The popliteal lymph nodes are nodes that are located around the knees. They are the lymphatic system for the legs and the feet. There are popliteal lymph nodes near the popliteal vessels and the superficial popliteal lymph node that is connected to the small saphenous vein. Within the popliteal lymph node a fibrous outer capsule encloses the lymphatic tissue that balances and filters the blood supply to the lower extremities. With all that being said, the lymph node is simply a node that is responsible for the transport of fluid called "lymph" fluid from the cells in your body and into the bloodstream. The lymph nodes are responsible for fighting infection, they trap bacteria and waste products and also destroy old or abnormal cells in the body. Lymphedema is the swelling of a limb on the body, which is usually around the feet or ankles or even the arm, this is due to poor drainage of the lymph fluid. Lymphedema can be the result of a surgery that occurred near the a lymph node or popliteal lymph nodes causing them to be subjected to damage during surgery. If in that instance a popliteal lymph node had to be removed then, there is a chance that a buildup of fluid will occur. The fluid accumulation causes swelling in the legs or feet. Lymphedema, can also be caused by a cancer that blocks the lymph nodes or vessels. This is tough, because if one is affected by lymphedema as a result of surgery then, what can be done to prevent it from constantly occurring? Compression of the lymph node or swollen area can be done to reduce the swelling or if tolerated exercise can be done along with manual lymphatic drainage. These are some of the therapeutic activities that can be done by a patient to reduce the swollen ankles or feet especially after surgery. Pedal edema is often referred to as the accumulation of fluid in the lower legs and feet. This can be caused by venous edema which is caused by retention of protein-poor fluid in the venous system or by lymphatic edema which occurs when there is a dysfunction of lymphatic flow resulting in the accumulation of protein-rich fluid in the limbs or arms, legs and feet. Let's just say that there is no venous edema, but obviously there is something wrong to cause so much swelling and discomfort. Hmm, perhaps a comprehensive metabolic panel which includes the lab test albumin will help figure things out. Albumin is a protein that is made by your liver. Albumin is responsible for keeping fluid in the bloodstream and preventing it from leaking into other tissues. Low albumin levels are an indicator that there is a problem with the liver or kidneys. Low albumin or hypoalbuminemia is also common in patients with congestive heart failure or CHF. Like I said, this is tough because sometimes CHF can be confused for lymphedema. Why? the symptoms can be the same when there is fluid build-up in the lower limbs. This is because since the heart is not pumping as it should in a person with congestive heart failure and blood builds up waiting to get into the heart since the heart's output of blood is less than normal, pressure in the veins also increases, since veins are permeable the extra pressure causes fluid to leak out of the veins and into the tissue; and most commonly into the ankles and legs since this is the area of greatest pressure and this causes the lower extremity swelling. The heart can sometimes be affected by surgery and in the instance of congestive heart failure lower extremity edema is a common symptom. When there is a cause for concern regarding uncontrollable lymphedema after surgery near the popliteal lymph nodes or any lymph nodes- get to the heart of the problem and make sure it is not congestive heart failure or CHF!
One would never think that happiness or being happy is somewhat of a rite of passage. It is a sad state of affairs when a person is not given his or her own right to be happy. I mean this to say, this should not be a world where you should be able to go out and put yourself in all kinds of danger so that one can be happy or free; but there should be some intelligence used when making such decisions. For example: Weary Writer loves to write and learn different things. She is in her early fifties so she gets the "memo" and is not a spring chippy. But Weary Writer has had one constant problem in her life, which is "she is never happy." All of the differences and constraints brought upon her in her life has really limited her in many a way. "I just want to be happy and make my own decisions in life." she says. Weary Writer finds her life being miserable because others or people who have their own selfish interests at heart usually interfere in Weary Writers world. It is well known that Weary Writer is not happy at her job, and she knows it's time to leave. It's sad that Weary Writer never became the grown up person she wanted to be because of the typical regression restraints people in society put on people like her. Weary Writer despises the fact that people see others as "animals in a zoo." Now, as exotic as that may seem, the way people are treated or even hired has affected them greatly because of this-even Weary Writer. Currently, Weary Writer feels caged in because of the ignorance of others, sure she has some food and of course water, but that is the life of a caged one, they have nothing else to speak of. Why?, there are those who don't want people to exist or blend into society, especially when things seem somewhat exotic for them. So there goes the salary that would allow one to live as a grown up person or be somewhat independent. Yes, Weary Writer appreciates all of the good things that people have done her, but there comes a point in life that she needs to establish her own self worth, which is part of being an able mind and body grown up person. Besides, as Weary Writer puts it, "if I knew that it was going to be this way- why can't I just stay home?" But, Weary Writer still needs to find that job that would allow her the happiness she so deserves and the salary that would enable her to do the things she wants to do within reason and and needs to do for her own happiness and survival. Weary Writer feels that her happiness was overlooked and this is distressing to her. Weary Writer's next goal is to be happy and to have a certain independence about herself that this life or existence does not provide- this also means time for Weary Writer to continue her writing and other creative interests. A few weeks ago, I made mention of a Sunday crossword puzzle. A bird may "sing" in expression because people are afraid of it's feathers-however exotic or different. When we realize that each feather should not be of fear then this world or country can soar as it should!
