MsMcDucket

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Posts by MsMcDucket

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  32

  Hubby's home!

  by MsMcDucket in

  1. jw
  2. friends

  my husband is back home.

  his hemoglobin is at 11. i will have to keep monitoring his stools for blood, and he will have to go back in for lab draws for blood counts.

  but, he's doing well; and he's happy to be home.. thanks again to everyone for your kind thoughts and messages!.

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  MsMcDucket

  I wasn't so lucky to get mine back..

  Snoozy, I'm so sorry to hear that. I hope that you are doing well. I will give him an extra hug for you!
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  22

  Suggestions Please

  by nonjwalltheway in

  1. jw
  2. friends

  my wife and i have been married for over 10 years and we have three sons.

  she grew up in a jw family.

  he sisters, brother, mother, aunts, uncles and other extended family are mostly jw.

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  MsMcDucket

  Did you ask her why she has changed her mind about the religion now? Why does she think it's good now? There has got to be something that will turn that light bulb on in her head. I know for me, it came after my girls were baptized. Way too late. You have got to keep her from getting baptized; because if she does, and then comes to her senses, her family will have a reason to shun her.

  Maybe you could ask her how she feels about shunning? Ask her if she would shun her own children?
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  69

  sayyyy

  by lola28 in

  1. jw
  2. friends

  .

  something nice about the person that posts above you.. .

  lola.

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  MsMcDucket

  I want to join jojo in having a beer with elsewhere.

  I like to join you two (Dams and Jojo) on having that drink with Elsewhere. I think that his post are hilarious. Sometimes, he almost makes me fall off my chair!
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  32

  Hubby's home!

  by MsMcDucket in

  1. jw
  2. friends

  my husband is back home.

  his hemoglobin is at 11. i will have to keep monitoring his stools for blood, and he will have to go back in for lab draws for blood counts.

  but, he's doing well; and he's happy to be home.. thanks again to everyone for your kind thoughts and messages!.

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  3. 
• 

  MsMcDucket

  Hello everyone! My husband is back home. His hemoglobin is at 11. I will have to keep monitoring his stools for blood, and he will have to go back in for lab draws for blood counts. But, he's doing well; and he's happy to be home.

  Thanks again to EVERYONE for your kind thoughts and messages!
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  2

  Let's not get too blood thirsty

  by MsMcDucket in

  1. watchtower
  2. medical

  while going through this psychological trauma with my husband's hospitalization, i realized that the doctors seemed to be more reluctant to give blood transfusions.

  so, i had to do a "google search" on why this could be.

  there's a lot of medical jargon in this report, but nevertheless, it's worth reading.

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  MsMcDucket

  I don't think it should be forced on anyone but a person should have the freedom to choose.

  I agree with you, 100%.
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  2

  Let's not get too blood thirsty

  by MsMcDucket in

  1. watchtower
  2. medical

  while going through this psychological trauma with my husband's hospitalization, i realized that the doctors seemed to be more reluctant to give blood transfusions.

  so, i had to do a "google search" on why this could be.

  there's a lot of medical jargon in this report, but nevertheless, it's worth reading.

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  MsMcDucket

  While going through this psychological trauma with my husband's hospitalization, I realized that the doctors seemed to be more reluctant to give blood transfusions. So, I had to do a "Google search" on why this could be. There's a lot of medical jargon in this report, but nevertheless, it's worth reading. IMHO

  I hope that I can get the whole article on here. If not, the address to the web page is listed.

  ---

  http://www.itxm.org/tmu2003/issue2003-5.htm

  
  
  Issue # 5 , 2003

  TMU SPECIAL EDITION: THE TRANSFUSION TRIGGER UPDATED: CURRENT INDICATIONS FOR RED CELL THERAPY Blood Bulletin: Vol. 6, No. 2, JULY 2003

  Recent studies have called into question the traditional concept of the transfusion trigger. Until the mid-1980s, this value, defined as the hemoglobin or hematocrit laboratory level at which most patients need red blood cell transfusion, was approximately 10/30; most medical or surgical patients were transfused at that level. During the past 15 to 20 years, a number of studies suggested that otherwise “healthy” adults could tolerate a greater degree of anemia without compromise. A number of transfusion guidelines published in the late 1990’s have been summarized and were reviewed in Blood Bulletin (Vol. 2, #3 1999).

