#Kidney Function Monitoring

[artisticdivasworld]

Compassionate Care for Chronic Kidney Disease: A Nursing Perspective

Chronic Kidney Disease (CKD) is a progressive loss of kidney function over time. Managing CKD is not just about slowing the progression of the disease but also about enhancing the quality of life for those affected. Nurses play a crucial role in this process, providing care that is as compassionate as it is competent. This blog post will explore the nursing interventions and desired outcomes that…

[drforambhuta]

Comprehensive Examination Components for Managing Peyronie's Disease

1. Blood Tests:

• Complete Blood Count (CBC): Evaluates red and white blood cell counts and platelet levels to detect signs of anemia, infection, or inflammation.

• Lipid Profile: Assesses cholesterol and triglyceride levels to gauge cardiovascular risk.

• Liver Function Tests: Examines liver enzyme levels to monitor liver health, crucial for overall well-being.

• Kidney Function Tests: Measures creatinine and blood urea nitrogen levels to evaluate renal function, which can affect medication processing.

2. Hormonal Evaluations:

• Testosterone Levels: Assesses serum testosterone levels to identify hormonal imbalances linked to erectile dysfunction and Peyronie's Disease advancement.

• Prolactin Levels: Examines prolactin levels for indications of underlying endocrine issues.

• Thyroid Function Tests: Analyzes thyroid hormone levels to rule out thyroid disorders impacting metabolism and sexual function.

3. Cardiovascular Checks:

• Blood Pressure Monitoring: Tracks blood pressure to detect hypertension, a common risk factor for cardiovascular ailments.

• Electrocardiography (ECG): Records heart electrical activity to detect arrhythmias and cardiac abnormalities.

• Echocardiography: Utilizes ultrasound to assess heart structure and function, identifying anomalies and signs of heart disease.

4. Imaging Techniques:

• Penile Ultrasound: Uses ultrasound to visualize penile plaques and assess curvature severity, aiding treatment planning.

• Magnetic Resonance Imaging (MRI): Offers detailed penile anatomy and plaque composition imaging, particularly useful in complex cases or pre-surgery.

5. Psychological Evaluations:

• Questionnaires: Administers standardized surveys to gauge psychological distress, depression, and anxiety linked to Peyronie's Disease.

• Interviews: Engages patients in discussions to explore emotional and psychological responses, identifying areas for intervention and support.

Doctors suggest undergoing a regular full body health checkup for the early detection and better management of conditions like Peyronie's Disease. There are many good hospitals in Mumbai that offer different types of health checkup packages to choose from based on your individual health condition and requirements.

[some1s-sista]

Happy Ash Valentine’s Wednesday!

Had my physical with my GP today. I have to monitor my blood pressure for two weeks and share the numbers so she can evaluate whether or not I can come off any of the meds after having lost 23% of my body weight. (I hate being on meds)

The dizziness … I’m dehydrated! So I have to ramp up the water intake. She said that’ll help with the joint pain too. But she’s gonna run some tests on my kidney function cuz sometimes chemo can mess with that. So off for a bunch of labs I went.

Now I have a killer headache. I think my body is rejecting the water.

[ayaaamuhanna]

Hello everyone

Let me tell you my story

I am Aya Muhanna, I am 21 years old and I study at a university digital marketing

I am Palestinian and live in Gaza City. Before October 7, my life and the life of my family was full of stability

As each of my family members sought to achieve their goals of success

The entire course of our lives has changed. Since the 7th of October, since the declaration of war on my city, our house has been almost destroyed due to the successive bombing around our house. Note that the enemy on the 9th of October forced us to leave our house and gave us only half an hour, and it was not enough time for us to take our clothes and get up. The enemy completely destroyed our house. The enemy killed everything that was beautiful in my house and killed our memories. You know very well that the house is nothing but a small homeland for us.

Then we moved to the house of one of our relatives in northern Gaza, and every day the enemy became more ferocious than the previous day. The bombardment was intense and there was no use of prohibited weapons, including phosphorus. Our suffering began with the lack of food supplies and the provision of water. The enemy prevented the entry of food supplies and destroyed any water truck.

All this suffering that we were going through, I had hope that one day I would return to my university in order to continue my studies and finish the educational stage, but even this right that any normal human being has, the enemy made it just a dream for us because he destroyed my university and it was not limited to my university only, as most of the universities in my city He destroyed it

We had three options: death from bombing,death from hunger, or submission to the enemy’s orders to go to southern Gaza.

We decided to leave for the south of the Gaza Strip, or the so-called safe zone, as the enemy claims, and we thought that it would be safer, as I stayed in a tent with my family, and it lacked the minimum necessities of life. There was no healthy food, not even clean water, and even our stay in a tent was not safe from the enemy’s explosions, as the occupation destroyed it. A nearby residential building, which led to the injury of my brother’s wife. The days of war extended and we fled from one place to another. Since our displacement from northern Gaza, we have moved to 4 governorates, including Al-Maghazi, Deir Al-Balah, Rafah, and finally Nuseirat. I do not know if we will have another displacement or not

As for my father, in 2017 he was diagnosed with cancer and had many operations since he learned about the disease until 2022. The operation was successful for him, and among the doctor’s instructions to my father was that he needed follow-up and health care always, and because he had many operations on the intestines, he needed to be provided with healthy food and Clean water and all these other instructions are available in my city, as my father cannot monitor his health in Gaza’s hospitals because they are so full of people injured in the war. Also, the simplest things he cannot do, such as tests to determine the extent of blood strength and kidney function, and the vitamin medications he needs have become difficult to obtain. He gets it

My father’s suffering did not stop with the loss of the house, which was completely destroyed by the enemy, and the enemy also destroyed the accounting office in which my father established his companies with my brother.

As for my sister, I remember how much she was trying to succeed in order to get her job and went through many difficulties until she succeeded

She was fulfilling my demands and trying to help me, and now she is unable to even help herself or me since the war on my city began.

Before October 7, I did not need Go Fund Me, but I now need your help because everything we owned was destroyed by the enemy. I need to build my future and the future of my family outside my city in search of safety first, and then build my future and the future of my family as we always aspired.

These are our most basic rights.

