25- Fluoride and why getting rid of it is a bad idea

There are a lot of dumb hills to pitch a fit over these days. My least favorite is the anti-fluoride movement.

Fluoride is important because it prevents cavities and strengthens teeth. As someone who has a complicated relationship to my dentist I am in favor of everything and anything that decreases my chances of additional tooth decay.

Fluoride has been shown in some shoddily done studies to “alter your gut microbiome and has suggested associations with thyroid disorders, weight gain and possibly decreased IQ”.

Note the important shoddily done study in question that indicates decreased IQ has been roundly criticized and recommended for retraction. Yes, it is that bad.

The measurements used to ascertain IQ decrease were 1) not validated, 2) used different testers, 3) done in multiple cities. It is the first point that is the most crucial. I can swear to you that the sky is pink, not blue. I can have other swear the same to you. But I won’t let you look at it to see for yourself that it is pink.

It is the same energy as the question that captivated the internet in 2015, is the dress blue or gold.

Bitch please, it depends on the lighting. True, sometimes the sky is pink, especially in the early morning as the sun is rising, or later in the day as it is setting.

For a sarcastic example: Yay, you proved that the sky was pink at 0635! Now prove it again and again and again. Also, prove it at noon.

I’ll wait.

Who are you going to believe? Me, or your lying eyes?

Ugh.

Nothing that the troglodytes and mouth breathers have brought up, none of the studies have been replicable. That means no one else has been able to do the same study, as outlined in the study, and gotten the same results. This is the major finding. This is the flaw in the study.

Trust me, I’ve taken many graduate level courses to make sure that the studies that I will create are able to be replicated. This is why what these people who are playing with fire drive me so insane with anger. They don’t know enough not to touch the hot stove. But they will blame the resulting burn on vaccines, don’t worry.

This is more bluster and nonsense coming from non-science believers.

There is a big story going around now that the Secretary that is pushing for this swam in feces contaminated water. Worse, he let his grandchildren swim in the same water. Gross.

Also, double ugh.

As someone who has spent thousands of dollars at the dentist in the last year, I will keep my fluoride toothpaste and my fluoridated water. Or is someone going to tell me that the hole in our bank account is a figment of my imagination or the pain that I’ve suffered through is in my head or is because I am overweight?

Triple ugh.

School Me Saturday 4/26/25- Funding changes, what do we do now?

Yes, I know I have written about this before. I don’t care. It is too important. Every day research that has been in the works for I can’t even tell you, research that has already been paid for, is shriveling in the petri dishes.

Research is expensive. Proper, well structured research is expensive. You have to pay for the researcher, you have to pay for the research assistant, you have to pay any adjunct helpers who are conducting the research, you have to pay for the computer you use to write up the reports, you have to pay for the electricity that run a lot of this, you have to pay for the IRB, you have to pay for the data analysis, you have to pay for the lab time, sometimes you even have to pay to get it published (those are the predatory publishers, don’t give in to them), and if you are offering an incentive to garner participation, you have to pay each participant the incentive.

It gets expensive. Capital red letter expensive.

Oh, not only do you sometime have to pay to publish, you have to pay to present at conferences. With all of those attendant costs as well. At AORN there were several international hospitals and countries and research presented. Each of them had to pay for the conference fee, the flight, the hotel, and the food while they were in Boston. Or Orlando, or Chicago, wherever the conference is held.

Many of these are covered in grant indirect costs. These indirect costs are not well understood and is more than a line item in the grant. Not being understood, like at all, means that people overact when they see the line item.

The hammer has fallen. Nascent grants are not being approved. Existing grants are being yanked, even as the research is underway. That is what I meant when I wrote that research is shriveling in the petri dishes.

Why?

This is a very good question. Because the researchers are daring to research something that isn’t white or male. It is being stripped because of the specter of DEI.

Another not well understood concept that is being used as a bludgeoning tool.

DEI doesn’t mean what they think it means. Inigo Montoya snuck in the chat.

This, of course, has started panic at the research universities. Especially the ones who don’t have billions of dollars in endowments. But even if you have that kind of money doesn’t mean it is just sitting around in coffers, or under a dragon like Smaug.

It has been a long time since the students (hello, that’s me and my cohort), had any guidance in the matter. Probably because those doing the reaping are being mum on the matter.

No DEI is all they know how to chant. Again, it doesn’t mean what they think it means.

