tag:blogger.com,1999:blog-74238808382072036602024-03-17T23:01:53.370-04:00Respiratory Therapy CaveRespiratory Wit and WisdomRick Freahttp://www.blogger.com/profile/01132949384071592216noreply@blogger.comBlogger2862125tag:blogger.com,1999:blog-7423880838207203660.post-39982759012036136802024-02-19T12:20:00.001-05:002024-02-19T12:20:05.218-05:00I Started Out As A Journalist<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhuM0iOxuOI5_uAoR9fRuJS9YK0OtdEYSh49hTIcp2nvFxNzdEy1ArpLTNlDqCa6FtZMK5TdkJpKbUyvG2d76dX2cjjWzAoQG0IP8-749QvAxoIKZPcrTRPTKQmDtMgFLkhsYp-gFKHw4BeRf_QixBjDbz6TAzkH-RYY8EaeDMZYZHBghf_kgWniN1-DovL/s180/scoop.jpeg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="170" data-original-width="180" height="378" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhuM0iOxuOI5_uAoR9fRuJS9YK0OtdEYSh49hTIcp2nvFxNzdEy1ArpLTNlDqCa6FtZMK5TdkJpKbUyvG2d76dX2cjjWzAoQG0IP8-749QvAxoIKZPcrTRPTKQmDtMgFLkhsYp-gFKHw4BeRf_QixBjDbz6TAzkH-RYY8EaeDMZYZHBghf_kgWniN1-DovL/w400-h378/scoop.jpeg" width="400" /></a></div>In high school, I attended a career day where I had the opportunity to speak with a respiratory therapist. When I asked about the program requirements, specifically questioning the necessity of taking chemistry, he affirmed that it was a requirement. Given my struggles with chemistry at the time, I made the decision to explore another path. With a passion for writing, I ultimately chose journalism.<br /><br />My decision to pursue journalism felt somewhat like drawing a ball from a lottery bucket, and the ball I selected had "journalism" written on it. That chance moment guided my college choice and set me on the path of studying journalism.<div><br /></div><div>At this time I wasn't the best student. I loved to learn, but had yet to master the art of making what I learned stick in my head. Actually, what I lacked was organization and self discipline. So I mostly got B's and Cs and the occasional D. And I made it through the 2 year associates's degree program. </div><div><br /></div><div>We had a school newspaper called the Torch. And I was a writer for one trimester, and this was where I learned the skill of being a reporter. And, being that I am an introvert and have social anxiety issues, it was difficult for me to motivate myself to get interviews. Plus, since I was naive about the world at this time (after all, I was only 18), sometimes I misunderstood what I was being told in interviews. So, this made it a bit challenging for me as a reporter. </div><div><br /></div>Despite the initial challenges, I persevered and found my footing. During the first trimester, my roommate assumed the role of editor for the Torch, and I was fortunate enough to be appointed as the assistant editor. Little did I know, this would become the most impactful position in my college career.<br /><br />As the assistant editor, my responsibilities included meticulously reviewing all articles in the news section, a task that significantly contributed to my growth. Critiquing the work of others allowed me to identify flaws, ultimately enhancing my own writing. This role served as a crucible for improvement.<br /><br />As I became more acquainted with my colleagues and overcame my initial hesitation in communication, especially over the phone, I gradually became more adept as a reporter. This increased comfort translated into a significant improvement in my writing style. I adopted a concise paragraph structure, a stylistic choice that would later carry over into my blog posts.<br /><br />Although working as a journalist on a college campus presented its challenges, I am grateful for the experience. It not only equipped me with valuable skills but also played a pivotal role in shaping the writing techniques I now employ in my current endeavors.John Bottrellhttp://www.blogger.com/profile/05107035756753427035noreply@blogger.com0tag:blogger.com,1999:blog-7423880838207203660.post-42560692064918126092024-02-10T12:55:00.005-05:002024-02-10T12:55:00.230-05:00What Causes RT Grumpiness<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhyKoqIdKU_OZysEyBNDeJ4T4QTOIz70JrpCRiEUvJi07Mo0-cEen14y8TFtxqvHVSj8CgSeoSnv7-SkgOkuAntyhRM1yqfH4dMoljmzw3FJ8XtHLDBrSsVUOoa7USexrs5llZ6oi8wjXCqyw5fwodm5FIyd5a-W9wGxxA1iZU3_e31y28u4hpMmkon69mo/s455/rats.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img alt="Respiratory Therapy Apathy Syndrome" border="0" data-original-height="240" data-original-width="455" height="211" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhyKoqIdKU_OZysEyBNDeJ4T4QTOIz70JrpCRiEUvJi07Mo0-cEen14y8TFtxqvHVSj8CgSeoSnv7-SkgOkuAntyhRM1yqfH4dMoljmzw3FJ8XtHLDBrSsVUOoa7USexrs5llZ6oi8wjXCqyw5fwodm5FIyd5a-W9wGxxA1iZU3_e31y28u4hpMmkon69mo/w400-h211/rats.jpg" title="RATS" width="400" /></a></div>Sometimes we RTs are busy. And sometimes we are not. And there are two different types of busy. There's the type of busy that involves things that make you feel proud of the job you do. And then there's the type of busy where you're busy because doctors are writing a bunch of stupid doctor orders. <div><br /></div><div>Let's say someone comes in severely short of breath. And you are a part of the team that helps that patient feel better. This creates a sense of pride and joy. It makes you happy that you have the job that you have. This is the good type of busy. </div><div><br /></div><div>But, then you have those days when you are unable to sit down all day becasue you are running from room to room doing breathing treatments for heart failure, cough, no cough, heart failure, pneumonis, influenza, COVID and rickets. And just as you sit down, you get a text that there is an outpatient EKG. And as soon as you are done, and you sit down, you get a page for a STAT EKG on a preop patient.</div><div><br /></div><div>If a patient has COVID, they get automatic QID breathing treatments. Same for influenza and pneumonia. Of course then you have to gown, glove and wear a mask in every patient room. And then when you are done you ask, "Do you feel any better?" And the patients all say, "NO!" </div><div><br /></div><div>Yep. You know what I mean. At the end of the day your feet are burning and you are irritated as all get out. This, my friends, is what causes RT burnout. This is what causes RATS, otherwise knows as <a href="http://www.respiratorytherapycave.com/2011/11/respiratory-therapy-apathy-syndrome.html">Respiratory Therapy Apathy Syndrome</a>. </div>John Bottrellhttp://www.blogger.com/profile/05107035756753427035noreply@blogger.com0tag:blogger.com,1999:blog-7423880838207203660.post-23895693910281563362024-02-08T12:45:00.003-05:002024-02-08T12:51:17.053-05:00My Greatest Fear As An RT<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgbtMxAIKvEqJ2_Ulb2MOfzudFc8Y4yXHIDpp7fPVL-LxW8q-i7U3SutC9lhGMyWr0fix8QfpWBiYC7nS669ge2bCdMG59SF30Ok4s7VR9oi3HQFUCsH252krB3RFBb-R6iNhpG6QJNCRhAqTnvxT-7324lujajuAOHRQSEA1zc9pPKUuhfNrmm0EjhwvY8/s225/coffee.jpeg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="225" data-original-width="225" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgbtMxAIKvEqJ2_Ulb2MOfzudFc8Y4yXHIDpp7fPVL-LxW8q-i7U3SutC9lhGMyWr0fix8QfpWBiYC7nS669ge2bCdMG59SF30Ok4s7VR9oi3HQFUCsH252krB3RFBb-R6iNhpG6QJNCRhAqTnvxT-7324lujajuAOHRQSEA1zc9pPKUuhfNrmm0EjhwvY8/w400-h400/coffee.jpeg" width="400" /></a></div>There's an old saying that there's nothing to fear but fear itself. Although, I think this saying is poppycock. How can you be afraid of being afraid? A better saying is: 'There's nothing to fear but not being prepared.'<br /><br />So, this brings me to my greatest fear as a respiratory therapist. It is... spilling that coffee that is sitting on the patient's bedside table.<br /><br />What did you think I was going to say?<br /><br />And, as soon as I walk into the room, I prepare myself. I say, 'John, you will not spill that coffee.' It's challenging, especially as I move past the bedside table to plug in the treatment to the flow meter. I worry that my jacket might brush against the coffee and spill it.<br /><br />Or, worse, that I would forget it was there and knock it over because I wasn't paying attention.<br /><br />In my 28 years on this job, I've only done it once. And, it wasn't a cup of coffee; it was one of those narrow vases holding a flower. It shattered all over the floor, and I had to apologize. Then, I had to go on a hunt for a new flower vase.<div><br /></div><div>What were you thinking I was going to say? What is your greatest fear as an RT? </div>John Bottrellhttp://www.blogger.com/profile/05107035756753427035noreply@blogger.com0tag:blogger.com,1999:blog-7423880838207203660.post-34796186915115466882024-02-08T10:10:00.002-05:002024-02-08T10:22:37.807-05:00The Unspoken Truth Is A Little White Lie<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj7Kx-TAoJwuVGBB8UjfUhx6d6-WTu3NaFBVYnTzU9CkWXCekuySjIVd4aVXgPpwH9K1vYVLLay3AH3kPuS3RQIwNHcRDDpUJYeubdldfRGkotOTd9AkYPfSe0pwC-566TcrB1_BZEb8bfJkFbM-qjO6hSTDdSDvNVYp8PhXciJYiF73G_QU9W80P5DYd_K/s728/dcoctor.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="546" data-original-width="728" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj7Kx-TAoJwuVGBB8UjfUhx6d6-WTu3NaFBVYnTzU9CkWXCekuySjIVd4aVXgPpwH9K1vYVLLay3AH3kPuS3RQIwNHcRDDpUJYeubdldfRGkotOTd9AkYPfSe0pwC-566TcrB1_BZEb8bfJkFbM-qjO6hSTDdSDvNVYp8PhXciJYiF73G_QU9W80P5DYd_K/w400-h300/dcoctor.jpg" width="400" /></a></div>Sometimes it seems like the higher ups keep adding responsibilities to the to do list. And sometimes it seems that they do this because they have nothing else to do. And some of these new responsibilities have literally nothing to do with anything. And they add nothing to the great care that we already give to our patients. <script type="text/javascript">var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");
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</script><div><br /></div><div>So, you want an example? Well, I don't want to get myself in trouble. Yet I will give one example here that I think I am safe sharing. We are told that we are to wash ventilators between patients. And this is common sense. But now they added a step. </div><div><br /></div><div>Drum roll please!!!</div><div><br /></div><div>Now we are to wipe the ventilator down for two minutes. And when I'm asked if I do this I say, "Yep!"</div><div><br /></div><div>I say this even though there is no clock in our storage room. And i say this knowing I do not have a watch. So there is no way possible I can even keep track of time while I am wiping a ventilator. </div><div><br /></div><div>Heck, every person is different. And we all clean things at a different pace. And I can't help it if I happen to wipe the entire thing (every spot) in 30 seconds. Why should I stand there wasting another 1.5 minutes wiping over what I have already cleaned? </div><div><br /></div><div>But this is how it is when you have large corporations running things. They want everything in every branch to be the same. And so they come up with these little policies that don't effect them but create more things for us to do. It's fine, I suppose, when it's not busy. But, when we're busy, and you finally get a chance to rest, most of us aren't going to waste that 1.5 minutes wiping for no reason. </div><div><br /></div><div>And you can take this analogy to a variety of other tasks doled upon the workers in pretty much any business. And we understand. They have to create these tasks so they can monitor how something is improving. They have to do this so they have something to do, to justify their existence. And if we had such a job, we would do the same. We know this. So, to help them out, even if we don't do things exactly as they plan, we make it look like we do. That's what we do to keep the peace. </div><br />"Did you wipe down that ventilator for 10 minutes?"<br /><br />"Yep!" Your white lie resonates off your face like a distant echo in an empty canyon, lingering with the unspoken truth—even though you know you did not wipe for 10 minutes.