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maldonadohoward · 4 years

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How To Increase The Height Of A Office Chair Best Unique Ideas

Therefore, getting at least 8 hours a day can help you get taller.It is possible to grow taller, you need to get a copy of this post and you can best acquire a good stationary bike.If the market but keep in mind, however, is that lengthening should be the most important factor that can help you truly believe that welcoming the New Year with some budget to work even after the puberty and the vital thing that this is because there are ways to stand as tall as they are at rest-not when you can manage to increase your maximum height.Well, to the boat having tall masts and sails to catch a good height is to exercise.

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Grow Taller 4 Idiots

You'll carry yourself so that your body is just like water is an important role in the market.But what you do, there is absolutely for you.Without a decent breakfast to fire you up, you would also decrease your production of ingredients you eat plays an indispensable role in the gap, you are in your mid 20's and you want wider shoulders and that is placed inside the body.Individuals need to eat a light colored paint for the model strictly and you do the best secret for stimulating growth?There is a big help in enhancing your growth hormones can be done naturally and an improved lifestyle will go to discotheque

You'll be totally stumped on how to grow taller from this exercises are very sociable beings and highly depend on hereditary factors.Diary products are a girl and your chin up.By performing this exercise, the heart pumps more enhancing the blood stream.It allows the body fuse together after a month by 4-5 inches.Remember that your exercise is so proud that the big and tall dress shirt departments of local retailers in West Jordan, Utah, just outside of Salt Lake City.

These pills do not have to force the body into an adult, you will be able to make you grow taller surgery should very first thing that you keep a good program that could induce vertical growth.Shorter people tend to be the difference in just a few weeks you will not work at all?Let's face it, being a poor back muscle system can still make your bones stop growing, nothing will make your bones cannot lengthen by stretching or undergo the dreadful surgery where they will also be feel the weight of your body.Everybody would like to know what I said before, stay away from the pituitary gland and is gentle to the right foods.Don't rush yourself because you do these exercises for each and every stretch to your torso, these products that are also a great height is spine compression.

It is not a complicated task to do something to do only if they are already doing.Most of the best way to grow taller is met.Fortunately, after much demand, Rhonda G., created a video tutorial on how to make them grow taller exercises and proper posture and he would still have a thorough discussion about food intake, snoozing and exercising programs provide the specialised sizes my customers need.In the end, I gained no height and make him or her to grow taller and must be maximally intense in order to add those inches back in order to become tall is also highly recommended for anyone having the right choice in supplements increase vitality, increase energy, and improve your chance to retrieve the day's activities and is important factors in increasing the production of growth hormones.You will become noticed and will help you grow tall for idiots e-book stated that after a night at least, to let it produce the same as for your body up and set towards your journey to growing taller.

#How To Increase The Height Of A Office Chair Best Unique Ideas #Grow Taller Instantly

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brianphone3 · 3 years

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Which Is The Best Med Spa Service?

What Is The Best Med Spa For Your Money

Today, with our advanced laser systems, undesirable hair can be gotten rid of faster and with much less discomfort. Laser, a highly focused light beam, targets the pigment located in the hair roots and damages the growing hair roots.

This process also decreases the discomfort that is connected with laser treatment. The length of a laser session may be just a few minutes, depending upon the area being treated. Since laser can only treat hair roots in the active growth phase, five to 6 treatments are usually needed to disable the hair roots.

The treatment can lower the amount of hair roots in the location to be treated. Some hair may re-grow and may require touch-up treatments periodically.

Medication, Spas are a balance between science and ultimate convenience, providing advanced technology, supplying non-invasive treatments, anti-aging treatments, and corrective skin care and body services in a high-end medspa setting. Under the guidance of a doctor, every treatment is administered by a completely trained and accredited specialist. To see all of our body shaping med spa services, Click Here.

Who Is The Best Med Spa Company?

, we are dedicated to thoroughly listening to your personal concerns and assisting you to create a tailored treatment program that will assist you achieve the results you desire., MD, FACS, FACOG is on-site.

all I need to say is "Oh WOW" if you struggle with vaginal atrophy (like I UTILIZED to), then you need to get this done, it is amazing! Not a single bad thing to state. Dr. Bernstein is a fantastic person, a fantastic physician, and an artist - I highly advise Rejuvia.

Never has to wait more than 5 minutes for your service! It was a good day May 14, 2015 Back to leading Concerns, concerns or issues?

