Ask a nurse anything.

reply to post by JohnPhoenix


Hey John,

Our conversation has prompted me to do a bit of research, and I'll tell you my now quasi professional opinion. Like I said I have 2 or 3 E-cigs, and have used them off, and on. I actually like them better than a traditional cig. But, being a cigar guy they just don't have the steam, or the bouquet I crave from a big ol' stoggie. Like you said the craving for the real deal is very much psychological. I truly LOVE the flavor of a Partagas black label, or a Punch grand crue #2. If they ever develop the E-quivalent I would be E-lated. Their are a few offerings, but they miss the mark. The E-cig however does do a good job approximating a cigarette. The E-cigars are a bit nappy IMO.

So here's my quasi professional opinion now that I read a few articles pro, and con. The diluent used in the E-juice is as you said PG, VG, or PEG 400. The PG, or propylene glycol is what is used in medical inhalants anway, and is on the FDAs GRAS list. (Generally Regarded As Safe) The nicoteine being "harmless" is a bit of an over simplification. Water is poisonous at the correct dosage. It'll make your electrolytes shift, and squish your brain like a cantaloupe, but you'd have to drink A LOT, and fast.

Nicoteine does in fact boost mental focus, and stimulate the nervous system just like caffeine, just like most other compounds ending in "eine" or "aine." A certain amount is necessary, and without any at all your nerves would not fire at all. We like to boost that effect a bit with more than the amount naturally found in common foods. In moderation you are right no great risk is present with the nicoteine alone. It seems the carriers used in the E-cig is generally regarded as safe. The articles I found discouraging the use of E-cigs could only site the "We just don't know in the long run." argument, which is a weak one in my opinion.

However... dun dun duuunn. My original caveat about potential overdosing still stands. The highest legal concentratin of E-juice is 36 mg/ml. In the advertising they drop the "/ml", and just say 36mg. That is not 36mg for an entire bottle. That is 36 milligrams per milliliter. The largest standard bottle is 30ml. That would contain over 1 gram (1080ml) of nicoteine. Your dosage for lethality is correct at 40-60mg, but it isn't quite that simple either. It is dosage over time. 40mg over a 24 hour period is probably about what a chain smoker takes in. If that same 40mg hit the blood stream all at once, then yes, you are in big trouble. Now vaping, or smoking 30, or 40 mg over an hour or two would be wholly different than orally ingesting 30, or 40mg all at once. Nicoteine is toxic, and by that I mean the literal translation, it is readily absorbed through mucous membranes. The absorbtion rate would be different. So I guess not only is the poison in the dose the poison is also in the route of administration. Orally it would take about 150mg at once to harm you because of the second pass effect through the liver where the liver would process the majority of it before hitting circulation. So you can see that one 30ml bottle of high concentration E-juice has about 8-10 lethal doses of nicoteine if the entire contents were mistakenly ingested. The point being don't let kids or pets anywhere near it. I'm sure that goes without saying, and is just common sense, but I still think that the potential danger should be disclosed better. A bottle of E-juice misused is about 5 times more dangerous than rat poison. Rat poison is required to have a big Jolly Roger on the side, and say "poison." I don't think they should do this with E-juice, but it should have a bit more of a warning on the bottle than what mine has. It just says "Not for oral consumption" in small print on the bottom of the label. It needs to say "Harmful, or fatal if swallowed." Maybe some do, and mine's just lacking.

So used correctly, and with common sense moderation I think it is a much safer alternative. A sensible amount of nicoteine in PG vapor should be fairly safe. Plus there's my #1 rule of thumb. If it works for you then use it!

About e-juice reproducing the cigar tobacco you like.. don't hold your breath. Sad to say but they just can't quite get that down. No tobacco "flavor" actually tastes like tobacco.

