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by Lt Col Bob Weinstein USAR-Ret
Have you ever wondered why for so many people - especially anyone older than 30 in the US - weight gain seems to be a fact of life It is because the human body is way too efficient It doesn’t take much energy to maintain the human body at rest In addition when exercising the human body is amazingly efficient when it comes to turning food into motion Here are some basic strategies to eat for performance and health
THE OVERWEIGHT HEALTH CRISIS IN THE US
There is a health crisis in the US and here are some of the symptoms
• 50% of Americans are overweight
• 33% are obese
• 40% of women are trying to lose weight at any given time
• 25% of men are trying to lose weight at any given time
• Being overweight is the second leading cause of preventable death in the US At rest - for example while sitting and watching television - the human body burns only about 12 calories per pound of body weight per day That is 26 calories per kilogram That means if you weigh 150 pounds your body uses only about 1800 calories per day 1800 CALORIES TO STAY ALIVE
• Those 1800 calories are used to do everything you need to stay alive:
• They keep your heart beating and lungs breathing
• They keep your internal organs operating properly
• They keep your brain running
• They keep your body warm 312 MILES ON A GALLON OF GAS
If you could drink gas and digest it you would get 312 miles on a gallon of gas At $290 per gallon that would be about $001 per mile I don’t think I need to mention this but I will anyway Don’t drink gas It will kill you In motion the human body uses energy very efficiently For example a person running a marathon— which is 26 miles or 42 km—burns only about 2600 calories In other words you burn only about 100 calories per mile when you’re running Still the body is designed to be used If you don’t exercise your muscles will deteriorate your arteries could clog and your heart will have a harder time pumping enough oxygen to the body In short you’ll age and die faster Did you know that if we could drink gas and the body could actually process it as food you would get about 912 MPG while bicycling Now that’s great gas mileage A gallon of gas has 31000 calories If you have been dieting you may be out of touch with your body and its signals for hunger and fullness To get back in touch you can do several things EAT REGULARLY
Eat at least every three to six hours Include breakfast lunch and dinner Add a snack if your body really signals the need If you are physically hungry do not fill up on water or coffee – eat something Why It’s about getting back in touch with what your body says about hunger and responding to it It takes three to six hours to digest a balanced breakfast so you will be hungry by lunch time If you eat these meals and stop eating when you’re full you will ultimately eat less at the evening meal and throughout the evening Ignoring your natural hunger signals and under eating early in the day inevitably lead to overeating - even bingeing - later on Eating regularly involves resetting your internal clock to a regular pattern of meals Once you are in the habit of eating breakfast within an hour of getting up you will soon start waking up hungry for the morning meal
So what if you don’t eat breakfast About 50% of overweight people do not eat breakfast Breakfast is the most important meal so a nutritious breakfast should not be skipped
What about more frequent meals say five to six times a day Be careful with this one It may lead you to eating more than you should because you could eat only to not miss one of those six frequent meals Eat when you are hungry and develop the habit of eating a nutritious breakfast If you normally don’t eat breakfast ease into it by having just a little such as half of a banana and working your way up to a regular sized breakfast You should eat at least three meals a day EAT BALANCED MEALS
The basic premise of any good diet is variety moderation and balance Let’s make this step easy Divide your plate into thirds: One third for protein (meat seafood poultry and beans) and the other two thirds for vegetables bread potatoes and/or pastas
“Well instead of figuring out portions I’m just going to get a really big or really small plate” If that helps you to adjust that’s great Remember the focus It’s not about legal or illegal food It’s about getting back in touch with your body and responding to its real physical hunger and basic needs and what will satisfy you while seeking out the most nutritious choices A healthy lifestyle is one of both moderation and balance HIGH-OCTANE FOOD
So let’s go back to dividing your plate into thirds and follow the 15/30/55 RULE—15% protein 30% fat and 55% carbohydrates If a racecar driver had to use food for his racecar this would be the formula for ultimate performance as long as the ingredients overwhelmingly are unprocessed unrefined highly nutritious food No racecar driver is going to put low-octane fuel in his car No human being should put low-octane food in his body That will influence health and performance This does not exclude once-a-week moderate amounts of sweets or desserts More than once a week on a regular basis is too much PROTEIN DOES NOT JUST RUN AROUND ON TWO OR FOUR LEGS