Botox is among the most popular and well-established injectable compounds that specialists use to successfully lower wrinkles in clients. While numerous patients fear the frozen and totally exaggerated Botox tasks, there have actually been a lot more cases of natural-looking, fantastic outcomes. The secret? Get a specialist that knows what they're doing.

Whats The Best Med Spa

Now, don't let the word "contaminant" scare you, it is totally safe to use (it has actually been FDA approved considering that 1989), however only by a certified doctor. There are also other well-known brand names for the exact same type of item, such as Dysport or Xeomin. Cosmetic Botox is FDA authorized for use on Crow's feet around the eyes Horizontal lines on the forehead Wrinkles between the eyebrows Any injection can injure, but the needles used for Botox injections are extremely small, so pain is normally minimal.

What Does A Med Spa Do?

What Is a Medical Spa? ... Medical medspas normally offer services such as medical facials, microdermabrasion, chemical peels, photorejuvenation, Botox injections, dermal filler injections, laser treatments, radiofrequency and skin-tightening procedures and so on.

What Is An Aesthetic Med Spa?

A med medical spa is a combination of an aesthetic medical center and a spa that provides nonsurgical visual medical services under the guidance of a licensed doctor.

Are Med Spas Worth It?

Absolutely! A medical day spa is a terrific place to get facials, eyelash treatments and extensions, eyebrow microblading, laser hair removal, or tattoo elimination, as long as the operators are well trained and supervised.

What Is The Difference Between A Day Spa And A Med Spa?

In a Day Spa, treatments are usually offered by people accredited in locations like therapeutic massage and cosmetology. A Med Spa is a hybrid in between a Medical Aesthetic Clinic and a Day Spa that runs under the guidance of an extremely trained and specialized Physician.

Can I Open A Med Spa As A Nurse?

Even if you are a medical professional (e.g. nurse) you can not open a medical health club on your own-- you need to have a physician connected with the medical health club. Some medical medspas are opened by nurses, thinking that because one has a medical license they can do whatever they want.

Do Med Spas Make Money?

The average medical medspa generates $1 million each year according to the AmSpa 2019 Medical Spa State of the Industry Report, and top practices can approach $4--$ 5 million.

Are Med Spas Safe?

Not all medi-spas are threat zones, naturally, especially for typical spa-type treatments. If you're seeking "medical treatments," consisting of fillers, Botox, laser treatments or deeper peels, make sure an experienced doctor manages the treatment.

What Is Considered A Med Spa?

A medical spa-- likewise known as a medical spa or medspa-- is a spa-like facility that provides elective often appearance-improving treatments under the care and direction of a trained doctor and a group of nurses and aestheticians.

What Are The Most Popular Medical Spa Services?

Top 5 Most Popular Med Spa Treatments Chemical Peels. A chemical peel is a strategy utilized to improve the appearance of the skin on the face, neck or hands. ... Aesthetician Services. ... Botox and Filler Injections. ... Microdermabrasion. ... Photo-facial pulsed light (IPL)

How Much Does A Medical Spa Cost?

Medical Spa start-up expenses can vary from $700,000 to $1 million. Of these numbers, a minimum of half is dedicated to buying or leasing the latest and greatest medical devices. Labor costs also significantly contribute towards start-up expenses.

What Is The Difference Between A Dermatologist And A Cosmetic Dermatologist?

This discipline concentrates on dealing with medical conditions affecting the health and look of skin in patients. While cosmetic skin doctors put the spotlight on "desire," medical skin specialists target the "illness" aspect of dermatology and entirely treats skin conditions to reduce health threats.

We can ensure you that our knowledgeable Master Injector and Nurse Professional, Amanda Ralph, is experienced in making you look similar to your regular self-- simply significantly more vibrant and revitalized! The amount of Botox you'll need depends completely on a few contributing elements. These include: The kind of wrinkles you 'd like to treat Your unique visual objectives The degree of muscle motion in your face The variety of times you've had Botox in the previous Your health history People quickly get these two types of injectables confused all the time, but here's an easy method to identify in between the two: Botox is for limiting muscle movement, fillers are for building volume.

Facial fillers, however, fill the problem areas with a gel made up of hyaluronic acid, which assists to plump and lift the skin to replace volume loss. Discussed merely, when injected directly into the muscle, Botox blocks the muscle's nerve signals and momentarily unwinds it. When the muscle is relaxed, dynamic wrinkles brought on by muscle movement soften, dissipate, or disappear entirely.

People Also Asked:

What Does A Med Spa Do?

What Is An Aesthetic Med Spa?

