Sunday, February 28, 2016

What You should Know about Osteoarthritis

What You should Know about Osteoarthritis

What You should Know about Osteoarthritis



by: Arlene Gentallan



What You should Know about Osteoarthritis

Osteoarthritis is not a normal part of aging.
    It's hallmark feature of articular cartilage destruction is not an expected package that comes with being old. The earlier belief that it is caused by aging is a myth. It is true that certain components of cartilage like proteoglycans diminished with old age, leading to decreased quality of articular cartilage, still the breaking off and loss of articular cartilage is not normal.


Osteoarthritis is incurable.
    The sad truth is, once the disease develops, it is lifelong and incurable. But there are still ways that allows us to slow down its progression.



Osteoarthritis can involve more than one joint
    Articular cartilage destruction can affect multiple joint in the body such as the spine, hip, knee, hands, etc.


The knee bears 6 times the body weight
    We exert about 6 times our body weight into our knee when we walk while we exert about 3 times our weight on our hip. The knee is a major weight bearing joint of our body. Overweight people are at an increased risk of developing osteoarthritis of the knee.





Osteoarthritis Review Series

Osteoarthritis Review Series

Osteoarthritis (OA)



Review Series by: Arlene Gentallan



Definition:

    • aka. degenerative joint disease
    • Marked by articular cartilage destruction
    • most prevalent type of arthritis
    • Types:
       · Idiopathic osteoarthritis
          - unknow cause
          - most common
          - may have a genetic link
       · Secondary osteoarthritis
          - Secondary to history of trauma / disease process



Etiology:

    • Inherited (family history of osteoarthritis)
    • Hormones
    • Aging
    • Obesity
    • Sedentary lifestyle
    • History of joint and skelletal injury / inflammation
    • Chronic overuse of joint (like sports and work related usage)
    • Chronic use of drugs such as steroid



Sign and Symptoms:

    • Joint pain
       · frequently affects weight bearing joint
       · worsens with activity
       · relieves by rest
    • Limited range of motion
    • Osteophytes (bone spurs formation)
         • Bouchard nodes - bone spur formation on the distal interphalangeal joints
         • Heberden nodes - bone spur formation on the proximal interphalangeal joints
    • Crepitus



Diagnosis:
    • Presence of signs and symptoms characteristic of osteoarthritis
    • X-ray
         - reveals formation of osteophytes (bone spur) and narrowing of joint cavity



Treatment:
    • Weight loss (if overweight)
    • Exercise
    • Hot compress - promotes cartilage flexibility
    • Cold compress - reduces inflammation
    • Medications
         - Acetaminophen - reduces joint pain
         - NSAIDs (Nonsteroidal anti-inflammatory drugs) - reduces joint pain and inflammation



Complications:
    • Permanent joint immobility
    • Disfiguring deformity



Facts:
    • Articular cartilage - cartilage that covers and protects the end of long bones
    • Our knee bears 6 times our body weight when we walk
    • Our hip bears 3 times our body weight when we walk



Legend:



What are the Complications of Osteoarthritis?

What are the Complications of Osteoarthritis?

What are the Complications of Osteoarthritis?



by: Arlene Gentallan



What are the Complications of Osteoarthritis?

    Effects of osteoarthritis is confined mainly to joints, it does not usually involve other organs. Complications arise as result of cartilage destruction.



    • Permanent immobility

         Progression of the disease, especially with improper management, ultimately leads to complete articular cartilage destruction leading to pain and immobility of the affected joint.



    • Disfiguring deformity

         Enlargement of the joint periphery due to bone spur formation (osteophyte) alters the normal shape of the joint. This may curve and twist the linear orientation of a joint. In cases where major weight-bearing joints are affected, this can have a serious impact on posture and balance.





What are the Treatments for Osteoarthritis?

What are the Treatments for Osteoarthritis?

What are the Treatments for Osteoarthritis?



by: Arlene Gentallan



What are the Treatments / Management for Osteoarthritis?

    Osteoarthritis is a lifelong disease. Treament is based on management of symptom and control of modifiable risk factors to slow down it's progression.

    • Weight loss

         Excess weight puts additional burden to the weight-bearing joints. Eating a balanced diet coupled with regular exercise is encouraged to promote weight loss.



    • Exercise

         There are several benefits that can be derived from exerise. Exercise promotes weight loss and strengthens bones, muscles, ligaments, and tendons. It is essential for articular cartilage repair since cartilage has no blood supply. Weight bearing exercise like walking promotes calcium storage in bones which strengthens it. A regular regimen of mild exercises such as brisk walking, biking, bowling, golf, and swimming is encouraged. Avoid streneous exerecises and sports such as heavy weight lifting, boxing, basketball, and marathon. There should also be a balance between physical activity and rest to avoid overexertion of the joint. If the joint is inflammed, it should be rested.



    • Hot compress

         Heat promotes flexibility of the cartilage so it helps with the range of motion of the joint. This eases the joint pain. Introducing heat to the affected joint directly by a hot compress or a warm shower is encouraged.



    • Cold compress

         If localized joint inflammation is present, applying cold compress over the affected joint is beneficial to reduce swelling and pain. Alternating hot and cold compress can be done.