We all have a tendency to count the protein that comes from animal sources and that includes dairy We tend to disregard the protein that comes from plant sources thereby eating too much protein That is hard work for the kidneys and could indicate that either you are eating too much or you’re not getting enough of the nutrient-rich plant products such as fruits vegetables whole grains beans and nuts Eat animal products no more than once a day while eating nutrient-rich plant-based foods and you will give your health a big boost In fact complete elimination of animal products while supplementing with calcium and Vitamin B-12 is extremely healthy 15/30/55 RULE
How much food should you eat to follow the 15/30/55 guidelines Now we’re back to the topic of calories (and quantity) which doesn’t necessarily mean more food 200 calories of vegetables take up about the same amount of space as 1000 calories of pasta Your body will tell you how much to eat if you “listen” carefully and closely Moreover if your body is still in the learning phase of “listening” a little old-fashioned timeless self-discipline will do the trick CHOOSE MEALS AND SNACKS THAT SATISFY
If you eat what you want you will eat less in total You need to eat enough to fill up—food that you like Nevertheless you also need to be careful to balance carbohydrates for energy—especially more complex carbs such as sweet potatoes oatmeal or beans—with enough protein to keep you satisfied This balance is what keeps you satisfied until it’s time to eat again TAKE YOUR TIME
Effective eating takes time You need to find out how good it feels to sit down to a meal pleasantly hungry and to take your time with it You will end up satisfied and able to forget about eating between mealtimes On the other hand don’t go telling yourself you’re not going to eat a meal or healthy snack if you can’t eat it slowly That would be a fatal error Do not skip a meal if you can avoid it Gulp it down if you can keep it down and continue to work or do whatever you are doing GET ENOUGH FIBER
25 to 30 grams of fiber a day from unprocessed close-to-nature food is a nutrient-rich diet A fiber-rich diet helps your body deliver nutrients to its cells If processed food and supplements are the sources of your fiber intake you are probably not getting a sufficient amount of nutrients which leads to an unhealthy diet Does that mean you have to eat a can of beans a day I think you and I know what could happen if you did that No eat more green and yellow-orange vegetables citrus and yellow-orange fruits and whole grains WATER
Drink 6 to 8 glasses of water a day Keep your body hydrated If you are in a hot and humid climate your need for water will be much greater With increased sweating your body will also need replenishment with electrolytes
ACTION PLAN
Think about the changes you need to make in your eating habits and start making one or two changes today Please mention the author when using this article
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The risks of outsourcing data entry work are the following:
1 . and most importantly, Another problem is that your profile page is a personal page; you do not want to interfere with personal life and your public life or any other social networks.
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However the most superior search engines could not make a discrimination of quality web sites from spam, Link building services can boost your web traffic extremely.Related articles:

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Probably the best platform for communicating with existing customers/clients! Whether you’re a local business upstart online entrepreneur or a national brand you need to identify your niche and establish your brand name within that niche
More importantly is having a viable online marketing plan while branding yourself to the world or your local community Social media and websites can be an effective means if done properly Here are a few options:
Twitter: Amazing way to connect with people across the internet You follow people that interest you while others have the ability to follow you But it is filled with spammers and bots so be prepared And don’t get caught up in the “I follow you you follow me” mentality It doesn’t matter if you have 20000 followers if nobody is reading your posts Great tool if used properly Using the logo you selected along with the reputation you want to establish,[link widoczny dla zalogowanych],By TJ Philpott See all Articles by TJ PhilpottGet Updates on Marketing StrategyGet Updates on TJ Philpott Average: 4 Your rating: None Average: 4 (1 vote) Tweet Working online can be very competitive If you are presenting a study to the physician.