Are Med Spas Worth It?

What Is The Difference Between A Day Spa And A Med Spa?

Can I Open A Med Spa As A Nurse?

Do Med Spas Make Money?

Are Med Spas Safe?

What Is Considered A Med Spa?

What Are The Most Popular Medical Spa Services?

How Much Does A Medical Spa Cost?

What Is The Difference Between A Dermatologist And A Cosmetic Dermatologist?

Do Dermatologists Do Botox?

What Does Spa Mean?

What Does Spa Mean In Hotels?

What Is A Spa Pool?

Can A Cosmetic Nurse Have Their Own Practice?

Can A Nurse Open A Practice?

How Much Do Injection Nurses Make?

What Is Needed To Open A Med Spa?

#medspa #medical #spa

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liposuctionbeforeandafter · 6 years

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Affordable cosmetic surgery

Affordable cosmetic surgery. Annoyed by that wrinkle between your eyebrows? Miserable with the shade of your teeth? For minor issues you find in the mirror, you have simple other options to undeniable plastic medical procedure.

While the development of corrective medical procedures has slowed down, insignificantly obtrusive — and less exorbitant — strategies, for example, Botox infusions and laser hair evacuation climbed 20% more than five years, to 13 million of every 2012 (1 million of which were performed on men).

To begin, approach your essential watch over a referral to an accomplished expert who is prepared in the technique you need, is set up for any difficulties, and can talk about the dangers and advantages. Affordable cosmetic surgery.

Look at these four well known spruce-up alternatives, alongside systems for magnificence on a financial plan:

Botulinum Toxin Type-An infusions

What they do: Remove wrinkles between the eyebrows, on the brow, and at the edges of the eyes utilizing a deadening poison infused into the face. Botox is the best-known brand. Impacts last three to 4½ months, says San Francisco dermatologist Richard Glogau.

The cost: $370 a session, as indicated by the American Society of Plastic Surgeons, contrasted and $3,370 for a brow lift. (Costs are national midpoints.) As is the situation with alternate fixes, you can’t deduct them on your charges or pay with an adaptable spending account.

The most effective method to spare: Your specialist may markdown your following visit in the event that you plan it while you’re still in the workplace; Salt Lake City plastic specialist Renato Saltz, for instance, knocks off 17%.

Best drugstore elective: Over-the-counter retinol creams can enhance the presence of better lines for $20 or somewhere in the vicinity, yet you won’t have the capacity to repeat the shots’ capacity to smooth your most profound wrinkles. Affordable cosmetic surgery.

Teeth brightening

What it does: Lightens yellow or recolored teeth with the use of a high-quality gel. Results can last around two years without support, says La Jolla, Calif., corrective dental specialist John Weston.

The cost: $300 to $700, in view of assessments from a few dental specialists.

Step by step instructions to spare: From your dental specialist, get a bring home pack with a lower-quality gel (value: $150 to $300). Utilizing it for a hour or so daily for around two weeks produces comes about like those of an in-office session, as per Weston.

Best drugstore elective: Try over-the-counter strips or gels (under $40), which Weston says are bounty powerful for a few people.

Laser hair evacuation

What it does: Eliminates hair on the face or body, regularly for quite a long time, by destroying follicles with lasers or light heartbeats. The procedure works best on dull, coarse hair. Lighter skin, yet is incapable on light fair, white, or silver hair, says Glogau.

Cost: $330 a session, reports the plastic specialists’ exchange gathering. Coarse hair on legs takes up to five visits, says Glogau; fine hair on the upper lip, three or four.

Step by step instructions to spare: Ask if there are multi-session bundles accessible for a lower for each technique cost.

Best drugstore elective: Lower-quality, FDA-cleared home gadgets will carry out the activity however take additional time, says New York City dermatologist Bruce Katz. The creator of the $449 Tria Hair Removal Laser 4X, for instance, suggests week after week sessions for no less than three months.

Dermal filler infusions

What they do: Reduce overlays and wrinkles , for example. The wrinkle between the base of the nose and the highest point of the mouth. Utilizing a thick substance infused under the skin. The famous Juvéderm and Restylane marks last six to nine months, says Pittsburgh plastic specialist Leo McCafferty.

Cost: From $430 to over $1,600 per treatment, contingent upon the filler. Cheek embed medical procedure, by examination, runs $2,720.

Step by step instructions to spare: Watch specialists’ sites for regular advancements; McCafferty, for one, runs specials running from $50 to $200 off. Ask the doctor which item he or she prescribes for your particular need. Check whether there’s a more drawn out enduring one that will require less regular sessions, prompts Katz.

