Each and every individual has the right to autonomy. Autonomy is defined as the right to self-govern or in other words, to make your own decisions. We have the right to choose where we work, who we marry, which medical procedures we undergo, and in the end, we have the right to choose whether or not we are resuscitated if something were to happen to us. So why do we not have the right to choose when and how we die?

Death and dying have been the topic of discussion for years however only recently has that discussion shifted focus to how people are dying. Towards the end of life, people often find themselves facing the decision of continuing on with aggressive treatments to prolong what little life they have left, or opting for palliative care and simply waiting for the day where they pass. People are now looking towards physician assisted death as a means to end their pain and suffering and as a way to die with dignity. Physician assisted death is when a physician provides or administers a lethal medication to a requesting individual with the sole purpose of ending that individual’s life. Many people view physician assisted death as wrong however, it is our right.

There are currently many treatment options available when it comes to end-of-life care. The first option is treatment based on the disease. For example, cancer patients have the option of chemotherapy, radiation, or surgery. When patients forgo these options, for one reason or another, they are forgoing one end-of-life treatment option available to them. Another option available is palliative care which can begin at the time of diagnosis and may occur at the same time as treatment. However, after treatment of the disease is stopped and it is unclear if the patient will survive, the patient must forgo palliative care and enter hospice care. During hospice care, opioids can manage pain, but cannot eliminate it all together. When opioids are insufficient and the suffering becomes unbearable, the patient is offered sedatives or other psychoactive medications in order to achieve complete unconsciousness until the patient dies, otherwise known as terminal sedation. If patients forgo all available options, depending on which state the patient lives in, a patient may opt for a fourth treatment option known as physician assisted suicide.

 As stated above, each and every individual has the right to autonomy and that autonomy should be respected up until the end of life. If an individual has deemed their suffering to be intolerable, and they are ready to say goodbye to their loved ones, they should be able to do so without having someone else force them to continue living in agony. Individuals often times choose physician assisted suicide as a way to prevent or escape further suffering or pain. We do not get to decide when an individual is done suffering and we certainly do not have the right to force individuals to continue suffering. 

Individuals choose physician assisted suicide for many different reasons depending on the situation they are in.  A study conducted in 2017 showed that ninety-two percent of individuals choose physician assisted suicide because of the loss of autonomy while ninety percent stated they could no longer enjoy activities that made life worth living and seventy-eight percent perceived a loss of dignity. A book published in 2017 discusses palliative care options for terminal ill patients but also argues that palliative care may not be sufficient in alleviating one-hundred percent of patients’ pain and discomfort. When palliative care is no longer sufficient, individuals often chose to end the pain and suffering and lessen the burden on family members by opting for physician assisted suicide. A physician’s duty is to help relieve the suffering of individuals. By assisting in physician assisted suicide, physicians are committing an act of compassion and fulfilling their obligation of non abandonment. In other words, physicians are fulfilling their obligation to their patients by caring for them and respecting their wishes up until death. 

As physician assisted suicide becomes increasingly more popular as a treatment option for terminally ill patients, safeguards and policies must be put into practice to ensure individuals are not simply using is as a means to commit suicide due to depression. For example, the Oregon Death with Dignity Act has certain requirements that patients must meet before committing physician assisted suicide. This bill requires that patients must have a terminal illness with less than six months to live. In addition, they must receive a second opinion from another physician. The patient must also be informed of other options available such as hospice, palliative care, aggressive treatment, or deep sedation. Patients are required to make a written request along with a verbal request for physician assisted suicide and the physician must wait fifteen days after the request before providing the patient with the prescription. Lastly, the patient must be able to swallow the medication themselves or inject themselves with the medication. The physician or nurse may not administer the medication in order for it to be considered a physician assisted death.

The main reasons why people consider physician assisted suicide to be wrong include religious or moral beliefs. However, due to the many different religions in the world with varying beliefs, religion should play no part in medical decisions. There are many different reasons why individuals choose to end their pain and suffering but the important concept to remember is no matter the reason why, the intention is always the same: End the agony. People should respect others’ autonomy and their decision regarding end of life care. Physician assisted suicide should be implemented as a final treatment option for individuals with terminal illnesses.

