ANAPHYLACTIC SHOCK:

EpiPens are utilized after signs and symptoms of anaphylactic shock are recognized; most common include (within minutes of exposure) hives, itching, swelling of the lips, tongue and throat, confusion, tachycardia, wheezing, chest tightness, and nausea (2016). Anaphylaxis can be caused by many triggers such as insect bites, food allergy, medicine allergy, changes in temperature, and so on. Anaphylaxis is sudden and can become fatal quickly; therefore, carrying an EpiPen (prescribed by your doctor) if you have extreme allergies can make the difference between life and death.

EpiPens hold an important life-saving synthetic substance called epinephrine, also known as adrenaline, which the body naturally produces and releases under stress. Epinephrine and adrenaline are exactly the same. Since it is produced naturally by the body, there are no absolute contraindications and is the ONLY first-line treatment for anaphylaxis (EpiPen 2016).

Many misconceptions regarding EpiPens exist, here I will discuss a few of them.

Myth: I only need to purchase one EpiPen; it can be used multiple times.

Fact: EpiPens are one-time use tools and you should have two available at all times. About one in five patients require a second dose after a severe reaction and it is possible a delayed response may occur up to 72 hours after the initial reaction (EpiPen 2016). Any further administration of epinephrine should be under direct supervision of medical personnel.

EpiPens expire after approximately one year; Brasted (2016) states after 18 months it is unknown how much of the epinephrine is still present. However, when faced with the option of no EpiPen or using an expired EpiPen, medical professionals suggest using the expired EpiPen as opposed to nothing at all.

Myth: Avoiding allergens eliminates the need for an EpiPen.

Fact: Even trying to avoid certain triggers, accidents can happen. Trace amounts of allergen can cause a reaction and at times, people do not recognize food allergens easily and can accidentally ingest a food they’re allergic to. It’s important to always be aware of the signs and symptoms of anaphylaxis and have access to two EpiPens.

Myth: I can inject EpiPen at the site of insect sting.

Fact: The EpiPen should only be injected into the middle of the outer thigh and in no other location. Intramuscular administration of epinephrine is necessary due to the fact that intravascular injection can be fatal; the thigh has the least amount of large blood vessels (Brasted 2016).

*Please keep in mind, after utilizing the EpiPen for anaphylactic shock, it is imperative to seek immediate medical attention.*

Step-by-Step use of Epi-Pen

INFORMATION ABOUT PURCHASING AN EPIPEN:

https://www.epipen.com/en/hcp/for-health-care-partners/for-pharmacists

FOR FURTHER INFORMATION, YOU CAN VISIT:

https://www.epipen.com

References

Brasted, I. D., & Ruppel, M. C. (2016). Anaphylaxis and Its Treatment. EMS World, 45(9), 31-37.

Guide to Using Your EpiPen® and Trainer Pen. (2017, March). Retrieved May 19, 2017, from http://www.epipen.co.uk/patients/epipenr-user-guide/

GrumpySam. (2016, January 11). Epipen autoinjector into ballistic gelatin. Retrieved May 20, 2017, from https://www.youtube.com/watch?v=vfx4qVsTFmg&feature=youtu.be

Tesluk, A. (2016, December 26). Live Anaphylactic Reaction and Use Of EPI Pen. Retrieved May 19, 2017, from https://youtu.be/MdBUZn1PG58

The official website for EpiPen® (epinephrine, USP) and EpiPen Jr® (epinephrine, USP) Auto-Injectors. (2016). Retrieved May 17, 2017, from https://www.epipen.com/en/hcp/sitecore/content/epipen/epipen-consumer/pages/home/what-is-anaphylaxis/facts-myths

What Happens during Anaphylaxis Medical Course. (2013, December 14). Retrieved May 17, 2017, from https://www.youtube.com/watch?v=9Qmzt94rRAw

By: Practical Cures

Anxiety is a common emotion, often accompanied by physical feelings of nervousness. These feelings urge us to escape or avoid a seemingly threatening situation. Mild anxiety can be useful in helping individuals avoid a seemingly threatening situation. It can also be useful when it helps people meet the challenges of uncertain experiences. For example, delivering a speech or performing. Anxiety becomes a problem when it consistently interferes with normal life. It also become a problem when it occurs in response to objects or situations that are not dangerous or in response to nothing at all. Recognized Anxiety Disorders today encompass several mental disorders. Mental health professionals typically recognize six general types of anxiety disorders, including phobias, social anxiety disorder, panic disorder, generalized anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder.

