RATS NEST formed

We're infested with rats.  I'm not talking about those little, nasty critters, but Respiratory Therapy Apathy Syndrome (RATS).  It's a disorder recently diagnosed by the newly formed Respiratory Therapy Apathy Syndrome Nebulizer Society (RATS NEST).

RATS NEST was formed by Mike Olin, a recently retired respiratory therapist out of Los Angeles California.  Olin informed the RT Cave that "I started feeling awkward, apathetic and passive in a way, toward my profession.  I loved my job, yet something was amiss."

Yet, he continued, "After a long discussion with my psychologist, I realized I wasn't burned out, and I wasn't depressed, what I had was RATS.  I was beyond burnout.  I had grown so tired of running around the hospital doing senseless procedures that even when I was doing something I loved about the job I was apathetic and passive."

He explained that before he retired he hired a research company with his own money to interview over 10,000 respiratory therapists around the world, and he learned that 80 percent of respiratory therapists with greater than 10 years experience had described RATS symptoms, such as sudden outbursts of anger, sore feet, grumbling loss of interest in working

A few days after he retired he formed the RATS NEST, a society of respiratory therapists infested with RATS.  The goal of the society is to "provide a place where respiratory therapists with like concerns can share their experiences and concerns and come up with a plan to improving RATS."

The main technique is to form committees, write articles, and hold seminars to help RTs cope with RATS and create techniques for improving conditions for RTs in hospitals, such as techniques and strategies to convince doctors and RT bosses and other RTs for the need for RT driven protocols. 

Olin said that so far he's the only member of the society to not remain anonymous and that's because he's retired and doesn't have to fear losing his job.  He said the main problem with RATS is "even infamous respiratory magazines like the RT Times refuse to acknowledge the existence of RATS. We're on our own here. We tend to lack the respect of other groups because most of our members choose to remain anonymous for fear of losing their jobs."

He says one of the next goals of the society is to create a blog and an online community for RTS infested with RATS and other RTS who love being an RT and want to create a better environment for RTS, improve patient care, reduce hospital costs and improve the inexplicable condition called RATS.

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Cancer Diseases Increasingly Threaten You

Cancer Disease more Threaten - Cancer has become the leading cause of death worldwide. The incidence rate and the greater the burden of cancer. Globally, cancer deaths exceeds the number of people with AIDS, malaria, and tuberculosis.

However, without any meaningful action to prevent premature death from cancer, the disease will continue to kill millions of people across the face of the earth. To stop the increase in deaths from cancer, needs urgent action from governments, individuals, and community health.

The World Cancer Congress to-21 in Shenzen, China, 18-21 August, which was held the International Union Against Cancer (UICC), UICC President David Hill said, the reduction of the global cancer epidemic has become one of the urgent global health priorities. Therefore, the global cancer community must continue to discuss and work together to promote the importance of prevention, screening, detection, and treatment and effective management.

Congress of the theme of prevention of preventable diseases, treat patients who can be treated, through a system of expectations into reality. This conference discusses cancer prevention, screening or screening, early detection, early treatment, and support for special treatment, hospital care, and other problems.

Based on data released by the International Agency for Research on Cancer, one of the agencies under the UN World Health Organization, global cancer patients reached 12.7 million people in 2008 and resulted in the death of 7.6 million people. In 2030 predicted there will be 21.4 million new cancer cases with 13.2 million deaths.

Cancer can continue to be a deadly disease, said Otis W. Brawley, because of the swift industrialization and the adoption of Western lifestyles. In addition, population growth and aging will also increase the cancer cases.

Patients with cancer in the world is lung cancer (12.7 percent), breast cancer (10.9 percent), and colon cancer (9.7 percent). As many as 58 percent of cancer cases occur in poor and developing countries as well as mortality reached 63 percent.

While the causes of cancer deaths globally is the highest lung cancer (18.2 percent), followed by stomach cancer, and liver cancer. If visible location, in developing countries more cases of cervical cancer and liver cancer. In developed countries the most dominant is prostate cancer and colon cancer.

