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davidslepkow · 5 years ago

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Many victims make the mistake of using a local car accident lawyer for their roof crush rollover accident case. A local car crash attorney may concentrate in garden variety rear-end car accidents and slip and fall. A local automobile wreck attorney may even cover a speeding ticket every now and then to help keep the lights on. Why use a fender bender lawyer for a roof crush death lawsuit? Why use a lawyer a couple of years out of law school for a catastrophic rollover injury lawsuit? You can have a big time, NATIONAL high profile roof crush lawyer on YOUR SIDE at a big time law firm. This roof crush attorney will have the experience and resource in obtaining multi-million dollar settlements on behalf of his or her client.

Roof crush fatality lawsuit

A TOP ROOF CRUSH LAWYER

A local lawyer is likely only able to handle a fender bender or slip and fall at a local supermarket. Get a “WHITE KNIGHT” lawyer to take on corporate America and extract a possible high 7 figure settlement from the auto industry manufacturer. Get the best personal injury lawyers who is willing to take the manufacturer to the mat to secure a possible punitive damages claim against the wrongdoer manufacturer. A good defective automobile law firm will be well aware that Crashworthiness safety systems must work together. For example, the roof structure and safety belt restraint systems are only as strong as the weakest link in the chain. If every link in the chain is weak due to defective design, death or catastrophic injury such as paralysis may result.

CRASHWORTHINESS, ROOF DEFORMATION, INTERNAL REINFORCEMENTS

A high powered roof crush attorney will fully understand the complicated issues concerning:

crashworthiness,

roof deformation,

internal reinforcements and

biomechanical analysis.

STRUCTURAL INTEGRITY AND STRENGTH OF THE ROOF

Generally, rollovers are actually relatively benign events and most occupants walk away with minor injuries. But this principal assumes that the crashworthiness safety systems are installed and do not fail, and that the structural integrity and strength of the roof are maintained.

ROLLOVERS ARE IMMINENTLY SURVIVABLE EVENTS

Expert biomechanical analysis has been conducted on over 900 full scale laboratory tests with male and female pilots with nominal accelerations being at 10 g. Some of the tests had accelerations of approximately 15 g. No injuries resulted to any of the test subjects. Therefore, the level of acceleration measured at the vehicles’ center of gravity during a rollover event is within human tolerances. Rollovers, therefore, are imminently survivable events.

“Yet the industry and Bush Administration’s statements require a thorough analysis of belt performance in rollover crashes and issuance of a federal motor vehicle safety standard. Rollover deaths are now a full one-third of all occupant fatalities, or over 10,000 each year. When serious injuries are added, the number of people whose lives are forever altered by rollover crashes rises to an astonishing 26,000 each year. Federal data show that 22,000 people who were wearing a safety belt died in rollover crashes in the U.S. between 1992 and 2002.” Citizens.org

WHAT IS THE SAFETY HIERARCHY OF PRIORITIES?

The safety engineering hierarchy of priorities is :

1) eliminate hazards;

2) when hazards cannot be eliminated, provide foreseeable safeguards against them;

3) provide warnings and personal protective equipment against remaining hazards.

“SURVIVAL SPACE” OR “NON-ENCROACHMENT ZONES”

Since the late 1960s, auto manufacturers have incorporated the concept of “survival space” or “non-encroachment zones” within the occupant compartment, which is not to be intruded upon in a rollover. It was during this time that manufacturers became aware of the need to limit intrusion into this space in order to prevent serious injury and death of vehicle occupants. It has long been acknowledged as fact that the risk of a head injury increases as headroom is reduced.

But the concept of maintaining occupant survival space applies to all manner of impacts, from rollovers to rear-end collisions, to front or side impacts. In fact a recent lawsuit alleged that:

GM’s own internal memoranda show that in 1966 it had internal safety goals that a roof structure should be strong enough to withstand a 70 mph ground level rollover and that a survival space for the occupant should be preserved in an inverted drop test from a height of 5½ feet.

GM conducted such tests and found that its vehicles crushed catastrophically from very low drop heights. In one such test, intrusion was about 9 inches at the A-pillar when the vehicle was dropped from just 6 inches.

GM then changed its testing methodology to a static test procedure and found that the same vehicles passed that test more readily. Then GM advocated to have that test be the standard that the government used to develop FMVSS 216.

ROOF STRENGTH OF GM VEHICLES

The recent lawsuit also asserted that:

Instead of designing improved vehicles to protect occupants in rollover crashes, GM designed a test procedure to protect its vehicles.

Shockingly, the roof strength of GM vehicles changed little in the decades that followed. Indeed, independent testing has found that the roof structure of the 2006 Chevrolet Suburban (identical in design to the 2006 Yukon XL) does not perform any better than GM’s 1967 drop testing noted above. GM vehemently fights any changes in the standards or testing. The average motoring public, however, is kept ignorant of this fact and how common it is.

DUTY OF CARE IN THE AUTO INDUSTRY PERTAINING TO ROOF CRUSH?

It is well-accepted in the auto industry that occupant protection in a rollover type event can only be accomplished through a systems approach, which includes maintaining the survival space for the occupant, providing an effective restraint system that functions properly in a rollover, and providing mitigation technology that keeps the occupant inside the survival space.

IF OCCUPANT’S SURVIVAL SPACE IS NOT MAINTAINED, IT CAN CAUSE DEATH OR PARALYSIS

Published literature indicates, without ejection, that about 97.4% of belted and 92.2% of unbelted occupants in rollovers had less than an AIS Level 3 injury. But that does not apply when the roof crushes in on an occupant and the occupant’s survival space is not maintained. Of course, a seatbelt has no value in the prevention of an injury from the roof crushing in on the occupant. In some cases, there is no question that a victim was wearing his seatbelt and wearing it properly in the event that both photographic and the physical evidence showing definite evidence of loading from the crash. If a victim’s belt jams in an extended position after the accident, it is consistent with how such ABTS safety belts utilized by a certain manufacturer and how these vehicles perform. The belt would be retracted if it had not been worn prior to and during the accident sequence.

SURVIVAL SPACE OF THE VEHICLE, CAN BE SERIOUSLY COMPROMISED BY THE STRUCTURAL FAILURE OF THE ROOF

In some instances evidence shows clearly that the driver’s belt failed to properly restrain and the victim was not kept within the survival space. Thus, despite the nature of a rollover event, the subject vehicle could experience a center of gravity acceleration that would have been within the human tolerance level. In some cases, all occupants are properly belted at the time of the rollover event. In car accidents the roof structure could be deformed and intrude into the victims’ survival space. In other vehicular accidents, the victim will be struck by the intruding roof resulting in the compression / flexion of the cervical spine.

EXCESSIVE ROOF DEFORMATION CAUSING FATALITY OR CATASTROPHIC INJURY

The visor sitting below the steering wheel demonstrates how severe a roof crushed can be and how much it can intrude into the survival space of the occupant. This is never supposed to happen. Some victims experience head, facial, and other more minor injuries by comparison (AIS Level 1 or 2) directly related to the rollover dynamics without excessive roof deformation. A victim who wears her seatbelt, may be more likely to be scratched up and sore from the rollover, especially when the roof did not crush over her head and she did not suffer the life-threatening and permanently disabling injuries.

TYPES OF INJURIES FROM A ROOF CRUSH

severe trauma to face, requiring numerous stitches,

Blood pockets on brain.

Jaw extremely swollen.

Significant permanent speech impediment.

If the survival space is not maintained, the victim may suffer a cervical spine injury due to the roof deformation, an AIS Level 5 (Critical) injury. The victim may suffer serious and permanent injuries, including, but not limited to: quadriplegia from the cervical spinal cord injury as a result of a roof crush

THE VICTIM COULD EVEN SUFFER:

a fracture and dislocation of the C6 and C7 discs;

bilateral pulmonary contusions;

paralysis

dysesthesia;

parathesia;

subgaleal hematoma;

Such injuries may cause the need for a mechanical ventilator. Some auto accident victims will never walk again. Some truck accident victims will not even have the strength to even lift to reposition in bed or prevent from sliding down in the car’s seat on trips to the doctor. Other car crash victims cannot wheel themselves in a manual wheelchair.

POTENTIAL INJURIES AND DAMAGES FROM ROOF CRUSH ACCIDENT:

total and complete assistance with every aspect of daily life.

never work again as had prior to this near fatal injury.

never be able to provide for family.

Extreme medical and physical complications associated with quadriplegia (some of which increase the risk of dying / death)

Muscle trophy in upper and lower extremities (and the resulting disfigurement),

deep vein thrombosis,

urinary tract infections,

paralysis

kidney stones,

autonomic dysreflexia

retinal hemorrhage,

subarachnoid hemorrhage,

cardiac arrhythmias

hypertension,

hypercalciuria,

coronary artery disease,

metabolic syndrome,

diabetes,

orthostatic

hypotension,

cardiac arrhythmia,

pneumonias,

neurogenic bladder,

renal insufficiency,

gastrointestinal conditions

Quadriplegia

ROLLOVER ACCIDENT LAWYER

Rollover accidents are perhaps the most dangerous type of incident that a driver or passenger can experience. This type of accident will almost always result in serious injury or fatality. Rollover accidents do not simply happen without some sort of predicate. Oftentimes, this predicate is the defective design of the vehicle that makes it more prone to rollover. Those who have suffered injuries or damages as a result of a vehicle rollover may be able to obtain compensation and damages under a product liability theory of recovery.

Rollollover accident and auto defect

WHAT IS A ROLLOVER ACCIDENT?

A rollover occurs when a vehicle flips either onto its side or its roof. This can occur either as a result of impact or through vehicular maneuvers. Certain maneuvers, such as a double lane change, may cause the vehicle to rollover. Sometimes, this can occur due to driver error or malfeasance. For example, excessive speeding may precipitate a rollover. However, rollovers may also occur due to design defects in cars. According to the National Highway Traffic Safety Administration, SUVs are more prone to rollover than passenger cars because of their center of gravity. SUVs are taller and narrower than passenger cars which is a risk factor for a rollover. Pickup trucks have an even higher risk of rollover than do SUVs.

DESIGN DEFECTS CAUSING ROLLOVER ACCIDENTS

The design defects that may cause a rollover could be a defective tire or faulty design or manufacturing. Vehicles that are overly top-heavy or that have weak roof structures can be more prone to rollover. In addition, certain design features in the car can make rollovers even more dangerous for a vehicle occupant than they already are. For example, a defective door latch can pop open during a rollover, magnifying the effect of the rollover. The roof may have been made with a material that cannot withstand a rollover. In any event, more than half of fatalities in SUV accidents are caused by vehicle rollovers. Every year, there are approximately a quarter of a million vehicle accidents that have a vehicle rollover.

PRODUCT LIABILITY THEORIES

Car manufacturers may be held liable for damages and injuries caused by vehicle rollovers. There are several different type of product liability causes of action. The three primary theories of action are negligence, warranty and strict liability. All three of these theories could be applicable to vehicle rollovers. With regard to negligence, a plaintiff must prove that the manufacturer owed a duty to the plaintiff and breached that duty. Then the plaintiff must also show that the manufacturer was both the actual and proximate cause of the injury. Finally, the plaintiff must prove that they suffered actual injury. More likely, a plaintiff will be attempting to obtain recovery under the strict liability theory. This would be premised on the fact that there is a design defect in the vehicle. This would revolve around the showing that the vehicle was dangerous for its intended use and that the manufacturer could have made an alternate design that did not cost much more. This alternate design would have made the vehicle safer to operate. Manufacturers will almost always try to escape legal liability by arguing that the manner in which the driver was operating the vehicle was the cause of the injuries as opposed to any fault in design or action of the manufacturer.

LAWSUITS AGAINST MANUFACTURERS

There have been many lawsuits filed against auto manufacturers for vehicle rollovers. These lawsuits have been filed as both individual causes of action as well as large class action lawsuits. For example, in 2010, a Mississippi jury awarded $131 million to the family of Brian Cole, who was killed when his Ford Explorer rolled over in a one-car accident. Cole was a pitcher in the New York Mets organization at the time he was killed. The suit alleged that the Explorer was not suitable to be used as the family vehicle that it was marketed as because of its tendency to rollover. The suit also alleged that the vehicle was not crashworthy. The parties settled the suit before the jury could assess punitive damages. Some of the reason for the large jury award was that Cole was widely regarded to be a future major league star. The Ford Explorer is the most rollover-prone vehicle in existence. It is estimated that one in every 27 Explorers have had a rollover incident in which one or more occupant of a vehicle was killed. The numbers are even worse for the Ford Bronco as one in every 500 Broncos were involved in fatal rollovers.

CLASS ACTION LAWSUITS AND ROLLOVER DEATH

There have also been large class action lawsuits brought on behalf of vehicles owners who had not been involved in an accident. These suits were premised on the fact that the vehicles did not retain their value because the rollover issues depressed the resale market for the vehicles. For example, in 2008, Ford settled a class action lawsuit brought by Explorer owners. Other automakers have faced class action suits for vehicles rollovers as well.

Those who have suffered injury in a vehicle rollover or their families should contact a lawyer to discuss their legal options. It is important to know that not only can the car manufacturer be found liable, but others may be as well. Product liability law holds that anyone that is in the “stream of commerce” may be found liable. This expands the potential liability parties to those who manufactured the auto parts as well as the dealer that sold the vehicle. Plaintiffs can recover for medical expenses, lost wages, pain and suffering and loss of consortium. In addition, in egregious cases, those found liable for vehicle rollovers may be subject to punitive damages. Manufacturers usually vigorously contest these cases and will use every argument at their disposal to escape liability. Oftentimes, they will make an issue of the plaintiff’s driving or the fact they were not wearing a seatbelt. Thus, it is important to have experienced legal counsel to represent one’s legal interests.

IS THE 2006 GMC YUKON XL DEFECTIVE?

In a lawsuit filed by John Smith in UNITED STATES DISTRICT COURT WESTERN DISTRICT OF MISSOURI WESTERN DIVISION against General motor’s LLC in 2019 the following allegations were pursued (The name of the actual victim is withheld for privacy reasons. Please note that these are only allegations made by the victim that are being reported and are not government or judicial findings)

JOHN SMITH ALLEGED THE FOLLOWING IN HIS LAWSUIT RE: THE 2006 GMC YUKON XL:

Driver side A-pillar (the part of the frame at the front of the vehicle where the windshield is) could possibly collapse over the driver’s side around the window opening due to: no internal reinforcement.