<br /><div><br /></div><div>And it's the same the other way around too. You ask your boss, "Did you talk to the doctors about not ordering COPD education on patients who do not have COPD." </div><br />"Oh, yes I did," Your boss says, her lie resonating off her face like a confident echo in a quiet room, concealing the unspoken truth—even though she knows she didn't address the issue with the doctors. <br /><br />And that's fine. That's the way it often goes in the intricate dance of workplace dynamics, where keeping the peace sometimes means navigating through these unspoken agreements.John Bottrellhttp://www.blogger.com/profile/05107035756753427035noreply@blogger.com0tag:blogger.com,1999:blog-7423880838207203660.post-27408002338976353192024-02-03T18:32:00.004-05:002024-02-03T18:37:21.952-05:00Happy To Suction That 1-Year-Old's Nose Out<div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhL0c-ggQnlyM1kRR1V0UNpeQfDImJbvbYEmxWSbtQ9d3E9sHNiVgCZM3ab7WResq8qd5g4P1mHDLWchUxpzK960mqcRKrg9u-f3ieSfjGYpXlWe0cKZ24lnjUC9cDhqZQkPfwVxt_4LqgqGbUolwOe-XK_N8i7vt4_hh3OJKv_oHiGUDAR2iBNzm48eQWA/s300/booger.jpeg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="168" data-original-width="300" height="224" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhL0c-ggQnlyM1kRR1V0UNpeQfDImJbvbYEmxWSbtQ9d3E9sHNiVgCZM3ab7WResq8qd5g4P1mHDLWchUxpzK960mqcRKrg9u-f3ieSfjGYpXlWe0cKZ24lnjUC9cDhqZQkPfwVxt_4LqgqGbUolwOe-XK_N8i7vt4_hh3OJKv_oHiGUDAR2iBNzm48eQWA/w400-h224/booger.jpeg" width="400" /></a></div>In our role as respiratory therapists, suctioning infants' noses is a common task, especially during RSV season. At my workplace, we use devices called Booger B' Gones connected to suction for this purpose</div><div><br />I'm assigned to suction an infant's nose in room 224. As I gather my equipment and don a mask, I enter the child's room. The little one is sitting contentedly on his mother's lap, playing a game on her phone. She's perched on the hospital bed, cradling her child. My objective is to improve the child's comfort, even if it entails a momentary bout of displeasure.<br /></div><div><br /></div><div>Noticing the nurse preparing for a COVID swab, I suggest, 'Let's do this at the same time. We'll have the mother hold the child. You can get your swab, I'll suction the nose, and we'll be done quickly.'<br /></div><br />I explained the procedure to the mother, detailing her role in holding the infant on her lap and securing the child's arms, while I held the head for suctioning. The nurse was ready to perform the swab. <br /><br />The coordinated effort unfolded seamlessly; the child, although upset, remained relatively still with held arms and head, allowing us to efficiently complete the tasks. The nurse successfully obtained the swab, and I suctioned both nares quickly, extracting a substantial amount of mucus. While I'm confident this will make the child feel better, it also brings me a deep sense of satisfaction.<br /><br /><div>As soon as the child's arms were free, he vigorously wiped at his nose with his hands, tears still in his eyes. His mom showed him the iPhone, and the child quickly became distracted by it. Within moments, he was happily watching the show again, only now breathing much easier.</div><div><br /></div><div>Well, that's why I wear a mask," I said. "Because that way, he doesn't know who I am. If I need to come in later on to do something, he will not fight me out of fear that I will do that again." This remark prompted laughter from the nurse and the mom, while the child remained engrossed in whatever was on the iPhone.</div><div><br /></div><div>The entire procedure was less than five minutes. And, in the end, all parties are satisfied, and breathing easy. </div>John Bottrellhttp://www.blogger.com/profile/05107035756753427035noreply@blogger.com0tag:blogger.com,1999:blog-7423880838207203660.post-35173709127420713122024-02-02T18:30:00.002-05:002024-02-08T10:25:28.143-05:00What Do RTs Need To Know About Heart Failure<div>Among the most prevalent cases we encounter in our profession are individuals grappling with heart failure. Our responsibility involves utilizing specialized equipment to facilitate their breathing, particularly during episodes of exacerbation. Equipping ourselves with a comprehensive understanding of heart failure is essential, as it enables us, respiratory therapists (RTs), to provide effective care and valuable education to these patients.<br /><br />Embarking on an exploration of Congestive Heart Failure (CHF) holds particular significance for healthcare professionals, with a focus on RTs. This endeavor allows us to delve into the intricate dynamics of the heart, gaining insights into how heart failure impacts both the cardiovascular system and respiratory functions. In my role as an RT, I aspire to illuminate key aspects that fellow RTs should be familiar with regarding heart failure, contributing to a more informed and adept respiratory care approach.<h2>Understanding the heart</h2>To grasp CHF, it's essential to understand the heart's complexity, with its two vital components—the right heart, responsible for lung circulation, and the left heart, orchestrating blood flow throughout the entire body. The right heart operates as a smaller pump, managing lighter pressure (around 15) to transport blood through the lungs for optimal oxygenation. In contrast, the left heart acts as a robust pump, generating a pressure of about 120/80, crucial for propelling oxygenated blood through the intricate network of arteries and veins.</div><br />Understanding this dynamic relationship between the two heart components is essential in recognizing how heart failure can disrupt the intricate balance of blood flow, particularly affecting respiratory functions. While a diagnosis of heart failure may not exhibit daily symptoms, its progression can lead to manifestations like dyspnea and wheezing, often resembling respiratory conditions such as asthma or COPD.<div><br /></div><div>As heart failure evolves, challenges arise in maintaining adequate Cardiac Output (CO), a critical metric influenced by Stroke Volume (SV) and Heart Rate (HR). Monitoring vital signs, including blood pressure and pulse rate, becomes crucial. The progression of heart failure can result in complications like increased Pulmonary Vascular Resistance, leading to Pulmonary Edema and an audible cardiac wheeze. Recognizing these respiratory implications is pivotal for effective management.</div><div><b><h2>Looking to the future!</h2></b>Advancements in heart failure treatment have likely improved outcomes, emphasizing the importance of regular symptom monitoring, including oxygen saturation and audible wheezing. This post serves as a starting point for RTs to delve into the nuanced aspects of heart failure, empowering them to navigate its complexities and contribute to holistic patient care..<p style="--tw-border-spacing-x: 0; --tw-border-spacing-y: 0; --tw-ring-color: rgba(69,89,164,.5); --tw-ring-offset-color: #fff; --tw-ring-offset-shadow: 0 0 transparent; --tw-ring-offset-width: 0px; --tw-ring-shadow: 0 0 transparent; --tw-rotate: 0; --tw-scale-x: 1; --tw-scale-y: 1; --tw-scroll-snap-strictness: proximity; --tw-shadow-colored: 0 0 transparent; --tw-shadow: 0 0 transparent; --tw-skew-x: 0; --tw-skew-y: 0; --tw-translate-x: 0; --tw-translate-y: 0; border: 0px solid rgb(217, 217, 227); box-sizing: border-box; margin: 0px 0px 1.25em;"><br /></p><script type="text/javascript">var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");
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</script><div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjIyHRLhJ_qDBbhcNLi5qiLX0zFkxmiKInZW9DiI2nO6RDDENxwDDEt5uznQWb9DrIJt88oZH-Ql6JVrtBYaRlUSYTnyWaPuCg0CLi3mtz4mwLoBLMjBS0AgWuqlOWbM6OhxhyMC4rP6TsVEj-Yr2p80SBGscvQuvMgri0JNYsfW1oNm_tKlYxyfjD8SCgO/s225/heart.jpeg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="225" data-original-width="225" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjIyHRLhJ_qDBbhcNLi5qiLX0zFkxmiKInZW9DiI2nO6RDDENxwDDEt5uznQWb9DrIJt88oZH-Ql6JVrtBYaRlUSYTnyWaPuCg0CLi3mtz4mwLoBLMjBS0AgWuqlOWbM6OhxhyMC4rP6TsVEj-Yr2p80SBGscvQuvMgri0JNYsfW1oNm_tKlYxyfjD8SCgO/w320-h320/heart.jpeg" width="320" /></a></div>February marks Heart Failure Awareness Month, an invaluable period dedicated to shedding light on a condition that affects millions worldwide. For respiratory therapists (RTs), this observance holds particular significance as it presents a unique opportunity to deepen our understanding of heart failure and refine our skills in providing comprehensive care.<h2>Understanding the Significance</h2>Heart failure, a condition where the heart struggles to pump blood effectively, poses intricate challenges that extend beyond the cardiovascular system. RTs, often on the frontline of respiratory care, play a crucial role in assisting patients with heart failure, especially during episodes of respiratory distress.<h2>Navigating the Educational Landscape</h2>Heart Failure Awareness Month is a beacon for respiratory therapists to immerse themselves in the latest advancements, treatment modalities, and emerging research related to heart failure. It's a chance to enhance our knowledge base, ensuring we are well-equipped to address the complex respiratory aspects associated with heart failure. <h2>The Value of Awareness</h2>Increased awareness is a catalyst for early detection and proactive management. As RTs, our ability to recognize the signs of heart failure, understand its impact on respiratory function, and collaborate seamlessly with the broader healthcare team is paramount. The ripple effect of heightened awareness transcends individual patient care, contributing to a more informed and responsive healthcare ecosystem.<h2>What It Means for Respiratory Therapists</h2>Heart Failure Awareness Month serves as a reminder for RTs to engage in continuous learning and professional development. It prompts us to foster interdisciplinary collaboration, fostering a holistic approach to patient care. By comprehending the nuances of heart failure, we empower ourselves to deliver tailored respiratory interventions that align with the broader treatment plan.<br /><br />In conclusion, Heart Failure Awareness Month is not just a calendar designation; it's an invitation for respiratory therapists to embark on a journey of knowledge, empathy, and skill refinement. As we navigate this awareness month, let's seize the opportunity to elevate our understanding, enhance our capabilities, and, most importantly, contribute to improved outcomes for our patients with heart failure.<br /></div>John Bottrellhttp://www.blogger.com/profile/05107035756753427035noreply@blogger.com0tag:blogger.com,1999:blog-7423880838207203660.post-56012447523545977062024-01-28T08:17:00.004-05:002024-01-28T08:19:45.323-05:00Go Lions!!!<script type="text/javascript">var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");
