Electrolyte balance (especially potassium and sodium) is important for ostomates. When the colon (large intestine is removed, a greater rist for electrolyte imbalance can occur. Diarrhea, ixcessive perspiration and vomiting can increase this risk. A person with short bowel syndrome is at high risk. Their electrolytes should be monitored closely. Your diet should include fluids and foods rich in electrolytes. A general rule is to salt foods to taste. Do not exclude sodium in the diet unless instructed to do so by your doctor.
Electrolyte Balance - Electrolytes refer to the normal chemicals dissolved in body fluids needed to maintain body activity. If electrolytes are out of balance, a person may become weak or ill and may need to take medications by mouth or intravenously.
Fluid and Electrolyte Problems:
Problem - Dehydration
Symptoms - Increased thirst, dry mouth, dry skin, decreased urine output, fatigue, shorness of breath, headaches, dry eyes and abdominal cramping.
Treatment - Increase fluids (any type, Gatorade/PowerAde are high in potassium and sodium). Daily intake of fluids should be 8-10 8oz. glasses.
Problem - Sodium Depletion
Symptoms - Loss of appetite, drowsiness, headaches, abdominal and leg cramping, feelings of faintness particularly when standing, cold sensation in arms or legs.
Treatment - Increase intake of foods and beverages high in sodium, such as any regular soup, bouillon and Gatorade/PowerAde.
Problem - Potassium Depletion
Symptoms - Fatigue, muscle weakness, gas, bloating, shortness of breath, decreased sensation in arms and legs.
Treatment - Increase intake of foods high in potassium, such as orange juice, bananas, and/or Gatorade/PowerAde.
Foods high in potassium: black-eyed peas, bananas, bouillon, chicken, fish, oranges, pinto beans, potatoes, raisins, tomato or vegetable soups, veal, watermelon and yogurt, to name a few.
Foods high in sodium: broth, buttermilk, canned soups, canned vegetables, cheese, soy sauce, table salt, tomato juice and most commercially prepared foods.
Source: UOAA Diet & Nutrition Guide, UOAA Update 3/12
Wednesday, March 27, 2013
Monday, March 25, 2013
Murphy's Lesser Known Laws
- Light travels faster than sound. This is why some people appear bright until you hear them speak.
- He who laughs last, thinks the slowest.
- Change is inevitable, except from a vending machine.
- Nothing is fool proof to a sufficiently talented fool.
- The 50-50-90 rule: anytime you have a 50-50 chance of getting something right, there is a 90% porbability you'll get it wrong.
- If you lined up all the cars in the world end to end, someone would be stupid enough to pass them, five or six at a time.... on a hill... on a curve... in the fog.
- If the shoe fits, get another one just like it.
- A flashlight is a case for holding dead batteries.
- The shin bone is a device for finding furniture in a dark room.
- He who laughs last, thinks the slowest.
- Change is inevitable, except from a vending machine.
- Nothing is fool proof to a sufficiently talented fool.
- The 50-50-90 rule: anytime you have a 50-50 chance of getting something right, there is a 90% porbability you'll get it wrong.
- If you lined up all the cars in the world end to end, someone would be stupid enough to pass them, five or six at a time.... on a hill... on a curve... in the fog.
- If the shoe fits, get another one just like it.
- A flashlight is a case for holding dead batteries.
- The shin bone is a device for finding furniture in a dark room.
Friday, March 22, 2013
Top 10 Favorite Songs After a Tough Shift
1. Bob Marley, “Three Little Birds”…“Don’t worry ‘bout a thing, ‘cuz every little thing gonna be alright.” Sometimes that little reminder is just what I need…and it makes me think of being on a beach, worry-free. :) —Meghan D
2. “Hit Me With Your Best Shot” by Pat Benatar…with dance moves and all!!!
—Lisâ
3. Well, I’ve been retired for a while, but back in the day during my 20-some-mile drive home, I fell in love with ACDC ‘cause it was wild and raucous enough that I could crank it up, sing at the top of my voice, thump the beat out on the steering wheel and just “get it all out” so that I was once again sane when I got home to my family! LOL!