Yesterday we had a rare in person day on campus where the second and third years who were interested, were given a ground level “this has happened and this is how we envision going forward” talk.

We had a group discussion about how to find and secure funding. Ideas about other funding sources were floated. It was a good conversation. Remember, all of us are nascent nurse researchers.

I know I left feeling a little more hopeful about this crappy situation we find ourselves in. I hope others did too.

I offered my notes to the rest of the cohort that were not there and I hope to have the notes to them tomorrow. I just want to reflect on it some more.

I wore my “Baking is Science” tee shirt with a baking cat on it. On my husband’s recommendation that I leave the political shirts at home. I think a stronger worded tee would have been better. There is always the August in person day.

Tuesday Top of Mind 12/17/24- Your grandparents would be rolling over in their graves if they knew!

I am not going to ask how we got here. It’s bad enough that we are here.

By that I mean the rampant feeling by some LOUD segment of the population that vaccines aren’t important. So unimportant that they don’t want them and, furthermore, their children don’t want them. Yes, I know that is grammatically incorrect.

They feel that the diseases that are currently being vaccinated against are a thing of the past. After all, THEY never heard of anyone getting whooping cough, or tetanus, or measles. And THEY certainly never had it themselves.

Now the anti-vaccinator himself, RFK Jr., has ingratiated himself into an essential job at the government level. He will be handed control of the Health and Human Services. This is a man who caused a fatal outbreak of measles in Samoa tby peddling his snake oil and misinformation about vaccines.

This man is not a doctor.

Like the yummy mummies on social media who are anti-vaxers and never expose their precious offspring to “chemicals” like di-hydrogen monoxide, that’s water, by the way. Until one of their children comes out with a PREVENTABLE disease, like influenza or measles, and dies. Then comes the rending of the clothes and the gnashing of the teeth and the wailing and fake tears. And the claims that no one told them that precious little Timmy-kins could die. After all, they just wanted to fit in with Tiffiny and Karin.

Spare me.

I’ve only read examples of death by tetanus. This is where your muscles lock up so tightly because of the toxin. The muscles are so rigid that bones break. Sounds horrible and not something I’d wish on my worst enemy. If I had any enemies, that is.

My great, great-aunt died of pertussis in the 1930s, even though a vaccine had been developed in 1914. The vaccine wasn’t widely used until the 1940s.

The DTP (diphtheria, pertussis, and tetanus) vaccine is a 3 vaccine for 1 shot deal. The caveat is that it only lasts for 10 years.

The flu shot is widely available, beginning in the fall. This is a yearly vaccine that everyone should get. After all, 28,000 people died of the flu in 2023 and the young, the old, and the immunocompromised are at risk, even with a vaccine.

Is this ringing a bell?

Same things we said about the covid vaccine and there were still millions of people who died worldwide. How many? We don’t know because they STOPPED collecting/reporting the data.

Your grandparents and great-grandparents lost children to what we can now prevent and would look at you in disappointment when you decide to listen to disgraced doctor Andrew Wakefield and his many, many, many, many times disproven paper that linked vaccines and autism.

Double spare me.

Better yet, spare your kids.

Post-it Sunday 11/24/24- Bbbbiiiiiggggg stretch/cough

The gown card reads, “Sometimes anesthesia reminds me of doting pet parents every time a cat stretches its entire length out, but instead of saying big stretch, the commentary is big cough.”

If you have a cat, or some dogs, you’ve given this commentary.

The cat stretches out their back legs or their front legs in an elongating stretch that makes you comment, every time, “big stretch”. The human extends the i sound to mimic the satisfying stretch the cat has just done. This comment is definitely a reflex on the human’s part.

When a patient is breathing on their own after anesthesia and is extubated by the anesthesia provider there is often a reflective cough after the tube is removed. Without fail, anesthesia will comment “big cough”. Extending the same i sound to encourage the patient to cough again.

I have a cat. I know how this goes.

The cat stretches for a variety of reasons. To say hi, to loosen up their muscles after a nap, and even to invite their owners to play. These are all positive affirmations by the cat that the human is a good human. A good stretch is also an indication that the cat is content and feels safe in the human’s company.

A good cough after extubation and the accompanying praise can also be a good indication that the patient is safe with the OR staff.

