Migraine Aura without Headache
Also called Ocular Migraine. However, the International Classification of Headache Disorders does not recognize this title. It can be challenging to distinguish this type of migraine from other conditions that cause visual disturbances. Many times, an aura warns of an imminent migraine. In this condition, it does not include head pain.
Usually visual in nature, the condition can involve seeing spots, zigzags, flashes, or even loss of sight for a short period.
The aura can start in the center of vision and move outward. Although individuals may believe it’s occurring in one eye, it’s actually coming from the occipital lobe of the brain.
Migraine without aura only occurs in about 4% of individuals, most commonly in the 20s and 40s. There may be a hereditary component.
Evidence suggests that the migraine aura is related to a chemical or electrical wave that moves across the brain. The part of the brain it spreads to determines the symptoms experienced. A visual aura occurs when electrical activity spreads through the visual cortex.
Migraine auras are categorized into three types:
- Visual occurs in 90-99% of sufferers. Impacting a person’s vision.
- Sensorimotor occurs in 36% of sufferers. And may experience numbness, tingling, dizziness, and tinnitus.
- Dysphasia impacts the ability to speak.
Symptoms:
- Zigzag lines.
- Flashing lights.
- Brightly colored spots.
- Blind spots.
- Foggy vision (like looking through water)
Symptoms usually start in the center of the vision field, then slowly move peripherally and disappear. These auras typically last less than 60 minutes.
Possible Triggers:
- Bright lights.
- Certain foods and medications.
- Stress.
- Sleep disturbances.
- Hormonal changes.
- Caffeine overuse or withdrawal.
- Dehydration.
- Weather conditions.
Diagnosis
Includes a physical and neurologic examination. In addition to the following:
- Eye exam to rule out any ophthalmic conditions.
- CT images of the brain to explore any neurologic conditions.
- MRI to visualize tissues, organs and structures of the brain for any disease process.
Management
- Pain management, even though no headache, can relieve the symptoms associated with aura.
- Acetaminophen, ibuprofen, and aspirin.
- Magnesium, CoQ10, and Riboflavin supplements.
- Staying hydrated.
- Avoid triggers.
Conclusion
Migraine Aura without Headache is not considered a serious condition; however, auras can be related to other medical conditions, such as stroke. Seek emergency care if the aura lasts more than several hours or occurs more frequently.
Immune Thrombocytopenia Purpura
| Narration | Text on Screen | Visuals |
| Introduction Hi, I’m Gini, and I want to help make Acute Immune Thrombocytopenia Purpura (ITP) in children more understandable. | ||
| What is Immune Thrombocytopenia Purpura? ITP is a blood disorder involving decreased platelet numbers. Platelets are small cell fragments found in the blood and spleen that stick together to form clots. Platelets are produced in the bone marrow, and when there are not enough circulating platelets, it’s difficult for clots to stop bleeding. Acute ITP occurs most often in children 1-7 years of age. It usually occurs abruptly following a viral infection such as Chickenpox or after receiving immunizations. Healthy children produce proteins called antibodies that protect against infection. However, in ITP a child produces abnormal antibodies. These antibodies adhere to platelet cells. An organ in the body called the spleen functions to filter out infection and recognizes these abnormal antibodies attached to the platelets as infection and destroys them. In this situation, platelets only survive a couple of hours. Whereas, healthy platelets survive 7-10 days. Although the onset of Acute ITP is abrupt, full remission occurs in less than 6 months with or without treatment, sometimes in as fast as two weeks, and does not reoccur. | ||
| Types of Immune Thrombocytopenia Purpura There are two types of Immune Thrombocytopenia Purpura also called Idiopathic Thrombocytopenia Purpura. Acute is rapid onset in children 1-7 years old with full remission in 6 months with or without treatment. Does not reoccur. Chronic can occur at any age but primarily in adults. Symptoms persist for 7-12 months. Usually, it requires treatment and can reoccur. | ||
| Symptoms It’s possible to have no symptoms. Easy bruising.Bleeding into the skin that looks like tiny reddish-purple spots called Petechiae. Usually, on the lower legs, and can resemble a rash. Reddish-purple spots that are larger than Petechiae are called Purpura.Bleeding from gums and nose.Blood in Urine or Stool. | ||
| Diagnosis The definitive test for acute ITP is a CBC or Complete Blood Count and a blood smear. This is examined under a microscope to evaluate the platelets. In chronic ITP a bone marrow biopsy may be required. | ||
| Treatment Acute ITP generally resolves without treatment. If treatment is necessary, the most common are Steroids or IVGG .Steroids help prevent bleeding and reduce the rate of platelet destruction. If it is effective an increase in platelet count occurs in 2-3 weeks. Intravenous Gamma Globulins (IVGG) are administered intravenously and utilized if steroids are ineffective. It is a protein that contains many antibodies and slows platelet destruction. Effective in 24-48 hours. | ||
| Conclusion When your child is diagnosed with an illness or condition, it raises many emotions and questions. We hope to share some of the basic information about ITP, including what it is, the symptoms, diagnoses, and treatment, to alleviate some of your fears and answer questions. We are always available to answer more in-depth questions. Remember, we are in this together. | ||
| References https://www.childrensnational.org/get-care/health-library/idiopathic-thrombocytopenia-purpura-itp https://www.ncbi.nlm.nih.gov/books/NBK537240/ https://www.childrenshospital.org/conditions/immune-thrombocytopenia-itp. | ||
What You Should Know About Traditional Chinese Medicine
Traditional Chinese Medicine or TCM has been in existence for 1000s of years. The first writings of TCM date back to 200 BCE (before the Christian Era). Chinese immigrants have been practicing TCM in the United States since the mid-19th century.