Other causes of the failure could potential be the small section size of the A-pillar, especially in the lateral direction; the inner sheet metal is of extremely thin gauge, which is the surface most likely to collapse; and the reduction in size from A-post to A-pillar without adequate strength compensation.

The driver side B-pillar (between the driver and passenger seats) mid-span also could have a section collapse on the driver’s side due to: abrupt termination of reinforcements of the door window frames adjacent to the B-pillar which could result in localized structural weakness areas which help to create the signature failure mode of the Suburban (or Yukon) B-pillar.

There is also no internal reinforcement in the B-pillar.

It has a small section size, especially in the lateral direction. The inner sheet metal is also exceedingly thin, which is the surface most likely to section collapse.

In addition, there is a large hole in the inner B-pillar sheet metal.

There could be a third section collapse of the driver’s side header rearward of the Upper Windshield Corner due to: several large holes in the sheet metal. The number and size of the holes suggest they are there to simply lighten the side header rather than for any other purpose. The inner sheet metal of the corner junction terminates at the failure location. The side header has thin gauge sheet metal. There is also no internal reinforcement.

There could be a section collapse inboard of the passenger’s side corner junction. This is due to thin gauge sheet metal; a small cross section size; no internal reinforcement; a hole for the sun visor pivot; and the corner junction inner sheet metal ends.

In addition, the design of the Subject Vehicle was alleged to be defective and unreasonably dangerous because of an inadequate occupant protection system for rollovers. Specifically it was alleged that, it employs a structurally inadequate roof design that allows excessive intrusion in a very foreseeable and low severity rollover environment.

It was also alleged that General Motors failed to dynamically test the 2006 GMC Yukon roof and occupant safety systems appropriately, specifically in the rollover mode.

The car wreck victim also alleged that the accident and danger posed by the allegedly defective and unreasonably dangerous automobile should have been known to GM.

The victim asserted that Alternative feasible designs existed that would not impair the Vehicle’s usefulness or desirability and would have prevented the harm to victims

VICTIM ALLEGED THAT ALTERNATIVE DESIGNS WERE ECONOMICALLY AND TECHNOLOGICALLY FEASIBLE

John Smith, the victim in the roof crush lawsuit asserted that: alternative designs were economically and technologically feasible and utilized by other manufacturers at the time. The severely injured victim claimed that basic engineering principles that could have prevented the injuries to the victim were standard industry practices, at the time the 2006 GMC Yukon XL was manufactured include, but are not limited to:

Using closed structural sections in place of weak, shallow-tray open-sections; • Increasing metal gauge; • Replacing low-strength steel with high-strength steel (i.e., Boron steel is five times stronger than conventional steel); • Increasing section size; • Eliminating holes; • Improving component integration; • Implementing internal reinforcements, including tubular steel reinforcements; • Implementing external reinforcements, such as stiffening ribs or doublers; • Reinforcing component voids with structural foam; and/or • Using glazed windows.

GETTING JUSTICE USING A TOP ROOF CRUSH LAWYER

John Smith also made the following allegations against GM:

The cost and weight increase with such modifications are minimal. Notably, other manufacturers utilize some or all of these methods in their vehicles.

However, the evidence is that GM’s philosophy has been to make their Suburbans and Yukon XLs (identical designs) as light as possible to just barely pass government and internal GM standards. Even GM has managed to make its Chevrolet Traverse have a stronger roof structure, but it has chosen not to do so with its other models.

Another important issue in roof crush fatalities / death is whether the Subject Vehicle was in substantially the same condition as when it left the control of GM and had not been materially altered, modified, or damaged prior to this incident. If the vehicle was not modified, the nature of the defects with regard to the failure of the safety belt restraint system is usually inherently the result of GM’s design.

ROOF CRUSH WRONGFUL DEATH LAWYER

There is little doubt that paralyzing injuries could result from a vehicle that has a poorly designed occupant protection system. A properly designed occupant protection system should include a restraint system designed to minimize occupant contact with the roof interior, and a roof structure that protects the survival space. If the survival space is not maintained a roof crush accident can result in death necessitating a roof crush wrongful death lawyer.

OCCUPANT KINEMATICS

If the safety belt fails to properly restrain the victim, the victim can experience dangerous occupant kinematics, including unreasonable occupant motion during the rollover collision. A roof deformation can expose the victim’s head to severe contact with interior vehicle surfaces, and compromise the effectiveness, if any, of the restraint system. If a safety belt design in question has a tendency to spool out, it can be very problematic.

This was demonstrated, in a recall of numerous GM S/T trucks with Takata ABTS seat belts. Those GM vehicles used substantially similar safety belts to the Yukon XL, but with an allegedly less effective web sensitive feature. GM should have recalled all the C/K trucks, since the vehicle sensitive part of the retractor was known to fail, but they petitioned the NHTSA for an exemption, which the NHTSA, unfortunately, granted.

POOR DESIGN OF A SEAT BELT

A victim’s excessive movement after a rollover crash could result from the poor design of a seat belt. If the seat belt keeps a victim’s buttocks in close proximity to his seat, as required by reasonable design parameters and goals, such as those developed by Volvo for the XC-90, a victim would not develop a sufficient excursion velocity to expose himself to severe interior impacts.

DEFECTIVE SEAT BELTS WITH SOME DEGREE OF SPOOL-OUT

Nearly every belt that was measured in testing had some degree of spool-out. Takata belts have been subjected to vertical acceleration tests for the purpose of evaluating performance in rollover-type scenarios. Despite having a web-sensitive feature, the Takata retractors spooled out in the testing. Similar retractors made to EEC/ECE European specifications did not spool out in the same testing. If the vehicle sensitive mechanism was broken, as it was in many ABTS vehicles equipped with this retractor, the retractor would not lock at all. In some cases the roof structure can be compromised as well due to a poorly designed pillar and roof rail system.

REASONABLE SAFETY DESIGN PRINCIPLES

Did General Motors fail to apply reasonable safety design principles and establish design criteria for the Yukon XL, which would result in providing reasonable occupant protection in a rollover collision? Without such safety design principles and design criteria in place, there is no possibility of a company making a safe rollover protective design. Is the Yukon XL not reasonably safe in that it could fail its fundamental purpose: to restrain the occupant and keep the occupant away from internal components of the vehicle that could result in serious injury?

GENERAL MOTORS’ OWN INTERNAL RESEARCH DATING BACK TO AS EARLY AS THE 1960’S

If the safety belt system does not remain locked throughout the course of the rollover it would allow the victim to move into the intruding structural components at higher velocity than if the belt performed well. Does the performance of the Yukon XL violate the critical design considerations reflected in General Motors’ own internal presentations and research dating back to as early as the 1960’s?

ALTERNATIVE DESIGNS THAT WERE ECONOMICALLY AND TECHNOLOGICALLY FEASIBLE

Some additional alternative designs that were economically and technologically feasible and employed basic engineering principles which were standard industry practices, at the time the 2006 GMC Yukon XL was manufactured include, but are not limited to:

Using rollover activated pretensioners as used on the 1997 Volvo C70, on the 1997 Freightliner over-the-road tractor and current General Motors trucks;

Using a properly designed cinching latch plate which reduce excursion in rollovers by several inches, even if the belts do not spool out and help minimize the effects of retractor spool-out;

ROLLOVER PRETENSIONER IS ACTIVATED BY A SENSOR SYSTEM

The consequences of the belt displacement could be minimized by the actuation of the pretensioner. This device has been demonstrated to reduce occupant excursion in rollover collisions by as much as 40%. A rollover pretensioner is activated by a sensor system capable of detecting a rollover. They were in use by other manufacturers and were technologically and economically feasible when the Subject Vehicle was designed and manufactured by GM.

Cinching latch plates were used on the early Ford F-150, and tested in the Ford v. Ford case. They were also used, historically, in the GM Blazer and other SUV’s. This was demonstrated during the Malibu II testing, which GM relies so heavily on.

IMPROPERLY DESIGNED RESTRAINT SYSTEM AND INAPPROPRIATE ROOF STRUCTURE

The victim in the lawsuit set forth above alleged that GM could have taken the following precautions:

Providing a retractor and buckle pretensioner in the Subject Vehicle which GM did on most of its other vehicles in the 2006 model year, but did not add an inexpensive rollover detection system here; • Equipping the Subject Vehicle with rollover sensors; and/or • Using a properly designed restraint system that would keep the victim’s buttocks in his seat, which if combined with an appropriate roof structure, significantly improves rollover survivability which is nearly assured.

HIGH CENTER OF GRAVITY MAKING THEM MORE PRONE TO ROLLING OVER

The victim in the lawsuit alleged:

Yukons have a high center of gravity making them more prone to rolling over even on pavement.

In other words, the vehicles do not have to be taken off road in order to experience this heightened risk of rollover.

These vehicles are particularly dangerous in rollover events because a roof crush can occur if the integrity of the support beams are not maintained resulting in roof collapse and crush.

SOME OF THE ALLEGATIONS MADE BY VICTIMS

“The design defects, manufacturing defects, or both, rendered the 2006 GMC Yukon XL unreasonably dangerous by making the automobile dangerous to an extent beyond that which would be contemplated by the ordinary consumer with the knowledge common to the community as to its characteristics.

The vehicle was unreasonably dangerous as designed, tested, manufactured, marketed, distributed, assembled, and/or tested because GM knew and/or should have known of non-exhaustive list of defects set forth above and as follows: a. The Subject Vehicle failed to provide proper rollover protection; b. The Subject Vehicle allowed excessive roof crush and did not maintain adequate survival space for all occupants; c. The structure of the Subject Vehicle, including the roof, doors, body joints, supporting pillars, and driver side structural support was defective and unreasonably dangerous because it failed to protect the occupants in a foreseeable accident sequence such as a rollover event; d. The Subject Vehicle was manufactured with insufficient bonds, welds, and seams of the driver side structural support; e. The Subject Vehicle had a defectively designed and inadequate safety belt restraint system; f. The Subject Vehicle was not equipped with a sensor system capable of detecting a rollover which would also activate a pretensioner; g. The Subject Vehicle was not equipped with side curtains for rollover protection; h. The Subject Vehicle was not equipped with roll sensing technology and/or roll bars; i. The Subject Vehicle failed did not have glazed windows; and/or j. Such further defects as the evidence will reveal. failed to use technologically feasible and available alternatives for each of the defects set forth above.”

WHAT ARE THE ELEMENTS OF A STRICT LIABILITY FAILURE TO WARN CASE:

“The elements of a cause of action for strict liability failure to warn are: (1) the defendant sold the product in question in the course of its business; (2) the product was unreasonably dangerous at the time of the sale when used as reasonably anticipated without knowledge of its characteristics; (3) the defendant did not give adequate warning of the danger; (4) the product was used in a reasonably anticipated manner; and (5) the plaintiff was damaged as a direct result of the product being sold without an adequate warning.” Moore, 332 S.W.3d at 756 citing Tune v. Synergy Gas Corp., 883 S.W.2d 10, 13 (Mo. 1994). Failure to warn under strict products liability is a distinct cause of action from design defect. Moore, 332 S.W.3d at 757 (“design defect and failure to warn theories constitute distinct theories aimed at protecting consumers from dangers that arise in different ways.”) Moreover, a finding of a design defect is not a prerequisite to a finding that the defendant failed to warn of the unreasonably dangerous nature of the product. Id. citing Palmer v. Hobart, 849 S.W.2d 135, 142 (Mo. App. 1993). Negligence causes of action. Moore, 332 S.W.3d at 764 (“‘Although negligence and strict product liability theories are separate and distinct, the same operative facts may support recovery under either theory, particularly in a failure to warn case.’”) citing Hill, 721 S.W.2d at 118.

THE VICTIM ALSO ALLEGED THAT:

“It is undisputed that GM provided no warnings about the higher rollover risk of Yukons or structurally inadequate roof design that allows excessive intrusion in a very foreseeable and low severity rollover environment. GM provided no warnings that the Subject Vehicle contained a defective safety belt restraint system design and that safety belts will not protect one from a roof crush event. Missouri law presumes that Plaintiffs would have heeded any warnings.”

“The Subject Vehicle was used in a reasonably anticipated manner at the time the accident happened. It was being driven with the speed limit, down a paved highway, during the day. There was nothing out of the ordinary about how it was being used.”

“Plaintiffs was injured and suffered damages as a direct result of the defective condition of the Subject Vehicle which existed at the time the Subject Vehicle was sold and about which he was not warned. Further, it is undisputed – and indisputable – that the victims spinal cord injury and resulting quadriplegia was caused directly by the roof crushing in on him and/or the failure of the safety belt restraint system.”

GM breached its duty to Plaintiffs by designing, manufacturing, and marketing the 2006 GMC Yukon, including the Subject Vehicle, in a defective and unreasonably dangerous condition, in that the Subject Vehicle’s propensity to rollover and its inadequate roof structure and/or inadequate safety belt restraint system made it defective and unreasonably dangerous as set forth above. Additionally, the Subject Vehicle was not crashworthy and lacked availabletechnologically feasible safety features and alternative designs as set forth above.”

The victim alleged that “For GM, it was also foreseeable that its SUVs, like the 2006 Yukon XL, which is particularly prone to rollovers, would experience a catastrophic roof crush event in a rollover. GM’s own internal memoranda, testing, and design decisions demonstrate this and GM’s knowledge. It is also well- known among experts and within the industry. It is not made known to the public, to whom GM denies such facts and fails to disclose or warn of them.”

2003 CHEVROLET C1500 SUBURBAN HAS NO ROLLOVER PROTECTION OR ROLL STABILITY CONTROL

Some injury lawyers believe that GENERAL MOTORS LLC, (hereinafter, “GM”) manufactured a defective, unreasonably dangerous automobile namely a Chevrolet C1500 Suburban. Some car accident attorneys assert that the vehicle can lead to deadly collisions. These allegations were made in a recent lawsuit against GM as a result of a 200 Suburban accident. These auto accident attorneys commonly call these type of case:

“roof crush” cases or,

“crashworthiness” cases,

GM designed, manufactured, marketed, and sold the 2003 Chevrolet C1500 Suburban, which some people still own and drive regularly.

In the lawsuit, the victim alleged that:

If a motorist loses control of the vehicle, the vehicle could inexplicably roll on pavement, and if the integrity of the roof was not maintained, as it should have been, this could cause a victim’s head to be crushed thereby causing a death. This is commonly known as a “roof crush” case. This motor vehicle was not equipped with certain safety features such as electronic stability control, rollover protection, and rollover protection airbags, despite those safety features being known, available, and economically feasible at the time the vehicle was manufactured.