Generalized Anxiety Disorder is characterized by chronic and excessive worry surrounding various aspects of an individual’s everyday life. These individuals suffer from repeated experiences of mild to severe fear or dread, which may arise with or without a situational trigger. This fear or dread can lead to emotional distress and disability.

Phobias involve strong excessive fear and avoidance of specific objects or situations that pose little or no threat. Common phobic objects and situations include certain animals, heights, water, and enclosed spaces.

Social anxiety disorder is an excessive fear and avoidance of certain social situations. Individuals with this disorder unrealistically fear they may be embarrassed, humiliated, or otherwise negatively judged by others.

Panic disorder is characterized by sudden surges of fear, or panic attacks. They occur unexpectedly and without apparent reason.

Individuals with obsessive-compulsive disorder experience intrusive, unwanted, and repeated fearful thoughts, images, or impulses. These ideas are called obsessions. The sufferer may find obsessions extremely distressing even while recognizing that they are highly unrealistic. Many OCD sufferers feel compelled to also engage in compulsions. Compulsions are mental or behavioral rituals that they feel help relieve the anxiety.

Post-traumatic stress disorder (PTSD) involves a distressing and disabling response to experiencing a trauma. Sufferers of PTSD experience intrusive uncontrollable recollections of the trauma in the form of nightmares or flashbacks. In a flashback, the person re-experiences the trauma while awake.

By: Jamie

Much like when treating any other disease or disorder, best course of treatment for anxiety disorders is highly individualized to each person suffering these conditions. Less aggressive interventions may be suitable for one individual with generalized anxiety disorder, where another with the same form of disorder may need more than one intervention to manage their disorder.

Medication management of anxiety disorders is aimed at reducing the symptoms of anxiety disorders. Categories of drugs used for management of anxiety disorders include antidepressants, certain anticonvulsants, certain sedatives and low dose antipsychotics.

Cognitive-behavioral therapy involves individuals learning to recognize and change thought patterns and behaviors that lead to troublesome feelings. Dietary and lifestyle changes can also be included in this form of therapy.

Mental illness is commonly not categorized by most individuals as a true “illness” by many individuals in America today. The need for education and understanding of these types of illnesses is crucial. Many people are unaware of the effects associated with these disorders as well as the correlation between mental and physical health and well-being. The psychological and physical influence these disorders have on suffering individuals is too often misinterpreted as just being a personality trait, rather than a medical condition that calls for intervention and management.

For more information on anxiety, visit:
https://www.adaa.org/understanding-anxiety

References
Anxiety. (2016). Funk & Wagnalls New World Encyclopedia, 1p. 1.

Bal, Z. E., Solmaz, M., Aker, D. A., Akin, E., & Kose, S. (2017). Temperament and Character Dimensions of Personality in Patients with Generalized Anxiety Disorder. Journal Of Mood Disorders, 7(1), 10-19. doi:10.5455/jmood.20170214015231

Siau Pheng, L., Ong, C., Vaingankar, J. A., Siow Ann, C., Subramaniam, M., Lee, S. P., & Chong, S. A. (2017). Validity of the Associated Symptom Criteria for Generalized Anxiety Disorder: Observations From the Singapore Mental Health Study. Journal Of Nervous & Mental Disease, 205(5), 390-396. doi:10.1097/NMD.0000000000000608

Sudhir, P. M., Rukmini, S., & Sharma, M. P. (2017). Combining Metacognitive Strategies with Traditional Cognitive Behavior Therapy in Generalized Anxiety Disorder: A Case Illustration. Indian Journal Of Psychological Medicine, 39(2), 152-156. doi:10.4103/0253-7176.203128

Here is what the women of The View had to say about Mama June’s recent weight-loss.

Discussions like these lead to more questions rather than answers. Weight-loss surgery is more than just a before and an after. It is an entire journey. Here are some misconceptions and facts about weight-loss surgery.