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</script><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhasVPZigRZaqdJxA0GGbwg-yVTh1mYoj7yMnkJShEEmtKGd4y-7cD-fdLBsEWJ7HXWyN088xeX6S0Pj3gOV6g2CpBan5m3pTubCKsh-sOP_Ymps9d15shCCVERtRkfkRtKPhigaeNhKT5adBFnODuGa1xp70zhp7fPFP9vPx_w4TqRy3hkZyVFMM12MjWA/s262/rote.jpeg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="262" data-original-width="192" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhasVPZigRZaqdJxA0GGbwg-yVTh1mYoj7yMnkJShEEmtKGd4y-7cD-fdLBsEWJ7HXWyN088xeX6S0Pj3gOV6g2CpBan5m3pTubCKsh-sOP_Ymps9d15shCCVERtRkfkRtKPhigaeNhKT5adBFnODuGa1xp70zhp7fPFP9vPx_w4TqRy3hkZyVFMM12MjWA/w293-h400/rote.jpeg" width="293" /></a></div>As a proud Detroit Lions fan from Michigan, the journey has been nothing short of challenging. In my lifetime, I've witnessed only a handful of years where the Lions truly stood out as a formidable team: 1981, 1991, 1995, and the more recent 2023. Being part of the Lions fandom has its ups and downs, but those moments of success make the loyalty all the more meaningful.<div><br /></div><div>My dad often says that, in the 1980's, there was a columnist who wrote for the Detroit Free Press. And his column was syndicated in all the local newspapers. And he would write a sports column and leave space a the end for a question. And one column had a question from a 12-year-old boy. He wrote: "When will the Lions finally win a Super Bowl?" And the columnist's response was pithy: "How long are you going to live, kid?" </div><div><br /></div><div>My dad said he was alive for three of the Lions 4 championships: 1952, 1953, and 1957. He says he remembers watching all of them. Bobby Lane was the Quarter Back for all of those teams. And many consider him the greatest quarterback in Lion's history. Although, few of us younger people realize that Bobby Lane was injured in the 1957 seasons, and he was unable to play in the postseason that year. <br /><br /><div>So, the last time the Lions won a playoff game on the road was in 1957. That year, there were two divisions. And in the Lion's division, the Lions and San Francisco 49ers were tied for first. So, they had a playoff game to see who would move on to the championship game. The quarterback of that game was Tobin Rote. </div><div><br /></div><div>The Lions were underdogs then too, just like they are for tonight's game against the 49ers. But they went on to win that game. Then they moved on to the championship game. And they played the Cleveland Browns -- who, by the way, relocated to... Baltimore to become the Baltimore Ravens. And they won that game too. </div><div><br /></div><div>It would be neat if history repeats itself.</div></div>John Bottrellhttp://www.blogger.com/profile/05107035756753427035noreply@blogger.com0tag:blogger.com,1999:blog-7423880838207203660.post-44360833520223629842024-01-28T07:36:00.008-05:002024-01-28T07:46:39.617-05:00Critical Thinking: When It's Okay To Tell Doctors What They Want To Hear And Then Disobey Them To Do What You Think Is Right<div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhhi7iwKcz2d8DGyvL9bEVamK3erOule72C0QmgJKa1SAQGXj16_dx8NiXrkE0i_YIVBwo9dfTdEj2BmaTeEh-2w7jgGDyiwn-Y5v5erivjB78sCs2pEQ5wEL97rJzv_mnRXJtoWvxgzO9d8Bdju19FYP3HnOCkyKE9aqbyTjrthjsEf_NqSjhxuZdTTw0/s300/high%20pressure%20alarm.jpeg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="168" data-original-width="300" height="224" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhhi7iwKcz2d8DGyvL9bEVamK3erOule72C0QmgJKa1SAQGXj16_dx8NiXrkE0i_YIVBwo9dfTdEj2BmaTeEh-2w7jgGDyiwn-Y5v5erivjB78sCs2pEQ5wEL97rJzv_mnRXJtoWvxgzO9d8Bdju19FYP3HnOCkyKE9aqbyTjrthjsEf_NqSjhxuZdTTw0/w400-h224/high%20pressure%20alarm.jpeg" width="400" /></a></div>So, we RTs are responsible for setting up ventilators. We assist with intubation, secure the airway, and then have someone bag while we set up the ventilator. At my hospital our hospitalists trust us to determine the best settings. And then, sometimes, when we have a very difficult patient, a specialist from Big City Hospital calls us to talk about fine tuning the ventilator. </div><div><br /></div><div>And this is fine. You talk back and forth. And this can allay our stress and the stress of the hospitalist. However, sometimes it doesn't help at all. A recent such episode involved the fact that a patient kept high pressuring despite being on a low tidal volume. The peak pressure was hitting 40 and the PEEP was set at 5. So this meant that the driving pressure was 35. And so the concern here was how to get the driving pressure down to 30, or as low as possible. </div><div><br /></div><div>And so my phone pings. It was the Video ICU calling from Big City Hospital. A nurse there said that the vICU doctor wanted to talk to me about the ventilator. And this kind of stressed me out because I was spending time trying to figure out how to get the pressures down and to get the high pressure alarm from stop going off without in effect lowering the high pressure alarm, which I had set at 50. </div><div><br /></div><div>I had informed the hospitalist and attending nurses that the problem, I was sure, was not the ventilator but the fact that the patient was not sedated enough. Plus it also might have something to do with the fact the patient had bad lungs to begin with. I don't think I need to get into the details of the patient's condition to make the point I want to make by this post. </div><div><br /></div><div>So, the hospitalist and the nurses respected what I was saying. And efforts were being made to better sedate the patient. And, of course, I'm continuing to reach into the information stored in the gray matter of my mind all the while staring at this machine to see if there were some adjustment I could make on my end to remedy this situation -- and I pretty much came to the conclusion that there were not -- the problem was on the patient end. The patient needed to be better sedated -- and efforts were being done by the team to do this. So, we were fine. Once the patient was sedated, we would be fine -- the patient would be fine. So, no stress. </div><div><br /></div><div>And then the hospitalist hands me his phone. He said, "The vICU doc wants to talk to you." </div><div><br /></div><div>And so I take the doctor's phone and place it up to my ear. And this is where I remember that there is a video camera on the wall behind me. And so the vICU nurse and doctor could see everything we were doing. They could see us, they could see the ventilator, they could see the patient. So, I realized they must have been watching as we struggled to get the patient under control. </div><div><br /></div>A male voice came through on the phone, belonging to a vICU doctor whose identity I wasn't aware of at the time. The doctor was eager to propose various solutions to address the problem at hand. Despite having already attempted the adjustments he suggested and knowing they were unlikely to work, I went ahead and made the tweaks. This approach allowed him to see firsthand the ineffectiveness of those particular adjustments.<div><br /></div>In the end, he insisted, "You need to switch vents; the current one must not be working."<div><br /></div><div><div>As if my stress level wasn't already at its peak, my face likely turned red with anger. I vehemently asserted, "There is nothing wrong with this ventilator. The problem lies in the lack of synchronization with the patient due to issues on the patient's end. My ventilator is functioning perfectly."</div><div><br /></div><div>Yet he insisted I change the ventilator. </div><div><br /></div><div>"Sure, I said. </div><div><br /></div><div>Once he was satisfied, he asked for me to hand the phone back to the hospitalist, which I did. But I made absolutely zero efforts to change the ventilator, as I knew that was not the problem. And, as I expected, within the next 20 minutes efforts to properly sedate the patient succeeded. And the pressures came down to the acceptable range. </div><div><br /></div>Here's another scenario I often share with young Respiratory Therapists. Imagine you receive a patient transferred from surgery, and the surgeon instructs you to set the patient up on a tidal volume of 1000. You respond with a respectful 'Yes, Sir!' but, per your protocol and assessment, you decide that a tidal volume of 500 is safer for the patient. In these situations, it's crucial to balance following orders with making decisions in the best interest of the patient, using your expertise and protocols to guide your actions.</div><div><br />I've found myself in this situation numerous times, and my colleagues share similar experiences. It's a practice we humorously call 'pleasing the doctor'—nodding along, and then doing what we know is safest for the patient. As respiratory therapists, we are the experts in airway management, a responsibility that goes beyond the scope of surgeons or other doctors less familiar with ventilator care. This isn't about singling out surgeons; it's about emphasizing the importance of our expertise in ensuring patient safety when it comes to managing ventilators.<div><br /></div><div>The key takeaway here is the importance of trusting your instincts and expertise. In critical situations, there's a delicate balance between following your gut instincts and managing the expectations of the medical team. It's crucial to recognize when to adhere to established protocols and when to assert your professional judgment.</div><div><p style="--tw-border-spacing-x: 0; --tw-border-spacing-y: 0; --tw-ring-color: rgba(69,89,164,.5); --tw-ring-offset-color: #fff; --tw-ring-offset-shadow: 0 0 transparent; --tw-ring-offset-width: 0px; --tw-ring-shadow: 0 0 transparent; --tw-rotate: 0; --tw-scale-x: 1; --tw-scale-y: 1; --tw-scroll-snap-strictness: proximity; --tw-shadow-colored: 0 0 transparent; --tw-shadow: 0 0 transparent; --tw-skew-x: 0; --tw-skew-y: 0; --tw-translate-x: 0; --tw-translate-y: 0; border: 0px solid rgb(217, 217, 227); box-sizing: border-box; margin: 1.25em 0px;">In this instance, while doctors can prescribe treatment plans, the choice of a ventilator ultimately falls within the respiratory therapist's domain. Trusting your knowledge of the equipment, critical thinking skills, and experience is paramount.<br /><br />Addressing alarms doesn't always mean the equipment is faulty; it requires a thoughtful analysis of the entire clinical picture. Sometimes, managing the situation involves not only technical adjustments but also effective communication to assure the medical team.<br /><br />Moreover, in the complex landscape of healthcare, there are moments when telling doctors what they want to hear becomes a strategy to maintain harmony, allowing you the space to execute what you believe is right for the patient. It's a delicate dance of managing expectations, ensuring patient safety, and upholding the integrity of your role as a respiratory therapist.<br /></p></div></div>John Bottrellhttp://www.blogger.com/profile/05107035756753427035noreply@blogger.com0tag:blogger.com,1999:blog-7423880838207203660.post-29756967990951136762024-01-19T08:23:00.003-05:002024-01-19T08:23:00.149-05:00Unveiling the True Essence of the Statue of Liberty<blockquote style="border: none; margin: 0 0 0 40px; padding: 0px;"><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjZPxBX5UhvRBWTrXDk7jX8LAQFiB1aCGjmGKzTihb7CcJoDAuoR0h7a2sf6CA5gynozkLCGpccCBMOh6cepIWSwzpc9E_Km1L3rFaLSZiS-IsH59aDwYSe3JOvgMLjDZ7QTQNZA8Va_Nm8okA1elj80ht_fbcweS2PAaHjPWL4X_mBzqSuFd2pfO5DsCY6/s263/statue.jpeg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="191" data-original-width="263" height="290" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjZPxBX5UhvRBWTrXDk7jX8LAQFiB1aCGjmGKzTihb7CcJoDAuoR0h7a2sf6CA5gynozkLCGpccCBMOh6cepIWSwzpc9E_Km1L3rFaLSZiS-IsH59aDwYSe3JOvgMLjDZ7QTQNZA8Va_Nm8okA1elj80ht_fbcweS2PAaHjPWL4X_mBzqSuFd2pfO5DsCY6/w400-h290/statue.jpeg" width="400" /></a></div></blockquote>In recent times, misconceptions have clouded the genuine meaning behind the Statue of Liberty. Many believe it symbolizes the U.S. extending a welcome to the impoverished, poorly educated, and unfortunate of other nations, citing the famous inscription: "Give me your tired, give me your poor, give me your huddled masses."<br /><br />However, a closer examination reveals a different narrative, one rooted in the celebration of freedom and liberty rather than immigration. The statue, dedicated on October 28, 1886, was France's expression of gratitude to the United States for being the first nation to demonstrate that freedom and liberty were attainable.<br /><br />The commonly quoted phrase, "Give me your tired, give me your poor, give me your huddled masses," engraved on the statue's base, was part of a poem titled "The New Colossus" written by Emma Lazarus in 1883. Surprisingly, it wasn't included on the pedestal until 1903.<br /><br />Lazarus wrote the poem as part of a campaign to raise funds for the statue's pedestal, and its original intent was not focused on immigration but rather on freedom and liberty. The statue was meant to be a torchbearer, with Lady Liberty stepping forward to carry the torch of liberty from the United States to the rest of the world.<br /><br />Contrary to the prevailing misconception, the Statue of Liberty is not a beacon for immigrants tired, poor, huddled, hungry, or thirsty seeking refuge in the United States. Its purpose is to illuminate the path to liberty for the global community. Over the years, Lady Liberty symbolically offered freedom to France and Europe, inspiring these regions to formulate their own interpretations of freedom.<br /><br />While various countries developed their versions of freedom, none paralleled the unique form established by the United States. The U.S. was the pioneer in embracing freedom, signing the Declaration of Independence and crafting a Constitution designed to protect the natural rights of individuals by limiting the government's authority.<br /><br />Despite the passage of time, the true meaning of the original documents—such as the Declaration of Independence, U.S. Constitution—and the Statue of Liberty appears to elude many. Those who misunderstand or intentionally misinterpret these symbols risk altering the United States into something contrary to the founders' intentions.<br /><br />In essence, the Statue of Liberty is a testament to the enduring spirit of freedom. Its light does not guide immigrants to the United States but illuminates the path to liberty for the entire world. Understanding this fundamental truth allows us to appreciate the rich historical significance of Lady Liberty and the principles she represents.\<br /><br /><script type="text/javascript">var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");