I ask you to help me and donate to me 5$ is enough to save me and my family from this hell

https://gofund.me/5fd8c4ef

[tallymali]

Don’t know if anon or messages is the better place to ask this. I have friend that’s had uti for 2 months and you came to mind. Would you mind telling your Dr/clinic and the new and previous meds you’re taking? Did both meds work & the new is just cheaper or does new work better also? Thank You Tally!

Oh my god, I'm so glad you've sent me this because I wish more than anything that I'd known about this illness so early on in experiencing it. I have soooo much to say about this so you're absolutely welcome to DM me and relay any questions your friend has.

Okay first off I definitely recommend your friend joins the facebook support group: www.facebook.com/groups/ChronicUTISupportGroup/

Even if they dont use facebook, they should totally just make an account to join. I didn't use it either so I just made a blank profile with a fake name. As long as you answer the questions they send, the mods should let you in with no problem. I said something like "apologies for the blank account, I don't use social media but I was told this is the best place for support" and I was accepted super fast.

So, the clinic I go to is the Harley Street chronic UTI clinic. They don't have their own website but all their info is here: www.chronicutiinfo.com/treatment/conventional-medicine/uk-treatment/prof-malone-lee/

(That website is also an incredible source of info on chronic UTIs)

You have to go there in person for the initial appointment, which costs £250. First thing they do is take your pee and analyse it under a microscope to get a count for white blood cells and epithelial cells. Then you go to the doctor's office (there's a team of doctors that all follow the same protocol) and they discuss your symptoms, any previous medications you've tried, and any other health issues you have. They will almost always prescribe Hiprex and a long term high dose antibiotic. Hiprex is a urinary antiseptic, and it essentially reacts with the acid in your urine to create formaldehyde. Most of us take high dose vitamin C pills with the Hiprex to keep our urine as acidic as possible (high bacteria in the bladder can raise urine pH so we often need help in that department).

At this point they will give you the prescriptions and say you can take them to your NHS GP and see if they're willing to fill them on the NHS. My GP didn't want to get involved with prescribing long term antibiotics, but was happy to fill the Hiprex prescription. I now get my antibiotics from Pharmacierge. Their prices are cheaper than regular pharmacies and they work closely with the Harley Street team. My doctor now just sends my prescriptions straight over to them which cuts out a little admin for me.

After that initial appointment you have to have a follow up appointment every 3 months, which can be done in person or over teams. Either way, they cost £200. If you go in person they will do the pee analysis again, but it's not super necessary to do that to monitor your progress. Patient symptoms are the number one thing they use to decide your treatment. Basically as long as you're in pain, they will keep treating you (the NHS would NEVER). Not a huge amount happens at these check ups, but being on long term antibiotics is risky so they will ask you a million questions about any possible side effects, and switch your meds immediately if you're not tolerating them well. They also ask that you contact your GP and request a blood test 3 times a year to monitor your kidney and liver function. They might also ask for other tests depending on your symptoms and the specific antibiotics you're prescribed.

So yeah, the treatment kind of just boils down to: find the right meds. Take them until you feel completely normal again.

As for the specific meds, here's a list of their most prescribed antibiotics:

Cefalexin

Amoxicillin

Co-amoxiclav

Nitrofurantoin

Trimethoprim

Doxycycline

Oxytetracycline

Azithromycin

Clarithromycin

Pivmecillinam

Lymecycline

For me, before starting treatment under Harley Street, I'd been treated by the Urology Partnership. They prescribed me 3 months of full dose Nitrofurantoin (brand name Macrobid, super common UTI treatment) and I was almost symptomless during that 3 months, but when I finished the course the symptoms returned instantly at full throttle. From that point they would only prescribe me the half dose of Nitrofurantoin which was NOT cutting it. That was when I decided to move to Harley Street. Definitely would not recommend Urology Partnership to people dealing with a chronic UTI.

SO. I emailed the Harley Street clinic with an appointment request and they booked me in for the next week. At my appointment the doctor prescibed Trimethoprim, which is usually the first one they try with new patients. I took it for a little while, (around 2 weeks to a month, I don't remember exactly) but I was still getting symptoms that weren't letting up, so I emailed their clinical enquiries address to let them know. I'd mentioned at my inital appointment that Nitrofurantoin had worked in the past, so they took me off the Trimethoprim and prescribed the Nitro instead, with the note that I'd have to discuss it at my next appointment.

Basically, Nitro is a really good antibiotic but has some of the nastiest side effects and is also the most expensive. So at my follow up appointment my doctor said he was happy for me to stay on it to get my symptoms back under control but he'd like to switch to a less risky antibiotic in time.

So a few months later (June this year) I was switched to Cefalexin, which has some of the least side effects and is one of the cheapest. I've been doing really well on it and I'm really feeling optimistic.

This is all to say that treatment is easy in theory but requires a little trial and error to find the right meds, and then takes a metric fucktonne of patience. There's no set length of time for the treatment, but in general, the longer you've had the cUTI the longer it takes to cure. So if your friend does have cUTI and can get treatment quickly, it shouldn't take too long to cure.

I had mine for two years before starting with Harley Street, which is actually much shorter than the average patient. They frequently treat older patients who have been suffering for over 20 years. I've read a depressing number of posts in the facebook group from people in their 50s+ who have been able to live normally for the first time in their adult life thanks to this treatment.

Knowledge of this condition with the general public AND with doctors (even urologists?????) is basically nonexistent. The NHS and most healthcare systems will slap you with a wastebasket diagnosis (PBS/BPS/IC) and tell you to piss off and live in pain forever. I genuinely don't think I will ever be able to trust a doctor right off the bat to actually prioritise my health ever again in my life. The NHS is full of people who really do care and really do everything they can for their patients but as an institution it does not give one iota of a fuck about the wellbeing of the people it's supposed to care about. It's a big complicated systemic issue but there will never be a good excuse for turning away patients who need medical care to live normally.

If your friend or literally anyone reading this is interested in the more academic/scientific side of this whole thing, I'd definitely read Cystitis Unmasked by Professor Malone Lee. It's written for doctors so it's not an easy read for a layperson but GOD it's so eye opening and infuriating. Professor Malone Lee is the guy who created the Harley Street UTI clinic and I think he spent his entire life raging at all the pillars of incompetance that modern UTI testing and treatment is built upon.