References

Blanke, C., LeBlanc, M., Hershman, D., Ellis, L., & Meyskens, F. (2017). Characterizing 18 years of the Death With Dignity Act in Oregon. ​JAMA oncology, 3(10), 1403–1406. doi:10.1001/jamaoncol.2017.0243

Orentlicher, D., Pope, T. M., & Rich, B. A. (2016). Clinical criteria for physician aid in dying. Journal of palliative medicine ​ , ​19 ​ (3), 259–262. doi:10.1089/jpm.2015.0092

Simmons K. M. (2018). Suicide and death with dignity. ​Journal of law and the biosciences ​ , ​5 ​ (2), 436–439. doi:10.1093/jlb/lsy008

Sulmasy, L. S., & Mueller, P. S. (2017). Ethics and the legalization of physician-assisted suicide: An American College of Physicians position paper. ​Annals of internal medicine, ​ ​167 ​ (8), 576. doi:10.7326/m17-0938

Sumner, L. W. (2017). ​Physician-assisted death: What everyone needs to know ​ . New York, NY: Oxford University Press.

CB – Do’s and Dont’s

What is CBD?

Cannabidiol, aka CBD is the second most abundant cannabinoid in the marijuana plant, but let’s take a step back and start with the basics. Marijuana, hemp, ganja, grass, bud, weed, good old Mary Jane; the stuff that your grandparents hate and everyone at The Grateful Dead concert loves. As more and more states decriminalize and recreationally legalize marijuana, the more it becomes apart of our every day lives. Growing up being force fed lies about the “devils lettuce” and all its gateway drug horrors, it’s hard to flip the switch and accept it as God’s gift to the world; but if we take a second and look at marijuana with some logic, you can really open your third eye. Looking at marijuana from a chemical standpoint looks like something out of a Syfy movie, but all you really need to know is that the plant has two main chemical compounds called cannabinoids. Cannabinoids get their fancy name due to the fact that they react with our bodies’ Cannabinoid receptors found in our brains and immune systems. The two main cannabinoids affecting the body when using marijuana are tetrahydrocannabinol, also known as THC, also known as the stuff that gets you high; the other is our good old friend CBD. Its in the news, its in the papers, its all over the internet, CBD is the world’s latest and greatest miracle drug. But before you wipe out that sketchy gas station around the corner of all it’s “CBD gummy bears”, lets dig a little deeper to the roots of this psychoactive plant.

Myths about CBD

“CBD will get me high” myth

CBD does interact with the cannabinoid receptors of the brain, but not in the same psychoactive manner that THC does.

“CBD will make me fail a drug test” myth

CBD isn’t what drug tests test for, drug tests test for THC because that’s the part that gets you high. If it isn’t getting you stoned, why bother testing for it?

“CBD is illegal” myth

CBD is federally legal, as long as it contains less than 0.3% THC. Some states have stricter laws than others when it comes to marijuana, for example in Virginia CBD requires a medical prescription. But at the end of the day CBD is legal for the same reasons it won’t make you fail a drug test.

“CBD is addictive” myth

As controversial as it is, its generally accepted that marijuana in itself is nonaddictive. I mean, if the part of weed that gets you stoned isn’t addictive, the rest of it most certainly isn’t.

“CBD cures all” myth

Every day the laundry list of medical benefits of CBD gets longer and longer, but one article will tell you CBD is the perfect cure for insomnia, while the next will tell you it’s the perfect subconscious stimulator to keep you up at night to, say I don’t know, stay up and write a blog about CBD. Let’s take a look at the real benefits of CBD.