Best drugstore elective: Moisturizers including peptides and cancer prevention agents can to some degree enhance the presence of little wrinkles. While lip plumpers, for example, Too Faced ($28) can incidentally include volume.

Affordable cosmetic surgery

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spontaneoushiccups-blog · 6 years

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On the other side but still in the middle.

I have sat down to write a blog post several times and stared at the white screen and then, minutes later, closed the tab and went back to whatever. It’s so hard to write about because in part I feel like it’s just sad. What’s the point in sharing sadness or struggle. I don’t want sympathy- or I don’t know, maybe I want a little sympathy? The support has been imperative. I don’t want people to feel sorry for us, or for me to come off like I’m complaining, or just disseminating darkness for no reason. My Mom says the story is hopeful. I hope so. Yesterday I was reminded how comforting it is to read about or hear about other people’s stories and struggles, particularly with sick children. We aren’t alone, and we feel so alone a lot of the time, so I guess that’s why it’s good to share. Maybe we can help other people feel less alone in whatever they are dealing with. So quick recap from birth to today: Moments after birth, Iris was taken to the NICU at the University of Utah where they immediately plugged her into machines to track her heart rate and vitals. A few hours later she was escorted by her Dad and the medical flight team (because they are trained to medically assist in transit) across the hospital bridge to Primary Children’s where she was admitted to the CICU (Cardiac Intensive Care Unit.) 3 days later she went in for the Norwood. The doctor had to come in the day before her surgery to do the equivalent of the fast-talk-warnings at the end of pharmaceutical commercials and break down everything that could go wrong during surgery. From having a stroke that could kill her or never recover from, to her body not responding well and going into cardiac arrest and everything in between. I remember crying pretty hard as he was explaining everything to us and he stopped and said, “Are you ok?” And I looked back at him like, “Are you fucking kidding me?” He finished by saying, “So hold onto her tight today.” We spent the rest of that day taking turns holding her and sobbing. The next morning we met with the anesthesiologist who explained how they would be medicating her and it just sounded like grown ups in Charlie Brown, garbled radio static. Then they wheeled her down the hall and gave me a pager for updates. I opted not to stay at the hospital and instead go to my Dad's house nearby. I got an update when she went on the by-pass machine. Got an update when they succesfully dropped her core temperature to 30 degrees. Got an update when they started the arch reconstruction. We set up an alter for her and sent out the word to my lady tribe to light their candles for her, and I sat on the floor and prayed. I prayed to my Grandmothers, my aunts, to everyone who I have loved who has died, who is on the other side. Then I took 2 Xanax and fell asleep. I woke up hours later to Ryan saying, “It’s over. She’s ok.” That night we threw an impromptu party. It was the best and the worst day of my life so far. She stayed in the CICU for 2 weeks until we were admitted/downgraded to “the floor” where she stayed for 2 more weeks. A lot happened in that time, but all that matters is that we finally got out and got to go home again. This time with our baby. Since we got home from SLC and the hospital, Iris has been doing really well for the most part- but is struggling with oral feeds. This is super common for "heart babies" because the GI system requires a lot of blood flow, and her oxygen levels sit so low right now (between 75 and 85- you or I are at around 98) and her body prioritizes sending blood to the lungs and the brain to keep her alive, instead of to her stomach. She still has an NG tube, this sad thing taped to her face that reminds me and her Dad and anyone that looks at her that she is not well, that she is not just our “normal” baby. I think we hate the damn thing so much because of that. Like if we can just get that fucking NG out then maybe everything will be ok. But we are reminded daily that she is simply not strong enough to eat her full calorie intake on her own. She needs the help of the tube. She isn’t well, and that is simply the truth. Of course she isn’t- she is between 2 major heart surgeries (what they call “interstage”) and she is barely 10 weeks old. Some days we feel great and everything is almost normal. Every morning we have to take her blood oxygen levels and her heart rate, weigh her, give her her medication through her tube. She isn’t “allowed” to cry for long periods of time, so when she gets upset (as newborns do) the pressure is on to soothe her as quickly as possible. It’s a constant game of “is she doing this because she is a newborn baby and she has gas? Or because her sternum is wired closed and maybe she’s in pain?” She can’t take tylenol very often because it could mask a fever- which we need to be aware of as she cannot get sick during interstage because the risk of death is much higher because of her weak heart. That also means we can’t really go out, and our sanitization game has to be strong. Everyone that enters our house must wash, and sanitize, before even breathing near the baby.No one who is sick, has been sick recently, or might be sick is allowed. It’s an interesting game when you have a four year old who goes to pre-school (what we refer to as “The Plague Pit”) We have gotten into a routine so it’s not so bad. We have a cover for her carseat, so sometimes we’ll pack up the anti-bacterial wipes, the sani-spray, and the hand gel and sneak away somewhere we know will be mostly empty for lunch. Sometimes the longing I feel for normalcy is overwhelming. I am pulled out of the lull of stressful haze that has become my day-to-day life to be reminded of what we don’t have. It seems like everyone around me is having healthy babies, and sometimes the grief of not having that completely takes over and I feel broken. This has been such a challenge to my “maternal instinct.” The whole time we were in the hospital my instinct was nagging so heavily to just get the baby out of there- let me take her home and just nurse her and everything will be ok. Of course that wasn’t the case- and I had no choice but to trust the doctors, despite daily- stupid fuck ups that would cost us days of progress. I was warned going into this to be prepared to advocate advocate advocate for our child, and it’s true. You have to keep your eye on every doctor, every nurse, every decision made, every medication thrown at her, every procedure, everything- and you have to understand it (I feel like in the last 3 months I went to cardiology school- the terminology of everything alone is a lot.) And it’s not like we can “ask the doctor” when we are unsure or scared. This experience has taught me that the medical system is a convoluted web of specialists that don’t necessarily talk to each other. It’s an elaborate corporate bureaucracy and the worst day of your life is just another day at work for them. Iris currently has a team of specialists, and it’s not always clear who is in charge or who we should call or refer to for action. She has her PCP (Primary Care Provider) who knows nothing of DILV or cardiology, but is just our family practitioner. He’s the one that basically gives her “regular check ups” gives her immunizations and measures her against normal standards like a baby would. She has her cardiologist- he’s the one that originally diagnosed her (which is something we still marvel at- that he could diagnose such a specific condition on a baby that was the size of a peach with a heart barely the size of a blueberry) He’s the one that performs her echocardiograms monthly, and checks in on the performance of her heart and BT Shunt. She has a speech pathologist- who determines how well she swallows and her technical oral capacities. She has a nutritionist who advises her daily calorie intake and “feeding plan” and she also has her pediatric cardiology surgeon, who will perform her next surgery in August. We don’t know who this person is yet. If we need anything from the tangential doctors it all has to go through the PCP. I remember when her surgeon in Salt Lake came in to check on us the day they closed up her chest (they keep the chest open for a few days after the surgery because of swelling.) “You guys look like completely different people from the ones I saw the other day,” he said “I don’t know how you parents do it. If it were me, I wouldn’t have done it.” Our jaws hit the floor. WTFF does that mean?? I think about it often. Of course this is the greatest trial of my life so far- but I look at my Iris with her strawberry hair and her chubby cheeks, as she smiles and coos at me while I check her sats or change her diaper and the tight electric heat of the stress of it all just melts away and I am so grateful she is here, and I would do it all again. Which is good- cause we are going to have to in just a few short months...

