Science and Suffering: My Two Months Battling the Aliens

By Ronald Pies, MD, professor of psychiatry and lecturer on bioethics and humanities, SUNY Upstate Medical University, Syracuse, New York; clinical professor of psychiatry, Tufts University School of Medicine, Boston; editor-in-chief emeritus of Psychiatric Times. Dr. Pies is also the author, most recently of, The Three-Petaled Rose, an exploration of the synthesis of Judaism, Buddhism, and Stoicism (iUniverse).

Doyle Alphabet by fdecomite, via Flickr Doyle Alphabet by fdecomite, via Flickr

It all started suddenly: weird, creeping sensations in my forehead and between my eyes, especially when I lay on my back or bent my head forward. The expression “my skin is crawling” quickly came to mind. Over the next few days, I began to experience intense pressure in my forehead and a weird sensation on the bridge of my nose—as if a large clothespin had been clipped onto it. Within a few days, it felt like someone had poured a sack of concrete into my head.

My self-diagnosis was sinusitis—a term that covers many etiologies. But most cases of sinusitis begin with head or facial pain and nasal discharge—not the strange sensations my wife and I soon started calling “the aliens.”

Nevertheless, I began an aggressive self-treatment program: decongestants, aspirin, and something called a Neti pot—an ancient form of nasal irrigation using a […]

2018-03-27T16:37:04-04:00June 12th, 2013|Nursing|3 Comments
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How Perioperative Medication Withholding Affects Patients with Parkinson’s Disease

By Sylvia Foley, AJN senior editor

The timing of antiparkinson medications has pro­found implications for motor and cognitive function.… If perioperative surgical staff aren’t sufficiently aware of the importance of minimizing disruptions to patients’ antiparkinson medication regimens, prolonged medi­cation withholding of several hours’ duration can occur. And patients with Parkinson’s disease whose doses are delayed may deteriorate quickly.

In January and again this month, we bring you a pair of CE–Original Research articles that describe the findings of two companion studies on how perioperative medication withholding affects patients with Parkinson’s disease. Here’s a short summary.

The quantitative study—what the EHRs said. The first article, “Perioperative Medication Withholding in Patients with Parkinson’s Disease,” discusses the results of a retrospective review by Kathleen Fagerlund and colleagues. The authors reviewed the electronic health records (EHRs) of 67 surgical patients who had undergone 89 surgeries unrelated to Parkinson’s disease. They looked at the duration of perioperative withholding of carbidopa-levodopa (Sinemet)—the gold standard treatment for Parkinson’s disease, it has a short half-life of just one to two hours—and at symptom exacerbations.

What they found was that medication withholding tended to be prolonged. The median duration of withholding for 32 inpatient and 57 outpatient procedures was more than 16 hours and more than 11 hours, respectively. They also found that for 56% of the inpatient procedures, the patient’s EHR contained a note referencing Parkinson’s disease symptoms or symptom management, which included increased agitation or confusion, increased tremors, and symptom management complicated by pain or pain medications. (Because outpatient EHRs contained […]

2017-07-27T14:51:56-04:00February 4th, 2013|nursing research|1 Comment
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Giving Noise a Red Light

By Marcy Phipps, RN, whose essay, “The Soul on the Head of a Pin,” was published in the May 2010 issue of AJN. She’s a frequent writer  for this blog.

This stoplight noise meter showed up at the nurse’s station last week.

I have to admit—we didn’t take it too seriously, at first.

It looks like something you could buy in a novelty shop, shelved next to lava lamps and strobe lights. And it’s modifiable; buttons and dials on the back of the gadget allow not only for sensitivity adjustments, but also give the option of changing the type of alarm that sounds when a noise infraction is detected. The default alarm warning is a soft-spoken, female “quiet, please!” that can be translated into Spanish, French, or German—but there’s also an option for a shrill siren, which seems ridiculous, considering that much of the cacophony of critical care is owed to noisy alarms and ringing phones.

We even discovered how to record our own admonishments (which opened the door to countless mischievous possibilities . . . not that we’d indulge in that sort of thing, of course).

In seriousness, noise reduction is vital to promoting a healing environment. In a recent article in Critical Care Nurse, the links between sleep deprivation and altered physiologic processes specific to the critical care population are reviewed. Noise reduction guidelines and recommendations from both […]

2016-11-21T13:12:28-05:00July 8th, 2011|Nursing, nursing perspective, patient experience|2 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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