Welcome to my blog about health, nursing, caring, kindness and positive change. Our world is full of such negative influences and bad choices, today is the day to make a positive change both physically and mentally in your life.
ERNursesCare is a blog incorporating my nearly 30 years of experience in the healthcare field with my passion for helping others, I want it to encourage others with injury prevention, healthy living, hard hitting choices, hot topics and various ramblings from my unique sense of humor. Come along and enjoy your journey......

Friday, November 29, 2013

A New Drug On The Block: Zohydro - another addictive substance

Frank Lewis

PDT Staff Writer

Anti-prescription drug abuse activist Lisa Roberts, RN, of the Portsmouth Health Department, says the Food and Drug Administration ignored it own panel and approved a new Hydrocodone drug called Zohydro which she says is 10 times more potent than Vicodin.

Roberts, speaking with the Daily Times from Michigan where she was serving this week as a presenter at their state Prescription Drug Summit, said, “They (FDA) continue to approve more blockbuster painkillers. Yesterday (Monday) they ignored their own panels recommendations and approved a new pure Hydrocodone product called Zohydro which has no built in abuse deterrent and is 10 times more potent than Vicodin.”

According to a watchdog report in the Milwaukee-Wisconsin Journal Sentinel, against the recommendation of its own advisers, the U.S. Food and Drug Administration has approved a new high-dose narcotic painkiller without an abuse-limiting formula and tested using a method critics describe as stacking the deck in favor of the drug.

Zohydro ER will be the first Hydrocodone-only opioid, and it will come in doses packing five to 10 times more heroin-like narcotic than traditional Hydrocodone products such as Vicodin, which combine Hydrocodone with over-the-counter pain relievers such as Acetaminophen or Ibuprofen.

Though the narcotic in Zohydro ER is designed to be released slowly over 12 hours, pleasure-seekers will be able to crush it, chew it or mix it with alcohol to unleash its full punch at once.”

The story said the November 2012 memo from the FDA’s own staff warned that the drug will be abused more than traditional Hydrocodone products. The memo compares what likely will occur with Zohydro to what happened with extended-release, Oxycodone-containing opioids.

“The FDA is too influenced by the Pharmaceutical Industry, and it is reflected in their decisions such as the recent discovery of the ‘Enriched Enrollment’ process to approve painkillers whereas, basically, people who experienced problems with opioid pain medication are removed from the clinical trials process insuring that these outcomes are favorable for the pain medication and those that manufacture them,” Roberts said. “The FDA charged the Pharma Companies $25,000 per meeting to be on this panel to help them enact Enriched Enrollment. If that’s not a fox in the hen house situation I don’t know what is.”

The Daily Times asked Roberts about an effort to combat “misuse and abuse” by the Food and Drug Administration in proposing new restrictions that would change regulations for some of the most commonly prescribed narcotic painkillers on the market.

The FDA’s latest proposal would specifically affect Hydrocodone combination pills, also known as opioids, which combine Hydrocodone with less potent painkillers such as Acetaminophen. One example is Vicodin.

Currently labeled as Schedule III drugs, these opioids would, if the reclassification proposal is accepted, be labeled as Schedule II.

This means patients would have to have a written prescription from a doctor, instead of a prescription submitted orally over the phone or via an internet-based delivery system, to access the drugs. And refills would be prohibited. Patients would have to check in with the doctor to get another prescription.

A Schedule II classification would also put manufacturing quotas in place for these Hydrocodone products. Pure Hydrocodone is already a Schedule II substance.

Drugs are categorized into one of five “schedules” by the Drug Enforcement Administration based on “whether they have a currently accepted medical use in treatment in the United States, their relative abuse potential and their likelihood of causing dependence when abused.” Other drugs, such as Adderall and Morphine, are also labeled as Schedule II.

“When you wonder why your dentist gives you 40 hydrocodone for a toothache, or your knee doctor prescribes far more than he should, that’s because they’re under the impression that it’s not as addictive as Percocet,” Dr. Andrew Kolodny, president of Physicians for Responsible Opioid Prescribing, told CNN in January when an FDA advisory panel first urged the administration to recommend tighter restrictions.