  Clinical transfusion therapy relies on clinical experience and investigation. The most highly regarded investigative studies are randomized clinical trials of various transfusion triggers; observational studies are also valuable. Both are reviewed in this issue of Blood Bulletin.

  Observational studies. Several studies have been conducted involving Jehovah’s witnesses who have undergone surgery and refused transfusion for religious reasons. An analysis of approximately 2000 adult patients undergoing surgery, excluding open heart procedures, in 12 hospitals between 1981 and 1994 demonstrated increasing risks as the hemoglobin falls. 1 A separate analysis of 300 patients with postoperative hemoglobin of 8.0g/dL or below was performed. 2 The subset included 70% females, with a mean age of 57 years. The overall mortality rate was 16%. Those with postoperative hemoglobin levels of 7.1-8g/dL had no deaths (upper 95% CI 3.7%), but 9.4% (CI 4.4-17%) had a morbid event, defined as a myocardial infarction, congestive heart failure, arrhythmia, or infection (bacteremia, pneumonia, or deep wound) that occurred within 30 days of surgery. Patients with a postoperative hemoglobin of 4.1 to 5g/dL had a mortality rate of 34.4% (CI 18.6-53.2%), and 57.7 % (CI 36.9-76.6%) had a morbid event. Adjustment for age, cardiovascular disease, and Acute Physiology and Chronic Health Evaluation II (APACHE II) score showed that for those with postoperative hemoglobin <8g/dL, every gram decrease in hemoglobin resulted in a 2.5 times higher risk of death (CI 1.9-3.2).

  Thus, patients with cardiovascular disease (defined as the preoperative presence of angina, congestive heart failure, or atherosclerosis) had a higher risk of death with low preoperative hemoglobin, or a decline of hemoglobin level during surgery. 1 These studies quantify the increased risk associated with cardiovascular disease regarding tolerance of anemia, but do not provide guidance about a transfusion trigger, since these patients did not receive transfusions.

  Prescribing red blood cell transfusions requires clinical decision making . · The lower limit or "transfusion trigger" for general medical and surgical patients approximates hemoglobin/hematocrit levels of 7.0g/dL and 21%, respectively. Below these levels, morbidity and mortality increase. · Some patient subsets, such as elderly patients suffering from acute myocardial infarction, appear to have better outcomes when transfusions increase the hematocrit to 30 to 33%. Current data suggest that restraining transfusions favors positive patient outcomes—except when significant underlying cardiac disease is present.

  Controlled trials . Ten controlled trials conducted over 40 years and involving 1780 patients were included in a review of randomized clinical trials involving transfusion. 3 Outcomes measured included proportion of patients transfused, volume of blood transfused, morbidity, mortality, and length of hospital stay. Five studies involved surgical patients, three addressed trauma patients or other acute blood loss situations, and two were performed in ICU patients.

  The use of a restrictive transfusion trigger overall (a lower hemoglobin/hematocrit concentration, although defined differently in the various studies) reduced the probability of transfusion by 42%, and resulted in an average saving of nearly 1 unit (0.93) per transfused patient. There was no increase in cardiac events, including infarction, or in the hospital length of stay. Mortality was lower with the restrictive strategy, though this was not statistically significant overall. Importantly, no functional status measurements were used. However, most of the data on clinical outcomes were generated by a single trial. 4. Several other studies stated that restrictive strategies might not be appropriate for several subsets of patients, including those with significant cardiac disease.