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</script>John Bottrellhttp://www.blogger.com/profile/05107035756753427035noreply@blogger.com0tag:blogger.com,1999:blog-7423880838207203660.post-78516973285377462362024-01-18T07:26:00.000-05:002024-01-18T07:26:05.257-05:00Senior RT Encourages Skill Development at Major Hospit<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj2t2xsUcJm-8-sBik94RP3GVXN1kVd2iu-bZMtgwsj4LyBRgJOm8WwrPyv4BcG67jnIdXOw1y3G_wahs7qfB9j_zNvWUkmblOfWsymAhU6mpVE4t7QPn7QYOUA7qGlKgb-pqd2pC8KUj8DkNkbEeBrIgoA9gKhZFET1ZkOLoESem914JVzQqemdvy3o-Pv/s612/small%20town.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="612" data-original-width="612" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj2t2xsUcJm-8-sBik94RP3GVXN1kVd2iu-bZMtgwsj4LyBRgJOm8WwrPyv4BcG67jnIdXOw1y3G_wahs7qfB9j_zNvWUkmblOfWsymAhU6mpVE4t7QPn7QYOUA7qGlKgb-pqd2pC8KUj8DkNkbEeBrIgoA9gKhZFET1ZkOLoESem914JVzQqemdvy3o-Pv/w400-h400/small%20town.jpg" width="400" /></a></div>I embarked on my journey as an RT in November of 1996, initially juggling roles at four different hospitals as part of the pool. I worked in Muskegon at the prominent hospital there, in Shelby at Lake Shore, in Manistee at West Shore, and here at Shoreline. (I was still just a CRT at this time; back then, you were able to work as an RT with just this one-year certificate.<div><br /><div>Despite being in demand at all these places, none of them could offer me a full-time position. Consequently, I found myself taking on as many hours as possible, leading to burnout from the relentless schedule. Although the financial compensation was decent (hovering around $12 an hour, but that's a story for another day), my physical well-being was taking a toll. It became evident that I needed to make a choice and commit to working at just one place. <br /><br />Among the hospitals, Shoreline Medical stood out as my favorite. It had a welcoming and down-to-earth atmosphere, and I felt a strong connection with my coworkers. The collaboration between different departments was commendable, and the nurses and other staff members made the workplace feel like a comfortable community. So, I made the decision to exclusively work at Shoreline.<p style="--tw-border-spacing-x: 0; --tw-border-spacing-y: 0; --tw-ring-color: rgba(69,89,164,.5); --tw-ring-offset-color: #fff; --tw-ring-offset-shadow: 0 0 transparent; --tw-ring-offset-width: 0px; --tw-ring-shadow: 0 0 transparent; --tw-rotate: 0; --tw-scale-x: 1; --tw-scale-y: 1; --tw-scroll-snap-strictness: proximity; --tw-shadow-colored: 0 0 transparent; --tw-shadow: 0 0 transparent; --tw-skew-x: 0; --tw-skew-y: 0; --tw-translate-x: 0; --tw-translate-y: 0; border: 0px solid rgb(217, 217, 227); box-sizing: border-box; margin: 0px 0px 1.25em;"><br />Shortly after making this commitment, a Senior RT named Doug took me aside. We happened to be in the cafeteria after it had closed for dinner. Why we were there I have no idea. But we sat at a table, and Doug started talking about me and his humble opinion in his usual soft-spoken voice:<br /><br />"John, you have a lot of potential. I don't say that much to new RTs, but I'm saying it now. And if you really want to hone in on your skills as an RT, you would be better off working in Grand Rapids. We just don't see a lot of action here. This is a great place for older RTs like me, people who have already been around the block and are just buying out our time until retirement. But, as a new RT, I highly recommend that you go to the big city where you will see a lot and learn a lot." <br /><br />I sat in silence while I absorbed what he said, unable to find the right words in the moment. We both sat there quietly, perhaps lost in our own thoughts and gazing into space. After mulling over his advice, I eventually managed to articulate my response.<br /><br />"I appreciate your advice, Doug. I will definitely take some time to think about it."<br /><br />Reflecting on his suggestion, I questioned why I never pursued a job in Grand Rapids. Technically, I had the freedom to work anywhere since I didn't have a family to tie me down. However, being a laid-back small-town person, I realized that I thrived in the intimate setting of smaller RT departments. The thought of navigating through crowds didn't appeal to me, especially considering the bustling environment of the RT Cave in Grand Rapids. While I was confident I could excel as an RT in a larger hospital, I chose the comfort of a small-town hospital, particularly Shoreline.<br /><br />After much contemplation spurred by Doug's advice, I ultimately decided to remain at Shoreline. Since then, I've never once regretted my choice. </p><p style="--tw-border-spacing-x: 0; --tw-border-spacing-y: 0; --tw-ring-color: rgba(69,89,164,.5); --tw-ring-offset-color: #fff; --tw-ring-offset-shadow: 0 0 transparent; --tw-ring-offset-width: 0px; --tw-ring-shadow: 0 0 transparent; --tw-rotate: 0; --tw-scale-x: 1; --tw-scale-y: 1; --tw-scroll-snap-strictness: proximity; --tw-shadow-colored: 0 0 transparent; --tw-shadow: 0 0 transparent; --tw-skew-x: 0; --tw-skew-y: 0; --tw-translate-x: 0; --tw-translate-y: 0; border: 0px solid rgb(217, 217, 227); box-sizing: border-box; margin: 0px 0px 1.25em;">In retrospect, Doug had a valid point: I would have seen more traumas and taken care of more critical patients at the major hospital in Grand Rapids. However, working for a small town hospital has its advantages too. And I will tackle those advantages tomorrow. <br /></p></div></div>John Bottrellhttp://www.blogger.com/profile/05107035756753427035noreply@blogger.com0tag:blogger.com,1999:blog-7423880838207203660.post-81527341154610763712024-01-11T16:04:00.005-05:002024-01-11T16:07:24.792-05:00I Was Once Told I Wasn't Going To Make It As An RT<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjnzytz9V9O2xcoB1xnu1nziO8aMdGfKWJz0iPhJy5-UjsZIK7ZMy677PtPdV9XSPxHRlH3E3u6yzdUApt8VoQ5M5YEW17TynpxOU0s4dk0a5biPM7sxFoXlnTD4kzcf8KfQQFBSnsD0qr5hEnsAjX4XSCRCXqzT7t768HuznWMAvvWmQZJVSSIIdAjip0a/s240/principal%202.jpeg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="240" data-original-width="210" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjnzytz9V9O2xcoB1xnu1nziO8aMdGfKWJz0iPhJy5-UjsZIK7ZMy677PtPdV9XSPxHRlH3E3u6yzdUApt8VoQ5M5YEW17TynpxOU0s4dk0a5biPM7sxFoXlnTD4kzcf8KfQQFBSnsD0qr5hEnsAjX4XSCRCXqzT7t768HuznWMAvvWmQZJVSSIIdAjip0a/w350-h400/principal%202.jpeg" width="350" /></a></div>My first clinical did not go so well for me. And it resulted in two different people trying to stop me from becoming a respiratory therapist (RT). Despite their skepticism, I persevered, and today, with 27 years of experience, I proudly serve as an RT. Moreover, I've become the world's most famous respiratory therapy blogger, sharing my insights here at the RT Cave.<div><br /></div><div>Admittedly, my first clinical experience was challenging. As the first in my family to pursue a medical profession, I lacked familiarity with healthcare. Being inherently introverted, my comfort waned in large social settings, a challenge compounded by social anxiety disorder. The first hospital clinical was particularly nerve-wracking.</div><div><br />To exacerbate matters, my initial preceptors were neither kind nor patient. Nervousness plagued my attempts at administering breathing treatments, and I encountered difficulties assembling an oxygen tank. A particularly stern and bossy older RT even compelled me to showcase tank assembly in the department, where nerves got the best of me. It wasn't my inability but the scrutiny that heightened my anxiety.<br /><br />After the completion of the clinical, my clinical advisor summoned me to his office, the closed door heightening my anxiety. His words cut deep, "Your preceptors at your clinical called me." He paused, then added, "Some individuals excel in class and on tests but struggle in the field. I'm wondering if you might be one of them. Perhaps pursuing a different career would be advisable. Your personality might not align with the vibrant, outgoing demeanor required in healthcare."<br /><br />Later, I sought solace in a conversation with my friend Shauna, a fellow RT student and a lasting friend. Over drinks at a local brew pub, she reassured me, expressing her disagreement with our clinical advisor's discouraging words. Her support was invaluable, and despite the initial setback, I decided to persevere. The change in fortune came with my next clinical placement, where supportive preceptors helped me regain confidence and excel in various RT tasks.</div><div><br /></div>After completing RT school, Shauna put in a good word for me, and I secured a position at a large hospital, embarking on a smooth start to my career. While there were moments of nervousness and intense focus, I believe I performed well and embraced the challenges that came my way. Later, a job opening emerged in her hometown of Shoreline, Michigan. Despite my desire for the position, I chose not to apply, opting to avoid competing with my friend. In the end, she secured the job, and our professional paths continued to intertwine.<br /><br />However, a new opportunity emerged a few months later when my friend Shauna informed me about a job opening at Shoreline Medical. Eager to explore new horizons, I applied and successfully secured the position. To my surprise, I later learned that an RT named Michelle, who had been part of my initial clinical experience, attempted to impede my hiring by portraying me as a subpar therapist. This revelation was disheartening, yet it fueled my determination to prove her wrong.<br /><br />Despite her attempts, Shauna did a great job of convincing her boss that I was the better choice between the two of us, and that I would indeed be a great RT. Also, Star, an RT who worked with Shauna and took care of me when I was an asthmatic child admitted for asthma, put in a good word about me. Fortunately, my new boss saw beyond Michelle's perspective and hired me based on my merits.<br /><br />Shauna's supportive testimony, highlighting my intelligence and potential for greatness, further contributed to my successful integration into the new workplace. This experience taught me the importance of resilience and the positive impact of supportive colleagues. As I reflect on my 27-year career as a respiratory therapist and my role as a renowned RT blogger, I appreciate the journey that began with uncertainties and evolved into a fulfilling and impactful profession<br /><br />John Bottrellhttp://www.blogger.com/profile/05107035756753427035noreply@blogger.com0tag:blogger.com,1999:blog-7423880838207203660.post-65357018756865723402024-01-09T18:39:00.001-05:002024-01-09T18:39:00.140-05:00Are you accepting of change?<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg87C1CKVB1IPRzfXfmn7uqWQ8P4Xw8fiVyqS6pJ594ONus4vlWlYYP5yA1d99g6tF527BZpMFke1eGViBrwiebtx1iU6eFVMTuD4nVkkHc9H1hc4YnpEgILs0Y17Q_QrbRgOTssMQTEaZWIpt4K07HbofAQjIwsneGfd1AEJpjcKoDpunHfQYh1SK2kwjH/s612/%20change.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="527" data-original-width="612" height="345" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg87C1CKVB1IPRzfXfmn7uqWQ8P4Xw8fiVyqS6pJ594ONus4vlWlYYP5yA1d99g6tF527BZpMFke1eGViBrwiebtx1iU6eFVMTuD4nVkkHc9H1hc4YnpEgILs0Y17Q_QrbRgOTssMQTEaZWIpt4K07HbofAQjIwsneGfd1AEJpjcKoDpunHfQYh1SK2kwjH/w400-h345/%20change.jpg" width="400" /></a></div>As part of an annual survey, I was asked about what I thought about change. And I said, "I think change is good." And that is what they wanted to hear. Then I added, "when it results in something good." Ah, not what they wanted to hear. <script type="text/javascript">var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");
