Sandra is the Founder, Lead Legal Nurse Consultant, and Coordinator of Krug Consulting, a Legal Nurse Consulting firm. She is a Certified Registered Nurse Anesthetist (CRNA), Advanced Practice Registered Nurse (APRN), and Registered Respiratory Therapist (RRT). She has over 12 years of college ...
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Relaxation actually reduces stress on the mind, body, life
By Sandra Krug
Relaxation is the state of being free from tension and anxiety.
National Relaxation Day is August 15, 2019. This unofficial holiday was first proposed by Sean Moeller in 1985 when he was only 9 years old. This is a day when people can slow down anything that their doing, relax, and just unwind.
Three Common Causes of Stress in Your Life and How to Deal With Them
One way to tackle stress is to improve your health, your energy levels, and your mood. By doing these things, you can help yourself to become more resilient and hardier to stress and you can avoid letting the smaller things bog you down.
But that’s a fairly abstract way to combat anxiety that doesn’t always have an immediate effect.
The other route to take then is to look at the specific causes of stress in your life – the stressors – and to remove them. Some of these will be big and some of them will be small, but all of them contribute to raising blood pressure and making us feel a little less calm and relaxed.
The problem is, many of us can’t put our fingers on exactly what it is that is causing us stress and even when we do, it’s not always obvious how we can deal with the problems.
Read on then and we will look at some of the most common causes of stress and at what you can do to deal with them once and for all.
1. The Commute
Did you know that the only ‘universal fear’ is things heading towards you? Thus, walking to work and having hundreds of people moving the other way down the street is pretty much a recipe for stress – especially if you’re running late or if you have a long way to travel.
One solution then is to avoid the rush hour. You can do this by speaking with your employer and asking them to give you more flexible working hours: perhaps 8 am to 4 pm would work for instance from 9 am to 5 pm? Alternatively, look at other ways of getting in, like cycling. Or just arrive a little early!
2. ‘Open Loops’
Many of us have lots of niggling jobs and stresses in the back of our minds that contribute to our stress. For instance, you might need to call your relative. Or maybe you have a bill to pay. These are what are known as ‘open loops’ and they can drain us of energy, focus, and positivity. The solution is to deal with each of them as soon as possible rather than letting them drag on.
3. Money
Money is a huge stress for many of us and can cause many a sleepless night.
The solution? Creating a budget. Budgets show us how much we’re losing and where and allow us to formulate a plan to get back on top. What you will often find is that simply canceling some of your recurring bills and changing your lifestyle a little can make a big difference and help you to get back in the black.
It isn’t every day that you are encouraged to relax. Enjoy to the fullest because this relaxation day is breath of fresh air amidst all the hustle and bustle of daily life.
This is the ABCs of Hepatitis
By Sandra Krug
Hepatitis means inflammation of the liver. It is often caused by a virus. The most common types of are A, B, and C.
Hepatitis A
A is a communicable disease of the liver caused by the hepatitis A virus (HAV). It is usually transmitted person-to-person through the fecal-oral route or consumption of contaminated food or water. It is a self-limited disease that does not result in chronic infection.
Most adults have symptoms, including fatigue, low appetite, stomach pain, nausea, and jaundice, which usually resolve within 2 months of infection; most children less than 6 years of age do not have symptoms or have an unrecognized infection. Antibodies produced in response to hepatitis A infection last for life and protect against reinfection.
Hepatitis B
This is a liver infection caused by the hepatitis B virus (HBV). The virus is transmitted when blood, semen, or another body fluid from a person infected with the virus enters the body of someone who is not infected. This can happen through sexual contact; sharing needles, syringes, or other drug-injection equipment; or from mother to baby at birth. For some people, it is an acute, or short-term, illness but for others, it can become a long-term, chronic infection.
The risk for chronic infection is related to age at infection: approximately 90% of infected infants become chronically infected, compared with 2%–6% of adults. Chronic infection can lead to serious health issues, like cirrhosis or liver cancer.