Benefits of CBD

Across the globe CBD is becoming more and more evident as a medical marvel, for example the United Kingdom just upped CBD from its list of nutritional supplements to a medicine. But don’t let this make you stop at every CBD mall kiosk for their caramel pomegranate hemp hand lotion. Here’s what will actually change if you use CBD

• Relives chronic pain or joint/muscle inflammation
• Stress relief
• Reduces nausea
• Improves sleep
• Treats epilepsy and seizures
• Calms anxiety, depression and other acute mental disorders
• Aids the body in fighting several drug resistant bacteria
• Topical use aids in treating of skin ailments, rashes and acne

What to watch for

Essentially, don’t buy into everything you read on the internet. CBD won’t cure your transient idiopathic arrythmia or your moderate to severe chronic plaque psoriasis, but that doesn’t mean it won’t help! Just because you saw on the 6 o’clock news that a mom from the next state over stops her son’s seizures with CBD oil, doesn’t mean you should use CBD on its own to cure that rash you’ve had for a few months. CBD has lots of medical benefits, and countless more that are undiscovered, but leave the discovering to the scientists running the clinicals.

On a daily basis CBD and marijuana in general is found to have more and more benefits. But just like any other good thing, for every person doing the right thing, there’s ten other guys undercutting the real deal for a rip off, to only gain profit. CBD when used in the right dosages, and for a long enough period of time can really show a lot of medical benefits. But that doesn’t mean you should trust everything you see in the window of the smoke shop. When you shop cheap online, or buy CBD from the corner store, you probably aren’t going to see any results. More often than not, what you’re getting isn’t even real CBD, usually it’s vegetable oil with a little bit of artificial flavoring. Proceed with caution when buying that CBD Juul pod from the gas station because 9 times out of 10 these CBD gimmicks aren’t FDA regulated, or regulated at all. When it comes to the stuff your putting in your body, you want it to be as safe as possible, especially when trying to combat another ailment. Using these imported knock offs probably won’t help your cause, and can open another medicinal can of worms that you really don’t want to, so if CBD really is the cure for you go see a doctor or professional that can point you in the right direction.

As much as we want it to be, CBD isn’t the cure all miracle drug, but it has the potential to be life changing for a lot of people, so commit to a trail, let the CBD run its course. And if all else fails, smoke a bone.

References

Goldenberg, (2019). Introduction to CBD. Journal of Continuing Education Topics & Topics, 21 (3), 58-62. http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=139253814&site=ehost-live

Teitelbaum, (2019). A Hemp Oil, CBD, and Marijuana Primer: Powerful Pain, Insomnia, and Anxiety-relieving Tools! Alternative Therapies in Health and Medicine, 25(S2), 21-23. http://search.ebscohost.com/login.aspx?direct=true&db=cmedm&AN=3120220&site=ehost-live

Welty, Luebke & Gidal, (2014). Cannabidiol: Promise and Pitfalls. Epilepsy Currents, 14(5), 250-252. https://doi.org/10.5698/1535-7597-14.5.250

Depression symptoms can vary from mild to severe causing different degrees of sadness, lack of energy, feelings of worthlessness, isolation and lack of desire to enjoy everyday life. Depression is a major concern and projected to be the number one cause of global burden by the year 2030 (Greeson, Smoski, Suarez, Brantley, Lynch & Wolever, 2016). Conventional medicine uses a combinations of treatment that include antidepressant medication and psychotherapy however a less conventional way of dealing with depression has become more and more common in recent time. Meditation, has proven to be effective in helping with symptoms of depression study after study. Not only has it helped with the symptoms, but people have reported increased feelings of connection and spiritual experience. Spiritual experiences are experiences of connection with the transcendent in daily life (Koenig, Pearce, Nelson & Erkanli, 2016) leading to an improved more fulfilling life. So, what is meditation? Meditation is a mental training capable of producing connections between the mind, body and spirit. Research shows meditation helps people achieve balance, relaxation and self-control, in addition to the development of consciousness (Sampaio, Lima, Ladeia, 2016). Once you have experienced the amazing feeling of connection, you will want to connect more and more.

In the video below you will find Dr. Lisa Miller, who has a background in psychology and neuroscience explaining her own story with depression and spiritual experience which she describes as two sides of one door.