    • Use of assistive device

         Use of assistive devices like cane and walker helps reduce stress on the affected joint.






Medications for Osteoarthritis



         • Acetaminophen

                Acetaminophen decreases joint pain, but not inflammation.



         • NSAIDs (Nonsteroidal anti-inflammatory drugs)

                NSAIDs or nonsteroidal anti-inflammatory drugs decreases both joint pain and inflammation.





Surgery for Osteoarthritis


      Surgery may be indicated to relieve symptoms like pain, correct a deformity or increase the functional capability of a joint.

         • Arthodesis

                In this surgical procedure, bone ends are fused together by removing the articular cartilage and joint cavity. This is only done if no other intervention is available to correct the joint. This because this procedure eliminates the joint rendering it immovable.



         • Total Hip Replacement or Total Knee Replacement

                In this produre, joint mobility of the hip or knee can be restored by replacing the joint with a prosthesis.





How to Diagnose Osteoarthritis?

How to diagnose Osteoarthritis?

How to Diagnose Osteoarthritis?



by: Arlene Gentallan



How to Diagnose Osteoarthritis?

    Diagnosis is based on several factors:

      • Presence of sign and symptoms characteristic of osteoarthritis

          Health history taking is an important tool for the diagnosis of osteoarthritis. Risk factors for the development of osteoarthritis like fracture and other predisposing condition can be identified. The individual may verbalize classic manifestation of the disease which is joint pain that worsens with movement and is relieved by rest, as well as joint movement limitation.


      • Physical examination

          Physical examination may reveal joint deformity like bouchard nodes and heberden nodes which are excessive bone growth at the joints of the finger which twist it's linear orientation and angle.


      • X-ray

          X-ray may reveal formation of irregularly distributed osteopytes (bone spurs) at the edge of the affected joint. Cartilage loss may reveal a hollowed center of the bone end. Narrowing of the joint cavity may also be seen.






Sign and Symptoms of Osteoarthritis

Sign and Symptoms of Osteoarthritis

Sign and Symptoms of Osteoarthritis



by: Arlene Gentallan



What is the age of onset of Osteoarthritis?

    Articular cartilage degeneration can begin as early as the third decade of life (30s) while symptoms becomes apparent at the fifth (50s) to sixth (60s) decade of life.


Sign and Symptoms of Osteoarthritis

    Signs and symptoms shown by a person suffering from osteoarthritis is the direct result of articular cartilage destruction and bone spur growth.

    • Joint pain

         The most common symptom brought about by osteoarthritis is joint pain. Due to articular cartilage loss, bone ends at joint intersection no longer has a smooth surface in which to glide when moving. Bone ends are exposed to increased amount of friction and joint's capability to do weight lifting is greatly decreased.
         The characteristic pain of osteoarthritis is the pain that worsens with continued joint movement and is relieved by resting the affected joint.



    • Limited range of motion of the affected joint

         While there is loss of cartilage along the center of the bone end, bony and cartilaginous projections forms along it's edges. This leaves a hollow center with irregular edges, making it extremely hard (or in other cases, impossible) for the joints to glide against each other. In this case, the individual can no longer move the joint to it's full range of motion.



    • Osteophytes (bone spurs formation)

         Osteophytes (bone spurs) are the bony projections that form along the edges of the bone end. This disfigures the bone end, leading to movement restriction and crepitus.
         Bouchard nodes and heberden nodes forms visible deformity of the digits of the hand (fingers.)

         • Bouchard nodes - bone spur formation on the proximal interphalangeal joints
         • Heberden nodes - bone spur formation on the distal interphalangeal joints



    • Crepitus

         Crepitus is the sound created when the irregular bone ends of the joint glides against each other's rought surfaces.



    • Localized inflammation

         There may be a localized inflammatory response at the affected joint due to cartilate destruction. The affected site may appear swollen and tender.



What are the commonly affected joints?

    Commonly affected are the weight bearing joints such as the:
         • Knee
         • Hip
         • Spine




Etiology and Risk factors of Osteoarthritis

Etiology and Risk factors of Osteoarthritis

Etiology and Risk factors of Osteoarthritis



by: Arlene Gentallan



Etiology and Risk factors of Osteoarthritis

Idiopathic Osteoarthritis

    In Idiopathic osteoarthritis, there is no definitive cause that can be pointed out. There is no history of bone / joint injury that can be linked to the development of this form of arthritis. Although there may be a genetic culprit.
    In most cases, the root cause of osteoarthritis can not be identified. So, idiopathic type of osteoarthritis is more common than the secondary type.

Secondary Osteoarthritis

    In secondary osteoarthritis, there is an identifiable precipitating factor like joint trauma or disease. It may also be caused by chronic overuse of joint which may be work (eg. typist) or sports related.

Risk factors for developing Osteoarthritis:
    • Presence of family history

         Studies have shown a link between a genetic fault and cartilage destruction.


    • Advancing age

         In older adults, the amount and composition of the cartilage matrix diminishes leading to decreased strength and flexibility of their articular cartilage. Older people are also prone to develop fracture and bone injury because of decreased bone mineral content.


    • Obesity

         Being overweight increases stress to the weight bearing joint.