“That’s completely false,” he said.

In an online statement posted Thursday, the FDA said it “has become increasingly concerned about the abuse and misuse of opioid products, which have sadly reached epidemic proportions in certain parts of the United States.”

“I agree with Dr. Dr. Andrew Kolodny,” Roberts said. “In fact, many of us locally signed the Petition that PROP sponsored calling for the reclassification of Hydrocodone products. Although the FDA is finally doing something, it is inadequate and long overdue.”

Frank Lewis may be reached at 740-353-3101, ext. 252, or at flewis@civitasmedia.com. For breaking news, follow Frank on Twitter @FrankLewisPDT.

Just another addictive substance, needs to be classified as a Schedule II

No Butts About It....Colonoscopy Saves Lives #justdoit

Holy Crap............thats about all I can say about my colonoscopy adventure last week. Nurses are the worst kind of patient, yes tis true. I recently turned another year older and had been putting off this most anxiety producing procedure for several years now. Due to the fact that my family history includes a father who had colon cancer and died with liver cancer, it was a "no brainer" per my internal medicine doctor. I should have had a first screening at age 40...............well just 9 years late, I put my mind to it and got it done.
Yes, I survived and it was not as bad as I had imagined at all.

If you have been putting off having this life saving test done, don't. Besides the prep the night before, it is not all that bad. It is the best test to detect precancerous and cancerous polyps or lesions in your large bowel or colon.
The prep that I endured was called "Suprep" and it was more like a ticking time bomb that went off several hours after I drank the 2nd bottle at 9pm the night before. It did take a couple of Zofran ODT(nausea medication) to get thru the prep, it made me sick on my stomach. It sure does work well though....sheesh. I highly suggest that you plan ahead to stay home and rest while doing your prep. You will go to the bathroom, have some abdominal discomfort and watery diarrhea that can be hard to control until it finally stops. Have a path to the bathroom and place a towel or protective barrier on your bed that night....just in case. I had several uh oh moments when the bathroom was just not close enough..... I told you this stuff worked well.....lol

I arrived at the Endoscopy center at 8am, got my IV started (took 2 sticks as usual, I am a difficult pt I told you) , hooked up to a bunch of monitors, rolled back to the procedure room and the anesthesia staff gave me some happy milk of anesthesia (propofol--Michael Jackson death juice) to sedate me. I don't remember any of the actual procedure and woke up as they rolled me into the recovery area. My hubby was waiting for me there. I felt safe and never embarrassed while I was there. The staff was great and made my experience much calmer and less stressful.

How is the procedure done? 
A colonoscopy is an exam that views the inside of the colon (large intestine) and rectum, using a tool called a colonoscope.
The colonoscope has a small camera attached to a flexible tube that can reach the length of the colon.

How the Test is Performed

You will usually be given medicine into a vein to help you relax. You should not feel any discomfort. You will be awake during the test and may even be able to speak, but you probably will not remember anything.
You will lie on your left side with your knees drawn up toward your chest. The colonoscope is inserted through the anus. It is gently moved into the beginning of the large bowel and slowly advanced as far as the lowest part of the small intestine.
Air will be inserted through the scope to provide a better view. Suction may be used to remove fluid or stool.
The health care provider gets a better view as the colonoscope is moved back out. Therefore, a more careful exam is done while the scope is being pulled back. The doctor may take tissue samples with tiny biopsy forceps inserted through the scope. Polyps may be removed with snares, and images may be taken.
Specialized procedures, such as laser therapy, may also be done.
More information can be found HERE 

Gas is what you will have post-procedure--lots of it, be prepared to toot toot toot it out as instructed by the staff, this is the only time when it is perfectly acceptable to let it all out...lol. You want to expell the gas so you don't have problems later as it rises up and causes pain & nausea. 
I feel very blessed that my colonoscopy results only showed a couple of diverticula areas and no cancerous areas. Now I only have to have this test every 5 years ( due to my family history). Normally it is every 10 years after age 50. 