[petfurri]

Captopril for Dogs: Benefits, Dosage, Side Effects, and More

Captopril for Dogs

Captopril is an angiotensin-converting enzyme (ACE) inhibitor commonly used in veterinary medicine to manage heart conditions in dogs, particularly congestive heart failure (CHF) and systemic hypertension (high blood pressure). Initially developed for human use, captopril has found its place in treating canine patients with cardiovascular issues, offering numerous benefits but also requiring careful administration and monitoring due to potential side effects.

Understanding Captopril and Its Mechanism of Action

Captopril works by inhibiting the angiotensin-converting enzyme, which is responsible for converting angiotensin I into angiotensin II, a potent vasoconstrictor. Angiotensin II causes blood vessels to narrow, leading to increased blood pressure and making the heart work harder. By blocking this conversion, captopril allows blood vessels to relax and widen, reducing the workload on the heart and lowering blood pressure. This action is particularly beneficial for dogs suffering from CHF, as it helps to improve blood flow and reduce fluid buildup in the lungs and other tissues.

Benefits of Captopril for Dogs

Managing Congestive Heart Failure (CHF): CHF is a common condition in dogs, especially in older or certain breeds like Cavalier King Charles Spaniels. Captopril helps manage CHF by reducing the resistance the heart faces when pumping blood, thus improving cardiac output and reducing symptoms like coughing, difficulty breathing, and lethargy.

Lowering Blood Pressure: For dogs diagnosed with systemic hypertension, captopril can effectively lower blood pressure, preventing damage to organs such as the kidneys, eyes, and brain, which can result from prolonged high blood pressure.

Improving Quality of Life: By easing the burden on the heart and lowering blood pressure, captopril can significantly improve a dog's overall quality of life. Dogs may exhibit increased energy levels, better appetite, and greater overall comfort as a result of treatment.

Potential Renal Protection: In some cases, captopril may offer renal protection by reducing the progression of kidney disease, particularly in dogs with proteinuria (protein in the urine), which is often associated with high blood pressure.

Dosage and Administration

The dosage of captopril for dogs must be carefully determined by a veterinarian, as it varies depending on the dog's weight, the severity of the condition being treated, and the presence of any other health issues. Captopril is usually administered orally, with or without food, typically two to three times a day.

Typical Dosage: The usual starting dose is around 0.5 to 2 mg per kg of body weight, given every 8 to 12 hours. The dosage may be adjusted based on the dog’s response to the medication and any side effects observed.

Monitoring: Regular monitoring is crucial when a dog is on captopril. Blood pressure, kidney function (via blood tests for creatinine and blood urea nitrogen levels), and electrolyte levels should be checked periodically to ensure the medication is working effectively without causing harm.

Potential Side Effects of Captopril

While captopril can be highly beneficial, it also carries the risk of side effects, particularly if not used correctly. Some of the potential side effects include:

Gastrointestinal Issues: Dogs may experience vomiting, diarrhea, or loss of appetite. These symptoms are usually mild but should be reported to the veterinarian if they persist.

Hypotension (Low Blood Pressure): As captopril lowers blood pressure, there is a risk that it may cause blood pressure to drop too low, leading to weakness, dizziness, or fainting. This is more likely to occur in dogs that are dehydrated or have other underlying health conditions.

Kidney Dysfunction: Captopril can affect kidney function, particularly in dogs with pre-existing kidney issues. It’s important to monitor kidney parameters closely during treatment to avoid exacerbating any renal problems.

Hyperkalemia (High Potassium Levels): Captopril can cause an increase in potassium levels, which can lead to dangerous heart rhythms if not managed properly. Regular blood tests are essential to monitor electrolyte levels.

Coughing: A persistent dry cough is a less common side effect but can occur due to the buildup of bradykinin, a substance that captopril can increase in the body.

Allergic Reactions: Though rare, some dogs may have an allergic reaction to captopril, manifesting as itching, rash, or swelling. Immediate veterinary attention is required in such cases.

Precautions and Considerations

Captopril should be used with caution in dogs with pre-existing kidney disease, dehydration, or electrolyte imbalances. It should not be used in dogs that are pregnant, as it can cause harm to the developing fetus. Additionally, it’s important to inform the veterinarian of any other medications the dog is taking, as captopril can interact with other drugs, including diuretics and nonsteroidal anti-inflammatory drugs (NSAIDs), potentially leading to adverse effects.

[newhologram]

Life as a high-risk patient during an ongoing pandemic, because it's not "over" for people like me

My dad's sick as a dog after going to a packed music festival unmasked. His whole office is out sick; none of them mask around each other and he stopped masking 2 years ago. He doesn't mask when he leaves his room and is coughing all over our small apartment. He insists it's not covid, but we're out of tests (even colds can fuck me up, so...). He's at least running the air filters on high 24/7 and trying to wipe down surfaces/order more tests, but not masking is obviously a huge problem. I'm a high-risk multi-dx autoimmune (+neuroimmune) patient with a childhood history of chronic bronchitis and pneumonia. For a year and a half now I've been monitored via bloodwork/CT/PET for leukemia/lymphoma since endometriosis/ulcerative colitis have caused enlargement of mesorectal lymph nodes. I'm already screened every 2 years for colon cancer. Endo also facilitates cancer, increasing the risk. I'm still awaiting major surgery to officially diagnose/excise endometriosis which, based on my severe symptoms, is likely invading my ovaries/bowel/bladder/kidneys/nerves/more. I wish they could also just biopsy my lymph nodes while they're in there, but it's apparently too hard to coordinate with my oncologist to do it in the same surgery. I'm doing everything I can to avoid getting sick. Masking in my own home, nebulizing 1-2x a day, keeping windows open and fans on despite the colder weather (so keeping myself as warm as possible), making strong-ass mugwort/mint/cinnamon tea to keep my lungs clear, blending vitamin-rich smoothies with sea moss gel to also support immune function/flush mucus build up, hot steamy mint baths, etc. Thankfully HRT does still seem to be keeping my immune system from over-reacting, but it's always hard to tell if I'm just having a regular flare or if I'm coming down with something. Fibromyalgia/myalgic encephalomyelitis feels like the flu every day anyway. Kind of interesting that I haven't gotten sick once in the past 4 years. Gee, wonder why. I'm so tired of it all falling on me, y'know?