References

Greeson, J. M., Smoski, M. J., Suarez, E. C., Brantley, J. G., Ekblad, A. G., Lynch, T. R., & Wolever, R. Q. (2015). Decreased Symptoms of Depression After Mindfulness-Based Stress Reduction: Potential Moderating Effects of Religiosity, Spirituality, Trait Mindfulness, Sex, and Age. Journal of Alternative & Complementary Medicine, 21(3), 166–174. https://doi.org/10.1089/acm.2014.0285

Koenig, H., Pearce, M., Nelson, B., & Erkanli, A. (2016). Effects on Daily Spiritual Experiences of Religious Versus Conventional Cognitive Behavioral Therapy for Depression. Journal of Religion & Health, 55(5), 1763–1777. https://doi.org/10.1007/s10943-016-0270-3

Sanchez Sampaio, C. V., Garcia Lima, M., & Ladeia, L. A. (2016). Meditation, Health and Scientific Investigations: Review of the Literature. Journal of Religion & Health, 411-427. doi:10.1007/s10943-016-0211-1

Photo by Priscilla Du Preez on Unsplash

Traveling is something that many people like to do or dream of doing, but don’t take it into action for a number of different reasons such as lack of money, job responsibilities, home/family responsibilities, etc. Perhaps if more people were aware of the physical, mental health and social benefits of traveling abroad, they would also make traveling one of their priorities. Let’s discuss the overall health benefits that according to scientific research happen when we travel more…

The most well-known benefits of traveling seem to be benefits to human’s mental health. One of the ways that traveling benefits mental health is that it broadens people’s perspectives, people’s views of the world, and eliminates narrow mindedness by pushing people out of their comfort zones and making them embrace the unfamiliar. Traveling also forces people to communicate, navigate and learn about other cultures. Traveling increases cognitive stimulation and enhances people’s creativity when they immerse themselves in new and unfamiliar places, sights and sounds. According to Kristen Fuller, a physician and mental health writer for Center for Discovery, changing ones environment causes new neuronal pathways to form, enhancing creativity (Fuller, 2018). According to Dr. Paul Nussbaum, Ph.D., ABPP, president and founder of the Brain Health Center, Inc., “Because it challenges the brain with new and different experiences and environments, travel is an important behavior that promotes brain health and builds brain resilience across the lifespan” (Global, 2018). Traveling also provides stress relief and allows people to focus on the present moment by resetting their minds and forgetting about their chores, work and responsibilities (Fuller, 2018). After being on vacation for only a day or two, 89 percent of people are able to leave the stressors of work behind and relax.  This has long-term effects, as stress has been shown to play a damaging role in health and can actually speed up the aging process (Global, 2018).

Photo by Element5 Digital on Unsplash

Traveling also increases people’s happiness by boosting their mood before, during and after the trip. According to a study by the University of Surrey, people are at their happiest when they have a vacation planned, they are more positive about their health, economic situation and general quality of life (Fuller, 2018). Another study by Cornell University found that people find more happiness from anticipating a travel experience in comparison to anticipating buying a new possession (Fuller, 2018). A survey by the US Travel Association found that traveling can strengthen relationships by sharing travel experiences and working together through mishaps (Fuller, 2018). In an article on the mental benefits of vacationing somewhere new, the authors discuss that traveling “enhances emotional agility, or the ability to not react immediately to emotions, but to observe those that arise, carefully collect information to understand the possible causes, then intentionally decide how to manage them” (Kashdan, Achor, Gielan, O’Brien, Kolb & Brady, 2018). The second benefit mentioned in this article is empathy, which according to studies, people who travel more are able to show a greater tolerance and trust toward strangers, greater ability to suspend judgment, and become more appreciative of people (Kashdan, Achor, Gielan, O’Brien, Kolb & Brady, 2018). Other interesting benefits of traveling found in literature reviews of research studies state that time allotted for family bonding is decreasing, likely attributed to increased career demands and changing family structures. Several studies showed travel as a means to improve communications within a relationship, reduce the possibility of divorce, strengthen lifelong family bonds and increase a sense of well-being in adults and children (Durko & Petrick, 2016).Photo by Frank Vex on Unsplash

