Japanese practice of eating only until ure 80% full then waiting 20-30mims to see if u require more food
Here is a basic way to read arterial blood gases.
1. First look at the disease of your patient. That will give you valuable information on whether it is a respiratory or metabolic problem.
2. Look at the pH. Normal is 7.35-7.45. If it is high, then the problem is alkalosis. If it is low, the problem is acidosis.
3. Look at the PaCO2 . Normal is 35-45. If the PaCO2 is high and the pH is low, then the patient probably has respiratory acidosis. Go back to the patient history to check. If the PaCO2 is low and the pH is high, then it might be respiratory alkalosis. Again go back to the patient history.
4. Look at the HCO3. Normal is 22-26. If the HCO3 is high and the pH is high, then the patient probably has metabolic alkalosis. Go back to the patient history. If the HCO3 is low and the pH is low, then the patient probably has metabolic acidosis. Again go back to the patient history.
So why do yo keep going back to the patient history? As the patient begins to compensate, the values of the opposite side will change. For example if the patient has respiratory acidosis over a long period of time, the body will compensate by increasing HCO3 levels. The final step is to determine if the body is compensating for the disorder. Another example of compensation- metabolic acidosis in a diabetic patient. The patient’s respiratory rate will increase and depth of respirations will increase in an attempt to blow off more CO2. So the HCO3 is low due to the diabetic acidosis,then CO2 will lower as the body tries to compensate.
For this class, know how to do the basic analysis. I won’t ask you about compensation- partial or full.
I. Hydrogen ion balance CO2 + H2O <——> H2CO3 <——> H+ + HCO3-
A. Chemical buffer system- proteins, HCO3-, Hgb, immediate
B. Respiratory system- CO2 + H2O —–> H2CO3, rapid
C. Renal system- H2CO3 ——-> H+ + HCO3-, slow
II. Respiratory acidosis- basic cause hypoventilation
1. Inhibition of respiratory center- drugs, oxygen therapy in chronic hypercapnia, cardiac arrest, sleep apnea
2. Disorders of the respiratory muscles and chest wall- neuromuscular diseases, chest cage deformity- kyphoscoliosis, extreme obesity, chest wall injury- fractured ribs.
3. Disorders of gas exchange- COPD, severe pneumonia, asthma, acute pulmonary edema, pneumothorax
4. Acute upper airway obstruction- aspiration of a foreign body or vomitus, laryngospasms
B. Clinical manifestations- dyspnea, disorientation, coma, dysrhythmias, hyperkalemia, hypoxemia, tremor, increased intracranial pressure.
C. Medical management- increase ventilation. Caution in giving O2 to patients with chronic hypercapnia.
III. Respiratory alkalosis- basic cause hyperventilation
1. Cerebral stimulation of respiration- psychogenic, hypermetabolic states such as fever, CNS disorders, head trauma, brain tumor, Salicylate intoxication- early
2. Hypoxia- pneumonia, asthma, pulmonary edema, congestive heart failure, pulmonary fibrosis, high altitude residence
3. Excessive mechanical ventilation
4. Gram negative sepsis, cirrhosis, exercise
B. Clinical manifestations- yawning, A light headedness, circumoral paresthesia, numbness, tingling of fingers and toes, carpopedal spasms, chronic exhaustion, palpitations, anxiety, dry mouth, sleeplessness, cold and clammy hands and feet, inability to concentrate, mental confusion, syncope, hypokalemia
C. Medical management- treat underlying cause, paper bag, sedation
IV. Metabolic acidosis
1. Bicarbonate loss- GI- diarrhea, ileostomy; renal loss- hypoaldosteronism
2. Increased acid load- hyperalimentation
3. Rapid infusion of saline solution
4. Increased acid production- lactic acid, diabetic ketoacidosis, starvation, alcohol intoxication
5. Ingestion of toxic substances- salicylate overdose, methanol, antifreeze
6. Failure of acid secretion- renal failure
B. Clinical manifestations- Kussmal breathing (deep, rapid respirations), peripheral vasodilation, hypotension, cardiac dysrhythmia, lethargy, coma, nausea, vomiting, growth failure, bone disorders, headache
C. Medical management- treat underlying cause, IV lactated ringer’s solution, if severe- NaHCO3.
V. Metabolic alkalosis- increase in plasma bicarbonate
1. GI loss- vomiting, chloride losing diarrhea
2. Renal loss- diuretics, mineralcorticosteroid excess- hyperaldosteronism, Cushing syndrome, excess licorice intake, carbenicillin or penicillin
4. Excess NaHCO3 administration
5. Antacids, milk, milk-alkali syndrome
6. Massive citrated blood transfusion
B. Clinical manifestations- signs of hypokalemia, hypoventilation, dysrhythmias
C. Medical management- mild chloride responsive metabolic alkalosis- parenteral isotonic saline with KCl, treat underlying condition, IV HCl if life threatening
VI. Arterial blood gases
I hate this cold weather… It demotivates me. I also hate facebook sometimes… It robs me of my life.
After church, I went to eat Filipino food with Ava. The restaurant I had my heart set on and even willing to eat a couple of spoons of white rice and some port wasn’t open. However, we went to another place. A dive, really. It was a waste of my $20. I wanted to puke it out as soon as the meal was over. I picked around the unhealthyness. I ate mung bean soup with uber wilted spinach. The oxtail for the kare kare was not even an ox or a tail =( and the bagoong was horribad.
What made my day worse was this two older men at the mall. I overheard them tell a younger fella not to say hi to one of us because one of us looked married. I believe they were referring to me. Damn that really affected me. ME??!?!? bloody fuckin hell… I’m not an ahjumma. FUCK it.