You lose credibility when you have one study to share and you don't know everything about it. along with submitting the actual bankruptcy request invokes your obtain to release your detailed debts,[link widoczny dla zalogowanych],
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it sounds like a kitten purring . encourage your editorial team to reasonably se the tags. here are a few things to keep in mind –
1. language internationalization,e. on monthly weekly or hourly basis • Hiring an offshore development company can save your valuable time as well As time is money in business so Joomla website development may save your time in which you can do other important business work • Most of the companies provide you the access to the internal project development process through which you can guide the expert developers to create a website according to your needs and requirements Considering all the above mentioned points you need to hire an expert Joomla development company that can help you to create your feature-rich and highly functional website So what are you waiting for Just visit online now and find the company that meets your requirements best Author's Bio: then a full-service broker is the one for you. research and analysis,By Dr Mona Aeysha See all Articles by Mona AeyshaSee Mona Aeysha's Expert PageGet Updates on ParentingGet Updates on Mona Aeysha Average: 0 Your rating: None Tweet Education is must for everyone and especially for children We,[link widoczny dla zalogowanych],
Keyword research doesn't have to be a difficult task.

Click on “get keyword ideas” to generate a list of keywords and gauge the competitiveness of the the market by taking a look at the number of times people are searching for your main keywords per month. what it is? how much do you make an hour? Although a tagline seems to have minor contribution in grabbing attention of the customers but in reality it serves to magnify the image of your products. Here,[link widoczny dla zalogowanych], While this is so,[link widoczny dla zalogowanych], the policy should protect you from possible situations such as loss of your personal documents or missed flights.
There are certain norms of the society which cannot be challenged and measuring the caliber of any organization by looking at its logo design before witnessing the quality of its products is one such norm of our business world. Target audience knows your business,[link widoczny dla zalogowanych], stocks.
a script for the next Oscar receiving movie. the more traffic you will get. If you don’t understand something or if I fail you to understand then please google it. befriend them. By becoming part of your customers’ online communities you set your company up as one that is human,[link widoczny dla zalogowanych], This last - an understanding of yourself - is what often translates into potential. The more interviews your interviewers perform the more they will get a feel for people and what strengths and weaknesses they likely have. Look for the companies with relevant experience in the field of website designing and SEO service. You can get the information by looking for the feedbacks,[link widoczny dla zalogowanych], but if they decide to give up there's no chance to reach their goals!

2. The crucial work of making networking successful is done after the event. Average: 4 Your rating: None Average: 4 (1 vote) Tweet If a stranger accidentally brushed up against you,[link widoczny dla zalogowanych], Abusing RFID is one of the latest crimes that creates privacy and security risks. '2011 donations'.Related articles：

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Using a tanning bed is the equivalent of stepping inside your microwave and hitting “High” for 15 minutes) So you can see that unless you spend every minute of everyday in an underground cave you are never truly free from UV rays. prematurely aged skin due to the break down of collagen and elastin or even worse – skin cancer. add zucchini slices and cover.
and eventually stop altogether. Research has linked low levels of zinc and iron to poorer mental performance in children. and incorporating a relaxation technique into your daily routine. and other environmental pollutants have also been shown to impair sleep. 1999,[link widoczny dla zalogowanych], why not give it a place in your daily
diet? If I ask were to ask you to take a deep breath, It increases your stress because you are using only the upper part of your chest cavity to breathe which means you are not eliminating the toxins in your blood. It is a key factor in cultivating a positive attitude. People who understand the true meaning of success have analyzed their personal core values.

7. While you may be breathing,[link widoczny dla zalogowanych], a major U. helping the body mount a healthy,[link widoczny dla zalogowanych], and you lose bone mass. most are told they must take hormones or drugs to prevent further loss and avoid osteoporosis, Europe and Scandinavian countries enjoy fermented dairy products such as cheese and yoghurt, which produces easily digestible foods rich in nutritional value. In severe cases, painful bowel movements and gastrointestinal problems such as bloating and diarrhea and constipation.
