CASE STUDY

Subjective: rash. 14 year old white male presents with many blisters filled with yellow or honey-colored fluid material on his right cheek. Some have been oozing and crusting over. Mom states her 12 year old daughter has also had a rash for over a month surrounding her nose/nostrils. Mom initially thought it was a mild case of acne and tried every acne product known to man to cure it, before finally decided it was time to take both of them to the doctor.


Objective: 14 yr old white male alert and oriented. No distress. Vital Signs are stable.
HEENT: unremarkable
H: RRR without murmurs
L: clear
Neuro: CN II-XII intact
Skin: multiple honey crusted lesions are noted on the right cheek. Some are reddened and appear to be drying up.

Assessment: Impetigo

Plan:
1. Wash (do not scrub) the skin several times a day, preferably with an antibacterial soap, to remove crusts and drainage.
2. Rx given for Bactroban to apply bid for 10 days
3. Patient education given. Impetigo is caused by streptococcus (strep) or staphylococcus (staph) bacteria. Methicillin-resistant staph aureus (MRSA) is becoming a common cause. The skin normally has many types of bacteria on it, but intact skin is an effective barrier that keeps bacteria from entering and growing in the body. When there is a break in the skin, bacteria can enter the body and grow there, causing inflammation and infection. Breaks in the skin may occur with:

Animal bites

Human bites

Injury or trauma to the skin

Insect bites


Prevent the spread of infection.

•If you have impetigo, always use a clean washcloth and towel each time.

•Do not share towels, clothing, razors, and and other personal care products with other family members.

•Wash your hands thoroughly after touching the skin lesions.

Are you looking for a new training coach? Let me give you a few things to consider when beginning your search. If you are a trainer and reading this...take notes.

#1: The best trainers perform thorough assessments when working with new clients before doing anything else.This means movement screens and basic performance tests. This also means identifying the client’s current food intake and assessing lifestyle variables, including schedule, primary complaints, current level of social support, willingness to change, and more.

#2: Clients are spending big bucks to get into shape. Often as much as five or ten thousand dollars. And if a trainer can get them into shape, they are worth every single penny. The greatest evidence of a trainer's value is found in their client record books.

That’s why the best trainers do the following:

• track client adherence
• log how their clients’ bodies are changing and over what time period
• record performance and lifestyle changes
• keep photo albums with before and after photos
• highlight before and after photos, body composition change data, and testimonials; and show this book to all prospective clients.

#3: The best trainers are lifelong learners. We all know how the fitness industry is riddled with weekend certifications and nutrition courses. High quality certifications and internships with the top coaches in the field are not easy to come by and they are often not cheap. But elite fitness pros find a way to get the best training anyway. Clients can recognize this. Knowing your trainer is worth every dollar they charge is priceless.


#4: The best trainers practice what they preach. Would you trust a realtor who’s never owned a home? How about a broke financial planner? Probably not. So why would anyone hire an out-of-shape trainer? Now, don’t get me wrong. Top trainers don’t have to look like fitness models or bodybuilders. However, they do have to live the kind of lifestyle they preach to their clients. They should have a little more muscle, a little less fat, and a better health profile than the average person. This is powerful evidence that they know both how the body works (exercise/nutrition physiology) and how the mind works (change psychology).

#5: The best trainers reward behavior, not outcome. For instance:
“I need to lose 10 pounds” is an outcome. “I need to exercise five times per week” is a behavior.

The outcome is the trainer's responsibility and the behavior is the responsibility of the client. Your trainer is good when he/she rewards you for following last week’s habits 90% of the time and didn’t miss any workouts regardless of the outcome — because it’s this pattern of behavior that will eventually lead to success. So, instead of setting outcome goals, your trainer should set behavior goals.

#6: The best trainers measure everything worth measuring. Clients want to achieve something measurable. Good trainers will monitor and record performance variables like sets, reps, and rest intervals. They’ll monitor nutrition habit and behavior compliance. They’ll monitor workout attendance. They’ll monitor body composition. They’ll take pictures.