Wow, it's been a 15 year journey in the medical field. As you know for me it was a miserable one. I often ask what is it about me that attracts people who do not seem interested in what they are doing, or have the know how? As a result I feel the burden and realize that when you work for people who don't have the interest in their work at least to be there then, it's no point in my staying around. It's interesting that there are those who have no conscious whatsoever about what it takes to do a job and what happens when you expect someone to be "all things to, all people." It bothers me to always have to compensate for someone else's ignorance or just not wanting to do something. But I have decided to find work that does not involve taking the medical boards or being used as a pawn for someone else to pass them. Ah, the exercise of brains and brawn. I feel the pressure and it makes me extremely unhappy. I don't think people who are physicians are anything but human, we all are imperfect and have, flaws also. I also have come to the realization that people seem to forget that I'm human also. I really despise this. But this should not be a reason to practice medicine by putting most of what you do on your staff, if that balance were broken down it would be staff 80 physician 20; sort of like health insurance. I was unimpressed with the physician approach to working meaning, "I can get out of doing most things, if you help me." People like this should not be physicians and they should not use their staff and patients abusively. The long wait times, and the burden they put on people and their staff due to their lives outside of the physicians office. Yes, we're all human but I just think that being a physician is just in a name for some. It gives them status, but besides that there was nothing else that was by way of human progress. I saw most of this as employment regression and the fact that you could take people and use them to exploit a certain ignorance. I have a few questions that I need answers to: What makes me not entitled to health insurance, vacation days, personal days and that retirement plan? Why is it that either I must "do the work of all people or work among those who are not or unable to work efficiently and effectively such as I do?" I'm tired of physicians who don't want to be board certified, so that they don't have to be a part of any group or hospital, because it may be a requirement. By doing this the physician does not have to do the work of exam study and their staff suffers from the rising costs of life. Nobody really shares the wealth and all I was looking for was a job with benefits. I don't see where this did anybody any good. I don't enjoy working for physicians, this experience has really made me unhappy and not in like with medicine. Sometimes you have to know when to move on and as a result it's time to leave. If physicians are not serious about their practice or being a physician then there is no point in my being there. This job was never my passion and in the 15 or so years I have come to find that it wasn't theirs either...