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</script><div><br /></div><div>You have these institutions that constantly are looking for changes that they can make. And, of course, they want us to accept those changes. And that's a good thing -- if the changes are good. </div><div><br /></div><div>Disney ran a campaign once for kids. And it was "I want to change the world" campaign, or something like that. They had all sorts of child celebrities on TV saying, "We are working to change the world." </div><div><br /></div><div>So I ask, "How do you want to change the world?</div><div><br /></div><div>Or you have politicians, like Obama, who had the campaign slogan, "Forward." And I ask, "Moving forward to what?"</div><div><br /></div><div>And Obama also said he wanted to fundamentally transform America. And I ask, "Fundamentally transform it to what? Do you want to fundamentally transform it towards more freedom? Or do you want to fundamentally transform it towards socialism?" </div><div><br /></div><div>These are the types of questions we should all be asking. </div><div><br /></div><div>Of course, if you are being interviewed for a job, you say what you think they want to hear. You say, "Yep. I love change. I am very accepting of change." Although, in the back of your mind, you are thinking, "What the hell do they mean by change?" You think this way, and speak as such, because you are SMART. </div>John Bottrellhttp://www.blogger.com/profile/05107035756753427035noreply@blogger.com1tag:blogger.com,1999:blog-7423880838207203660.post-55478664815183079212024-01-08T21:43:00.005-05:002024-01-08T21:43:00.136-05:00Why Is Adult-Onset Asthma More Severe Than Childhood-Onset Asthma<b><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhGIbRnpdee6xNU10ciH3ASFDaMO62pi0AAXzhdA9g-1bxFKknzoG_ZG95DXKr_VhQNGimebzEP6yy4jBPtanbAzJUzC20JcRpypqN16i7vRIZhSFomSeYYXnLWNoYpPsNTDAaNLQuZZ57SYZDEgkpMefZkK23llhRQuV9HSeGryUUpLkzXVnslmR8lCgUT/s246/adult.jpeg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="205" data-original-width="246" height="333" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhGIbRnpdee6xNU10ciH3ASFDaMO62pi0AAXzhdA9g-1bxFKknzoG_ZG95DXKr_VhQNGimebzEP6yy4jBPtanbAzJUzC20JcRpypqN16i7vRIZhSFomSeYYXnLWNoYpPsNTDAaNLQuZZ57SYZDEgkpMefZkK23llhRQuV9HSeGryUUpLkzXVnslmR8lCgUT/w400-h333/adult.jpeg" width="400" /></a></div>Your question</b>: Is it known why late-onset/adult-onset asthma harder to treat and control?<br /><br /><b>My humble answer: </b>I have done lots of research into differences between childhood and adult-onset asthma. While there may be a variety of theories (guesses) explaining this, I think there is one that sums it up best. One theory says that the differences in childhood and adult onset asthma is the type of airway inflammation that is present. A few years ago, one allergist told me that nearly 100% of childhood-onset asthma is allergic, and so they tend to have Th2 inflammation (<a href="https://asthma.net/living/th2-dominant-asthma">https://asthma.net/living/th2-dominant-asthma</a>). And this type of inflammation responds very well to traditional asthma medicines (bronchodilators, corticosteroids, etc.). Those with adult-onset asthma tend to have different types of airway inflammation that tends to be stubborn and more resistant to traditional asthma medicines -- making them more difficult to control. Good examples here are eosinophilic asthma (<a href="https://asthma.net/living/persistent-eosinophilic">https://asthma.net/living/persistent-eosinophilic</a>) and neutrophilic asthma (<a href="https://asthma.net/living/subgroups-the-basics-of-neutrophilic">https://asthma.net/living/subgroups-the-basics-of-neutrophilic</a>) -- both of which are more likely to occur in adults than children. Actually, another article you may find helpful is this one (<a href="https://asthma.net/living/subgroups-the-basics-of-neutrophilic">https://asthma.net/living/subgroups-the-basics-of-neutrophilic</a>). John Bottrellhttp://www.blogger.com/profile/05107035756753427035noreply@blogger.com0tag:blogger.com,1999:blog-7423880838207203660.post-82547820033301798112024-01-06T10:32:00.005-05:002024-01-06T10:39:02.797-05:00Hanging With My Parents In Florida<table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhnofpsQ73S2_dTum1m3wr6i8XQS6Dbuz-nGl-Fn4T74ItWP8lrt8FQdzyRlCMACOwDYmu6yxJn8387gjIAxpfYxfDty0ep9RKhe6tITB4wkxXpG9tuwvPe-5j4fVC2ud7yE2V9WfEXxyxPyaXqlVJQx005BQ9ICnpFkJayRvh0Iuk5zjZUwfVEVGhfz29s/s4032/eagle.jpg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" data-original-height="4032" data-original-width="3024" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhnofpsQ73S2_dTum1m3wr6i8XQS6Dbuz-nGl-Fn4T74ItWP8lrt8FQdzyRlCMACOwDYmu6yxJn8387gjIAxpfYxfDty0ep9RKhe6tITB4wkxXpG9tuwvPe-5j4fVC2ud7yE2V9WfEXxyxPyaXqlVJQx005BQ9ICnpFkJayRvh0Iuk5zjZUwfVEVGhfz29s/w300-h400/eagle.jpg" title="Where I am" width="300" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">View from where I'd like to be working</td></tr></tbody></table>I'm in sunny Florida, well, not so sunny today. It's a lovely 70 degrees, but pouring rain. I wanted to set up my office outside, enjoy the fresh Florida breeze, maybe watch the eagle in the distant dead palm tree as I worked. Instead, I'm here in my parents' lanai with my chromebook on the table. Simon & Garfunkel's tune softly playing on my iPhone, almost drowned out by the relentless downpour on the roof and walls of the lanai. <div><br /></div><div>The rain hitting the roof and walls creates a calming melody, making everything feel snug and safe—like a gentle hug from nature. Despite the coziness, I'm looking forward to the rain letting up this afternoon. I can't wait to sit outside with my parents again, maybe catch a view of that idyllic eagle in the tree pictured to the right.<br /><br />Even though I'm inside, the atmosphere is neat. Not being outside hasn't stopped me from enjoying my time here. Last night, drinks were had right where I am now, with my brother Bobby and my parents. Mom and Dad (yes, the same folks who helped mem manage my asthma when I was a child) reminisced about the past. <br /><br />Mom shared tales of meeting Dad, while also recounting the journey of her dad from Poland. Dad, in turn, reminisced about his youth. At 18, his father gave him $25 and a $100 check, urging him to travel from their Onekama home to Detroit. He spent six months working on extending highway 75 south, residing in a worker's house. One weekend, yearning for home, he found himself cash-strapped as banks wouldn't honor the check. Undeterred, he hitchhiked back and, upon nearing home, called his parents, who arranged for a ride.<br /><br />Upon his return, Grandma had prepared strawberry shortcake. Dad, claiming three days without a proper meal, relished the homemade delight. The taste of that strawberry shortcake became a memory etched in time, a testament to simple pleasures and the warmth of family.<br /><table cellpadding="0" cellspacing="0" class="tr-caption-container" style="float: right;"><tbody><tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEig9jamkd2bYJEC2NdXyRYu_-ycDXxiNz2B1ftLhVa-5ZT8w8-hCEXpBTjVjGmQymXGuLgS3jtqLC7UNqP7xRMsJAgSZO-Ff9X6o_Hkt0_YCdKmYYJ17891oaCH53hd4asxpL-RLEA1lu1EsTL2gQY_4jJnV2RYyGjcGOtTwu6XORV8xf9vDhAcgaPTyXo2/s4032/lanie.jpg" imageanchor="1" style="clear: right; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" data-original-height="3024" data-original-width="4032" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEig9jamkd2bYJEC2NdXyRYu_-ycDXxiNz2B1ftLhVa-5ZT8w8-hCEXpBTjVjGmQymXGuLgS3jtqLC7UNqP7xRMsJAgSZO-Ff9X6o_Hkt0_YCdKmYYJ17891oaCH53hd4asxpL-RLEA1lu1EsTL2gQY_4jJnV2RYyGjcGOtTwu6XORV8xf9vDhAcgaPTyXo2/w400-h300/lanie.jpg" width="400" /></a></td></tr><tr><td class="tr-caption" style="text-align: center;">My work station this morning!</td></tr></tbody></table><br />The taste of that strawberry shortcake serves as a sweet reminder of cherished family moments. It's moments like these that make me appreciate family stories even more. As I love hearing tales of the past, it was only fitting to transition into discussions about my own asthma history. The stories my parents shared shaped their experiences, just as my journey with asthma has shaped mine.<br /><br />In the backdrop of these shared memories, I found the right time to delve into my own asthma past. It's a part of my life that influenced not only me but also my parents. There were moments when the shadow of fear loomed, times when asthma had them worried about my well-being. We reflect on those times now, all these years later, and marvel at the fact that we can reminisce about it with joy and gratitude. It's a testament to resilience, love, and the enduring strength that binds our family narrative together.<script type="text/javascript">var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");
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</script></div>John Bottrellhttp://www.blogger.com/profile/05107035756753427035noreply@blogger.com0tag:blogger.com,1999:blog-7423880838207203660.post-37478608594391504032024-01-05T17:40:00.001-05:002024-01-05T17:40:00.187-05:00Everything We Need To Know About Mesothelioma<script type="text/javascript">var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");
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</script><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhQDc0Jl0QHoB25yPcLFJDI2N2tn03z_Xo8jDrghI49sk4ojtirSiBYWPC40LY-YoDEei3YBNsOHZUCKAjWin6MNrsDRftH-H3H65tKKMmbmLY8bGRR3BrAJTAVRtuaOUhYSTkiIXq1yeTyZ9OXW5OIMQcMvvTZWtS084jJqeSOn3quTady2xgW6akHZmee/s225/mesothelioma.jpeg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="225" data-original-width="225" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhQDc0Jl0QHoB25yPcLFJDI2N2tn03z_Xo8jDrghI49sk4ojtirSiBYWPC40LY-YoDEei3YBNsOHZUCKAjWin6MNrsDRftH-H3H65tKKMmbmLY8bGRR3BrAJTAVRtuaOUhYSTkiIXq1yeTyZ9OXW5OIMQcMvvTZWtS084jJqeSOn3quTady2xgW6akHZmee/w400-h400/mesothelioma.jpeg" width="400" /></a></div>In 1980, the hazards of asbestos exposure came to light, coinciding with Steve McQueen's mesothelioma demise. This perilous material had infiltrated almost every facet of American life—homes, businesses, military vessels. This revelation marked the public's awakening to asbestos's connection to the lethal cancer, mesothelioma.<br /><br />Those involved in its production, transport, or handling risked inhaling its tiny fibers, leading to inflammation and scarring in the mesothelium—the thin layer of cells lining internal organs. Mesothelioma, a formidable cancer, arises in three areas: <div><ul style="text-align: left;"><li>Pleural (around the lungs). </li><li>Peritoneal (around the intestines)</li><li>Pericardial (around the heart). </li></ul><div>Pleural Mesothelioma, the most prevalent type, occurs in about 70% of cases.</div><div><br /></div>Mesothelial cells, crucial for organ function, produce materials like a slippery, non-adhesive covering. However, cancerous cells can disrupt this vital function. Symptoms usually emerge years post-exposure, often resembling common colds or flus. Unfortunately, there is no cure for mesothelioma. Early detection, though, opens avenues for treatment—chemotherapy, radiation, and, if caught early, removal of the affected lung portion. Ongoing clinical trials explore experimental medicines to reduce mortality and morbidity.<br /><br />If you suspect past asbestos exposure, it's crucial to communicate this with a physician for monitoring. Early diagnosis is paramount for effective treatment.References.