—Susan
4. Peace and quiet leaving and “Welcome to the Jungle” arriving.
—Pamela
5. Prince’s “Let’s Go Crazy.” The funny thing is…I work in a mental hospital and, until now, never even associated the two!
—Patti Ann
6. “Nah nah nah nah, nah nah nah nah, hey hey hey, goodbye!”
—Clo
7. Janis Joplin’s “Me and Bobby McGee.” I actually got pulled over by the police one night after a long shift for blaring it too loud…ha ha ha…such a great stress-reliever song!
—Kelley
8. Johnny Paycheck, “Take This Job and Shove It.” Just kidding! I love my job, but some days… :)
—Rhonda
9. “I Will Survive.”
—Myra
10. Um, is the sound of wine hitting the glass considered a song?
—Natty
What’s your favorite song to unwind to after a long, tough shift?
Friday, March 15, 2013
Murphy’s law of personal protective equipment
• March 8, 2013, Scrubsmag.com
As a nurse, personal protective equipment (PPE) is probably the most-used piece of equipment in your arsenal (next to your stethoscope). I mean, seriously: How many times per shift do you put on or take off a pair of gloves? Add into the mix taking care of a patient in contact/droplet precautions and you probably spend almost a quarter of your shift just gowning up. Just imagine if you have more than one patient in some type of precautions. Yep, we’ve all been there.
I know I’m not the only one who notices the handful of ironic situations that are guaranteed to happen almost immediately after you’ve completely gowned up. It’s sort of like saying the “Q” word on the unit–there are just certain inevitable events that are bound to happen after you have on your mask, gloves and gown. Here are just a few:
Your nose itches uncontrollably.
Unless you have a mask on, you SURELY can’t scratch your nose with gloved hands.
There’s a phone call for you.
Yeah, that provider or colleague you’ve been paging all morning is finally calling back.
You need to write something down.
And you realize the only writing instrument you have is buried underneath your PPE gear.
Equipment? You just realized there isn’t a designated stethoscope in the room. Or you need another IV pump. Better yet, you just realized there aren’t adequate wound care supplies.
The IV machine is beeping.
And you need a new bag of fluid.
It’s the little things that drive you up the wall, huh? (Insert sarcastic snicker.) I don’t know about you, but I still run into “Murphy” and his gosh-darn law no matter how well I prepare before gowning up and entering my patient’s room.
What else would you add to the list?
As a nurse, personal protective equipment (PPE) is probably the most-used piece of equipment in your arsenal (next to your stethoscope). I mean, seriously: How many times per shift do you put on or take off a pair of gloves? Add into the mix taking care of a patient in contact/droplet precautions and you probably spend almost a quarter of your shift just gowning up. Just imagine if you have more than one patient in some type of precautions. Yep, we’ve all been there.
I know I’m not the only one who notices the handful of ironic situations that are guaranteed to happen almost immediately after you’ve completely gowned up. It’s sort of like saying the “Q” word on the unit–there are just certain inevitable events that are bound to happen after you have on your mask, gloves and gown. Here are just a few:
Your nose itches uncontrollably.
Unless you have a mask on, you SURELY can’t scratch your nose with gloved hands.
There’s a phone call for you.
Yeah, that provider or colleague you’ve been paging all morning is finally calling back.
You need to write something down.
And you realize the only writing instrument you have is buried underneath your PPE gear.
Equipment? You just realized there isn’t a designated stethoscope in the room. Or you need another IV pump. Better yet, you just realized there aren’t adequate wound care supplies.
The IV machine is beeping.
And you need a new bag of fluid.
It’s the little things that drive you up the wall, huh? (Insert sarcastic snicker.) I don’t know about you, but I still run into “Murphy” and his gosh-darn law no matter how well I prepare before gowning up and entering my patient’s room.
What else would you add to the list?