People who undergo weight-loss surgery are lazy.

Wrong! Americans are constantly trying to lose weight, but many are failing at the attempt. People are not overweight because they are lazy. American culture makes it difficult to maintain a healthy weight. An estimated 34.2% of U.S adults aged 20 years and older are overweight, 33.8% are obese, and 5.7% are extremely obese (Nardulli, 2012). Once a person reaches the point of obesity it is very difficult to get back down to a healthy weight and maintain that weight. Obesity is a chronic disease that presents significant challenges for treatment long term. For lifestyle interventions, only 20% of people attempting weight loss can achieve and maintain 5% weight loss over a year (Stoklossa & Atwal, 2013).

Surgery is a quick fix for rapid weight-loss.

Wrong! Surgery should not be viewed as a cure, or quick fix. Instead, it is a tool to help get someone to their weight-loss goal. Diet and exercise are still important components to overall success. Patients must adhere to a strict nutritional regimen to ensure safety and success. Also, patients who undergo surgery must consider the risks of surgery as well. When examining a laparoscopic sleeve gastrectomy, the perioperative and postoperative mortality rates are 0.29% and 0.34%, respectively, with complication rates of 13%.14,23 Rare complications occur in the early postoperative period. Serious complications include difficult-to-remedy proximal leaks (4.9%) and bleeding from the long gastric staple line (2.4%) Most complications occur in the late postoperative period. These include gastroesophageal reflux (23%), vomiting (18%), gastric tube stricture (2.3%;), stenosis (2.4%), leak (2.4%), incisional hernia (2.4%), gastrocutaneous fistula, and weight regain (Ma & Madura, 2015).

The Doctors discuss the science behind bariatric surgery.

Does insurance cover weight-loss surgery?

This is often determined by the individual insurance company. Some companies will cover the cost without issue. The easiest way to get covered is through the recommendation of a doctor. However, this does not always mean the insurance company will cover the cost. Coverage is determined on a case by case basis so individuals interested in undergoing weight-loss surgery should check with their insurance carriers.  The cost of the surgery, without complications, is approximately $13,000 dollars (Nardulli, 2012).

Is weight-loss the only benefit of surgery?

No! Quality of life and reduction of comorbidities are other major reasons why individuals seek surgical intervention. Obesity contributes to approximately 300,000 premature deaths each year because of health-related complications (Agala, 2017). Obese individuals often suffer from a variety of comorbidities that negatively impact their overall health and well-being. Some comorbidities include hypertension, diabetes, sleep apnea and hyperlipidemia. Those who are overweight also suffer from psychological issues like anxiety and depression (Parks, 2015).

Who qualifies for weight-loss surgery?

1. A person with a BMI ≥ 40, or more than 100 pounds overweight.
2. A person with a BMI ≥35 and at least two obesity-related comorbidities.
3. Inability to achieve a healthy weight loss sustained for a period of time with prior weight loss efforts (Agala, 2017).

The Doctors discuss another celebrity who had great results with bariatric surgery.

Weight-loss surgery is not a quick fix, it is a journey. It is not as simple as the media portrays it to be. It is a choice for a better, healthier lifestyle!

References

Agala, R. A., Almusaiad, S. M., Alsufi, A. M., Aldhiafah, Z. A., Muzaffar, A. H., Al Ghamdi, S. S., & … Alaeq, R. A. (2017). A Critical Review on Risks versus Benefits of Bariatric Surgery. Egyptian Journal Of Hospital Medicine, 279-284

Ma, I. T., & Madura II, J. A. (2015). Gastrointestinal Complications After Bariatric Surgery. Gastroenterology & Hepatology, 11(8), 526-535.

Nardulli, J. A. (2012). The Road to Health Is a Battle Hard Fought: Support for Requiring Coverage of Bariatric Surgery for an Expanded Group of Qualified Individuals. Journal Of Legal Medicine, 33(3), 399-415.

Park, J. (2015). The meanings of physical appearance in patients seeking bariatric surgery. Health Sociology Review, 24(3), 242-255.

Stoklossa, C. J., & Atwal, S. (2013). Nutrition Care for Patients with Weight Regain after Bariatric Surgery. Gastroenterology Research & Practice, 1-7.