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Archive for date: October 12th, 2015
Hello world!
Welcome to WordPress. This is your first post. Edit or delete it, then start blogging!
Medications at Home…a Closer Look
It so happens that when this blog was assigned, an interesting medication teaching opportunity came up with a relative of mine. She has diabetes type 2 which is controlled by diet and exercise only; her doctor has not yet prescribed any single medication for her blood sugar control. If/when we are together and eat, I always chat with her about her blood glucose number. It so happens that on that particular day we were visiting, and she was telling me about the lunch she had at a new restaurant up the street. When I asked about her blood sugar level, she said that it was 275! When I asked her what she was going to do about it, she replied that she was going to take her cholesterol medication for it! I gave her a glass of water to drink and asked to if she wanted to take a short walk (to help lower her blood sugar). My plan was to chat with her on the walk about her medication and to retest her BGC when we returned. (By the way, it later went down to 135 to my relief).
I initially thought that she was confused about the difference between cholesterol medication and blood sugar control medications. She told me that when she tests her blood sugar and found it high, she has been taking a dose of her cholesterol medication, believing that her BGC level would decrease. I assumed she was referring to a statin and asked her to show me her medication packaging. I was surprised with my findings…
Her medication is named Welchol. It is a bile acid sequestrant, and considered an alternative to taking a statin to reduce/control high cholesterol levels. It works in the bowel to help remove bile acids from the body, then the body’s cholesterol to make more bile acids, which causes blood cholesterol levels to decrease. Ingenious!
Further intrigued, I went to the manufacturer’s website to investigate this interesting drug and saw…large banners that Welchol helps to lower blood sugar levels! Then I realized that is why/how my relative came to the conclusion that Welchol would symptomatically reduce her blood sugar levels. I read the “for patients” information section and found that this medication mostly works “in addition to” blood sugar lowering drugs, such as metformin and insulin. There was absolutely no mention of it helping to reduce blood sugar levels on its own.
Later, I pulled up several websites on Welchol to review with her. She was not aware that Welchol was not lowering her blood sugar. She also thought that she was supposed to take the Welchol symptomatically. Directions say to take it every day with food and to not miss a dose. She was also unaware of the potential side effects, so I reviewed those with her as well. I encouraged her to also chat with her doctor if she had any other questions and to keep on top of her blood sugar regimen.
I felt bad that I had not reviewed her medication with her before. We do, after all, educate patients at the hospital clinicals…why not educate out family too? I had just assumed that her provider had educated her, or that she had received information at the pharmacy. I should not have assumed, and decided from hereon that I would spend some quality time chatting with other family members about their medications (with their permission of course!). I also decided to take my own “medicine” so to speak, and to review the details, side effects, etc. for a medication that I am taking as well. Although I read the entire attachment that came with the one medication I take, it was a year ago and I decided that it would serve me well to have a review, just in case.
This was a great assignment…it reminds us to not take anything for granted, especially our medications. We have a responsibility to understand them and I am renewing my dedication 
References:
Deglin, Judith Hopfer, and April Hazard Vallerand. Davis’s Drug Guide for Nurses. 11th ed. Philadelphia, Penn.: F.A. Davis, 2009. Print.
“FDA Expands Advice on Statin Risks.” FDA Expands Advice on Statin Risks. U.S. Food and Drug Administration, 14 Jan. 2014. Web. 12 Oct. 2015.
Shah, R. V., and A. B. Goldfine. “Statins and Risk of New-Onset Diabetes Mellitus”” Circulation (2014): E838. Print.
Testing
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Week 8 Assignments & Guest Speaker Details
Hello, class. We hope you are engaged with the lurking process by now. Here are a few important updates for you.
Week 8 Assignments Due Tomorrow:
- You have 5 items due tomorrow, Tuesday, by 4:15. They are listed in the order you should complete them here: http://univ349.brocansky.cikeys.com/weekly-schedule/#week-8
Guest Speakers this Thursday
- In class this Thursday, we will be joined by Michael Berman and Raechelle Clemmons, who have volunteered their time to speak with you about their experiences as “social CIOs.” Learn more and submit a question for Michael and Raechelle here: tiny.cc/whybesocial
- If you have a Twitter account, we encourage you to Tweet your reflections and observations during our class session Thursday. Be sure to include our hashtag #UNIV349DC. Your Tweets will appear in our Twitter widget on our course page.
Option to Attend Class Virtually this Week
- This Thursday, we (Jill and Michelle) will both be attending a conference out of the area and, therefore, will be attending class virtually. We would like to extend the same option to all of you. To be clear, this Thursday you have the option to attend class in-person or virtually using Zoom. The instructions for virtual participation are included in weekly schedule under Week 8.
Michelle & Jill
Health literacy and Medications
To my surprise, the health literacy of the individuals in my family vary greatly. I am going to use my father and my father-in-law as examples because their similarities and differences provide an interesting illustration. Both men are in their seventies, both are a healthy weight and have lived active lives, both received a Masters degree from Columbia University and had successful careers.
My father was diagnosed with type II diabetes mellitus when he was in his forties. His treatment plan includes oral antidiabetic medications along with exercise and diet modification. He is in good health and knows more about the physiology of his body than most members of the general public. In addition, he is married to a Nurse Practitioner who keeps him on informed about his medications, as well as aware of any signs and symptoms that indicate potential problems. He is knowledgeable about what medications to take, what they do, when to take them, and what is doses are.