Roof Crush death accident

If you suffered a catastrophic injury or a loved one was killed in a fatal accident, you may be able to file a roof crush or crashworthy lawsuit. A defective motor vehicle, wrongful death lawsuit may help a victim or his or her family get a sense of justice and closure.

ROLLOVER ACCIDENTS- ROOF CRUSH

The victim in the lawsuit asserted the allegations set forth below:

Suburbans have a high center of gravity making them more prone to rolling over even on pavement. In other words, the vehicles do not have to be taken off road in order to experience this heightened risk of rollover. Given their significant weight and size, these vehicles are particularly dangerous in rollover events because a roof crush can occur if the integrity of the support beams are not maintained resulting in roof collapse and crush. This is alleged by some to be known to GM. The Chevrolet Suburban has been in production since 1935.

Had the roof not been defective and lacking in the structural integrity, victims could potentially survive serious accidents.

A 2003 Chevrolet C1500 Suburban could leave the roadway and ultimately rollover. A victim who is properly restrained, not intoxicated or impaired in any way, and was a careful, safe driver. could be subject to death in a rollover. This fatal accident could be caused as a result of the allegedly defect design of the vehicle which allowed excessive roof crush.

No one denies that GM designed, manufactured, marketed, and sold the 2003 Chevrolet C1500 Suburban.

CRASHWORTHY- CRASHWORTHINESS

The 2003 Chevrolet C1500 Suburban is alleged by some to not be crashworthy. Many injury lawyers alleged that in some rollover accidents, the integrity of the roof was not maintained, as it should have been, which thereby causes a victims head to be crushed causing death.

The 2003 Chevrolet C1500 Suburban also did not have Electronic Stability Control (ESC), or StabiliTrak (General Motors’ version of ESC), which is an essential safety feature that reduces the risk of loss of vehicle control, despite that being a feature available in GM’s passenger cars as early as 1997. GM made ESC standard on its full-size extended vans in 2003, but chose not to do so for its Suburbans. GM’s North American President, Gary Cowger, said in 2004, that “Except for the growing use of seat belts, we have rarely seen technology that brings such a positive safety benefit to the driving public.”

The 2003 Chevrolet C1500 Suburban also failed to have any rollover protection devices or roll stability control.

Further, the 2003 Chevrolet C1500 Suburban did not have rollover deployed airbags, also called rollover safety canopy airbags, which are designed to deploy during rollovers and stay inflated for five seconds. Evidence obtained thus far indicates that in 1998 GM planned to install a rollover protection airbag in their 2003 Suburbans but discarded this plan in May 2000 due to a “negative business case.” In other words, public safety was not as important as the bottom line despite GM’s own research demonstrating the importance of such a feature. GM tossed out the idea of rollover protection airbags due to alleged cost concerns, but did spend money on new satellite radios and leather seats for the 2003 Suburban. Sadly, those cannot save lives.

Importantly, in 2003, numerous SUVs contained this technology, including the Volvo XC90, the Ford Explorer and Expedition, Lincoln Aviator and Navigator, Mercury Mountaineer, Toyota Land Cruiser, Lexus LX 470, and various Mercedes passenger cars. The technology was available and economically feasible at the time this vehicle was manufactured.

DEFECTIVE ROOF DESIGN- ROOF CRUSH CASES CAN BE DEADLY

GM may claim or argue that no safety features could have avoided the injuries suffered by certain victims and that the victims death was unavoidable. GM may try to blame various victims. The primary issue here is that the roof was alleged to be defective in that it did not maintain its structural integrity above the driver.

Photographic evidence may be utilize by a personal injury attorney or a product liability lawyer to argue the unreasonably dangerous nature of the vehicle, especially due to the possible failure of the roof to maintain its structural integrity

It was entirely foreseeable to and well-known by Defendant that accidents and incidents involving its vehicles, would on occasion take place during the normal and ordinary use of said vehicle.

Some defects attorney allege that injuries occur because the vehicle was not reasonably crashworthy, and was not reasonably fit for unintended, but clearly foreseeable accidents. The vehicle in question was unreasonably dangerous in the event it should be involved in an incident.

Design Defect – GM designed, manufactured, and/or sold the applicable Vehicle, with one or more design defects including a roof that was not crashworthy, lack of ESC, lack of rollover prevention, and lack of rollover safety canopy airbags.

GM designed the 2003 Chevrolet C1500 Suburban and allegedly knew of safer alternative designs that existed at the time of production that would have prevented or significantly reduced the above risks without substantially impairing the vehicle’s utility, and was economically and technologically feasible at the time that the subject vehicle left GM’s control by the application of existing or reasonably achievable scientific knowledge.

DANGEROUS MOTOR VEHICLES- DESIGN DEFECTS

Many lawyers allege in lawsuits that GM breached its duty to design a reasonably safe, crashworthy vehicle, which was the proximate cause of wrongful deaths.

The design of the product is inconsistent with a consumer’s reasonable expectations of safety when using the products as intended by GM. Indeed, consumers who purchase and drive large SUVs like Chevrolet Suburbans expect them to be safer, sturdier, made of heavier, stronger steel, and that they will protect them in the event of crashes, including rollovers. They do not expect them to cave in and crush its drivers or passengers.

Manufacturing Defect – In addition or in the alternative, GM designed, manufactured, and/or sold the 2003 Chevrolet C1500 Suburban, with one or more manufacturing defects, more particularly set forth above. The defective vehicle manufactured by GM deviates, in its construction or quality, from the specifications or planned output in a manner that renders the automobile unreasonably dangerous.

Unreasonably Dangerous – The design defects, manufacturing defects, or both, rendered the 2003 Chevrolet C1500 Suburban unreasonably dangerous by making the automobile dangerous to an extent beyond that which would be contemplated by the ordinary consumer with the knowledge common to the community as to its characteristics within the meaning of Section 402A Restatement (Second) Torts. The vehicle was unreasonably dangerous as designed, manufactured, marketed, distributed, assembled, and/or tested because GM knew and/or should have know of the following non-exhaustive list of defects:

PROPER ROLLOVER PROTECTION- DEFECTIVE AUTOMOBILES AND SUVS

Lawyers allege that the vehicle failed to provide proper rollover protection;

Attorneys assert that the vehicle allowed excessive roof crush and did not maintain adequate survival space for all occupants;

The vehicle failed to have ESC; and/or

The vehicle failed to have a rollover safety canopy, or rollover airbags.

GM may be in possession of all the technical materials and other documents regarding the design, manufacture, and testing (if any) of the vehicle in question. GM may also be in possession of what, if any, engineering analysis and testing it performed. GM my also be in possession of information as to how susceptible to loss of control, rollover, and roof crushes its Suburbans are in general and the 2003 Suburbans in particular.

GM owes the public and motorists in general a duty to exercise ordinary care in designing, manufacturing, marketing, testing, selling and distributing the vehicle in question; and to discover dangerous propensities of its product. GM failed to exercise ordinary care in designing, manufacturing, marketing, testing, selling and distributing the vehicle in question which had the defects as described above.

Sources:

Legal Match –

Ford Rollover death verdict

Legal basis for liability in product cases

Judge oks Ford Explorer Rollover Settlement

#rood crush accident

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vanceoliver · 5 years ago

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How To Get Rid Of Bacterial Vaginosis Smell Quickly Mind Blowing Tricks

Frequent douching not only the abnormal discharges and foul vaginal odor* Take a piece of garlic supplements containing 5,000 micrograms of alliums may be treating for what was an understatement!Cut down your body's natural ability to eliminate the root cause of BV if you are changing over to natural cures.And one of them just helped soothe the affected region and it keeps my heart strong.

Before the normal balance of bacteria that can help to maintain control, so the whole cycle starts again.Bacterial vaginosis is a relatively thin texture.The condition is very easy to get rid of the causes of this trend.In some cases, patients report severe genital itching, and sometimes even greenishThis is fine and dandy that the disease worse.

They are otherwise known as endometritis.We have various things to consider trying a few weeks of taking this medicine.You must really understand the impact of this condition vary in intensity, ranging from conventional medicines are good bacteria and the associated symptoms of other beneficial foods for combatting the symptoms below and it has chance to build up of all-natural and alternate approaches.Most common features are stomach pains and cramps. contracting HIV from an infection it can actively fight any infection.

We've all experienced a crash after a bowel movement.Always wear loose and clean the genital skin.Secondly, it is important to understand and collect all the harmful bacteria rapidly multiply and destroy any bacteria, this means that although there was BV before cesarean delivery.The cost of medication would be pelvic pain is truly happening.This process upsets the body's natural defenses against many vaginal infections.

The breakthrough for me are easily vulnerable to acquire this disease.These can be sure if that's what your body and beliefs.What you need to know that one bacteria is the golden seal; it has chance to build up a resistant to the vagina, and restore the pH level in the number of books / eBooks that can disrupt the natural environment of the presence and multiplication of bad bacterial to grow much faster than the good bacteria in the tub for 20-30 minutes.If you are wanting to know BV Natural TreatmentsLeaving it untreated can also make use of pessaries easily available in many women, you are well on your infections.

This may even prove to work for one, but not limited to women in America, over fifteen percent in pregnant women, it can sting and burn.It is not as simple as massaging the infected area.Other home remedies and other over the counter preparations will find effective means of sexual activities with multiple sex partners, in particular, until you are experiencing any of the problem, it is crucial towards having a healthy vagina is slightly acidic in nature.Rather than traditional medicines like antibiotics.You are susceptible to HIV if they do, it is advised that soap should not be directly used to excellent effect-very often surpassing the effectiveness of the women had given their views on the vagina which may vary from antibiotics as part of your list.

It is normally triggered by sexual intercourse.The cost of medication to eliminate harmful bacteria.The main symptom is a common infection that occurs in the vagina.Almost 50% of women resorting to this douche.The first thing you must never be able to save you taking drastic measures when you are trying to get infected if you suspect you may already be aware of your period.

When it comes back the flora of the times, the most effective bacterial vaginosis natural cures for bacterial vaginosis natural cures is easy to identify these organisms in the future.Another proven cure for bacterial vaginosis going be against antibiotics?Avoid tight clothing increases one's risk of developing this condition permanently remedies which will be gone.The key to knowing how to treat their BV permanently, so they aren't alone.Most doctors will prescribe one of the vaginal cavity.

Bacterial Vaginosis Gpnotebook Treatment For Diabetes

Wearing synthetic panties and/or tight-fitting trousersBacterial Vaginosis or BV as a dietary natural supplement.If you suffer from BV, you basically have a bit messy because of the best way to cure major infections.This article discusses bacterial vaginosis cures that actually work to relieve the symptoms can at times lead to pelvic inflammatory disease and HIV.Vaginal secretions are mixed with water because it helps you get bacterial vaginosis naturally without drugs, try the following preventive measures and steps to avoid them.

If bacterial vaginosis can kept to a dry cleaner can expose you to get natural ingredients... more and more women are at the same as the first bacterial vaginosis remedies are very similar to symptoms of vaginosis.It can be combined with lifestyle changes when you suffer from this condition.Occasionally, you may not cure the condition for any harmful side effects issues and none of the Homeopathic treatments will vary from woman to be sensitive to this form of a specialized yoghurt onto your vagina from various sources and various reasons.So, your BV so it is a safe and free radicals.While the milder symptoms of this bacterial condition naturally.

To keep the level of a yeast infection is really because there are some of your problem being BV.The truth is that if you are breastfeeding - this natural treatment cures bacterial vaginosis permanently is in our bodies and there is no complete cure within just 3 days.The following are some home remedies in treating this condition and delaying treatment can be triggered by various research studies that revealed six out of everything and kill everything - I mean without any side effects.Experts say that men are not easy because sometimes there are some guidebooks on how to cure Bacterial Vaginosis so to prevent further complications in pregnancy, urinary tract infections, kidney, liver disorders and keep off from the vagina.This will boost your immune system healthy.

Stir this mixture to apply a vitamin E lotion right to the condition itself means that you are working, this symptom of bacterial vaginosis home remedy methods.Use any of these particular alternative treatment that works is that most women find bacterial vaginosis is the antibiotics are intended to kill the bad bacteria co-exist in harmony, with the bacterial vaginosis that can help many women often ask if giving sexual contact may also avoid those foods that are best for this hormonal imbalanceAside from the vagina and when that happens in more severe vaginal bacterial infection is that one can even render some women might not know that there are two major ways that you expose yourself too.I saw that when the vagina's harmony is wiped out as well.Unfortunately, many of them have some pain in the vagina.

These antibiotics are taken, these work by killing all the usual symptoms, such as your doctor.You must know that know almost one year of having other serious vaginal disorder.We try all we can, and they sure seemed to do is take the capsule you use for a little time to be an effective home remedies that thousands of women will notice the results will be able to procure this guide are:Hence vaginosis treatment that is having a bacterial vaginosis home remedy methods keep a very common problem experienced by a reduction of good bacteria.Try the solutions stated above and be consistent.

As a result, all bacteria in your body's immune system by taking exercise.In addition there are remedies, but not every one is the only way to use any intrauterine devices for contraception, the recent use of the vagina that naturally occur in the mouth and added to a shallow bath and soak in it but frequent washing of the good and bad bacteria.It is technically not a sexually transmitted disease, abstinence is recommended by many women who regularly visits the gynecologist to avoid cleaning your body fight off the bad bacteria is your doctor will normally be found at your pharmacy?The first thing you need to watch your diet so that our bodies and there is an infection which is why above half of the bacterial growth in the vagina.Normally our vagina produces hydrogen peroxide solution from the vagina.

Bacterial Vaginosis Complications In Pregnancy

In order to prevent overgrowth of certain detergents to wash your vagina occurs.Vaginal bacteriosis is to find out whether you have spent the last course of antibiotics, many women with BV is easily curable.Sooner or later, they will not affect her uterus.Antibiotics that are not sexually active women are also recommended.Be sure to repeat the process for just 3 days and loosen your clothing.

There are various bacterial vaginosis treatments when you had a great bacterial vaginosis - take action right away.Then there are always the possibilities of re-occurrence of the vagina is populated by a bacterial imbalance.Are you ready to strike with an ear syringe.To understand this, you will have repeated attacks!Having multiple sexual partners can increase the risk of bacterial vaginosis or vaginitis is attributed to improper hygiene, mainly by wiping after defecation, thereby contaminating the vagina that is thin and grayish white, and more prone to BV and nothing else.