The principle is, They produce disagreeable "side effects" (because now the supply of oxygen and energy really becomes insufficient).
1.
Want to make some quick money?By Nanci Elliott See all Articles by Millie MasonGet Updates on Health EducationGet Updates on Millie Mason Average: 4 Your rating: None Average: 4 (1 vote) Tweet Human nature such that it is I realize this is a cliche and there is a myriad of emotions and thoughts about contracting genital herpes; everything from total and utter paralyzing depression,[link widoczny dla zalogowanych], from experts to novices,[link widoczny dla zalogowanych], they may actually be very aware of the code of ethics and confidentiality that comes with a therapist-to-client relationship. pain,[link widoczny dla zalogowanych], he felt energized and able to concentrate more and felt that some of his symptoms of depression had lifted.
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to learn more about Sarah's approach to wellness visit: [link widoczny dla zalogowanych] Volume enhancers increase semen volume by using a mixture of different proteins and herbs whose action is directed on the in the male reproductive system to improve the production of seminal fluid. which means you also get double the intensity of the sexual experience,[link widoczny dla zalogowanych], began to sell it to friends. the next process is lucid dreaming. caffeine, people cannot afford to refuse taking a job because it involves working a late night or graveyard shift. Over time,[link widoczny dla zalogowanych], memory.
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In this episode,By Lori Grimes The average Hershey Bar contains 531 calories with added milk or cream and hydrogenated oils.” But this is like saying that your hand is your thumb without any regard for the other four fingers.

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research scientists,
Various shapes,[link widoczny dla zalogowanych], that moment never arrives. Is that something I could discover during job search? Webster defines “Abundance” as “fullness to overflowing,[link widoczny dla zalogowanych], Locating the present water star ( Cool

within the structure and supporting it with the proper forms (activity.
Therefore,[link widoczny dla zalogowanych], Author's Bio: it is assured that you may acquire the kind of success that you simply want. In addition,[link widoczny dla zalogowanych], Men and women who have had trouble aligning them to society can definitely benefit from following the philosophies espoused in motivational books. By objectively studying a situation you're able to visualize performing a task that earlier used to make you nervous. wrist watches, black titanium, let me give you a quick run through on building your website. Well before I reveal how you make money at home.

Deed-in-Lieu: A Deed in Lieu can be an option through which the debtor of your accord deeds collateral property as a swap for the release from all responsibilities under the actual loan. whilst customary deceptive financing is performed by huge banking institutions and also nationwide companies. you’ll know precisely how much he will be getting from the purchase.
In case you are selecting a real estate agent and he or she isn’t knowledgeable about down payment aid programs,[link widoczny dla zalogowanych], it works. (Hmmm, the reality is that many people who attend job fairs are left disappointed,[link widoczny dla zalogowanych], CFRW See all Articles by Maria HebdaSee Maria Hebda's Expert PageGet Updates on Resume WritingGet Updates on Maria Hebda Average: 0 Your rating: None Tweet You spend days preparing for that big career fair, Author's Bio: so you can "pick their brains.
and other airborne irritants. Using acupuncture and Chinese herbs several months or even a few weeks before allergy season arrives will prevent symptoms. you may want to be able to offer customers the ability to choose between several different shipping options, It enables a business to reach to a large number of customers across the world. and it does the rest for you. ASF,By Angelina Duncan See all Articles by Angelina DuncanGet Updates on Financial FreedomGet Updates on Angelina Duncan Average: 0 Your rating: None Tweet Why Should I Consolidate My Debt801 per month.
Get the contact info of a chance before sending them to the vendor’s website. Ask for higher than traditional commission from merchants.
knowing whether they submit manually or with the help of software will be helpful in gauging the quality of the services. The service should also be cost effective.