    • Sedentary lifestyle

         Exercise plays a crucial role for cartilage repair. Furthermore, lack of physical activity may lead to weight gain.


    • History of joint / skelletal trauma

         Incidence like fracture can increase the chance of a person to develop OA later in life.


    • Chronic overuse of joint

         Injury brought about by overuse of a joint over a long period of time can lead to osteoarthritis. This may be related to occupational or sports. Examples are typist who occasionally use their wrist to type using a keyboard.







What is Osteoarthritis?

What is Osteoarthritis?

What is Osteoarthritis?



by: Arlene Gentallan



What is Osteoarthritis?

    Osteoarthritis (also known as degenerative joint disease) is the most prevalent type of arthritis. It is marked by articular cartilage destruction / degeneration leading to joint pain and decreased range of motion.


What is an articular cartilage?

    Articular cartilage is the pearly white membrane that covers the end of bones where they meet to form a joint. The articular cartilage protects the bone ends of a joint when we move and lift weight. It provides a smooth surface so bone ends will not be damaged by friction when they slide against each other during a movement.

A joint capsule holds and surrounds the articular cartilages where they form a joint. The joint capsule has a cavity filled with synovial fluid which serves as a lubricant to prevent excessive friction when bone ends (covered with articular cartilage) move against each other.

Cartilage is composed of:
       • Collagen - makes the cartilage tough
       • Proteoglycan - enables the cartilage to spring back to it's original shape after being stretched or squeezed (like when we are doing heavy lifting)

The composition of the cartilage makes it an excellent shock-absorber. However, it is worth knowing that cartilage has no blood supply so they heal slowly when damaged.


What happens to the articular cartilage when you have osteoarthritis?

    • Proteoglycan and collagen diminishes.
    • Articular cartilage turns from shiny white to dull yellow / brown.
    • Articular cartilage's surface peels off while deeper layers cracks, leading to eventual cartilage lost.
    • Cartilage at the center of the bone end is lost while there are new formation of cartilage along the edges, giving the bone an irregular contour (making it hard and painful to move leading to movement limitation.)
    • Articular cartilage is no longer able to protect bone ends.




Lifestyle Modifications to Control Hypertension

Lifestyle Modifications to Control Hypertension

Lifestyle Modifications to Control Hypertension



by: Arlene Gentallan

What is Hypertension?

    Hypertension, also known as high blood pressure, is a potentially lethal health condition that can have devastating outcome.

    In hypertension, the heart works harder than normal to pump blood throughout the body. The resulting high blood pressure it creates can damage the blood vessel wall and vital organs if left uncontrolled.

    When it comes to controlling hypertension, lifestyle modification comes first. Here's a shot at some modifiable factors

MIND YOUR SALT INTAKE

    Sodium chloride (table salt) supply us with two important electrolyte for the healthy functioning of our body. Too low sodium and chloride electrolyte can have serious effect on the body. But too much isn't good either.

    Sodium attracts water. So if you loaded your bloodstream with lots of sodium, the tendency is for water to be drawn from your cell into your circulation. When this happens, your circulating blood volume increases, obligating the heart to pump harder than already is.


       The recommended daily intake of sodium is about 1500mg. This is equivalent to 1 teaspoon salt per day.


    What are the things you can do?

       Limit salty foods

    There are certain commercial foods loaded with salt that you should be warry of. Avoid indulging yourself with too much salt. Remember, the more salt you eat, the more you'll crave. So keep it within the limits. Make it a habit to always...

       Read the label

    Nutritional label of commercial foods will give you a good estimate of it's sodium content. This will prove valuable when it comes to your food selection.

       Prepare your meal...make your own snack

    Cooking your own food will give you better control when it comes to the salt you add to it.


    Foods high in sodium includes:

         • Canned foods
         • Processed meat like bacon and ham
         • Fast foods like french fries and hamburgers
         • Instant noodle
         • Pasta
         • Cheese
         • Salted pop corn and nuts
         • Pickled veggies and salad dressing


POTASSIUM

    Potassium counters sodium. That means the more potassium you consume, the more sodium and water you excrete.


       The recommended daily intake of potassium is about 4700 milligrams.


    Make it a habit to eat foods high in potassium like:

         • Pineapple
         • Banana
         • Coconut water
         • Orange
         • Avocado
         • Plain yogurt
         • Potatoes
         • Tomato
         • Funegreek seed
         • Raisin
         • Apricot
         • Dates
         • Mushroom
         • Dark leafy vegetable like Spinach
         • Yellow fin tuna
         • Salmon

    Please note that excessive amount of potassium in the body can have serious effect so please consult your doctor first before trying a potassium supplement.


OMEGA-3

    Omega-3 fatty acid lowers triglyceride (which is made up of glycerol and fatty acid) while increasing your "good cholesterol" HDLs (high density lypoprotein.) This lessens the buildup of cholesterol plaque within the blood vessel wall, thereby, preventing arterial narrowing and occlusion. This reduces the risk of hypertension, heart attack, and stroke. Omega-3 also improves memory and boost the immunity.

    There are 3 types of omega-3, namely:

      • ALA (aka. Alpha-linolenic acid)

      • DHA (ka. Docosahexaenoic acid)

      • EPA (aka. Eicosapentaenoic acid)

    ALA comes from plant sources such as wallnuts and flaxseed. DHA and EPA comes from fishes and is superior than ALA.

