BSO offers pizza to child protectors who cut caseload | Miami Herald

How very low of any boss .. disgusting

The Broward Sheriff’s Office wanted to reduce caseloads in its child abuse unit. But how to incentivize? The department brass offered a pizza party for whoever could close the most cases.
— Read on www.miamiherald.com/news/local/community/broward/article229394934.html

A Dr I network in Germany Info on CF & ME

Anesthesia Recommendations For Chronic Fatigue Syndrome & Myalgic Encephalomyelitis

Anesthesia-Recommendations-for-ME-CFS

By Erica Verrillo*

Having Chronic Fatigue Syndrome & Myalgic Encephalomyelitis (ME/CFS) does not exempt patients from other illnesses and conditions that may involve surgery. Procedures that require anesthesia, such as extraction of wisdom teeth, cataract surgery, or removal of an inflamed appendix or gallbladder are common enough in the general population to predict that you will likely have one or several procedures after contracting ME/CFS. Unlike the general population, patients with ME/CFS have a specific set of sensitivities that require modification of anesthetic drugs.

Avoid Histamine-Releasers

A study conducted by Fred Friedburg, Lucy Dechene, Maggie McKenzie and Robert Fontanetta in 2000 found that nearly 90% of long-term Chronic Fatigue Syndrome & Myalgic Encephalomyelitis patients suffered from allergies. (1, 2) Histamines are part of the inflammatory immune response to infection, and are responsible for some of the weakness, exhaustion, and malaise experienced by normally healthy people when they become ill. As these are symptoms experienced by most ME/CFS patients, an increase in histamine levels will only make them feel worse. In fact, Lucy Dechene, Ph.D., has proposed that histamine overproduction can substantially contribute to the development of the ME/CFS’s most significant effects. (3)

Because so many ME/CFS patients not only have allergies, but are sensitive to histamine itself, anesthesiologist Patrick L. Glass, MD of Reno, Nevada recommends against histamine-releasers. This group includes sodium pentothal, which is a thiobarbituate. In fact, Dr. Glass cautions against any drug in the thiobarbituate family, as they are all histamine-releasers. (These can be identified by the inclusion of “thio” – Thiamylal, Thiobarbital – in the name.)

Patients should also avoid muscle relaxants in the Curare family, such as Curare, Tracrium, and Mevacurium, which are also potent histamine-releasers.

For ME/CFS patients, Dr. Glass recommends Diprivan (propofol) as the induction agent, Versed (midazolam), fentanyl (a short-acting narcotic) and droperidol (an anti-nausea agent) during the anesthetic.

Avoid Epinephrine (Adrenaline)

Epinephrine (adrenaline) is commonly added to anesthetics. As a vasoconstrictor, epinephrine serves to narrow blood vessels, which helps to maintain blood pressure and prevent excessive bleeding. Epinephrine also prolongs the effect of anesthesia, which means not as much needs to be used.

Tilt table testing on Chronic Fatigue Syndrome & Myalgic Encephalomyelitis patients has shown that a majority of long-term patients experience orthostatic intolerance – POTS (postural orthostatic tachycardia syndrome), black-outs, and feeling light-headed when standing. All of these can be caused or exacerbated by cathecholamines (epinephrine), sympathomimetics (isoproterenol), and vasodilators (nitric oxide, nitroglycerin, alpha-blockers, and hypotensive agents).

Epinephrine can also produce panic attacks. (8) ME/CFS patients who have had anesthesia with epinephrine have reported sleeplessness, jitters, and anxiety.

Avoid Hepatoxic Agents

Dr. Paul Cheney advises against any agent that might be harmful to the liver (hepatoxins). (4) Chronic Fatigue Syndrome & Myalgic Encephalomyelitis patients are more sensitive to medications than healthy people. Dr. Cheney has proposed that a combination of low blood volume and diastolic heart dysfunction hampers patients’ ability to remove drugs from the bloodstream. If a drug that is toxic to the liver is used, a patient with ME/CFS will not be able to clear the drug from the body efficiently.

In addition to an inability to quickly remove toxins from the body, people with ME/CFS often have reactivated Epstein-Barr virus (EBV), which places a great deal of strain on the liver. An excess burden of hepatoxic drugs could potentially lead to inflammation of the liver (hepatitis).

Halothane and other inhaled anesthetic agents, such as enflurane, isoflurane, sevoflurane, and desflurane are highly hepatoxic, even in the general population, and should be avoided by patients with ME/CFS. (6,7)

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What You Should Do

When asked about allergies, patients with Chronic Fatigue Syndrome & Myalgic Encephalomyelitis should mention sensitivity to epinephrine. This will become part of your medical record, and will be reported to the anesthesiologist.

Patients should hydrate prior to surgery and avoid drugs or supplements that lower blood pressure (vasodilators such as aspirin, nitroglycerin, vitamin E).

Dr. Cheney advises that because intracellular magnesium and potassium levels are often low in ME/CFS patients, anesthesia can cause cardiac arrhythmias. He recommends giving patients Micro-K (potassium) using 10 mEq tablets, 1 tablet, BID and magnesium sulphate 50% solution, 2cc. IM 24 hours prior to surgery. For local anesthesia, Dr. Cheney recommends using Lidocaine sparingly and without epinephrine.

