FeaturedCovid Intubation; Stridor, Glottic Stenosis 

Covid Intubation; Stridor, Glottic Stenosis. Misleading Vital Oxygen Readers.

Do you have a loved one struggling after coming home after recovering from a severe case of Covid-19, was Intubated fighting for his/her life and you now notice unusual sounds coming from your loved one?

Perhaps it sounds like a bazaar humming sound or harmonic as time goes by. The noises are becoming longer durations and distressing for your loved one, yet vitals are stable, including O2 oxygen reader…? 

Then this topic may help you or your loved one. Vital O2 oxygen readers can be very misleading and rather confusing when it comes back within normal range, yet your loved one looks to be in distress, trying to breathe? This would include those especially with tracheostomy or post tracheostomy after Covid-19 recovery

What is Stridor Breathing…?

Bilateral vocal cord paralysis is a common cause of stridor in adults. It results from a disruption in nerve function in both of the vocal cords, the two small structures in the throat that vibrate and collide to produce sound, leading to vocal cord tissues blocking the airway. This causes biphasic stridor, which means the symptoms of noisy breathing occur when a person inhales and exhales.

Bilateral vocal cord paralysis can result from being intubated, having a breathing tube inserted. These procedures can cause scar tissue that interferes with breathing.

What is Glottic Stenosis…?

Glottic stenosis describes a fixed narrowing of the upper airway at the level of the glottis. The glottis is the portion of the larynx containing the vocal cords and the glottic opening. Anatomically, the glottis is the part of the larynx extending from the junction between the true and false vocal cords at the apex of the laryngeal ventricle to a line one centimeter below the inferior aspect of the vocal cords. The anterior two-thirds of the glottis is the glottis vocalis, while the posterior third is known as the respiratory glottis.

Acquired glottic stenosis is more common and has multiple factors. The most frequent is trauma secondary to endotracheal intubation, which is thought to occur due to the tube’s pressure effect causing tissue ischemia, inflammation and scarring. The risk of glottic stenosis is related to the duration of the intubation, the size of the endotracheal tube, the number of intubations, and excess movement of the endotracheal tube in agitated patients. Also, prolonged nasogastric intubation causes mucosal ulceration which may progress to posterior stenosis.

Post endotracheal intubation stenosis is the most common type of glottic stenosis.  The risk of developing stenosis in intubated patients has been found to be higher based on two prospective studies realized in the long term intubated patients, particularly in those intubated for five days or longer.

Acquired glottic stenosis thought to be caused by mucosal ulceration which leads to infection, perichondritis, and cartilage necrosis leading to granulation tissue formation over the vocal process of the arytenoid cartilage. Subsequently, scar formation and fibrosis cause contraction and arytenoid fixation.

The clinical presentation of glottic stenosis is variable and depends on the cause and the severity of the stenosis. The most common presentation of laryngeal obstruction is stridor. The level of the airway obstruction determines the nature of the abnormal breathing sounds. Upper airway obstruction results in mostly inspiratory stridor while obstruction in the lower respiratory tract results in expiratory or biphasic stridor.

Acquired glottic stenosis symptoms depend on the severity and location of the stenosis. Respiratory symptoms are the predominant symptoms in posterior glottic stenosis while anterior glottic webs mainly present dysphonia. In general, patients may present with respiratory distress. Other symptoms include hoarseness, alteration of voice, and aphonia. Dysphagia and aspiration may also be present.

History needs to concentrate on the assessment of dyspnoea and stridor, the onset and severity of the symptoms as well as the aggravating and relieving factors. Also, the voice should be thoroughly assessed. Finally, history should focus on previous episodes of intubation, trauma, infectious and inflammatory processes as well as co-morbidities.

Lastly, when in doubt and you feel something alarming going on with your love one, keep on track getting the best care and don’t settle on an ER Band-Aid treatment. Keep going until you find answers.

This especially true to those who had intubation for extended period of time due to Covid-19, those with healing trach wounds from previous Tracheostomy and removed post Covid-19.

Marsha B

FeaturedWhen the beast comes at night; Covid-19

At times coronavirus Covid-19 can be at it’s worst at night, well into the early mornings. This would be why this coronavirus Covid-19 has earned it’s title “The Beast”.

With much uncertainty at times trying to figure out if it’s possible to know if you’d had the coronavirus prior to vaccine being available as medical professionals lingered with identifying telltale signs and symptoms; often diagnosing patients labeled as an “indicator”. Yet it’s too soon for any of us to let our guards down as the coronavirus Covid-19 has the ability to mutate into different variants. I know I had my share of doubts because this can be very confusing for many, including myself. We hear and see the stories of shear horrors of families suffering in dominoes effective; one after another. Then comes along others that test positive without knowingly carrying variants of Covid-19.