When viewed by gender, based on data from the World Health Organization (WHO), among men, the highest mortality occurred in patients with lung cancer, stomach, liver, and colon. As for the cancer among women breast, lung, stomach, colon, and uterus.

Cancer Can be prevented

Hill said, is actually one-third of all cancer cases are preventable. Almost most or about 40 percent incidence of lifestyle factors caused cancer, infectious diseases, and environmental or work-related hazardous substances.

"That means the potential to prevent cancer. Necessary adaptation of global, national, and individuals to prove if these factors were addressed, cases and cancer deaths can be reduced, "said Hill.

In developing countries, triggering the high incidence of cancer is tobacco use, alcohol, eat less vegetables and fruits, as well as chronic infections of hepatitis B virus (HBV), hepatitis C virus (HCV), and some types of Human Papilloma Virus (HPV).

Prevention strategies by increasing avoidance on the factors above, vaccination against HPV and hepatitis B virus, control the intake of substances hazard, and reduce exposure to sunlight.

In controlling the increase of cancer in the world, according to Otis W. Bradley of the American Cancer Society, said the current message should be heavily echoed this is early detection saves lives.

Early detection can reduce the burden of one-third of cases of cancer if detected and treated early. Early detection of cancer based on the observation that treatment is more effective when cancer is detected early. The aim is to detect cancer when it is local (not spread).

Tobacco products

From a number of lifestyle factors that trigger the emergence of cancer, tobacco use could be one of the main factors preventing the most widespread cancer in the world today. Tobacco causes 80-90 percent of deaths from lung cancer and about 30 percent of deaths from cancer in developing countries.

Control of tobacco products which harm their own health became a serious issue discussed in the world cancer congress this time. Ala Alwan, Assistant Director-General of the World Health Organization, said the cigarette the most risk for non-comunnicable diseases, like heart disease, stroke, cancer, diabetes, and chronic lung disease.

Therefore, there should be a comprehensive strategy, including the prohibition of advertisements and sponsorship of tobacco products, increasing taxes on tobacco, and intensify programs to reduce tobacco consumption. This initiative has demonstrated effective results reduce the number of cancer deaths. Unfortunately, not all countries implement the necessary interventions.

Only about 9 percent of the country that mandates smoke-free bars and restaurants as well as 65 states reported implementing tobacco-free policies at the national level.

Infectious diseases cause nearly 22 percent of deaths in developing countries and 6 percent in industrialized countries.

The world needs to join hands to make the cancer is no longer a major killer. The challenge that control the global increase in cancer cases, found a treatment that does not torture people, and improve survival.

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Tuberculosis Patients More Prone to Lung Cancer

Tuberculosis Patients More Prone to Lung Cancer - People with tuberculosis disease must now be more vigilant in maintaining their health condition. Research experts in Taiwan showed that those who suffer from tuberculosis have a tendency to 11 times more likely to have lung cancer.

The conclusion was made after scientists looked at more than 700,000 people selected at random for six years, including 4480 people diagnosed with TB disease.

"The incidence of lung cancer in patients with TB accounting for 11 times higher compared with patients without TB. This study proves the importance of preventing lung cancer through the campaign against TB," said Chen Chih-yi, a researcher from the China Medical University in Taichung city center , Taiwan.

The findings, published in the Journal of Thoracic Oncology January issue that supports the link between TB and lung cancer, which had previously been predicted but not yet proven.

"TB is the most common chronic diseases in the world. Patients are most contagious disease exists in the developing and less advanced. Lung cancer is also commonly known as related to smoking. Attention is less focused on people with TB who are also at high risk for lung cancer, "said Chen.

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1 of 5 Lung Cancer Patients are Nonsmokers

Lung cancer is the leading cause of death in the cancer group, both in women and men. Although 80 percent of patients with lung cancer are smokers, but 1 in 5 patients with this cancer are not smokers.

Quoting data in the United States, deaths from lung cancer each year reaching 40,000 per year. The female non-smokers are also two times greater risk of dying from lung cancer as well as ovarian cancer.

Because it's true experts claim is no longer appropriate if lung cancer is referred to as the disease of smokers.