After all, a good couch stirs up the juices (for lack of a better, less icky word) that have been stagnating in the lungs during the duration of anesthesia and surgery. This improves lung exchange and can have a positive effect on the pulse oximeter reading.

The intonation and the elongated i in big is the same.

Both instances are hilarious.

Post-it Sunday 9/29/24- the in crowd

The gown card reads “Drs are a collegial bunch. As if having an MD gets you into a special club.”

My sister is a doctor. A pathologist, in fact. I know all about the years of schooling, the internship year, and the resident years, and the fellowship years (if they do that).

I get it.

I also understand why there is a special handshake doctor club.

I get it.

No one else can possibly understand but another doctor.

However, there is also a hierarchy among doctors. The general surgeons generally look down on the ob-gyns, the orthopedists look down on the podiatrists, and the neurologists and cardiothoracic surgeons look down on everyone.

Bullying between doctor groups is not okay.

It smacks of high school. And all the doctors I know have at least 10 years of post-high school education.

There is also a rivalry between the PhD nurse and the DNP (doctor of nursing practice), for no good reason. The PhD nurse does the research, and the DNP puts it into practice.

Stop acting like a bunch of teenagers!

Did you not learn in high school that bullying and snobbish behavior are not how to treat a colleague?

I was gonna write act your wage, but I don’t think so.

Definitely act your age.

Bullying is not on.

*** As an aside, reading the rest of the notes on the card I wonder if this was not a note about healthcare. The rest of the gown card is about a serial killer mystery I plotted out. And the main characters. The age of the gown card definitely bears this out. But the message is still the same, fictional doctors or non-fictional doctors need to stop acting like a bunch of teenagers and act your age.

Tuesday Top of Mind 9/24/24-They don’t care about anything but control and money… do you?

I realize that not everyone is as informed about the news as I am.

I realize that everyone doesn’t have the same reaction to the news that I do.

I realize that the reason for this is because some people just don’t care.

They don’t care that over half of Americans are being told that we are worth only what our uterus can produce. AKA the tax revenue that can be brought in by the potential uterine output.

They don’t care that women are dying.

They don’t care that babies are being tortured into existence where they will live their short lives in agony.

They don’t care that medical professionals, those who have gone to school for at LEAST 20 years, and those who don’t want to torture women or the cells that will become the baby, are leaving the red states in droves.

They don’t care that the patients who are left behind who cannot/will not move, are in what we term as an OB desert. This means that the number of doctors who stay in the red states is not enough to care for the women of the state.

They don’t care that women over 50 are still of childbearing age. Instead, they find it easier to mock them and ask why they care about the bodily autonomy of those who can still have children. Never mind that women over 50 can still bear children and never mind their daughters and granddaughters are impacted by the abortion can she or can’t she shell game they have going on.

They don’t care that anyone can be a signatory to an abortion amendments petition without the police/sheriff showing up at their house and interrogating them about it.

All these things they don’t care about. All of these things have been in the news in the last five days.

What do they care about?

It isn’t the unborn. It is money; It is the control of women.

What are they afraid of? Women.

Vote in November like your bodily autonomy depends on it.

Or someone you love.

School Me Saturday 9/21/24- above all else, take care of your health

Being a student is hard.

Like, really hard.

I understand and am suffering along with you.

However…

That is no excuse for not doing the minimum to care for your health.

Eating, hydration, and exercise. Oh, and sleep.

I know that shrinkflation has hit the grocery stores hard and it is sometimes hard to find time to eat, but do your best.

Eat a salad a day, or at least a vegetable. Less fast food and more at-home eating is also key.

I get that fast and easy will win sometimes. Just not every time.

Hydration. Drink that water. Hydration can impact all of your systems. And I mean ALL of them. Make sure you drink water first thing in the morning and try to make it the last thing you drink at night.

Exercise. Go for a walk on the Pomodoro break. Or do desk exercises. There are a lot of really great desk exercise videos and books out there. Your bone density will thank you. And bone density will be important for all the years you plan on living.

Sleep. This is the one that is the easiest to slide on. Aim for seven hours of sleep a night at a minimum. I’m not going to say no screens before bed because I read myself to sleep every night but minimize the engagement with the screens.

After all, you only get one body. Make sure you take care of it.

Gravity tolls for everyone

Summer means being outside frolicking. Biking, skateboarding, skating, walking the dog, playing outside with the kids, yard work…

The list is endless.

