What you need to know about Achalasia as a patient

Achalasia is a disorder of the esophagus (the passageway for food from the mouth to the stomach) that makes it difficult for food and fluid to pass into the stomach. Normally, the esophagus is empty between swallows. When a person swallows, muscle contractions sweep down the esophagus, the esophageal sphincter (the opening at the lower end of the esophagus) opens, and food or fluid passes into the stomach. People with achalasia have difficulty swallowing because the wave of muscle contractions that sweep food and fluid down the esophagus does not occur. In turn, the esophageal sphincter does not open properly, so food and fluid cannot pass into the stomach. With Achalasia, food and fluid remain trapped in the esophagus causing discomfort and other symptoms. The esophagus usually becomes wider than normal.

For more information, visit: http://www.mayoclinic.org/diseases-conditions/achalasia/basics/definition/con-20024482?mc_id=us&utm_source=youtube&utm_medium=sm&utm_content=video&utm_campaign=mayoclinic&geo=national&placementsite=enterprise&cauid=100504


Whooping Cough Diagnosis: MedlinePlus Lab Test Information


What is a whooping cough test?

Whooping cough, also known as pertussis, is a bacterial infection that causes severe fits of coughing and trouble breathing. People with whooping cough sometimes make a “whooping” sound as they try to take a breath. Whooping cough is very contagious. It is spread from person to person by coughing or sneezing.

You can get whooping cough at any age, but it mostly affects children. It’s especially serious, and sometimes deadly, for babies less than a year old. A whooping cough test can help diagnose the disease. If your child gets a whooping cough diagnosis, he or she may be able to get treatment to prevent severe complications.

The best way to protect against whooping cough is with vaccination.

Other names: pertussis test, bordetella pertussis culture, PCR, antibodies (IgA, IgG, IgM)

What is the test used for?

A whooping cough test is used to find out whether you or your child has whooping cough. Getting diagnosed and treated in the early stages of infection may make your symptoms less severe and help prevent the spread of the disease.

Why do I need a whooping cough test?

Your health care provider may order a whooping cough test if you or your child has symptoms of whooping cough. You or your child may also need a test if you’ve been exposed to someone who has whooping cough.

Symptoms of whooping cough usually occur in three stages. In the first stage, symptoms are like those of a common cold and may include:

  • Runny nose
  • Watery eyes
  • Mild fever
  • Mild cough

It’s better to get tested in the first stage, when the infection is most treatable.

In the second stage, the symptoms are more serious and may include:

  • Severe coughing that’s hard to control
  • Trouble catching your breath when coughing, which may cause a “whooping” sound
  • Coughing so hard it causes vomiting

In the second stage, infants may not cough at all. But they may struggle to breathe or may even stop breathing at times.

In the third stage, you will start to feel better. You may still be coughing, but it will probably be less often and less severe.

What happens during a whooping cough test?

There are different ways to test for whooping cough. Your health care provider may choose one of the following ways to make a whooping cough diagnosis.

  • Nasal aspirate. Your health care provider will inject a saline solution into your nose, then remove the sample with gentle suction.
  • Swab test. Your health care provider will use a special swab to take a sample from your nose or throat.
  • A blood test. During a blood test, a health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes. Blood tests are used more often in later stages of whooping cough.

In addition, your health care provider may order an x-ray to check for inflammation or fluid in the lungs.

Will I need to do anything to prepare for a whooping cough test?

You don’t need any special preparations for a whooping cough test.

Are there any risks to the tests?

There is very little risk to whooping cough tests.

  • The nasal aspirate may feel uncomfortable. These effects are temporary.
  • For a swab test, you may feel a gagging sensation or even a tickle when your throat or nose is swabbed.
  • For a blood test, you may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

A positive result probably means you or your child has whooping cough. A negative result doesn’t completely rule out whooping cough. If your results are negative, your health care provider will probably order more tests to confirm or rule out a whooping cough diagnosis.

Whooping cough is treated with antibiotics. Antibiotics can make your infection less serious if you start treatment before your cough gets really bad. Treatment may also help prevent you from spreading the disease to others.