  Patients with cardiovascular disease. An analysis of the 357 patients in the above study who had cardiovascular disease showed similar 30-day and other mortality rates in the two groups. 5 In the restrictive group, those with severe ischemic heart disease had higher (but statistically insignificant) mortality. The authors assert that the trigger of 7g/dL is as appropriate in cardiac patients as in other patients. A separate analysis showed that hemoglobin concentrates and transfusion did not affect the duration of mechanical ventilation in patients requiring this intervention. 6

  While these reports showed no difference in outcomes between the restrictive and liberal strategies (or possible benefit of restricting transfusion in some subsets), a large multicenter observational study of European ICU’s 8 showed 33% higher mortality among transfused patients versus non-transfused patients—even when all other variables were controlled, including scores of acuity and organ dysfunction. However, these results should be interpreted with caution because of the heterogeneity of the patient population.

  In certain patient populations, higher transfusion triggers may lead to improved outcomes. An analysis of nearly 79,000 Medicare beneficiaries with acute myocardial infarction showed that transfusion was associated a lower short-term mortality rate if the hematocrit at admission was 30% or lower and transfusion might be effective in patients with a hematocrit as high as 33%. 8

  In another study of 32 patients with low-level anemia (hemoglobin 10-11.5g/dL) randomized to treatment with erythropoietin (epo) or placebo, the group receiving epo had less mortality and strikingly better functional outcomes than the group not treated.9 This small study and the large observational study by Wu8 identified patients benefiting from higher hemoglobin concentrations.9 In a third study, anemia increased the risk of 1-year mortality with acute MI, although confounding factors such as demographics and co-morbid conditions may have explained the effect.10 Thus, it appears that a subset of cardiac patients will benefit from more liberal transfusion—while general surgical and medical patients may benefit from a more restrictive strategy.

  What might be the cause of poorer outcomes of transfusion in patients without cardiovascular disease? One study cites immunomodulation, but gives no specific examples. 6 This and another study suggest that leukocyte content and the age of red cells transfused may influence outcomes. 6, 11 However, a recent study of 1200 ICU patients showed that mortality was similar in patients receiving epo or transfusion, at a trigger of approximately 8.5g/dL, 12 casting doubt on the potential role of leukocytes or red cell age. If one assumes excess mortality in the transfused group, as suggested by the Hebert and Vincent studies, this effect is not ameliorated by epo. 13

  Clearly, randomized controlled trials and observational studies have provided additional data for making clinical decisions. Results of further studies will provide additional information to enhance the clinical use of blood transfusion.

  ---

  
  I hope that you will find this information helpful.
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  31

  Husband had to get a blood transfusion

  by MsMcDucket in

  1. jw
  2. friends

  hi all, i told you about the heart attack.

  well, he developed complications from the anticoagulant.

  he got acute gastritis and started loosing blood in his stools.

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  MsMcDucket

  Hi all, I told you about the heart attack. Well, he developed complications from the anticoagulant. He got acute gastritis and started loosing blood in his stools. His hemoglobin dropped to 7.4. The nurse came in said that he would need a transfusion. I said "okay". She said he's going to take it even though he's a Jehovah's Witness? I was like he's not a witnesss. They had it in the computer from his last admission, from I don't know when, that he was a Jehovah's Witness. I said he's not a JW. Take that out of the computer! My husband was never baptized. He was an approved associate at one time.

  I called the twins to tell them that they may not want to come up today because their dad was going to have to have a blood transfusion. They said okay. Well, while he was receiving the second unit of blood, the girls popped in. They stayed the whole time. They didn't say anything about the blood.

  The anticoagulant situation has caused a snare in his treatment. The doctors said that they would stop it for the weekend to try to let his stomach heal, but there would be a risk of the stent clotting. So far, so good. Tonight is the first night that I have left him alone. His vital signs are stable, his heart rate is regular, his hemoglobin is above 9 (not good but better than 7). He's had more energy today, and is more like himself.

  I'm going to sleep in my bed instead of a chair tonight. I'll be back to the hospital in the morning.

  Take care everyone!
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  68

  My husband had a heart attack

  by MsMcDucket in

  1. jw
  2. friends

  hello all, the last 24+ hours, i've been at the hospital.

  i took my husband in because he was having chest pains.

  come to find out his cardiac enzymes were elevated and his ekg was abnormal.