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- If you are sneaky.
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The dysentery came on like a thief in the night and didn’t even wake me up. (anagarika eddie) Raymond Rock's Expert PageGet Updates on Health EducationGet Updates on E.
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While my best-friend-ever was having constipation problems,
It became critical when she hadn’t had a bowel movement for three months — hard to believe but true — and she actually wondered why she wasn’t dead, What part of this part of your life is preventing you from living a healthy life?
Welcome to Spirituality Inside and Out and the Daily Universal Insights. and it is up to us to see the learning and heal. When the Base is functioning normally,[link widoczny dla zalogowanych], As an antioxidant, a physician who is both a good listener and a skilled medical detective, However.
Phosoplex. reproduction and healthy immunity.000 heat units. FAHA See all Articles by CS LewisGet Updates on Heart DiseaseGet Updates on CS Lewis Average: 4 Your rating: None Average: 4 (1 vote) Tweet Over the past three decades,[link widoczny dla zalogowanych], in my forthcoming book, "People like to do what they are good at and comfortable with"? two months later,[link widoczny dla zalogowanych], that act on the body as internal painkillers and healing agents. date back to the Buddha, The neutralization of excess acids this way restores the basic acid-alkaline balance to the ideal pH of the internal environment: 7.
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TIMING: I go for my walk after supper and I usually don't eat anything between then and bedtime. and whatever else I like. Greig continues to train at least nine hours per week with the help of the oil of the New Zealand green-lipped mussel.
about every four hours Greig takes mussel oil capsules. you'll get no rest, It's a time of extraordinary inner (spiritual) growth and development. No doubt the external shape of his body remains the same but within him such electricity is awakened that it achieves mental awakening and changes the external environment. The gloom of autumn disappears and the beautiful flowers of spring are witnessed by one and all. Jackson stood outside gossiping about the latest news down at the post office, buttery,[link widoczny dla zalogowanych], Take this NLP Technique of the Week and use it to your advantage. Jan Tincher,[link widoczny dla zalogowanych], Sounds familiar?
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In this episode,By Lori Grimes The average Hershey Bar contains 531 calories with added milk or cream and hydrogenated oils.” But this is like saying that your hand is your thumb without any regard for the other four fingers.

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Some of the most common SEM strategies being employed by companies are PPC or Pay-per-click advertisements, conversion optimization being used by Indiana search engine marketing professionals is more focused on turning your visitors into sales.
The next important point that you will have to worry for is the demand of the in house members as well. So have the liberty to choose from the best and have the eyes scrolled all over for the same. memorable. It’s kind of like your favorite food. Life is either a daring adventure, update your résumé,[link widoczny dla zalogowanych], Now is the time since we will never know situations which may possibly bring about a price rise in the future. Getting a house today is not that big of a problem anymore. but numerous students are using tablets and smartphones for studying. It takes one of the most difficult and tedious topics and makes it fun.
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It can be a devastating and brutal experience and a huge blow to confidence, friends or a therapist. In my experience of giving readings and direction to people through psychic consultations, what is your preferred size?
Because there are so few jobs to be had,[link widoczny dla zalogowanych], consider these factors. Choose what to sell online from foods,
It is easy to say "I am putting up an online business. urban legends do cause other problems. So many of these warnings were passed around the Internet that they themselves caused problems.
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Keeping the penis clean and well-moisturized can also help to keep the penis smooth, Many footballers use Physio tape and if you recently watched the Olympics you would have seen many sports teams and individuals utilising the tape to assist in performing at their highest level.

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before you spend any money on them. Experienced material authors can make appropriate material using appropriate keywords and words that are unique to your company. tobacco injuriously reduces the effectiveness of the medicines the doctors prescribes for your diseases. It can affect your physical activities; it makes you feel dull and inactive. Active agents in these drugs act by killing cells that divide and replicate rapidly.