If you have questions about your test results or treatment, talk to your health care provider.

Is there anything else I need to know about whooping cough tests?

The best way to protect against whooping cough is with vaccination. Before whooping cough vaccines became available in the 1940s, thousands of children in the United States died from the disease every year. Today, deaths from whooping cough are rare, but as many as 40,000 Americans get sick with it every year. Most cases of whooping cough affect babies too young to be vaccinated or teens and adults who are not vaccinated or up to date on their vaccines.

The Centers for Disease Control and Prevention (CDC) recommends vaccination for all babies and children, teens, pregnant women, and adults who have not been vaccinated or are not up to date on their vaccines. Check with your health care provider to see if you or child needs to be vaccinated.

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How to Brush Your Teeth

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13 [HealthCare] Leadership Lessons from the Lady with the Lamp

“What nursing has to do is put the patient in the best condition for nature to act upon them,” said Florence Nightingale.  The mother of modern nursing was born May 12, 1820 in Florence, Italy, and passed on this day, August 13, 1910 in London England.   As the founder of the science, her philosophy of managing the patient changed the face of nursing forever.

Today, the 108th anniversary of her death, marks a wonderful time to reflect upon the life and work of the woman who more than anyone else can also be properly credited with building the framework for modern healthcare leadership. In her groundbreaking work in Crimea, the “Lady with the Lamp” crafted guidelines for hospital administration and the use of statistics which still serve as the basis for clinical leadership today.

In a very real sense, her innovative approaches make Nightingale the architect of the modern hospital. With the exception of high-tech medicine evolution over the past half century, virtually every department in today’s hospitals and every clinician office can trace the roots of their standards back to those first introduced by Florence Nightingale.


In 1853, the Crimean War broke out….The British Empire was at war with the Russian Empire for control of the Ottoman Empire.  During this time of open conflict, no fewer than 18,000 soldiers were admitted into military hospitals across the war zone.  The English were in an uproar about the neglect of their soldiers, who not only lacked sufficient medical attention due to under-staffing, the conditions in these hospitals were appalling, inhumane and unsanitary.

In late 1854, Florence Nightingale was a highly regarded superintendent living in London when she received an urgent letter from the Secretary of War, Sidney Herbert.  He requested she organize a corps of skilled nurses to tend their sick in Crimea.

Nightingale rose to the call, assembling a team of 34 nurses.  Though they we’re made aware of the horrid conditions, not one was truly prepared for the reality of what they faced upon arriving in Scutari – the base hospital in Constantinople.

The hospital was built on a large cesspool which contaminated the water and the hospital itself.   Patients were lying in their own feces on stretchers strewn throughout the hallways.  Rodents and bugs scurried over them.  More soldiers were dying from controllable infectious disease, like typhoid and cholera, than from their injuries.

The no nonsense Nightingale quickly set to work.  She and her team procured scrub brushes and cleaned every surface within Scutari.  She then spent every waking moment caring for the sick, and, at night, moved through the halls carrying a lantern ministering to patient after patient.  The soldiers who were inspired, comforted and healed by her compassion took to calling her the “lady with the lamp”.  To others, she became me known as “The Angel of Crimea”.

Her work reduced the hospital’s deaths by two-thirds.  In addition to vast improvements in cleanliness, Nightingale also created many patient programs that significantly contributed to a healthy, healing environment – both physically and psychologically – using the application of statistics.

13 Leadership Lessons from the Lady with the Lamp

Follow Your North Star

Born into wealth, Florence could easily have settled into a life of Victorian ease at her family’s country mansion; instead, she chose a path of arduous commitment to caring for others. Nightingale found something more than just a job to do – she was on a mission.  She did not inquire about pay and benefits before leading her team of young nurses off to the Crimea, where they endured working conditions that would be beyond intolerable in today’s world.

