The quilt is 8.5 in X 10 in. The back includes a 2 in sleeve to facilitate hanging it. 
This is a very simple baby quilt made using 6 in squares. It is scrappy using fabric from other projects. The quilt is machine pieced and quilted. It measures 36 in X 42 in. It was given to a friend of my husband’s.
This photo shows a weight-lifting alligator, cars, a school house, and a cowboy. 
Here you can find dogs, Eeyore, horses, Indians, a lion, and more. 
Here you find more cowboys, zebras, a ladybug, Pooh and Tigger. 
The back of the quilt is a simple fabric with red stars. 
The occurrence of complications using expander-implants can exceed 40% in published studies. However, despite a significant rate, the complications themselves are usually minor and do not prevent completion of a satisfactory reconstruction. In experienced hands, good to excellent aesthetic outcomes can be obtained in more than 80% of patients.
| Additional Operation (Reoperation) | 40% |
| Loss of Nipple Sensation | 35% |
| Capsular Contracture III/IV or grade unknown | 30% |
| Asymmetry | 28% |
| Implant Removal | 27% |
| Wrinkling | 20% |
| Breast Pain | 17% |
| Infection | 9% |
| Leakage/Deflation | 9% |
| Irritation/Inflammation | 8% |
| Delayed Wound Healing | 6% |
| Seroma | 6% |
| Scarring | 5% |
| Extrusion | 2% |
| Necrosis | 2% |
| Hematoma | 1% |
| Position Change | 1% |
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Welcome to this Edition of Grand Rounds. I'm honored to be hosting for my first time. The topic is education and lessons learned. I hope you enjoy! ……….
Don't forget to check out Grand Round next week with a special election themed edition, Dr. Wes is hosting. Enjoy your Tuesday!
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Most of us can’t keep up with all the new ways to avoid cancer. Thanks to the Internet, we now have an unlimited supply of cancer knowledge at our fingertips. But, how can we filter out the good, the bad and the questionable?Below are steps to help you tease out the facts when reading that next big news story on preventing cancer.Says who?Don’t just take the writer’s word for it. Dig a little deeper to find out the source behind the hype. The American Cancer Society says you should ask yourself these questions when reading an article: ………….Knowing the answers to these questions can help you decide on where you need to go to seek more details about the study findings. Visit the source of the information to learn more about how this new substance or method was tested. ………..
Health care providers often assume they know what inpatients are experiencing. How different the view is from the hospital bed. Suddenly, the paradigm is flipped. Insights gained about hospital care from that vantage point can be quite astounding and must be examined if inpatient care is to improve. It is toward this end that I share my experience as an inpatient for seven days in an acute-care U.S. hospital. I was out of town and a longtime friend took me to the emergency department (ED). …………….
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U.S. Navy releases Social Media Handbook (View Online) http://tinyurl.com/2v6w37o
The Medical Team Training program includes 2 months of preparation and planning with each facility's implementation surgical care team. This is followed by a day-long onsite learning session. To allow surgical staff to attend as a team (surgeons, anesthesiologists, nurse anesthetists, nurses, and technicians), the operating room (OR) is closed.Using the crew resource management theory from aviation adapted for health care, clinicians were trained to work as a team; challenge each other when they identify safety risks; conduct checklist-guided preoperative briefings and postoperative debriefings; and implement other communication strategies such as recognizing red flags, rules of conduct for communication, stepping back to reassess a situation, and how to conduct effective communication between clinicians during care transitions.The learning session included lecture, group interaction, and videos. After the learning session, 4 quarterly follow-up structured telephone interviews were conducted with the team for 1 year to support, coach, and assess the Medical Team Training implementation. Follow-up calls were usually conducted with the OR nurse manager or an OR nurse, a surgeon or chief of surgery, and other staff nurses, and administrative support staff also frequently participated.