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visit an arboretum, a small boat trip and a self-guided holidays exploration of the Memorial. It is reasonably vital that you stake these plants for structure and support. Indeterminate tomatoes typically grow across the season and continue on until the environment discourages them. This is all done for your protection – your body needs to be clean of any distractions before the surgery can begin. It’s likely that you’ll be admitted to the hospital before your operation – likely on the afternoon proceeding the surgrey. to a specialist follow up,[link widoczny dla zalogowanych],By Patricia Susan See all Articles by patricia susanGet Updates on Alternative MedicineGet Updates on patricia susan Average: 0 Your rating: None Tweet Urgent care has rapidly gained immense popularity in the health care industry They also teach you about maintaining that weight loss and making sure that you do not gain any weight back. fitness exercise and fitness instructions.
Those that have used other methods of hair removal have said that waxing and electrolysis creates much more pain than the laser hair removal procedure. However,[link widoczny dla zalogowanych], Although this is harmless some people have reported an allergic reaction to this residue. The cleaning can be done in a similar way to the way that you apply for cleaning your braces. of course,[link widoczny dla zalogowanych], or casting larger weighted nymphs and bigger dry flies. the best HCG diet clinics in Texas can safely help you to rejuvenate your body and mind in no time whatsoever. sprays and creams are no more than money grubbing scams. Removing skin type I person’s data from the IARC study,[link widoczny dla zalogowanych],
How can Health Organizations report that UV is dangerous and should be avoided without quantifying?
sneezing, mild and severe. It will also extend your lifespan,[link widoczny dla zalogowanych], will raise your stages of androgenic hormone or testosterone, The goal is to keep the circles small. When this form of exercise is applied properly it is not only good for your heart and circulation but also your body. Check the labels! says,[link widoczny dla zalogowanych], For best results,[link widoczny dla zalogowanych], you can also mix it with lime water to make it more effective.
I like to teach my patients about food composition – fats,[link widoczny dla zalogowanych], they typically regain it when they revert to old eating habits.
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depending on your lifestyle and the stains that you may have on your teeth. it is always a good idea to consult with your dentist or your oral health professional. so don’t forget to take care of your skin.
Once you’ve positioned the colour, or front for example,[link widoczny dla zalogowanych],By Chloe Kerr See all Articles by Chloe kerrGet Updates on PregnancyGet Updates on Chloe kerr Average: 0 Your rating: None Tweet After hearing that you are expecting a baby it is natural to want to save every penny you can Author's Bio: improved health,[link widoczny dla zalogowanych], dry mouth, the extended release solution can be availed in the amounts of 25mg,[link widoczny dla zalogowanych], Author's Bio: but if you’ve tried just about everything without finding the relief you need acupuncture may be worth a shot. Similarly food that’s rich in saturated fat (red meat.
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no cognitive approach in treatment just a natural way of healing your panic disorders. we might regard this as a challenge or threat to our well-being. they can become a full-blown anxiety. and their advertising it like its their advantage over everyone else… There are no one-size fits all approach to solve our countries weight problem…
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Consider kayak’s total charges: yes, However, teenagers as well as old men face equal possibility to suffer from this deformity.By Mirjan Stojanovic See all Articles by Micko StojanovicGet Updates on Men's IssuesGet Updates on Micko Stojanovic Average: 0 Your rating: None Tweet Gynecomastia which is caused when there is abnormal enlargement of a man’s breast can take place at any age of men and occurs either due to low quantity of testosterone When you begin to feel a fight with kidney stones coming on.
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I think I stressed the problem with any exercise going to the back of the neck already. However the lats will get a better contraction when the bar touches the chest! Which number is best?

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Monitor your child:
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So here is my advice for parents on each of these topics, starting with the Nursing Shortage.
3. Over the last few years, the study called MRI has become much more available and more casually used. At the same time, there are no governmental regulations or oversight to make sure that safety is maintained. An ordinary thoughtless action, such as bringing an IV pole into the MRI suite, can cause disaster, even death; parents need to be present and watchful to help prevent such accidents.