Monday, March 4, 2013
The top 10 ways nurses boost their moods on the job
The top 10 ways nurses boost their moods on the job
1. I remind myself, “Self, as long as your patients are alive and pain-free at the moment, your day isn’t that bad and half the battle is over…the other half is charting to prove that my patients are alive and pain-free.” Deep breath, looooong sigh and carry on, girl, because you’ve got this!”
—NiKisha
2. Maybe eat lunch or go pee…those are always nice. LOL!
—Jen
3. We adopted a five-second dance-off at the top of the hour. Regardless of what you’re doing in the ER, when the music comes over the intercom, you have to stop and break it down! Doesn’t go over well with the director, but what he doesn’t know…and it really works!
—Casie
4. I use my break to call the ones I love. My husband and my mom are great for reminding me why I do this job. My mom—one of my favorite people to call—is also a nurse, and has done three deployments in more than 25 years of military nursing. If I think I’m having a bad day, I know for sure she’s gotten through worse ones, and she gives great advice. A little perspective goes a long way.
—Elizabeth
5. Hand puppets. Life is better with hand puppets. Seriously. They make you laugh.
—Rachael
6. Sometimes I look at job listings for positions outside of the medical field. Every time I read them, it reminds me I would never, ever make as huge an impact on anyone’s lives like I can in nursing.
—Victoria
7. I’m gonna go with “drink.” After work, of course.
—Coleen
8. As corny as it is, I go into the bathroom, stare at myself in the mirror and start making funny faces. Gives me a chance for a breather, and hey, if you can’t laugh at yourself, then who can?
—Raquel
9. We send jokes to other departments via fax or tube system to try to brighten someone else’s day. It’s very rewarding. ;)
—Taffiney
10. I remind myself that if I’m having to nurse someone for any reason, they are having a worse day than I am. A smile goes a long way, and seeing and making someone else smile ALWAYS makes me feel better…and them, too!
—Jody
What do you do to boost your mood when you’re having a rough day on the job?
Friday, March 1, 2013
Wednesday, February 27, 2013
Fast Freeze Cryospray
NEW!
While roll-on applications are good for pinpoint control of acute pain, Fast Freeze treats larger areas, or more recurring pain. Simply point, spray and rub in for faster relief than taking pain/anti-inflamitory medication. Use for arthritis, joint pain, muscle pain and more.
Fast Freeze Cryospray, 4oz spray bottle.
(compare to BioFreeze)
BL948 Price $9.83
While roll-on applications are good for pinpoint control of acute pain, Fast Freeze treats larger areas, or more recurring pain. Simply point, spray and rub in for faster relief than taking pain/anti-inflamitory medication. Use for arthritis, joint pain, muscle pain and more.
Fast Freeze Cryospray, 4oz spray bottle.
(compare to BioFreeze)
BL948 Price $9.83
Friday, February 22, 2013
Wednesday, February 13, 2013
Friday, February 8, 2013
Better Living Corner: What is TubiGrip?
"My friend recommended Tubigrip. What exactly is TubiGrip?"
Tubigrip provides tissue support in the treatmnet of strains, sprains, soft tissue injuries, general edema, post-burn scarring and ribcage injuries. Tubigrip is easy to apply and reapply without pins or tapes and is washable too! Tubigrip is designed to stretch to size and can be cut to length as needed.
Here is a size chart:
Size C - Medium wrist/Small elbow
Size D - Large wrist/Medium elbow/S-M ankle/Small knee
Size E - Large elbow/M-L ankle/Medium knee
Size F - Large knee/Small thigh
(Larger and smaller sizes available by special order)
Tubigrip Prices start at $6.20/40" long roll.
Tubigrip provides tissue support in the treatmnet of strains, sprains, soft tissue injuries, general edema, post-burn scarring and ribcage injuries. Tubigrip is easy to apply and reapply without pins or tapes and is washable too! Tubigrip is designed to stretch to size and can be cut to length as needed.