You can btw get larger bottles than 30 ml. I just got a 120 ml bottle of pre-mixed 24mg/ml juice for 40 bucks. A good deal. I also mix my own at home with a 60mg nicotine solution in 100% PG along with big bottles of PG, VG and flavoring. (You can purchase 100 % Nicotine but of course this is not pure nicotine it's 10 % of pure mixed in PG or VG as I understand it. This like the 60 mg is strictly sold for mixing and not to vape straight.) I mix to 24 mg/ml. There are many nifty e-juice calculators on the net. Kids and pets.. even wives are not allowed to touch this 60 mg nicotine. I won't give you a hard time about stressing the potential lethal ability of e-juice. We all hope no one ever tests this and is stupid enough to drink a bottle. We all hope people keep it away from kids and pets. Many people do this Do it Yourself method to keep cost down. Aside from the potential harm of nicotine the flavorings have not been tested for long term inhalation as has PG and VG but they are FDA approved flavorings made with GRAS ingredients.

The big point here of course is that if used responsibly these things can help save a life and get one off the harmful cigarette smoke while having minimal health risks. I think of the chemicals in processed foods and the things parents give their kids on a daily basis, makes me shutter when anti e-cig groups claim they are just as bad as cigarette smoking. It's all lies of course to support someones hidden agenda. I'm glad you did more research. In fact there is new data coming out all the time on the "relative" safety and effectiveness of e-cigs as a quit smoking device. Something the pharmaceutical companies are not too happy about. E-cigs compete with a multi billion dollar a year pharmaceutical based quit smoking product industry. Talk about conspiracies.

Thank you again for your input. I'll let ya get back to answering the tough questions now.

sometimes I get strong sensations in my brain, not always "randomly" but usually in response to something I feel more deeply about eg. music. Very euphoric- even more than an orgasm. The sensation lasting probably no more than 10 seconds.

Nicotine withdrawal did produce this (not exactly the same) in the past. Seems coffee withdrawal does this too? Is it possible I have a tumor or am stroking out a couple times / once a week or something awesome like that

Kinda doubt its lingering psychic powers

I've had acupuncture and the energy movement is very similar in strength but primarily localized in the brain

Please forgive me if my question was already asked here (no time to read 7 pages right now), but what is the best way for a person to opt out of getting vaccines?

I wholeheartedly believe that vaccines are extremely toxic poisons that are VERY unhealthy and dangerous to the body. I also believe that in many cases, vaccines are dangerous experimental drugs (history reveals this to be done many times before to an unsuspecting public in many countries).

So what is the BEST way for a person to REFUSE a vaccine and NOT have to suffer any BS for making this healthy choice? Do vaccines get documented on our health charts? Can a person claim that they had one just to get out of being pressured by a doctor to take one.

I can count on one hand how many times I have had the flu. Others who I know who are well-vaccinated went from otherwise healthy people to ones who get sick BADLY every year!

I dont need POISONS and SICKNESS, so what advice would you be able to offer here?

THANK YOU!!!!!!!

reply to post by HangTheTraitors


It is called consent to treat. You do not have to agree to any treatment you do not want whatsoever, ever, end of story. Don't lie, they will find out, and then your credibility in the future goes out the window. They may ask you your rationale for refusal, but if they ever say you "have to" they have broken the law. You have the right to refuse ANYTHING. I don't get a whole lot of the vaccinations they push us to get, and neither do a lot of my coworkers.

A good rationale if asked would be that your personal incidence of illness is very low, and that you consider the risks of vaccination to be higher than the benefits at this time. If they want to argue further just politely insist that your answer will be no today, If it goes further than that for any reason(it shouldn't) Simply say "This conversation is over, and I am exercising my right to refuse, and I am leaving, any attempt to stop me will be considered assault, and prosecuted as such." Unfortunately I have seen it escalate all the way to that point with an extra pushy doctor, or nurse. Very rare, but possible. You ALWAYS have the right to refuse, no exceptions.

reply to post by WaffleBear


These all sound like dopaminergic reactions. Nicoteine stimulates the production of dopamine. Sometimes, though rarely, when you quit cold turkey their can be a rebound over production of dopamine, same thing for coffee, or any stimulant for that matter. Orgasm is a similar, but not exactly the same, process. Emotional responses can be very powerful. For instance a panic attack commonly has an emotional trigger. A panic attack clinically presents just like a heart attack, and can even lead to one if left to escalate. If music leads you to euphoric feelings better than orgasm I would suggest investing in a kick ass stereo!

reply to post by Binder


Thanks.
To correct myself, coming off these addictive substances the feelings are primarily within the head....

