Cardiology Studies: Conditions Involved and Services Offered

Cardiology Studies: Conditions Involved and Services Offered 1. The area of medicine it studies  [i] Cardiology derived from Greek and Latin. Kardia in Greek means the heart and logia also from Greek stands for logy or study. Branch of medicine dealing with diseases of the cardiovascular system (heart, aorta and smaller blood vessels), their diagnosis and treatment. 2. Title of consultants in this field Cardiology department is run by Cardiologists which is divided into cardiac sections and various cardiac consultants including Heart surgeons, Cardiologist Electrophysiologist, Cardiothoracic [surgical treatment of thorax (the chest) of the heart (heart disease) and lungs (lung disease)]. surgeons and Cardiovascular (diseases that involve the heart or blood vessels) Imaging Consultants.   Ã‚   3. Services offered in the Cardiology department. Cardiology department is divided into various other sub departments which fall under Cardiology category: Cardiac Catheterisation Laboratory  [ii] (Cath Lab): there are many procedures carried out in the Cath Lab some of which may be; Coronary Catheterization, Coronary (relating to arteries surrounding and supplying the heart) Angioplasty (opens blocked arteries and restores normal blood flow to heart muscle), Permanent and Temporary Pacemaker Implantations and many more. Coronary Care Unit  [iii] (CCU) care of patients with heart attacks, unstable angina, cardiac dysrhythmia (abnormality in heart rhythm) etc. Chest Pain Assessment Unit  [iv] is to assess and treat patients with life-threatening heart conditions, chest pain, heart attacks, shortness of breath, palpitations etc. Cardiac Rehabilitation  [v] is a program for people who are on their way of recovery from a heart attack, heart failure, heart valve surgery, etc. the program involves adopting heart-healthy lifestyle changes, exercise training, and help you return to an active life. Cardiology Outpatients examines and treats patients without keeping overnight. 4. Surgical procedures and diagnostic tests used in the Cardiology department.  [vi] Coronary Angiogram (x-ray photo of blood and lymph vessels) is carried out in the Cath Lab it is an invasive imaging procedure, used to; evaluate the presence of disease in the coronary arteries, valves or aorta and heart muscle function. Also to determine the need for further treatment. Permanent Pacemaker (PPM) Insertion is an invasive procedure used to stabilise the heart rhythm. An incision is made on the left side of the chest under the clavicle, following local anaesthetic, the leads and pacemaker are inserted. Catheter Ablation invasive procedure used to treat an abnormal heart rhythm (arrhythmia). Several catheters are inserted into the patients groin, neck or arm and guided with the aid of x-ray equipment to the heart. Implantable Cardioverter Defibrillator (high energy shock to bring back heart action) (ICD) it is an invasive procedure used to stabilise the heart rhythm. An incision is made on the left side of the chest after local anaesthetic and the ICD leads and device box are inserted. Using x-ray guidance, the leads are fixed into position. Coronary Angioplasty used to widen narrowed coronary arteries. Opening up the arteries improves blood flow to the heart and may improve symptoms. A catheter with a small balloon at the tip is guided through a blood vessel into the heart artery. The balloon is inflated at the site of the narrowed artery, widening its diameter (balloon angioplasty). 5. Medical conditions encountered in the Cardiology department.  [vii] Most common heart conditions are: Coronary thrombosis: a blood clot in the coronary artery. Cardiac arrhythmia: Abnormal electrical activity in the heart, the heart beat may be too fast or too slow, it can be regular or irregular. Cardiac failure: the heart impairs its ability to supply sufficient blood flow to meet the bodys needs. Palpitations: abnormal awareness of the beating of the heart; whether it is too slow, too fast, irregular or at its normal frequency. 6. Common abbreviations relating to Cardiology MRI Magnetic resonance imaging CT Computed tomography (X-Ray) ECG Electrocardiogram (or EKG) VF Ventricle failure CHD Coronary heart disease 7. Common blood tests used in diagnosing heart disease. Cardiac biomarkers: these tests are used to diagnose a heart attack by determining if heart cells have been damaged.  [viii] Lipid blood tests: checks levels of cholesterol and triglycerides, which are associated with the risk of heart disease.  [ix] Question 1 Endo Endoscopy used to examine a persons digestive tract Question 2 Norovirus winter vomiting bug side effects; nausea, vomiting, watery diarrhoea, abdominal pain Question 3-5 Term Explanation Gingivitis Inflammation of gums Gingiv= gums Itis= inflammation Endocarditis Infection of the inner lining of the heart Endo= inner lining of Card= the heart It is= inflammation Atherosclerosis Narrowing and hardening of arteries Athero= artery Scler=hardening Osis= condition of the Question 6-8 Term Explanation Relates to Cystitis Inflammation of bladder Urinary system Uraemia Blood in the urine Urinary system Enteritis Inflammation of gastrointestinal tract Digestive system Question 9-11 Term Department Consultant Disorder of hormones Endocrinology Endocrinologist Disorders of the digestive system Gastroenterology Gastroenterologist Disorders of the skin Dermatology Dermatologist Question 12-17 HCV Hepatitis C virus HIV Human immunodeficiency virus PUD Peptic ulcer disease IVF In-vitro fertilisation MRSA Methicillin-resistant Staphylococcus Aureus C. Diff Clostridium Difficile Question 18-20 Term Suffixes Examples Inflammation Itis Conjunctivitis Cystitis Bone Osteo/Ortho Osteoporosis Rheumatoid Arthritis Tumour Oma Malignant melanoma Squamous cell carcinoma References [i] https://en.wikipedia.org/wiki/Cardiology [ii] https://en.wikipedia.org/wiki/Cath_lab [iii] https://en.wikipedia.org/wiki/Coronary_care_unit [iv] http://www.westerntrust.hscni.net/services/2577.htm [v] https://www.nhlbi.nih.gov/health/health-topics/topics/rehab [vi] http://www.blackrock-clinic.ie/services-procedures/cardiology/procedures/ [vii] An introductory to Anatomy Physiology, 4th Edition, reprinted in November 2012, written by Louise Tucker. Chapter 5 The Cardiovascular System page. 85 [viii] http://www.leehealth.org/cardiaccare/tests/blood.asp [ix] http://www.webmd.com/cholesterol-management/cholesterol-and-triglycerides-tests#1 Good Will Hunting: Sean Maguire Good Will Hunting: Sean Maguire Melissa Hernandez This case is about, Sean Maguire, a character in Good Will Hunting. Mr. Maguire is a 56-year-old Caucasian psychologist and therapist male. He teaches different types of psychology classes at Bunker Hill Community College in Boston. He was married to, Nancy Maguire for eighteen years before he lost her to cancer. They have never had any children. After his wife passed away, Mr. Maguire withdrew himself from friends and family. He is also a Vietnam Veteran. He continues to teach at the college because he wants to be surrounded by the people he is familiar with, people he grew up with. This case study will cover Mr. Maguires transition being secluded from friends into his turning point when he starts to make amends with his friends. Life Course Perspective The life course perspective (LCP) looks at how biological, psychological, and social factors act independently, cumulatively, and interactively to shape peoples lives from conception to death, and across generations. Of course, time is only one dimension of human behavior . . . (Hutchinson, 2015, p. 7). The LCP has five basic concepts; cohorts, transitions, trajectories, life events, and turning points (Hutchinson, 2015, p. 11). Cohort A cohort is a group of persons who were born during the same time and who experience social changes within a given culture in the same sequence and at the same age (Hutchinson, 2015, p. 11).   Sean Maguire belongs to the Caucasian, team of professors cohort. All of Mr. Maguires friends are professors who have gone on to do more with their lives. During the period Mr. Maguires wife was sick he quit counseling and he regretted it. After her death, he secluded himself from his friends. Mr. Maguires cohort were his friends from college, his colleagues, and his wife. Life Events A life event is a significant occurrence involving a relatively abrupt change that may produce serious and long lasting effects (Hutchinson, 2015, p. 15).   Mr. Maguires life events evolve around his wife from the moment he meets her until she passes. He passes up the Boston Red Sox playoff games, probably one of the most crucial playoff games during the history of baseball, to spend time with Nancy who he had just met. It was a risk worth taking because later he marries her and he states, I dont regret the 18 years I was married to Nancy. I dont regret the six years that she was sick and I gave up counseling. I dont regret later when she got really sick.   I sure as hell dont regret missing that damn game. After his wifes death, he lives an independent life. The pain he is left with after her passing became difficult to deal with. He doesnt know how to move on until he meets a young man, Will Hunting, he starts to counsel who helps change his life. Also as a child, Mr. Maguire experiences abuse from his alcoholic father who he tries protecting his mother from. He can relate to his patient Mr. Hunting. Transition A transition is a process of gradual change that usually involves acquiring or relinquishing roles, but it can be any change in status, such as change in health status (Hutchinson, 2015, p. 13).   