My father-in-law has been healthy for most of his life. Three years ago he was diagnosed with prostate cancer. After consulting with his physician he decided that the best intervention was no intervention. He, like many elderly men with prostate cancer, is using the approach of “watchful waiting” and “active surveillance.” He lives alone in an apartment in midtown Manhattan. About a year ago he started to show signs of early memory loss and has since been diagnosed with the Alzheimer’s disease. Several factors now contribute to his low health literacy level and confusion about medications. One problem is that while he was gifted in mathematics, he had little interest and is not knowledgeable about how the body works. Having lived a very healthy life, he has little experience with medications or the medical system. In addition, one of the first signs of changing cognitive function is difficulty solving math problems (eg paying bills). While he can remember what medications he is taking and when to take them, he is not able to understand safe doses.
I think both of these men illustrate how two seemingly similar individuals can have two totally different health literacy levels and require different approaches to education about medications. Being able to recognize the needs of the individual is paramount and requires careful assessment.
Project 2 Discourse community slides draft
https://docs.google.com/presentation/d/1khn_nvxyYNA600JyHuXMzuMeNBg1c487JZjkYoV9Ez4/edit#slide=id.p
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Writing as Reflective Practice 2015-10-12 17:42:17
Summary
In the except for Stephen King’s memoir On Writing: A Memoir of the Craft, King explains that writing is a skill to be built upon. King makes the analogy of a toolbox. His uncle own a toolbox that “had three levels, the top two removable, all three containing little drawers as cunning as Chinese boxes. It was handmade, of course. Dark wooden slats were bound together by tiny nails and strips of brass. The lid was held down by big latches; to my child’s eye they looked like the latches on a giant’s lunchbox” (112). King’s uncle carried this massive toolbox with him on every handyman job and when a young Stephen questioned his uncle—after all, carrying the entire toolbox when all that’s needed is a few screws and a screwdriver seems pretty impractical—his uncle replies calmly “It’s best to have your tools with you. If you don’t, you’re apt to find something you didn’t expect and get discouraged” (114). King carries this advice into his writing and encourages writers of all abilities to have their own writing toolbox.
King believes that the writer’s toolbox should have vocabulary and grammar within reach on the uppermost level. Although vocabulary is the most exercised tool used by writers, King does not believe writers should work on vocabulary at all. Vocabularies will either strengthen as writer’s read or it won’t. But, forcing complex words into a sentence when a simpler word would be more appropriate is harmful to the writing overall.
Grammar is just as important as vocabulary, and King implores writers to understand the difference between active and passive voice and to make an effort to say away from passive voice. Although the passive voice is safe and alluring to newer writers, it is ultimately detracting from the power of the words. King expresses similar views about adverbs—they’re nice, but still detracting from the power of the prose. King attributes the use of passive voice and the overuse of adverbs to both fear and affection. A newer writer fears that their readers will not understand them—hence the overuse of adverbs—and the dependence on passive voice.
Under the vocabulary and grammar that make up the topmost layer of the writer’s toolbox, there should be a layer on the elements of style. King is specially referring to paragraph structure here. As essay writing and fiction writing are two completely different animals, it makes sense that the structure of the paragraphs would be different as well. King emphasizes the idea that paragraph structure will be different in expository prose as opposed to fiction prose, and that paragraphs in fiction will be far less structured.
Further Reflection
While I agree with the ideas of having a toolbox, I do not completely agree with King’s ideas about not working on vocabulary. As writers, it is our responsibility to actively learn and sharpen our skills in order to be the best writers we can possibly be. Vocabulary is included in this skillset. Even if you never use the word postulate in your own writing, it would be good to know what it means. At the very least, to be able to guess the meaning. I completely agree with King’s thoughts on paragraph structure. Paragraph structure is something I struggled with while making the leap between expository writing and fiction. The idea of a paragraph consisting of a topic sentence then supporting sentences was so ingrained in me that I could not fathom a paragraph as anything else.
Central Question
- What is your relationship to paragraph structure or writing structure in general? Do you see writing as something that needs to be structured?
- What would you put in your writer’s toolbox?
Links
Adverbs—should we really fear them?
Active voice vs. Passive Voice
Active voice vs. Passive Voice (Part 2)
Works Cited
King, Stephen. On Writing: A Memoir of the Craft. New York: Scribner, 2000. 111-31. Print.
“Why?” She Said Questioningly.” Reference For Writers,. N.p., 11 May 2013. Web. 12 Oct. 2015.
“When to Use Adverbs.” The Writing Café,. N.p., 16 June 2013. Web. 12 Oct. 2015.
“Active v Passive Voice (#storiesshouldn’tsleep).” The Writing Café,. N.p., 14 June 2013. Web. 12 Oct. 2015.
PROJECT 2:
https://docs.google.com/a/myci.csuci.edu/document/d/1T0TkyA7bBiGIVWPy0zxfO_e9CVGD3CVOaMjv_Z_yLQ0/edit?usp=sharing
http://prezi.com/ojuhs5e0weue/?utm_campaign=share&utm_medium=copy