When I'm off them for some time and therefore have decent sleep and am more sensitive overall etc the sensations are all upper body- mainly spine (lower and upper back) and usually it resonates prominently throughout 90% of one of my brains hemispheres and less significantly in the other; notably more often my right brain is elated beyond belief.... arm hair standing up

I'm totally over cigarettes..found smoking before acupuncture completely deadens/sedates the massive sensations you'd otherwise get.. And I'm finally waning off caffeine atm.... Once officially off all stimulants (working on it for years) hopefully we'll finally see if its just withdrawal or suppressed mystical energy

Thanks for the reply and take care

Originally posted by Binder
reply to post by HangTheTraitors

 

It is called consent to treat. You do not have to agree to any treatment you do not want whatsoever, ever, end of story. Don't lie, they will find out, and then your credibility in the future goes out the window. They may ask you your rationale for refusal, but if they ever say you "have to" they have broken the law. You have the right to refuse ANYTHING. I don't get a whole lot of the vaccinations they push us to get, and neither do a lot of my coworkers.

A good rationale if asked would be that your personal incidence of illness is very low, and that you consider the risks of vaccination to be higher than the benefits at this time. If they want to argue further just politely insist that your answer will be no today, If it goes further than that for any reason(it shouldn't) Simply say "This conversation is over, and I am exercising my right to refuse, and I am leaving, any attempt to stop me will be considered assault, and prosecuted as such." Unfortunately I have seen it escalate all the way to that point with an extra pushy doctor, or nurse. Very rare, but possible. You ALWAYS have the right to refuse, no exceptions.

Great info, thank you!!

I appreciate it very much.

WOW!, just WOW!

I don't know if this is just some kind of one time screwed up incident or if this is the new face of "Hope, and Change." that Obama(I don't)care is going to bring.

Last week I took care of an aged gentleman having an acute miocardial infarction, AMI, or HEART ATTACK, for the layman. His indicator enzymes were through the roof, he was having chest pain, and he had EKG changes(another indication that the poo was getting flung into the ventilation.) We sat on him!!!! Sat on him 4 days!!!!! Why? WHY?!

The answer: An ambiguos "That's just the way things are now, things are changing, we don't have it in our budget etc, etc.... ad nauseum." I don't normally get political, but when you are actively harming MY PATIENTS the gloves come off. If you voted for that socialist pig you'll rot in hell sooner rather than later. They won't kill you they'll just wait for nature to take it's course while giving you medication to keep you numb, and dumb, and tell your family it was just unavoidable. Obamacare my fat white A$$!!!!!

Sorry to rant, but ATS is my ventilation port. If you like Obama, and his policies I appologize again, but please plug your brain in to charge. I really feel sorry for the uninformed that these new "hopey changes" are going to kill.

reply to post by Binder

Thanks for this opportunity...

Having read only a page or three thus far I will ask you these...in hopes of being original queries;

DPTA External text;

DTPA Diethylenetriamine pentaacetic acid, or DTPA, is another common form of treatment for radiation poisoning. Radiation poisoning can often come from exposure to the radioactive metals of americium, curium and plutonium. Upon exposure these elements can lodge in the body. DPTA binds to the metals. It is then excreted in urine or feces.

Is it researchable to compare the amount of this medication being prescribed today as opposed to five years ago?

Thanks.

Medically speaking I was wondering, is it weird that one of my testicles is bigger than the other two?

I recently had my DNA analyzed. I have individual genetic markers for Alzheimer's. Even more important my haplogroup is also especially predisposed to AD.

Advice, please?

reply to post by cry93


Hi Cry93,

First off, calm down, get a cup of coffee, shot of bourbon, or whatever makes it all better. Just because you have a genetic predisposition for a disease does not mean you will end up with it. You have a lot of say in what happens to your body! Secondly DNA research is still in its infancy. There is more that we do not know, than what we know. Staying active, eating healthy, staying mentally engaged, and being happy are all much greater indicators of your health into your golden years.

Most important advice I can give you... DO NOT WORRY ABOUT IT! I have a familial history of Parkinson's. I could care less, really. If I get it, I do, and I will fight it. But I WILL NOT WORRY ABOUT IT, and lose precious time with my loved ones now! Cross that bridge when you come to it, not before. There are amazing breakthroughs in Alzheimer's, and more in the pipe. The disease can be slowed considerably now. Plus, if you are affected by it early, and profoundly you won't know, or care. Your family will love you just as much anyway, that's what's cool about family they're stuck with us, mwahahaha!