Sean Maguire transitions into life without his wife after she dies. This life event changed Mr. Maguires environment as well as his self-concept and expectations. He is not able to move past losing his wife and watching her grow more and more ill. It hurts him knowing there was nothing he could have done for her but he is grateful he was able to spend her last months with her. This transition required Sean Maguire to make social adjustments. He stopped counseling for the duration Mrs. Maguire was sick, which he previously stated he regretted. Transitioning to life without his wife has been a challenge for Maguire. Life Course Perspective Themes There are six themes that pertain to the life course perspective; interplay of human lives and historical time, timing of lives, linked or interdependent lives, human agency in making choices, diversity in life course trajectories, and developmental risk and protection (Hutchinson, 2015, p. 20). This case study will cover linked or interdependent lives, human agency in making choices, and developmental risk and protection. Linked or Interdependent Lives The life course perspective emphasizes the interdependence of human lives and the ways in which people are reciprocally connected on several levels. (Hutchinson, 2015, p. 24). Mr. Maguire shut off communication with his college friends which left him with no social support, which is defined as help rendered by others that benefits an individual or collectively, is an obvious element of interdependent lives (Hutchinson, 2015, p. 24). The one person who was Sean Maguires family who always stood by his side through everything passed away, thus causing him to push away friends who could have supported him. Human Agency in Making Choices Constructing a life course through the exercise of human agency, or the use of personal power to achieve ones goals. (Hutchinson, 2015, p. 28).   Sean Maguire grew up with an abusive alcoholic father who would beat on him, his mother, and younger brother. He would protect his mother and sibling by taking the beatings for them. He confesses this to his client, Mr. Hunting. Growing up with an abusive father and in a low-income community, led Mr. Maguire to make goals to get out of that environment. He enlisted in the military and fought in the Vietnam war, returned home and made another goal to achieve his Doctorate degree in Psychology. Then he fell in love with, Nancy who he soon married. According to Albert Bandura, Mr. Maguire uses all three modes of efficacy; self-efficacy, efficacy expectation, and collective agency to set these goals and accomplish them. Developmental Risk and Protection As the life course perspective has continued to evolve, it has more clearly emphasize the links between the life events and transitions of childhood, adolescence, and adulthood. (Hutchinson, 2015, p. 31).   As a child Mr. Maguire experiences abuse at the hands of his father. As a young adult, he experiences difficult situations during his time served in the Vietnam war. An example of him protecting himself is when his client, Mr. Hunting criticizes his painting which is a painting done by Mr. Maguires late wife. He pushes Mr. Hunting up against the wall and proceeds to walk out of the room to gain his power back. He protects himself by pushing people away, he doesnt want to get close to anyone for fear of losing them or getting hurt. Banduras Social Learning Theory AlbertBandura proposes that humans are agentic, meaning they are capable of intentionally influencing their own functioning and life circumstances (Hucthinson, 2015, p. 28). Bandura argues that everyday life requires use of all three modes of agency. The three agencies will explain how Sean Maguire used them through his life course perspective. Personal agency Personal agency is exercised individually, using personal influence to shape environmental events or ones own behavior (Hutchinson, 2015, p. 28). Sean Maguire grew up in a low-income neighborhood with an alcoholic father who abused his mother and him. He used personal agency to get out of the neighborhood and rise up from the physical and mental abuse. He set goals to get out of his neighborhood, enlist in the U. S. Army and attend college. He did well because he earned a Ph. D. Proxy agency Proxy agency is exercised to influence others who have greater resources to act on ones behalf to meet needs and accomplish goals (Hutchinson, 2015, p. 28). Sean Maguire is a professor and psychologist who helps people resolve any conflicts they might have. In this case Mr. Maguire helps Will Hunting resolve his issues he has been dealing with since his childhood and young adult life. Mr. Hunting believes the abuse he endured as a child was his fault and was stuck in his childhood. Collective agency Collective agency is exercised on the group level when people act together to meet needs and accomplish goals (Hutchinson, 2015, p. 28). Sean Maguire and Will Hunting help each other accomplish life perspective goals together, which benefits both men. The time Mr. Maguire spent with Mr. Hunting was beneficial for both men because they opened up to each other and helped one