[xlynnbbyx]

Before I post photos of Jensen from the con last weekend I wanna make a post to apologize for the lack of posts here. Normally I’m on top of anything Jensen & Jared during con weekends. But last weekend was a scary weekend for me. Last Friday I noticed my handsome boy Scooter was peeing blood. At first I wasn’t too sure it was blood I just knew it was not Casper. He tends to pee in the corner of the litter box. Scooter pees in the middle of the litter box or sometimes on the left side of the litter box. For the record before I go on yes I have 1 litter box for 2 cats. I know you are supposed to have 1 litter box for each cat plus an extra. So technically you should have 3 litter boxes. Well I don’t have the space for more than 1 litter box. Plus I can’t afford to buy litter for each box. So I have 1 extra large litter box which is enough for both of my boys. They each have a side of the litter box and I never have any issues with them sharing. Plus it is easy to monitor their bathroom habits/leavings.

Anyway back to Scooter I didn’t know it was blood until I saw him come in and actually pee blood in the litter box. At first I was going to wait til Monday to take him but when he started straining I knew it couldn’t wait. I took him to the emergency vet Saturday. Turns out he has what the call feline lower urinary tract disease basically an UTI. His bladder was full of blood which was scary. He wasn’t blocked but if I had not gotten him there when I did he could have become blocked. Which would have been fatal. The vet was originally talking surgery and a 2 to 3 day stay in the vet hospital. Which would have cost up to $6,000. No way I could have done that so my choice would have been surrender him and they would have gave him a new home after he was better or put him to sleep. So either way I would have lost him and that was NOT an option. The vet said it could be possible to avoid that if his kidney were functioning properly. Luckily his kidneys are normal and functioning properly. So the recommendation was a 24 hour stay to over hydrate him to flush his bladder out. I hated leaving him there cause I didn’t want him to think he was being abandoned. They let me see him before I left. I told him I love him he needed to get better and I was not leaving him that I would be back.

Next day we got a call that he responded well to treatment and he was ready to come home. He was sent home with antibiotics and for some reason 2 pain medications. He does have to be on prescription urinary dry & wet food. This will prevent crystals from forming causing stones which will cause him to get blocked. Thursday he had a check up and he is doing good responded well to the antibiotics. I asked if he could have Purina urinary food cause it is cheap and easy to get. Vet said nope it has to be either Royal Canin or Hill’s prescription food. Over the counter urinary foods don’t have what he need. We went with Hill’s but sadly it is very expensive. It’s $32 for a 4lb bag & $2 or $6 a can for wet food. But I have no choice if I want to prevent him from getting sick again. The vet said it was even safe to have Casper on it too. Cause it’s easier to transition them to the same food than to separate them. I can’t believe it’s been a week since everything happened.

Sometimes I doubt myself as a fur. Sometimes I think I get paranoid when it comes to my 2 cats & pup. But I’m glad I went with my instincts when it came to Scooter. Everyone who knows me knows Scooter means the world to me. Scooter was given to me as a birthday gift in October 2018. I was sick on my birthday so I was upset. 2 days after my birthday my dad found this tiny orange kitten who was 3 weeks old. They could not find his mother so my dad brought him home to me as a gift. I raised him since he was 3 weeks. Since he couldn’t eat food yet I bottled fed him. I set up a safe bed area for him. I would help him get to sleep and litter trained him. He will be 5 on Oct 5th as I estimated that is when he was born. I couldn’t imagine my life without him. It will be a struggle to pay for his food but it is worth it to keep him healthy and with me where he belongs.

Sorry this is so long but I needed to let it out. My life this year has been one shit storm after another. I’m just grateful to still have my baby boy with me.

[nourishandthrive]

The Role of Hydration in Overall Health and Well-being

Staying hydrated is essential for maintaining good health and well-being. Water plays a crucial role in many bodily functions, and proper hydration can improve physical and mental performance. Here’s why hydration is so important and some tips to ensure you’re getting enough water daily.

Supports Physical Health

Regulates Body Temperature: Water helps regulate your body temperature through sweating and respiration. Staying hydrated ensures your body can effectively manage heat.

Aids Digestion: Water is vital for digestion, helping to break down food and absorb nutrients. It also prevents constipation by keeping the digestive tract functioning smoothly.

Lubricates Joints: Proper hydration keeps joints lubricated, reducing the risk of discomfort and injury during physical activities.

Promotes Kidney Health: Water helps flush toxins from the body through urine. Staying hydrated supports kidney function and reduces the risk of kidney stones.

Improves Skin Health: Adequate hydration keeps your skin moisturized and can improve its elasticity, reducing the appearance of wrinkles and dryness.

Boosts Mental and Cognitive Function

Enhances Brain Function: Dehydration can impair cognitive function, leading to difficulties in concentration, memory, and alertness. Staying hydrated helps maintain optimal brain performance.

Improves Mood: Hydration levels can affect mood and energy levels. Dehydration may cause fatigue, anxiety, and irritability, while proper hydration can boost your overall mood.

Supports Weight Management

Regulates Appetite: Drinking water before meals can help regulate appetite and prevent overeating. Sometimes, thirst is mistaken for hunger, leading to unnecessary calorie consumption.

Boosts Metabolism: Staying hydrated can help boost your metabolism. Drinking cold water, in particular, may increase the number of calories your body burns at rest.

Enhances Physical Performance

Increases Endurance: Proper hydration is essential for maintaining endurance during physical activities. Dehydration can lead to muscle cramps, fatigue, and decreased performance.

Reduces Risk of Injury: Staying hydrated helps maintain muscle function and flexibility, reducing the risk of strains and injuries during exercise.

Tips for Staying Hydrated

Set a Daily Goal: Aim to drink at least 8 cups (64 ounces) of water per day. Individual needs may vary based on activity level, climate, and overall health, so adjust as necessary.

Carry a Water Bottle: Keep a reusable water bottle with you throughout the day to remind yourself to drink regularly. Opt for a bottle with measurement markings to track your intake.