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  MsMcDucket

  Hello everyone thanks for your kind thoughts. My husband is still in the hospital. They're having a hard time keeping his blood pressure up. He managed to "vagal" this morning, meaning he dropped his blood pressure and oxygenation status so low that he almost passed out. I was standing there and dragged him to the bed, and started doing the nursing work that I should of let the other nurses do. Anyway, they started a normal saline bolus on him. He's going to have to stay in the hospital. I don't know how long. They may let him out tomorrow...they may not???

  Josie, you didn't say one word. How's your husband doing? I hope that all is going well. Please, post and let us know how everything is going.

  I'm pretty tired. I slept a few hours last night, and went back up to the hospital. I've been there over 18 hours. Time for me to get some sleep.

  ((((hugs to everyone)))

  P.S. The twins are doing there part when it comes to their dad. They talk to me respectfully, but they are careful not to bring up anything about the dubs. It seems that every hospital that we went to there was a dub around. I guess this helps to keep the kids in dub mode. I'm thankful that they still care about their dad!

  I'm off to bed.
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  68

  My husband had a heart attack

  by MsMcDucket in

  1. jw
  2. friends

  hello all, the last 24+ hours, i've been at the hospital.

  i took my husband in because he was having chest pains.

  come to find out his cardiac enzymes were elevated and his ekg was abnormal.

  1. 
  2. 
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  MsMcDucket

  Hello all, the last 24+ hours, I've been at the hospital. I took my husband in because he was having chest pains. Come to find out his cardiac enzymes were elevated and his EKG was abnormal. A cardiologist comes in and tells him that he has had a heart attack, but to try and stay calm. They started him on a heparin drip and Integrilin after they had given him an aspirin and a nitroglycerin tablet.

  He was taken to MICU to await transfer from the VA hospital to a major hospital here in our city. They took him in for a heart catherization and angioplasty this afternoon. He was found to have an artery that was really damaged. The doctors opened it up and put a stent in it. They found two other areas of occlusion/blocks, which they "ballooned" (flattened them out to make the artery more open).

  I have had minimal sleep during this time. I stayed by his beside the whole time (well not during the procedure). I'm so sleepy now that I could cry, but I had to stop here and tell the story before hitting the sack. My twins (the one's that are shunning me) did come up during the night. They are there with him now, which has allowed me to come home to get some rest. I'm going to get some sleep and then I'll be going back up to the hospital.
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  1

  Nothing like marrying a good man??

  by MsMcDucket in

  1. social
  2. humour

  for all of you that don't believe in a faithful man......

  my wonderful girlfriend and i had been dating for over a year, and so we decided to get married.

  there was only one little thing bothering me...it was her beautiful younger sister.

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  MsMcDucket

  For all of you that don't believe in a faithful man......

  My wonderful girlfriend and I had been dating for over a year, and so we decided to get married. There was only one little thing bothering me...It was her beautiful younger sister. My prospective sister-in-law was twenty-two, wore very tight miniskirts, and generally was bra-less. She would regularly bend down when she was near me, and I always got more than a pleasant view of her private parts. It had to be deliberate. She never did it when she was near anyone else. One day her "little" sister called and asked me to come over to check the wedding invitations. She was alone when I arrived, and she whispered to me that she had feelings and desires for me that she couldn't overcome. She told me that she wanted to make love to me just once before I got married and committed my life to her sister.

  Well, I was in total shock, and couldn't say a word. She said, "I'm going upstairs to my bedroom, and if you want one last wild fling, just come up and get me." I was stunned and frozen in shock as I watched her go up the stairs. When she reached the top she pulled off her panties and threw them down the stairs at me. I stood there for a moment, then turned and made a beeline straight to the front door. I opened the door, and headed straight towards my car.

  Lo and behold, my entire future family was standing outside, all clapping! With tears in his eyes, my father-in-law hugged me and said, "We are very happy that you have passed our little test. We couldn't ask for a better man for our daughter. Welcome to the family."

  And the moral of this story is:

  Always keep your condoms in your car