Her devotion to her calling changed the work of healthcare forever while ensuring she never experienced burnout.  Her legacy reminds us caring for the sick is more than just a business – it’s a mission, and that being a caregiver is more than just a job – it should be a calling. The first duty of healthcare leadership is inspiring this commitment, beginning with our own examples.

Many of the problems in today’s healthcare system stem from the fact too many clinics and hospitals focus more on their business plans rather than on their missions, and far too many healthcare professionals have jobs rather than a calling. Nightingale might encourage a re-commitment to the things that really matter – those passions that hopefully attracted our idealistic younger selves into healthcare in the first place.  Create a compelling mission for your team, and lead others with that mission front of mind at all times.


Nightingale was courageous and unstoppable. She did not allow opposition from the British aristocracy or the antiquated views of military leaders to prevent her from doing her work. When she ran into a wall, she found a way around or over, even to the extent of going directly to the English public for funding support and to the Queen for political backing.

With a never ceasing, never ending single minded focus to Exceed Expectations, it is always important to remain resolute and thrive, even when facing challenges or obstacles.  If the mission is compelling enough and routinely rallied around, you Will ensure your ongoing efforts lead to ultimate success.

Build a Culture of Discipline

Less well-known than Nightingale’s contributions to hospital and nursing practice was her pioneering work in the field of medical statistics. Her painstaking efforts to chart infection and death rates among soldiers at Scutari gave weight to her demands for improved sanitary conditions first at military hospitals, and later in civilian institutions. She demonstrated that if you want to be effective, it’s not enough to know that you’re right – you must be able to demonstrate that you’re right with the facts.

Be Truly Present

Long before Daniel Goleman coined the phrase “social radar” in his book Emotional Intelligence, Nightingale appreciated that awareness and empathy are central to quality patient care (and to effective leadership). In Notes on Nursing, she wrote: “The most important practical lesson that can be given to nurses is to teach them what to observe – how to observe… If you cannot get the habit of observation one way or another you had better give up being a nurse, for it is not your calling, however kind and anxious you may be.”

In today’s fast-paced healthcare environment, it’s important that caregivers  and healthcare leaders stop for a moment for a quick mental reminder to really be in the moment with patients and team members, and not mentally off onto the next chore.   It is critical leaders apply the “social radar” principle when interacting with everyone.

Set the Stage

Nightingale’s environmental theory was “the act of utilizing the environment of the patient to assist in recovery”.  This involves the nurse’s initiative to configure the environmental settings appropriate for the gradual restoration of a patient’s health and acknowledges external factors associated with the patient’s surroundings affect life and biological and physiologic processes and development.

Just as important is creating a work environment for your staff that encourages peak performance.  Without doubt, the greatest influence in life is our environment – it affects our moods, our ability to perform, our effectiveness, our health, our peace of mind, our sense of wellbeing, and our beliefs.  Our environment impacts everything.

It is critical leaders create an environment where the teams they guide are challenged, supported and more energized than ever before.  Build a workplace that reinforces the mindset of peak performance, which empowers the team to drive the results you want, and routinely encourages everyone to take the necessary steps to create remarkable success.  Take the initiative to set the stage and configure physical and psychological environments that unleash greatness.

Maintain Mutual Respect

Nightingale cared passionately about the nurses under her wing and the soldiers under her care. As one example, she was adamant, in her hospital, triage would be performed on the basis of the patient’s medical condition and not his rank in the military, social standing, or religion – a precept that was quite radical in Victorian England. Many of the specific techniques in her ground-breaking work Notes on Nursing are now outdated, but her absolute commitment to patient dignity and a spirit of mutual respect in the workplace remains essential.

Choose your Attitude

Nightingale would have agreed with the statement, “Attitude is everything”. She had an intuitive understanding that emotions are contagious, and would never have tolerated the gossip, complaining, and other forms of toxic emotional negativity prevalent in many work environments today. Toxic negativity is the emotional and spiritual equivalent of cigarette smoke, and, in its own way, just as harmful.