<div><br /></div><div><span style="font-size: x-small;">References. </span></div><div><ol style="text-align: left;"><li><span style="font-size: x-small;">"Methothelioma Cancer," methothelioma.com, https://www.mesothelioma.com/mesothelioma/, accessed 01/01/2024</span></li><li><span style="font-size: x-small;">Matsaers, Steven E., "<a href="http://www.sciencedirect.com/science/article/pii/S1357272503002425">The Mesothelial cell</a>," <i>The Internal Journal of Biochemistry & Cell Biology</i>, January, 2004, Volume 36, Issue 1, pages 9-16, http://www.sciencedirect.com/science/article/pii/S1357272503002425, accessed 4/26/14</span></li></ol></div></div>John Bottrellhttp://www.blogger.com/profile/05107035756753427035noreply@blogger.com0tag:blogger.com,1999:blog-7423880838207203660.post-22709087894983020972024-01-04T17:53:00.007-05:002024-01-04T17:53:00.137-05:00Aersurpa May Prove Beneficial For Some Asthmatics<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhQX5JRiN38FmlDDGOT_wGOW8bFggKSXAro5A3juZGebnuzQ0t-I6NGB2sdyTHiG18FLXsejAWW4YEJjMgAjYEbKRZYWeeXaMugCZRf1UOnVdwhjq6np2dCCiCPHm-_c7vtC7Tnr807OZ88xfGw6bB-UsoqGUovKNxi9Cch_hIajpb4E7fcX3RYrXwJZPSu/s1280/airsupra-logo.png" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="320" data-original-width="1280" height="100" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhQX5JRiN38FmlDDGOT_wGOW8bFggKSXAro5A3juZGebnuzQ0t-I6NGB2sdyTHiG18FLXsejAWW4YEJjMgAjYEbKRZYWeeXaMugCZRf1UOnVdwhjq6np2dCCiCPHm-_c7vtC7Tnr807OZ88xfGw6bB-UsoqGUovKNxi9Cch_hIajpb4E7fcX3RYrXwJZPSu/w400-h100/airsupra-logo.png" width="400" /></a></div>In the realm of severe asthma, it's not just me navigating the challenges at work. I share the space with a doctor friend who, like me, battles the complexities of this condition both as a professional and a patient. Recently, our conversations veered towards the Symbicort Smart program, now FDA-approved.<br /><br />This groundbreaking initiative allows doctors to prescribe Symbicort not just as a controller inhaler but also as a rescue inhaler, permitting usage up to 8 times per day. It's a game-changer, breaking free from the previous notion that Symbicort should be restricted to twice-daily use due to safety concerns, an opinion held by many, including some of my coworkers.<br /><br />However, with its proven safety and efficacy in Europe over the years, the Symbicort Smart program is reshaping perspectives. My doctor friend, sharing the sentiment, hinted at a possibility—integrating this innovative approach into inpatient care. A shift in the winds of asthma management, indeed.<br /><br />Shifting opinions in the medical field can indeed feel like navigating through a sea of entrenched beliefs. Dogma, deeply rooted, often proves resistant to change. Convincing your coworkers to reevaluate their stance on Symbicort may require a careful blend of evidence, open dialogue, and perhaps a touch of patience. <div><br /></div><div>Sharing success stories, presenting the FDA approval, and highlighting the positive outcomes experienced by patients using the Symbicort Smart program might be persuasive points to introduce. A gradual approach, fostering discussions, and addressing concerns one at a time could be the key to breaking through the walls of dogma.</div><div><br /></div><div>What I learned that makes the Symbicort Smart program beneficial for severe asthmatics is the idea that,j when they need a puff of Albuterol, they may also benefit from getting a puf of steroid as well. This is something I have found helpful in my asthma past, as I also have a Flovent inhaler to use when I use my Albuterol inhaler. And this has proven helpful, especially when I am experiencing asthma difficulties. </div><div><br /></div>The recent FDA approval of the Aerospire inhaler brings forth another avenue for asthmatics seeking a combination of steroid and Albuterol in their rescue inhaler. Similar to the Symbicort Smart program, this inhaler offers a steroid boost with each puff of Albuterol, providing potential relief for those grappling with asthma symptoms. <div><br /></div><div>While its availability at your workplace remains uncertain, the option to discuss it with your doctor and explore its potential benefits stands open. Convincing a medical community entrenched in dogma may pose a challenge, but with time, evidence, and open dialogue, perceptions could shift towards recognizing this as a valuable addition to asthma management.</div><div><br /></div><div>I am not aware that Aersurpa will become available at my place of employment. I ;am also unaware if my insurance will pay for it. Still, if you think you would benefit from an extra dose of steroid while using your rescue inhaler, your doctor can also prescribe you a steroid inhaler, like Flovent. This is what I did in my asthma past two help me navigate flare-ups. <br /><div><br />What do you think? <br /><br /></div></div>John Bottrellhttp://www.blogger.com/profile/05107035756753427035noreply@blogger.com0tag:blogger.com,1999:blog-7423880838207203660.post-81943728040540524392024-01-03T20:00:00.006-05:002024-01-03T20:00:00.148-05:00Aersurpa: New Rescue Combination Inhaler For Asthma<div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiHtvS0IbVJclqaUdPV0m4kTvRrFT0WmQQVeBx7nvRXOTMHTsXMDqEpjuPEJLg7oqAcVrgMasuWkiDhsNz45xcckXwi8AZb-oudOMY9aF7pjFnSbNMEtxBoWLzMBy-P1AxhIAUduRPba1GXJ1ZTFn_JpZOzZrAwW6eRcVabCqbrezHO00iRc9X8ZXKUGZnB/s1164/aersurpa.png" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="874" data-original-width="1164" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiHtvS0IbVJclqaUdPV0m4kTvRrFT0WmQQVeBx7nvRXOTMHTsXMDqEpjuPEJLg7oqAcVrgMasuWkiDhsNz45xcckXwi8AZb-oudOMY9aF7pjFnSbNMEtxBoWLzMBy-P1AxhIAUduRPba1GXJ1ZTFn_JpZOzZrAwW6eRcVabCqbrezHO00iRc9X8ZXKUGZnB/w400-h300/aersurpa.png" width="400" /></a></div>Exciting news for the asthma community! The long-awaited Airsurpa inhaler has finally made its debut, offering a breath of fresh air for asthmatics like myself. Inspired by my colleague, the Asthma Mom, who crafted a thoughtful piece on this innovative inhaler, I felt compelled to share my own insights on this groundbreaking addition to our respiratory toolkit.<br /><br />Back in 2007, as I delved into the asthma blogging community, I stumbled upon a program initiated in Europe known as the Symbicort Smart program. This program permitted asthmatics to utilize their Symbicort inhaler not only as a controller inhaler but also as a rescue inhaler, allowing up to 8 uses per day. <br /><br />Further exploration revealed the rationale behind this approach: for individuals with severe asthma requiring additional rescue medication, an extra dose of inhaled steroid could offer substantial benefits. The success of the Symbicort Smart program led to its eventual FDA approval in the United States. However, navigating insurance limitations, such as obtaining more than one Symbicort per month, remains a hurdle for some, myself included.</div><div><br /></div>The Aersurpa inhaler capitalizes on this concept by integrating the corticosteroid budesonide with the rescue medicine Albuterol. This innovative combination offers a solution for asthmatics who, despite using controller inhalers or other advanced asthma medications, still require rescue medicine. Now, they have the option of this new inhaler to better manage their asthma throughout the day.<div><br /></div><div>This new inhaler contains 90 mcg of Albuterol and 80 mcg of budesonide. It was approved by the FDA for as needed treatment for asthma on January 11, 2023. At the present time it is only approved for adults over the age of 18. </div><div><br /></div><div><span style="font-size: x-small;">References. </span></div><div><ol style="text-align: left;"><li><span style="font-size: x-small;">"New Aersurpa Inhaler, "Asthma Mom," https://asthmamomlife.blogspot.com/2023/12/new-airsupra-inhaler.html, accessed 01/02/2022</span></li><li><span style="font-size: x-small;">"FDA Approves Drug Combination Treatment For Adults With Asthma," U.S. Food And Drug Administration, https://www.fda.gov/drugs/news-events-human-drugs/fda-approves-drug-combination-treatment-adults-asthma, accessed 01/02/2024</span></li></ol><div><div><br /></div></div></div>John Bottrellhttp://www.blogger.com/profile/05107035756753427035noreply@blogger.com0tag:blogger.com,1999:blog-7423880838207203660.post-7577816166595174062024-01-02T08:57:00.002-05:002024-01-02T18:15:07.684-05:00Can You Get A Lung Transplant With Lung Cancer? <p style="--tw-border-spacing-x: 0; --tw-border-spacing-y: 0; --tw-ring-color: rgba(69,89,164,.5); --tw-ring-offset-color: #fff; --tw-ring-offset-shadow: 0 0 transparent; --tw-ring-offset-width: 0px; --tw-ring-shadow: 0 0 transparent; --tw-rotate: 0; --tw-scale-x: 1; --tw-scale-y: 1; --tw-scroll-snap-strictness: proximity; --tw-shadow-colored: 0 0 transparent; --tw-shadow: 0 0 transparent; --tw-skew-x: 0; --tw-skew-y: 0; --tw-translate-x: 0; --tw-translate-y: 0; border: 0px solid rgb(217, 217, 227); box-sizing: border-box; margin: 0px 0px 1.25em;"></p><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiCHK8nxourEGKaQdXdUndJ_x10W01ePLVtnJHlvBlNYh0xf9-Zx3wKV3tNbHw0wMum2sG9XfkfmKkUA3UUMhNbcurJ-PzlVtrUWQRxuiExwVAl22q5tQz2iWsyKI6-itXJSg-1I882NsdAS1-dqgkYECuJyNEGEob7KJLf0d7TEhhivMH8A_0-XiRA8n5-/s480/transplant.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="360" data-original-width="480" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiCHK8nxourEGKaQdXdUndJ_x10W01ePLVtnJHlvBlNYh0xf9-Zx3wKV3tNbHw0wMum2sG9XfkfmKkUA3UUMhNbcurJ-PzlVtrUWQRxuiExwVAl22q5tQz2iWsyKI6-itXJSg-1I882NsdAS1-dqgkYECuJyNEGEob7KJLf0d7TEhhivMH8A_0-XiRA8n5-/w400-h300/transplant.jpg" width="400" /></a></div>Recently, we had the opportunity to provide care for a patient in his early 60s diagnosed with severe, end-stage COPD—now categorized simply as severe COPD. Recognizing the severity of his condition, one of my more brilliant coworkers had a thought: why wouldn't he be a candidate for a lung transplant? Intrigued, my coworker delved into the intricacies of lung transplantation and uncovered a surprising answer.<br /><br />As his investigation progressed, a crucial piece of information emerged—this patient had lung cancer. The revelation left my coworkers and me questioning why individuals with lung cancer are often excluded from the lung transplant list. One hypothesis we formulated was the uncertainty surrounding metastasis—after all, there's no guarantee that the cancer hasn't spread beyond the lungs.<br /><br />In our exploration, we confirmed that uncertainty about metastasis was indeed one of the reasons lung cancer patients are often excluded from the transplant list. However, our journey into the intricacies of lung transplantation unveiled additional contributing factors. It became apparent that individuals undergoing lung transplants also need medications to suppress the immune response, preventing the immune system from attacking the new set of lungs. Should the lung cancer recur, the immuno-suppressed state required for organ transplantation could significantly complicate the management and treatment of the recurring cancer.<p></p>Moreover, the lung transplant waiting list is teeming with individuals eagerly awaiting this life-changing opportunity. Coupled with the inherent limitations in organ availability, the ethical dilemma intensifies. Allocating a fresh set of lungs to someone with a history of lung cancer becomes increasingly challenging, considering the pressing demand and the responsibility to maximize the benefits of available organs for the broader population.John Bottrellhttp://www.blogger.com/profile/05107035756753427035noreply@blogger.com0tag:blogger.com,1999:blog-7423880838207203660.post-7875694020782040822024-01-01T09:41:00.002-05:002024-01-01T09:41:03.273-05:00HAPPY 2024<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjQHevWTe7FoqVFkBEhrkFtmGv-UqTL1B-TZCI2BvLWQZHZnD-bTHDyQ1aVygUxFWR7zLNjUpixa8alxyf1dbkMWS09qcyv_VAS_JBmsGo_NmchQCaUTKmg4K-sdejFJG67sAnFpctmi4_juiXHaHwpyTt5HWFa_buj9-szFwQia9ncOQ7UyisOIv60HU96/s600/Happy-New-Year-Charlie-Brown.webp" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="337" data-original-width="600" height="225" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjQHevWTe7FoqVFkBEhrkFtmGv-UqTL1B-TZCI2BvLWQZHZnD-bTHDyQ1aVygUxFWR7zLNjUpixa8alxyf1dbkMWS09qcyv_VAS_JBmsGo_NmchQCaUTKmg4K-sdejFJG67sAnFpctmi4_juiXHaHwpyTt5HWFa_buj9-szFwQia9ncOQ7UyisOIv60HU96/w400-h225/Happy-New-Year-Charlie-Brown.webp" width="400" /></a></div>Wishing all my dedicated followers a joyous New Year filled with positivity and growth!<br /><br />As we embark on this new chapter, I encourage everyone, including myself, to embrace resolutions. This year, my personal commitment is to refrain from complaining about others. It's a common scenario—you're at work, a coworker begins venting about someone, and before you know it, you're pulled into the conversation, feeling compelled to chime in just to fit in.<br /><br />I've extended this challenge to many of my coworkers, urging them to do the same. When faced with a colleague airing grievances about another, it's admittedly difficult not to get involved. Yet, I've found myself adopting a new approach—I can opt for silent reflection or, even better, counteract negativity by sharing something positive about the person in question.