Perhaps I may have lost sight of this beast that reeks havoc because when it hits home, your loved ones, this beast Covid-19 can tranquilized fear and begin to spiral like a vortex leaving heavily guarded hearts in much distress. This virus Covid-19 doesn’t discriminate, rather it exploits and devior human souls. As it did, leaving my loved on fighting for her life on a ventilator. I saw this beast Covid-19 as it came barreling down on more loved one and ravaged in ways I hadn’t seen. I assure this beast leaves wounded scares on those untouched.

As doctors and scientists race to discover, learn as time surpasses there’s still much uncertainty. I would say health-care workers, the essential workers on the forefront reinforce the hardest task at hand caring for our love ones through recovery and sometimes to the end. I give much gratitude to all for having strength where many of us couldn’t fathom the amount of courage, dedication, integrity within; what it takes to save lives by multitude.

It baffled many healthcare works and scientists where two topics came from trials of saving many lives. Blood clotting factors and oxygen levels as some healthcare professionals spoke with patients who would go see doctors, be able to respond in complete sentences without having catch their breath.

The irony came when patients would get vitals done their oxygen  levels were low and yet a person could speak freely without in some sort of hesitation. The monstrous beast, the coronavirus linked the ability to allow a person to inhale breaths but struggle to exhale carbon dioxide from a person’s lungs which resulted in lower oxygen levels.

The virus Covid-19, given testimonials by people who have survived “the beast that comes out at night while a person rest may do more harm and ravage chaos by early morning”.

Having a oxygen/carbon dioxide reader may save lives and get your love ones to a hospital or urgent care before this coronavirus, Covid-19 reeks havoc in silence.

When the beast comes at night; Covid-19

At times coronavirus Covid-19 can be at it’s worst at night, well into the early mornings. This would be why this coronavirus has earned it’s title “The Beast”.

As doctors and scientists race to discover, learn as time surpasses there’s still much uncertainty. I would say health-care workers, the essential workers on the forefront reinforce the hardest task at hand caring for our love ones through recovery and sometimes to the end. I give much gratitude to all for having strength where many of us couldn’t fathom the amount of courage, dedication, integrity within; what it takes to save lives by multitude.

It baffled many healthcare works and scientists where two topics came from trials of saving many lives. Blood clotting factors and oxygen levels as some healthcare professionals spoke with patients who would go see doctors, be able to respond in complete sentences without having catch their breath.

The irony came when patients would get vitals done their oxygen  levels were low and yet a person could speak freely without in some sort of hesitation. The monstrous beast, the coronavirus linked the ability to allow a person to inhale breaths but struggle to exhale carbon dioxide from a person’s lungs which resulted in lower oxygen levels.

The virus Covid-19, given testimonials by people who have survived “the beast that comes out at night while a person rest may do more harm and ravage chaos by early morning”.

Having a oxygen/carbon dioxide reader may save lives and get your love ones to a hospital or urgent care before this coronavirus, Covid-19 reeks havoc in silence.

FeaturedPower of Persuasion

Aristotle Wrote:
“All human actions have one or more of these seven causes: chance, nature, compulsion, habit, reason, passion and desire”

Spirituality as we know comes in many forms through core values, exposure, personalization, ethnic, culture, religion, beliefs, etc.

Spirituality is within a person’s inner source, intuitive thoughts and how one might perceive things in life.

Elements within a person’s core values may reflect traditional methods through integration and/or congregation within one’s own habitat. One may choose to surround themselves in a manner of how one perceives life’s spiritual values.

Where the wheel spins within ones thoughts and human behavior, actions form in regards as to how a person responds to circumstances in life and at times bring more spirituality into life in such divine ways.

Cause & Effect:

Circumstances within cause and effect may compellingly choose to respond with or without engaging in some form of action. Cause and effect may acknowledge its existence in an underlining source subconsciously.

Through subconscious awareness one may link in some sort of inner source; connective thoughts lay down a foundation of complexity placed within itself. Sometimes collective thoughts may form visions about life; one where people, places or things are better in an abstract of a daydream.

Disarray may at times mimic a cluster of personal distress and how one function in everyday life. At times during emotional distress one might feel as life has become an avalanche. One where everyday stress may build-and-build until it all unfolds; pours out in a colossal mess…

Finding Balance:

Cause and effect through turbulent emotions may at times linger or fester and lead to explosive reactions when things become bothersome.