"If we have a lung then we can get lung cancer. Cancer is now the same as cancer that attacks other organs," said Linda Wenger, executive director of Uniting Against Lung Cancer.

The experts said the stigma surrounding smoking habits attached to lung cancer, which is called as a disease that sought his own, has reduced public sympathy for patients and lead to lack of funding to research this disease.

"Research in lung cancer as a stepchild in the family of cancer because of the influence of stigma," said Holli Kawadler, a cancer researcher. He pointed out, funding for breast cancer research every year to reach 27,000 U.S. dollars, while for lung cancer only 1400 U.S. dollars.

Nevertheless, scientists slowly began to understand the causes of this cancer in nonsmokers. One fact is women non-smokers have a greater risk than men, which is two to one.

Although the exact cause is unclear, but, like a tumor in the breast, lung cancer aggressiveness is influenced by estrogen.

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The key to a healthy lifestyle

When doling out food, it is my belief that you should not go by the serving size that's on the package of the product. This serving size was made up by the manufacturer to make their product look good.

I'm not sure what all the rules are, but if you have less than half a gram of fat in a serving, then you can call your product fat free. Thus, if half a cup of corn flakes has 0.499 grams of fat in it, then corn flakes is considered fat free.

Well, corn flakes doesn't have 0.499 grams of fat in a serving, I was just using that as an example. A better example is butter spray. You know butter is bad for you. If you smear a tablespoon of butter on a piece of toast you're getting 5 grams of fat.

Yet if you take the spray version of that butter, one squirt is considered a serving. If you're normal like me, one squirt is never enough. Because the product says fat free, you think you're not putting fat on your bread. Yet you are, because that 0.499 times however many squirts you are using adds up.

Now I don't think one gram of fat is going to hurt anyone, but if you put 10 squirts of butter on your toast thinking there is no fat in it, that comes to 5 grams of fat. Now make that 20 squirts, and you're really delving into the fat with 10 grams.

If you're on a diet thinking you're eating a fat free product, you could be in a world of hurt come Saturday weight in time. You might have been good all week, and you barely lost a pound.

So serving sizes on products are meant to make the company look good. Let's go back to our bowl of cereal example. One serving is half a cup. If you're a little grandma perhaps half a cup of cereal fills you up. Yet if you're a grown man like me, half a cup of cereal is like eating a cracker.

Therefore, a serving size should be based on something other than what's on the side of the box.

That said, what is the best way to determine serving size? First, you have to do your homework. You have to decide what is healthy for you, and what you can eat on whatever diet you're on. Then you have to do a Google search to find out how much fat is in that product.

Or, if you're like me, I simply eat the foods in the Body For Life diet. Yet sometimes there's food not mentioned on this diet, and then I have to use another method of determining if it's a product I can eat.

So that brings us to the: how-to-determine-the-best-serving-size-for-you method. First, you Google your product to learn how much fat is in it. Don't go by serving size, I'm talking: is there fat in it? Or whatever content you're looking for: calories, carbohydrates, etc.

If it's cereal, for example, you pour a bowl so you have enough cereal to cover your fist. And if it's a steak, a portion size (one serving size) would be whatever fills covers your flat palm. If you have a large hand, then you're aloud to eat a little more. If you have a small palm, then you will be eating a little less.

Ideally, if you're eating the appropriate foods, a serving of two or more products should fill you up just nice. The BFL diet allows me to eat a protein and a carb with each meal, plus as many vegetables as I want. You can adjust the diet in other ways depending on how serious you are, yet I usually take the easiest route because I only have one goal: lose weight and/or don't gain.

You can adjust the diet however you want. I mean, if you're really serious, you can only purchase lean meats. You can only eat low glycogen carbs, which would be those that are basically not white, such as no white bread and no baked potato. I believe most fruits are low glycogen, yet you still have to do your homework.

Me, however, I take the easy route. I eat pretty much whatever I want, I simply make sure I get the correct serving size, not the one doled out in a restaurant, and not the miniscule amount noted on the package. As a rule, if I eat a sandwich at a restaurant, I usually cut it in half. Steaks are cut in half too. Burgers, well, it depends on how big it is.