When a patient or person suffers from a cardiac tamponade it is because their heart is surrounded by fluid or blood or both in the pericardium. Cardiac tamponade prevents the ventricles in the heart from moving effectively, by expanding and once this occurs your body cannot pump enough blood to the other parts of it. I guess to understand this in a layman's explanation is to view the pericardium as a pool and your heart inside of it. Once the pericardium becomes full with fluid the heart then drowns in it's own fluid. No blood can enter or leave the heart as a result of the fluid accumulation. The body will be affected by this due to cardiac arrest and the organs or vital organs in the body will cease to function. Illness that can cause fluid to spread to the heart and can cause cardiac tamponade. When an underlying problem of illness causes the pericardium to be surrounded by fluid, the heart becomes compressed in it's ability to pump blood normally. The problem with patients or heart patients who suffer from cardiac tamponade is this: when should a physician know when to drain the pericardium so that pressure is released from the heart? In prostate cancer there is such a thing as a Gleason Score that is used to determine the presence of cancer and also it's tumor size and growth. So the lower the score, may mean that there is no immediate presence of cancer and a higher score means that the cancer is growing and spreading through the body. The use or implementation of scoring indexes or scoring systems in not widely used to determine if the cardiac tamponade will become life threatening or result in death. Of course, this would mean a revised cardiac criteria, regarding pericardial effusions.Physicians get paid to party, they don't have time for this! For example: A patient presents himself to the Purple Heart clinic complaining of chest fullness and occasional dizziness. A chest x-ray is done and an EKG, the patient is also examined and was noted to have, a cardiac silhouette on the chest x-ray, the ekg noted that the patient was in tachycardia and upon examination he was suffering from hypotension and dyspnea. An echocardiogram was performed and it showed that the heart was severely affected by cardiac tamponade, due to fluid buildup. The patients tamponade score was above 7 since he was unable to do regular daily activities without the onset of dyspnea. The tamponade or cardiac tamponade score is determined or used to determine the overall effect that the cardiac tamponade has ones heart. If a patient is prevented from doing regular activities then that tamponade score would be high as as clinically warranted all tests and even basic ones such as ekg's and chest x-rays, or even an echocardiogram indicated the distress of a patient in cardiac tamponade. Once this occurs, then a pericardiocentesis should have been performed on the patient immediately. Pericardiocentesis is the drainage of the fluid from the pericardium that surrounds the heart. Had the Purple Heart clinic performed the urgently needed pericardiocentesis the patient could be enjoying a day like today. But what if the fluid and blood accumulation from the heart was due to illness or other heart problem that would cause more than one pericardiocentesis procedure to be performed? Good question, and this is why I say physicians are not all that smart. This is where medicine needs a good scrub. Pericardiocentesis can be done by the apical, parasternal or subxiphoid area of the heart. All the physician would need to do is to perform a pericardiocentesis procedure in the parasternal area of the heart, that creates a "port", to allow fluid and or blood to be released from the pericardium, and then affix a catheter and drainage pouch to it, so that this would collect any more fluid or blood that accumulates in the pericardium resulting from cardiac tamponade or the spread of other illnesses that cause fluids to buildup around the heart. Once the heart is not affected by the surrounding fluid, then it can function as it does until the illness or condition such as a heart problem or disease can be remedied. The pericardiocentesis cardiac port is very useful as it allow continuous pericardium drainage and allows the patient to do normal activities as he or she is seen by a physician for other ailments or chronic conditions, as it keeps the heart functioning despite other problems the body may be affected by. The cardiac tamponade scoring system and the pericardiocentesis cardiac port- just some of the things that work well together! Now, it's time to part with those partying Purple Heart clinic physicians, some people just should not be physicians...
Gasotransmitters are classified as endogenously-generated transmitters that are freely diffused across the membranes and are responsible for signal transduction, as it is regulated by enzymes in mammalian cells. Gasotransmitters also control the physiological functions by creating a defense against pathogens in the body, preventing apoptosis and the metabolism of energy. The loss of physiological function in the body is what "constitutes" or is considered aging. This occurs when cellular damage at the molecular and cellular tissue level becomes impaired or altered in some way to create the aging process or functional loss. A very important category of aging involves the integrative process of aging which includes stem cell exhaustion and altered intercellular communication. The loss of function in the integrative process results as the damage to the brain and body becomes difficult to reverse naturally. This important when it comes to matters of the heart. Why? Myocardial ischemia reperfusion injury occurs when there is damage to the heart. Once heart begins it's flow of blood through the damaged heart or areas of the heart where oxidative stress has resulted since the heart did receive nutrients from the blood or oxygen during that time of myocardial ischemia, free radicals are released and inflammation, apoptosis or cell death occurs due to the absence of vital nutrients to the heart. As a result the heart ages considerably. Sulfur dioxide is a gasotransmitter, in the body that becomes an endogenous molecule of gas that is a signaling molecule. The uniqueness of sulfur dioxide as compared to the other gasotransmitters is that sulfur dioxide or sulfites are found in red wine. Now, you know that red wine is good for the heart in moderation. But, here's the thing you cannot drink red wine before you go to work or during working hours-unless you're the boss and I mean that one, as well. Regarding the heart, sulfur dioxide or sulfites help reduce myocardial inflammation, increase cardiac function, and reduce myocardium apoptosis. The issue here is prevention and there are people who do not drink among other things and just want to take a baby aspirin or 81 mg's worth of aspirin daily. This is ok of course, but you may still want to have antioxidant protection. Now, sulfur dioxide can cause people to become allergic to it, so it would not be wise to take a large amount of it. If a vitamin supplement company could take an aspirin of 81 mg's and infuse it with red wine sulfates in a small amount(so that there are no headache or allergic side effects), this would be some heart attack prevention! Even if someone appeared to have the onset of a heart attack the aspirin along with the red wine sulfates as a gasotransmitter, could certainly help prevent the heart from having more damage to it. Aspirin and red wine sulfates in a supplement can keep the heart going until medical intervention arrives!