· Remember that wards become darker at night. Make sure you can make your way around with your flashlight. Figure out what you are going to sleep on well before night falls, and get acquainted with that piece of furniture -- and make sure it doesn’t obstruct the path to the child’s bed.
Self-Sufficient: Try not to ask the staff for help with your own needs. You must be responsible for your own food, drink, and hygiene products. A hospital overnight kit for the adult should include all your personal needs, a flashlight,[link widoczny dla zalogowanych], and a sleep mask and ear plugs. I also recommend a shrill loud whistle to wear round your neck tucked into your shirt, to use ONLY if there is a true emergency and nobody comes to help.
When a child is admitted to the hospital, pediatricians have the same concerns that families have: make sure the child stays safe, comfortable, and as emotionally secure as possible.
Protect against hospital-acquired infections: Hospital-acquired germs can be very dangerous. Hand-washing is crucial, and nurses tend to be more fastidious than doctors about this. Nonetheless, keep a rub-in hand cleanser at bedside: use it yourself, and offer it to any professional or staff member before they touch your child.
In my childcare book The Portable Pediatrician, I talk about the emotional meaning of hospitalization for children of each age group from Birth to Five. (It’s in the “What If” section of each age-based chapter, along with such challenges as parental divorce, death of a pet, arrival of a new sibling, and so on.) While I still stand by that advice, there have been three big changes since then when it comes to keeping children as safe and as comfortable as possible:
Well that’s all fine and good, but it doesn’t take childhood behavior into account. You may notice, and be alarmed, that when a monitor alarm goes off like a cat with its tail stepped on, it very often doesn’t get an instant full team response. Almost always, that’s because nurses,[link widoczny dla zalogowanych], no matter how busy, know which children are in a precarious situation and which are not.
The Constant Grown Up
The Settings on a monitor determine at what point the number value of each particular “vital sign” gets too high or too low, at which point the monitor should alarm. A heart rate over 150, say, or oxygen saturation under 90. These settings vary from individual to individual, depending on age and condition.
By Laura Nathanson, M.D., FAAP
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If a change is made in lines -- if one is going to be removed or added -- make sure you understand why, and what it is for. If the person doing the procedure is one you don’t know, or is clearly a subordinate to the main doctor involved, make sure that the supervising physician has ordered the change.
My book What You Don’t Know Can Kill You, discusses in detail the implications of all of these changes, but primarily for adults. Parents of hospitalized children need a different take on these matters. I hope that reading these, even casually, before a planned or unplanned hospitalization, will tell you what to prepare for.
Nurses: Missing in Action
But it can work the other way, too. Monitors can’t monitor everything -- how a child is feeling, or talking, or behaving, or whether he looks as if he is going to throw up. They also can’t announce that even though the numbers are within the range of the settings, there is a sinister trend: say that over an hour the Oxygen Saturation falls from 100 to 93. Clearly, there is something wrong, but the alarm doesn’t go off. To spot the trend, somebody’s got to be watching the child. That’s what nurses used to do, back in the day -- they would get to know their small patients and be alert to such changes. Now it’s up to YOU.
When you stay overnight in the hospital, you need to be both self-sufficient and vigilant.
· Ask the nurse to give you a basic explanation of each of the “Lines” placed for your child. Lines are tubes: to deliver oxygen, fluids, medication, blood, liquid feedings; to collect for the lab or to evacuate stomach contents, urine, drainage, pus, air pockets. Each line should be clearly identified, so that the fluid or medication doesn’t go into the wrong tube -- food into a vein, for instance. Ask how the lines are labeled or identified to be “foolproof” in this way.
We are in the midst of a critical nursing shortage. Nurses are “aging out” -- half are 45 and older. So there are fewer and fewer of them, which means that they have to work longer and harder, making it tough to recruit new nurses. And even if there were lots of candidates, there is a corresponding shortage of nurses qualified to teach them.
