Spotlight on Men’s Health: LOVEstrong 51 Foundation

The mission of Men’s Health Month is to raise awareness of preventable health problems and encourage early detection and treatment of disease among men and boys. Men’s Health Month gives us an opportunity to encourage men and boys to seek regular medical care. Men’s Health Month is celebrated across the world with screenings, health fairs, media appearances, and other health education activities. Today, we’re celebrating MHM by putting a spotlight on the LOVEstrong 51 Foundation.

LOVEstrong 51 was created by former Frostburg State University lacrosse player and testicular cancer survivor Spenser Love. In the summer of 2015, Spenser was anxiously awaiting his 21st birthday and preparing for his senior year of college and lacrosse at Frostburg. His plans seemed to be shaken when he felt a pea-sized lump on the side of his testicle. After initially brushing off his discovery, Spenser woke up in the middle of the night and took to the internet. Could it be what he thought it was? Testicular cancer doesn’t happen this young, right? As Spenser found, testicular cancer is one of the most common cancers in men ages 15 to 24 years old.

Starting the conversation about cancer can be gut-wrenching and uncomfortable. Spenser first went to his girlfriend Sydney who pushed back with questions about whether he had told anyone else or scheduled any appointments. Spenser had not; he planned to wait and see if it got bigger before deciding to see a doctor. Unsatisfied with Spenser’s plan, Sydney refused to talk to him until he told his family and scheduled a check-up. A move that was difficult but could have saved Spenser’s life. During a conversation with his dad and a sibling, Spenser finally spoke up through a nervous, cracking voice… “I think I have testicular cancer.”

Without wasting any time, Spenser’s dad set up an appointment for him to see his primary care provider who then sent him to see a urologist that same day. Four days later, Spenser’s urologist performed surgery to remove and biopsy the mass. After about a week of recovery and anxiously awaiting the biopsy results, Spenser heard from his doctor. It was testicular cancer… 100% embryonal cancer. There is little worse in this world than the moment your greatest fear is realized. Where to go from here? Spenser never stood down from a challenge before, and this would be no different. Setting up a plan of attack was the only step forward.

Spenser found an oncologist at Johns Hopkins Hospital, and they planned to perform two rounds of platinum-based chemotherapy. Chemo felt so scary to Spenser; more thoughts of being too young for this filled his head. So many preconceived notions about chemotherapy made the idea even more terrifying. Losing his hair, and fighting through nausea turned the next few months into a fight for the last day of treatment. Spenser says “I was throwing up throughout the day, it basically felt like I had the flu for about two months straight.” The love and support Spenser received from his family, friends and the Hopkins staff made the experience as tolerable as possible.

Now, almost three years cancer-free Spenser is sharing his story to increase testicular cancer awareness.  If diagnosed early, the survival rate is nearly 100% which highlights the importance of early identification and treatment. He reminds us that “the conversation may be uncomfortable, but it is worth it.” Spenser Love created the non-profit organization, LOVEstrong 51, to inform those directly involved with young men– coaches. His organization’s mission is to educate coaches so they can teach their players and make discussing testicular cancer more comfortable.

Most boys and young men (ages 15-35) don’t realize they are at-risk for testicular cancer and need to be taught to regularly perform testicular self-exams (TSE). Ninety percent of the time, testicular cancer is painless so feeling for any lumps, enlargement, or hardening of the testicles is is vital. Don’t wait for the pain because it may be too late. Spenser’s story teaches us that testicular cancer is a game changer and early intervention saves lives.

To help support Spenser’s mission and the LOVEstrong 51 Foundation, share his story and then take a moment to visit their website and purchase one of their awesome LOVEstrong t-shirts!

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Money Advice for New Nurses

As healthcare professionals, we tend to focus on physical and mental well-being, forgetting another essential type of health– financial health! As a new nurse, one of the greatest things I learned is how to set myself up for the future by making smart money decisions. Now, as you begin your journey into the field of nursing, I’m here to pass on a few of the most important pieces of advice so future you will look back and thank twenty-something you.

Start Investing For Retirement

I know you’re just getting started and retirement is a literal lifetime away, but what you do now will have an incredible impact on your life in 30 or 40 years. The simplest way to start investing is in your employer’s retirement plan, whether it be a 401(k), 403(b), Roth IRA, etc. These retirement plans automatically deduct and invest your contribution with each paycheck into various funds. Over time, your investments may gain and lose money, but historically the stock market has always recovered from slumps to reach new highs (see below).