As with mental health, there are also physical health benefits of traveling. These benefits have a lot to do with the physical activities most commonly associated with traveling. A study by the Global Coalition of Aging on the physical, cognitive and social benefits of travel found that travel provides a path to a healthy aging process. The article states that “women who vacationed every six years or less had a significantly higher risk of developing a heart attack or coronary death compared to women who vacationed at least twice a year” (Global, 2018) as well as “men who did not take an annual vacation had a 20 percent higher risk of death and 30 percent greater risk of death from heart disease” (Global, 2018). Traveling involves plenty of physical activity, and according to a collective article by Transamerica Center for Retirement Studies and US Travel Association “Older adults who are physically active have lower rates of heart disease, high blood pressure, stroke, diabetes, cancers, lower risk of falling, and better cognitive function” (Global, 2018). Some of the mental health benefits of travel go hand in hand with the physical health benefits, and a perfect example of this is the “stress relief” benefit and stress has been linked to having damaging effects on physical health. The same collective article mentioned above states that “after being on vacation for only a day or two, 89 percent of people are able to leave the stressors of work behind and relax. This has long-term effects, as stress has been shown to play a damaging role in health and can actually speed up the aging process” (Global, 2018).

Photo by Capturing the human heart. on UnsplasPhoto by Capturing the human heart. on Unsplash

After learning about all the physical, mental and social benefits of traveling, it is safe to say that we should start thinking of travel less like a luxury and more like a necessity for optimal health.Photo by Caroline Selfors on Unsplash

References:

1. Kashdan, T. B., Achor, S., Gielan, M., O’Brien, E., Kolb, D. M., & Brady, S. M. (2018, May 21). The mental benefits of vacationing somewhere new. Retrieved from https://hbr.org/2018/01/the-mental-benefits-of-vacationing-somewhere-new
2. Global Coalition on Aging. (2018, July). Destination Healthy Aging: The physical, cognitive and social benefits of travel. Retrieved November 10, 2019, from https://globalcoalitiononaging.com/wp-content/uploads/2018/07/destination-healthy-   aging-white-paper_final-web.pdf
3. Durko, A., & Petrick, J. (2016). The benefits of travel: Family and relationships review of literature. Travel and Tourism Research Association: Advancing Tourism Research Globally. 16 https://scholarworks.umass.edu/ttra/2013/AcademicPapers_Oral/16
4. Fuller, K. (2018, November 27). Six ways traveling can boost your mental health. Retrieved November 10, 2019, from https://www.psychologytoday.com/us/blog/happiness-is-state-        mind/201811/six-ways-traveling-can-boost-your-mental-health

Vaping has grown in popularity over the years and is done with the use of e-cigarettes. E-cigarettes were first introduced as an alternate nicotine delivery device in 2007 in the United States. Today, e-cigarettes are sold online and in stores, with a global market worth approximately $6 billion.

What is Vaping?

Vaping is the inhalation and exhalation of vapor produced by products used in an electronic cigarette (e-cigarette). E-cigarettes heat the liquid/ cartridges to produce an aerosol that the user inhales into his or her lungs. The cartridges that are vaporized often contains nicotine (impacts addiction), tetrahydrocannabinol (THC), cannabinoid oils (CBD) and other additives. The e-cigarettes are available in hundreds of different flavors, many shapes and sizes to include those that look like regular cigarettes, pens, USB flash drives and everyday items.

Claims

It is reported that e-cigarettes are marketed as a smoking cessation product. No government agency has endorsed this claim. The World Health Organization (WHO), stated that due to inconclusive evidence, it is not concluded that vaping aids in smoking cessation. Additionally, there are claims of vaping being a safer alternative to smoking due to e-cigarettes exposing users to less harmful chemicals than burned cigarettes. However, Centers for Disease Control and Prevention (CDC) states that “the use of any tobacco product, including e-cigarettes, is unsafe for young people.”

What are the Experts Saying?

There are many unknowns of the chemicals that are included in vaping products, and this unknown brings uncertainty of the long-term effects of vaping in the coming years. According to the United States Food and Drug Administration (FDA), due to the unknown risks and benefits, the use of e-cigarettes remains controversial. Currently, due to vaping-related illnesses and deaths, organizations such as the CDC, are urging individuals to refrain from vaping while investigations are conducted to determine the cause of incidences and to determine the safety of the various substances used in vaping products.