So pretty much on my diet I am allowed to eat steak and hambergers every two hours throughout the day if I want. Of course you have to use common sense here too. How serious are you? Plus, is the meat you're eating lean or not? Usually, I limit myself to one such luxury per day. But you can do what you want.

Farmers back in time would eat when they had the chance. That's where we get our standard three meals a day: breakfast, lunch and dinner. If you really want to be a serioius dieter, you will want to forget about the three meal plan. You should start your own.

The problem with the three meal plan, to make it simple, is by the time it's meal time, you are starving. And what happens when you're starving? You pig out. You eat too much. Plus, by the time you're body is saying it's hungry, it's going into emergency mode and slowing it's metabolism and storing fat -- the exact opposite you want.

You want your body metabolizm to be continuously going. You want your body burning fat all day. You want your body to be a lean mean fat burning machine. To do that you will want to eat a small meal (for example, one protein and one carb with a veggie and glass of water) every 2-3 hours. This will keep your metabolism going.

Usually what I do is I plan on eating two really nice sized meals a day, and I consider these lunch and dinner. Here I will have my steak, potato, hamberger, pork, and vegetable with a bun, bread, or whatever. I want to really be full when I'm done.

Then two hours later I'll have what I call a snack. Stuff I consider snack food is: cereal, cottage cheese, oat meal, yogurt, small sandwich, etc. You might consider these meals, but these things don't satiate my hunger enough to last long.

Thus, after my "meals" I wait three hours before I eat a snack. After my snacks I wait two hours before I eat a meal. That way, I keep myself satisfied. I never go hungry. This is my own tweak of the BFL diet. Whatever diet you do, you can do your own tweaking to satisfy your own body.

I think that's one of the reasons so many poeple fail at diets, becasue they think they can read a diet and do what the diet says. Well, that would basically entail every person in the world eating the same diet, and having the same results. In the real world, that won't work. Every body is different. Every body needs a different serving size.

One more thing here. Another key to not getting hungry is fiber. If you eat a steak or a burger, chances are you will be filled up. Yet if you eat a bowl of cereal, you will probably be hungry in an hour and risk the urge of binging. So, when eating something like cereal, you need to only eat cereal that are high in fiber.

So Special K is out. Sure they say it's a good diet cereal, but you can't eat it becaue it has no fiber in it. You'll just be hungry an hour later. You'll be wanting to eat. You'll be craving that cake your spouse made the night before, or that candy Butterfinger you have in the cupboard.

A couple other rules I have is that if someone offers me something I'm allowed to eat it, or drink it. I don't want to be anti-social. If I'm at my neighbor's house and he offers me a Bud, then I drink up and enjoy. If I take the kids to my aunt's pool and she has cake and hot dogs, then I endulge.

Of course you don't want to do this kind of stuff every day, yet you can. You're body's metabolism needs to be fooled once in a while anyway.

Another rule is when you start your diet, or lifestyle, or whatever you want to call it, don't expect to feel good the first week if you eat small portion sizes. Eat big the first too weeks. Cheat the first two weeks if you need to. Do whatever you need to do to make it through.

Then in wees three or four, when you're stomach has shrunk, you can get more satisfaction from the smaller meal sizes. Then you can tinker with size. When you start you're diet your stomach is going to be full of all the junk you normally eat, and it will probably be large.

Another rule is I take one day off a week and eat anything I want. I try to make this day the one I might be tempted to otherwise eat bad, such as if I plan on going to a party, or aunt Mary's pool, or the neighbors for drinks, I try to make that my day off. Yet things don't always go as planned.

I certainly don't want to be the boring person who says, "No, I'm dieting." You'll never hear me say that. Ever. Nobody knows I diet. In fact, when I go to work, I carry with me a big bag full of food to last the 12 hour shift. I actually take more food with me to work when I'm "dieting" than when I'm not.

The fact is, if you're eating healthy, you can actually eat more and more often. The key is you want to eat several small meals through the day to keep your metabolism going. That's it.