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Its never too early to start contributing to your retirement because the earlier you start out, the more your money will work for you. That’s right, your money will work for you! Albert Einstein once said “compound interest is the eighth wonder of the world. He who understands it, earns it… he who doesn’t… pays it.” Compound interest allows you to not just make money on your initial investment, but also the interest it gains. It enables your wealth to snowball over time and makes it easier for you to reach your financial goals. Keeping all of your money in a savings account to gain 0.25% or less is just not enough to survive on in retirement.

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This chart shows how much money you can accumulate over time if you invest $250 a month starting at age 25, 35, and 45 (assuming an 8% return). Notice the difference time can make!

So how much should you be saving? Investopedia interviewed a number of financial advisors across the country and found that the recommended contribution rate is at least 10% to 15%. The most important thing is to at least contribute enough to take full advantage of your employer’s contribution match. The employer match may vary across institutions, but let’s say your employer will match a 4% contribution. You only need to contribute 4% of your pay for them to add an additional 4% for free.

Avoid the Post-Grad Spending Spree

It’s inevitable. You and your friends will graduate, begin earning a real income, and you will see many of them buy big-ticket items like a new 4-door Jeep Wrangler or an entry-level luxury car. Just wait for the posts on social media… This is known as rapid lifestyle inflation. In other words, as our income improves, we spend more on things we may not necessarily need– a brand new car or a pricey apartment, for example. There are many expenses you will incur as a new-grad nurse without making it more difficult for yourself. You may have to pay for new scrubs, a stethoscope, and other supplies while also covering rent, utilities, commuting expenses, etc.

Instead of blowing your first few paychecks immediately, resist splurging and spread out your purchases so you can build up emergency savings. Most financial advisers will say your emergency fund should cover at least three to six months worth of expenses, but financial expert Suze Orman insists an emergency fund should cover close to a year of living costs. Yes, this is a lot of money and will take you time to accomplish, but that’s the point! You need to be serious about monitoring your habits and keep track of your income and expenses to achieve financial security.

In his book “How to be Richer, Smarter and Better Looking than Your Parents,” Zac Bissonnette details common mistakes and misconceptions when buying a car:

  • Buying a used car these days not mean driving a vehicle with 100,000 miles and severe maintenance issues
  • Used cars are not only cheap but safe to drive too
  • Buying a used car for just a couple thousand dollars in cash will save you from the depreciation of a new car the moment you drive it off the lot
  • You likely won’t need theft or collision insurance because thieves are less likely to steal older cars

So, avoid the brand new car and do some research to find a reliable, used car you can pay for in cash. It may be tempting to finance a vehicle and stretch out the loan to keep your monthly payments low, but you will end up paying much more than the value of your car by the time it is paid off! Bottom line: if you do not need a new car, save yourself the money and get as much as you can out of what you have or take public transportation.

Now that I covered the basics, here are a few more tips I’ve learned over the past few years that can help you accomplish your financial goals:

  • Paying off your student loans should be your number one priority! Make the minimum payment on loans with the lowest interest rate and pay extra on loans with higher interest rates.
  • Don’t rely on credit cards to get by. Use credit cards to help build a good credit score by paying off the card before interest is applied each month. If you’re close to or are maxing out your credit card, you’re living outside your means and need to review your budget.
  • Invest in yourself. Whether it be graduate school, advanced certifications, or conferences, make a continued effort to improve your worth. Pursuing further education will increase your earning power and open up opportunities for advancement. If your employer offers continuing education and tuition assistance, take advantage of that valuable benefit!

The First Job Checklist for New-Grad Nurses

Your first job as a new grad nurse can be many things… eye-opening, exciting, humbling, or just terrifying! We all come from different backgrounds and with different experiences that contribute to how our first nursing job will go. One thing I learned through my nurse residency is that whether you start out on a med-surg unit, in the ED, or an ICU, we all have the same feelings as we navigate through our first year as new nurses So here are five tips that I put together from my experience as a new grad nurse to help make your transition as smooth as possible!