    Furthermore, our body can not make omega-3 so we have to depend on the food we eat. Here are foods high in omega-3:

         • Tuna
         • Fish oil
         • Sardines and Achovies
         • Mackerel


       The recommended intake of omega-3 is 250-500 mg DHA/EPA per day. According to AHA, two servings of fatty fish each week is recommended.



FRUITS AND VEGETABLES

    Fruits and vegetables supplies us with fiber and nutrients. Eat plenty of serving each day.


       The recommended daily intake of fruits and vegetables is about 4-5 serving.

         1 serving is equal to:
           • 1 cup raw vegetable
           • 1/2 cup frozen/canned vegetable
           • 1 medium sized fruit
           • 1/2 frozen/canned fruit
           • 1/4 dried fruit


EXERCISE

    Exercise improves the cardiovascular system, burns fat, and help you loose extra weight.

      The AHA (aka. American Heart Association) recommends 40 minutes of aerobic exercise either of moderate or vigorous intensity 3-4 times a week to lower blood pressure and cholesterol level. This exercise recommendation will lower the risk of heart and brain attack.

    Examples of moderate intensity exercises are:

         • Brisk walk

         • Dancing

         • Yoga

         • Bicycling with moderate effort

         • Frisbee

         • Golf

         • Housework and gardening

    Examples of vigorous intensity exercises are:

         • Running

         • Jogging

         • Jumping rope

         • Aerobic dance

         • Mountain climbing

         • Bicycling with vigorous effort

         • Basketball

         • Volleyball

         • Soccer

         • Football


QUIT SMOKING

    Smoking is dangerous to your health. It is one of the risk factor for many diseases like hypertension. Tobacco contains many carcinogen. It's nicotine content causes the blood vessels to constrict which increases blood pressure. While you can not quit smoking in a single day due to withdrawal syndrome, you can slowly taper it. You can do this by decreasing the amount of stick you smoke per day until you reach the point when you no longer smoke.


LOOSE EXTRA POUNDS

   
Obesity is one of the modifiable risk factors of many lifestyle related diseases like secondary hypertension. Start to eat right and combined this with proper exercise to stay fit and strong.


CHOLESTEROL AND FATS

    Too much cholesterol can have serious results such as narrowing of blood vessel lumen due to fatty plaque deposition which can lead to an increase blood flow pressure and increased risk of heart attack and stroke. Monounsaturated and polyunsaturated fat is preferred over saturated fat and transfat.

    AHA recommends to consume no more than 6 % total calorie from saturated fat, which is no more than 13 grams for those with 2000 calorie requirement. Transfat consumption should be less than 1% total calorie which is less than 2 grams for those with 2000 calorie requirement.


LIMIT ALCOHOL

    Drinking too much alcohol has several health implications like obesity, diabetes, high blood pressure, and cardiac problem. Drink alcohol in moderation.


       The recommended daily intake alcohol is 1 drink per day for women and 1-2 drinks per day for men. 1 drink is equivalent to a 12 oz beer or 4 oz wine.




Calorie: List of Caloric Content of Foods

Calorie: List of Caloric Content of Foods

Calorie: List of Caloric Content of Foods



by: Arlene Gentallan

What is calorie?

    Calorie is a unit of energy. It has two types; namely: small calorie (cal) and large calorie (kcal, Cal). Small calorie is the energy required to raise the temperature of 1 gram of water by 1 °C, while Large calorie is the energy required to raise the temperature of 1 kilogram of water by 1 °C. ( 1 Cal or 1 kcal = 1000cal)

    Large calorie (kcal, Cal) is the unit of energy measurement used for foods. In simple terms, calories is the amount of energy you get from the food you eat.



      HERE IS A LIST OF CALORIC CONTENT OF SOME OF THE MOST COMMON FOODS BASED ON USDA:

FRUITS
Food Product Serving Kcal (calorie)
Apple (Medium size), (182g) 95
Banana (Medium size), (188g) 105
Grape (1 piece), (2.4 g) 2
Grape (1 cup), (92g) 62
Orange (1 fruit 2-5/8" dia), (131g) 62
Stawberry (1 small), (1" dia), (7g) 2
Stawberry (1 cup), (144g) 47



DRINKS
Food Product Serving Kcal (calorie)
Beer (1 can), (356g) 154
Wine/td> (1 serving 5 fl oz), (148g) 123
Cola (1 can 12 fl oz), (368g) 138
Powdered milk (1 cup), (128g) 635
Whole milk 3.25% fat (1 cup), (244 g) 148
Non fat milk (1 cup), (100 grams) 83
Milk, 1% fat (1 cup), (244g) 103
Coffee (1 cup plain coffee) 0
Espresso (1 fl oz), (30g) 3
Instant coffee (1 packet), (2g) 2
Instant mocha coffee (1 serving 2tbsp|), (13g) 60
Instant french coffee (1 serving 4 tsp), (13g) 63