You don't even have to exercise. Exercise helps, as it can get your metabolism going even faster, and muscle burns fat a gazilion times faster than fat, which barely burns anything. So aerobic activity, getting your heart rate over 100 for 20 minutes three times a week is important, but not necessary.

Some form of weight training helps too. Yet, if you hate to exercise, studies have been done, and common sense says this too, if you put into your body less than what goes out, you will lose weight. If you put in 2,000 calories a day and you burn up 3,000, you will lose. It may be gradual, yet if you stick to it you'll lose, or at least not gain.

I guess it all depends on what you want. It all depends on what your goals are It all depends on what kind of food you like. But to sit on the couch all day eating potato chips is not going to get you feeling better about yourself. To get results, you'll need to take some form of action.

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Happy New Year! Welcome to 2012.

As I look back over 2011 I remember many wonderful experiences. I was so surprised and honored to be chosen CT NASW Social Worker of the year. I was also delighted to participate in a round table discussion at the UConn School of Social Work that was later featured in the UConn Alumni magazine. That caused even people I swim with to congratulate me! I presented at some wonderful conferences. The Vermont foster care annual conference comes to mind- amazing to find my name on a program with Bruce Perry, and great to hear his presentation. I also remember the ATTATCh conference, the Health Care for the Homeless training, and my wonderful visit to CALO (during which I had no voice). Participation in the Carter Center Mental Health Symposium was a great honor and extremely valuable. I also taught some wonderful Risking Connection basic trainings and Train the Trainer events,

Largely due to the efforts of my colleague Steve Brown, 2011 was the year we entered electronic teaching and started offering webinars to our geographically distant trainers. We are beginning master the technology and hope to expand the offerings this year. And speaking of our Associate Trainers, we had some excellent Consult Groups this year. Notable among them were Kathy MacAfee on presentation techniques, a seminar on the role of grief in our work, and our Day of Learning and Sharing. In that event Kay Saakvitne presented about the trauma survivor as parent. I always learn a lot from Kay. I am particularly proud of the Associate Traianer consultations. Through them we increase the knowledge and sophistication of the treatment offered to trauma survivors, as well as strengthen the community of providers doing thIs difficult work. Every event includes some focus on vicarious traumatization.

Our colleague and friend Laurie Pearlman has recently been developing the concept of vicarious transformation, and I was lucky to be able to hear her speak about this at the ATTACh conference. This refers to the positive ways our work changes us, and to what elements of our work maximize positive change. Expect to hear more about this in 2012.

One sustaining element of our work is our participation in a Transformation Summit which is our collaboration with the personnel of Sanctuary and CARE. We help each other with all the challenges of promoting system change.

A very exciting development in 2011 was that my colleague Steve Brown's research paper on Risking Connection was published in a peer reviewed journal. Congratulations to Steve, that involved a lot of hard work.

There were also difficult parts of 2011. At Klingberg and around the country non-profit agencies are feeling the pain of state budget crisises. When money is tight, training and supervision are often areas that get cut. Yet these times of treating increasingly challenging clients with less resources are the very times when it is most important to think about our work and to use our resources most artfully. Treatment efficacy is strongest when the treater is operating from a theory.

What will 2012 bring to the Traumatic Stress Institute? We are almost finished with an adaptation of Risking Connection for teaching foster and biological parents. This curriculum is timely as states are moving away from congregate care and utilizing version of foster care for troubled youth. Training in trauma can preserve placements as the foster parents learn to unerstand the behavior and not take it personally. We are also developing trauma informed in home services to support families in keeping kids.

We are working on oour version of Risking Connection for professionals in the Developmental Disabilities field. We would welcome the participation of any one with expertise in that area.

I hope to meet many of you either when you bring me to your agency for training or when you talk to me at conferences.

Perhaps this is the time to announce that I have written a book about the Restorative Approach, or all I know about working with kids in congregate care. It is in the editing stage now, and should come put this spring.

Let's hope that 2012 brings us further down our path of transforming treatment settings towards trauma informed care. Let's hope we have the good health and strong spirits to continue to change the world.

