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Saturday, February 13, 2010

Real Dr's Creed: Bronchodilators treat CHF too

Many of the following might seem like nonsense to thinkers like you and me, but the Real Physician's Creed teaches doctors more than what we RTs learn in RT school. Heed, what follows is suruptitious wisdom previously shared only with physicians.


Section B7

While heart failure was mentioned in section B5 as an indication for bronchodilator, we decided to add this section due to questions ad nauseum regarding the use of bronchodilaotrs for such a purpose.

It is believed that bronchodilators are merely bronchodilators, although we as physicians know that can't possibly be true. Since heart failure causes a wheeze, a bronchodilator is definitely indicated.

The known scientifically proven fact is that heart failure can often cause a prolonged expiratory wheeze and shortness of breath similar to asthma.

This wheeze is caused by increased pressure in the lungs due to pulmonary fluid overload, secondary to left heart failure. Since the increased pressure basically causes the fluid to squeeze the lungs, symptoms mimicking asthma occur.

Now while it might appear a bronchodilator will not resolve this problem because this is not real bronchospasm per se, it sure makes us physicians feel like we are doing something, and it also makes the patient and family feel like we are doing something too.

Yet we are doing something. While it is not scientifically proven, it only makes sense that the 0.5 micron particles of the bronchodilator reach the bronchioles and bind to beta receptors there, these magically shrink to 0.1 microns and reach the alveoli.

From there we know that by a magic osmosis process the Ventolin particles cross over into the blood stream and take up a spot on hemoglobin and sits next to the oxygen molecule, and then it is transported to the kidneys, which have a known affinity to Ventolin.

Once there, the Ventolin attaches to the beta adrenergic receptors that we just know have to be there. Thereby to treat the renal muscle spasm. This also works to undead necrotic kidney tissue and improves the kidney's ability to clean blood and excrete secretions. Thus, along with being a bronchodilator, Ventolin is also a distal tubular dilator.

It can only be stated that while RTs will complain that our methods are not scientifically proven, we know that even with all the data, studies, hypo-the-sisses and hoax theories 'round and 'bout, lets add another.

Note: Like the rest of this Real Physician's Creed, this information must never be mentioned verbally in front of RTs. They can wonder, but must never know.

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