Thursday, November 28, 2013

Having A Safe Thanksgiving Dinner: Turkey Cooking Safety Tips

We all want a safe and a Happy Thanksgiving, so a case of food poisoning that involves the entire family would not be very "happy" , so make sure you are aware of a few basic tips to cooking your bird ,gobble, gobble....

Thawing your Bird: 
Turkeys must be kept at a safe temperature during "the big thaw." While frozen, a turkey is safe indefinitely. However, as soon as it begins to thaw, any bacteria that may have been present before freezing can begin to grow again.

A package of frozen meat or poultry left thawing on the counter more than 2 hours is not at a safe temperature. Even though the center of the package may still be frozen, the outer layer of the food is in the "Danger Zone" between 40 and 140 °F — at a temperature where foodborne bacteria multiply rapidly.

There are three safe ways to thaw food: in the refrigerator, in cold water, and in the microwave oven.

Cooking your Bird: 
 A food thermometer should be used to ensure a safe minimum internal temperature of 165 °F has been reached to destroy bacteria and prevent foodborne illness.

Many variables can affect the roasting time of a whole turkey:
  • A partially frozen turkey requires longer cooking.
  • A stuffed turkey takes longer to cook.
  • The oven may heat food unevenly.
  • Temperature of the oven may be inaccurate.
  • Dark roasting pans cook faster than shiny metals.
  • The depth and size of the pan can reduce heat circulation to all areas of the turkey.
  • The use of a foil tent for the entire time can slow cooking.
  • Use of the roasting pan's lid speeds cooking.
  • An oven cooking bag can accelerate cooking time.
  • The rack position can have an affect on even cooking and heat circulation.
  • A turkey or its pan may be too large for the oven, thus blocking heat circulation.


1. Set the oven temperature no lower than 325 °F. Preheating is not necessary.

2. Be sure the turkey is completely thawed. Times are based on fresh or thawed birds at a refrigerator temperature of 40 °F or below.

3. Place turkey breast-side up on a flat wire rack in a shallow roasting pan 2 to 2 1/2 inches deep.
Optional steps:
  • Tuck wing tips back under shoulders of bird (called "akimbo").
  • Add one-half cup water to the bottom of the pan.
  • In the beginning, a tent of aluminum foil may be placed loosely over the breast of the turkey for the first 1 to 1 1/2 hours, then removed for browning. Or, a tent of foil may be placed over the turkey after the turkey has reached the desired golden brown color.

4. For optimum safety, cook stuffing in a casserole. If stuffing your turkey, mix ingredients just before stuffing it; stuff loosely. Additional time is required for the turkey and stuffing to reach a safe minimum internal temperature (see chart).

5. For safety and doneness, the internal temperature should be checked with a food thermometer. The temperature of the turkey and the center of the stuffing must reach a safe minimum internal temperature of 165 °F. Check the temperature in the innermost part of the thigh and wing and the thickest part of the breast.

6. Let the bird stand 20 minutes before removing stuffing and carving.

(325 °F oven temperature) 

UNSTUFFED (time in hours)
  • 4 to 6 lb. breast — 1 1/2 to 2 1/4
  • 6 to 8 lb. breast — 2 1/4 to 3 1/4
  • 8 to 12 lbs. — 2 3/4 to 3
  • 12 to 14 lbs. — 3 to 3 3/4
  • 14 to 18 lbs. — 3 3/4 to 4 1/4
  • 18 to 20 lbs. — 4 1/4 to 4 1/2
  • 20 to 24 lbs. — 4 1/2 to 5

STUFFED (time in hours)
  • 8 to 12 lbs. — 3 to 3 1/2
  • 12 to 14 lbs. — 3 1/2 to 4
  • 14 to 18 lbs. — 4 to 4 1/4
  • 18 to 20 lbs. — 4 1/4 to 4 3/4
  • 20 to 24 lbs. — 4 3/4 to 5 1/4

More Ways to Cook a Turkey
For other cooking methods, read the publication "Turkey: Alternate Routes to the Table" atwww.fsis.usda.gov/Fact_Sheets/Turkey_Alt_Routes/index.asp.


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