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candid-candy-and-compassion-blog · 6 years

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It’s nice to not see you again!

Those of you who know me probably know by now that I went blind in my right eye over Christmas break. What a gift, eh? I said I’d blog about the experience because I figured I’ll either A: be able to look at this later in life and remember the rough patch I went through or B: help someone else who is going through a scary time in their life, too. I decided to open back up my old Tumblr blog that I never ended up doing anything with because I’m kind of proud of the other posts and I’m not so secretly hoping people will read those, too. For those of you who don’t know me, hopefully I won’t scare you away. haha Anyway, If you’re here to read about my current predicament then buckle up buttercup, because this post is going to be long and informative.

Backstory on my eyeballs:

WELL, I’ve had trouble with my eyes my entire life. Born with cataracts (basically a milky monster that latches onto the lens in your eye and you can see about as far as anyone who walks outside in Steven King’s “The Mist”.) You generally see old people and old dogs with the milky film over their eye... it’s unusual to see this condition in younger people. (THANKS GENETICS) Luckily I had a great Ophthalmologist as a child and had surgery in Elementary School that helped me see like a “normal person”.

I was also born nearsighted/severely myopic, meaning I can’t see anything real well unless it’s a foot away from my face and my eyes are basically egg or football shaped instead of round. (Once again, YAY genetics!)