Hepatitis C
This is a liver infection caused by the hepatitis C virus (HCV). It is a blood-borne virus. Today, most people become infected with the virus by sharing needles or other equipment to inject drugs. For some people, it is a short-term illness but for 70%–85% of people who become infected with the virus, it becomes a long-term, chronic infection.
Chronic hepatitis C is a serious disease that can result in long-term health problems, even death. Many people might not be aware of their infection because they are not clinically ill. There is no vaccine. The best way to prevent it is by avoiding behaviors that can spread the disease, especially injecting drugs.
Burden of the Virus
Worldwide, hepatitis causes 2 in every 3 liver-related deaths. 290 million people who live with the virus are unaware. Without finding these undiagnosed and linking them to proper medical care, they will continue to suffer, and 1.34 million lives will be lost per year.
Every year July 28th is World Hepatitis Day. The goal is to raise awareness of the global burden of the virus and to influence change.
The month of May is designated as Hepatitis Awareness Month in the United States, and May 19th is Hepatitis Testing Day. During May, CDC and its public health partners work to shed light on this hidden epidemic by raising awareness of the virus and encouraging priority populations to get tested.
Are You At Risk?
CDC developed an online Risk Assessment to help people find out if they should get tested or vaccinated for the virus. The assessment, which takes only five minutes, will provide personalized testing and vaccination recommendations for hepatitis A, B, and/or C.
https://www.cdc.gov/hepatitis/riskassessment/index.htm
When you have proper hydration, you feel a lot better
By Sandra Krug
Hydration is important to living healthy. National Hydration Day, recognized on June 23, was created to honor the late football coach Victor Hawkins. He had created a special hydrating mouthguard to keep his players healthy on the field.
Drinking enough water each day is good for overall health.
Plain drinking water has zero calories, so it can also help with managing body weight and reducing caloric intake when substituted for drinks with calories, like sodas.
Drinking water can prevent dehydration, a condition that can cause unclear thinking, result in mood change, cause your body to overheat, lead to constipation, and kidney stones.
Exercise can be for your health, but working out while dehydrated is not healthy. Water provides your body with the fuel you need to get through a workout or a busy afternoon outside.
When you are properly hydrated, you are able to exercise in a healthy way, making your mind and your body happy.
Water & Nutrition
Getting enough water every day is important for your health. Healthy people meet their fluid needs by drinking when thirsty and drinking with meals. Most of your fluid needs are met through the water and beverages you drink.
However, you can get some fluids through the foods that you eat. For example, broth soups and foods with high water content such as celery, tomatoes, or melons can contribute to fluid intake.
When you are properly hydrated, you feel a lot better than when your body is short on water. Dehydration causes symptoms like headaches, dizziness, and feelings of exhaustion.
Getting into the habit of drinking water more often may inspire you to build other healthy habits into your life.
Water helps your body:
Keep your temperature normal
Lubricate and cushion joints
Protect your spinal cord and other sensitive tissues
Get rid of wastes through urination, perspiration, and bowel movements
Your body needs more water when you are:
In hot climates
More physically active
Running a fever
Having diarrhea or vomiting
If you think you are not getting enough water, these tips may help:
• Carry a water bottle for easy access when you are at work or running errands.
• Freeze some freezer-safe water bottles. Take one with you for ice-cold water all day long.
• Choose water instead of sugar-sweetened beverages. This can also help with weight management. Substituting water for one 20-ounce sugar-sweetened soda will save you about 240 calories. For example, during the school day, students should have access to drinking water, giving them a healthy alternative to sugar-sweetened beverages.
• Choose water when eating out. Generally, you will save money and reduce calories.
• Add a wedge of lime or lemon to your water. This can help improve the taste and help you drink more water than you usually do.
Heatstroke or dehydration can happen to anyone, no matter how healthy they may seem on the surface. It has happened to me on many occasions. No one is immune to the risks of not staying properly;y hydrated.
Hydration awareness is an important reminder that no matter how young, agile, or fit we may feel, our bodies need water, and health is not something to mess around with.
For more information, check out this hydration factsheet:
http://www.wellness.uci.edu/toolkit/june/HydrationFactsSheet.pdf
World No Tobacco Day is May 31, 2019
By Sandra Krug
Tobacco use is the leading cause of preventable disease, disability, and death in the United States.