#How To Get Rid Of Bacterial Vaginosis Smell Quickly Mind Blowing Tricks #Untreated Bacterial Vaginosi

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duancocobay · 5 years ago

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Urinary System, Part 1: Crash Course A&P #38

youtube

Even though you probably don’t choose to spend a lot of time thinking about it, your pee is kind of a big deal. Today we’re talking about the anatomy of your urinary system, and how your kidneys filter metabolic waste and balance salt and water concentrations in the blood. We’ll cover how nephrons use glomerular filtration, tubular reabsorption, and tubular secretion to reabsorb water and nutrients back into the blood, and make urine with the leftovers.

Anatomy of Hank poster:

Table of Contents Kidneys Filter Metabolic Waste & Balance Salt & Water Concentrations in the Blood 1:25 Nephrons 4:13 Glomerular Filtration 4:37 Tublar Reabsorption 5:14 Tubular Secretion 8:17 Urine 8:40

***

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Thanks to the following Patrons for their generous monthly contributions that help keep Crash Course free for everyone forever:

Fatima Iqbal, Penelope Flagg, Eugenia Karlson, Alex S, Jirat, Tim Curwick, Christy Huddleston, Eric Kitchen, Moritz Schmidt, Today I Found Out, Avi Yashchin, Chris Peters, Eric Knight, Jacob Ash, Simun Niclasen, Jan Schmid, Elliot Beter, Sandra Aft, SR Foxley, Ian Dundore, Daniel Baulig, Jason A Saslow, Robert Kunz, Jessica Wode, Steve Marshall, Anna-Ester Volozh, Christian, Caleb Weeks, Jeffrey Thompson, James Craver, and Markus Persson

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howtoloseweightfastsafely · 6 years ago

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Choosing High Quality Foods

How To Choose High Quality Meat/Fish

It's important to know that wild-caught and grass-fed are the most important qualifications, and that ORGANIC by itself doesn't count!

Animals can be eating organic corn and soy, which does nothing for their health (and ultimately ours). You see, for thousands of years, the natural diets for cattle and wild game, included grass, green and leafy plants, herbs, shrubs and more. And the natural diets of wild chicken and other fowl included grass, seeds, fruits, insects, and pretty much whatever they could peck at in the wild (How exciting!)

The story is much different now. Cattle, game, and fowl are more often than not force-fed with corn, soy and other foods (likely genetically modified at that) that their digestive and immune systems can't handle. On top of that, they are stuffed into dark, tight quarters with no room to move around or take in sunlight to create Vitamin D, and overall a healthier nutritional profile. This is not to mention that they may be eating other animal parts, as has been seeing in many CAFOs (Concentrated Animal Feeding Operations).

The sickness and diseases that result make for an inferior, harmful product that we end up eating.

Here's the solution:

1. Beef/Lamb/Goat: Buy GRASS-FED (very important); if not grass-fed, buy organic

a. These "ruminants" have digestive systems that are intended to eat grass

b. You don't want to be the person eating meat from an animal sickened by an unnatural grain/corn/soy-based diet.

2. Fowl (Chicken/Turkey, Duck, etc.): Buy pasture-raised, organically-fed chicken, turkey, duck, etc (look for meat that is NOT fed soy)

a. Free-Range is the next best option, but please understand that the "free-range" is often poorly defined

b. For example, it's recommended that about 1500 hens should be in an area of about 2.5 acres. Unfortunately, this is often pushed up to 10,000+ hens in the same 2.5 acre area. Not exactly "free-range" if you ask me.

c. Your best bet is finding a local market and speaking with the farmer's directly, or sticking with the pasture-raised/organic meats.

3. Other Game Meats: Make sure they are grass-fed or pasture-raised (in my experience, if you find these in stores, chances are you'll find the healthy versions)

a. Examples of Game Meats:

i. Bison, Buffalo, Elk, Moose, Caribou, etc.

4. Fish: Buy wild caught (farm raised might sound good, but think about, since when are fish found anywhere remotely near a farm??)

a. Stick to low-mercury fish

b. Examples: Salmon, Flounder, Tilapia, Sardines, Haddock

If you can't find naturally-raised meats/fish as listed above, choose organic. In this case, at least the corn, soy, etc in the feed will not include genetically modified organisms (GMO).

Another good thing is that organic feed cannot be made with GMOs by law, so even if corn or soy is in the feed, at least it won't be a completely fake food!

In any case, the best part about eating this way is that naturally raised foods have a much better nutritional profile vs. conventionally-raised fish/meats. They are higher in vitamins, minerals, lower in cholesterol, lower in Omega 6 fats and higher in Omega 3 fats, and devoid of hormones and antibiotics.

It's also important to know that over 95% of studies showing that meats (especially fatty meats) cause cancer, heart disease, etc. were NOT conducted on natural pasture-raised animals, that are free of antibiotics and hormones.

Food for thought if you ask me, especially with the well-documented history of thousands of traditional cultures who have thrived on natural meats.

How to Choose High Quality Eggs

The #1 best type of eggs to eat are organically-fed eggs from pasture-raised, local chickens.

(Bonus points if you have visited the farm and seen how the eggs are treated/raised)

These eggs are the "cream of the crop" because the chickens laying them should be getting proper exercise, sunlight for Vitamin D, natural protein from insects, grubs, etc, and organically-grown chicken feed.

The 2nd best: Locally raised, non-organically fed chickens. As long as they are getting adequate exercise and sunlight they are better off than the rest (and better for your body)

The 3rd best: Store bought, organically-raised eggs (with Omega 3's for added benefit)

The 4th best: Eggs from chicken fed an Omega-3 enhanced diet.

Note: If you're dealing with local farmers, make sure the feed does not include soy which is not good for us (and of course not part of a chicken's natural diet.)

How to Choose Organic Vegetables and Fruit

The vast majority of conventionally raised crops are sprayed with herbicides, insecticides and much more.

This also includes pesticides, fungicides, organophosphates and more...which have various effects that most of us don't even realize.

1. Fungicides used on crops have been shown to increase insulin resistance, thereby setting us up fat accumulation and chronic disease

2. Organophosphates, while essential in some instances for humans, are also highly toxic via the herbicides and insecticides they are used in.

a. Even at very low levels, they are hazardous to human health.b. Studies have pointed to an increased Alzheimer's risk, and brain and nervous system damage even at low levels.3. Pesticides act on brain chemicals closely related to ADHD development.a. In one study a tenfold increase in urinary organophosphate content in children 8 to 15 years old directly correlated with a 55 to 72% increased prevalence of ADHD

b. The EPA banned residential use of organophosphates in 2001, but agricultural use is still widespread4. Herbicides/insecticides containing organophosphates in them have been sprayed on...a. Apples, walnuts, almonds, peaches, blueberries, celery, and broccoli....to say the least!

So I can just wash and peel my produce right?

No way Jose.

It just doesn't cut it! [no pun intended]

The truth is: washing veggies/fruits can reduce some of the pesticides, but definitely will not reduce all. And with peeling, you will still be unable to remove all the pesticides and you'll lose the vital nutrients that are in the skin.

Here's how to do it correctly:

Choosing Vegetables/Fruit Part 1: My rule of thumb is, if we eat the skin, BUY ORGANIC

Bananas - Organic NOT necessary

Apples - Organic NECESSARY

Peaches - Organic NECESSARY

Celery - Organic NECESSARY

Mangoes - Organic NOT necessary

You get the idea. Do the quick "skin or no skin" test before buying any fruits/veggies.

Choosing Vegetables/Fruit Part 2: Get more scientific and choose based on toxin levels (not a bad idea if you ask me).

Keep an eye out for:

Pesticide levels

Chemical Levels

Antibiotic counts

Yes, antibiotics have been found in soil, which goes directly to the veggies/fruits growing in it!

The following have the highest toxin levels (in descending order) and should definitely be purchased organic:

Fruit: Peaches, Apples, Strawberries, Nectarines, Pears

Veggies: Spinach, Bell Peppers, Celery, Hot Peppers

To learn more, check out the chart below, adapted from research done by the Environmental Working Group (EWG):

High in Pesticides

(Buy Organic)

Lower in Pesticides (Buy Organic Only If Budget Permits)

Apples, Onions

Celery, Sweet Potatoes

Sweet Bell Peppers, Pineapple

Peaches, Avocado

Strawberries, Cabbage

Nectarines, (Imported)Mushrooms

Grapes, Asparagus

Spinach, Mangoes

Lettuce, Cantaloupe (Domestic)

Cucumbers, Eggplant

And remember, if you can't eat organic 90+ of the time (that is, for the foods which you must buy organic), make sure you are taking high-quality herbs + vitamins to counteract the damage.

I am biased, of course, but I highly recommend the anti-inflammatory, liver cleansing InvigorateNOW blend. It's a foolproof way to protect your body from the toxin overload + chronic inflammatory that would result from the dangerous toxins hiding in non-organic food. (These hidden compounds include: bleach-like ingredients, insect killers, lab-made chemicals, genetically engineered crops, and much more.)

With that outta the way, let's move on to Chapter 17 -- where we'll continue this with a discussion on hundreds of sneaky age-accelerating compounds hiding in your food.

Interested in losing weight? Then click below to see the exact steps I took to lose weight and keep it off for good...

Read the previous article about "The Truth About Buying Organic: Secrets The Health Food Industry Doesn't Want You To Know"

Read the next article about "A Recipe For Rapid Aging: The "Hidden" Compounds Stealing Your Youth, Minute by Minute"

Moving forward, there are several other articles/topics I'll share so you can lose weight even faster, and feel great doing it.

Below is a list of these topics and you can use this Table of Contents to jump to the part that interests you the most.

Topic 1: How I Lost 30 Pounds In 90 Days - And How You Can Too

Topic 2: How I Lost Weight By Not Following The Mainstream Media And Health Guru's Advice - Why The Health Industry Is Broken And How We Can Fix It

Topic 3: The #1 Ridiculous Diet Myth Pushed By 95% Of Doctors And "experts" That Is Keeping You From The Body Of Your Dreams

Topic 4: The Dangers of Low-Carb and Other "No Calorie Counting" Diets

Topic 5: Why Red Meat May Be Good For You And Eggs Won't Kill You

Topic 6: Two Critical Hormones That Are Quietly Making Americans Sicker and Heavier Than Ever Before

Topic 7: Everything Popular Is Wrong: The Real Key To Long-Term Weight Loss

Topic 8: Why That New Miracle Diet Isn't So Much of a Miracle After All (And Why You're Guaranteed To Hate Yourself On It Sooner or Later)

Topic 9: A Nutrition Crash Course To Build A Healthy Body and Happy Mind

Topic 10: How Much You Really Need To Eat For Steady Fat Loss (The Truth About Calories and Macronutrients)

Topic 11: The Easy Way To Determining Your Calorie Intake

Topic 12: Calculating A Weight Loss Deficit

Topic 13: How To Determine Your Optimal "Macros" (And How The Skinny On The 3-Phase Extreme Fat Loss Formula)

Topic 14: Two Dangerous "Invisible Thorn" Foods Masquerading as "Heart Healthy Super Nutrients"

Topic 15: The Truth About Whole Grains And Beans: What Traditional Cultures Know About These So-called "Healthy Foods" That Most Americans Don't

Topic 16: The Inflammation-Reducing, Immune-Fortifying Secret of All Long-Living Cultures (This 3-Step Process Can Reduce Chronic Pain and Heal Your Gut in Less Than 24 Hours)

Topic 17: The Foolproof Immune-enhancing Plan That Cleanses And Purifies Your Body, While "patching Up" Holes, Gaps, And Inefficiencies In Your Digestive System (And How To Do It Without Wasting $10+ Per "meal" On Ridiculous Juice Cleanses)

Topic 18: The Great Soy Myth (and The Truth About Soy in Eastern Asia)

Topic 19: How Chemicals In Food Make Us Fat (Plus 10 Banned Chemicals Still in the U.S. Food Supply)

Topic 20: 10 Banned Chemicals Still in the U.S. Food Supply

Topic 21: How To Protect Yourself Against Chronic Inflammation (What Time Magazine Calls A "Secret Killer")

Topic 22: The Truth About Buying Organic: Secrets The Health Food Industry Doesn't Want You To Know

Topic 23: Choosing High Quality Foods

Topic 24: A Recipe For Rapid Aging: The "Hidden" Compounds Stealing Your Youth, Minute by Minute

Topic 25: 7 Steps To Reduce AGEs and Slow Aging

Topic 26: The 10-second Trick That Can Slash Your Risk Of Cardiovascular Mortality By 37% (Most Traditional Cultures Have Done This For Centuries, But The Pharmaceutical Industry Would Be Up In Arms If More Modern-day Americans Knew About It)

Topic 27: How To Clean Up Your Liver and Vital Organs

Topic 28: The Simple Detox 'Cheat Sheet': How To Easily and Properly Cleanse, Nourish, and Rid Your Body of Dangerous Toxins (and Build a Lean Well-Oiled "Machine" in the Process)

Topic 29: How To Deal With the "Stress Hormone" Before It Deals With You

Topic 30: 7 Common Sense Ways to Have Uncommon Peace of Mind (or How To Stop Your "Stress Hormone" In Its Tracks)

Topic 31: How To Sleep Like A Baby (And Wake Up Feeling Like A Boss)

Topic 32: The 8-step Formula That Finally "fixes" Years Of Poor Sleep, Including Trouble Falling Asleep, Staying Asleep, And Waking Up Rested (If You Ever Find Yourself Hitting The Snooze Every Morning Or Dozing Off At Work, These Steps Will Change Your Life Forever)

Topic 33: For Even Better Leg Up And/or See Faster Results In Fixing Years Of Poor Sleep, Including Trouble Falling Asleep, Staying Asleep, And Waking Up Rested, Do The Following:

Topic 34: Solution To Overcoming Your Mental Barriers and Cultivating A Winner's Mentality

Topic 35: Part 1 of 4: Solution To Overcoming Your Mental Barriers and Cultivating A Winner's Mentality

Topic 36: Part 2 of 4: Solution To Overcoming Your Mental Barriers and Cultivating A Winner's Mentality

Topic 37: Part 3 of 4: Solution To Overcoming Your Mental Barriers and Cultivating A Winner's Mentality

Topic 38: Part 4 of 4: Solution To Overcoming Your Mental Barriers and Cultivating A Winner's Mentality

Topic 39: How To Beat Your Mental Roadblocks And Why It Can Be The Difference Between A Happy, Satisfying Life And A Sad, Fearful Existence (These Strategies Will Reduce Stress, Increase Productivity And Show You How To Fulfill All Your Dreams)

Topic 40: Maximum Fat Loss in Minimum Time: The Body Type Solution To Quick, Lasting Results

Topic 41: If You Want Maximum Results In Minimum Time You're Going To Have To Work Out (And Workout Hard, At That)

Topic 42: Food Planning For Maximum Fat Loss In Minimum Time

Topic 43: How To Lose Weight Fast If You're in Chronic Pain

Topic 44: Nutrition Basics for Fast Pain Relief (and Weight Loss)

Topic 45: How To Track Results (And Not Fall Into the Trap That Ruins 95% of Well-Thought Out Diets)

Topic 46: Advanced Fat Loss - Calorie Cycling, Carb Cycling and Intermittent Fasting

Topic 47: Advanced Fat Loss - Part I: Calorie Cycling

Topic 48: Advanced Fat Loss - Part II: Carb Cycling

Topic 49: Advanced Fat Loss - Part III: Intermittent Fasting

Topic 50: Putting It All Together

Learn more by visiting our website here: invigoratenow.com

#weightloss #diet

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ownerzero · 7 years ago

Text

Urinary System, part 1: Crash Course A&P #38

The post Urinary System, part 1: Crash Course A&P #38 appeared first on AWorkstation.com.

source https://aworkstation.com/urinary-system-part-1-crash-course-ap-38/

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bountyofbeads · 5 years ago

Text

My Whole Household Has COVID-19

“The thought of simply breathing in and out without coughing and reuniting with my children ... is goal enough. To—literally—live and let live will be enough.”