CARBOHYDRATES
Food Product Serving Kcal (calorie)
Potato (1 medium sized), (213g) 163
Baked white potatao (1 medium sized), (138g) 130
White bread (1 slice), (25g) 66
Multi-grain bread (1 slice), (26g) 69
Garlic bread (1 slice), (59g) 206
Pita bread (1 oz white unenriched pita), (28.4g) 78
Bagel (1 piece), (98g) 245
Roll (1 piece), (25g) 77
Muffin, plain (1 piece), (57g) 169
Muffin, blueberry (1 piece), (31g) 117
Spaghetti, cooked (1 cup), (140g) 221
Spaghetti (1 cup), (140g) 174
Macaroni, cooked (1 cup elbow shaped), (140g) 221
Macaroni, whole-wheat cooked (1 cup elbow shaped), (140g) 174
White rice (1 cup cooked white long-grain), (158g) 206
White rice (1 cup cooked glutinous), (174g) 169
White rice (1 cup steamed), (132g) 199
Brown rice (1 cup cooked long-grain), (195g) 216
Brown rice (1 cup cooked medium-grain), (195g) 219



PROTEIN
Food Product Serving Kcal (calorie)
Chicken wings (1 wings bone and skin removed), (21 g) 43
Chicken liver (1 piece, 44g) 76
Roasted chicken leg (1 drumstick bone and skin, 105g) 182
Fried chicken (1 leg), (94g) 196
Pork broiled whole loin (3 oz), (85g) 206
Pork chop, blade, boneless, broiled (1 chop), (131g) 265
Beef rib steak (3 oz), (85g ) 302
Corned beef (1 oz cooked brisket), (85g) 213
Beef (3 oz tenderloin roast), (85 g) 276
Bacon, pan-fried (1 slice), (8g) 43
Bacon, microwaved (1 slice), (9.1g) 43
Yellowfin tuna (1 oz boneless), (28.4g) 31
Sardines, canned in oil (2 sardines), (24g) 50
Egg (1 large raw), (50g) 72
Egg (1 large boiled egg), (50g) 78
Egg (1 large fried egg), (46g) 90
Egg (1 large scrambled), (61g) 91
Egg omelet (1 large), (61g) 94
Quail egg, raw (1 piece), (9g) 14
Egg white, raw (1 large), (33g) 17
Egg yolk, raw ( 1 large), (17g) 55
Hotdog (1 piece), (52g) 151
Ham, boneless & roasted (11% fat) (3 oz regular), (85g) 151
Sausage (1 serving cooked beef sausage), (43g) 142
Sausage, meatless (1 slice), (28g) 72
Balogna (1 slice pork balogna), (23g) 57



Food Product Serving Kcal (calorie)
Hamburger, single patty (1 piece), (86g) 254
Hamburger, double patty (1 piece), (120g) 354
French fries, fast food (1 small serving), (71g) 222
French fries, fast food (1 medium serving), (117g) 365
French fries, fast food (1 serving large), (154g) 480
Pizza (1 slice 14" regular crust), (107 g) 285
Potato chips (1 oz), (28.4g) 152
Pretzel, hard salted (1 oz), (28.4g) 108



SWEETS
Food Product Serving Kcal (calorie)
Apple pie (1 piece 1/6 of 8" pie), (117g) 277
Milk chocolate (1 miniature bar), (7g) 38
Milk chocolate (1 bar), (1.55 oz), (44g) 235
Chocolate ice cream (3.5 fl oz), (58g) 125
Vanilla ice cream (1/2 cup), (66g) 137
Food preserves like jam and jellies (1tbsp), (20g) 56
Cake (1 piece without frosting), (95g) 352
Butter cookie (1 piece), (5g) 23
Chocolate chip cookie (1 piece medium), (2-1/4" dia), (16g) 78
Peanut butter cookie (1 piece), (3" dia), (20g) 95
Marshmallow (10 miniatures), (7g) 22
Marshmallow (1 cup miniature), (50g) 159
Doughnut with sugar (1 piece medium), (3"dia), (45g) 192
Doughnut with chocolate (1 piece medium), (3"dia), (43g) 195
Doughnut jelly( (1 piece), (3-1/2" x 1-1/2") 289
Doughnut with creme (1 piece), (3-1/2" x 1-1/2"), (85g) 307



Food Product Serving Kcal (calorie)
Butter (1 tbsp), (14.2g) 102
Margarine (1tbsp), (14.2g) 102
Peanut butter (2tbsp), (32g) 188
Liverwurst spread (0.25 cup), (55g) 168
Ketchup (1tbsp), (17g) 19
Fish oil (1 tbsp), (13.6g) 123



NUTS
Food Product Serving Kcal (calorie)
Almond (1 piece), (1.2g) 7
Almond (1 cup sliced), (92g) 529
Cashew (1 oz), (28.4g) 157
Hazelnut (10 nuts), (14g) 88
Hazelnut (1 cup chopped), (155g) 722
Mixed nuts, oil roasted with salt added (1 oz), (28.4g) 172
Mixed nuts, oil roasted with salt added (1 cup), (134g) 813
Peacan (1 oz 19 halves), (28.4g) 196
Peacan (1 cup halves), (99g) 684
Wallnut (1 oz 14 halves), (28.4g) 185
Wallnut (1 cup ground), (80g) 523







12 Promising Tips to Loose Extra Weight

12 Promising Tips to Loose Extra Weight

12 Promising Tips to Loose Extra Weight



by: Arlene Gentallan

1. CUT DOWN 500 CALORIE EACH DAY TO LOOSE 1-2 LBS (2.2-4.4 KG) PER WEEK

    Large calorie (kcal, Cal) is a measure of the amount of energy you get from the foods you eat. Daily caloric intake depends on several factors like age, weight, height, level of physical activity, and metabolic rate. Caloric intake varies from one individual to another because of the differences among these factors.