And from “OhMyNerves” BlogContribute a 12" x 12" patch to be added to the RSD/CRPS Awareness quilt make sure you keep what you want to show 1" away from the borders.This is for pain awareness help spread the word and make a square.Mail all quilt panels (squares) to:RSD/CRPS Awareness Quilt P.O. Box 500915 Malabar, Fl. 32950-500915Check out our links for information that can help you put your square together...everything from sewing tips to iron on transfers using your printer.If you have any questions please feel free to drop Troy Walker a message and I'll help you out if I can. Thank you very much for helping to spread awareness of Chronic Pain
The RSD/CRPS Awareness Quilt is an ongoing project and will be until there is a cure, If you have RSD or someone you love has it, please take the time to participate and send in your square for the quilt. Its growing fast and is already attracting some media attention. This project will do more than anything yet to finally get the problem of RSD/CRPS the attention it desperately needs
You may have noticed over the years that I like scrappy quilts. I like using scrapes of fabric in baby quilts to add interest and encourage discovery. This one uses scrappy diamonds. It is machine pieced and quilted. It is 36 in X 50 in.
The next several photos show details of the quilt. Here you can find snowmen, rabbits, a squirrel, a dog, and many colors. 
In this one you can find an angel, a frog, a bird, the “eye” of a peacock feather, and the moon. 
Here you can see a frog, a butterfly, an eagle, a goose, and more. 
Here you can see a squirrel, a cowboy, a dog, a skunk. 
The back of the quilt uses the same gray fabric as the outer sections. I have given this quilt to a twitter friend.
The breast originates from the mammary ridge, which develops in utero from the ectoderm during the fifth week. Shortly after its formation (in the seventh to eighth weeks), most parts of this ridge disappear, except for a small portion in the thoracic region, which persists and penetrates the underlying mesenchyme around 10 to 14 weeks. Further differentiation and development of the breast occurs during the intrauterine life and is completed by the time of birth, after which essentially no further development occurs until puberty.During puberty, the mammary tissue beneath the areola grows with enlargement of the areola, until the age of 15 to 16, when the breast assumes its familiar shape. As a result of the ectodermal origin of the breast and its invagination into the underlying mesenchyme, the breast tissue is contained within a fascial envelope, the superficial fascia. This superficial fascia is continuous with the superficial abdominal fascia of Camper and consists of two layers: the superficial layer (which is the outer layer covering the breast parenchyma) and the deep layer (which forms the posterior boundary of the breast parenchyma and lies on the deep fascia of the pectoralis major and serratus anterior muscles). The deep layer of the superficial fascia is penetrated by fibrous attachments (suspensory ligaments of Cooper), joining the two layers of the superficial fascia and extending to the dermis of the overlying skin and the deep pectoral fascia. Of note is that the superficial layer of this fascia is absent in the area underneath the areola, as can easily be demonstrated by the invagination of the mammary bud in the mesenchyme.Clinical experience has shown us and other authors that in cases of tuberous breasts, there is a constricting fibrous ring at the level of the periphery of the nipple-areolar complex that inhibits the normal development of the breast. This constricting ring of fibrous tissue is denser at the lower part of the breast and does not allow the developing breast parenchyma to expand during puberty. Histology confirmed the existence of such dense fibrous tissue in the area of this “constricting ring.” Specimens from two of our patients have been examined, and they showed large concentrations of collagen and elastic fibers, arranged longitudinally. We believe this ring represents a thickening of the superficial fascia, as described earlier. Perhaps the two layers of this fascia join at a higher level than usual, or the suspensory ligaments are thicker and more dense.
RT @laikas: RT @gfry "Breast cancer is not a pink ribbon" Exhibition has its own site: http://www.thescarproject.org/home.html Impressive!
The SCAR Project is a series of large-scale portraits of young breast cancer survivors shot by fashion photographer David Jay. Primarily an awareness raising campaign, The SCAR Project puts a raw, unflinching face on early onset breast cancer while paying tribute to the courage and spirit of so many brave young women.Dedicated to the more than 10,000 women under the age of 40 who will be diagnosed this year alone The SCAR Project is an exercise in awareness, hope, reflection and healing. The mission is three-fold: Raise public consciousness of early-onset breast cancer, raise funds for breast cancer research/outreach programs and help young survivors see their scars, faces, figures and experiences through a new, honest and ultimately empowering lens.The SCAR Project subjects range from ages 18 to 35 and represent the often overlooked group of young women living with breast cancer. (Breast cancer is the leading cause of cancer deaths in young women ages 15-40). They journey from across America and the world to be photographed for The SCAR Project. Nearly 100 so far. The youngest 18.