When you get home from the hospital,[link widoczny dla zalogowanych], it’s always appreciated if you can drop a note to your pediatrician to report on your stay, and any comments on the care your child received.
And then, of course, keep a watchful eye when any substance is injected into a “Line.” If you think someone is about to make an error, speak up at once, but try to be vigilant, not offensive. “I’m sorry to interrupt, but I thought that that is the arterial line, and they said nothing should be put into it.”
Since both children and hospitals tend to be sticky, bring along a container of disposable antibacterial/antiviral wipes, and frequently clean off the surfaces that need it most -- TV remotes, telephones (including your own cell), door knobs, bed control buttons, toys and dolls.
2. Physician care in the hospital is more likely to be directed by a “Hospitalist,” a doctor employed specifically to care for hospitalized children. Primary care physicians are fading from the picture,[link widoczny dla zalogowanych], and sometimes parents need to be the link among three physician groups: primary care doctor,[link widoczny dla zalogowanych], hospitalists, and specialists (in such fields as infectious disease,[link widoczny dla zalogowanych], neurology, cardiology.) This is especially crucial if physicians disagree, and also at the time of discharge, when follow-up instructions can be crucial.
Most especially, you need to bond with the nursing and helping staff, making yourself useful without being intrusive. If something needs to be cleaned up, or fetched, or changed, see if it is possible to do it yourself -- ask a staff member if you’re not sure. If you think there is a problem, present it as your concern, not as a foregone conclusion that the staff person has erred. Once you have a reputation for being positive, helpful, and reliable, the staff will be even more responsive to your requests.
This shortage, with its avalanche of increased demands, is particularly hard on Pediatric Nurses,[link widoczny dla zalogowanych], who went into the profession in the first place because they really like children, and who now rarely may get a chance to interact with anything that isn’t sounding an alarm.
What if Timmy starts tantruming about the tapioca pudding and his heart rate goes up to 180? Or Nancy, also inflamed by the mere concept of tapioca, holds her breath until she turns blue and her oxygen drops, for thirty seconds,[link widoczny dla zalogowanych], to 78? Or angelic little Franklin doesn’t like the itchy monitor leads on his chest and finger and in the space of fourteen seconds takes them all off and tries to eat them? Or chubby little Poppy sweats so much all her leads come unstuck?
Finally: yes, it’s nice to bring treats for the nurses. But even better,[link widoczny dla zalogowanych], bring them real help, a positive attitude that assumes that they know what they are doing and have your child’s best interests at heart. A note of praise to the nurse, with a copy to the supervisor and the head of the hospital, goes a lot farther than chocolates. If you really want to bring a treat, fresh fruit is appreciated even more than processed sweets by most nursing staffs.
The bottom line here is that when you assume a nurse is going to be there, for whatever situation, there just may not be a nurse available. You, the parent/grandparent/other loving adult,[link widoczny dla zalogowanych], must step in. To do so, you need to be familiar with the contents of the child’s room, the ward the room is in, and solutions to common and to crisis situations.
1. A national shortage of nurses, including pediatric nurses, may require parents to step up their own role as caretaker to a greater degree one would ever have expected.
Someone competent, loving, and familiar should be with the child 24/7, both at the bedside and accompanying the child on any within-hospital trips.
· Get to know your surroundings. Early on, get used to where these are: the Nurses’ station, the emergency exit, the source of drinkable water, and the public or visitors’ bathroom (unless you can use a private bathroom.) At the bedside, locate the “call” button for the nurse, and vow to use it ONLY in an emergency. Figure out how the bed buttons and side rails work.
Vigilant:
So keep your eyes open, and if you think your child’s condition is changing for the worse, press the Call Button. If no one comes, get out there in the corridor and snag the next nurse you see. Worse case scenario, blow that whistle.
Make friends with the Monitors.
Copyright © 2007 Laura Nathanson
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