There has been very little change in this practice over the centuries. The basic concept is that a vital force of life called “Qi” surges through the body. The definition of Qi, states, it is a circulating life force whose existence and properties are the bases of TCM.
When there is an imbalance of Qi, disease and illness can occur. This imbalance is thought to be caused by an alteration in the opposite and complementary forces that make up Qi. These are known as Yin and Yang. (Johns Hopkins Medicine “n.d.”)
Ancient Chinese believed that a human is a microcosm, or a larger surrounding universe and they are interconnected with nature and subject to its forces. The balance between health and disease is the key concept. Restoring balance through treatment of the specific individual is the goal of TCM.
It is believed that to achieve this you must achieve a balance between the internal body organs and external elements of earth, fire, wood, and metal.
How is this balance restored;
- Acupuncture: involves pricking the skin or tissues with needles, to alleviate pain and to treat various physical, mental, and emotional conditions. It has received the most study of all alternative therapies.
- Moxibustion: burning of herbal leaves such as mugwort, on or near the body. Believed to enhance Acupuncture.
- Cupping: the use of warm glass jars to create suction on certain points of the body. Helps with pain, inflammation, blood flow, and relaxation.
- Herbal Remedies: active ingredients made from plant parts, such as leaves, roots, or flowers.
- Movement and Concentration Exercises: Tai Chi and yoga.
If you are considering TCM, a certified professional practitioner is advised. The Federally Recognized Accreditation Commision for Acupuncture and Oriental Medicine (ACAOM) accredits schools offering these teachings.
National Certification Commision, for Acupuncture and Oriental Medicine, offers separate certification programs in Acupuncture, Chinese Herbology, and Oriental Body Works. (Johns Hopkins “n.d”)
TCM should not replace conventional or allopathic treatment, especially for serious conditions. It can be used as a complementary therapy. Because some herbal medications can interfere or be toxic with western medicines it is important that you discuss their use with your Provider. Additionally, Chinese herbal medicines have been contaminated with toxic compounds, metals, pesticides, and microorganisms.
Be sure to do your research when using these therapies. (National Center for Comprehensive and Integrative Health 2019)
References
Ehrlich, S. D. (2016). Traditional Chinese Medicine. www.mountsinai.org
Hopp, D. C., & Shurtieff, D. (2019). www.nccih.nih.gov
Traditional Chinese Medicine. (n.d.). www.hopkinsmedicine.org
Challenges In Selecting a Nursing Program
There is a plethora of information to consider when you select a nursing program. Once you decide to become a nurse, the next step is to pick a program that fits your needs. Nursing is one of the most in-demand professions in the United States. It is primarily due to the extended nursing shortage, which has several contributing factors.
- The aging nurse workforce, with 19% of Registered Nurses, being over 65.
- Post Covid 19 era. Many nurses left their careers at that time.
- Nursing facility shortages.
Many more factors have contributed; however, these are the three primary ones.
How do you pick the program that best suits your needs?
(Marian University 2024) Lists these seven factors to consider.
- What the Nursing Program is like for the students.
- Requirements and Prerequisites.
- Approval and Accreditation.
- Curriculum Standards.
- Program Costs.
- Clinical Partnership.
- Length of Program. (ADN or higher)
There are additional factors, but we will explore these top 7 factors further.
1. What the Nursing Program is Like for Students
What does this mean? Does the nursing program meet your expectations? Such as time for testing, skills lab, lectures, and clinicals. Does it factor into your current lifestyle? Do you work or have family obligations? Are you considering ADN or BSN and higher? What is your learning style? Is class size and staff support a factor in the consideration?
2. Requirements and Prerequisites
When you apply to a nursing program, research which requirements you need to meet to be eligible and know which prerequisite college classes you need to complete before being considered; an example is Anatomy and Physiology. You can find this on the college website.
3. Approval and Accreditation
You will need to find an accredited Nursing Program. If the State Board of Nursing does not approve your school, it can prevent you from taking the National Council Licensure Examination (NCLEX-RN). Without the ability to take and pass the NCLEX, you won’t be able to receive your nursing license. Accreditation will also affect your degree advancement at other institutions. There are two recognized accreditation agencies.