    To loose weight, you will need to cut down on your caloric intake. So that means, eating less. Crash diet isn't the answer since it can pose danger to your health. It is recommended that you cut around 500 calorie from your daily calorie intake. This will result to you loosing about 1 to 2 pounds in a week.

   
    List of Caloric Content of Foods It's important you know how much calorie your food contains so you'll know which food you'll limit or avoid.

MONITOR YOUR WEIGHT REGULARLY AND HAVE A DIARY IN WHICH TO RECORD IT TO BE ABLE TO TRACT YOUR PROGRESS.


2. Don't skip meals
    Eat a balance diet with the right combination of carbohydrates, protein, fat, fiber, water, nutrients, minerals, and vitamins.

    Schedule a meal and snack pattern that suits you. Do not skip a meal since this will only cause you to get hungry and overeat. Eat three meals a day: breakfast, lunch, and dinner. Schedule a morning snack and afternoon snack in between. Avoid midnight snack. Avoid sleeping late at night.


3. Enjoy your food; Avoid distraction
    Don't hurry. Take it slowly. Enjoy your meal. There's studies showing that people whose attention is not focus on the food they are eating, tend to overeat.
  • Avoid watching TV while eating
  • Eat at your table. Avoid eating on the go.



4. Limit Salt
    Salt (also known as sodium) is important for the function of our body but too much of it is harmful. Salt retains water which add up to your weight. High salt is also linked to other health problems such as hypertension. Limit salty foods:
  • Processed foods like bacon and ham
  • Canned goods
  • Noodles
  • Fast foods
  • Cheese



5. The Magic of Sugar
    Consuming sugar triggers a good response from our brain which makes us feel good, unfortunately these foods usually have high calorie content. Sweets can power our craving. It can also make us feel hungry. Limiting sugary food is a must:
  • Cookies
  • Cakes
  • Soft drinks
  • Jam
  • Candies

    Glucose is a simple sugar which is our main energy source. It can be broken down from carbohydrates. Fructose, on the other hand, is a type of simple sugar found in fruits. High fructose corn syrup contains higher amount of fructose. High fructose corn syrup is a popular commercial additive because it is cheaper and sweeter than glucose.

    While your liver store glucose as carbohydrates, fructose is stored as fat. It increases triglyceride production. High triglyceride is dangerous to you. It increases the risk of cardiovascular disease and stoke. High fructose corn syrup is found in many commercial products like cookies, cake, softdrinks, jam, and candies. Table sugar (aka. sucrose) is half glucose, half fructose. Read the label of a food product before you buy it to check if it contains high fructose corn syrup.


6. Drink water
    There are times when we mistake hunger for thirst. There are times when drinking a glass of water is what all it takes to satisfy your tummy.

    There are many considerations when it comes to daily recommended water intake like age, sex, level of activity, geography, and metabolism. The Institute of Medicine (IOM) recommends a daily water intake of 11 cups or 2.7 liters for adult women and 15 cups or 3.7 liters for adult men. The 8 glass of water intake per day is outdated.


7. Develop an Exercise Regimen
    Religiously following a daily exercise regimen is one of the best way to loose weight. If you can't motivate yourself, find an instructor or a friend that will accompany you. Take up zumba lesson.

    The best exercise to loose weight are cardio exercise (aka. aerobic exercise). It is a form of exercise that raises your heart rate. Did you know that high-intensity exercises done at short duration raises your metabolism up to 24 hours after the exercise and it burns more calories. You can combine high-intensity short duration exercise with low/medium intensity exercise. Like walking then adding jogging for 1 minute every 5 minute interval.

    Examples of high intensity cardiovascular exercise are:
  • Running
  • Jumping rope
  • Jogging
  • Lap swimming

    Examples of low intensity cardiovascular exercise are:
  • Brisk walking
  • Cycling with moderate effort
  • Yoga
  • Frisbee



8. Get enough sleep
    Sleeping at least 8 hours a day actually pays. Did you know that you burn more calories when you are asleep that when you're awake just sitting there doing nothing. Sounds like a lazy way to loose weight, but sleeping does a number of important things to you like consolidating your memory and repairing your body.

    Think about it, you actually burn more calorie while you sleep while you tend to overeat when you are sleep deprived.

       The Power of Nap

    Taking a nap during the day, especially when you are feeling tired and stress helps replenish your energy and burn down calorie.


9. Anxiety and Stress
    Being subjected to chronic stress can trigger us to overeat. That's why being able to handle stress is important. Although, eliminating stress in today's modern world is almost impossible, there are certain ways we can lessen them:
  • Listen to music to cheer you up.
  • Have a proper work life balance. Take a break.
  • Don't overwork yourself. Recognize when you've had enough.
  • Give yourself a token for a job well done.
  • Schedule a vacation for yourself with your family.
  • Do your best so you won't regret the rest.