Health Risks

As of November 5, 2019, the CDC reported 2051 cases of lung-related illnesses (163 more than the previous week), as well as 39 confirmed deaths. The exact cause of the illnesses and deaths are unknown, but the common factor in all the reported cases is vaping.
Some symptoms associated with vaping includes:

• Cough
• Trouble breathing
• Chest pain
• Nausea
• Vomiting
• Diarrhea
• Fatigue
• Fever
• Weight loss
• Lung-related illness
• Heart-related complications
• Death

Teen Use

It has become a major concern of the increase statistics of teens who vape. It is reported that e-cigarettes are marketed to attract non-smokers and teenagers, primarily through the flavored options of the liquid products that are used in the e-cigarettes. Flavors such as bubblegum, vanilla, strawberry among others, makes the product more tolerable and enjoyable. Nicotine is found in most e-cigarettes and with the added flavors, makes vaping much more addicting. The impact of nicotine can be harmful on brain development which continues up to age 25 years. According to the CDC, 24 years is the median age of vapors, with a reported age range between the ages of 13 and 75 years. A National Youth Tobacco Study conducted by the American Cancer Society, reported that more than 3.6 million middle and high school students vape.

Vaping Ban

Due to increase in vaping related illnesses and deaths many concerns have been raised including the lack of regulations regarding vaping. In a peer reviewed article titled “450 Vaping-related Illnesses, 5 Deaths: No You Don’t Know What’s in Your Vape,” the author stated that in August 2019, Michigan became the first state to ban flavored-e-cigarette liquids and products. Additionally, he stated that the FDA gave a deadline of May 2020 for e-cigarette manufacturers to submit their product for FDA review (Fratantoro, 2019). Additionally, more states such as: New York, Massachusetts, Rhode Island, Montana, Washington, Oregon and California, have implemented ban on sale of vaping products due to the increase in vaping related illnesses and deaths.

Recommendations

CDC recommends:
• Do not use e-cigarettes or vaping products containing THC
• Do not modify or add any substances to vaping products
• E-cigarettes or vaping products should not be used by youths, young adults and women who are pregnant.
• Adults addicted to nicotine who currently vape, should weigh all the risks and benefits and consider using FDA approved nicotine replacement therapies: Over the counter (patch, gum, lozenge), Prescription (inhaler, nasal spray).
• If you continue to vape, carefully monitor yourself for symptoms and seek medical attention immediately if severe symptoms occur.

Organizations such as the American Medical Association (AMA) recommends that until health officials can investigate and pinpoint the cause of vaping-related illnesses and deaths, “all Americans should avoid using vapes.”

Resources

• Centers for Disease Control and Prevention https://www.cdc.gov/tobacco/basic_information/e-cigarettes/index.htm
• Centers for Disease Control and Preventionhttps://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html
• Fratantoro, M. (2019). 450 Vaping-related Illnesses, 5 Deaths: No, You Don’t Know What’s in Your Vape. RT: The Journal for Respiratory Care Practitioners, 4. Retrieved from http://library.neit.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=139284585&site=ehost-live
• Merianos, A. L., Gittens, O. E., & Mahabee-Gittens, E. M. (2016). Depiction of health effects of electronic cigarettes on YouTube. Journal of Substance Use, 21(6), 614–619. https://doi.org/10.3109/14659891.2015.1118565
• Time USA https://time.com/5685936/state-vaping-bans/
• World Health Organization https://www.who.int/bulletin/volumes/92/12/14-031214/en/

The Centers for Disease Control has found children with disabilities have a 38% higher risk of obesity than children without disabilities (Office of Special Education and Rehabilitative Services, 2011).

Why is physical activity important?

Physical activity is a vital and necessary part of life for people of all ages. It is especially important for children with disabilities. Studies have shown participation in physical activity improves physical and mental health, along with promoting inclusion with peers.