As of 2017, about 34 million US adults smoke cigarettes. Every day, about 2,000 young people under age 18 smoke their first cigarette, and more than 300 become daily cigarette smokers. Over 16 million people live with at least one disease caused by smoking, and 58 million nonsmoking Americans are exposed to secondhand smoke.
World No Tobacco Day, May 31, 2019, raises awareness of the negative impact tobacco has on lung health (from cancer to chronic diseases) and what fundamental role lungs play for total health and well-being.
This campaign also serves as a call to action, advocating for effective policies for reducing tobacco use and engaging stakeholders across multiple sectors in the fight for tobacco control.
The World Health Organization (WHO) and global partners celebrate World No Tobacco Day to raise awareness on the harmful and deadly effects of tobacco, including second-hand smoke exposure, and to discourage the use of tobacco in all forms.
Visit the WHO report on the global tobacco epidemic here.
Cigarette smoking harms nearly every organ of the body, causes many diseases, and reduces the health of smokers in general.
Health Risks from Smoking:
Cancer
• Bladder
• Blood (acute myeloid leukemia)
• Cervix
• Colon and rectum (colorectal)
• Esophagus
• Kidney and ureter
• Larynx
• Liver
• Oropharynx (includes parts of the throat, tongue, soft palate, and the tonsils)
• Pancreas
• Stomach
• Trachea, bronchus, and lung
Chronic Disease
• Aortic aneurysm, early abdominal aortic atherosclerosis in young adults
• Atherosclerotic peripheral vascular disease
• Blindness, cataracts, age-related macular degeneration*
• Chronic obstructive pulmonary disease, tuberculosis,* asthma, and other respiratory effects
• Congenital defects-maternal smoking: orofacial clefts*
• Coronary heart disease
• Diabetes*
• Ectopic pregnancy*
• Hip fractures
• Immune function*
• Male sexual function-erectile dysfunction*
• Overall diminished health
• Periodontitis
• Pneumonia
• Reproductive effects in women (including reduced fertility)
• Rheumatoid arthritis*
• Stroke
Lung Cancer
Smoking tobacco is the primary cause of lung cancer, responsible for over two-thirds of lung cancer deaths globally. Second-hand smoke exposure at home or work also increases the risk of lung cancer. Smoking cessation can reduce the risk of lung cancer: after 10 years of quitting, the risk of lung cancer falls to about half that of a smoker.
If no-one smoked, one of every three cancer deaths in the United States would not occur.
Chronic respiratory disease
Tobacco smoking is the leading cause of chronic obstructive pulmonary disease or COPD, a condition leading to a build-up of mucus in the lungs resulting in a painful cough and agonizing breathing difficulties. The risk of developing COPD is particularly high in those who begin smoking at a young age because tobacco smoke significantly slows lung development. Tobacco also exacerbates asthma, which restricts activity and contributes to disability.
Early smoking cessation is the most effective treatment for slowing the progression of COPD and improving asthma symptoms.
Health of infants and Children
When infants are exposed in-utero to tobacco smoke toxins, whether through maternal smoking or maternal exposure to second-hand smoke, they experience reduced lung growth and function.
Young children who are exposed to second-hand smoke are at increased risk for the onset and exacerbation of asthma, pneumonia, and bronchitis, as well as recurring lower respiratory infections.
Tragically, it is estimated that globally 60,000 children die before the age of 5 due to lower respiratory infections caused by second-hand smoke.
Those who live on into adulthood continue to suffer the health consequences of second-hand smoke exposure, as frequent lower respiratory infections in early childhood significantly increase risk of developing COPD in adulthood.
Tuberculosis
Tuberculosis (TB) damages lungs and decreases function. This is further exacerbated by smoking tobacco. About one-quarter of the world’s population has latent TB, placing them at risk of developing the active disease. People who smoke tobacco are two times as likely to catch TB. In people with active TB, compounded by the damage of tobacco smoking, the risks of disability and death from respiratory failure are substantially increased.