Good morning! Thank you for all the submissions which have flooded my inbox over the past week. They kept me going through a stretch of countless overnight shifts in the emergency department, which seemed never-ending and darker than a moonless night. In the midst of stunning fall foliage this October, the vibrant colors of this week’s Grand Rounds reach towards the sky. Take a moment out of the day to live in the present. Listen to the sounds around you, whatever they may be – leaves rustling in the wind, blaring sirens, constant monitors. Sit back, relax, take a long, deep breath and a sip of your favorite morning drink. Take in the flying kites, subtle music, and silver linings of today’s indulgence: Uplifting Moments in Medicine. ………….
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Rachel Maddow, in a discussion related to the provision of abortion services, once proposed that we (society) should invoke the Amish Bus Driver Rule whenever medical professionals invoke their personal convictions in refusing to provide legal medical services.The Amish Bus Driver Rule goes like this: If you’re Amish, and therefore have religious convictions against internal combustion engines, then you have disqualified yourself for employment as a bus driver. …..
Compare to @Pew_Internet survey: Half of all adults use FB, MySpace, LinkedIn; ~13% use Twitter http://pewrsr.ch/awb5wt
………….According to Dr. Glick, 7% of the U.S. population is on Twitter, while 20% of ACS survey respondents (approximately 300 as of last week) are on Twitter. 41% of the U.S. population is on Facebook, compared with 64% of ACS survey respondents (see table, page 3). The more sobering results, according to Dr. Glick, are the number of ACS survey respondents who participate in online forums or read online health blogs – 34.5% – which is a comparatively low number. ….………………………….
Join Dr. Sanaz Majd and guest host Dr. Lissa Rankin as they answer the most common questions women have about their bodies and their health. This is a chance for you to learn about all those issues you were so curious about, but were too afraid or embarrassed to ask about. Girlfriend MD will show you that you are not alone, and that no topic is off-limits. After all, we are all girlfriends here.
@pfanderson T2 My tip sheet for patients using ehealth info w/docs http://www-personal.umich.edu/~pfa/mlaguide/free/quickgd.pdf #hcsm
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Upcoming shows:
10/23 : Saturday Nite
10/28 : About FMEC Mtg
10/30 : On Location
Here is photo of me trying it on and you can see why I stick to the disposable caps. My hair which I am growing back out isn’t easily contained. 
water as a catalyst: disease prevention.
charity: water focuses on life’s most basic need -- water. But to significantly cut down disease rates in the developing world, water is just the first step. Almost everywhere charity: water builds a freshwater well, we also require sanitation training. In some communities, we build latrines; at the very least, we promote simple hand-washing stations made with readily-available materials. Clean water can greatly alleviate the world’s disease burden, but only with education and hygienic practice. charity: water is committed to using water as a gateway to sanitary living.
Here is a close up to show the fabrics better. 
If a nail penetrates both the shoe and the sock, it may also force leather, rubber, or sock material into the foot. A blunt object may push a plug of epidermis deep into the dermis. This traumatic implantation results in an epidermal inclusion cyst.
CT Scan may be more sensitive than plain-film x-ray, but they also cost more and have an increased radiation dose.Metal, aluminum, bone, some types of fish spines, teeth, graphite (from pencils), some types of plastics, glass, gravel, stone, wood, and sand are visible on plain x-ray.Multiple projections can also be used to help estimate the location of the foreign body after placement of radiopaque skin markers, such as paper clips, on the skin at the wound site.
Ultrasonography has a sensitivity of 50% to 90% and may be used to estimate the depth and size of a foreign body, as well as determine its relationship to surrounding anatomic structures.
Pyoderma gangrenosum (PG) is an uncommon ulcerative cutaneous condition of uncertain etiology. Pyoderma gangrenosum was first described in 1930. It is associated with systemic diseases in at least 50% of patients who are affected. The diagnosis is made by excluding other causes of similar appearing cutaneous ulcerations, including infection, malignancy, vasculitis, collagen vascular diseases, diabetes, and trauma. Ulcerations of pyoderma gangrenosum may occur after trauma or injury to the skin in 30% of patients; this process is termed pathergy.The 2 primary variants of pyoderma gangrenosum are the classic ulcerative form, usually observed on the legs, and a more superficial variant known as atypical pyoderma gangrenosum that tends to occur on the hands.