To promote a more positive and productive workplace culture, we must raise our attitudinal expectations and lower our tolerance for deviation from those expectations. Even in the horrendous circumstances that prevailed at Scutari, Nightingale insisted people be treated with dignity.  One thing is certain: she would never have tolerated, much less condoned, the gossip and the complaining hallways and in the “Coffee-Clutch” today. In one of the many letters she delivered to newly graduated nurses from the Nightingale School of Nursing, Florence wrote:

“Prying into one another’s concerns, acting behind another’s back, backbiting, misrepresentation, bad temper, bad thoughts, murmuring, complaining. Do we ever think of how we bear the responsibility for all the harm that we cause in this way?”

Guide with Encouragement

In her quiet and dignified manner, Nightingale was a cheerleader devoted to encouraging qualified young women to enter her profession – even though the work was hard and the pay was low. One suspects she would have had harsh words for doctors and nurses of our era who are telling the next generation to stay out of healthcare because they themselves are working too hard, not making enough money, and not having enough fun.

Aspire to Improve Passionately

Nightingale never rested on her laurels; instead, she continuously raised the bar. After proving a more professional approach to nursing care would improve clinical outcomes, she helped found the first visiting nurses association, chartered the first modern school of professional nursing, created a blueprint for the modern hospital, and used her writings to create professional standards for hospital management.

She remained active until the end of her life at the age of 90. Her commitment to never-ending improvement shines like a lamp across more than a century, inspiring us to work our way through the challenges of today and never lose sight of the better world we need to create for tomorrow.

Create and Model Loyalty

 Nightingale was a team-builder who cared passionately about the nurses under her wing and the soldiers under her care. She was a demanding leader, but also showed uncompromising commitment to the people she led.

Upon her return to England from Scutari she personally endeavored to make sure that every nurse who had served with her there would find employment upon their return home. Her legendary loyalty to the soldiers she served was reflected in the fact that when she was buried, her coffin was escorted by octogenarian veterans of the Crimean War honoring their debt to the lady with the lamp.

Introduce Humor


Nightingale’s contemporaries reported she had a wonderful sense of humor and was often able to defuse tense situations with the light touch of laughter.   She might reflect, if she could laugh in the hell-on-earth environment of the Scutari Barrack Hospital, then no matter what the world throws at us, we can’t forget the restorative and healing power of laughter.

Maintain Open Collaboration

 We are constantly hearing about the “healthcare crisis”, and we are likely to be hearing those two words in sound bites for decades to come.  What would Nightingale tell us about dealing with this perennial drain on our wellbeing?  Sara Rutledge, a nurse who’s a character in Joe Tye’s book The Florence Prescription: From Accountability to Ownership, put it this way: “We need to see opportunities where others see barriers. We need to be cheerleaders when others are moaning doom-and-gloom. We need to face problems with contrarian toughness because it’s in how we solve those problems that we differentiate ourselves from everyone else.”

Difficulty is the common thread woven into every great achievement.  To encourage innovation and accountability, foster open collaboration and even embrace contrarian opinions.  We will always achieve far more working together.  When we are fully transparent with one another, facilitate a culture of trust and mutual respect and make room for and learn from opposing ideas, we will grow.  Together, we must support the mission and growth of the team at all times.

Display and Encourage Initiative

 Nightingale attributed her success to the fact she “never gave or took any excuse.” When told there was no money to repair a burned-out wing of the Scutari Barrack Hospital that was scheduled to receive hundreds of new casualties, she hired a Turkish work crew and before anyone could stop her, had the wing refurbished. The acid test of an “empowering” workplace is whether people – regardless of job title – can take the initiative to do the right thing for patients and coworkers without seeking permission or worrying about recrimination.

A concluding thought

Equip, enable, empower and encourage your people.  They will take care of the patients and customers, and that will take care of the results.  In this way, we can create a better healthcare world, confidently confront the challenges we face with courage and determination, and ensure we are making wellness a priority for all.

And here is another cool way to make wellness a priority.  Go to HealthLynked.com and signup for free, today!  There, you will be able to connect and collaborate more closely on the efficient exchange of health information.