#7: The best trainers are well-trained and adaptable. They’re able to produce results in every type of client. From 18 year old guys, to 65 year old women, from level 1 beginners, to level 3 pros...they can do it all. That makes them indispensable. (And in demand.)

#8: The best trainers offer integrated nutrition and training solutions as part of their programing. They oversee exercise programming. They coach the movements. They provide motivation. They also schedule private nutrition sessions. They assess nutritional intake and compliance regularly. They show their clients around the grocery store, and encourage them to prepare and cook their food.

#9: The best trainers care about their clients. It is every trainer's responsibility to help every person that comes to see them. And that means actually caring about that person and doing whatever it takes to help them make improvements in their body – and their life.

#10: The best trainers read more than just training books. Trainers also need to read about other things as well. Learning about the psychology of change is a significant part of being a good trainer.

Today's lesson is that of respect. Respect, as many of you are aware, has great importance in everyday life. One hopes that children will learn respect from their parents. The child learns the most from the way the parents behave in the presence of the child. If, in presence of the child, the parents fight or rebuke each other or use curse words, the child is bound to learn this. If the child sees that the parents respect not only each other but also other members of the household or society they move in, they will also learn the same. They will also develop the habit of respecting others.

As a child growing up in a single parent family, I'm sure outsiders tended to judge my brother and I on the basis of our simple living conditions and adherence to rules. It was common to hear my dad explaining to my brother and I why a desired behavior is so important. For example, he would explain that thanking someone for a gift shows how much we appreciate the thought, time and money that went into choosing and purchasing the gift. My dad would tell us to look people in the eye when they speak to us to show that we are respectful listeners, and we don't interrupt. He would especially teach us respect for our things as well as the property of others. This was very important to my dad as he knew he could not give us the things the other kids got, but instead, he taught us that saving our money to buy things was very powerful. Taking care of things would allow them to last longer, and most importantly, he thought teaching boundries was important when it came to property. Can you imagine that feuds my brother and I had over Hot Wheels? My dad set us straight on that one.

Unfortunately, I do not witness appropriate parent role models every day. If only parents realized just how powerful their actions can be.

You may have heard the famous verse, "children learn what they live" authored by Dorothy Law Nolte in 1974. I will leave you with this short verse in hopes that it will spur parent role modeling in a positive way upon children. It goes like this:

If children live with criticism, they learn to condemn.
If children live with hostility, they learn to fight.
If children live with fear, they learn to be apprehensive.
If children live with pity, they learn to feel sorry for themselves.
If children live with ridicule, they learn to feel shy.
If children live with jealousy, they learn to feel envy.
If children live with shame, they learn to feel guilty.
If children live with encouragement, they learn confidence.
If children live with tolerance, they learn patience.
If children live with praise, they learn appreciation.
If children live with acceptance, they learn to love.
If children live with approval, they learn to like themselves.
If children live with recognition, they learn it is good to have a goal.
If children live with sharing, they learn generosity.
If children live with honesty, they learn truthfulness.
If children live with fairness, they learn justice.
If children live with kindness and consideration, they learn respect.
If children live with security, they learn to have faith in themselves and in those about them.
If children live with friendliness, they learn the world is a nice place in which to live.

More Jobs Lost Because of ObamaCare


We all know that ObamaCare is going to kill hundreds of thousands of jobs. What we didn't know was that this trend would hit President Obama's hometown of Chicago so quickly. Major Chicago pharmaceutical company Abbott Laboratories will be forced to cut 1,900 jobs-more than 2% of their entire workforce. This follows the 9,000 jobs they were forced to cut last September. The spokesman for the company explained that ObamaCare was the main cause. Already, the Democrats' health care law has cost them over $200 million in the past year alone. He went on to say that the layoffs were "in response to changes in the health- care industry, including U.S. health-care reform and the challenging regulatory environment." Looks like if ObamaCare isn't repealed, and fast, even the President himself won't be able to stop it from harming his own backyard