Here is a size chart:
Size C - Medium wrist/Small elbow
Size D - Large wrist/Medium elbow/S-M ankle/Small knee
Size E - Large elbow/M-L ankle/Medium knee
Size F - Large knee/Small thigh
(Larger and smaller sizes available by special order)
Tubigrip Prices start at $6.20/40" long roll.
Monday, February 4, 2013
Humor for a Monday
A nurse caring for a man from Kentucky asked, “So how’s your breakfast this morning?”
“It’s very good, except for the Kentucky Jelly. I can’t seem to get used to the taste,” the patient replied.
The nurse asked to see the jelly and the man produced a foil packet labeled “KY Jelly.”
“It’s very good, except for the Kentucky Jelly. I can’t seem to get used to the taste,” the patient replied.
The nurse asked to see the jelly and the man produced a foil packet labeled “KY Jelly.”
Thursday, January 31, 2013
Better Living Corner - Automatic Pill Dispenser
"My patient can do everything on their own, but they need help taking their medicine. Do you carry medicine dispensers?"
Taking medication on time and in the correct dose is critical, so we recommend the MED-E-LERT to help administer medication automatically:
MIMEDELERT - $76.36
This fully automatic pill dispenser is easy to use and setup. Features long duration buzzer that sounds continuously until the pills are removed. Holds one weeks supply of pills taken up to 4 times per day (28 compartments) and for safety, the unit is lockable. Battery operated with low battery alarm.
Taking medication on time and in the correct dose is critical, so we recommend the MED-E-LERT to help administer medication automatically:
This fully automatic pill dispenser is easy to use and setup. Features long duration buzzer that sounds continuously until the pills are removed. Holds one weeks supply of pills taken up to 4 times per day (28 compartments) and for safety, the unit is lockable. Battery operated with low battery alarm.
Monday, January 28, 2013
I (Heart) These Scrub Tops!
LUKO178 - $25.99
LUCH84724 - $18.99-$21.99
LUCH82840C - $24.49-$26.49
LUCHY82849C - $24.49-$26.49
LUCH6741C - $27.49-$29.49
LUCH3728cmb - $25.49
LUCH84724C - $18.99-$21.99
To shop our full line of heart-friendly Holiday Scrubs, click HERE.
Wednesday, January 23, 2013
New Year, New Shoes!
We have three new Dansko shoes for the new year!
Whether you are in health care or food service, we have something for everyone!
Dansko PROFESSIONAL in Silver Opal Leather - $131.99
Same classic down curve and rocker movement that you know and love!
Dansko SEDONA Elise in Suede - $96.99
A flexible, featherweight show with all day comfort and support. Slip resistant in wet or oily conditions!
Dansko PRO XP in Vintage Floral - $146.99
The PRO XP now comes in patterns! Features same details as the Professional but with a lighter weight and memory foam removable foot bed.
Because Dansko shoes are designed for maximum support and comfort, a perfect fit must be obtained. Unless you are a current Dansko wearer, trying on these shoes is extremely important, and if you have your eye on a different Dansko shoe, you will definitely want to be sized again. Because of this fit requirement, we only sell Dansko shoes in our store.
Monday, January 14, 2013
Insurance and Your Osotomy Supplies
Adapted from State of the Insurance Industry and Your Ostomy Supplies, an update by Bruce Frishman, President, New Hampshire Pharmacy and Medical Equipment, Washington, DC, September 2012, Metro Maryland
Rarely, if ever, are ostomy supplies NOT covered, at least partially, by a medical insurance policy. If your insurance company informs you that ostomy supplies are not a covered item, more often than not it is miscommunication. If you are told your supplies are not covered, asked to speak to a supervisor.
When speaking to your insurance company, it is helpful to know proper "insurance jargon". Most of the time, ostomy supplies are categorized as DMEPOS, or "Durable Medical Equipment, Prosthetic, Orthotics and Supplies". Knowing the HCPC code (pronounced HICPIC) for your specific ostomy supplies is also helpful. All ostomy supply manufacturer's can provide you with a HCPC code that corresponds with your ostomy system.