Air pollution
The actual smoke from tobacco is a very dangerous form of indoor air pollution. Tobacco smoke contains a deadly mixture of over 7,000 chemicals, 70 of which are known to cause cancer. The smoke can linger in the air for up to five hours, putting those exposed at risk of lung cancer, chronic respiratory diseases, and reduced lung function.
Stopping smoking is associated with the following health benefits
Reduced risk for:
lung cancer and many other types of cancer
heart disease, stroke, and peripheral vascular disease
respiratory symptoms, such as coughing, wheezing, and shortness of breath
developing some lung diseases (such as chronic obstructive pulmonary disease)
infertility in women of childbearing age
Additionally
People who stop smoking lower heart disease risk within 1 to 2 years of quitting.
Women who stop smoking during pregnancy reduce the risk of having a low birth weight baby.
Smokeless Tobacco
Is not burned
Includes tobacco that can be sucked or chewed
Can be spit or swallowed, depending on the product
Can be spitless, depending on the product
Contains nicotine and is addictive
May appeal to youth because it comes in flavors such as cinnamon, berry, vanilla, and apple
Types of smokeless tobacco:
Chewing tobacco (loose leaf, plug, or twist and may come in flavors)
Snuff (moist, dry, or in packets
Dissolvables (lozenges, sticks, strips, orbs)
Smokeless tobacco is not a safe alternative to smoking. Learn more about these products.
Causes cancer of
mouth
esophagus (the passage that connects the throat to the stomach)
pancreas (a gland that helps with digestion and maintaining proper blood sugar levels)
Also can lead to
nicotine addiction
diseases of the mouth
increased risks for early delivery and stillbirth when used during pregnancy
nicotine poisoning in children
increased risks for death from heart disease and stroke
Using smokeless tobacco during pregnancy can increase the risk for early delivery and stillbirth.
Nicotine in smokeless tobacco products that are used during pregnancy can affect how a baby’s brain develops before birth.
Electronic Cigarrettes
Get the facts about electronic cigarettes, their health effects and the risks of using e-cigarettes.
E-cigarettes are sometimes called “e-cigs,” “vapes,” “e-hookahs,” “vape pens,” and “electronic nicotine delivery systems (ENDS).” Some e-cigarettes look like regular cigarettes, cigars, or pipes. Some look like USB flash drives, pens, and other everyday items.
Since 2014, e-cigarettes have been the most commonly used tobacco product [PDF–808 KB] among US middle and high school students. Between 2017 and 2018 alone, the number of youth who used e-cigarettes went up by 1.5 million. In fact, the US Surgeon General has called e-cigarette use by youth an “epidemic,” and warned that it threatens decades of progress toward making sure fewer young people use tobacco.
Research also shows that e-cigarette advertising uses many of the same themes that have led to cigarette smoking among young people. In 2016, nearly 7 out of 10 US middle and high school students saw ads for e-cigarettes [PDF–3.69 MB] in stores, on the Internet, on TV, or in magazines or newspapers.
Advertising can also make e-cigarette use look harmless for young people.
Most e-cigarettes contain nicotine, the highly addictive drug in tobacco. Nicotine is especially harmful to young people. The human brain keeps developing until around the age of 25. Using products with nicotine under age 25 can harm the part of the brain responsible for memory, attention, and learning.
Many young people who use e-cigarettes also smoke regular cigarettes. There is evidence that young people who use e-cigarettes may be more likely to smoke regular cigarettes in the future.
The liquid that e-cigarettes heat to form an aerosol (vapor) contains harmful ingredients—including heavy metals and even cancer-causing chemicals—that can be breathed deep into the lungs. The part of the e-cigarette that heats up may also explode or cause serious burns.
If you work with young people, you may have seen an e-cigarette device without even knowing it. The most often sold e-cigarette in the United States is a brand called JUUL, which looks like a USB flash drive. JUUL “pods,” which contain liquid heated by the device, have as much nicotine as a pack of 20 cigarettes. They also come in flavors, which can make them more appealing to young people.
E-cigarettes can also look like other everyday items, such as highlighters, credit cards, remote controls, and pens.