It is characterized by the presence of 1 or more ulcerations that are typically violaceous with an undermined border. Diagnosis is clinical and dependent on the exclusion of other causes of cutaneous ulceration. No specific pathologic or laboratory findings exist. Concurrent systemic disease occurs in 50% of affected patients. Commonly associated conditions include inflammatory bowel disease, arthritis, and hematologic malignancy. The remaining cases are considered autoimmune or idiopathic
In most of these cases the lesions were related to previous surgical interventions, probably as the result of a pathergy phenomenon. The main differential diagnoses were skin and soft tissue infections including necrotizing fasciitis, and malignant neoplasms. Negative initial wound cultures and the relative sparing of nipple/areola complex helped to eliminate these disorders.
Topical therapies include gentle local wound care and dressings, superpotent topical corticosteroids, cromolyn sodium 2% solution, nitrogen mustard, and 5-aminosalicylic acid. The new topical immune modifiers tacrolimus and pimecrolimus may have some benefit in certain patients.Systemic therapies include corticosteroids, cyclosporine, mycophenolate mofetil, azathioprine, dapsone, tacrolimus, cyclophosphamide, chlorambucil, thalidomide, tumor necrosis factor-alpha (TNF-alpha) inhibitors, and nicotine.Intravenous therapies include pulsed methylprednisolone, pulsed cyclophosphamide, infliximab, and intravenous immune globulin.Other therapy includes hyperbaric oxygen.
Surgery should be avoided, if possible, because of the pathergic phenomenon that may occur with surgical manipulation or grafting, resulting in wound enlargement. In some patients, grafting has resulted in the development of pyoderma gangrenosum at the harvest site. In the cases in which surgery is required, the best plan, if possible, is to have the patient on therapy in order to prevent pathergy.
This is e-Patients.net’s first opportunity to host Grand Rounds. which is a collection of some of the medical blogosphere’s best writing over the last week. We asked bloggers to look at our sister website, the peer-reviewed Journal of Participatory Medicine, and create posts inspired by or extending the articles there. We did this not to be self-serving, but because we think it’s important to shine a light on the Journal’s role as a source of peer-reviewed, evidence-based participatory medicine research. A group of us formed the Society of Participatory Medicine to advance the credibility and understanding of patient empowerment and patient advocacy.We want to dedicate this edition of Grand Rounds to our friend and mentor, Dr. Tom Ferguson, founder of e-Patients.net and direct inspiration for the founding of the Society for Participatory Medicine and the Journal of Participatory Medicine. Tom’s selfless, tireless work in support of the empowered patient culminated in the creation of the seminal, visionary white paper, e-Patients: How They Can Help Us Heal Healthcare (pdf), published just after his death.Thanks also to Nick Genes and Val Jones, instigators of Grand Rounds.This week’s posts …
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A few weeks ago, I stood among 21,000 people at the Susan G. Komen Foundation's annual Race for the Cure in New York City. The participants, including me and 1,500 other breast-cancer survivors, walked, ran, or wheeled their way to the finish line in Central Park. Nearby was a "survivors' village." I wandered about, uncertain whether I belonged.Survivor seems a strange term for a patient like me, said by her oncologist to be in remission—meaning that there's no overt evidence of persistent cancer cells in the body. The National Cancer Institute defines a "cancer survivor" as someone who's had a malignant tumor and remains alive. …..
For those living in or near New York City, there is an unusual opportunity to attend one or all of three plays that bear directly on individual experiences of illness, altered bodily states, and the cultural and social context in which those alterations occur. …Angels in America, by Tony Kushner. Signature Theater Company."This play explores "the state of the nation"-the sexual, racial, religious, political and social issues confronting the country during the Reagan years, as the AIDS epidemic spreads. ….Three Women, by Sylvia Plath. 59E59.
"three intertwining interior monologues, contextualized by a dramatic setting: " ‘A Maternity Ward and round about.’ . . The three women of the title are patients, and each describes a different experience."Wings, by Arthur Kopit. Second Stage Theater.