How to obtain your HCPC code:
1) On the box of your ostomy supplies, look for a toll-free phone number for the manufacturer. All major manufacturers such as Hollister, Coloplast and ConvaTec put a phone number on their boxes.
2) Simply call that number and tell them you need the HCPC code for your exact supplies.
3) Keep that HCPC code in a safe place such as your address book for future reference. If you switch ostomy products, you may need a new HCPC code.
HCPC stands for Health Care Financing Administration Common Procedure Coding System and is a code that is used by insurance companies to describe a particular product. These codes are also used by Medicare/Medicaid.
Since a prosthetic is something that replaces a normally functioning body part, ostomy supplies are usually categorized as prosthetic supplies. Sometimes ostomy supplies are placed within the DME, or "Durable Medical Equipment" category. This occurs when an insurance company will not cover prosthetic devices but choose to cover ostomy supplies.
As an ostomate, its important to know how your insurance company categorizes ostomy supplies.
With the changes in health care coverage and limited reimbursements, there is an increased disincentive for ostomy manufacturers to spend funds on research and development of new ostomy products. Insurance companies in particular, are always asking, "How can we cut expenses?" and some insurance companies are saying, "If it can be purchased without a prescription from a doctor, we aren't covering it." While your doctor may tell you what type of ostomy system to use, a prescription is generally not required.
Every ostomate should be aware and diligent when dealing with current health insurance or assessing a potential insurance plan. If you find an insurance company does not offer ostomy supply coverage, speak to your personnel office or human resources manager, explain what an ostomy is, and see if they can get the benefit added to the policy. Some people have had the benefit added within a week. It is also helpful to get the medical justification from your physician for coverage for your ostomy supplies in writing. If a new appliance is added or changed with your ostomy system, you should get an updated justification from your doctor.
Even if you have an ostomy supply benefit with your insurance company, it most likely will not cover all products you may need. There are approximately 10 to 15 items that are related to the ostomies themselves. Medicare's maximum allowed quantities are outlined in their billing manuals. As a general rule, the published maximums include the following monthly supply:
60 closed pouches
20 drainable pouches
31 stoma caps
20 urinary pouches
4oz of paste
20 wafers/skin barriers
20 seals
If you require, for example, both drainable and closed pouches to manage your ostomy, you will likely get a combined maximum amount.
If you have to pay out of pocket for some or all of your ostomy supplies, shopping around for best pricing is sound advice and you could save up to hundreds, maybe even thousands of dollars per year. Most supply companies that accept insurance, or rather "accept assignment" for payment from your insurance company, are much higher priced overall. So, for example if you need 40 drainable pouches per month and your insurance company only pays for 20 drainable pouches, you will have to pay out of pocket for the extra 20 that you need. One supplier might charge $40 for the same exact product another supplier charges $60 for. The reason suppliers charge more if they accept insurance is because their overhead is higher. Managing insurance claims can be time-intensive, plus having to float an accounts payable balance until payment is made from the insurance company can be costly.
It is also important to note that most ostomy supplies are tax-free so you should not be paying tax on your supplies.
Rarely, if ever, are ostomy supplies NOT covered, at least partially, by a medical insurance policy. If your insurance company informs you that ostomy supplies are not a covered item, more often than not it is miscommunication. If you are told your supplies are not covered, asked to speak to a supervisor.
When speaking to your insurance company, it is helpful to know proper "insurance jargon". Most of the time, ostomy supplies are categorized as DMEPOS, or "Durable Medical Equipment, Prosthetic, Orthotics and Supplies". Knowing the HCPC code (pronounced HICPIC) for your specific ostomy supplies is also helpful. All ostomy supply manufacturer's can provide you with a HCPC code that corresponds with your ostomy system.
How to obtain your HCPC code:
1) On the box of your ostomy supplies, look for a toll-free phone number for the manufacturer. All major manufacturers such as Hollister, Coloplast and ConvaTec put a phone number on their boxes.
2) Simply call that number and tell them you need the HCPC code for your exact supplies.