Infuse Your Water: If you find plain water boring, try infusing it with fruits, herbs, or vegetables like lemon, cucumber, or mint to add flavor without added sugars.

Eat Hydrating Foods: Incorporate water-rich foods into your diet, such as cucumbers, watermelon, oranges, and lettuce. These can contribute to your overall hydration.

Establish a Routine: Make drinking water a part of your daily routine. For example, drink a glass of water when you wake up, before meals, and before going to bed.

Set Reminders: Use phone apps or set alarms to remind yourself to drink water at regular intervals throughout the day.

Monitor Your Urine: Pay attention to the color of your urine. Pale yellow indicates proper hydration, while dark yellow or amber suggests you need to drink more water.

Listen to Your Body: Thirst is a natural indicator that your body needs more water. Don’t ignore it—drink when you feel thirsty.

Conclusion

Hydration is fundamental to maintaining overall health and well-being. By supporting physical health, boosting mental function, aiding weight management, and enhancing physical performance, water is essential for every aspect of your life. Incorporate these tips to ensure you stay hydrated and reap the benefits of proper hydration. How do you stay hydrated throughout the day? Share your tips and experiences in the comments!

[gunsli-01]

So, Triage was certainly a thing huh. Whelp, let me tell you. I've been listening to triage all day and I have some thoughts that may just conflict with everything else said. So, watch me go against my own interests and state for all to see despite me personally voting Shidou Innocent I'm certain he's everything but that!

I believe Shidou’s spouse may have gotten sick which is what initially made him begin taking organs. However, since he was also the main source of income for his household he was gone often. His wife may have still taken care of the house but was not really permitted to do too many strenuous activities because of her illness. Inevitably, her illness worsened, and she was put into a hospital full time. The beginning of Triage even alludes to this being the case with lyrics,

“Those cards of promise I discarded were they retribution for my incessant taking. In that case, I should have been the one. That’s the correct answer, but then why?”

He was already taking organs before his children were impacted more than likely to save his wife from whatever illness she had. In Shidou’s second interrogation he says,

“You saw my true self, didn’t you? There ought to be very few people who have killed more than I have. In comparison to me, the prisoners who weren’t forgiven have also hardly done anything wrong.”

He responds to Es’ assertion that his murder was the act of harvesting organs from brain dead patients with,

“Well… About halfway, I would say."

Es assumed that Shidou’s patients were brain dead and he’s halfway correct but that’s pretty far from correct. Chances are Shidou’s patients were not brain dead but more than likely in vegetative or comatose states with possibly very little chance of recovery. Es is once again seeing what he wants to see here and creating the best-case scenario to justify the choices already made.

Even worse Shidou could have lied to his patients families stating they were brain dead when they weren’t in order to persuade them into pulling the plug faster. When he confronts family members of his patients in Throw Down, he has no paperwork concerning the individual being discussed. So, the family members just have to take his word on it. This is shown being the case multiple times.

Even worse we see the actual patient records scatter through the air and strewn down at Shidou's feet near the end of his first mv.

Average people wouldn’t be able to immediately tell the difference between brain death and a coma.

“Their loved one who has suffered from an injury to the brain is in a hospital intensive care unit. Doctors are doing everything possible to help the patient including supporting blood pressure and heart rate with medications, breathing for the patient with a ventilator, and constantly monitoring the patient’s condition. Often, for the patient with a non-traumatic brain injury like a stroke, there is no outward sign that their loved one has suffered a devastating and non-survivable injury to the brain. The patient looks to be asleep, is warm to touch and appears to breath, albeit with the help of a machine.”

“ “NO” the hesitation I killed is holding its breath and sniffing out lies.”

“Lying, replacing with hope.”/ “To keep you alive, you are still living.”

There is a chance that the person who was brain dead was Shidou’s wife. I’m saying this because of the amount of organs Shidou is displayed taking and the height of the individual he is shown to be working on in Throw Down. If his wife was brain dead and he was deluding himself into believing she could recover she would constantly need new organs. Because organs in brain dead patients can only remain functioning with the assistance of life support for a short time.

“However, the vital organs such as the heart, lungs, liver, pancreas and kidneys can be kept viable for a few days if supported by artificial or mechanical support.”

“You don’t even know yet, and yet- Killing, extracting, I still won’t see them again.”/ “Not dead; yeah, she’s definitely not dead.”

This could be why we see the kids go from being supervised by her to playing by themselves. Under this framing Shidou would still have a very demanding job that he would have to do even more to manage to pay for his wife’s hospital bills, collect organs for her possibly already brain dead body and meet his children’s basic needs. While he was gone either one or both of his kids could have gotten into an accident while playing.

More than likely related to the soccer ball we see bounce to a halt in Triage before we see Shidou in a dark empty home. The call Shidou misses in Triage could be someone attempting to contact him about the accident. This could also explain why the imagery that alludes to an individual (possibly the wife) flatlining is accompanied by the noise a landline phone makes when it’s busy.

Something that conflicts with what we hear at the beginning of Triage which is someone calling Shidou’s cellphone not a housephone. We can tell this is the case because the calling noise rings three times before he sends the call to voicemail. More than likely because he was busy with something else either work related or related to his wife’s care.

From the reaction of the kids when Shidou enters the house he doesn’t seem to be home often. Then when we see him spending time with his wife he’s wearing the same clothes he was when he was walking there. So, they probably were spending time together on one of his off days. The house we see Shidou in is also completely different from the apartment we see him residing in during Throw Down. So, chances are he rented an apartment close to his work and would regularly send money back to his family and visit them when he got free time.

After the mother fell ill to the point of needing hospitalization or was found brain dead. Shidou may have moved the whole family out of that house and into the city where she could get better care for her needs. This is why when the kids are seen playing Shidou sings,

"I yearn to be found guilty."

However, after we see him and his wife walking together it changes to,

"But it tilts towards, find me Innocent."

This is also why he's happy to get his judgement handed down to him by a child. Because in his deluded pursuit to prolong his wife's life regardless of if it had ended already or not, he neglected his children which ultimately led to him losing everyone he loved.