I came home and ran towards brown rice and grilled tuna with some seaweed, healthy sushi roll like but without anything else. I need to go to sleep soon…
Originally uploaded by aJ GAZMEN ツ GucciBeaR
couldn’t take a picture of the before numbers but it was horribad =(
The previous scores were due to poor diet, poor hydration, and stress.
Moisture: 22, Sebum: 98 (egads) , Elasticity 35 O_O=
I usually do my 21day PCRM Vegetarian Challenge every three months, but what’s the point of cleaning your body off toxins if I don’t stay away from saboteurs and sucker branches.
One can be meat-free all you want, but drink beer and emotionally eat with someone who doesn’t care about their health isn’t the right habit to have.
After 30 days of eating clean and living lean, this new reading is very encouraging.
The skin around my eyes have gotten lighter and less wrinkly-prone like.
I don’t want to just become physically and mentally fit; I want my glowing skin and silky smooth shining hair.
Goals for next month: sleep a solid six to eight, more sauna time, pamper thyself with massages, eat more organic & raw foods from the ground, meditate and yoga stretch at least 30mins before my morning work-outs
I want Logan Hood to be my trainer. Didn’t I say I’d do the dasing 300 workouts one day?
Damn. Need to get back on that goal.
I don’t want to just look fit, I want to stay fit. This isn’t a joke, it’s a lifestyle and mentality change.
You know how I want to do the prison cell push ups properly?
Well, I just thought just now, why NOT adhere to a prison like regimen. There’s something about how cut ex-cons get. They don’t have the typical machines in the typical 24 hr fitness I go to. THey use their own bodies for lifts, pulls, sits, and squats. Old school gym techniques while breathing mother nature’s healing air. I need the sand and the beach…. Shade as well.
I’ve turned into one of those… If you’re not serious , don’t talk to me. I can see it in your eyes… I’ve been there. I didn’t come to the gym for a social call.
Yesterday was an awesome WO with an hour of Cardio courtesy of “Latin Spice” at one of the five within 10miles of me 24hr fitness. I did 45mins of back. It has begun… the most dreaded days of the gym. When all the people with their New Year’s resolution to loose weight have gathered to lurk around the machines, paying more attention to their outfits and playlist rather than the proper posture and form. My New Year’s resolution is to NOT let them bother me out of my zone.
According to the heart rate monitor, I’ve burned 1000+ cals. Not good, since I didn’t plan on that at all… Proven by the not so peaceful, not complete enough rest. I kept tossing and turning all night. It could’ve been the cold weather, but I feel much better after ingesting a cup of 190cals Ezekiel sprouts, 20 black berries, 10 blue berries, and a little over a cup of 60cals almond milk. Oh, yeah, I also gotta watch my intake. Meaning, I need to log everything…
I’ve a new coach. Matt. I met him at the Super Saturday with Tony Horton up in Dallas a couple of months back. Turk inspired me, but it wasn’t the buddy support system I know I need at the moment.
I’ve also removed some expensive baggage aka the sucker branch from my tree of life.
I did pretty well on my 21days of PCRM Vegan Kickstart for December. I only forgot that I wasn’t supposed to eat any meat a couple of times. The moment I did, I spat it out. I will continue to do this every three months. Actually, I wanted to flirt with the vegetarian for most of the week idea. Need to tweak up some numbers to make sure my body doesn’t go into starvation mode.
The holidays didn’t prove to be hard mainly because I didn’t go to any parties. People at work were not as understanding, while some saboteurs aka friends who aren’t as supportive, didn’t make it easier either. Holiday calories do not count, someone said. Tell that to my hips; they freakin’ don’t lie. Oh… yea… no sleep, I sound like a fuckin’ pirate. Didn’t realize I ruined the 7ft sandwich division because I couldn’t eat my portion…
One chatty lady inside the sauna with me last night annoyed me. She said she started eating happy meals rather than her usual big macs because smaller portions is the key. Deep sigh… I hate to be one of those people; the one that rolls their eyes. But I did. I remembered her. She was texting the entire time she was in the gym. She got to the gym after I did and was already in the sauna before I. Kthanxbai. Vent over. More vent for laters.
You know how I used to say nothing can make me feel like puking while I eat? New love… Dexter. That show is fuckin’ brilliant. I probably shouldn’t watch it before I go to sleep…
Oh, and doing extra stretching and warming up have done wonders for my upper back. I’ve been pain free for a week it catches me off guard. My freakin’ shoulder joints aren’t as tight. Methinks sleeping on my own bed and worrying of just me have done wonders.
My body is rejecting meat. Last summer, my body started to reject dairy products. In reality, I’m perplexed because I was craving a juicy rib-eye steak.
I’m very hormonal today… It’s pretty bad and I’m close to tears. Saw an old couple holding hands and I was the only table at luby’s eating alone.
Bwahahahah I need a hug.
I got caught up in the gym or maybe not?
I was so focused that I lost track of time… I worked out for almost 3hours.
First, zumba was hardcore cardio… she meant bitness that itty bitty instructor.
Then, I did shoulders and arms with some triceps thrown in.
Then, did half of ARX when I started to feel bonk out… I looked at the clock and I was there that long?
Man… I rushed home to a double dose of shakeology, bananas, and almond butter.
I’ll post pic of heartmonitor watch here.
I think I over did it…
Gonna go to the jacuzeeeeeeee, my muscles need it im sure
why can’t i have the male’s physical propensity to burn calories and look like a greek statue just by hitting bbal with the boys…