I do wish that employer's were not so paranoid or intimidated. I really hate that. Why would I say something like this? Well, it's because when people such as bosses do things like not providing a lunch hour, vacations or days off or being "understaffed" as a reason for the whole thing; it just seems to me that they are afraid of a person running off and leaving. I know it sounds strange but, there are those on the top and those on the bottom-just like clothes. So those on the top generally like to keep track or know where their employees are all of the time so that they don't leave or go anywhere so that they are around to do the work that they want them to do. There is no need to be that desperate. Employers who have a superiority complex are the ones who underpay their workers because they have a need to feel as though they reign supreme over something. It's usually these types of people who cause problems in larger companies because of the requirement to provide such benefits as retirement and health insurance. They just don't like to see certain people have any, at least from a company because they feel that in some way it takes from somebody else. Yes, this is paranoia because for the most part these people are very hardworking. The employer or cohorts decides to take away jobs that provide health insurance and retirement benefits from hardworking people and give them to those who don't do nearly as much. Yes, the paranoid employer probably has their preferences and they also like to remain superior in their Anglo or Anglo Saxon existence. I don't get this and at my age I don't think I ever will. America has vastly become third world, by the lack of opportunities for jobs and the ways in which society governs it's people as a result. When you take away workplace entitlement you then introduce government entitlement. Such as health insurance, food,clothing and housing ect. But, it is these same Anglos and Anglo Saxons who get upset about their tax payer dollars being spent for this one to live free and that one to be seen by a physician for free. Anglos and Anglo Saxons are the hypocrites in all of this. If they take away the entitlement from those that are hardworking and then resourcefully use the government as their "please stand by-reparation"(There is no M----- F----- Unc Sam that could pay me enough!), then it is the Anglos and Anglo Saxons that are doing the injustice to such people and have no one to blame but themselves for people who have to use government funds to survive off of, because the Anglos and Anglo Saxons caused the problems. When you're paranoid you fear the person on the bottom to have any money to do anything with, so how can a world thrive economically? There is no need to be this paranoid or intimidated, I know there's hate also and people come by it honest because their elders are that way. But, this is what it all comes to concerning entitlement and the fact that the Anglo or Anglo Saxon can use his or her color pass to put somebody in a governmental way of survival as opposed to being entitled by simply being hardworking and capable. Intimidation and paranoia among the Anglo and Anglo Saxon has created a demise of what could have been a thriving society. Yes, there are tops and there are bottoms-just like clothes, but what you really need to ask yourself is this: Do you really want your tax dollars to support people who are capable and hardworking on the government(they have to eat, wear clothes and live without threat or inhabitable harm also), or do you want to just complain about it, since your intimidation and paranoia does little else for you but to put people in situations of the government? When you use tops and bottoms together this way, they don't work well because you are doing something called oppression- which of course is hypocrisy in paranoia and intimidation.
