Happy Holidays

Happy Holidays
Merry Christmas

I worked last night myself
but off today

Arrogant Doctors

Arrogant Doctors, or so people believe.

I have never been nor will I be insensitive to the competent, hard work others do.

If only others would do the same.

I have been working part time as an RN until the Match this year. Most know I'm also an MD.

Some at first are apprehensive but as they get to know me they calm down and realize I don't care about titles as much as Patient care issues.

Some people it would not matter anyway. If you are sitting in a seat they think is theirs they let you know how displease they are. If you are, in this case, the only RN with clerks and LPN's you still get ignored by major issues even though you are responsible for what happens.

Yes arrogance comes from anyone, self importance is, well a sin when it affects patient care.

My feelings are not important compared to patient care issues.

Are some "Angles of Mercy" petty? Work in medicine awhile and you will find out.

Ok Twitter Time

Yes I have had a Twitter Account for awhile but have not used it much, maybe I will more.

When I'm not working ( we cannot carry any electronics where I'm working part time ) I will tweet and check twitter.

If interested

mine

@DRFP1

No activity this week, still just relaxing and working after Step 2 CS, no news on the Match for me, still in the game.

I may have to scramble this coming year :(

Have a Safe Holiday all.............

Mold, not all is Toxic

As I watch home renovation show after home renovation show then do internet searches I can see the widely held belief that all mold is toxic and dangerous in a home. It is fueled by junk and bad science and blogs that ramble on with nonsense at times.

As we study and become physicians it is our duty to teach people about good science and how a real study is done to prove claims.

The source, The CDC has studies about house molds and if they are toxic or not.

CDC

Linking to blog is ok but the proof is trusted sources.

What the CDC says:

I heard about "toxic molds" that grow in homes and other buildings. Should I be concerned about a serious health risk to me and my family?

The term "toxic mold" is not accurate. While certain molds are toxigenic, meaning they can produce toxins (specifically mycotoxins), the molds themselves are not toxic, or poisonous. Hazards presented by molds that may produce mycotoxins should be considered the same as other common molds which can grow in your house. There is always a little mold everywhere - in the air and on many surfaces. There are very few reports that toxigenic molds found inside homes can cause unique or rare health conditions such as pulmonary hemorrhage or memory loss. These case reports are rare, and a causal link between the presence of the toxigenic mold and these conditions has not been proven.

In 2004 the Institute of Medicine (IOM) found there was sufficient evidence to link indoor exposure to mold with upper respiratory tract symptoms, cough, and wheeze in otherwise healthy people; with asthma symptoms in people with asthma; and with hypersensitivity pneumonitis in individuals susceptible to that immune-mediated condition. The IOM also found limited or suggestive evidence linking indoor mold exposure and respiratory illness in otherwise healthy children. In 2009, the World Health Organization issued additional guidance, the WHO Guidelines for Indoor Air Quality: Dampness and Mould [PDF, 2.52 MB].

A common-sense approach should be used for any mold contamination existing inside buildings and homes. The common health concerns from molds include hay fever-like allergic symptoms. Certain individuals with chronic respiratory disease (chronic obstructive pulmonary disorder, asthma) may experience difficulty breathing. Individuals with immune suppression may be at increased risk for infection from molds. If you or your family members have these conditions, a qualified medical clinician should be consulted for diagnosis and treatment. For the most part, one should take routine measures to prevent mold growth in the home.

What are the potential health effects of mold in buildings and homes?

Mold exposure does not always present a health problem indoors. However some people are sensitive to molds. These people may experience symptoms such as nasal stuffiness, eye irritation, wheezing, or skin irritation when exposed to molds. Some people may have more severe reactions to molds. Severe reactions may occur among workers exposed to large amounts of molds in occupational settings, such as farmers working around moldy hay. Severe reactions may include fever and shortness of breath. Immunocompromised persons and persons with chronic lung diseases like COPD are at increased risk for opportunistic infections and may develop fungal infections in their lungs.

In 2004 the Institute of Medicine (IOM) found there was sufficient evidence to link indoor exposure to mold with upper respiratory tract symptoms, cough, and wheeze in otherwise healthy people; with asthma symptoms in people with asthma; and with hypersensitivity pneumonitis in individuals susceptible to that immune-mediated condition. The IOM also found limited or suggestive evidence linking indoor mold exposure and respiratory illness in otherwise healthy children.

How do you get the molds out of buildings, including homes, schools, and places of employment?

In most cases mold can be removed from hard surfaces by a thorough cleaning with commercial products, soap and water, or a bleach solution of no more than 1 cup of bleach in 1 gallon of water. Absorbent or porous materials like ceiling tiles, drywall, and carpet may have to be thrown away if they become moldy. If you have an extensive amount of mold and you do not think you can manage the cleanup on your own, you may want to contact a professional who has experience in cleaning mold in buildings and homes. It is important to properly clean and dry the area as you can still have an allergic reaction to parts of the dead mold and mold contamination may recur if there is still a source of moisture.

If you choose to use bleach to clean up mold:

• Never mix bleach with ammonia or other household cleaners. Mixing bleach with ammonia or other cleaning products will produce dangerous, toxic fumes.
• Open windows and doors to provide fresh air.
• Wear non-porous gloves and protective eye wear.
• If the area to be cleaned is more than 10 square feet, consult the U.S. Environmental Protection Agency (EPA) guide titled Mold Remediation in Schools and Commercial Buildings. Although focused on schools and commercial buildings, this document also applies to other building types. You can get it by going to the EPA web site at http://www.epa.gov/mold/mold_remediation.html.
• Always follow the manufacturer’s instructions when using bleach or any other cleaning product.

For more information click on the link above.

Of course if you are truly worried about Mold and health issues and feel you need the experts to evaluate the mold and remove, then do it, but you can take care of it yourself and save thousands.

Stay healthy. Dr. Bill

Took CS yesterday.............OMG

CS is a mess, it just rattles me too much,
I was almost 95% in practice, but in a situation you are monitored and taped and passing is your life.....................I screw up due to anxiety

I messed up 3 cases by not asking meds and allergies

I have no idea how it will be scored so if I get enough points during the exam I know I pass

I finished all cases
during the 15 min and the 10 min note
Focused on asking questions ( still screwed up)

If I pass I will post how I came up with the method

till then I will chill and enjoy the Holidays

Later all