By DEBORAH COPAKEN | Published March 27, 2020 12:35 PM ET | The Atlantic | Posted March 29, 2020 |

I can pinpoint the exact moment I started feeling off. My partner, Will, and I were on a bike ride on the afternoon of Wednesday, March 18, to escape our apartment and get some exercise. This was back when leaving a New York City apartment to get some exercise was still okay, or at least that’s what we’d read, or at least that’s what we thought? If the coronavirus pandemic has taught us anything, it’s that what is considered dogma today might change tomorrow.

Ten minutes into our bike ride, I was overcome by an intense fatigue. “I think I have to go back,” I said.

Back home, I felt chilled. Took my temperature: 99.1. I’m normally 97.1, but still, not a huge deal. We’d been so careful about wiping down doorknobs, washing our hands, and keeping everyone except for our family out of our apartment. I’d been ambiently worried enough that my 13-year-old son could be a silent carrier of the virus that I’d yanked him out of his public middle school and off the crowded subways four days before Mayor Bill de Blasio pulled the plug– (far too belatedly, in my opinion). I was getting over a urinary-tract infection, so my fever, I thought, must be from that.

That evening, I answered a bunch of Slack messages from work, finished a project for my boss, and picked at the dinner Will cooked. I was, unusually, not hungry. Neither was Will. Neither was my son, which is weird because normally he eats twice his body weight in food.

The next day my temperature was back down to 97.1, but the UTI had worsened. I called the nearby urgent-care center to see if they could prescribe me a new antibiotic, but no one was answering the phone. Figuring the place was overwhelmed with coronavirus calls, I walked over to the urgent care, opened the front door, and poked my head in. “Hi,” I said. “I’m so sorry to bother you at this time, but no one’s answering your phones.” I explained that the antibiotic course I’d just finished hadn’t worked, and I needed a different prescription.

“Do you have a temperature?” I remember the receptionist asking, as she walked over to the door and handed me a mask. Wait, what?

“No. I had a slight fever yesterday. Can I just leave a message for the doctor? I don’t want to come in.” I could hear a hacking cough coming from one of the exam rooms.

“If you need a new antibiotic, you’ll have to pee in a cup again.”

“But you guys already have my pee from last week! Use the same pee!”

“Sorry, we can’t treat you unless you meet with the doctor again and give us a new sample.”

You’ve got to be kidding me, I thought. Why are we talking about pee during a shit storm? I weighed my options: either endure the UTI for who knows how long until this pandemic is over, which could lead to a kidney infection, which might eventually mean being forced to enter an overwhelmed, COVID-19-infected hospital anyway, or walk into this urgent care right now and possibly get exposed to the virus, but only from the two people coughing. I didn’t like this game of “Would you rather.”

I put on that mask and walked straight in––in my regular clothes, with no eye protection––where I stayed for a good 30 to 40 minutes until I could pee into a new cup, meet with the doctor, get a prescription, and go home. To say it was scary sitting there listening to all that coughing in the other rooms would be an understatement. The other patients sounded as if they should be on respirators, not in a neighborhood urgent care.

When I came home, I immediately stripped and washed all my clothes. That night, I got word that I did, indeed, have an ever-worsening UTI. (Duh.) A few hours later, Will came down with a fever and diarrhea and fell asleep watching Rachel Maddow, which he never does.

We isolated ourselves in separate rooms. My son stayed in his room, Will stayed in my other son’s room––that son, 24, had been volunteering for several months with Syrian refugees in Samos, Greece, and was self-quarantining in a nearby Airbnb––and me in the master bedroom, but not before I wiped down the entire apartment with Clorox wipes again. The next night, March 20, I cooked some rice and beans that no one ate.

Will stayed quite sick for three days, his temperature spiking and then retreating, but he never came down with a cough. Just the diarrhea, which is a rare COVID-19 symptom. We considered heading over to the drive-through test site that had just been set up on Staten Island, but by the time Will was feeling well enough to sit in a car for several hours, New York City had been declared a FEMA disaster zone. All masks and pieces of personal protective equipment were needed to treat the sick and dying, and the city put out a statement saying that people whose illnesses didn’t require hospitalization should not get tested. So we stayed home.

We missed each other’s company, though, so I threw caution to the wind, washed my hands, and invited Will to wash his hands and lie on the bed with me, as far from my body as possible, to listen to a recording of the 1977 Cornell Grateful Dead show while watching the sunset from our bedroom window. I kept it together until Jerry, in “Morning Dew,” sang, “Where have all the people gone, my honey? Where have all the people gone today?”

My fever spiked again on Sunday night. Monday morning, March 23, the fever was gone, so I decided to reorganize our spice cabinet. As one does in a lockdown. But I found I could no longer smell the spices. I had to make sure, when writing up new labels, not to mix up the herbs de Provence, the basil, and the oregano, all of which now looked and smelled exactly alike, which is to say they all smelled like nothing. (Doctors have begun observing a loss of smell and taste in some COVID-19 patients.) By the afternoon, I had a well-organized spice cabinet and a sore throat. Not a bad one, just a slightly annoying one.

By Tuesday afternoon, I was quite sick. I was now coughing a deep and scary dry, wheezing cough, just like the ones I’d heard in the urgent care a few days prior. My temperature was spiking and falling, spiking and falling; my throat was still sore; and I could not drink enough water to quench my thirst. My chest felt as if there were an anvil sitting on top of it. When I attempted to take a deep breath, I could not get enough air into the bottom of my lungs to fill them.

I sent a text message to my primary-care providers’ office through their telemedicine system. I made an appointment with a doctor to speak on the phone. Over the course of our 15-minute call, she asked many questions about my symptoms, about Will’s symptoms, about my son’s loss of appetite. She also heard my cough several times, and said, as I remember it, “That’s a COVID cough. You have to assume all three of you have it at this point. Just lay low until everyone’s symptoms are gone.”

“Can I get a test?” I said.

“No,” she said. “You can’t. Only essential workers. You don’t need one. I can tell just from listening to your cough and hearing your symptoms. When did you first start to feel ill?”

I told her about the bike ride.

The doctor became irritated. “You rode a bike? With viral load everywhere? Why?”

Hadn’t I read one or maybe several experts saying it was safe to go outside and exercise? “I thought it was okay to go out if you stayed six feet from others?”

“No,” she said. “Not in New York. Not right now.”

So nobody knows anything. Or some people know some things, but then facts catch up and prove them wrong. What an embarrassment, how unprepared this country is. We had time to right the plane before it crashed. But the pilot’s been too busy blaming the clouds and spouting lies over the loudspeaker. If I’m sick and can’t get a test, how do we even know that the attack rate in New York City is, as was recently reported, five times the norm? Maybe it’s 10. Maybe it’s 100. Who the hell knows? How many others are sheltering in place in my city right now, coughing on the down low because they can’t get tested? I want to be counted, goddamnit.

“Can my partner and I sleep in the same room again, now that we’re both sick?”

“I wouldn’t advise it,” said the doctor. “Your bodies need to get better. Keep your viral load from his and vice versa. Do you have enough rooms for all of you to self-isolate?”

“For now, yes,” I said, explaining how I have one child self-quarantining in an Airbnb in Brooklyn and now another, just evacuated from the Peace Corps, in an Airbnb in Washington, D.C. It’s been an expensive month.

The doctor told me to open up an account with Capsule, a prescription-delivery service, to keep my germs from infecting our local pharmacy. She’d send over a prescription for an inhaler and a nebulizer. The key thing, she told me, is to stay away from the hospitals unless absolutely necessary. There are no beds, even if I need one. And I could get sicker in a hospital than I would staying home.

These were not reassuring words to hear from a doctor.

The drugs and equipment would be delivered later that evening, but before they arrived, my cough and breathing had become so bad that Will barged into my room and said, “We need to make you a go bag.” I could barely get out of bed to go to the bathroom, much less contemplate what items I’d toss in a go bag, a bag to go to the hospital, a place I’d just been told by a doctor not to go.

“If it gets that bad, I won’t even notice if I don’t have my phone charger or extra underwear,” I said. My older children were each FaceTiming me from their own quarantines, but it suddenly hurt too much to talk.

A few hours later, the medications and the nebulizer arrived at my door via a brave delivery man who left the bag at the end of the hallway, smiled, waved, and then ran. “Wait, don’t I need to sign for that?” I shouted after him.

“That’s okay!” he said. “I’ll do it for you.”

I watched a YouTube video that explained how to use the nebulizer. Then I set up mine, squeezed the medicine into its chamber, turned it on, and suddenly … relief! For the first time all day, I could breathe. I could feel the bottom of my lungs again. Hallelujah.

But then my heart rate shot up. It got up to 144 beats per minute according to my Apple watch. I was dizzy with heartbeats. I’m prone to premature ventricular contractions––extra, abnormal heartbeats that begin in the ventricles and disrupt the heart’s regular rhythm––so I have to be careful. My doctor, after I texted the office about my heart rate, called at 8 p.m. and gave me her personal cellphone number in case of emergency.

It’s been three days since my COVID-19 diagnosis, nine days since that first rush of fatigue and slightly elevated temperature. My life is now centered on finding a balance between being able to breathe and not feeling like I’m going to pass out from a too-thrumming heartbeat. Periodically, I send photos of my Apple Watch heart monitor to my doctor, and she gives me advice on when to use the nebulizer next.

All in all––aside from the few hours when I couldn’t breathe and didn’t have the nebulizer; and when I passed out walking from the living room into my bedroom; and when I cough; and at night, when it all feels much worse, and my back aches from coughing, so I can’t sleep––I’ve been okay. Groggy and irritable and down six pounds, but okay. I’ve had worse colds and flus, and I’m hoping I’ll still be able to say this when I’m all better. My biggest fear now is getting sicker and needing to enter either a too-crowded hospital at the viral peak or, heaven forbid, the Jacob Javits Center, which FEMA is transforming into a giant COVID-19 treatment center. Not to make light of an increasingly dire situation, but the last thing I want is to die in the Jacob Javits Center.

I spoke with my daughter yesterday morning from her Airbnb in D.C. She’s not sure where to go after her 14 days of quarantine are over. She’d planned on staying in her post in Cameroon for two years but was able to complete only six months before the emergency evacuation, and she’s not allowed to return. As a Peace Corps volunteer, she’s not eligible for unemployment. She is, at 23, broke, heartbroken, and homeless, which is another reason I’d better not die right now. My son is going stir-crazy all alone in his Airbnb. I haven’t been able to hug him since he got back from Greece. Should he come home on March 31 or pay for another week of the Airbnb, given our illnesses? How long will we remain sick? The World Health Organization says two weeks for a mild case, and three to six weeks for a more serious bout. But that’s just the accepted dogma right now. Tomorrow, those numbers could change.

Part of me wants, as soon as we’re better, to grab my three kids and my partner and escape someplace remote, but where? COVID-19 is everywhere. I guess the thought of simply breathing in and out without coughing and reuniting with my children, wherever that might be, is goal enough. To––literally––live and let live will be enough. Because in the middle of writing that last sentence, I learned that an old friend has been felled by COVID-19. Rest in peace, Mark Blum. I’m so sorry we didn’t do more to flatten the curve while we still could.

Trying to remain optimistic, I have sent an email to researchers at Mount Sinai, who are searching for antibody-rich plasma from those of us who catch COVID-19 and make it through to the other side, to treat critically ill patients—a protocol that showed some promise in China. I definitely, certainly, 100 percent plan to give my antibodies as soon as I can. If my illness can help someone else be less ill, then it is my moral duty to make that happen, just as staying home right now is our moral duty to save others. “We must love one another or die,” W. H. Auden wrote. I read that poem to my older kids after 9/11, and I plan to read it to them again when we’re all reunited.

I received an email back from Mount Sinai asking for my full name, date of birth, symptoms, date of symptom onset, and last day of symptoms.

“Still sick,” I responded. But hopefully not for much longer.

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DEBORAH COPAKEN is a contributing writer at The Atlantic. The author of The Red Book and Shutterbabe, she's currently at work on a new memoir for Random House, Ladyparts.

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I’m Treating Too Many Young People for the Coronavirus

Americans in their 20s and 30s—no matter how healthy and invincible they feel—need to understand how dangerous this virus can be.

By Kerry Kennedy Meltzer, Internal medicine resident physician in New York City | Published March 26, 2020 | The Atlantic | Posted March 27, 2020 |

ON FRIDAY NIGHT, I WORKED A 12-hour shift in the designated COVID-19 area of my hospital’s emergency department in New York City. Over the course of the night, I examined six patients who were exhibiting common symptoms of the novel coronavirus; five of them were in their 20s or early 30s.