People or customers should be limited as to what information they need to provide to a company or entity they use to spend money by using a credit card. Many people are just using these credit card management type systems to buy or purchase goods online. Sure, they can use their credit card but they don't want to keep that information on file from where they purchased any products ect., from. The customer should not be required to provide bank statements or other personal information that can be compromised somehow by workers who are well, dishonest. It should be ok to provide identification. But, there is such a thing as too much information and that all has to do with how and why you are using a account or credit card management website. For example: if you are just using this type of access to pay for things as you buy them without pulling out your credit card each and every time and risking it being on file, then hey it's not like you have an open access to deposit other money onto the credit card or receive money in any way. Therefore, a person is using that credit card management system on a limited basis and should not be required to provide anything more than a valid identification. Perhaps, if the use of that credit card management were utilized by way of full banking such as: transferring money to other accounts, receiving money and actually having an account in terms of it being used financially they it would be important to know the customer and their banking transactions to validate such an account. However, if a credit card management system is for "pay only" then nothing more besides identity information should be required. It is very important to the consumer not to jeopardize themselves by providing information about another financial institution, since that information has nothing to do with a particular account. Even for verification purposes if one provides a credit card statement, that information becomes no longer protected. Limited access is just that and limited information should coincide within the terms of the way or what extent something is being used. Information gets compromised all of the time and as a result consumers should not provide any more information than they have to. Credit Card management or payment systems need to come up with other ways to ensure security within their use by way of passwords, questions and other forms of "only known to the user or account holder" information. This ensures privacy not only to the consumer but it protects a company from accusations that they were fraudulent in some way.
I'm giggling right now because people or at least people in the Department of Labor view these type of jobs as secure. Computers and robots cannot replace people, or so they think. Why would I want a medical office to be automated? Several reasons. One of them has to do with patient independence with the exception of people who are ill and chronic or terminal in suffering or handicapped. The problem with medical care is that there is this person to person attachment that really bothers me because, you get patients who don't try and figure things out as a result. Health insurance is not a walk on water deal, at least in America. You need all of these referrals, precerts, and sometimes have to have a physician assigned. Yes, patients should know this about their health insurance. Automation or medical automation can relieve the front desk staff from telling people all the things that patients should know. Tablet kiosks can inform a patient of what they need with a swipe of the insurance card or by inputting the insurance company name and the patients subscriber identification number. There is another way automation can assist in a medical office. How, you ask? By allowing the patient to do all of the things he or she urgently needs. Patients should be allowed to do their own referrals, and select their own physicians. This enables a patient to get the referral when they needs one and especially if they decide to see a physician and the medical staff was not notified- this creates a problem since referrals must then be backdated. Hmm, perhaps if patients and many of them use computers can do their own referrals this will alleviate a lot of what can make working in a medical office very bothersome. This would also help insurance companies who are busy with phone calls for other things. Patients need more independence and ability through their insurance company to select their primary physician and to also obtain referrals, since they know when their visits are and what physician they are going to see. Anyways, automation allows for a medical office EMR to obtain all specifics about the patient. A drivers license will populate all information about a patient as will a health insurance card. Don't worry the information can be corrected if a patient changes address ect., medications via the swipe pharmacy card can be automatically entered into the medical office EMR. This is another thing, that can be very useful when implemented. In the EMR-select the patient- select medications- and once you swipe a medication pharmacy card, the pharmacies that are used are populated into the EMR database along with the current meds that are being used. And no more of this not knowing what they take, how much, or where they go to get it. It's their health, why should the front desk be responsible, if the patient is not? Now, is there a national I HATE MY JOB DAY? In life all there is, is time and in the medical area all people know how to do is waste it. The medical office is in need of automation people are getting older, when a mind cannot provide information, automation can be of great assistance.