I welcome your thoughts on what you achieved during 2011 and your hopes for 2012. Just click on comment below.

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Lungers: Here's your incentive to get in shape

Asthmatics! Here's your incentive to get in shape this year. Read my latest post from MyAsthmaCentral.com

Alright Asthmatics! Here's Your Incentive to Get in Shape This Year

Happy New Year, fellow asthmatics. If you're like me you focus on getting in better shape all year, but continue to fail. I'm going to provide you with some added incentives to never quit trying to get into shape.

It's a simple fact that many of us tend to, well, gain a little weight as we age. It's normal actually. Yet, if you have asthma like me, you need to be a little more careful, because obesity and asthma do not bode well together. It's a fact.

Quite often I'm asked this question: "Am I short-of-breath because I have asthma or because I'm overweight?" To be honest, the answer might be both.

I actually asked myself that question once, and I got my answer after I started doing the Body-for-Life Program and lost 40 pounds. Not only was I no longer winded, I was able to cut way back on my rescue inhaler usage. It was awesome.

For one thing, if you are overweight your heart is already working extra hard to pump blood through all your extra weight. So even minimal exertion may make you winded even if you don't have asthma.

Plus a full stomach, and stomach fat, may push up on your diaphragm, which may give your lungs less room to expand, which may also make you feel winded.

Eating McDonalds and other Fatty foods is fun and quite convenient, yet many studies show fatty foods may cause asthma.

A study completed by the Center for Disease Control showed that obese adults were 66% more likely than normal weight adults to have asthma. Experts at the University of South California did a study that showed obese children were 1.5 times more likely to be diagnosed with new onset asthma.

Results from the National Health and Nutrition Examination Survey 2005-2006 (as you can see here) showed that "Obese children were about 26 percent more likely to have allergies than children of normal weight".

According to researchers from Kaiser Permanente, Massachusetts General Hospital and Harvard Medical School, people with asthma are five times more likely to be hospitalized for asthma, have a lower quality of life, and have worse asthma control as compared to those with asthma at a normal weight.

Likewise, according to a study released in 2007 by researchers at Emory Crawford Long Hospital, obese asthmatics are more likely to have persistent or severe asthma.
This 2005 study by experts at the Harvard School of Public Health notes that 75% of emergency room visits are among asthmatics that are obese.

The study also notes that many people are obese before they become asthmatics. There are two theories why obesity may lead to asthma:

• Shallow breathing
• Hormones released from fat tissue

Breaths are shallower than normal due to fat tissue making less room for the lungs to expand. Full stomachs also puts added pressure on the diaghragm, which further restricts the ability of the lungs to expand.
This shallow breathing increases the probability inflammation will exist in the air passages of the lungs, and this causes the airways to narrow.

Inflammation in of air passages is also believed to be caused by hormones, such as leptin, released from fat tissue. Leptin is present in all asthmatics, but it is elevated in the obese.

Likewise, people that are obese are less likely to have a hormone called adiponectin, which is an anti-inflammatory hormone.

Researchers at Kings College in London, according to study performed at York University in Toronto shows that asthmatics who exercise "might" have better asthma control. Basically, this pretty much proves what we already know, although it's neat to have a little proof.

However, it must also be noted that inactivity due to asthma itself may lead to weight gain. This is why it is especially important to maintain good asthma control so you don't have an excuse to miss out on exercise.

Another study showed that while obesity may not worsen asthma, it may make asthma medicine work less well. Experts here recommend that if you're overweight you may need a higher dose of controller meds as compared to those of normal weight.

Still, it should also be noted that many asthmatics are not overweight. In fact, many children are skinny as I was as a child.

Regardless, getting in shape and staying in shape is hard. Yet because asthma and being out of shape do not bode well together, you must never quit trying. More so than people with normal lungs, we asthmatics have an even greater incentive to get in shape this year.
So come on and join me. I'm doing the Body-For-Life Program because it works for me. I challenge you to find a diet and exercise program that works for you, and then stick with it for the full year.

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