In a Nutshell

Hydrate before surgery to keep your blood volume up

Inform your doctor and surgeon that you are sensitive to epinephrine

Ask your surgeon not to use histamine-releasing agents

Supplement with potassium and magnesium

Stop taking vitamin E and other vasodilators three days prior to surgery

Pass on the above recommendations to your doctor

Wearable Medical Alerts

If you are a patient who is prone to fainting, or have allergies and chemical sensitivities, it may be a good idea to wear a Medic Alert bracelet.

Medical professionals routinely look for a Medic Alert bracelet or necklace. If you arrive at a hospital unconscious, the hospital can call the phone number on your bracelet. Medic Alert will tell the hospital who your doctor is and how to reach them, plus anything critical in your medical history, including allergies and recommendations regarding anesthesia.

* Erica Verrillo is ProHealth’s expert editor for the ME/CFS HealthWatch and Natural Wellness newsletters. She is the author of Chronic Fatigue Syndrome: A Treatment Guide, 2nd Edition, available as an electronic book on Amazon,Barnes & Noble, Kobo and Payhip (PDF file). Her website,CFSTreatmentGuide.com, provides practical resources for patients with ME/CFS. She also writes a blog, Onward Through the Fog, with up-to-date news and information about the illness, as well as the full text of CFS: A Treatment Guide, 1st Edition (available in translation).

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References

Friedberg, Fred et al. Symptom patterns in long-duration chronic fatigue syndrome. J Psychosom Res. 2000; 48: 59-68. http://www.ncbi.nlm.nih.gov/pubmed/10750631

Friedberg, Fred, PhD. Characteristics of Long-Duration CFS CFIDS Chronicle, Fall 2001. http://www.cfids.org/archives/2001rr/2001-rr4-article03.asp

Duchene, Lucy. CFS: Influence of Histamine, Hormones and Electrolytes. CFIDS Chronicle, Summer 1993, pp 31-35.

From Doctors, To Doctors and Anesthesiologists. http://www.squidoo.com/anesthesia-with-CFS

Kaplan, Melissa. Surgery, Anesthesia and CFS/FM/MCS. http://www.anapsid.org/cnd/drugs/anesthesia.html#anes

Peralta, Ruben, MD Halothane Hepatotoxicity. Medscape. http://emedicine.medscape.com/article/166232-overview

Desflurane. Drug Record. NIH http://livertox.nih.gov/Desflurane.htm

van Zijderveld GA, Veltman DJ, van Dyck R, van Doornen LJ. Epinephrine-induced panic attacks and hyperventilation.J Psychiatr Res. 1999 Jan-Feb;33(1):73-8.

Narcissists Use Trauma Bonding and Intermittent Reinforcement To Get You Addicted To Them: Why Abuse Survivors Stay

In general not recognized by profession , who

ignore or close their eyes to what trauma bonds

are , as in my case since a Dr had labeled me

despite my honesty from the get go that I was

hit , and targeted by win at all cost , ” family”

in denial that they were not perfect .

Sacrificing their grandchildren and me , was

a piece of cake.. a horrid truth I discovered

adversely affects more folks in hollowed halls

of law and men.

It’s a very good thing to witness healing of

this pick of speed as many wake to the erasure

of families , and the profit by bottom-feeders

whose deserving of being spotlighted , as

poster child’s , abuses that no Hail Mary

Father Forgive Me excuses . Holding this

abuse as excusable, is foolhardy, a higher

power begs surrender , residence puts

abusers , front and center .

I am more that ready , Thy Will Be Done

#FlyingMonkeys

©️

Blessings & Peace,

Doña Luna

Trauma bonds are intense, unshakeable attachments which occur in abusive relationships, making it difficult for abuse survivors to leave. Here are signs you might be trauma bonded to a narcissistic abuser.
— Read on blogs.psychcentral.com/recovering-narcissist/2019/03/narcissists-use-trauma-bonding-and-intermittent-reinforcement-to-get-you-addicted-to-them-why-abuse-survivors-stay/

Whitney Houston – I have nothing

There are certain songs that I know will evoke

tears of release , much needed on a full moon .

Same release as laughing ..

The passion of her words , the object of her

love , move me . That said, I know that my

worlds would be altered but not ended with

the Beloved , for I have tempered my heart

to understand the love that does not die

yet the heart does go on .

Perhaps rearranged but not desperate or grief

for life , but cherishing each moment , soul

to soul , that exceeds the physical , transcending

a physical existence , the higher love . I have

only begun to know as factual , has been the vision

of my child self .

To know he exist in human form has been an

affirmation of long ago words from a seer ,

as I now understand all timelines are off,

he would show up later in my life .

Meanwhile I won’t be late for my life

which is also a song lol.

May your wishes bear fruit on this full moon

in Libra ♎️.

#AlwaysReachForTheStars

©️

Blessings & Peace ,

Doña Luna

Whitney Huston

www.youtube.com/watch

420 celebrations spark up Roanoke Valley, Floyd on Saturday | Arts & Entertainment | roanoke.com

My homies

Aren’t they beautiful .

Adore the celebration and spirit of 4/20

In a world where anti-marijuana laws are growing looser, a stoner’s holiday has emerged. Nightspots in Southwest Virginia have planned their own celebrations.
— Read on www.roanoke.com/content/tncms/live/