When working in a medical office that is not part of a larger facility like a huge medical group or hospital, it becomes sometimes cumbersome to obtain medical records from that facility. This creates problems for the patient who has probably seen physicians from all over the county and then some. If a patient does not have certain medical reports on them to provide to the physician then a physician may not be able to fully recommend if anything what else the patient needs to do. A physician will say I see and advise patients, I can't fetch all sorts of paperwork at the same time. A hospital medical worker will inform the physician, that there is hospital EMR technology that they can simply log in to and retrieve such necessary information. I'm sure that there are some multi task and all in one type of physicians with that quality in disposition, but probably not very many. Please note that the medical office is becoming the precert department due to many diagnostic tests and medications going under scrutiny before being approved. Lab tests are done in the office and well what would cardiology be without an EKG or an echo ect.? The job is boring and exhausting, but hey, I do what I can. I don't find medicine exciting, although it may be interesting. Meanwhile, the medical office staff really has no way of getting access to patient information unless they call the hospital file room and upset the people there. Believe me, we don't want to call and nag each and every time for a medical report of a test from the hospital but we have no other way of obtaining the information. The medical office staff needs intervention because it would assist in processing work among other things in a timely manner. Physicians who are affiliated with a hospital or facility have access to patient information but they are busy with the physical presence of a patient to get on another EMR and search for medical records. As a result the physician will ask the medical staff, who now is seen as a burden because of it, or is it the physician who is a burden? I must say that there is no benefit to having access to patient information outside of a medical office, so why would I care or be bothered with it except for the fact that they physician needs the results? Medical offices with physicians who are affiliated with a hospital(s), should seek permission from the hospital personnel to perhaps have what is known as auxiliary access for their medical staff. Yes, auxiliary access, it would qualify because the medical office or staff provides support to the hospital in a certain capacity. With auxiliary access to the hospital EMR, The medical office staff would log in, and submit requesting physician information (this is so that the hospital knows that the patient is being seen by a physician who is affiliated with that hospital, and that is the physician who is requesting the information). This is also helpful regarding HIPAA compliance and to make sure medical information is not being misused in any way. A log can be entered in the EMR stating that the patient has an appointment with the physician. This way or by the use of auxiliary access, the medical office staff can access hospital medical records and the physician nor the patient has to wait until the front office staff finally gets someone from the file room and provides the patient information and to wait for it to be sent over. This often adds to a patient visit time and can keep a physician behind schedule. Gosh, just open the door and I'll get it myself!
Yes, medical offices still do this, and by this I mean taking co-payments and bill payments from patients. This kind of thing should also be available as self-serve. Sure, patients can do this by using an EMR that is equipped to handle payment information, but a lot of the time patients like to discuss their bill and pay in person. We need to make technology oriented to the patient and in doing so this means patient independent. Let's just say Quare- which is a credit card, check and cash processing system has a product out that allows medical office workers to collect payments via credit cards from the patients. The Quare system will allow a medical office to input payment information to generate a receipt, since it can handle electronic checking as it does cash. This is simple enough as the medical office workers among doing other things, take the credit card, cash and check information and enter the amount the patient wants to pay and submits it for payment. They then provide the patient with a receipt and all is good. But what about linking Quare with your EMR system so that not only will the patient be able to self pay for things like co-pays or outstanding bills it also helps them keep a receipt for all payments that they have made to a physicians office. How would Quare work? I'm glad you asked. For example a patient has a bill due and a co-payment. He or she can combine it into one bill or make separate payments. On the patient Quare screen or touchscreen monitor the patient presses make a payment. Then they would enter the amount of the payment. The Quare software would ask the patient if they would like to make another payment. If you have more than one payment and need to keep them separate or if you are paying a 2017 bill in 2018, and things like that, the this would come in handy. After you have entered all of your payment amounts, you can then enter your credit or debit card information or you can use check or cash. This is very useful for health saving plans or if you need to use more than one type of payment. The Quare software will ask you to enter or swipe payment information. Once you do this if you have more than one payment the Quare software will ask if you want to use the same payment information, you just select yes or no and it will either continue to processing your payment or allow you to enter another credit/debit card, cash or check. If you are using a check you just swipe the check as you would a credit card or you can enter the information for checks credit and debit cards. The Quare software is able to process more than one type of payment and payment amount. The Quare software as linked with the medical office EMR is able to locate name and address of a patient and assign their processed payment information the your EMR so that there is no need to provide two different receipts, because Quare will send a payment receipt to the EMR and to the patient by email. The Quare touchscreen tablet is very useful when connected to an EMR. A patient can even make payments while they wait for appointments, or they can be given a payment ID and make payments in the comfort of their own home through the online Quare/EMR payment system. The options of choice and versatility enable a medical office to receive payments that are due and eliminate problems when paying bills by coming to the office-the staff is very busy. Save gas, save time and money-Quare!
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