• Abstract and Figures
• Public Full-text

MEDICAL NOTES Valerie J. Shereck, MSN, ANP-C DEGENERATIVE SPINE Degenerative spine is also known as degenerative disc disease (DDD). DDD is actually not a disease but a progressive medical condition which results from aging and wear and tear. DDD affects nearly 30 million people every year and is one of the most common sources of back pain. We have 33 bones or vertebrae in our spine. The area between the vertebrae is called intervertebral discs which act as cushions or shock absorbers. As people age, repeated daily stress on the spine and occasional injuries, even minor ones, can damage the intervertebral discs. Age-related changes in the spine include: Loss of fluid - The intervertebral discs of a healthy young adult consist of up to 90% fluid. With age, the fluid content decreases, making the disc thinner. The distance between the vertebrae becomes smaller, and it becomes less effective as a cushion and shock absorber. Disc structure - Very small tears or cracks develop in the outer layer of the disc. The soft and gelatinous material in the inner part (nucleus pulposus) may seep through the cracks or tears, resulting in a bulging or rupturing disc (herniated disc). The disc may break into fragments. When the vertebrae have less padding between them, the spine becomes less stable. To compensate, the body builds osteophytes or bone spurs which are small bony projections that develop along the edges of the bones. The bone spurs can press against the spinal cord or spinal nerve roots and interfere with the nerve function and cause pain, weakness, numbness, or tingling. Other problems that can occur with DDD are a breakdown of cartilage, the tissue that cushions the joints, herniated disc (as stated previously), or narrowing of the spinal canal or spinal stenosis. RISK FACTORS - Age - This is the biggest risk factor. Approximately 40% of people at 40 years of age have DDD. More than 80% of individuals 80 years of age and older have DDD. - Obesity Sedentary lifestyle - Tobacco use - Car accidents or other injuries - Falls - Strenuous physical work For women, there is evidence that menopause and related estrogen loss are associated with DDD of the lumbar spine. DIAGNOSIS The diagnosis of DDD is made upon review of symptoms such as pain, where it occurs, if it radiates, and if there is numbness and tingling. Other health history questions are a review of whether there have been falls, accidents, or injuries. Physical assessment includes observation and testing of the following: Muscle strength - The person is checked for atrophy, wasting, and abnormal movements. Pain with motion or in response to touch - The person is asked to move in specific ways, and pressure is applied to specific areas. Nerve function - A reflex hammer is utilized to test for normal reflexes. Hot and cold stimuli may also be used to test for sensation. Other testing may include imaging studies such as X-rays, CT scan, and MRI to determine disc damage. TREATMENT of DDD depends upon the severity of the condition. It can consist of non-surgical or surgical treatment; however, non-surgical treatment is usually utilized first. Non-surgical Treatment Methods Include: Heat and/or cold therapy - Hot packs and cold packs may reduce inflammation and pain. - Pain medication - Over-the-counter (OTC) pain relievers such as acetaminophen or ibuprofen may be used to decrease inflammation and reduce pain. Prescription pain medications may be utilized when OTC medications are not effective. Some of these medications may include steroids to reduce inflammation and muscle relaxants to reduce muscle cramps. - Corset or back brace - This provides support for the spine. Surgical Options Include: - Anterior discectomy and fusion - This procedure is done on the cervical spine to remove the disc and replace it with a small bone graft or graft substitute. - Faceotomy - This procedure removes part of the facet to increase space. - Laminoplasty - This procedure reaches the cervical spine from the back of the neck. October 31, 2020 Pegi Schlis, CTRS, ACC, AC-BC Many historians believe that the origins of Halloween is a combination of Celt (Druid), British, and Christian traditions. The Celts celebrated Samhain (pronounced sow-in) which meant “summer’s end” and was held on October 31, the last day of their year. Their priests sacrificed animals to appease the gods in a bonfire, and people dressed in costumes danced around the fire. The Celts believed the dead walked the streets that night, and they left out treats for the spirits that were unfriendly. Some sources say children went doorto-door