"Consider the humble paper clip. A thin piece of steel wire bent into a double-oval shape. And yet over the past century, it remains the standard method of holding loose sheets of paper together. The first paper clip was invented in 1867 by Samuel Fay. The patent was issued on April 23, 1867 and was actually for a Ticket Fastener. The modern paper clip was patented on April 27, 1899 to William D. Middlebrook of Waterbury, Connecticut, and for more than 100 years has been fastening loose paper with few modifications"

ObamaCare Sends Doctors Packing



A new poll shows doctors are more willing to close down their practices and retire than live under the Democrats' health care law-which proves what Investor's Business Daily has been saying all along. During a previous study performed by Investor's Business Daily, 4 out of 9 doctors said they would "consider leaving their practice or taking an early retirement," which meant as many as 360,000 physicians could be lost as the number of people in this country who need medical care keeps growing. 67% also said they expected fewer people to apply to medical school if ObamaCare went into effect. Other results from the poll showed that they believed the health care bill would result in lower-quality care for seniors and higher costs for taxpayers. Although this study was initially scorned, a new poll actually proves its findings. Today, a Merritt Hawkings survey shows that a whopping 40% of doctors are considering leaving their practices now that the health care overhaul has officially passed. If we don't repeal ObamaCare as soon as possible, we may lose the very people who make our health care system work in the first place.

Looking for a challenge? How about interval training? Interval training trains your system to utilize different fuels for energy.

Interval training is an training system that combines short bursts of intense activity, called intervals, with periods of lower intensity, or rest periods. By alternating the two throughout your workout, your body is forced to exert more effort than it normally would during a steady, continuous workout of moderate intensity.

Intervals can be used by anyone, beginner or advanced, for almost any kind of workout. You will find that interval training takes less time, but the challenge it provides is very intense. For instance, instead of 45 minutes on a recumbent bike, reading a magazine, try 15 minutes of interval work.

An example of interval training is the Tabata Method, which alternates 20 seconds of ultra-intense exercise with 10 seconds of rest for a total of four minutes, the results have been “through the roof.”

According to the American College of Sports Medicine, short, high-intensity exercises burn more calories than longer, low-intensity aerobic workouts.

Interval training is accomplished by adjusting several factors in a workout: the length or duration of the intervals, the length or duration of the rest periods, and the type of activity taking place during the rest periods.

Each increase and decrease of activity corresponds to an increase and decrease in your heart rate -- and that’s where the extra calorie burning occurs. But it’s not about how fast your heart is beating. It’s how fast it slows.The important thing about interval training is not the rate of activity; it’s the rate of recovery. For instance, if you walk a block and you can’t walk another one until the next day, your rate of recovery is horrible.

Try interval training on the treadmill, walking or running. Try it on the elliptical, the bike, and even jumping rope. You can use interval training in any sport.

Until next time, keep training hard and eating smart!

The human body was designed to survive. The way it survives during times of famine is to:

1) Lower metabolic rate, to use as few calories as possible.
2) Burn off lean tissue (muscle) as fuel.
3) Store as much fat, as possible, in order to have a reserve of calories on hand.

Most people skip meals or eat too few calories during the day, by doing this you are putting your body into starvation mode, which the body treats as a famine and lowers metabolism.

And most people also come home at night and eat a big meal followed by a few snacks, by loading up on calories at night you are signaling your body to store up fat.

The right thing to do is eat several small meals throughout the day to let your body know there is plenty of food available and so will raise metabolism and burn more calories and not feel the need to store fat.

These meals should be the types of foods the human body was designed to use, such as lean meats, fish and fowl, along with fresh raw fruits and vegetables.

Early humans ate what they could hunt and gather, they ate no refined foods, no sugar, no wheat, no grains and they did not drink milk past infancy and that was human milk not the milk of another species.

When modern people stray from this, by eating refined foods, candy, bread, chips, cows milk, ice cream, etc., they tend to get fat and develop all kinds of health problems.

Strength training is very important because it builds or at least maintains lean tissue and therefore keeps your metabolism high thus burning more calories.