1. Talk with your preceptor

Your preceptor should take it upon themselves to reach out to you, but not all will do this. If you haven’t talked with your preceptor yet, get their contact info from your unit’s nurse manager or educator. Send them an e-mail or text letting them know who you are and that you’re looking forward to working with them. Make sure you have each other’s phone numbers in case you need to communicate more quickly than what e-mail allows. This is a great way to start off your professional relationship and shows initiative. They’re going to be the one leading you through the madness as you learn the ropes, so the earlier you get to know each other the better!

2. Hit the books

Hopefully, you didn’t sell all your textbooks because it might be time to break them out again! Before I began my first job as a cardiac surgery nurse, I spent some time each day on anatomy and physiology and meds. Your work should eventually provide you with educational materials for whatever specialty area you choose, but getting a head start is smart. Just remember, you will not know everything before you start your first job nor are you expected to! You might want to search for any textbooks specific to your area so you can keep it as a resource even after you start. For any other cardiac nurses out there, I recommend the Manual for Perioperative Care in Adult Cardiac Surgery by Robert M. Bojar (this is my bible).

3. Don’t get lost

If you work in a big hospital, it can get confusing at times. After one year at my job, I still wasn’t sure how to get everywhere in the building. To be fair, the EP lab is about half a mile away… You’ll visit your unit before starting, but just make sure you remember the route, so you aren’t lost on your first day of work. This is also where contacting your preceptor ahead of time can come in handy! Meet up with them before starting your first shift or just send them a quick message if you get lost.

4. Get your routine down 

You’ll need to have your routine down in the morning (evening, for you night-shifters) so you can get in on time. Think about how long it takes you to get up and out the door, the route you’ll take, the traffic you’ll hit, where you’ll park, and the walk from your car to the unit. Having your uniform, supplies, and lunch ready to go the night before can help save a lot of time in the morning. Also, be aware of any busy events near your work. I hit traffic coming into Baltimore when the Orioles or Ravens have home games, so I always keep an eye on their schedule. If you’re in a similar situation, print out the schedule so you’ll remember to leave early.

5. Understand that you will make mistakes

I’m sure you’ve heard this plenty, but guess what… no one’s perfect! You’re going to mess up, maybe look plain stupid, but don’t get down on yourself because it’s all a part of becoming a good nurse. Don’t let fear or anxiety of making a mistake hold you back or shake your confidence! Reading up on what not to do can’t hurt either… 9 Mistakes To Avoid as a New Nurse

If you’re starting soon as a new nurse, good luck and know that it will continue to get easier. You are a badass nurse in the making and don’t ever forget it!

Cardiac Rhythm Series: Second Degree AV Block, Mobitz Type I

Click here to review First Degree AV block before reading this post.

In a Mobitz I (Wenckebach) block, the PR interval becomes progressively longer with each cardiac cycle until a P-wave appears with no QRS to match1, 2. This occurs when the cardiac conduction system delays or blocks an atrial impulse traveling through the AV node and/or bundle of His3. If you look closely at an ECG, you will see the atrial rhythm (P-P interval) is regular but the ventricular rhythm (R-R interval) is irregular2. The P-wave is not moving, but the QRS complex is.

Mobitz I

Characteristics: PR interval progressively widens until a QRS is ‘dropped’; QRS less than 0.12 seconds; regular atrial rhythm but the ventricular rhythm is irregular.

Wenckebach has many possible causes:

  • Cardiac surgery: AV node conduction is affected in approximately 25% of CABG patients1.
  • Digitalis toxicity: Digoxin increase the refractory time of the AV node which slows conduction.
  • Myocardial ischemia/infarction: The AV node is perfused by the right coronary artery in 90% of individuals and the left circumflex coronary artery in the remaining 10%2.

“Longer, longer, longer, DROP– now you have a Wenckebach”

Treatment is not usually required unless the ventricular rate is slow1. Atropine or chronotrope infusion (dopamine or epinephrine) may be administered if cardiac output is inadequate2. The patient may experience symptoms related to decreased cardiac output– lightheadedness, dizziness, or syncope2. If symptomatic, AV pacing (DVI mode) at a slightly faster rate is recommended. If the atrial rate is too fast to overdrive, it can be treated by pacing in DDD mode1.