I need to state I'm not saying this to get Shidou’s verdict to change by any means I think he should still be Innocent even while recognizing these things as possibilities. I’m only saying this so people don’t delude themselves into thinking Shidou is someone he’s not.

Certainly, he is willing to care for those who are injured now but that was not always the case and he had to lose a lot to even get to that point. Even after that he tried to find the quickest way to run from his guilty conscious by asking for the death penalty right out the gate. Kirisaki, Shidou is not such a simple case and looking away from the truth in favor of the ideal is how he wound up in Milgram.

Don’t make the same mistakes he did. Look that bastard dead in the eyes and tell him to do something right for once. When I made that post saying friendship ended with my morals I meant that don’t fall for Es’ misconceptions and remember to think for yourselves. If you don’t and allow yourselves to be led by your biases all you’ll get is disappointed or worse used.

[thoughtportal]

For patients battling diabetes, a group of Chinese scientists and clinicians may offer a glimmer of hope. For the first time in the world, a patient’s diabetes has reportedly been cured using cell therapy.

The patient, a 59-year-old man who had been living with type 2 diabetes for 25 years, was at serious risk of complications from the disease. He had a kidney transplant in 2017, but had lost most of his pancreatic islet function which controls blood glucose levels, and relied on multiple insulin injections every day.

“He was at great risk of serious diabetes complications,” Yin Hao, a leading researcher at Shanghai Changzheng Hospital, told Shanghai-based news outlet The Paper earlier this month.

The patient received the innovative cell transplant in July 2021. Eleven weeks after the transplant, he was free of the need for external insulin, and the dose of oral medication to control blood sugar levels was gradually reduced and completely stopped one year later.

“Follow-up examinations showed that the patient’s pancreatic islet function was effectively restored,” Yin said. The patient has now been completely weaned off insulin for 33 months.

The medical breakthrough, achieved by a team of doctors and researchers from institutions including Shanghai Changzheng Hospital, the Centre for Excellence in Molecular Cell Science under the Chinese Academy of Sciences, and Renji Hospital, all based in Shanghai, was published in the journal Cell Discovery on April 30.

“I think this study represents an important advance in the field of cell therapy for diabetes,” said Timothy Kieffer, a professor in the department of cellular and physiological sciences at the University of British Columbia in Canada.

Diabetes is a chronic condition that affects the way our bodies convert food into energy.

What we consume is broken down into glucose – a simple sugar – and released into the bloodstream. Insulin, produced by the islets of the pancreas, is essential for regulating blood sugar levels.

In diabetes, this system is hijacked: either the body does not produce enough insulin, or it cannot use the insulin it produces effectively.

There are several types of diabetes, of which type 2 is the most common, affecting almost 90 per cent of sufferers. It is largely diet-related and develops over time.

Regardless of the type of diabetes, failure to maintain normal blood glucose levels over time can lead to serious side effects, including heart disease, vision loss and kidney disease.

According to the US Centres for Disease Control and Prevention, “there isn’t a cure yet for diabetes”.

Along with losing weight, eating well and taking medication, insulin is the mainstay of treatment for some, but this requires frequent injections and monitoring.

Scientists around the world are researching islet transplant as a promising alternative, mainly by creating islet-like cells from human stem cell cultures. Now, after more than a decade of work, the group of Chinese scientists has come a step closer.

The team used and programmed the patient’s own peripheral blood mononuclear cells, Yin said, which were then transformed into “seed cells” and reconstituted pancreatic islet tissue in an artificial environment.

While preclinical data from Kieffer’s team supports the use of stem cell-derived islets for the treatment of type 2 diabetes, the report by Yin and colleagues is, to Kieffer’s knowledge, “the first evidence in humans”.

Yin said the breakthrough was another step forward in the relatively new field of regenerative medicine – where the body’s own regenerative capabilities are harnessed to treat illness.

“Our technology has matured and it has pushed boundaries in the field of regenerative medicine for the treatment of diabetes.”

Globally, China has the highest number of people with diabetes. According to the International Diabetes Federation, there are 140 million people with diabetes in the country. Of those, about 40 million depend on lifelong insulin injections.

China’s diabetic population is disproportionately high, according to Huang Yanzhong, a senior fellow for global health at the Council on Foreign Relations.

In an article last year, he pointed out that while China accounted for 17.7 per cent of the world’s population, the country’s diabetic population made up a staggering quarter of the global total, placing a huge health burden on the government.

If this approach for cell therapy ultimately works, Kieffer said, “it can free patients from the burden of chronic medications, improve health and quality of life, and reduce healthcare expenditures”.

But to get there, he added, studies in more patients based on the findings of this Chinese study were needed.

[renee-mariposa]

Nothing in my day-to-day job shows me the limits of modern medicine like vancomycin does. And it makes me insane.

(extremely long, somewhat incoherent nerd rant below the cut)

See, vanc is really good at, like, three things: treating MRSA (when given IV), treating ampicillin-resistant enterococcus (when given IV), and treating c diff (when administered orally ONLY). Most every use outside of that, like when it’s used to treat methicillin-susceptible staph aureus for “penicillin allergic patients” (don’t get me started on PCN allergies), actually has data that it increases risk of morbidity and mortality (i.e. harm and DEATH).

Unfortunately, due to the prevalence of multi-drug resistant organisms, vancomycin is empiric therapy for a lot of presumed infections. And it's a lot more difficult to actually tell if someone has an infection than you'd think. A lot of medical conditions imitate each other and when time is of the essence to identify what's going on, the most ethical thing is to start an antibiotic and rule out infection as the hospitalization continues. Lab techniques have gotten a lot quicker: I can remember 8 years ago, it would take 3 days just to identify what microbe the patient had in their presumed infection. These days, anno domini 2023, PCR comes back in a matter of hours, identifying gram positive/gram negative staph/strep/bacilli/etc, and it's the sensitivities that take 2-3 days. (Don't get me started on contaminated cultures.) But even with improvements in lab technique, we might not culture any microbe at all or the provider might keep vancomycin on "just in case" because we don't know IF the patient is infected, WHAT they're infected with, or if the infection will get better with a different drug.

And vancomycin is terrible on kidneys. Extremely nephrotoxic. It isn’t as bad as the 80s when the drug first came out and was called Mississippi Mud colloquially, but it will fuck the patient up if not monitored closely.