3) Keep that HCPC code in a safe place such as your address book for future reference. If you switch ostomy products, you may need a new HCPC code.
HCPC stands for Health Care Financing Administration Common Procedure Coding System and is a code that is used by insurance companies to describe a particular product. These codes are also used by Medicare/Medicaid.
Since a prosthetic is something that replaces a normally functioning body part, ostomy supplies are usually categorized as prosthetic supplies. Sometimes ostomy supplies are placed within the DME, or "Durable Medical Equipment" category. This occurs when an insurance company will not cover prosthetic devices but choose to cover ostomy supplies.
As an ostomate, its important to know how your insurance company categorizes ostomy supplies.
With the changes in health care coverage and limited reimbursements, there is an increased disincentive for ostomy manufacturers to spend funds on research and development of new ostomy products. Insurance companies in particular, are always asking, "How can we cut expenses?" and some insurance companies are saying, "If it can be purchased without a prescription from a doctor, we aren't covering it." While your doctor may tell you what type of ostomy system to use, a prescription is generally not required.
Every ostomate should be aware and diligent when dealing with current health insurance or assessing a potential insurance plan. If you find an insurance company does not offer ostomy supply coverage, speak to your personnel office or human resources manager, explain what an ostomy is, and see if they can get the benefit added to the policy. Some people have had the benefit added within a week. It is also helpful to get the medical justification from your physician for coverage for your ostomy supplies in writing. If a new appliance is added or changed with your ostomy system, you should get an updated justification from your doctor.
Even if you have an ostomy supply benefit with your insurance company, it most likely will not cover all products you may need. There are approximately 10 to 15 items that are related to the ostomies themselves. Medicare's maximum allowed quantities are outlined in their billing manuals. As a general rule, the published maximums include the following monthly supply:
60 closed pouches
20 drainable pouches
31 stoma caps
20 urinary pouches
4oz of paste
20 wafers/skin barriers
20 seals
If you require, for example, both drainable and closed pouches to manage your ostomy, you will likely get a combined maximum amount.
If you have to pay out of pocket for some or all of your ostomy supplies, shopping around for best pricing is sound advice and you could save up to hundreds, maybe even thousands of dollars per year. Most supply companies that accept insurance, or rather "accept assignment" for payment from your insurance company, are much higher priced overall. So, for example if you need 40 drainable pouches per month and your insurance company only pays for 20 drainable pouches, you will have to pay out of pocket for the extra 20 that you need. One supplier might charge $40 for the same exact product another supplier charges $60 for. The reason suppliers charge more if they accept insurance is because their overhead is higher. Managing insurance claims can be time-intensive, plus having to float an accounts payable balance until payment is made from the insurance company can be costly.
It is also important to note that most ostomy supplies are tax-free so you should not be paying tax on your supplies.
Friday, January 11, 2013
Monday, January 7, 2013
Introducing More Affordable Koi Scrubs!
Meet Orange Standard. Fashion, fit and comfort for under $20.
The Laguna Cargo G3700 Pant features style, comfort and plenty of pockets! This pant has a drawstring waist, double cargo pocket on left side, J pockets at waist, double needle stitching for durability. Made of 65% polyester, 35% cotton. Available in navy, black, slate gray, fierce fuchsia or electric blue.
$19.99
The Catalina Flare G3701 Pant features striking style for the professional! This pant has a flat front waistline for a flattering look, flare leg, slash pockets for easy access, two large cargo pockets and side slits at the bottom hem. Made of 65% polyester, 35% cotton. Available in navy, black or slate gray.
$17.99
The Redondo Top G3102 is fashion forward with a flattering fit! Split v-neckline, longer fitted body, darts in back for a more fitted shape, two "phantom pockets" with hidden contrast pocket bags, contrast screen print at pocket, contrast back neck facing, and side slits. Made of 65% polyester, 35% cotton. Available in navy, black and slate gray.