That’s why it’s up to you to educate yourself about e-cigarettes. Know what to say when the topic comes up. The earlier and more often you speak with young people about e-cigarettes, the more likely they are to listen.
It’s important that schools, community centers, and other places where young people gather during or after school hours have tobacco-free campus policies.
If there is already a tobacco-free policy in place, make sure students know about it and that it is enforced. School or community events should also set a good example by not accepting sponsorship from tobacco or e-cigarette companies.
Young people are also more likely to pay attention if the adults in their lives who they trust and respect are willing to talk. Teachers and administrators can use health classes and assemblies this upcoming school year to invite students to ask questions about e-cigarettes. There are many e-cigarette prevention programs teachers can use in their classrooms to let students know about the risks of e-cigarette use.
It’s also important to give students who do use e-cigarettes and want to stop the support and resources they need to quit.
Many resources are available, including a mobile app to help youth quit using e-cigarettes.
Finally, if you use any tobacco products, commit to quit. Kids are more likely to use tobacco products if others around them do. So lead by example – be tobacco-free. As students return to classes this school year, you can help make sure they are more informed and confident than ever about making healthy choices.
Death from Smoking
Tobacco use can lead to tobacco/nicotine dependence and serious health problems. Quitting smoking greatly reduces the risk of developing smoking-related diseases.
Tobacco/nicotine dependence is a condition that often requires repeated treatments, but there are helpful treatments and resources for quitting.
Smokers can and do quit smoking.
Spotlight on the danger of abuse
By Sandra Krug
It may sound strange, but people who have lived with abuse for many years may not even realize that they are being abused.
If you have grown up in a family where abuse occurs almost every day, you may think that hitting, pushing, or constant yelling are normal ways to treat the members of your family and other people.
Every family has arguments, but when yelling goes too far or lasts too long or when disagreements turn physical, that is abuse, and abuse is not normal or healthy.
National Crime Victims’ Rights Week is April 7-13, 2019
If you have been hurt—physically, sexually, emotionally, or due to neglect—you are a victim of abuse.
Abuse and neglect can affect the way you view yourself and the rest of the world.
You might—
Feel afraid, anxious, angry, confused, or sad.
Fear being hurt again.
Have trouble sleeping, eating, and concentrating.
Skip school or not do well in school.
Have lots of headaches or stomachaches.
Use drugs or alcohol.
Feel ashamed or even blame yourself for becoming a victim.
Have trouble with relationships with friends or other people.
Not know where to turn for help.
If you feel things are not so great in your family, or if things in your life hurt or confuse you, keep reading. You’ll see that it’s not your fault and that things can get better.
If at any time you feel that you are in immediate danger, we strongly urge you to call your local police department’s emergency number (911).
What Should I Do If I’m a Victim of Abuse?
The way to stop abuse is to talk about it. If you or someone you know is being abused, it’s important for you to tell someone you trust. Trusting someone after you’ve been hurt can be hard to do, but there are people who will believe you and want to help you. If there is no one you can trust at home, talk to someone at school, like a teacher, counselor, school nurse, coach, or a friend’s mom or dad. You should not keep the abuse a secret, even if the adult abusing you tells you that something bad will happen if you tell.
Sometimes, the people you turn to may not want to believe that you have been abused. If you talk to someone who is not helpful or who tells you to forget about the abuse, don’t give up. Tell someone else, and keep telling until you get the help you need to feel safe.
Talking to someone can help you—
Learn that the abuse is not your fault. No one deserves to be abused.
Get support to be safe.
Find out that you are not alone. Other people have been through similar things.
Start the process of feeling better and getting your life back more quickly.
Build trusting and healthy relationships.
Feel more hopeful about your life and the future.
Some adults are required by law to report some types of abuse to child protection services or the police. These professionals investigate abuse and find ways to protect youth and, if possible, keep families together. Although an investigation can sometimes be difficult and cause children and families to worry about what will happen to the abuser and to their family, remember that these professionals need to find out the truth so they can stop the abuse and get children and families the help they need to recover and get their lives back on the right track.