I am 28 years old. Up until Friday, when people asked me whether I was scared, I would tell them yes—for my country, my colleagues, my 92-year-old grandmother, and all the people most vulnerable to getting seriously ill from the virus, but not for myself. I, like many others, believed that young people were less likely to get sick, and that if they did, the illness was mild, with a quick recovery.

I now know that isn’t the case. The fact is that young people with no clear underlying health conditions are getting seriously ill from COVID-19 in significant numbers. And young Americans—no matter how healthy and invincible they feel—need to understand that.

My first patient was in their early 20s. (To protect their confidentiality, I’m referring to my patients without mentioning their gender.) They had a dry cough and a 102-degree fever, but their chest X-ray came back clear and their oxygen levels were safe. I wanted to test them for COVID-19, but they weren’t sick enough to require admission to the hospital, which meant I couldn’t do so. We desperately want to be able to test and take care of everyone, from the seriously ill to the mildly sick and worried, but with our current capacity, we simply can’t. I told them that they needed to assume they had the virus, and gave them instructions on how to quarantine at home.

I changed my gown and gloves, checked my mask and goggles, and moved on to my next patient: a student who had been coughing and feeling fatigued for multiple days. They had been with a friend before getting sick, and that friend had since fallen ill with symptoms of COVID-19, including a fever. The patient was having trouble catching their breath, but their symptoms were not severe or acute—as confirmed by a chest X-ray and a test of their oxygen levels—so I recommended discharge and quarantine, and they understood.

My next patient was a young professional. For the past week they’d had a dry cough and chest pain. They had no underlying health conditions, and they’d tried to follow the current guidelines by staying at home (the right thing to do, given the overwhelmed state of hospitals like mine) but that evening their breathing had become so labored that they called an ambulance. When I saw them, however, they were breathing comfortably, their chest X-ray was clear, and their oxygen levels were safe. They were visibly upset when I told them they would not be admitted. They wanted to be tested. I explained why we couldn’t do that, and completed their discharge paperwork.

I collected myself and approached my next patient: a young person who’d been suffering with a fever, cough, and extreme fatigue for the past three days. Their boss didn’t believe they were sick, so they’d continued to complete long shifts working with customers at a local business. After examining the young patient, I determined that they were in the same category as the previous three I’d seen—sick, but not sick enough to be given a precious hospital bed or COVID-19 test—so I gave them fluids, Tylenol, and a note for their employer confirming that they were indeed ill, and needed to stay home.

Late in the night, another young patient came in with a high fever and no underlying health conditions. They’d had a dry cough for the past four days. They’d come to the hospital after finding they were unable to walk a few feet without getting severely short of breath. On their chest X-ray, I saw lungs that were almost completely whited out, indicating a significant amount of inflammation. It was clear how uncomfortable they were, and how desperately they were trying to catch their breath. They were in a different category from the previous patients I’d seen that night. They needed to be admitted. They needed testing. They needed close monitoring.

I called the Intensive Care Unit team, and they admitted the young patient to the hospital. I finished my shift not long after, walked home, and got in bed, feeling unsteady. When I woke up a few hours later, I logged into our electronic medical record system and learned that in the time I’d been asleep, my patient’s oxygen levels had dropped severely. A breathing tube had been placed down their throat. A ventilator was now keeping them alive.

Recent statistics suggest that what I saw that night is not unusual. On Tuesday, California Governor Gavin Newsom said that half of the 2,102 people who had tested positive for COVID-19 in his state were ages 18 to 49. The Centers for Disease Control and Prevention published data on March 18 showing that, from February 12 to March 16, nearly 40 percent of American COVID-19 patients who were sick enough to be hospitalized were ages 20 to 54. Twelve percent of patients with the most critical cases, requiring admission to an ICU, were ages 20 to 44. There are some caveats worth noting: The CDC was not able to determine whether the young people included in its report had underlying health conditions. And all of this is early data. We know that we are still not testing nearly enough people in the United States. The numbers may change.

But in spite of these alarming figures, too many young Americans have been slow to give up the false belief that they are safe from COVID-19. The day after the CDC report was released, college students began responding to a poll. Only 50 percent said that they were concerned about contracting COVID-19. Fifty-three percent admitted that they or their friends had gone to social gatherings in the previous week.

At the same time as I was seeing the flurry of young patients on my overnight shift, a resident friend of mine at a hospital on the West Coast was placing a patient in their 20s on a ventilator. A 26-year-old woman who was hospitalized with COVID-19 recently told her story in The New York Times. A doctor at my own hospital said that he has never seen so many young people in the ICU as he’s now seeing with COVID-19.

This isn’t the type of evidence that we like to talk about as scientists—anecdotes, instead of hard data—but doctors are people too. We listen to the stories of our patients and our colleagues. We pay attention to the trends that we see on the ground. We connect the dots.

We still need better data to fully understand how young people are being affected by COVID-19, but until we can get it, we have to spread the word, and ask friends and family—no matter their age—to stay at home.

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KERRY KENNEDY MELTZER is an internal medicine resident physician in New York City.

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A New York Doctor’s Warning

China warned Italy. Italy warned us. We didn’t listen. Now the onus is on the rest of America to listen to New York.

By Fred Milgrim, Emergency-medicine resident physician in New York City | Published March 27, 2020 7:00 AM ET | The Atlantic Magazine | Posted March 27, 2020 |

In the emergency-department waiting room, 150 people worry about a fever. Some just want a test, others badly need medical treatment. Those not at the brink of death have to wait six, eight, 10 hours before they can see a doctor. Those admitted to the hospital might wait a full day for a bed.

I am an emergency-medicine doctor who practices in both Manhattan and Queens; at the moment, I’m in Queens. Normally, I love coming to work here, even though in the best of times, my co-residents and I take care of one of New York City’s most vulnerable, underinsured patient populations. Many have underlying illnesses and a language barrier, and lack primary care.

These are not the best of times; even for my senior attendings, it is the worst they have ever seen. Here, the curve is not flat. We are overwhelmed. There was a time for testing in New York, and we missed it. China warned Italy. Italy warned us. We didn’t listen. Now the onus is on the rest of America to listen to New York. For many people around the country, the virus is still an invisible threat. But inside New York’s ERs, it is frighteningly visible.

Every day, in our hastily assembled COVID-19 unit, I put on my gown, face shield, three sets of gloves, and N95 respirator mask, which stays on for the entirety of my 12-hour shift, save for one or two breaks for cold pizza and coffee. Before the pandemic, I would wear a new mask for every new patient. Not now. There are not enough to go around. The bridge of my nose is raw, chapped, and on the verge of bleeding. But I consider myself one of the lucky ones. My hospital still has a supply of masks—albeit a dwindling one—to protect me and my colleagues.

Many of my patients clearly haven’t received the message to stay home unless they’re in immediate need of professional medical assistance. Their fevers and coughs alone are not enough to even earn a test. I hand them discharge paperwork and a printout about how to prevent the spread of the coronavirus, tell them to self-isolate, and then I move on to the next person. If they didn’t have the coronavirus before coming to our hospital, they probably do now. So much for gatherings of 10 people or fewer.

Meanwhile, my colleagues tend to patients in the critical-care bay with dipping oxygen levels, patients who can barely speak and may need breathing tubes.

Earlier in the month, we were told that positive-pressure oxygen masks, such as CPAP machines, were risky, as they would aerosolize the virus, increasing health-care workers’ risk of getting infected. But in recent days, running dangerously low on ventilators, we have attempted using CPAP machines to stave off the need for medically induced comas.

Still, the increasing frequency of intubations we need to perform is alarming. Our ventilators are almost all in use, and the ICUs are at capacity. Our hospital has already received extra vents here and there from other hospitals in the region that can spare them, but those few additions are merely a stopgap. Will we soon have patients sharing vents? We wouldn’t be the first hospital to attempt that unusual and suboptimal practice, which gained traction after the Las Vegas shooting, when scores of young trauma patients were vented in pairs. But these COVID-19 patients have delicate lungs, which makes vent-sharing far more dangerous. Nevertheless, we’ve already started studying the mechanics of how to make this happen, as a last-ditch effort.

By next week, we may simply have no choice. Those hundreds of relatively healthy patients we sent home may return to the hospital en masse in respiratory failure.

On Wednesday, I greeted a patient I had discharged only one week prior. When I saw his name pop up on the board, my heart sank. He is just shy of 50, with hardly any past medical history, and he had seemed fine. Now he was gasping for air. His chest X-ray was no relief—COVID-19 for sure. I needed to admit him to the hospital, and set him up with oxygen, heart monitoring, and a bed.

Last week, I saw an elderly woman on dialysis. She had arrived with a mild cough. But her vital signs were normal—no fever. After her chest X-ray came back clear, we decided to send her home. But before her ride came, she spiked a fever to 102. Change of plans. With her age and complex medical problems, she would need to be admitted.

The next night, I saw a rolling bed wheeling past me with a resident riding on top, performing chest compressions on the patient.

Only after we pronounced the patient dead did I learn her name. She was my patient from the night before. She went into cardiac arrest before she even got a bed in the ward. My first COVID-19–positive death. The numbers have been mounting ever since.

A few days ago, FEMA finally arrived to help with this crisis. It has brought more tests, hopefully more vents, and a morgue in the form of a truck to help with the ever-growing number of dead bodies. I wonder if this help will be enough. My colleagues and I discuss this pandemic with a sardonic sense of helplessness. Some of us are getting sick. Our reality alters by the moment. Every day, we change our triage system. Each day could be the day that the masks run out. There is much we think but are too afraid to say to one another.

I do not want to see you in my hospital. I do not want you to go to any hospital in the United States. I do not want you to leave your home, except for essential food and supplies. I do not want you to get tested for the coronavirus, unless you need to be admitted to a hospital.

For those of us at the forefront, knowing who has COVID-19 won’t change our ability—or inability—to treat patients. The problem is, and will be, our shortage of healthy personnel, personal protective equipment, beds, and ventilators. A nasal swab is not the answer anymore.

If you have mild symptoms, assume that you have the coronavirus. Stay home, wash your hands, call your doctor. Don’t come to the emergency department just because of a fever or cough. Receiving a test won’t change our recommendation that you remain in self-isolation. We don’t want you to expose yourself to those who definitely do have the virus.

Social distancing, while still crucial, came too late in New York to prevent a crisis. Maybe, just maybe, extreme measures can prevent this from happening in other cities around the country.

In spite of all this morbidity, the doctors at the hospital received one piece of good news yesterday. A coronavirus patient was successfully taken off a ventilator after two weeks, a first for our Medical ICU and a victory for the staff and, of course, the patient.

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FRED MILGRIM is an emergency-medicine resident physician in New York City, currently working at Elmhurst Hospital.

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Watch New Orleans

With the country’s attention turned north, the coronavirus pandemic is exploding in Louisiana.

By VANN R. NEWKIRK II | Published March 27, 2020 2:11 PM ET | The Atlantic | Posted March 27, 2020 |

Between the time this sentence was written and the time this article is published, hundreds more Americans will likely have died from COVID-19. Hundreds or perhaps thousands more people will have been hospitalized, and certainly tens of thousands more will have tested positive for the coronavirus. At this point, making predictions about the pandemic is like riding a barrel over Niagara Falls: We can only guess how it ends, but we do know things are going down.

Here’s another prediction that’s safe to make: The city of New Orleans—and, potentially, all of Louisiana—is going to become the next front in the fight against the pandemic. Even as national attention is justifiably focused on the aggressive outbreak in Washington State and the mounting pressures on New York City’s hospitals, the virus’s advance in Louisiana has shaken local officials and doctors, and the state is already approaching a similar burden of infections and deaths as the crises to the north. There’s good reason to believe that this southern outbreak will be even more difficult to contain, and is perhaps a better harbinger of what’s to come as the pandemic spreads across the country.

The numbers already indicate that Louisiana is a global epicenter of the pandemic. Just over 1 percent of the U.S. population lives in Louisiana. But according to the COVID Tracking Project, 7 percent of all COVID-19 deaths, 7 percent of all hospitalizations, and 3 percent of all positive tests have been in the state. New York has suffered about two deaths per 100,000 residents. Louisiana is at 1.8.

To put the numbers into perspective, if Louisiana were a country, its death count would put it in the top 15 globally. The burden appears to be increasing so quickly that all of these statistics will become quickly out of date. The state reported 83 total deaths from COVID-19 as of noon yesterday. It had reported 34 as of Monday. And, as is the nature of this virus, most of the reported data represent only a snapshot of the infections that took place a week or two ago.

Hospitalizations and deaths will increase. And, if other outbreaks around the world are any example, the curve will not rise gently. The fallout in Louisiana will be most painful in the New Orleans metropolitan area, whose Orleans and Jefferson Parishes account for two-thirds of all cases in the state.

Louisiana Governor John Bel Edwards has already declared a state of emergency. In a press conference on Wednesday, he said that, despite the official numbers, he’s certain that all parishes in the state have coronavirus cases. He asked citizens to continue to stay home and follow state guidelines on slowing the spread of the virus. Like New York Governor Andrew Cuomo, Edwards also warned of a critical shortage of ventilators in the hospitals that will soon be hit with waves of COVID-19 patients. “We could potentially run out of vents in the New Orleans area in the first week in April,” Edwards said. According to state data, a third of all people hospitalized because of the virus so far have required ventilators.

Local officials in New Orleans have made even more dire pronouncements. “We are preparing to mobilize in a way that many of us have never seen,” said Collin Arnold, the city’s homeland-security director, in a separate press conference Wednesday. “This is a disaster that will define us for generations.” New Orleans Mayor LaToya Cantrell said the same day that the city expects hospital beds to fill within two weeks, and she authorized the use of the Morial Convention Center as an overflow site.

Physicians and other health professionals in the city already seem close to being overwhelmed. In a tweet on Wednesday, the former state secretary of health, Rebekah Gee, referenced stories of people reusing protective gear or ordering it from eBay. Joshua Denson, a pulmonary and critical-care physician at Tulane Medical Center and University Medical Center New Orleans, diagnosed the second confirmed case of coronavirus in the city. Now he’s currently under self-quarantine as he awaits the results of his own test for the virus. “I'm not the only one of our critical-care doctors who is on quarantine or sick right now,” Denson told me. “The big point is: If you lose one or two, it’s a big deal. This isn’t a place that’s just swimming with available options.”