10. The Evil Craving
    What is the difference craving and hunger? Craving is when you want to indulge a specific food even when you are full. So it's the desire to eat a specific food even when you are not hungry.

    So you're in diet...calorie reduction...regular exercise. All for the sake of attaining that slim and fit body built you've always wanted. What's the worst part of dieting? Is it the fact that most of your favorite foods are on the "no" list? Or is it the truth that you're still far away from reaching that desired weight?

    All of a sudden, out of nowhere, an image of a delicious desert grips your senses. You can't think of anything aside from this forbidden fantasy. In just a second, you loose it all. You may reason that the animal inside of you ate the chocolate cake, but it doesn't matter, because before you know it, you're pack full of carbs.

    Craving can ruin your diet commitment. There are times when craving becomes so powerful it's impossible to control. Hey! At some point, we all experience craving. But there are things you can do to help yourself and attain the figure you've always wanted. Here are tips to avoid craving:



    A. TAKE A BITE

    Eating just a small portion of a craved food can relieve one's craving...

    But in some people, taking just a small bite from the food can trigger them to loose their senses and consume a larger potion of the food.

    So you have to watch out and do what best works for you. Know yourself: Is one bite enough to satisfy your craving or do you have to totally avoid it?



    B. The Wonder of Peppermint Scent

    Our sense of smell has a profound effect to our appetite. In a study conducted by psychologist Bryan Raudenbush (professor at Wheeling Jesuit University in West Virginia) people who sniff peppermint tend to eat less.



    C. Why not do something else...

    If you keep thinking about a certain food, chances are it can get the better of you. So you have to stop thinking of it. Find activities that will divert your attention. Even simple activities like reading your favorite book, listening to music, taking a shower, and watching a non food-related TV show are good distractions.

    Craving is something that don't last long. It goes away. There are times when you just have to bear and ignore it.

    Productive non-stressful diversions are highly recommended. Have you ever played a computer game like dota and tetris and experienced seeing flashbacks of the game itself whenever you close your eyes even after you're done playing it. Playing computer games maybe non-productive but if all else fails why not try this alternative?


11. Develop a habit
    Habit is a strong determiner if whether or not you will succeed and maintain it. You don't want to be tempted and loose control. So you have to develop a routine you find comfortable and doable. Proper diet coupled with exercise.




    Lastly but most importantly is...


12. Master Discipline
    Let me tell you, nothing is impossible if you give your 100%. Whatever you set your mind to do, you can. Discipline can make or break everything. All of the above tips wont't matter if you don't have the determination. It's just a matter of discipline and proper mindset.




IV Cannulation: IV Insertion Tips & Tricks

IV Cannulation: IV Insertion Tips & Tricks

by: Arlene Gentallan

    IV insertion is an important indispensable skill, yet you may realize that it is one of the hardest skill to master. While it's not easy, your skill can be improved through continuous clinical practice. Here are some tips and tricks you can apply to do a successful intravenous cannulation:

DETERMINE THE APPROPRIATE SIZE OF CANNULA TO BE USED

    There are varying cannula sizes which is measured in gauge. The higher the gauge number, the smaller the size of the needle and it's bore.
   
  • Gauge 14 - (color Orange) Very large bore cannula reserved for emergency in which rapid fluid resuscitation or medicine administration is needed
  • Gauge 16 - (color Gray) Used for surgery
  • Gauge 17- (color White) Used for rapid intravenous infusion or blood transfusion
  • Gauge 18 - (color Green) Used for blood transfusion
  • Gauge 20 - (color Pink) Standard for adult intravenous fluid infusion
  • Gauge 22 - (color Blue) Use for pediatrics. Can be used for adults with small vein
  • Gauge 24 - (color Yellow) Used for pediatric patients

Note: If the patient's vein is small, use a small bore cannula so the vein will not blow. If you will use a large bore needle, choose a large vein.

BE CONFIDENT

    Even if it's your first time to insert an iv cannula, don't act with uncertainty in front of the patient. Even if you haven't gained experience yet, keep calm and show the patient that you can. Appearing confident, even when you know you're not, will give you positivity and will enable you to gain the trust of the patient.

    Be positive. If you have the mindset that you will succeed, your halfway there. If you appear non confident in front of the patient, they may refuse you and ask for someone else. Or they may blame you if you are unable to insert the iv cannula even if the patient's fragile vein is the real cause.

FIND A VEIN

    Find a suitable vein for insertion by visualizing and palpating it.

VEIN VISUALIZATION TRICKS

    Here are several tips to enable you to better see veins. Veins are usually bluish in color that can easily be seen if engorged.


      Apply tourniquet

    Apply tourniquet 3-5 inches above the insertion site so this will impede blood flow and dilate (enlarge) the vein for easier palpation and visualization. Make sure that it's not too tight nor too loose.


      Rub the area with alcohol

    After rubbing a site with cotton balls with alcohol, some veins will become visible.