Adapted from the following works:

100 Day Challenge, by Gary Ryan Blair

10 Leadership Lessons from Florence Nightingale, by Joe Tyre



C-Reactive Protein (CRP) Test: MedlinePlus Lab Test Information


What is a c-reactive protein (CRP) test?

A c-reactive protein test measures the level of c-reactive protein (CRP) in your blood. CRP is a protein made by your liver. It’s sent into your bloodstream in response to inflammation. Inflammation is your body’s way of protecting your tissues if you’ve been injured or have an infection. It can cause pain, redness, and swelling in the injured or affected area. Some autoimmune disorders and chronic diseases can also cause inflammation.

Normally, you have low levels of c-reactive protein in your blood. High levels may be sign of a serious infection or other disorder.

Other names: c-reactive protein, serum

What is it used for?

A CRP test may be used to find or monitor conditions that cause inflammation. These include:

Why do I need a CRP test?

You may need this test if you have symptoms of a serious bacterial infection. Symptoms include:

If you’ve already been diagnosed with an infection or have a chronic disease, this test may be used to monitor your treatment. CRP levels rise and fall depending on how much inflammation you have. If your CRP levels go down, it’s a sign that your treatment for inflammation is working.

What happens during a CRP test?

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This process usually takes less than five minutes.

Will I need to do anything to prepare for the test?

You don’t need any special preparations for a CRP test.

Are there any risks to the test?

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

If your results show a high level of CRP, it probably means you have some type of inflammation in your body. A CRP test doesn’t explain the cause or location of the inflammation. So if your results are not normal, your health care provider may order more tests to figure out why you have inflammation.

A higher than normal CRP level does not necessarily mean you have a medical condition needing treatment. There are other factors that can raise your CRP levels. These include cigarette smoking, obesity, and lack of exercise.

If you have questions about your results, talk to your health care provider.

Is there anything else I need to know about a CRP test?

A CRP test is sometimes confused with a high-sensitivity-(hs) CRP test. Although they both measure CRP, they are used to diagnose different conditions. An hs-CRP test measures much lower levels of CRP. It is used to check for risk of heart disease.

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Measles Virus as a Cancer Fighter

A medical first — a woman with an incurable form of cancer has had all signs of living cancer cells eradicated from her body for at least 6 months. What’s more, it was accomplished in a single treatment. And the magic potion — was the measles virus. For more information or to schedule an appointment, visit http://www.mayoclinic.org.


How to Keep Mosquitoes Away From Your Home

Between their itchy bites and their ability to carry diseases, mosquitoes are houseguests nobody wants. To really yank the welcome mat out from under them, get rid of any standing water around your home. You’ll be taking away the soggy spots where they are likely to lay their eggs. Here are their favorite watering holes and how to keep the area around your home dry.

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Breast Biopsy: MedlinePlus Lab Test Information


What is a breast biopsy?

A breast biopsy is a procedure that removes a small sample of breast tissue for testing. The tissue is looked at under a microscope to check for breast cancer. There are different ways to do a breast biopsy procedure. One method uses a special needle to remove tissue. Another method removes tissue in a minor, outpatient surgery.

A breast biopsy can determine whether you have breast cancer. But most women who have a breast biopsy do not have cancer.

Other names: core needle biopsy; core biopsy, breast; fine-needle aspiration; open surgery biopsy

What is it used for?

A breast biopsy is used to confirm or rule out breast cancer. It is done after other breast tests, such as a mammogram, or a physical breast exam, show there might be a chance of breast cancer.

Why do I need a breast biopsy?

You may need a breast biopsy if:

  • You or your health care provider felt a lump in your breast
  • Your mammogram, MRI, or ultrasound tests show a lump, shadow, or other area of concern
  • You have changes in your nipple, such as bloody discharge

If your health care provider has ordered a breast biopsy, it does not necessarily mean you have breast cancer. The majority of breast lumps that are tested are benign, which means noncancerous.

What happens during a breast biopsy?