Stay alert, but don't be a hypochondriac, get tested every few years, but don't dwell on it. If it does happen, fight it like a champion boxer, but do not worry about it. The worry will kill you faster than the disease ever could.

reply to post by mikem


It is perfectly normal for one of your three testicles to be bigger than the others. I have two that are a bit larger than the rest myself.

reply to post by Binder


I really like your line of thought that my family will love me anyway. Thanks.

reply to post by Binder


Hi Binder
Do you realise the things that go thru my mind when you say ask a nurse anything. It's like wow pull back on those reins Randy. Don't make any trouble for yourself. I apologise. Any way this may have been asked.
Do you intend to comply with mandatory vaccination or have you already ? I think making anyone get a vaccine is tripe.

Originally posted by Binder
HI ATS, I am a critical care RN with some other letters behind my name that I won't get into, but anyway. I searched, and was surprised that I didn't find another post similar to this. So... here goes. Ask away.

I recently read an article where a bunch of nurses fielded questions, and gave a lot of "inside" info to how things really are in the medical profession. It was quite popular, and the nurses were very candid as I will be. If there are any other medical professionals on ATS that want to chime in please feel free.

I do not intend to diagnose, or offer modes of treatment for any particular problem. You should go see your doctor for that, it is their job. I will offer my opinion, but it is just that my opinion based on personal experience.

What I would rather focus on is a medium of communication to help people get the best care they can if, and when they get sick. We are on your side always, even when it doesn't seem that way. For example: A nurse will never tell you that your doctor is a moron. We will however tell you that you can always get a second opinion. I can also explain why we can't, or don't always tell you everything you want to know about everything going on. Or why visiting hours are strictly enforced sometimes, and not at others etc... I'll let you in on a lot of the "code" words we use to do our best to advocate for YOU our patient, but not lose our jobs.

A nurse walks a tight rope of legal, and ethical constraints that most people simply cannot fathom. Some jobs are physically difficult, some jobs are mentally difficult, some jobs are emotionally difficult. Nursing is all of the above. I absolutely love what I do, or I wouldn't do it. Believe me I do not get paid enough to do what I have to do sometimes, but I really can't imagine having near the satisfaction from doing anything else. I am often asked. especially as a male nurse, why I didn't become a doctor. Simple, I didn't want to. I am who I want to be, and have no regrets. So ask away ATS I look forward to your questions. [/quot

Have you read the book The Golden Stesocope? Is it accurate?

reply to post by randyvs


Hey Randyvs,

I always read your screen name as "Randevious" was that the idea? If so, I like it. Bar no holds here my friend. You cannot ask a question out of bounds for me!!! There are certain vaccinations I have researched, and I have gotten, there are others I do not, and will not get.

The yearly flu, nope. I think it is too much of a crap shoot, and a money making device. I do get the yearly TB test. It isn't a vaccination per se, it's just an indication of whether or not you have been exposed, kinda nice to know in my line of work. You wouldn't believe the number of inconsiderate jerks that will cough full in your face! I have wiped spittle, and sputum from my eyes more times than I care to recall. Really guys a hand in the middle is all I ask, is that so much?

With the exception of healthcare workers I don't think there is any absolutely mandatory vaccinations. There are protocols in place to refuse pretty much all vaccines. They don't like for you to do it, but you always have the right to refuse. With us it isn't considered "mandatory" per se, it's just if you want a job you have to. Kinda the same thing huh?

reply to post by longjohnbritches


I have not read "The Golden Stethoscope." Could you give me synopsis? Perhaps I should read it. I'm always up for a good book!

reply to post by loveguy


I'm sure it is researchable somewhere, but I wouldn't have the foggiest idea where to begin. Treatment of radiation exposure is very source material specific. You don't treat any two types of exposure alike. Every isotope has a unique "antidote." There is no one size fits all cure. What helps one may actually make another worse, and vice versa. Radiation poisoning is very hard to diagnose, and treat. Even when the exposure source is known exposure levels are often a matter of clincal observation. Basically if you aren't dead in three to seven days exposure level was sublethal, but still very harmful.