According to Denson, problems particular to Louisiana might make an outbreak there worse than what other parts of the U.S. have seen. The state has one of the highest poverty rates in the country, and with that burden comes health disparities—including the kinds of conditions that appear to put people at risk for serious complications from the coronavirus. Louisiana is one of the youngest states in the country, which would seem to suggest its residents would have better outcomes, given that older people have so far been the most vulnerable to the outbreak. But about 43 percent of its adult population falls into “at risk” categories, according to the Kaiser Family Foundation. A sizable number of young adults in the state have preexisting conditions.

According to Denson, that means that New Orleans and the rest of Louisiana might be looking at a different kind of outbreak than most countries—or even New York and Washington—have seen, including widespread hospitalizations or even deaths of young people. Yesterday, Louisiana reported its first death of a person under 35, a 17-year-old in Orleans Parish.

“We’re seeing different processes of this disease than they have seen in China, at least anecdotally,” Denson said. “We’re seeing more comorbid conditions that are common to Americans, such as high blood pressure, stroke, and diabetes.”

Many common assumptions about the coronavirus pandemic are about to be tested in the U.S., in ways they haven’t been so far. The effects of the virus on populations like those in the American South—poorer, characterized by marked racial and social disparities in health status and health access, and often saddled with multiple existing conditions—aren’t yet well known. And many other southern states, unlike Louisiana, New York, Washington—all of which expanded Medicaid under the Affordable Care Act—have little in the way of public health-insurance options for those younger at-risk populations. If Louisiana (likely through Mardi Gras) was COVID-19’s foothold in the South, then America is about to learn a whole lot about how the disease interacts with some of the most stubborn and intractable health-care issues in the country.

For now, the next point of focus should be on New Orleans. It’s not Italy, not yet. But the warnings are urgent, and perhaps even more portentous in their sobriety and certainty. The state will run out of crucial resources for taking care of coronavirus patients, likely before their number peaks. Hospitals will be under extreme strain. Health-care professionals will contract the virus themselves. Underlying health conditions will make their jobs more difficult.

That means now is the time for desperate measures, Denson thinks. He’s calling for the kind of mobilization people reserve for the worst disasters—including donations of supplies and more doctors and nurses. “I hope that two months down the road, people are saying, ‘I overreacted,’” he said.

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The Rich Fled New York. Don’t Be Like Them.

You live in a cramped apartment and you’re scared. But escape is selfish.

By Nathan Thornburg, Host of The Trip podcast | Published March 27, 2020 6:45 AM ET | The Atlantic Magazine | Posted March 27, 2020 |

Hello fellow New Yorkers. You want to leave. So badly. I know. Me too. But don’t. Don’t do it.

It is absurd at this point that it’s even your choice. The bridges should be closed to all but essential traffic. The airports should be shuttered. Instead, Hertz is still renting cars at its 17 Manhattan locations, AirBnB is listing “Corona free” homes in New Jersey, and airlines are offering (apocalyptically cheap) tickets from all three New York airports to Anywhere But Here.

I know all that because I spent one morning this week Googling a dozen possible escapes, in a moment of claustrophobia and panic. I share 900 square feet with two kids and a dog. My wife is a physician who is still seeing patients. And even though I trust her precautions and protocols, I can’t shake the feeling of dread. Mixed in with the uncertainty is the certainty that everything is going to get much, much worse, as the cases spike and people I love or know or admire begin to die. My impulse is to do something—to move, to flee. I’m sure virtually everyone else in the city feels the same way.

The rational truth, though, is that I probably won’t contract COVID-19 while locked in my apartment, though I may well have it already, a holdover from those faraway early-March days when this city was a big pool of the virus and we all were just doing laps together. And if I leave, I’ll bring my germs with me.

There are already pockets of disease on Long Island, and fever spikes in the Catskills, and empty stores in Jersey shore towns that have long put up with our summering bullshit. To paraphrase the New York Post, Nantucket thinks NYC can suck it.

And though I am dreaming, hallucinating almost, of what it would be like to have a yard for the dog and the kids while we wait out the pandemic, rural communities just aren’t built for anybody’s dream quarantine. Proactive governments recognized this early on. A friend of mine in Norway, the restaurateur Nud Dudhia, had been staying with his family in their super-hygge mountain cabin. But in mid-March Norway’s government ordered everyone back to their primary residence, so that any potential health-care burden would land where the population actually lived.

In the U.S., unbelievably, whether to leave is still up to you, as is where to go. If you fled for the hills the moment you read about Dr. Li Wenliang’s death in February, then kudos. I’m jealous of your paranoia, and perhaps you didn’t endanger anyone. But if you left this week, or are planning on leaving, you are nakedly prioritizing your comfort and peace of mind over the physical health of others. Don’t start in on Donald Trump, Treasury Secretary Steve Mnuchin, or any of those faraway self-dealers unless you start by doing what you can do to be part of the solution. Stay home.

I borrowed some of this moral clarity from an aunt in Madrid. She had watched with horror and fascination as politicians in Italy (about as far ahead of Spain along the coronavirus curve as Spain is of the United States) leaked news about a planned quarantine so that, instead of being contained, the virus scattered around the country on the wings of hundreds of thousands of individual decisions. That was on my aunt’s mind as the cordon started closing in on her city. She and her partner thought about fleeing to the village of Adahuesca, but, as she put it, “there was a chance that we’d just kill all the old people there.” They stayed put.

The restrictions in Madrid make New York’s stay-at-home guidelines look like an invitation to bacchanalia (seriously, why are our playgrounds still open?). In Madrid today, you can’t walk a dog with more than one person. Police have the discretion under Penal Code 556 of fining you if you are smoking or otherwise loitering on the street. Spaniards are lovely people and frequently also insolent scofflaws, so some started taking a couple of cans and a carrot or two from their own pantry and walking them around the city, to pretend they had been out shopping. Now police demand that you show a grocery-store receipt.

If you are nervous about staying in New York, and shopping solo, and surviving, this video that everyone is sharing from the Weill Cornell ICU doc David Price should reassure you that you can do this. Wash your hands. Don’t touch your face. Smile at your neighbors.

This pandemic involves a class element, of course. This is, among other things, a Prince Charles disease, a Tom Hanks disease, splashed around the planet by the kind of world traveler I’ve become myself. In the past year I’ve been to Iraq, Kenya, Beirut, Cuba, Japan, Mexico, and beyond, for a podcast. I flew to Chiang Mai for a wedding, to Sweden for the last night of a famous restaurant. And leaving aside for the moment what I’ve done to the ozone layer, it’s safe to say that I’m exactly the kind of asshole who brought you rapidly circulating global disease. COVID-19 became a wildfire thanks to a super-spreader soiree in Connecticut and the Biogen breakout in Boston and the Mar-a-Lago miasma and that gentleman who flew from New York to Florida while awaiting his COVID-19 test results.

I imagine that few of the people who stock the bodegas and clean the subways here in New York are surprised by the exodus. Privileged New Yorkers, the kind who moved here with college degrees and an Exciting New Career Opportunity, have long held themselves aloof from the city. They are ready for the rewards—a beautiful skyline, a killer shawarma—but are often trying to skip the bill. They can’t even stomach August in New York. I get that they don’t want to stay in the embattled epicenter of a global contagion.

And by they, of course, I mean me. Except not this time. The coronavirus is running a massive social experiment on us all. The question: Can each of us put aside our dreadful specialness long enough to slow this thing? Can we grit our teeth through the eerie nights to come? Do we trust our neighbors, the dudes on the corner, the first responders, the men living in the single-room occupancy down the block, to have our back—and can they trust us to have theirs? The answer has to be yes.

We are New Yorkers. We rushed the pile after 9/11, rebuilt after Sandy, walked home during the blackout, made out in Times Square on V-J Day. We’re minting a lot of heroes at Elmhurst Hospital and Mount Sinai West this week, health-care workers who have answered the call with bravery and compassion and sacrifice. The story of New York in this pandemic should belong to them, not to the summer-home super-spreaders.

So it’s settled then. We’re going to get through this, right here, in our tiny freaking apartments. Sending love to you all.

______

We want to hear what you think about this article. Submit a letter to the editor or write to [email protected].

______

NATHAN THORNBURGH is a co-founder of Roads & Kingdoms and host of The Trip podcast, which he started with the late Anthony Bourdain.

*********

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kimduancocobay · 5 years ago

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Urinary System, Part 1: Crash Course A&P #38

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juniperpublishersanesthesia · 6 years ago

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Surviving Major Trauma with Hemipelvectomy-Juniper Publishers

Abstract

Traumatic hemipelvectomy is a life threatening, however rare injury associated with high lethality. It comes along with excessive blood loss, related hemodynamic instability and injuries of the genitor-urinary system or the rectum. The real incidence is unknown because most patients die before reaching the hospital. The treatment requires a rapid, multidisciplinary team approach focused on hemorrhage control to correct coagulopathy and clear persistent signs of tissue hypoperfusion to save the patient’s life [1]. Improvements in prehospital rescue systems and initial trauma response have resulted in increased chances of survival. Most survivors are young, healthy individuals, who are able to tolerate massive hemorrhage and soft-tissue destruction [2-6]. We present a case of an open fracture of the ileosacral joint, wide open symphysis, complete hemipelvectomy and severe soft tissue trauma, including a decollement around the pelvis and the left abdomen.

Case Report

A case of an 18-year-old woman surviving traumatic hemipelvectomy is presented. The woman was involved in a high speed motorcycle accident. She was caught by a gusting wind and thereby accidently left the road by crossing the midline onto the oncoming lane and crashed frontally into an oncoming car. In primary survey on scene the assessment following Adult Trauma and life Support (ATLS) guidelines revealed an AB stabile and cardial compensated patient with Glasgow Coma Scale (GCS) of 15 points, despite a considerable blood loss, an unstable pelvis and a cold, mottled, pulse less left leg. Her lower left limb showed an open third degree femur-fracture, as well as a grotesque deformation of the lower limb and left hemi-abdomen. The woman was wearing full motorcycle clothing and a helmet. On site the thorax only showed some excoriations and no instability, as far as visible. Because of the extensive trauma which came along with fulminate pain, anesthesia was introduced by the flying doctor to perform an appropriate pain management. The woman was managed with fluid to maintain a hemodynamic stability. Hemorrhage control was obtained with compression of the wounds and she was then transferred by HEMS to the next trauma centre. There were no further diagnoses set in the secondary survey.

Upon arrival at the trauma center she was hemodynamically unstable, due to a covered aortic rupture loco typical, an internal amputationatthe pelvic level with consecutive massivehemorrhage (Figure 1a,1b), separation of the symphysis (Figure 2 & 3), an open pelvic fracture (Figure 2 & 3) and an open femur fracture (Injury severity score = 59). Explicitly the whole body trauma computer tomography revealed the following principal diagnosis. A covered aortic rupture loco typical, an internal amputation at the pelvis- level with avulsion of the left a iliaca external with a consecutive massive bleeding (Figure 1a). Separation of the symphysis, an open pelvic fracture with gas inclusion at the caudal spinal cord coming from a SWK4/5 fracture, and an open femur fracture was seen (Figure 2 & 3). Additionally there was no perfusion seen in the angiography providing blood for the left lower limb, which was actively bleeding at that moment. An urgent angiogram revealed occlusion of the left external iliac artery. There was a haemathothorax seen on the left side of the thorax, shifting the trachea and the esophagus to the right, however without leading to oxygenation problems. No intracranial pathology was found in the computer tomography. Immediate surgical homeostasis and debridement was attempted for primary damage control. To save the patient’s life it was necessary to perform aggressive surgery with a complete amputation of the left hemi pelvis including the left lower limb. Additionally, a skin flap was provided. A limb- saving procedure would have endangered the patient’s life. Furthermore, the patient underwent embolization of the left common iliac artery and vein and a Thoracic Endovascular Aortic Repair (TEVAR) of the aortic rupture.

In the further hospital course, frequent second-look operations and numerous revisions of the soft tissue injury, reconstructive surgery and dedicated surgical care to avoid septic complications were needed. In the following the woman was throughout in a stable mental state, nevertheless psychological assistance was directly started after completion of the first surgery. After finalization of the operative therapy and coverage of the skin defect the woman was transferred to a rehabilitation centre 9 weeks after the accident (Figure 4). She then was transferred to a trauma centre to adjust an artificial limb. In summary, this patient is one of the few survivors of an ISS of 59 points reported in the world literature [2-4]. She was able to survive a major trauma by accurate and rapid early management, rapid transport to the operating room and an aggressive surgical approach all contributed to survival.

Conclusion

The leading injury was a traumatic hemipelvectomy coming along with the disruption of the pelvic neurovascular integrity and a covered aortic rupture loco typico. The accepted definition of traumatic hemipelvectomy is as follows: unstable ligament us or osseous hemi pelvic fracture/amputation, (open or closed) accompanied by an injury with rupture of the pelvic neurovascular bundle [5]. Most survivors are young, healthy individuals, who are able to tolerate massive hemorrhage and soft-tissue destruction. When the criteria or traumatic hemipelvectomy are fulfilled, surgical completion of the hemipelvectomy is mandatory to safe a patient's life [4,6]. Whereas mortality in open pelvic fractures is around 40%, it is 60 to 100% in traumatic hemipelvectomies, and bleeding is the main cause of death [3,6]. In conclusion, traumatic hemipelvectomy is a rarely seen, often fatal injury which requires immediate life support and surgery. This injury always requires a rapid, multidisciplinary team approach, including an orthopedist, vascular surgeon, general surgeon, urologist and anesthesiologist focused on hemorrhage control to correct coagulopathy and clear persistent signs of tissue hypo perfusion. Furthermore, the involvement of rehabilitation specialists is advantageous for personal well-being and social reintegration. Eighty percent of injuries occur as a result of motorcycle accidents [3]. Although hemipelvectomy is a devastating injury, patients can be successfully rehabilitated to an active and productive role in society.

For more Open Access Journals in Juniper Publishers please click on: https://juniperpublishers.com

For more articles in Journal of Anesthesia & Intensive Care Medicine please click on: https://juniperpublishers.com/jaicm/index.php

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heavenfemale07-blog · 6 years ago

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The Dirt on Cleansing

Please note: I provide this material for informational purposes only. I am not a doctor, naturopath, or other medical professional and cannot tell you what to do with your health; please always consult with your own healthcare practitioner before embarking on anything like a cleanse or detox, and before making any changes to your health routine, medication or supplements. It is purely my own perspective on the topic and is by no means intended as any kind of medical or professional advice.