There are three main types of breast biopsy procedures:

  • Fine needle aspiration biopsy, which uses a very thin needle to remove a sample of breast cells or fluid
  • Core needle biopsy, which uses a larger needle to remove a sample
  • Surgical biopsy, which removes a sample in a minor, outpatient procedure

Fine needle aspiration and core needle biopsies usually include the following steps.

  • You will lay on your side or sit on an exam table.
  • A health care provider will clean the biopsy site and inject it with an anesthetic, so you won’t feel any pain during the procedure.
  • Once the area is numb, the provider will insert either a fine aspiration needle or core biopsy needle into the biopsy site and remove a sample of tissue or fluid.
  • You may feel a little pressure when the sample is withdrawn.
  • Pressure will be applied to the biopsy site until the bleeding stops.
  • Your provider will apply a sterile bandage at the biopsy site.

In a surgical biopsy, a surgeon will make a small cut in your skin to remove all or part of a breast lump. A surgical biopsy is sometimes done if the lump can’t be reached with a needle biopsy. Surgical biopsies usually include the following steps.

  • You will lie on an operating table. An IV (intravenous line) may be placed in your arm or hand.
  • You may be given medicine, called a sedative, to help you relax.
  • You will be given local or general anesthesia, so you won’t feel pain during the procedure.
    • For local anesthesia, a health care provider will inject the biopsy site with medicine to numb the area.
    • For general anesthesia, a specialist called an anesthesiologist will give you medicine, so you will be unconscious during the procedure.
  • the biopsy area is numb or you are unconscious, the surgeon will make a small cut into the breast and remove part or all of a lump. Some tissue around the lump may also be removed.
  • The cut in your skin will be closed with stitches or adhesive strips.

The type of biopsy you have will depend on different factors, including the size of the lump and what the lump or area of concern looks like on a breast test.

Will I need to do anything to prepare for the test?

You won’t need any special preparations if you are getting local anesthesia (numbing of the biopsy site). If you are getting general anesthesia, you will probably need to fast (not eat or drink) for several hours before surgery. Your surgeon will give you more specific instructions. Also, if you are getting a sedative or general anesthesia, be sure to arrange for someone to drive you home. You may be groggy and confused after you wake up from the procedure.

Are there any risks to the test?

You may have a little bruising or bleeding at the biopsy site. Sometimes the site gets infected. If that happens, you will be treated with antibiotics. A surgical biopsy may cause some additional pain and discomfort. Your health care provider may recommend or prescribe medicine to help you feel better.

What do the results mean?

It may take several days to a week to get your results. Typical results may show:

  • Normal. No cancer or abnormal cells were found.
  • Abnormal, but benign. These show breast changes that are not cancer. These include calcium deposits and cysts. Sometimes more testing and/or follow-up treatment may be needed.
  • Cancer cells found. Your results will include information about the cancer to help you and your health care provider develop a treatment plan that best meets your needs. You will probably be referred to a provider who specializes in breast cancer treatment.

Is there anything else I need to know about a breast biopsy?

In the United States, tens of thousands of women and hundreds of men die of breast cancer every year. A breast biopsy, when appropriate, can help find breast cancer at an early stage, when it’s most treatable. If breast cancer is found early, when it is confined to the breast only, the five-year survival rate is 99 percent. This means, on average, that 99 out of 100 people with breast cancer that was detected early are still alive 5 years after being diagnosed. If you have questions about breast cancer screening, such as mammograms or a breast biopsy, talk to your health care provider.

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How to Safely Instill Eye Drops – Mayo Clinic

Brigitte Keener, O.D., optometrist at #MayoClinicFL, demonstrates how to safely and effectively instill eye drops for patients who have prescribed drops for treatment of ocular conditions.

For more information visit http://mayocl.in/ophthalmology or call 904-953-2232

Spanish version: http://youtu.be/JKK6I-XgbgI


Holiday Pet Dangers – The Basics

‘Tis the season to be merry, so keep an eye on these festive plants, decorations, and food when your furry friend is around. Learn more: http://wb.md/2hdrf76

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