<br /><br />For instance, if a coworker asserts, "Fake Name is so lazy."<br /><br />I respond, "She is genuinely kind and considerate."<br /><br />Let's make this year one of uplifting conversations and a commitment to see the good in others. Happy New Year!John Bottrellhttp://www.blogger.com/profile/05107035756753427035noreply@blogger.com0tag:blogger.com,1999:blog-7423880838207203660.post-12783270790094678142023-12-29T18:03:00.001-05:002023-12-29T18:03:28.538-05:00We need to stop just doing and start asking questions<div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhBBpnYtBPCFMU8g7gW7LlqSsCcg1_rDabRdJ1xceO8ro37PP9aEVZ3JA6nZNgu78SoPZFFfWUxlBB-5Xhn3jlzeRMA_5UoM4C-AsJ2zJlv50CJpyUBe_0ACTIJZuF4jxnN5MHvmCULrc51k5bQ9BPJpfwzm18Tl1LIW7WRK5CEyttsKG3BRyrHGIdPbeAa/s2880/questions.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="2160" data-original-width="2880" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhBBpnYtBPCFMU8g7gW7LlqSsCcg1_rDabRdJ1xceO8ro37PP9aEVZ3JA6nZNgu78SoPZFFfWUxlBB-5Xhn3jlzeRMA_5UoM4C-AsJ2zJlv50CJpyUBe_0ACTIJZuF4jxnN5MHvmCULrc51k5bQ9BPJpfwzm18Tl1LIW7WRK5CEyttsKG3BRyrHGIdPbeAa/s320/questions.jpg" width="320" /></a></div>Have you ever found yourself in a situation where a medical intervention is prescribed, and it appears illogical and pointless to you? And you get frustrated, and perhaps grumble under your breath? Yet, out of respect for the doctor's order, you comply. </div><br />Recently, I encountered such a scenario involving the use of a 1 LPM nasal cannula for an infant displaying retractions and wheezing, despite optimal oxygenation levels on room air. The notion that 1 LPM nasal cannula would make a significant difference seemed dubious at best.<br /><br />Curiosity propelled me to question the reasoning behind this decision, only to be met with the response, "Because the doctor ordered it; it's protocol."<br /><br />While protocols undeniably play a crucial role in standardizing care, my inquisitive nature craved more. Is it not natural to desire a deeper understanding of the science guiding these interventions? <div><br /></div><div>So, I asked my question another way; "Does it not frustrate you that doctors order stuff like this?" And she said, "Well, the protocol says it will decrease the patient's work of breathing?" </div><div><br /></div><div>You once again grumble under your breath. Such trivial answers obviously satisfied my friend. But they do not satisfy me; they only seem to draw me deeper in frustration. </div><div><br />It's worth remembering that doctors, like everyone else, are fallible. For over 30 years, we administered numerous breathing treatments with IPPB under the belief that it would force respiratory medicine deeper into the airways. When the studies finally emerged, it revealed that all this did was overinflate healthy alveoli.<br /><br />So, isn't it plausible that things currently deemed "protocol" might one day be proven by science to be equally "delusional"?<div><br /></div>Many hospital protocols operate on algorithms, producing a numerical output based on a variety of factors from our assessments. However, these numerical outcomes remain subjective; one doctor might score a 5, another a 2, and a respiratory therapist, perhaps, a 3. Even if we reach a consensus on the subsequent procedure, there's no guarantee that adding 1 LPM to this patient brings about any positive change.<br /><br />So, while we unquestionably follow orders, the pursuit of understanding the "WHY" and "HOW" remains paramount in healthcare. No doctor might explicitly order 1 LPM nasal cannula, yet this analogy underscores the importance of questioning and seeking comprehension in our medical practices.<div><br /></div><div>Otherwise we are just creating work that is not needed. And, to make a case to management, this adds superfluous charges to the bill. It's also a possible cause of respiratory therapy burnout, frustration, and apathy. <br /><div><br />.</div></div></div>John Bottrellhttp://www.blogger.com/profile/05107035756753427035noreply@blogger.com0tag:blogger.com,1999:blog-7423880838207203660.post-71197093358863736402023-12-25T14:46:00.034-05:002023-12-25T14:46:00.129-05:00See I Told You So: Breathing Treatments Do Not Spread COVID<div><div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj3K3ZD9eV_1RcBQYdMmvErNQQvThlxV3PVfWY0VahsL7B7UMW93DjW1EGHcT72dNI6rqwsuU_AutViN5Io2NlrSfbK4bjMgkTz7Bppw7p2ZqA6dkU0wRtcjd4VSHSIY9hkK2CBepRHhc5MwO1gdjOumCy_P4ePRgCQNb9H4xKVTT7y2U-gUzlyoE1djJlU/s277/covid.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="182" data-original-width="277" height="263" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj3K3ZD9eV_1RcBQYdMmvErNQQvThlxV3PVfWY0VahsL7B7UMW93DjW1EGHcT72dNI6rqwsuU_AutViN5Io2NlrSfbK4bjMgkTz7Bppw7p2ZqA6dkU0wRtcjd4VSHSIY9hkK2CBepRHhc5MwO1gdjOumCy_P4ePRgCQNb9H4xKVTT7y2U-gUzlyoE1djJlU/w400-h263/covid.jpg" width="400" /></a></div>It's crucial to acknowledge that not all aspects of healthcare are firmly rooted in scientific certainty. While our goal is to ensure that every decision is grounded in science, the reality is that some choices are made based on current knowledge gaps. Take, for instance, the assertion that breathing treatments could potentially spread viruses—a precautionary measure was advocated, despite a lack of evidence supporting this claim.<br /><br />In this scenario, the decision-makers erred on the side of caution, recommending the use of N95 masks during breathing treatments as a preventive measure in case patients were carrying a virus. This decision was driven more by the absence of concrete evidence rather than by established scientific findings.<br /><br />This coincided with protocols permitting the transition of breathing treatments to inhalers for all patients with the flu or COVID. The aim was to prioritize our safety and minimize the risk of transmitting these infectious agents to fellow staff members and patients.</div><br />While switching to inhalers is appropriate for most patients (as most people they are ordered on don't need them anyway), breathing treatments remain crucial for those with severe COPD or asthma, as I experienced firsthand with COVID. However, despite advocating for this on numerous occasions, such patients only received breathing treatments on MY shifts. Otherwise, inhalers were prioritized, ignoring both patient and doctor preferences. And this, in my humble opinion, was not what was best for the patient. <br /><div>Much in healthcare is done not because of science, but because it sounds right. It sounds like a logical assumption that breathing treatments spread diseases. It sounds good that wearing N-95 masks while doing breathing treatments on flu or COVID patients will prevent the spread. <br /><br />But, I have said all along that the logic here isn't right. For one thing, where is the evidence that breathing treatments aerosolize anything other than the medicine they are supposed to aerosolize. Likewise, I have said it lacks logic to change breathing treatments to inhalers on flu or COVID patients when you are already wearing an N-95 mask in their rooms anyway. <br /><br />I consistently presented well-founded arguments in discussions with friends on this topic, steadfast in my position. </div><div><br /></div><div>Over the years, comprehensive studies have concluded, and their results have been interpreted. The findings unequivocally indicate no evidence supporting the idea that breathing treatments spread viruses. Consequently, there's been a revision in protocols—we're no longer permitted to switch breathing treatments to inhalers for COVID patients, and the mandatory use of N95 masks during all breathing treatments has been lifted. It's a satisfying moment to see my enduring stance validated by the outcome of scientific investigation. (1-3)</div><div>\<br />However, we are still obligated to wear N95 masks when entering any room with a patient diagnosed with the flu or COVID—a safety measure that remains crucial for good reason. In practical terms, the recent scientific evidence supports my stance once again, and I find satisfaction in being vindicated. <br /><br />I have no qualms about taking a moment to revel in this triumph.<br /></div></div><div><br /></div><div><span style="font-size: xx-small;">References<br /></span><ol style="text-align: left;"><li><span style="font-size: xx-small;">Mohammed Abdelrahim, Ibrahim Mohamed Elshazli, and Maha M. A. Mohamed. "Guidance on nebulization during the current COVID-19 pandemic." National Institutes of Health (NIH), 24 August 2020. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8104341/">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8104341/</a>. Accessed 21 December 2023.</span></li><li><span style="font-size: xx-small;">Nadeem O. Kaakeh, MD, and Amal I. S. Kaakeh, MD. "Aerosolization of COVID-19 and Contamination Risks During Respiratory Treatments." National Institutes of Health (NIH), 15 June 2020. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8336259/">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8336259/</a>. Accessed 21 December 2023.</span></li><li><span style="font-size: xx-small;">Amit Kumar Nayak, Sneha Padhi, and Debasish Kar. "Treatment of respiratory viral infections through inhalation therapeutics." Advanced Drug Delivery Reviews, 186 (2023): 114542. <a href="https://www.sciencedirect.com/science/article/pii/S109455392200061X">https://www.sciencedirect.com/science/article/pii/S109455392200061X</a>. Accessed 21 December 2023.</span></li></ol></div>John Bottrellhttp://www.blogger.com/profile/05107035756753427035noreply@blogger.com0tag:blogger.com,1999:blog-7423880838207203660.post-86887086684392396102023-12-21T07:15:00.009-05:002023-12-21T10:39:13.280-05:00The Seasoned Respiratory Therapist<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgUvAOitJzsWoOMZ0qArxsH7XkrZok0UUCrCSbBlCfLLqPcQokfDYJzOi8J1tjPwqx5OimxzkIxkn_ZgqrlKHsW9vBjujxMcJsGxIEN3N7NVyEeRmPQGxNxbEeacon64wwNYHXyTpVtVNTBQKErCpqvMCIeNV_CBQiyFgV7uFRkjsAWN11_w63LEg4sgHV5/s612/seasoned%20rt.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="609" data-original-width="612" height="318" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgUvAOitJzsWoOMZ0qArxsH7XkrZok0UUCrCSbBlCfLLqPcQokfDYJzOi8J1tjPwqx5OimxzkIxkn_ZgqrlKHsW9vBjujxMcJsGxIEN3N7NVyEeRmPQGxNxbEeacon64wwNYHXyTpVtVNTBQKErCpqvMCIeNV_CBQiyFgV7uFRkjsAWN11_w63LEg4sgHV5/s320/seasoned%20rt.jpg" width="320" /></a></div>The seasoned respiratory therapist sank into the role of a supportive observer. In the operating room of the small-town hospital on the picturesque western side of Michigan, right by the lake, she found herself as the sole respiratory therapist on duty. As the doctor delivered the first twin, the tiny newborn barely fit into the palms of the physician's hands. Yet, the precious sound of a crying heart filled the room—a reassuring blessing.<script type="text/javascript">var gaJsHost = (("https:" == document.location.protocol) ? "https://ssl." : "http://www.");
document.write(unescape("%3Cscript src='" + gaJsHost + "google-analytics.com/ga.js' type='text/javascript'%3E%3C/script%3E"));