  1. Bojar, R. M. (2016). Manual of perioperative care in adult cardiac surgery (5th ed.). West Sussex, UK: Wiley-Blackwell
  2. University of Maryland Medical Center Office of Clinical Practice and Professional Development. (2014). Introduction to cardiac rhythm interpretation (6th ed.).
  3. https://emedicine.medscape.com/article/161919-overview

The Great Pumpkin (Seed)

Halloween is one of the most underrated holidays out there. It has it all- fall weather, parties, scary movies, haunted houses, candy. Oh and I forgot one thing… pumpkin! Whether you carve your pumpkins or keep them intact as porch decorations (what are you, a monster?), don’t let those seeds go to waste.

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Pumpkin seeds may have more uses than you realize. They can be baked in the oven, used to top salads, or used in homemade granola with nuts and dried fruit. You can even make your own pumpkin seed butter by blending raw pumpkin seeds in a food processor!

In addition to tasting great, pumpkin seeds have some amazing health benefits! Pumpkin seeds are a good source of fiber with 5 grams in a single one ounce serving. Fiber helps lower the total amount of cholesterol in the blood, decrease the risk of heart disease, and promote good digestive health. Pumpkin seeds are also a good source of antioxidants, magnesium, zinc and fatty acids which help keep the heart healthy by lowering bad cholesterol and high blood pressure and decreasing risk for thrombosis, atherosclerosis, and arrhythmias.

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You can choose many different options for how to prepare your pumpkin seeds, but my favorite is simply baking them with olive oil. If you want to spice things up a little (pun intended), here are a few other ways you can season your seeds.

The steps are really simple, so let’s get started:

  1. After removing the seeds from your pumpkin, rinse them to remove the pulp and strings.
  2. Spread the seeds out on a baking sheet and drizzle a small amount of olive oil over seeds.
  3. Bake at 325°F for about 30 minutes or until lightly toasted.
  4. Stir occasionally during cooking to cook thoroughly and prevent burning.

 

Let me know below about your your favorite pumpkin/seed recipe! When I was little, we would bowl our old pumpkins down our back yard to see who could make theirs roll the furthest- not to brag, but I am the reigning “Pumpkin Bowling” champion…

Fall isn’t over yet- click here for 5 great activities to keep moving this season!

The Future Healthcare Landscape

The future of healthcare is constantly being assessed with an eye on trends in economics, politics, labor, and society in general. It is essential to forecast the environment we will operate in the next several decades so that we are prepared to face new challenges.

Think about nurses who are nearing the end of their career… What the field of medicine and its challenges were 30 or 40 years ago compared to now. The technology they had at their disposal at the beginning of their career versus the end. We will have the same experience of change. If you’re newer in nursing or medicine with the bulk of your career ahead of you, these are a few trends that you are likely to see:

Image result for back to the future gif, serious shit

  1. Change in caregiver ratio. In 2010, the ratio of caregivers to patients was 7:1. As “Baby Boomers” age and retire, there will be a growing number of Americans in need of health care. Patients will be living longer and the number of American with chronic conditions is expected to sky-rocket. The growth of this group is expected to outgrow the healthcare workforce. By 2030, the ratio is expected to drop to 4:1 and by 2050, even lower to 3:1.
  2. Medicare is at risk. We Americans sure hate socialist healthcare systems, unless its Medicare or any other system already established in the U.S. (okay, I’ll leave the politics for another day). Unfortunately, this system that over 50 million Americans rely on is at jeopardy. This also has a lot to due with the aging of older generations. The working Americans contributing to Medicare is expected to grow more slowly than the elderly population using the funding. This means more health care to be paid for with less money. It will be more important than ever to improve the efficiency and outcomes of our healthcare system!
  3. Demographic shift. By 2050, the Latino population is expected to make up 29% of the U.S. population. In comparison, the 2010 U.S. Census reported 16.3% of the population was Latino or Hispanic. A 13% jump would even further solidify this group as the largest minority in the U.S. So, why does this matter? As the consumers of healthcare change, so must our strategy to provide patient-centered care. This means incorporating more alternative medicine, overcoming language barriers, accompanying family and cultural values, food preferences, and religious beliefs. In addition, our workforce will likely become more diverse which will be a strength as the client-base changes.

There are a number of other trends and innovations to be expected in healthcare- just look up some of the advancements being made with robotics and 3D printing. Nurses and physicians will continue to improve the application of evidence-based practices and make patient-care even more customized. What do you think about the future of healthcare? Let me know in the comments below!