Improvements in Overall Physical Health

• Weight Loss
• Increased Strength and Cardiovascular Endurance
• Improved Flexibility, Balance and Agility
• Reduced Risk of Developing Further Medical Conditions

Inclusion with Peers

• Improved Social Skills
• New Friendships
• Teaches Competitiveness and Teamwork Skills

Mental Health Benefits

• Increased Self-Confidence
• Promotes Independence
• Reduced Symptoms of Anxiety and Depression
• Achievement of Goals

Physical activity provides many benefits for children with disabilities. The U.S. Department of Health and Human Services recommendation for physical activity is at least 60 minutes daily of moderate to vigorous intensity for all children (Office of Special Education and Rehabilitative Services, 2011). The significant physical and psychosocial benefits activity can have on a child with disabilities can range from improved motor coordination and weight loss to increased self-esteem and decreased risk of depression. Participation in physical activity has also been shown to have an influence on a child’s social skills. These benefits all have the possibility to have a drastic impact on the life of a child with disabilities.

References

Geslak, D. S. (2016). Exercise, Autism, and new possibilities. Palaestra, 30(2), 32–36. Retrieved fromhttp://library.neit.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=116184585&site=ehost-live

Menear, K. S., & Shapiro, D. R. (2004). Let’s get moving! Physical activity and students with physical disabilities. Physical Disabilities: Education and Related Services, 23(1), 9–18. Retrieved from http://library.neit.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=eric&AN=EJ842011&site=ehost-live

Murphy, N. A., Carbone, P. S., & Council on Children with Disabilities. (2008). Promoting the participation of children with disabilities in sports, recreation, and physical activities. American Academy of Pediatrics, 121(5). doi:10.1542/peds.2008-0566

Office of Special Education and Rehabilitative Services (ED). (2011). Creating equal opportunities for children and youth with disabilities to participate in physical education and extracurricular athletics. Office of Special Education and Rehabilitative Services, US Department of Education. Retrieved from http://library.neit.edu:2048/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=eric&AN=ED524248&site=ehost-live

vAPING IS THE NEW FAD FOR TEENAGERS AND YOUNG ADULTS

Vaping is know as an alternative to cigarette smoking. In 2014 vaping companies such as “Juul” started displaying advertisements about vaping to their targeted audience, teenagers. The advertisements in magazines and TV commercials state that vaping is a healthier alternative to smoking cigarettes. A vape cigarette pen is a device that resembles that looks like an usb that you would plug into your computer. The vape pen vaperizes oils that contain nicotine without the tobacco and other chemicals that are terrible for your lungs.

Advertisements in 2014 make the vape pens look like a healthy, fun and hip alternative to cigarette smoking. 

The video above is an advertisement that is displaying a positive effect on vaping. This video displays views of capers looking as:

• healthy individuals
• vaping as a recreational activity without consequences
• a tool to help an individual quick smoking
• young adults looking “cool” as they smoke the vape pen

4 years into vaping…

In 2018 there have recently been new views on vaping and the negative effects it has had on society, teenagers and young adults.

In 2018:

1 in 5 high school students are using vaping pens

1 in 20 middle schools are using vaping pens

3.6 million students are engaging in the use of vaping pens…

Evidence based articles recently state the negative effects that vaping pens have on individuals and the long term effects that are not stated in advertisements towards young teens.

• Vaping is now classified as a “gate way” drug to smoking cigarettes, individuals who start vaping are more likely to start smoking cigarettes
• Although vaping pens do not contain tobacco, they contain chemicals and other unhealthy oils
• Vaping has long term health complications including: shortness of breath, inflamed lungs, lung disease and respiratory problems

The media may be displaying a positive image on  vaping, but evidence based research has proved that vaping is not as healthy for you as perceived! 

References:

Sherratt, F. C., Newson, L., & Field, J. K. (2016). Electronic cigarettes: a survey of perceived patient use and attitudes among members of the British thoracic oncology group. Respiratory Research, 17(1), 55. https://doi.org/10.1186/s12931-016-0367-y

Van Gucht, D., & Baeyens, F. (2016). Health professionals in Flanders perceive the potential health risksof vaping as lower than those of smoking but do not recommend using e-cigarettes to their smoking patients. Harm Reduction Journal, 13(1), 22. https://doi.org/10.1186/s12954-016-0111-4

Wang, J. B., Olgin, J. E., Nah, G., Vittinghoff, E., Cataldo, J. K., Pletcher, M. J., & Marcus, G. M. (2018). Cigarette and e-cigarette dual use and risk of cardiopulmonary symptoms in the Health eHeart Study. Plos One, 13(7), e0198681. https://doi.org/10.1371/journal.pone.0198681