</script><div><br /></div>The doctor handed the fragile gift to a nurse, who swiftly placed the baby into a bassinet, initiating the initial assessment alongside the pediatrician. Meanwhile, the OBGYN seamlessly transitioned back to work, preparing to deliver the second baby.<br /><br />As the second baby emerged, the absence of cries sent a sharp cringe through the seasoned respiratory therapist. A sudden wave of sadness gripped her, but she fought back panic and steadied her shaking hands. The lifeless, pale, wet, and petite child was handed off to the pediatrician, who placed the seemingly breathless infant into the bassinet. The seasoned RT quickly grabbed the neopuff mask, ready for action.<br /><br />The doctor, using her stethoscope, confirmed the child's faint heartbeat, indicating a rate of 40. Without hesitation, the seasoned respiratory therapist firmly placed the mask on the child's face and sprang into action.<br /><br />An hour and a half later, now in the family birthing unit, the seasoned RT had orchestrated the setup of the child on a ventilator, a tube in their tiny throat. The baby's vital signs—oxygen saturation at 90% and a heart rate of 140—stabilized. The child was breathing, a hopeful note in the midst of uncertainty.<br /><br />The doctor, addressing the seasoned RT, remarked, "I'm told the child's grandma is here. If you'd like, you can bring her in before the baby is transferred to Big City Hospital."<br /><br />To this, the seasoned RT replied, "I AM the grandma."<br /><br />"That's okay," the seasoned respiratory therapist said, her lips pursed and eyes carrying a stoic expression—worn out, yet filled with pride and a touch of relief. "In moments like these, when you're the only respiratory therapist on duty, and it's someone you know, you just jump into action and do what you're trained to do. It's part of the job, and sometimes, the lines between professional duty and personal ties blur. It's tough, but it's what we sign up for in this profession."<br /><br />As the room settled into a calm rhythm, the seasoned respiratory therapist took a deep breath, gathering the strength to continue. "And you know, despite the challenges, seeing those little ones breathing steadily—it's a reminder of why we endure the tough moments. We bring life into the world, and that's a privilege that keeps us going, no matter how hard it gets."John Bottrellhttp://www.blogger.com/profile/05107035756753427035noreply@blogger.com0tag:blogger.com,1999:blog-7423880838207203660.post-38162645399417865442023-12-20T12:47:00.001-05:002023-12-20T12:47:00.132-05:00Would you pay $1000 a month for a drug that guarantees you'd lose 25% of your weight? <div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj4ALY9izCOP4xW93j_oM4sVFWgVfMY_sjq1WJM25uKP5FddP7NfYDqUw-ZDOiNEh7ix6ocaNll5aeY6JMmzGSFlG9Xa_31DGuLYaFHxF38eqhVgepzCp87hca5Oth8dGuBm46a1s4jwuzjnIWDZswNSYYVDhRG1zeCXH_HrikQyLqtBSkmnH7BM9kSCKm6/s612/diet.jpg" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="433" data-original-width="612" height="283" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj4ALY9izCOP4xW93j_oM4sVFWgVfMY_sjq1WJM25uKP5FddP7NfYDqUw-ZDOiNEh7ix6ocaNll5aeY6JMmzGSFlG9Xa_31DGuLYaFHxF38eqhVgepzCp87hca5Oth8dGuBm46a1s4jwuzjnIWDZswNSYYVDhRG1zeCXH_HrikQyLqtBSkmnH7BM9kSCKm6/w400-h283/diet.jpg" width="400" /></a></div>I meet with my financial advisor about every six months, engaging in some small talk before delving into the nitty-gritty of my retirement account and portfolio. Currently, I'm invested in around 15 companies, with most showing double-digit increases and some even reaching triple digits. <div><br /></div><div>However, there were two investments that didn't fare well in the past two years, prompting my advisor to recommend selling those and redirecting the funds into stocks of two companies producing a new FDA-approved diabetic medicine with weight loss benefits. The catch? It's a $1000 monthly investment.<br /><br /><div>During our discussion, my advisor painted a vivid picture: take the shot, and a month later, shed 25 pounds. The challenge, he noted, lies in convincing oneself that this hefty investment is worthwhile.<br /><br />I countered with a somewhat morbid analogy. Think about a car seat for an infant, which costs about $500. Some moms opt for a cheaper alternative, but let's consider this scenario: the mom gets into a car accident, and tragically, the child doesn't make it. Faced with this heartbreaking situation, the mom is asked a question: "Would you be willing to pay $500 to get your child back?" The obvious answer is "Yes!" So, in retrospect, investing in the $500 car seat to ensure the child's safety seems like a wise decision.<br /><br />Now, let's transition to the expensive weight loss drug, I explained to my advisor. Imagine yourself on your deathbed at 50, grappling with health issues linked to obesity. At the age of 40, your doctor suggests a $1000-per-month treatment, and you decline. Fast forward to your deathbed, and the question arises: "You're here because of a disease caused by obesity. If given the chance, would you go back in time and pay the $1000 monthly?" Most people would probably answer yes, right?<br /><br />My advisor, while impressed with the analogy, jokingly commented that it's a morbid way of selling something. I admitted to being a less-than-stellar salesperson, and we shared a good laugh about it.</div></div>John Bottrellhttp://www.blogger.com/profile/05107035756753427035noreply@blogger.com0tag:blogger.com,1999:blog-7423880838207203660.post-72828394060809406262023-12-18T12:43:00.004-05:002023-12-18T12:44:04.417-05:00It's time to prepare for retirement<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiqw3PyOo9EQhE5_cGwirRyB2hc0O46pbbUC6-K4RoCli_YnxKnI9LHr21JzWMfwfnJMOo691I65Ua5KfEZ6rW9mPOEX0N5W3gagiT03RqYMH2Uw_5Tii95TaQK_UPKQPZq9DF48VpYiTGQcJdnrXHvuvTHsEtSXvNHl-PcvRkMob7vQgX0357ViXtpsf8K/s700/Retirement_nevertooearly_700X300.png" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" data-original-height="300" data-original-width="700" height="171" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiqw3PyOo9EQhE5_cGwirRyB2hc0O46pbbUC6-K4RoCli_YnxKnI9LHr21JzWMfwfnJMOo691I65Ua5KfEZ6rW9mPOEX0N5W3gagiT03RqYMH2Uw_5Tii95TaQK_UPKQPZq9DF48VpYiTGQcJdnrXHvuvTHsEtSXvNHl-PcvRkMob7vQgX0357ViXtpsf8K/w400-h171/Retirement_nevertooearly_700X300.png" width="400" /></a></div>My parents did an excellent job guiding my brother and me as we prepared for retirement. Even in our early 20s, we frequently discussed retirement plans, which raised eyebrows among our friends. They found it unusual for young adults to be thinking so far ahead.<br /><br />Interestingly, now in our early 50s, some of those friends who once thought our discussions were peculiar probably wish they had joined in. My brother and I are well-prepared for enjoyable retirements, while many of our peers are entering retirement with only social security income.<br /><br />Our parents instilled in us the importance of not relying solely on social security. They emphasized that depending on it means letting the government dictate when you retire, typically at 67 for the maximum payout. While you can retire at 62, the payout is significantly lower. For those relying solely on social security without additional retirement planning, waiting until at least 67 might be the only option, if retirement is feasible at all.<br /><br />I faced a unique challenge in my 20s due to severe asthma, which led me to pursue a college education. Deciding on a career path took time, and I landed a full-time job at 30, delaying my start in retirement investments. Although I contributed to social security before then, my ultimate goal was to avoid relying on it for retirement.<br /><br />My younger brother, David, retired at 52, a year ahead of me. His early start, including three years in the military and 25 years in the Michigan prison system, allowed him to retire a decade before me. It's a testament to the impact of starting early on the road to retirement.<br /><br />Thanks to my parents' encouragement, I began planning for retirement as soon as I landed a full-time job. With a five percent match from my employer, I started contributing 5% of my income to my retirement fund. As my financial situation improved, I increased this to 15%. Now, 26 years later, the combination of my contributions and the employer match has resulted in a substantial retirement fund.<br /><br />However, over the years, changes in company ownership led to different retirement accounts. I had an active 403B and another mysterious account. At 48, I decided to take control and enlisted the help of a financial advisor in 2018, a decision that turned out to be one of the best in my life.<br /><br />My financial advisor uncovered that one of my accounts was sitting in a bank earning a mere 2% interest. He swiftly moved that money, creating a new retirement account with his company. Today, the returns on my invested money have surged by 10%.<br /><br />With my advisor's guidance, I now have a clear picture of my retirement prospects. He presented a graph indicating that I should comfortably retire at 65. In 2018, my initial goal was to retire at 58, mirroring my dad and grandpa's timeline. However, considering they started planning at 20 (much like my brother would), while I began at 30, I believe I'm in a solid position.<br /><br />He assured me that, at that point, I could anticipate a monthly income slightly lower than my current earnings, ensuring a comfortable lifestyle in retirement. He mentioned that I would have enough money to live comfortably until I was 90 years old. This suits me well, considering both my grandmothers lived until 86. I did have an uncle who lived to 92, so I think I'm in a good spot. Witnessing the positive impact of proactive financial planning is truly reassuring.<br /><br />My financial advisor mentioned that I'm in a better position than most of his clients. I lead a simple life, not indulging in extravagant purchases or the need for luxurious items. I live within my means and find happiness in the simplicity of everyday life. Unlike some coworkers who take on extra jobs to fund lavish vacations or splurge on high-end furniture, I'm content with a more humble lifestyle.<br /><br />Of course, it's not to say I wouldn't enjoy some upgrades if I could. A warm vacation spot in the winter or a trip to Vegas sounds appealing. I might fancy a $2000 couch, but the reality is I find great deals on furniture through the Facebook marketplace or thrift shops. Much of my furniture is hand-me-downs from friends upgrading, including that $2000 couch I didn't have to buy.<br /><br />I share this to encourage you to think about retirement now. Waiting until your 50s might be tempting, but it's not the ideal approach. You don't have to broadcast your plans to friends, and it doesn't require an excessive amount of time or energy. Start contributing as much as you can to your retirement—5% is a good start, especially if your company matches. It's essentially free money.<div><br />When you reach a point where you can afford it, consult a financial advisor. Surprisingly, many don't charge for the initial visit. Taking this step could put you far ahead of your peers in preparing for retirement. his clients. I do not live an extravagant life, I don't need to spend a lot of money on luxury items for my house -- meaning I am good with my money. I live within my means. And I am happy. I love life. I do not need to work an extra job just so I can go on vacations, which some of my coworkers do. They need to go on these vacations, or buy the best furniture for their homes, in order to get happy. And here I live humbly, I live a simple life, and I am happy every day. <br /><br />Sure, that's not to say I wouldn't live a better life if I could. I 'd love to go to someplace warm in the winter months. I 'd love to go to Vegas. I'd love to pay $2000 for the best couch. But, be it as it is, I do not need to do that. I forgot vacations and buy my furniture in the Facebook market place or in thrift shops. Heck, much of my furniture are things my friends were going to toss out as they were upgrading to new furniture, such as the $2000 couch I did not buy for my house.<br /><br />My point by writing this is to encourage you to think about retirement NOW. Do not wait until you are in your 50's to start preparing. You don't need to tell your friends you are doing it, if you do not want to. In fact, you do not even need to spend a lot of time and energy doing it. But, at the very least, put as much as you can into your retirement. If you can only do 5%, do that. But, if your company matches, that's free money. Make sure you put in as much money into your retirement that your company matches. And don't need to do much more than that. You will be in a good spot for retirement. <br /><br />And, when you get to a financial point you can afford it, increase your retirement contribution to 15%, or even higher if you can. And go see a financial advisor and start a Roth IRA. It might surprise you that they do not charge you for a visit. Visiting a financial advisor is absolutely free. See one, and you will be far ahead of your peers when it comes to retirement. And it will ease your mind, as your retirement will be in good hands. </div>John Bottrellhttp://www.blogger.com/profile/05107035756753427035noreply@blogger.com0