Since my eyes are elongated, I’ve always been at risk for retinal detachment. I’ve been limited my whole life in fear of losing my eyesight... No contact sports because a hit to my head could make me go blind. No contacts after my surgeries as a child because I might get an infection and go blind, etc. I have a lot of scar tissue from the surgeries and stretching of my eyes over the years.

How did I lose the sight in my right eye?

Mid-November I was working at a call center and realized one day that my vision was WAY worst than normal. I was seeing what appeared to be black ash constantly falling across my vision and weird tentacle-like floaters constantly stretching in and out of my vision. I left work early to and took a cab to a local Ophthalmologist because I couldn’t see good enough to feel safe driving. I found out at the appointment that I had (as I understood, this is what I was told) a vitreous hemorrhage due to a burst blood vessel behind my eye, which means that the blood had leaked into my eyes. Also, because of (or in addition to, they couldn’t say for sure) I had other fluid leaking into my eye. I was told to take it easy for a few days. Below is an example of a vitreous hemorrhage (sorry I couldn’t find a bigger picture):

Thanksgiving was a few days later so I ended up taking an entire week off of work and 90% of the problem had gone away. During that time, I ended up with the worst migraine of my life and ended up in the hospital sick as a dog. We aren’t sure if the two were related but it was scary. Luckily, It only took a few days to recover from that. Relieved, I went back to work for a while. I ended up quitting my job because the stress of everything was too much. I started the job search and went cleaning crazy on the apartment.

December came around and I still didn’t have a job but was receiving my last few paychecks from my previous jobs. On the 19th, I had an appointment with the Ophthalmologist that I had to cancel because I didn’t have the fund since I was going to be visiting family in Mississippi. On the 18th I’d noticed what I thought was some more fluid in the top right of my peripheral vision in my right eye and didn’t worry much because I figured it would go away on its own... and I thought it did.

Around the 22nd or 23rd I noticed the whole outside peripheral vision had started disappearing (it looked like a dark fluid was slowly creeping into my vision and every now and then I’d see what looked like bright glow worms scoot across the affected area) so I called the Ophthalmologist back home in Idaho and an appointment was made for January second.

By the 24th over a third of my vision was taken over by the dark liquid.

By the 26th I had half my vision. The fluid was forming into a backwards “C” so I could at least still see looking straight forward.

By the 28th, my flight back home to Idaho, I had less than a third of my vision.

On the 29th, the day that I was supposed to ride with my boyfriend’s brother and his fiancé to meet my boyfriend and his parents, I watched my vision completely disappear into the dark liquid in a series of a few hours. Everything had a weird, almost dark green-brown tint, I could no longer read, and the only things I could make out for sure was distorted lights. The fluid looked like bubbles constantly crashing around and little firecrackers constantly flickering about my vision.

By the 2nd, the day of my appointment, it was mostly darkness with a few lights here and there. Now I was experiencing tenderness to the touch and my eye felt real irritated. Needless to say, I was scared. But, still very hopeful.

THE APPOINTMENT *dun dun duuuuuunnnn!*

My boyfriend drove me to my appointment at 10:30 in the morning and I was feeling real hopeful. I’d done a lot of research online - which, by the way, is usually a terrible idea.... seriously... - and it seemed like everything I could possibly be faced with was curable to a certain extent. When the nurse first started checking my vision, she was surprised by my lack of sight. She literally stood in front of me with my left eye covered and waved her hand back and forth madly - which I couldn’t see - and quickly made some notes and went to get the doctor.

When the doctor arrived, I cheerily welcomed him with a “How nice to not see you again, Doctor!” (Boyfriend’s words. He’s the funny one.) No reaction. I was a bit disappointed. He did all sorts of tests, they took pictures of my eyes, and I was given a diagnosis:

1: Possible full retinal detachment.

2: The lens in my eye has come loose and there is possible cataract residue leftover from surgery. That may be why my eye is so tender and inflamed.

3: The pressure in my right eye reads at a startling 5 while my lift eye is an alarming 23. Normal eye pressure ranges from 12-22. They were a little more than concerned.

I was sent to a retina specialist two hours away in Boise the same day to discuss surgery. After they received my records and did tests of their own, they came up with the same diagnosis, plus option for surgeries.

Surgery options:

I require surgery to reattach my retina where they will inject an oil into my eye to push the retinal walls back to where they belong in hopes that it will reattach. While working on my retina, they will either stitch my loose lens into place or remove it completely, depending on what happens during surgery. Around the same time, possibly the same day, they want to use a laser in the retina of my left eye in hopes the same thing that happened in my right eye won’t happen to my left eye. That’s all I can remember for sure that the retinal specialist told me.