As are the ways that these activities can injure the human body. Injure in ways that need surgical interventions.

You name it, I’ve seen it.

Fractures of all sorts from the tips of your toes to your facebones.

Lacerations of all sorts everywhere there is skin. A laceration is a cut or an owie as we medical professionals call it.

Infected bug bites that subsequently need to be drained or otherwise surgically treated.

Random infections sometimes from the lacerations.

Summer has many ways to hurt people.

Most of them start with gravity exerting its will on people.

Word the wise, babies bounce but adults thud.

And with a fall and it’s sudden stop at the end, things can happen to the human body.

No one can escape gravity. And bubble wrap suits would be expensive, not very sustainable, and hot. Can you imagine the sweat?

Yep, gravity has everyone’s number. It is just a matter of time before you feel the impact of gravity.

No one is getting away from it.

In fact, gravity is in the room with you right now!

Tuesday Top of Mind 7/16/24- Fifth verse, same as the first

Yes, the post title is meant to reference the song”I’m Henry the VIII, I Am” by Herman’s Hermits.

What the post title is referencing is that this is the FIFTH covid summer. 2020, 2021, 2022, 2023, 2024.

Not as bad, but still lethal. Masks have been legislated against or banned in many cities and states. You know, the masks that have kept some of us safe through this entire time.

It is illegal to wear a mask in some states if you are committing a crime.

Since when is the desire not to get covid a crime? Depends on who you ask. Are you asking the ones who don’t believe in covid, who think it’s a boogeyman dreamed up by those with public health in mind? To scare the stock market? To get people to buy into Big Pharma? To want to care for others, no matter their age, sex, religion, and orientation?

Yeah, those people. The ones who excuse the death of over one million Americans (the exact data is hard to come by). According to the CDC tracking database, there have been 1-9 covid deaths in North Carolina in the last week. However, the previous week’s numbers that allow comparison and percentages are not available. Ask yourself what they don’t want you to know or even acknowledge to themselves.

I am keeping a close eye on the infection rate at the hospital. We went from 1 admitted case to more than 5 times in a couple of weeks. ooh, five more patients? Yes, and these are just the ones that got admitted. Or came in. These are definitely the ones who are quarantining because they are in the hospital.

I have not resumed mask-wearing as a general rule. I have some in my car. However, I shop early or late or not at all. I don’t go places where there are a lot of people. On purpose, but then I’ve always kinda done that. Who knew being an introvert could help? Just every introvert known to man.

I have no idea how many covid posts this makes. My record-keeping has been spotty. And incomplete. And my mind has been busy with other things.

As always, it doesn’t matter if you don’t believe in covid; it believes in you.

Post-it Sunday 5-26-27- Outlook not so good, ask again later

The gown card reads “Surgery is not without its risks.”

My favorite thing is when people assume that surgery will solve everything.

Or should I say least favorite thing?

I get it. People want surgery to be an answer. Strike that. People want surgery to be THE answer.

My second least favorite OR thing is when people discount the c-section as not surgery.

Bitch, we opened up your belly like a can opener to get the baby out.

Understand?

I mean, we put it back together and stitched it up real nice. But the point is that someone was inside your abdomen, rooting around. There are all sorts of risks in this.

And people just answer no, no surgeries when asked in pre-op about previous surgeries. Only to casually drop that all four of their babies were born via section.

Um. That is major abdominal surgery. With a great prize at the end. But major abdominal surgery nonetheless.

But back to the least favorite thing with patients assuming that surgery is the answer to all their problems. Nope, not even a little.

There will be the risk of anesthesia. The risk of death. The risk of infection. The risk that the surgery might not even solve the problem that the patient is having. The risk that surgery itself will lead to another list of problems because of the risk of anesthesia, the risk of infection, or even the risk of it not being the appropriate surgery for their problem.

Why?

Because often to cut (do surgery) is to definitively find out what the problem is. Even if the problem was not the one that the patient and the surgeon thought they had.

Because your skin and insides are not transparent and until the surgeon gets a direct view of the problem, there is always the possibility of a missed diagnosis. Because although surgeons are excellent at their job (ahem, for the most part), they are not prognosticators.

This means they don’t have a crystal ball.

All they can do is their best.

And all the OR team can do is support them.

This is how you get the best outcomes for patients.

There is no magic 8-ball in surgery.

Imagine if there was.