another deal with conflicts they probably would not have otherwise dealt with. Mr. Maguire was able to reconnect with old friends and enjoy life even though his best friend is no longer alive. Mr. Hunting was able to accomplish his goal of falling in love and trusting someone, specifically a woman who he was afraid to get close to. Eriksons Theory of Psychosocial Development Eriksons theory explains socioemotional development in terms of age defined stages such as basic trust and mistrust which ranges from birth to one year old; autonomy versus shame and doubt which falls into one to three year olds; initiative versus guilt which is from three to five year olds; industry versus inferiority which has an age range of six to 11 years old; identity versus role diffusion from ages 11 to 20 years old; intimacy versus isolation which includes 21 to 40 year old adults; generativity versus stagnation which 40 to 65 year olds fall; and ego integrity versus despair which is 65 and older (Hutchinson, 2015, p. 112). Intimacy versus guilt Sean Maguire is 56 years old and finds himself dealing with intimacy and isolation. During the time his wife was sick he momentarily ceased his practice and regrets not helping clients. It was during that time that he also isolated himself from his friends and colleagues. After he became a widower Mr. Maguire further confined himself as he tried to deal with the death of his wife. He became distant from his students, who lost respect for him and he stopped communicating with his friends. He does not believe he will ever find a love like the love he experienced with his wife. Levinsons Theories of Finding Balance Daniel Levinson suggest that middle adulthood is a time when individuals attempt to find balance in their lives in several ways (Hutchinson, 2015, p. 321). Levinson sees the transition to middle adulthood attachment versus separation. Mr. Maguire deals with being attached to his wife and then losing her to cancer. He does not know how to deal with this in a positive manner. He has a huge tab at a local bar that has not been paid in months. Ethical Issues Ethical issues a social worker could possibly face could be, Sean Maguire is a psychologist who may not want to speak about his issues because he doesnt realize he has any issues to resolve. It would probably be an issue trying to convince Mr. Maguire what him and the social worker speak about is strictly between them and will be kept confidential. The social worker will not speak to her colleagues about what is discussed nor will the sessions interfere with Mr. Maguires careers. Ethical Principles The social worker may face dignity and worth of a person ethical principle when working with Mr. Maguire. Social workers treat each person in a caring and respectful fashion, mindful of individual differences and cultural and ethnic diversity. Social workers promote clients socially responsible self-determination. Social workers seek to enhance clients capacity and opportunity to change and to address their own needs. Social workers are cognizant of their dual responsibility to clients and to the broader society. They seek to resolve conflicts between clients interests and the broader societys interests in a socially responsible manner consistent with the values, ethical principles, and ethical standards of the profession (NASW, 2008) The social workers client, Mr. Maguire may not feel worthy and may feel his dignity is lost if he needs to speak about some issues that are interfering with his life. Ethical Values Dignity and worth of the person is an ethical value a social worker may deal with when working with Mr. Maguire. As stated previously, Mr. Maguire could possibly feel like his dignity is lost and his self-worth is diminished. The social worker must not allow the client to feel they have lost their dignity and make them feel they are worthy, because it is not easy to for Mr. Maguire to admit he needs help and seek it to become a healthier individual. Discrimination Sean Maguire received discrimination as a child growing up in an impoverished neighborhood. As an adult he was discriminated against because his friends think he did not anything further with his life after he earned his college degree. Oppression Sean Maguire experienced oppression at the hands of his father while growing up as a child. His father had abused him and his mother physically and psychologically. The oppression he experienced made him stronger and more willing to accomplish goals. Conclusion Sean Maguire has accomplished many goals while counseling his client, Will Hunting. He has learned how to deal with the passing of his wife in a positive way and he has reconnected with old friends who can bring him joy during this time in his life. Mr. Maguire needed someone who he could relate to and connect with who would help him come out of seclusion and experience the fulfillment of life. He is able as well to understand the abuse