      Press on the site

    Press on the area several times with your finger pad, especially if it's edematous to make veins visible. Pressing the area will blanch it's color enabling you to visualize the vein which is bluish in color.


      Advice your patient to make a tight fist

    This will engorge and dilate the vein.


      Advice your patient to wiggle fingers or repeatedly close open palm

    Muscle contraction will dilate the vein because it causes the blood to return to the heart which is impeded by the tourniquet.

PALPATE THE VEIN WITH YOUR FINGER PAD

    Palpate the vein with your finger so you'll be able to feel if it's a good vein. This will aid you to make the right choice. Feel if the vein is movable or stable. Feel for fullness. It's ideal to choose a stable non-movable vein that feels full.

    In cases when you are unable to visualize a vein, palpation is very helpful to know where a vein is.

CHOOSE A VEIN FOR INSERTION

    Consider the non-dominant side first

    For the convenience of the patient, choose the non-dominant hand as the insertion site. Insert only on the dominant hand if you are unable to find a good site.


      Choose a straight vein.

    Choose a straight vein that can accommodate the entire length of the cannula. Do not hit a vein over the area where it overlaps with another vein or in an area where a large vein branches to smaller veins because these veins blows more readily.


      Start with a distal vein

    Choose a vein over the dorsal side of the metacarpal. If you can't find a suitable vein, you can move up.


      Avoid inserting above a joint

    To prevent the iv site from being displaced by joint movement, avoid inserting over a joint. Avoid inserting over the wrist joint and elbow.

TIPS WHILE INSERTING THE IV CANNULA

    Stabilize the vein

    Hold a movable unstable vein with the finger of your other hand as you insert the cannula to let you hit the vein.


      Advice the patient to relax the area in which you will insert

    When you are inserting the needle, advice the patient to relax his/her arm so the vein will not constrict.


      Bevel up

    Insert the needle with the bevel up. This will allow you ease of insertion of the needle.


      Insert at about 15 degree angle

    This will prevent you from inserting too deep.


      No "fishing"

    Don't attempt to insert and retract the needle several times. This is too painful for the patient and increases your chance of blowing the vein.


      Check for backflow

    Once there is a backflow in the flashback chamber of the iv cannula, that means you've hit the vein, advance the needle further to ensure the iv catheter is inside the vein before retracting the needle and advancing the catheter all the way in.


      Retract the needle

    Retract the needle as you advance the cannula into the vein. There should be a smooth movement with no resistance once you insert the cannula on the vein.


      Release the tourniquet

    If the patient's vein is fragile, make sure to release the tourniquet before advancing the cannula to prevent the vein from blowing.


      Start IV line slowly

    Especially if the patient's vein is fragile, initial iv flow rate should flow very slowly for a few seconds before adjusting to a desired flow rate. This will prevent a weak vein from blowing because of increase pressure.



8 Things to Learn to be a Better Staffnurse

8 Things to Learn to be a Better Staffnurse

by: Arlene Gentallan

    Your job as a staffnurse may not be easy. It can be stressful and demanding. But it's a rewarding and fulfilling job.
    Continuous learning benefits not only yourself but your patients as well. Here are the things you can learn to be better at what you do:


# 1. PRIORITIZATION & TIME-MANAGEMENT

      A usual nurse's shift lasts 8 hours. Compiling all you have to do as a staffnurse demands time-management. Rendering patient care, taking vital signs, preparing and giving medications, making appropriate referrals, documenting on the patient's chart...the list go on. With so many responsibilities a staffnurse has to squeeze in that 8 hours, every single minute counts so you can't afford to waste any. Know your priorities and do the most important thing first.


# 2. FLEXIBILITY

      Nurses handles patients across the lifespan, with varying conditions, personalities and culture. The flexibility to handle different patients is one of the most valuable skills that can be developed. It's important to know what your patient's culture is and respect them.


# 3. SKILL TRAINING

      Skill, as opposed to knowledge, is something you build through experience. There are things you just don't get out of a book. These are stuffs which real life teaches you. Don't get frustrated too soon, practice requires patience and determination. A sound knowledge and understanding will guide you through it.

      Learning never stops. Upgrade your skill. Attend seminars and trainings, accept new duties and responsibilities...continuously improve yourself.


# 4. KNOWLEDGE - FOR A SOLID FOUNDATION

      Those information you've acquired while studying nursing is your foundation. These are what you will use in your journey through masterning the profession. Knowledge will guide your decisions especially when you haven't yet fully mastered your nursing skills.


# 5. LEARN FROM YOUR MISTAKES

      Mistakes can be fatal. It happens but make it a point that it will never happen again. When you've done something wrong, allot a time to think it through. What have you done wrong? What could you have done to prevent it? What can you do to make sure it will not happen again?


# 6. STRESS MANAGEMENT

      Working as a staffnurse puts high demands on you. It's one of the most stressful jobs in the world. You'll have to learn to deal with your job and the people you go about in order to survive and thrive in this field.


# 7. ASSESSMENT

      A thorough assessment will guide you in providing quality patient care. Read the patient's chart, observe, and interview the patient.


# 8. VERIFICATION

      When in doubt, don't hesitate to verify. This will prevent an error. Nursing seldom has a place for mistakes since we are dealing with lives. Don't be afraid to ask.