Someone once said “it comes in a can.” This implies at times we can become stuck reminiscing, ruminating and over-thinking situations by setting the stage and making things appears worse than they really are. At times this may create problems that were never there to begin with. Almost as if one were to mix magnesium sulfate with soda to calm a storm.

However, staying in the present moment and not allowing things to unfold in the heat of moment can lead to more positive outcomes. But also learning to stay mindful with reminders to not let things become bothersome and spiral downward by placing defensive reactions out of an alarming emotional response. Reminders to not to over-think; explaining the same thing 5 different ways.

Finding balance in life will be the most beneficial element to achieving respite within. Most of us will spend a lifetime searching for this. Life doesn’t come with instructions and neither does balancing our everyday lives. But through our own trial and error we can adopt readiness guided by willingness to make personal change.

Conditioned to Crisis:

A crisis can condition a person to stray far from stabilization in any manner within cause and effect, creating an avalanche effect that may continue to build regardless.

Many individuals at one time or another have come across circumstances in their lives that sent them on a mission in an overwhelming emotional state. This doesn’t necessarily change or modify another person’s elevated emotional state of mind, but rather dysfunction may occur.

One may at times mimic or draw conclusions to reflect on their own emotional response conditioned through a belief system right down to personal and core values.

One may find within their own personal habitat that their own state of mind may react spontaneously to a crisis mode (often referred to as a rescue mode).

Perhaps worrisome thoughts have captured an emotional response and created a downward spiral of emotions flooding in a state of panic towards one’s spouse, family member or a loved one. In a state of panic (rescue mode) to rid unwanted emotions or problem solve we sometimes become compelled in stressful situations to place ourselves in the driver’s seat of a vehicle, only to find that one is in overdrive with their foot floored to the gas pedal based in a state of fear to React! Respond! Do Something!

The Impact Effect:

Many individuals at one time or another have come across circumstances in their lives that sent them on a mission prompted by emotional state of reaction to current events.

At times current events may have unfolded in our community or around the world, leaving a reaction of overwhelming emotional response prompted by chain of events. The cause and effect reactions to how one may feel about presumable actions or a crisis in current events may prompt a reaction within one’s own emotional state of being; where at times unintentionally create more havoc where mass hysteria may occur within society.

Spirituality in the Making:

Perhaps a loved one has been ill with a serious medical condition and you find yourself facing fears head on. Maybe it’s a friend having a difficult time managing his/hers mental health distress or perhaps it is someone close to you fighting a drug/alcohol addiction and you feel absolutely powerless to do anything.

In any state of being it can be difficult to carry someone close to one’s heart who inflicts emotional harm onto themselves or others, leaving one to be unable to receive a healthier connection.

In some cases where one’s spiritual beliefs may be in distress and broken down. It can be difficult for a loved one to comprehend the impact of cause and effect. To learn to set aside differences because each person is unique to their own core values when it comes to spirituality.

At times it is necessary to place one’s own spiritual beliefs aside; to be checked in and left at the front door. Individuality creates each person to uniquely define their own core values; their own belief system.

At times ones spiritual beliefs may lead one to believe notions through spiritual entity to be the only path in such divine ways. Ultimately by engaging in a sense of notions disagreeable to another may prompt one to create actions that may do more harm than good.

Validation:
Most often relationships become much more wholesome when a person can relate on a more personal level without judgments and lack thereof the use of words that may hinder a person’s ability to feel validation.

Validation is crucial part of communication when it comes to a healthier connection. Whereas one being empathetic in comparison isn’t because  it may become misguided words.

Things in life aren’t intended to be all-or-nothing; black-or-white. There are many shades of gray to lay down a healthy foundation in one’s life.

Spirituality Right Down to the Core:

If I were to use addiction as an example with someone struggling to find reasons to believe things will get better. Most often a person’s addiction can spiral into a path of destruction, leaving one’s self-worth, personal core values to plummet downward.

One’s spirituality may have already been hindered collectively through emotional duress without the ability to reason and/or see things differently.

For some spirituality may falter so far that even an avalanche couldn’t persuade one to find shelter.

Quote:

“It is often said when it comes to addictions, mental illness, health conditions one may strive at a bare minimal in times of struggles. One’s ability to maintain a faction of hope strays far, just enough to keep a person on solid ground and living moment-by-moment in any given circumstances where there are shadows of doubts…”

Copyright © by Marsha Beede 2016

All Rights Reserved