. PDA stands for personal digital assistant (for those who always wondered, but felt too dumb to ask), otherwise known as a palm pilot. In nursing school, one thing I hated was carrying around 5 different books to get me through clinicals. After biting the $200 bullet, I got hip to my first palm pilot. The greatest thing about these little devices is that you can carry 10 or more different medical books all on this little device. One thing you may be thinking is, "I can't afford this. She's out of her mind." Believe me, I couldn't afford it, either; however, it has proven to be the best investment (besides becoming a nurse) that I have made for myself financially and medically. This is what you can do. Again, tell all of your family members...I mean all of them, to not get you anything else for your birthday/Christmas except a palm pilot. You will have a vast array of knowledge at your fingertips, your backaches will go away, and people in the hospital (doctors, nurses, patients) will be impressed. Plus, every palm pilot comes with some kind of built-in calculator (another nursing school must), calendar to schedule appointments/meetings, and an address book to help you manage your hectic life. See Part II of this post (will be posted soon) on what to look for when buying a palm pilot and programs/books to put on it. 7. The knowledge that things will get better and that you will overcome this. I didn't want to have to be all preachy, but I wanted to include this because I think it's important. The decision to become a nurse is a very important one. You will hold people's lives in your hands, literally. The pressure between nursing school, your job to make ends meet, possibly kids/family can all seem like it's just too much...not to mention all the blood, vomit, mucous, urine, and poop that you're going to have to put up with. There is something to be said about those nurses that tend to eat their young. It seems like they use you as their own little "fresh blood" punching bag. Someone probably did the same thing to him/her in nursing school or his/her first job, so they feel like they need to pass on the tradition. I don't believe is this bs. This is part of the reason that there is such a shortage, because even some nurses can't appreciate each other and stop the cycle of hate. You need to take it upon yourself to kill that person with kindness and do your job 150%. If you are still thinking of quitting nursing school/nursing in general, speak to a nurse who has been around the block a few times (not sexually) and that truly loves what he/she does. You may not find many nurses that like where they work, but you should find nurses that love what they do. No nurse should be in this profession that is burned out and/or hates what he/she does. When a person comes to this point, this is when they should leave nursing, even if there is a shortage. It's just not fair to the patients. Coming Soon: Things Every Nursing Student Should Have...Even Through Grad School: Part II---palm pilots, programs, books, and websites. Oh My!

Why should you care that all the bees are dying?

Recently it has come to my attention that all of the nations bees are seriously threatened. Iaren't bees cute? know, it's hard to believe that it would be a big deal, and in fact, no one has really made a big stink about it yet. But it's important. Why, you might ask? Well, even if you didn't ask, you should probably read on since this topic definitely affects everyone, even if you don't like honey or bees. Most people know that bees are responsible for honey and bee stings but what you may not know is that they are a much more important member of the agricultural community. Bees, especially honey bees, are responsible for the pollination of flowers (you might be saying duh, here but follow me on this one, please), and said pollination causes plants to actually bear fruits as the method of their reproduction. And said fruits are important for not only human nutrition, but also for that of most of the animals we raise as pets and most of the animals that we eat. This topic came to my attention from my grandfather, an almost retired farmer. He brought it up to my mother in this manner. Grandpa: "Hey, The Fidge (that's me, btw) is a biologist, right?" Mom: "you know she is" G: "Well, can she tell me why the lady down the road's bees are almost all dead?" M: "Really? They are almost all dead? Why?" G: " Well, if we knew, we wouldn't be asking The Fidge, would we? Of her 20 hives, only two of them are still alive. All of the other hives are dead. And the other guy down the road, he had 125 hives and now only maybe twenty of them are still alive. They asked me if I knew what was happening, and I said I would ask the Fidge." So, this has become a job for me. Although I am just using the internet to research it, I do plan on calling a visit on these beekeepers to talk to them about their practices, but in the meantime I will fill you in on what the vast spaces of the interweb have to say about this little bee apocalypse. First of all, officials are calling this epidemic Colony Collapse Disorder, or CCD for short. (I just would like to point out that everything needs an acronym.) This used to be called Fall Dwindle Disease (FDD) but it was changed b/c it was noticed that this is not due to seasonality, nor can it be ruled to just being a disease. Actually, most experts are baffled to what exactly CCD is. Basically, they can't narrow it down to what is really killing all the bees. For example, according to the Penn State College of Agricultural Sciences news release on the topic: "Preliminary work has identified several likely factors that could be causing or contributing to CCD," says Dennis van Engelsdorp, acting state apiarist with the Pennsylvania Department of Agriculture. "Among them are mites and associated diseases, some unknown pathogenic disease and pesticide contamination or poisoning." That helps narrow it down, doesn't it? So, basically we can't really rule out anything at this point. We don't know what is killing the bees, and we can't decide what it could be, either. Most of the information I am using in my research comes from the Mid-Atlantic Apiculture Research and Extension Consortium Web site. In the hives that were researched by MAAREC there was evidence of vampire mites, a small parasite that lives off the "blood" of adult bees, viral infection, stress due to constant relocation of hives for crop pollination, intestinal amoebas, fungal infection, stunted learning and development due to industry chemicals (pesticides, fungicides, herbicides), and on and on. You get the point. We have not been able to narrow CCD down to any particular thing, which makes it incredibly difficult to treat the problem. The drastic amount of bees found dead over such a short period of time is what is so scary about the whole thing. A small bee apocalypse, the few surviving bees are all very young adults from what most beekeepers can see. I mean, as I pointed out, the two local cases above have lost an incredible amount of bees from their original numbers, and this is the case all around the country. The rate at which these bees are dying is alarming, especially since we cannot narrow the cause of their mortality down to anything specific. According to Jean-Louis Santini of AFP, "Bee numbers on parts of the east coast and in Texas have fallen by more than 70 percent, while California has seen colonies drop by 30 to 60 percent. It is normal for hives to see populations fall by some 20 percent during the winter, but the sharp loss of bees is causing concern, especially as domestic US bee colonies have been steadily decreasing since 1980." Well, either way, I have not really helped to narrow it down, but I hope you have learned something. Maybe this summer when food is really expensive you will know why, since most of the food we eat comes from the pollination efforts of bees, with only a few crops such as corn and wheat being wind pollinated. And just so you know, this is not something just limited to specific areas. This is affecting not only the US, but parts of Europe as well. This is a big deal, and no one seems to know anything about it. I figured I would end this article with a quote from Albert Einstein. "If the bee disappeared off the surface of the globe then man would only have four years of life left. No more bees, no more pollination, no more plants, no more animals, no more man," This may seem a little extremist, but it does bring the point home.