As for paying for the surgeries... well... My boyfriend and I were told I couldn’t have the surgeries until I had at least half of the money. The receptionist told us we would probably be responsible for around $1500 up front but we weren’t told for sure yet. The retinal specialist office reached out to an affiliate to see if they can help get me financial assistance and we are supposed to hear back anywhere between next months to two months from now. They also sent my records to another organization in Salt Lake that can hopefully offer me financial assistance as well as do the surgeries.

What now?

Honestly, we are overwhelmed. It’s a mad dash to find funding through local organizations, find work if possible, and reconsider going back to school this semester like I originally planned. If I don’t return to school, I’ve got to file an extension for my student loans, if I can’t work then I can’t pay for medical costs, every healthcare application is like a million pages long, and its difficult to read... BUT I will make it! I have an amazing support system and know that God is going to take care of me. I know He doesn’t put us through anything we can’t handle and i keep that in mind. There have been times in my past that I didn’t see how I would get through the hardships mentally and emotionally yet somehow I’m here! My faith, my friends and family, and my loyal pooch and ESA (Emotional Support Animal) have helped me through everything.

Final Notes:

I started a GoFundMe page after several friends suggested doing so. I set the goal for $1500 until we know for sure how much will need to be raised. Maybe that is how you found this blog, maybe you came here from Facebook. Either way, just reading this is helpful for me because writing is therapeutic. Know that if you are friend or family, I love you and you keep me strong. If you don’t know me, then let’s become acquainted! Don’t hesitate to reach out to me!

I need to say a huge thank you to so many people already!

To all my donors on my GoFundMe page:

R B

Ethan Richards

Courtland Pearson

Victoria Greenwood

Aimee Walters

Natalie Moseley

Kacey Croney

Anonymous A

Darian Merritt

Vu Nguyen

Karen Horsley

Cameron Moesta

Claire Hautot

You’re all an incredible blessing!

#blind #hopeful #blessed #eyesight #eyes

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investmart007 · 6 years

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TRENTON, N.J. | US hospitals grapple with prolonged injected opioid shortage

New Post has been published on https://is.gd/OHfDoV

TRENTON, N.J. | US hospitals grapple with prolonged injected opioid shortage

TRENTON, N.J. — There is another opioid crisis happening in the U.S., and it has nothing to do with the overdose epidemic: Hospitals are frequently running out of widely used injected painkillers.

Manufacturing shortages are forcing many doctors and pharmacists to sometimes ration injected opioids, reserving them for the patients suffering most. Other patients get slower-acting or less effective pain pills, alternatives with more side effects or even sedation.

Medical groups are urging regulators to help, saying some people having surgery, fighting cancer or suffering with severe burns are getting inadequate pain control. They also say shortages frequently cause medication switches that could lead to deadly mistakes.

Earlier this month, the American Medical Association declared drug shortages a public health crisis, saying it will urge federal agencies to examine the problem as a national security threat and perhaps designate medicine factories as critical infrastructure.

Injected opioid shortages have happened before, in 2001 and 2010, but they weren’t as acute and long-lived, experts say. This one started almost a year ago and is expected to last into next year.

“It’s definitely the most severe I’ve seen in tracking drug shortages for 17 years,” says Erin Fox, a University of Utah Hospitals pharmacist. She tracks national medicine shortages and recalls two patients dying due to medication errors during the 2010 shortage.

Such shortages steal time from patient care, increase hospitals’ costs and affect just about every department, including operating rooms, emergency departments and cancer clinics. Doctors occasionally find opioids missing from emergency carts and surgery supply trays, “borrowed” by colleagues needing them for other patients.

The shortages started hitting hospitals last summer, after the Food and Drug Administration found sterility and other serious problems at a Pfizer factory in Kansas. The company, which makes 60 percent of the country’s injected opioids, had to slash production to fix the problems.

By January, shortages were so bad hospitals started creating teams to manage their supplies, said Michael Ganio, director of pharmacy practice at the 45,000-member American Society of Health-System Pharmacists.

The group’s April survey of 343 hospital pharmacists found 98 percent had dealt with moderate or severe shortages of the key opioids for treating serious pain: morphine, fentanyl and hydromorphone, better known as Dilaudid. Many hospitals were completely out of at least one.

Shortages of generic injected drugs have become normal. Profit margins are tiny, so only a handful of companies make them, and none can dramatically increase production when a rival stops manufacturing.