Accreditation Commission for Education in Nursing (ACEN)
Commission on Collegiate Nursing Education (CCNE)
4. Curriculum Standards
Does the nursing program integrate NCLEX preparation into its curriculum? Is your curriculum comprehension compared to the national benchmark? The curriculum should align with your goals and expected outcomes.
5. Program CostsThe cost will depend on multiple considerations. Are you seeking an
Associate Degree Nurse (ADN) program or a Bachelor of Science in Nursing (BSN)? ADN accelerated programs are generally 16 months in length after completing prerequisite classes, whereas a BSN is a 4-year program.
What is the cost per credit hour? Some programs have a lower cost per credit hour but require more credits. Other programs may require fewer credits but charge more per credit hour. Books are an additional cost.
6. NCLEX Pass Rate
Compared to the national average, what is the first-time NCLEX pass rate of the program you are considering?
7. Clinical Partnerships
Nursing Program partnerships with local hospitals can make the job-seeking process more manageable after passing your NCLEX. It is typical for a facility to hire graduates who have a partnership with a nursing program.
Even when you’ve picked the right Nursing Program, personal challenges remain, such as grueling lectures, homework and projects, high expectations of oneself, financial hardship, and lifestyle changes. Being mindful of these many changes helps you move forward with full awareness.
References
ACEN. (n.d.). https://www.aacnnursing.org/ccne-accreditation.
Commission on Collegiate Nursing Education. (n.d.).
Gamba, A. (2023, 9 6). How to Find the Right Nursing Program.
Marian University. (2024, 4 26). 7 Factors to Consider When Choosing a Nursing School.
Nature Therapy
Nature Therapy, you might ask what does that mean. Well, it has many different names and can mean different things to different people. I am going to share my personal experience with Nature Therapy as well as the benefits individuals can get from this practice.
How you practice Nature Therapy can come in many different forms. Whether it is an adventure, animal interaction, exercise, conservation, gardening, or wilderness training.
When it comes to Adventure therapy it could include, white water rafting, rock climbing, hiking or windsurfing, etc. There are many more activities you can do that fall under this classification. When I was in my thirties and forties I was all about white water rafting and would take three to four-day rafting trips down many California rivers. After each trip, I was energized and ready to take on whatever came my way when I returned from my trips.
Animal Interaction helps many and can come in the form of visiting zoos and wildlife care centers. Volunteering at a rescue or animal shelter. When I was in my 20s whenever I felt stressed I would find a local zoo and spend hours there wandering around by myself until I felt the stress drain away.
Exercise. This would probably be the most common form of Nature Therapy. Biking, walking, and running outdoors. I walk four miles every day rain or shine in all kinds of environments. Deserts, forests, beaches, and mountains. It not only keeps me physically healthier but mentally.
Gardening is a great form of Nature Therapy. Helping to nurture and grow plants can be very satisfying and relaxing.
There is also doing conservation work like helping build mountain trails and restoring land. Wilderness activities like fishing and wilderness trips. And so many more activities to do indoors and outdoors.
There are so many benefits to Nature Therapy:
- Mood elevation.
- Decreasing stress.
- Improved relationships.
- Decreasing depression.
- Medical recovery.
- Improved mental health.
- Decreasing anxiety.
- Improving physical health.
And I am sure many more that are not listed. My personal experience with Nature Therapy started at a young age. So, at this point, I am going to share some of those experiences.
When I was growing up I came from a very stressful household and I would often go out into nature to get away from these situations. Enveloping myself in the forest was always so healing but at that young age, I didn’t understand why.
In my twenties, I was a young mom in a loveless marriage and found that my way to reduce stress at that time was to walk around a local zoo for hours. And at that time I still did not comprehend why this always made me feel better.
In my 30s and 40s, I was all about adventures and did understand that my time in nature whether camping, rafting, or hiking always elevated my mood, decreased stress, and improved our family dynamics.
Later in my career as an Oncology Nurse, working at the same job for decades, some of my coworkers created a very toxic work environment that was slowly tearing me down to the point of severe depression. I ended up leaving that job and hit rock bottom. I hadn’t been very active out in nature for a while and while I was deciding what to do I remembered how I felt going for long walks in the mountain town where I live in California. I decided to return to that activity and slowly but surely my depression lifted. My confidence returned and I felt renewed. Three months after I left my old job I found a new one I loved as an Urgent Care Nurse and stayed there for six years in a healthy environment until I retired. The coworkers who created that toxic environment were not so lucky. Maybe, they should practice Nature Therapy.
In conclusion, Nature Therapy has many positive benefits for a better life. Whatever form it takes you definitely will reap the reward. In my retirement, I am even more immersed in this activity daily