"the sounds and sights inside and outside of Emily as well as her private dialogue are combined masterfully by Kopit to bring about a high degree of verisimilitude to the chaos produced by stroke."
Welcome to my blog. I've created this blog to keep friends and faraway family up to date on my battle with Inflammatory Breast Cancer. When you’re a writer, there is no need to be reported about - right? So instead, I’m going to be the author of my own story. You keep praying while I fight this nasty disease. We’re going to win!
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Upcoming shows:
10/16 : On Location
10/21 : About DigPharm Mtg
10/23 : Saturday Nite
10/28 : About FMEC Mtg
10/30 : On Location
The need to appliqué all the small leaves slowed me down too. I admit it was easier to put it aside and piece a baby quilt or two instead. 
The quilt top has literally hung on my design wall all this time. Granted often covered up by some other work-in-progress. I have decided it is time to re-design the border and breathe new life into the project.
I like it much better. I have now removed the blue border and replaced it with the pieced one. I have machine appliqued the leaves in place. 
Rubin says he's excited about the potential of stem cells in the cosmetic field and beyond. Still, he adds, there are many unanswered questions about the cosmetic use of stem cells, and anyone who claims to have already mastered the technique is jumping the gun. As Rubin puts it, "Claims are being made that are not supported by the evidence."While researchers in Asia, Italy, Israel and elsewhere are reporting decent cosmetic results with injections of stem cell-enriched fat, Rubin says that nobody really knows how the stem cells themselves are behaving. He points out that fat injections alone can improve a person's appearance, no stem cells needed.Rubin believes it's possible that injected stem cells could create new collagen and blood vessels — as they have been shown to do in animals studies — but such results have never been proved in humans. And, he adds, the long-term effects of the procedures are an open question.Stem cell face-lifts could someday offer real advances, says Dr. Michael McGuire, president of the American Society of Plastic Surgeons and a clinical associate professor of surgery at UCLA. But he believes that scientists are still at least 10 years away from reliably harnessing stem cells to create new collagen and younger-looking skin. Until then, promises of a quick stem cell face-lift are a "scam," he says.
“Procedures with no solid science behind them, stem cells included, give unproven hope to patients and the marketing of them brings dishonor to our entire specialty,” said Felmont Eaves, III, MD of Charlotte, NC, President of ASAPS. The Aesthetic Society is working together with the other core societies to address this through an evidence based medicine program that will rate any procedure or device on the legitimacy of the scientific evidence behind it. This program is in its development stage and will be available to the public within the next 12 months”.“The use of ‘stem cells’ in advertising for cosmetic surgical applications is a global problem," says Doug Sipp, Head of the Science Policy and Ethics Study Unit at the Center for Developmental Biology of RIKEN in Kobe, Japan, who monitors supposed stem cell treatment claims worldwide in all different specialties. "There have been many cosmetics, nutraceuticals, and device makers who claim either to use stem cells in their products, or to use ingredients that activate the customer’s own stem cells. To the best of my knowledge, none of these has a basis in scientific evidence."
Stem cell face-lifts: A Sept. 13 Health section story assessing stem cell face-lifts offered by two Beverly Hills doctors said that Dr. Nathan Newman charges between $5,500 and $9,500 for the procedure and Dr. Richard Ellenbogen charges $15,000 to $25,000. The story should have noted that Ellenbogen often performs a surgical face-lift along with his injection of stem cells. —
A successful body contouring patient must satisfy four key elements to achieve and maintain optimal results.
1. Lifestyle change
2. Regular exercise
3. Well-balanced diet
4. Body contouring
The wet technique involves instillation of 200 to 300 mL of solution per area to be treated, regardless of the amount aspirated.The superwet technique employs an infiltration of 1 mL per estimated mL of expected aspirate, and this is the technique practiced at our institution.Tumescent infiltration, popularized by Klein, involves infiltration of wetting solution that creates significant tissue turgor and results in infiltration of 3 to 4 mL of wetting solution per mL aspirated.Recent data suggest that, for patients undergoing general anesthesia with the superwet technique, the lidocaine component may be reduced and/or eliminated without postoperative sequela of increased pain.