But finding the correct dose for each patient in a timely manner is nigh impossible. This is because vancomycin is renally eliminated. We have to mathematically estimate how well the kidneys are working. Unfortunately, our mathematic equation is next to useless if you are:

-Less than 50 kg

-Shorter than 5 foot tall

-Have a BMI of more than 40

-Are an adult younger than 45 (twenty-year-olds get astronomical doses that would be destructive in an older patient)

-Are older than 65 (the official definition of 'geriatric', i'm relatively sure)

-Are female (this is really only applicable if the patient is less than 50 kg or older than 65 - think: little old frail lady - we have absolutely no fucking idea how their kidneys are doing until we order the serum drug level. It is next to impossible to accurately dose vancomycin in little old ladies on the first try.)

-Are missing limbs (lots of leg amputations in the older and impoverished diabetic population!!)

-Have a lot of muscle mass (think bodybuilder or really tall guys)

Fun fact: we estimate renal function by looking at height, weight, age, birth gender (few, if any, studies on trans patients taking HRT), and a lab value called serum creatinine. Creatinine is a byproduct of muscle metabolism, I don't know the fine details, but we can generally estimate how well kidneys are working by seeing how much creatinine is in the blood: low creatinine usually means kidneys are excreting it as they 'should' be. High creatinine means there's something wrong, the kidneys aren't able to excrete it as efficiently as they 'should' be. But the effect of low muscle mass and high muscle mass haven't been studied enough to be able to adjust our mathematical equation to compensate for them. And with high BMI: we often overestimate their renal function because we don't know how to estimate their muscle mass vs their body fat.

(I work out in the boonies. ~70% of our patients have diabetes. ~80% of our patients have a BMI of greater than 35. So what I'm trying to say here is: we are shooting in the fucking dark when we're estimating the renal function of the vast majority of our patients.)

Complicating this: vancomycin is useless until it reaches steady-state concentration in therapeutic range. On one side of this problem: a lot, if not most, medical providers assume that vancomycin starts working its magic from the first dose. So we sometimes get orders for "vancomycin 1 gram now and see how the patient is doing in the morning". That isn't going to solve jack shit! That's just going to increase the incidence of microbial resistance!!

OR, like in the multiple situations I dealt with this afternoon, you make an educated guess on what regimen is going to work for the patient. You get a level 48 hours after the dose starts. And you find out that you fucking guessed wrong and the patient is subtherapeutic. It has been two fucking days and the patient hasn't started being treated for their (presumed) infection yet!! And we've increased the possibility of microbial resistance! *muffled screaming in frustration*

So what I'm trying to say here is: on almost every presumed infection that comes into the hospital (which we're guessing like 30%? 50%? of the time), we're starting an extremely toxic drug, oftentimes 100% guessing what regimen will be therapeutic, only finding out in 2 days that it is not therapeutic, and it can sometimes take days and days to titrate the dose sufficiently to find a therapeutic regimen. And sometimes we're really fucking unlucky and we destroy the patient's kidneys temporarily (or permanently! but kidneys can be very resilient so that's thankfully rare) because we guessed a regimen that's too high!! This is a fucking nightmare!!!!!!!!

And if all of this wasn't bad enough, we don't really have any drugs that do what vancomycin does therapeutically. We have things that can be used to cover some of what vancomycin does, but nothing that's equivalent AND less toxic.

Like, to fix this situation, we need:

-Better education to providers on what drugs are appropriate empiric therapy for different presumed infections (we're working on it, we are working on it)

-Better ways to estimate kidney function (there needs to be more research on kidney function in patients with BMI greater than 35!! And little old ladies!! And patients with low body weight and high body weight and amputations and...)

-Better prognostic tools to tell 1. when the patient is infected (looking at you, sepsis!!!) 2. what they're infected with

-Less-toxic antibiotics AND/OR better ways to treat infection (this would be the evolution of medicine as we know it)

And I want to be clear: vancomycin isn't bad. It's an extremely effective tool when used correctly but we often either don't have enough data to use it correctly or the provider doesn't understand that this tool is fucking useless for the job they're trying to perform.

[sac-bestsupplements]

Creatine Side Effects: Is it Safe? The Toxic Effects of Creatine Monohydrate, Powder, HCL and Capsules

Discover our top 10 best creatine supplements ranking: https://super-achiever.com/best-creatine-supplements

Read more on our website: https://super-achiever.com/creatine-side-effects

#creatine #creatinesideeffects #creatinemonohydrate

Hey there, Achiever Fam! 🌟 Today, we're unraveling the mystery behind the side effects of creatine, a staple in gym bags worldwide. Sure, it's known for muscle gains, but there's more to this story. 🏋️‍♂️🤔 If you're curious about the lesser-known effects of creatine and how to balance its benefits with potential risks, you're in the right place! Don't forget to hit that subscribe button for more insightful content. Let's get into it! 💪 Common Side Effects: Bloating: A familiar side effect due to creatine pulling water into muscles. Usually temporary as the body adjusts. 💧🤰 Water Retention: Increases weight slightly, but it's water, not fat. Normal response to creatine. ⚖️💦 Digestive Issues: Ranging from discomfort to cramps and diarrhea, especially at high doses. A sign to reassess your dosage. 🚽🤢 Dosage and Type Matter: Stick to 3-5 grams per day post-loading phase to minimize side effects. The form of creatine you choose (monohydrate, hydrochloride, etc.) can affect your body differently.

🔍💊 Lesser-Known Side Effects: Sleep Disruptions: Creatine might affect your sleep cycle due to increased energy levels. 🌙😴 Mood Changes: Some experience anxiety or irritability. Always monitor mental health changes. 😠🧠 Kidney Function Concerns: Safe for most, but those with kidney issues should be cautious. 🚨👩‍⚕️ Dehydration Risks: Increased muscle water retention might lead to dehydration. Stay hydrated! 🥤💧 Muscle Cramping: Possible due to dehydration and electrolyte imbalances. Drink water and eat balanced meals. 🍽️💪 The Balancing Act of Creatine: Dosing is Key: Start low, increase gradually, and find what works for you. Individual factors matter. 📊🧲 Timing Matters: Taking creatine near workouts may enhance benefits. Consistent daily intake is crucial. 🕒🏋️‍♀️ A Balanced Diet: Creatine works best with a healthy diet. Eat a mix of proteins, carbs, fats, and vitamins. 🥗🍲 Supplementation Duration: Consider cycling creatine use – periods of taking it followed by breaks. 🔄⏳ Professional Consultation: Essential for those with health conditions or experiencing severe side effects. 👨‍⚕️👩‍⚕️ When to Seek Professional Advice: Existing Health Conditions: Particularly kidney, liver, or heart issues. Unusual or Severe Side Effects: Persistent digestive issues, cramping, or changes in urination. 🚨👩‍⚕️ There you have it!