Victims of Domestic Violence
The most difficult step for you to take is to admit that you are being or have been abused by your partner. Remember, your partner’s violence is the problem, not you. You do not provoke it. You do not deserve it.
The physical and emotional suffering you experience may have long- and short-term effects. The suffering may seem to use up all of your energy. You may feel trapped, alone, and that you have lost control of your life. You may question yourself and your reactions. Regardless of your reactions, it is important to remember that every victim is different, as is every response to domestic violence. The reactions you are having to your abuse are normal.
Your safety is the first priority. Every person in an abusive relationship should have a safety plan—concrete steps you can take to stay safe or to get to a safe place if you or your family is in danger. Domestic violence shelters and advocates in your community can help you develop a safety plan that is tailored to your individual situation. The people closest to you can be part of your safety plan. Let trusted friends and family members know about your situation unless doing so will endanger you in any way. Know where to get help. Tell someone what is happening to you.
Remember, as a domestic violence victim, you are not alone. Do not lose hope.
Where Can You Get Help?
A domestic violence advocate can help you learn about your rights as a victim of domestic violence and provide you with information about your legal options, such as reporting the crime to local law enforcement or obtaining a protective order. An advocate can also connect you with your local women’s center, shelter, or domestic violence program, which can be another important resource for emotional support, shelter, or financial assistance. Local police, hospitals, churches, family or conciliation courts, crisis intervention services, or departments of health and human services can also give you information about local resources.
All states have crime victim compensation programs that reimburse victims for certain out-of-pocket expenses, including medical expenses, lost wages, and other financial needs considered reasonable. To be eligible, you must report the crime to the police and cooperate with the criminal justice system. Victim assistance programs in your community can give you more information about applying.
It is important to remember that the abuser is the only one who can change his or her violent behavior. Many communities have batterers’ programs, which try to help abusers learn how to control or change their behavior. Participation in these programs is often a court-ordered condition when batterers are convicted of domestic violence charges.
Whatever type of domestic violence situation you are in, resources are available to you. You deserve help. You deserve support. You deserve to feel safe.
Child Abuse & Neglect
Child abuse and neglect is, at a minimum, any recent act or failure to act on the part of a parent or caretaker, which results in death, serious physical or emotional harm, sexual abuse, or exploitation (including sexual abuse as determined under section 111), or an act or failure to act which presents an imminent risk of serious harm (Child Abuse Prevention and Treatment Act).
Please read this factsheet on how child abuse and neglect are defined by Federal Law.
This factsheet outlines the legal definition of child abuse and neglect; the different types of abuse and neglect; and the signs and symptoms of abuse and neglect, including human trafficking. It also includes information on how to effectively identify and report maltreatment and refer children who have been maltreated as well as additional resources.
It takes courage to ask for help, but if you are abused and you tell someone, things can get better. If you are too nervous or scared to tell someone you know, you can talk to a counselor at the ChildHelp National Child Abuse Hotline by calling 1-800-4-A-CHILD (1-800-422-4453).
Learn how to apply for crime victim compensation and find contact information for victim assistance programs in your state on the Office for Victims of Crime Help in Your State page.
Resources for Information and Assistance
ChildHelp National Child Abuse Hotline
Crisis counselors are available to talk 24 hours/day.
1-800-4-A-CHILD or 1-800-422-4453
www.childhelp.org
National Sexual Assault Hotline
This 24-hour online hotline provides free and confidential support to survivors of sexual assault and their family and friends.
www.rainn.org
National Runaway Switchboard
This confidential 24-hour service helps youth in crisis find local resources.
1-800-RUNAWAY or 1-800-786-2929
www.1800runaway.org
National Domestic Violence Hotline
1-800-799-SAFE or 1-800-799-7233
1-800-787-3224 (TTY)
www.thehotline.org
National Coalition Against Domestic Violence
303-839-1852
www.ncadv.org
National Center for Victims of Crime
202-467-8700
www.ncvc.org
Life may try to knock you down, but if you are persistent with your passions and cultivate resilience, grit, tenacity, and endurance, success will come.
– AMIT RAY (1960 – )
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