Advantages include less surgeon fatigue, as well as improved results in fibrous areas and in secondary procedures.Disadvantages have been reported to include larger incisions, longer operative times, and the possibility of thermal injury.
LAL has been at the forefront of marketing hype for the past several years. The treatment involves insertion of a laser fiber via a small skin incision. Depending on the manufacturer, the fiber may either be housed within a cannula or stand alone. …. Most companies and physicians utilizing this technique employ a four-stage technique: infiltration, application of energy to the subcutaneous tissues, evacuation, and subdermal skin stimulation. …… Currently, these devices are being heavily marketed for purported skin-tightening effects. The belief is that the heating of the subdermal tissue may in fact be the contributing factor for LAL’s possible skin tightening effect. No large, prospective trials have been undertaken to examine the benefits of LAL over existing technologies, so unfortunately, most of the reports remain anecdotal.
In a questionnaire to board-certified members of ASAPS, Hughes reported a significant increase in complications when liposuction was combined with other procedures. This increase in the complication rate was most notable in liposuction combined with abdominoplasty. …….Incidence of DVT in liposuction has been reported at <1%, but a marked increase in this percentage is demonstrated when liposuction is combined with other surgery (abdominoplasty/belt lipectomy).
Welcome to Grand Rounds, the weekly collection of best health and medical blog posts. This week we invite you to enjoy a broad range of insights, tips, and first-hand stories, presented as a Q&A conversation with bloggers willing to answer, below, a total of 22 good questions. ………….
Kim, Emergiblog, is the host of the latest edition of Change of Shift (Vol 5, No 7) which is in its 5th year! You can find the schedule and the COS archives at Emergiblog. (photo credit)……………………………………….
Welcome to Change of Shift!
While this is a bit of a “mini” version of the nursing blog carnival, it is far from “lite”.
There are old friends and new blogging colleagues; musings, opinions and rants…it’s all here!
Let’s get it started! …………..
More than half of all adult Americans spent nearly 27 billion dollars last year on dietary supplements to get healthy, stay healthy, lose weight and gain an edge on the sports field and in the bedroom. And in the process, some of them got seriously sick. We talk with Nancy Metcalf, senior program editor for Consumer Reports-Health about the findings of their recent investigation, “Dangerous Supplements, What You Don’t Know, Could Hurt You.”
NNT stands for “number needed to treat” and is explained:I'm announcing my new website: TheNNT.com -- an evidence-based resource for medical interventions. Spread the word! #sa10 #thennt
Check out Graham’s new website. It is full of useful information.There is a way of understanding how much modern medicine has to offer individual patients. It is a simple statistical concept called the “Number-Needed-to-Treat”, or for short the ‘NNT’. The NNT offers a measurement of the impact of a medicine or therapy by estimating the number of patients that need to be treated in order to have an impact on one person. The concept is statistical, but intuitive, for we know that not everyone is helped by a medicine or intervention — some benefit, some are harmed, and some are unaffected. The NNT tells us how many of each.
@MD_chat: Let's nudge more physicians onto Twitter. Tuesday 10/5 12:30pm EDT is #MDchat - http://MDchat.org #hcsm Plz support them! :)
………..So rather than waiting for doctors’ orders, I am launching @MD_chat for physicians to participate in advancing our collective understanding of the influences of emerging technologies on our culture, health, privacy, dignity and many other aspects of the human condition.Below is a slideshow introducing MDchat and explaining how it works (if you can’t see it, you can view it here or here): ……………….
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An old barn is more than a storehouse for hay and livestock in the eyes of some area folk-art lovers. It's a canvas for their favorite art form — the quilt.Quilting enthusiasts in Western Kentucky are encouraging farmers to let them hang large panels painted in traditional quilt patterns on their barns."The first time I saw a barn quilt I thought, 'I want one of those!'" said Judi Inge, 55, of Owensboro, Ky., who is active in the Owensboro Area Quilters Guild. "My mother felt the same way." ……….
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Upcoming shows:
10/9 : From Seattle
10/14 : About Social Health Track at BlogWorld Expo
10/16 : On Location
10/21 : About DigPharm Mtg
10/23 : Saturday Nite
10/28 : About FMEC Mtg
10/30 : On Location