$19.99
The Malibu Top G3100 is sporty and stylish for all body types! The Y-neck mock wrap has tonal screen print at neckline and patch pockets sewn into hem for durability. Side slits, made of 65% polyester and 35% cotton. Available in navy, black, slate gray, fierce fuchsia and electric blue.
$17.99
To shop our full line of Koi Scrubs, visit www.laureluniforms.com
The Laguna Cargo G3700 Pant features style, comfort and plenty of pockets! This pant has a drawstring waist, double cargo pocket on left side, J pockets at waist, double needle stitching for durability. Made of 65% polyester, 35% cotton. Available in navy, black, slate gray, fierce fuchsia or electric blue.
$19.99
The Catalina Flare G3701 Pant features striking style for the professional! This pant has a flat front waistline for a flattering look, flare leg, slash pockets for easy access, two large cargo pockets and side slits at the bottom hem. Made of 65% polyester, 35% cotton. Available in navy, black or slate gray. $17.99
The Redondo Top G3102 is fashion forward with a flattering fit! Split v-neckline, longer fitted body, darts in back for a more fitted shape, two "phantom pockets" with hidden contrast pocket bags, contrast screen print at pocket, contrast back neck facing, and side slits. Made of 65% polyester, 35% cotton. Available in navy, black and slate gray.$19.99
$17.99
To shop our full line of Koi Scrubs, visit www.laureluniforms.com
Friday, January 4, 2013
Laurel Uniforms is now a PERKA Merchant
We are pleased to announce that Laurel Uniforms and Apparel is now a PERKA merchant! What is PERKA, you ask?
PERKA is a smartphone loyal customer reward program app that you use on either your iPhone or Android phone. If you don't have a smartphone, (you just use a basic cell phone), you can still continue to use our Laurel Customer Loyalty Cards to earn rewards.
HOW TO SIGN UP FOR PERKA:
A: From your smartphone, text “Laurel” to 330-400-3300 and then follow the text instructions - it’s THAT easy!
B: Or, visit our website at www.laureluniforms.com, and click on the “We Love Regulars” icon in the upper left corner. Once you click the icon, simply follow the prompts to download the app and start earning points!
And to get you started, just for signing up, you automatically earn 25 points!
HOW TO CONTINUE EARNING POINTS: When you visit Laurel Uniforms, simply open the PERKA app on your smartphone and click “check in” at the bottom. This will notify us that you have arrived! Then, once you make your selections, let us know you want to earn more PERKA points and we will then confirm your purchase points to your PERKA account at the time of purchase. At any point, we are happy to let you know how many “available points” you currently have.
REWARDS: To start earning rewards, download the PERKA app to your smartphone and sign up as a Laurel Loyal Customer, and you will automatically get 25 points! Then, when you earn 200 or more points, you then receive $20 off your next purchase. Each dollar spent is equal to one point.
Again, this is just for Laurel Uniform customers at this point, but we do hope to add Mountain View Medical Supply as a PERKA merchant sometime in the future.
Wednesday, January 2, 2013
Vitamin B-12 Replacement Therapy for Ileostomates
by Bob Baumel, Ostomy Association of North Central Oklahoma, UOAA update 7/2012
Vitamin B-12 is, under normal conditions, absorbed in only a small section of the terminal small intestine (ileum), raising the possibility of B-12 deficiency if that section of the ileum has been removed surgically or damaged by disease. People who may have lost that portion of ileum include some ileostomates, people who had a J-pouch or Kock pouch, and some people with urinary diversions (especially continent urinary diversions) made using the terminal ileum. A condition such as Crohn's disease may have damaged the terminal ileum, even if it hasn't been removed surgically.
Vitamin B-12 is necessary for many metabolic processes including development of red blood cells, and also maintains normal functioning of the nervous system. Deficiency causes anemia (reduced oxygen-carrying capacity of the blood resulting in fatigue) and can also cause nervous system damage. It's worth noting that folic acid (another B vitamin) can correct the anemia caused by vitamin B-12 deficiency, but it will not correct the nerve damage caused by B-12 deficiency. So it's important to get enough vitamin B-12.