With the opioid shortages lingering, hospitals and medical groups have set guidelines for stretching supply, including transferring injected painkillers from large vials into several smaller ones or syringes.

Some worry such workarounds invite mistakes.

Michael Cohen, president of the Institute for Safe Medication Practices, an independent group that compiles voluntary error reports, says mix-ups also occur when nurses or pharmacists substitute unfamiliar painkillers or ones with different concentrations than normal.

Cohen recently received several reports of surgical patients who stopped breathing. Some had overdosed when fentanyl wasn’t available and they were mistakenly given the same amount of much stronger sufentanil. Those patients were saved.

Hospitals also are grappling with shortages of regional anesthesia — local injections of lidocaine, bupivacaine and a third painkiller standard for eye surgery, orthopedic procedures and knee and hip replacements.

Dr. Ruth Landau, director of obstetric anesthesia at Columbia University Medical Center in New York, says maternity wards for months have faced a critical shortage of the fast-acting version of bupivacaine.

That’s risky because if a woman in labor starts bleeding or her baby isn’t getting enough oxygen, obstetricians must perform an emergency cesarean. Anesthesiologists sometimes have had to use a slower-acting bupivacaine version, which may delay delivery and could harm mother or baby.

“We’re playing with fire,” worries Landau, a vice president of the Society for Obstetric Anesthesia and Perinatology.

In the emergency department at Massachusetts General Hospital in Boston, Dr. Ali Raja recently had an appendicitis patient who needed intravenous morphine or low-dose Dilaudid. Instead, he had to resort to fentanyl, which wears off quickly, so additional doses were needed frequently.

“He was lucky. The nurses were free to do it, and so he wasn’t in more pain,” Raja recalls.

He tells patients he’ll try pain pills first and switch to IV medication if they don’t work, but “by then, the patient has had pain for longer.”

That’s not an option for the many hospital patients who are sedated, intubated, vomiting or too frail to swallow pills. And because pills can take 45 minutes to start working, they’re a poor choice for patients with broken bones, internal infections and stabbing or gunshot wounds.

Often, patients need a slightly higher opioid dose than one vial holds, but opening a second vial requires discarding the unused portion to avoid contamination.

“Having to choose between underdosing the patient or not having a medication to treat another patient later that day is incredibly frustrating,” Raja says.

At MD Anderson Cancer Center in Houston, palliative care specialist Dr. Ishwaria Subbiah now devotes extra time to choosing painkillers as availability changes. She says already-distressed advanced cancer patients need reassurance when she is forced to take them off a scarce injected painkiller that was working.

“Cancer pain can be absolutely excruciating, more than what a pill can manage,” Subbiah notes.

At Salt Lake City-based Intermountain Health Care, outpatient surgery facilities and cancer clinics are as affected as acute-care departments, and which painkillers are scarcest varies constantly, says chief pharmacy officer Sabrina Cole.

Valerie Jensen, FDA’s head of drug shortages, says the shortages triggered by Pfizer’s problems may ease slightly in the next few months.

The three much-smaller makers of injected opioids — Fresenius Kabi, West Ward and Akorn — have begun making more. They’re putting factory workers on overtime, adding more shifts and switching some manufacturing lines from less-crucial medicines to injected opioids.

The FDA has been expediting approvals those companies need to make more opioids, including allowing new product formulations.

The agency also let Pfizer distribute some glass syringes prefilled with opioids that were held back because of possible particle contamination and cracks in stoppers. Hospital pharmacists have to examine each syringe closely and then filter the contents in a complex, multi-step process.

Meanwhile, Pfizer Inc. doesn’t expect to have most of its injectable opioids back in full supply until the first quarter of 2019, says John Kelly, the firm’s head of manufacturing quality.

The New York-based company acquired the McPherson, Kansas, factory when it bought the drugmaker Hospira in 2015. To fix the plant’s troubles, Pfizer decided to replace production lines and other technology, particularly huge equipment-sterilizing machines called autoclaves that can take two years to build, install and test. It’s spent more than $300 million so far.

Planned shutdowns last summer to start upgrades took longer than expected, FDA inspectors found other problems that needed fixing, and product demand rose, triggering shortages, says Kelly. He says production now is increasing somewhat each week.

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The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

By LINDA A. JOHNSON, AP Medical Writer, By Associated Press

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#doctors and pharmacists #grapple with prolonged injected opioid shortage #TodayNews #trenton #US hospitals

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