begging for materials to keep the bonfire burning. After the Romans conquered Britain, the celebration of this date continued but was changed to November 1. In the Middle Ages, Christians celebrated the martyrs of the church initially on May 13. Later, that date was changed to November 1 by Pope Gregory III and called All Hallow’s Day (now known as All Saints Day). The evening before was called All Hallow’s Eve, and it is believed that children and the poor went from house-to-house begging for small soul cakes in return for saying prayers for the dead. All Hallow’s Eve became known as Halloween. HALLOWEEN-THEMED SONG TITLES -This 1978 one-hit wonder by Warren Zevon began as a joke by Phil Everly (The Everly Brothers) after he watched a 1935 film, Werewolf of London. He suggested to Zevon to adapt it into a song and dance craze. WEREWOLVES OF LONDON -This 1962 song was co-written by Bobby Pickett and band mate, Lenny Capizzi. Pickett was an aspiring actor by day and sang with the Cordials at night. During a show, Pickett did a monologue in imitation of horror movie actor Boris Karloff, and it led to this song. MONSTER MASH -This 1966 novelty record by Napoleon XIV became an instant hit. The lyrics appear to express a man’s mental anguish after a break-up with a woman leading to madness and being committed to the “funny farm” (mental hospital). The final verse reveals he’s not driven insane by a woman, but a runaway dog…”They’ll find you yet and when they do they’ll put you in the ASPCA, you mangy mutt.” THEY’RE COMING TO TAKE ME AWAY -This 1972 song, written by Don Henley and Bernie Leadon and recorded by the Eagles, was about a seductive enchantress. Some of the lyrics were a result of when Henley read a biography about Zelda Fitzgerald (wife of F. Scott Fitzgerald) while he was really sick with the flu. Zelda was known as a wild, bewitching, and mesmerizing flapper of the jazz age. WITCHY WOMAN - This 1979 song performed by The Charlie Daniels Band is more spoken than sung. It tells the story of a young boy named Johnny who made a deal with the devil. THE DEVIL WENT DOWN TO GEORGIA - This 1958 novelty song by David Seville became a No.1 hit. It’s the story of a man in love with a woman who does not return his affections. He goes to get advice…“Oo ee oo aa aa ting tang walla walla bing bang.” WITCH DOCTOR - This 1956 song, written and composed by Jalacy “Screamin’ Jay” Hawkins, was intended to be a refined love ballad. Instead, his producer brought in ribs, chicken, and alcohol and got everyone drunk and it resulted with Hawkins screaming it. When it was finally released, this version was banned from most radio stations. Despite that, it sold more than a million copies. I PUT A SPELL ON YOU - This theme song of the 1984 movie by the same name starring Bill Murray and Dan Aykroyd was written and performed by Ray Parker, Jr. GHOSTBUSTERS CULTURE CHANGE FROM PAPER TO COMPUTERS Barbara Ritchey, ADC, RLC, CDP Technology is the name of the game, folks. Get on board or get left behind. For someone like myself, a “dinosaur” who learned her skills at school on a typewriter and taking shorthand, it can be quite daunting learning so many new skills at such a fast pace. With the COVID-19 pandemic that hit our world and the need for social distancing, it has been all hands on deck to find new ways to engage our residents. Person-centered activities have never been more needed than now to combat the loneliness and depression that isolation can bring. Technology provides avenues that we couldn’t implement in the old days. There are many companies providing programs and apps including Linked Senior, McKnight’s Senior Living, the IN2L, Skype®, Facebook®, Facetime®, Zoom, smart TVs, and smart phones, just to name a few. If you don’t know some of the words, don’t bother looking in a dictionary (if you can find one). They won’t be there. “Google” it! Facing something new can, in some people, be quite unnerving and cause them to shy away from what could open a whole new world. On a personal note, I fought with my kids for ages about getting a Facebook® account. I had heard a lot of bad things about people airing things causing so much turmoil. No way was I going to be a part of that! Well, at least I thought I wouldn’t be a part of that social media site until our company required us to participate in the company’s Facebook® page. I was terrified not knowing what to expect but jumped in and gave it my all. It was not what I’d thought. I asked family members, volunteers, team members, etc. to like our page and comment, as I would read the comments to our residents.

Load more

  6

Copy Link