If you think you are at risk for vitamin B-12 deficiency, you can ask your doctor to check your serum (blood) B-12 level. This test can be added easily to routine blood testing. If your ability to absorb vitamin B-12 by the normal pathway involving the terminal ileum has been impaired, you can supplement the vitamin by three basic methods.
By Injection: This method bypasses the normal gastrointestinal process of B-12 absorption by inserting it into the body by intramuscular or subcutaneous injection. B-12 injections may be self-administered in the same way that diabetic patients can give themselves insulin shots. Maintenance therapy may require only one B-12 injection per month.
Nasally: This method bypasses the normal gastrointestinal absorption process, as vitamin B-12 can be absorbed through nasal mucous membranes. The nasal form of B-12 was developed first as a nasally applied gel and later a true nasal spray (brand name Nascobal). This product is marketed by the company Strativa Pharmaceuticals, who promotes it as the only FDA-approved form of vitamin B-12 besides the injectable form. Nasal B-12 can be effective, but because one company has sole rights to distribute it in the U.S., it can be an expensive way to get your vitamin B-12.
Orally: Until recently, doctors believed that B-12 taken orally was useless to people who lack the normal absorption mechanism involving the terminal ileum. That opinion has changed, however, as research has revealed that even in such people, when a large dose of vitamin B-12 is taken orally, a small fraction (typically 1%) gets absorbed by mass-action transport across the gut.
Note: Time Released medications should, in general, be avoided if you have an ileostomy, as they may pass through your gut.
Vitamin B-12 is, under normal conditions, absorbed in only a small section of the terminal small intestine (ileum), raising the possibility of B-12 deficiency if that section of the ileum has been removed surgically or damaged by disease. People who may have lost that portion of ileum include some ileostomates, people who had a J-pouch or Kock pouch, and some people with urinary diversions (especially continent urinary diversions) made using the terminal ileum. A condition such as Crohn's disease may have damaged the terminal ileum, even if it hasn't been removed surgically.
Vitamin B-12 is necessary for many metabolic processes including development of red blood cells, and also maintains normal functioning of the nervous system. Deficiency causes anemia (reduced oxygen-carrying capacity of the blood resulting in fatigue) and can also cause nervous system damage. It's worth noting that folic acid (another B vitamin) can correct the anemia caused by vitamin B-12 deficiency, but it will not correct the nerve damage caused by B-12 deficiency. So it's important to get enough vitamin B-12.
If you think you are at risk for vitamin B-12 deficiency, you can ask your doctor to check your serum (blood) B-12 level. This test can be added easily to routine blood testing. If your ability to absorb vitamin B-12 by the normal pathway involving the terminal ileum has been impaired, you can supplement the vitamin by three basic methods.
By Injection: This method bypasses the normal gastrointestinal process of B-12 absorption by inserting it into the body by intramuscular or subcutaneous injection. B-12 injections may be self-administered in the same way that diabetic patients can give themselves insulin shots. Maintenance therapy may require only one B-12 injection per month.
Nasally: This method bypasses the normal gastrointestinal absorption process, as vitamin B-12 can be absorbed through nasal mucous membranes. The nasal form of B-12 was developed first as a nasally applied gel and later a true nasal spray (brand name Nascobal). This product is marketed by the company Strativa Pharmaceuticals, who promotes it as the only FDA-approved form of vitamin B-12 besides the injectable form. Nasal B-12 can be effective, but because one company has sole rights to distribute it in the U.S., it can be an expensive way to get your vitamin B-12.
Orally: Until recently, doctors believed that B-12 taken orally was useless to people who lack the normal absorption mechanism involving the terminal ileum. That opinion has changed, however, as research has revealed that even in such people, when a large dose of vitamin B-12 is taken orally, a small fraction (typically 1%) gets absorbed by mass-action transport across the gut.
Note: Time Released medications should, in general, be avoided if you have an ileostomy, as they may pass through your gut.
Tuesday, December 18, 2012
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