The thought of going under the knife is frightening to most people which usually leads to patient’s avoiding surgery and dealing with their circumstances. This is very common in people who are suffering with excruciating hip pain. According to the Agency for Healthcare Research and Quality, more than 300,000 hip replacements are done each year in the United States and only a small 1% of them fail and require a revision. Usually the patient’s who require a revision are ones who are noncompliant with their hip precautions, lack the knowledge of what tools to use during healing, or may have gotten an infection. Following your precautions and having access to adaptive equipment are simple ways to avoid further injury and promote healthy healing.

What Can Lead to a Hip Replacement?

A hip replacement may be needed after having a traumatic injury (i.e. car accident or a bad fall) however, the main culprit is usually arthritis.

Arthritis itself means inflammation in a joint and there are several different kinds of arthritis. The different types of arthritis that may lead to the need for joint replacement include:

• Osteoporosis- is an ailment in which bones become very weak and break easily.
• Rheumatoid Arthritis- is a chronic inflammatory disorder which effects many joints including ones in hands and feet.
• Osteoarthritis- occurs when the stretchy tissues around the bones are worn down.

How Would You Know if You Need a Hip Replacement?

Usually your orthopedic doctor and/or surgeon would be the one to decipher whether or not a hip replacement is necessary or if another intervention would be more appropriate. Some signs that may indicate that it is time for a hip replacement include:

• Hip pain while at rest, during, or after exercise
• Stiffness in your hip
• Pain medication aren’t providing you the relief you want
• Hip pain prevents you from doing your everyday tasks
• Hip pain keeps you from engaging in your leisure activities
• You’re not as mobile as usual
• You have been diagnosed with arthritis in your hip
• X-Rays show damage to joint

What are the Hip Precautions?

Depending on what type of hip replacement your surgeon performs, posterior or anterior (other approaches may be used), you may a different set of rules to abide by.

Anterior Hip Precautions May Include:

• Do not step backwards with surgical leg. No hip extension.
• Do not allow surgical leg to externally rotate (turn outwards).
• Do not cross your legs. Use a pillow between legs when rolling.
• Sleep on your surgical side when side lying.

Posterior Hip Precautions May Include:

• Don’t bend your hip past a 90 degree angle.
• Don’t cross your legs.
• Don’t twist your hip inwards- keep knees and toes pointed upwards.

Adaptive Equipment

Once you meet with your Occupational Therapy practitioner, she/he will introduce something called a “hip kit”. A hip kit includes are a set of tools that will help you achieve your maximal level of independence while adhering to your hip precautions. These tools will help make your life a whole lot easier and help you avoid another trip to the doctor. In fact, the study done by Bozorgi et al (2016) concluded that patients who received rehabilitation services post hip replacement showed improvement. However, patients who were in the experimental group (which had additional supervision) and were trained in use of adaptive devices, demonstrated physical function, strength, reduced disability, and pain intensity significantly more than the group who weren’t trained on adaptive devices.

Hip Kits May Include:

• A dressing stick
• A sock aid
• A reacher
• A shoe horn
• A long handled sponge
• A bathroom bottom buddy

References:

Spalević, M., Milenković, S., Kocić, M., Stanković, I., Dimitrijević, L., Vesna Živković, V., Čolović, H., Spalević, M. (2018). Total Hip Replacement Rehabilitation: Results and Dilemmas. Acta Medica Medianae, 57(1), 48-53. doi:10.5633/amm.2018.0108

Lee, G. R. H., Berstock, J.R., Whitehouse, M. R., & Blom, A. W. (2017). Recall and Patient Perceptions of Hip Precautions 6 Weeks After Total Hip Arthroplasty. Acta Orthopaedica, 88(5), 496–499

Bozorgi, A. A., Ghamkhar, L., Kahlaee, A. H., & Sabouri, H. (2016). The Effectiveness of Occupational Therapy Supervised Usage of Adaptive Devices on Functional Outcomes and Independence after Total Hip Replacement in Iranian Elderly: A Randomized Controlled Trial. Occupational Therapy International, 23(1), 143–153.