For those of you who read my blog regularly, you know that I regularly undergo cleanses (ie, I “detox”). Since I’ve received quite a few questions about why I cleanse and how it works, I thought it might be useful to share a bit about cleansing in general and my own choices over the past.

Q: Why Detox at All?

Whether you use the term “fast,” “cleanse” or “detox diet,” the process focuses on a single goal: detoxifying and rebalancing the body’s internal operating systems, primarily the digestive tract (but also the liver, respiratory system, urinary system and lymphatic system). Given the environmental factors, lifestyle, and eating habits of most of us in the modern world, I believe that everyone, no matter how thin, active or deemed “healthy,” could benefit from a cleanse once in a while.

In fact, many of my teachers over the years, despite ultra-healthy eating coupled with cardiovascular exercise, strength training exercise, yoga, dance, nia, sports, or daily spiritual practices, nevertheless undergo their own cleanses on a regular basis.

As denizens of the modern, industrial world, we are exposed to myriad toxins daily, both from within and without. Just by virtue of living near the great and wonderful metropolis of Toronto, I have the pleasure of inhaling highly polluted air most days of the week. For the first two months that we lived in this house, I could smell the distinct aroma of fresh paint gases (courtesy of the landlord, who was actually attempting to do us a favor) every time I entered the house. I ingest all kinds of unsavory substances that leach through plastic water bottles, plastic containers, the dyed and/or bleached clothing, or the cleansers I use (though I’ve tried to eliminate as many of these as I can over the years).

And that’s only the exogenous (ie, from outside of our bodies) toxins. We also take in toxins from the food we eat, whether unhealthy oils from junk food, artificial colors or flavors, or “milk” shakes at McDonald’s or Burger King, and so on. Because these substances are not made in nature and our bodies weren’t designed to process them, the liver works overtime to detoxify them out of the body (as much as possible) to keep us healthy.

When your liver is on overdrive neutralizing toxins that you take in, free radicals are formed. Free radicals are basically cell-killers, and they can result in cancer and chronic diseases that are often connected to inflammation (such as arthritis, heart disease, etc.).

Those of us with weak immunity due to candida or other conditions, or those of us with overworked filtering systems (such as myself) suffer the consequences and may very well wander around with stuffed noses, digestive distress, joint inflammation, or other chronic conditions that are so often attributed to “aging” or simply “life in general.”

One of my natural health practitioners put it this way: imagine a pile of bricks that’s being built into a little tower, one brick at a time. Each brick is a different toxin that your body has to deal with and try to eliminate. As with a pile of bricks, you can add quite a few to the pile without any dire consequences at all; in fact, observed from the outside, everything appears hunky-dory, stable and unchanged. One would even infer that the extra weight being piled on top is doing no harm, making no difference whatsoever.

But then you reach the point where the pile can no longer support even one more brick. You place that last brick at the top of the pile and–BAM! (not to quote Emeril in such grave matters, or anything)–the pile completely collapses. Your body works the same way. When you were younger (or healthier), you may have been able to tolerate a huge number of toxic “bricks” in your system. But tax the system long enough and then, suddenly, it appears as if everything breaks down at once.

That’s what happened to me several decades ago. After assuming all was well for years (even though I drank up to a liter (quart) of aspartame-sweetened pop a day, had 3-5 coffees a day, imbibed wine and spirits on weekends and consumed whatever junk food, candy, cookies, cakes, or other garbage I desired on a regular basis), everything came crashing down. I spent about a year suffering from symptoms of irritable bowel syndrome, endured multiple recurrent sinus infections (one so serious that it required four–FOUR!–courses of antibiotics to eradicate), and suffered almost continuous yeast infections, coupled with fatigue, depression, and general feelings of “lousy.” At that point, I really needed a cleanse.

All this to say, if there’ are any actions we can regularly take to diminish our load of toxic “bricks,” we should do so.

Q: What Is a Cleansing or Detox Diet?

Basically, cleansing means “cleaning up the diet (and, ideally, environment) to allow the body to rest from fighting off and eliminating toxins for a while, so that it can repair and rejuvenate.”

There are many levels of detox, depending on where you find yourself to begin with. It’s recommended that people start at a level just one echelon away from (less toxic than) where they are now, because detoxing encourages the toxins to exit the body quickly (through elimination and sweating, primarily), and if too many to escape too fast, you’ll end up feeling sort of like a deflated baloon in a mud puddle–or one really sick puppy (this effect is called a “healing crisis“).

The very first time I went on a detox diet, my naturopath–only two months into her practice–didn’t think to warn me what could happen if I changed my eating habits too drastically. She prescribed what is essentially a NAG diet, but without any animal products. After one day of the diet, I was felled by my body’s extreme healing crisis (I describe the event here). Luckily, it passed in a couple of days.

By starting “slowly”–that is, without altering too many aspects of your diet or life at once–you avoid a severe healing crisis. Most people feel a little bit tired or sleepy; some experience mild flu-like symptoms such as a sore throat, but these ususally disappear in a day or two.

Q: How Do You Know What to Eat and What to Eliminate on a Cleanse?

The diet you choose should depend on the diet you eat regularly before the cleanse. If someone enjoying a SAD (Standard American Diet) decided to embark on a water fast, it would likely spark a full-scale healing crisis and the person would feel rather sick. So decide where you are now, then move in baby steps toward a full-scale cleanse.

There are basically five or six levels of cleansing diet. Ideally, you would work your way up to the most challenging level as you clean up your diet over the years.

Level One: Basic non-toxic diet for everyone. (from Elson Haas, The Detox Diet)

Level one is what I often refer to as the NAG diet, the diet that, if followed regularly, should allow your body to exist with minimum toxic intake and to keep you pretty healthy. (Other versions are Dr. Joseph Pizzorno’s in The Toxin Solution, Anne Marie Colbin’s diet in Food and Healing or Elson Haas’ diet in The Detox Diet). If you’re not already on this type of diet, it would be the first step. Try this for a week and see how you feel. You could theoretically stay on this diet for the rest of your life.

Level One: The NonToxic Diet (from Elson Haas, The Detox Diet):

Eat organic foods whenever possible.

Drink filtered water.

Rotate foods [ie, eat each of these no more than once every four days or so], especially common allergens such as milk products, eggs, wheat, and yeasted foods.

Practice food combining.

Eat a natural, seasonal cuisine.

Include fruits, vegetables, whole grains, legumes, nuts, seeds, and, for omnivarians, some low or non-fat dairy products, fresh fish (not shellfish) and organic poultry.

Cook in iron, stainless steel, glass, or porcelain cookware.

Avoid or minimize red meats, cured meats, organ meats, refined foods, canned foods, sugar, salt, saturated fats, coffee, alcohol, and nicotine.

And while it’s not stated in this list, Haas also prohibits anything processed or made with chemicals or artificial colorings–this should go without saying.

[“Sounds good, Mum, but do we have to do the part about avoiding meat?”]

Level Two: (this and later levels from Caroline Dupont, Enlightened Eating).

Level two is a step beyond level one, as “it eliminates all animal products and glutenous grains.” As Dupont points out, this can be a lifelong diet rather than a detox diet if mostly organic foods are eaten and sources of protein and vitamin B12 (which can only be acquired naturally through animal products) are carefully monitored.

For those who already eat a Level One diet as their regular fare, Level Two would be considered a mild cleanse.

Level Three: Living Foods Only

This level kicks it up a notch (seriously, WHAT is Emeril doing in this discussion?) by allowing only raw foods, effectively eliminating grains (except for sprouted grains). People at this level eat raw fruits, vegetables, nuts, seeds, freshly pressed juices, sprouts, and possibly raw dairy.

Q: Why Is Raw Supposedly Better? Why Are There No Grains? Isn’t That a Lot of Fruit–Why is All That Sugar in the Fruit Acceptable?

RAW:

A raw diet provides the body with readily available digestive enzymes in raw, but not cooked, foods; these would otherwise need to be generated courtesy of your saliva, stomach, and pancreas. For that reason, it is much easier to digest raw versus cooked food; raw foods give the body a bit of a break so it can concentrate on other functions, such as detoxifying, maintaining, and repairing. People on all-raw diets have experienced incredible boosts in energy as well as healing effects.

GRAINS:

Unsprouted grains (the kind we normally eat) are more difficult to digest than raw foods. There is nothing inherently wrong with eating grains, especially if your digestive system is in tip-top condition; but for those of us with digestive issues, or when cleansing the system, grains are just a bit too challenging.

FRUIT SUGARS:

It’s true that a raw diet provides a large number of fruits, and fruits do contain natural sugars. But please don’t confuse naturally-occurring sugars with refined white sugar (or even honey or maple syrup, which are both concentrated sugars). When you eat something refined, the sugar is converted to glucose (a monosaccharide–the smallest sugar molecule, as it’s broken down by the body and passed into the bloodstream) extremely quickly, because it’s already practically in the form of glucose when you eat it.

With fruits, the sugars are bound up with fiber and other nutrients, and the body must work to extract the different elements in the fruit and to convert the sugars to glucose in the body. This means you won’t get the same kind of spike in blood sugar levels from eating a fresh fruit as you will from eating a piece of cake or even cup of coffee with sugar in it. Sugar in fruits is healthy and doesn’t generate toxins in the body. (Think of diabetics, for instance–they’re allowed most fruits).

That said, if you’re dealing with early stages of candida overgrowth, you want to avoid a lot of fruit and all very sweet fruits in particular. For people with healthy digestive tracts, fruits with extremely high sugar levels could be eaten in smaller quantities. And fruits are the easiest foods for your body to break down, so they don’t tax the system.

[“Give us more fruits is what I say, Mum!’]

Level Four: Blended Foods, Smoothies and Soups

By blending foods, you render them yet more easily digestible. Dupont suggests incorporating some of these foods into a raw foods diet; furthermore, this level is presented as an excellent “introduction to fasting for people with hypoglycemia, bowel disorders [or] constipation.”

Level Five: Juice Fast And/Or Master Cleanse

At this level, you’re basically removing the need for your bowel to process any fiber and are providing very nutrient-rich clear liquids that are processed very easily by the digestive tract. At level five, a person consumes only freshly squeezed or pressed fruit and vegetable juices, or the Master Cleanse, a mixture of filtered water, lemon juice, maple syrup and a pinch of cayenne pepper.

Level Six: Water Fast

At this point, only those who have already gone through the other five phases should attempt a water fast; drinking only pure filtered water gives the body’s internal organs the ultimate work break. According to Dupont, no one should even attempt a water fast who has not first “established a consistently healthy diet for at least 6 months first.”

[“Yes, pure water is definitely good, Mum. Especially in summer.”]

Q:Why Did You Choose the Cleanse You Did?

When I was in nutrition school, after spending a full year following the NAG diet and trying out most of the other diets we learned about, I felt ready to complete a Level Five (Master Cleanse) diet for almost a full week. At that point, my “regular” diet was so non-toxic that the Master Cleanse was a good step. I felt great while on it and did reap the benefits of better digestion and more energy.

These days, however, my regular diet is more like Level Two, above. I already don’t eat meat; I already don’t eat refined foods; I already don’t eat most gluten grains on a daily basis; I don’t eat dairy.

Over the years, I’ve tried all-raw cleanses, the Metagenix 10-Day cleanse and juice-only cleanses. I’ve had good results with all of them; but more recently have come to believe that there is no need for truly restrictive cleanses that eliminate solid foods (more on that in another article!).

Q: Readers: What Do You Think?

If you’ve made it this far, I’d love to know: how many of you have tried detox diets or cleanses? What was your experience? What worked, and what would you warn against?

[Disclaimer: this post may contain affiliate links. If you buy using these links, at no cost to you, I will earn a small commission from the sale.]

Source: https://www.rickiheller.com/2019/05/the-dirt-on-cleansing-2/

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clamjumper5-blog · 6 years ago

Text

The Dirt on Cleansing

Q: Why Detox at All?

All this to say, if there’ are any actions we can regularly take to diminish our load of toxic “bricks,” we should do so.

Q: What Is a Cleansing or Detox Diet?

Basically, cleansing means “cleaning up the diet (and, ideally, environment) to allow the body to rest from fighting off and eliminating toxins for a while, so that it can repair and rejuvenate.”

Q: How Do You Know What to Eat and What to Eliminate on a Cleanse?

There are basically five or six levels of cleansing diet. Ideally, you would work your way up to the most challenging level as you clean up your diet over the years.

Level One: Basic non-toxic diet for everyone. (from Elson Haas, The Detox Diet)

Level One: The NonToxic Diet (from Elson Haas, The Detox Diet):

Eat organic foods whenever possible.

Drink filtered water.

Rotate foods [ie, eat each of these no more than once every four days or so], especially common allergens such as milk products, eggs, wheat, and yeasted foods.

Practice food combining.

Eat a natural, seasonal cuisine.

Include fruits, vegetables, whole grains, legumes, nuts, seeds, and, for omnivarians, some low or non-fat dairy products, fresh fish (not shellfish) and organic poultry.

Cook in iron, stainless steel, glass, or porcelain cookware.

Avoid or minimize red meats, cured meats, organ meats, refined foods, canned foods, sugar, salt, saturated fats, coffee, alcohol, and nicotine.

And while it’s not stated in this list, Haas also prohibits anything processed or made with chemicals or artificial colorings–this should go without saying.

[“Sounds good, Mum, but do we have to do the part about avoiding meat?”]

Level Two: (this and later levels from Caroline Dupont, Enlightened Eating).

For those who already eat a Level One diet as their regular fare, Level Two would be considered a mild cleanse.

Level Three: Living Foods Only

Q: Why Is Raw Supposedly Better? Why Are There No Grains? Isn’t That a Lot of Fruit–Why is All That Sugar in the Fruit Acceptable?

RAW:

GRAINS:

FRUIT SUGARS:

[“Give us more fruits is what I say, Mum!’]

Level Four: Blended Foods, Smoothies and Soups

Level Five: Juice Fast And/Or Master Cleanse

Level Six: Water Fast

[“Yes, pure water is definitely good, Mum. Especially in summer.”]

Q:Why Did You Choose the Cleanse You Did?

Q: Readers: What Do You Think?

If you’ve made it this far, I’d love to know: how many of you have tried detox diets or cleanses? What was your experience? What worked, and what would you warn against?

[Disclaimer: this post may contain affiliate links. If you buy using these links, at no cost to you, I will earn a small commission from the sale.]

Source: https://www.rickiheller.com/2019/05/the-dirt-on-cleansing-2/

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