Understanding the side effects of creatine is crucial for harnessing its power safely and effectively. 🌟💊💪 If you've used creatine, we'd love to hear your experiences. Drop a comment below, and don't forget to subscribe for more empowering content. Catch you in the next video! 📹👋

[puppyexpressions]

Hypothyroidism in Dogs: Symptoms, Causes and Treatment

When a dog’s thyroid gland does not produce enough hormones, a condition called hypothyroidism occurs. Middle-aged and older dogs are most commonly affected. Thyroid hormones help regulate many internal functions, such as metabolism and heart rate. When these hormones are low, vital functions are impaired and symptoms develop. Fortunately, with early detection and treatment, most hypothyroid dogs have a normal life expectancy.

Causes of hypothyroidism in dogs

Lymphocytic thyroiditis, an immune-mediated condition, is the most common cause of hypothyroidism in dogs. It occurs when the immune system attacks and destroys the thyroid gland, resulting in significant inflammation and low hormone production. It is unknown why the immune system decides to attack the thyroid gland, but it is thought to be hereditary.

Hypothyroidism in dogs can also occur due to thyroid gland atrophy. During this process, the functional tissue of the thyroid gland is replaced by fat. Veterinarians also don’t know why this process occurs.

A pituitary gland tumor is another cause, but it is extremely rare. The pituitary gland is located at the base of a dog’s brain and is responsible for secreting thyroid stimulating hormone. In dogs with a pituitary tumor, this process is impaired, and the thyroid gland is not stimulated. Therefore, thyroid hormones are not produced.

Symptoms of hypothyroidism in dogs

Hypothyroidism causes numerous symptoms in dogs, which may include the following:

Weight gain despite a normal appetite

Fat accumulation around shoulders, neck, and hind end

Lethargy

Dull hair coat

Slow hair regrowth

Flaky and/or thickened skin

Patches of alopecia (hair loss)

Slow heart rate

Cold intolerance

Recurrent skin and ear infections

Fertility issues

Reduced tear production (dry eye)

Nerve abnormalities

Dogs with hypothyroidism may have high cholesterol, high fat content and mild anemia on bloodwork.

How to treat hypothyroidism in dogs

Dogs with hypothyroidism require oral supplementation of a synthetic thyroid hormone called levothyroxine. This medication is given daily and is relatively inexpensive. The dose, which is determined by the dog’s weight, may change over time based on his response to treatment. Periodic bloodwork helps the veterinarian assess hormone levels and adjust the dose when necessary. Supplementation is required for the remainder of the pet’s life.

Since hypothyroid dogs are already prone to high cholesterol, switching to a low-fat kibble is beneficial. Omega-3 fatty acids also promote a healthier skin and coat. Your veterinarian can recommend the best type of food to meet your dog’s specific needs.

Life expectancy

Hypothyroidism is not a curable condition. However, most healthy, hypothyroid dogs live long, happy lives with the proper monitoring and treatment. Dogs with additional health issues, such as heart disease or kidney disease, may have shorter lifespans due to the difficulty in managing hypothyroidism alongside concurrent illness.

If left untreated, hypothyroidism results in a poor quality of life, an increased risk of complications and a reduced lifespan. Early diagnosis ensures your pet receives the treatment he needs to be happy and healthy. If you notice any signs of hypothyroidism in your dog, bring him to the veterinarian for evaluation.

[cabernet-and-calculations]

Incident Report 12282023, Incident Location: Site-██ On 12/28/2023 within room ███ at Site-██, an MTF team was dispatched to respond to a localized threat that was reported at 23:15:06. Upon arrival, the team discovered the door to the room to be open with two entities recovered from the room (see injury report). Much of the furniture in the room had been disturbed with several items being broken in a manner similar to enduring a blunt force. Upon review of footage, it was deduced that the equivalent of a minor bomb had been detonated within the quarters utilizing Type Blue methods. The individual behind the attack, ██████ █. █████████ of the ██████-██, "██████████ ██████", was spotted fleeing the scene shortly following the explosion and was traced to be attempting to escape through the Northern fire exit where they were caught and apprehended. ██████-██ has not claimed responsibility for this attack, it appearing to be a continued reaction of a splintered opinion forming within the GOI. Further monitoring will be necessary.

[Only visible to anons & muses with O5 clearance.] Injury Report 12282023-A, Incident Location: Site-██, O5-10 O5-10 was recovered alongside O5-12, unconscious. Physical examination showed bruising to the kidneys and spleen, minor internal bleeding, extensive bruising to the skin and muscles, moderate whiplash, and increased aggravation of the left eye and surrounding skin. Upon arrival, bleeding was staunched and its condition stabilized. Cognitive function appears normal, with some minor confusion presenting and severe fatigue. Injury Report 12282023-B, Incident Location: Site-██, O5-12 O5-12 was recovered alongside O5-10, unconscious and in critical condition. In a physical examination, it was determined that the radius of his right wrist had sustained a moderate fracture, the 7th rib on his right side sustaining a moderate fracture with the 8th rib on his right side sustaining a mild fracture, and a fractured skull and subarachnoid hemorrhage as well as extensive bruising across the body. Upon arrival, the hemorrhage was stabilized and the rest of the injuries were administered aid. Cognitive functions appeared to be partially disrupted upon awaking in the evening of 12/30/2023 with the presentation of confusion and agitation as well as lacking significant memory of the day leading up to the event. Motor functions cannot be accurately gauged at this time. More documentation will be provided as monitoring of his condition continues.