he endured as a child was not his to blame and he is able to nurture and love another person despite his life experiences. References Affleck, B., Damon, M., Driver, M., Elfman, D., Escoffier, J., Sant, G. V., Williams, R. (Writers). (1997). Good Will Hunting [Video file]. Hutchison, E. (2015). Life Course Perspective. In Dimensions of Human Behavior: The Changing Life Course (Fifth ed., p. 7, 11, 13, 20). Thousand Oaks, CA: SAGE Publishing. Code of Ethics (English and Spanish) National Association of Social Workers. (n.d.). Retrieved November 11, 2016, from https://www.socialworkers.org/pubs/code/code.asp Sun, X., Kim, D. O. (1999). Adaptation of 2f1-2f2 distortion product otoacoustic emission in young-adult and old CBA and C57 mice. The Journal of the Acoustical Society of America, 105(6), 3399-3409. doi:10.1121/1.424668 Wood, R., Bandura, A. (1989). Social Cognitive Theory of Organizational Management. Academy of Management Review, 14(3), 361-384. doi:10.5465/AMR.1989.4279067 What was the Reasoning behind Medicare and Medicaid? What was the Reasoning behind Medicare and Medicaid? Early in the twentieth century, those concerned in the human condition, mostly reformers and progressives, reasoned that the American family needed protection from the debilitating effects of lost wages subsequent to the family provider becoming unable to work due to an illness or injury. Many of the social service benefits we enjoy today were rooted in what was referred to at that time as Sickness Insurance. Sickness insurance included the seeds of future programs like Social Security Retirement, Social Security Disability Insurance (SSI), Unemployment Insurance, Workmans Compensation and yes Medicare and Medicaid. Although advocates for sickness insurance included plans to cover medical expenses. They were far more concerned with families recouping losses due to lost wages than they were with recovering medical expenses. This was because medical expenses during that time period were significantly less expensive and burdensome than they are today. During the first part of the twentieth century the average person spent roughly $30.00/year and that amount included burial expenses should they be needed. As a result, the political climate in the first half of the twentieth century, accompanying opposition from the medical profession and other interest groups, defeated any successful attempt towards establishing health insurance in any form or, for that matter, developing any type of comprehensive health care strategy until the mid to late 1930s. Although the Social Security Act was passed by Congress in 1935 and physicians began organizing the first private healthcare plans like Blue Shield to cover costs of physicians care in 1939, it wasnt until the late 1950s and early 1960s before the groundwork began which eventually produced Medicare and Medicaid. The stimulus for this development was directly attributable to private insurance companies adjusting their premiums on growing employer-based health coverage on ever increasing medical costs. As a result, the retired and disabled found it progressively more difficult to find affordable coverage as costs for same quickly exceeded their means. Because of this, health reformers focused their efforts on the elderly a battle more easily won. In 1960, Federal Employees acquired a health benefit plan (FEHBP), providing health insurance coverage to federal workers. The Kerr-Mills Act was also passed that year which provided federal monetary support to state programs providing medical care to the poor and elderly. The Kerr-Mills Act was the precursor to the Medicaid program. Shortly after the Civil Rights Act passes in 1964, President Lyndon B. Johnson signed the Medicare and Medicaid programs into law (1965). This legislation created Medicare Part A (covering hospital and limited skilled nursing and home health care), as well as Medicare Part B (a plan to help cover the costs of physicians services). The Medicare and Medicaid programs were incorporated into the Social Security Act as a result of support from the hospital and health insurance industries mainly because this legislation contained no cost controls or physician fee schedules along with public approval and a congress containing a progressive, democratic majority. The next ten years, 1971 1981 saw an expansion of services under the Social Security Income (SSI) program such as a cash assistance program to elderly and disabled persons along with amendments that allow those with long-term disabilities to qualify for Medicare while healthcare costs continued to skyrocket and politicians squabb led with special interest groups over proposals and reforms. The next 30 years, 1981 to 2009, was composed of a flurry of disjointed legislative attempts to both expand healthcare coverage for specific target groups while attempting to reign in the constant upward spiral of health care costs. For example: in 1986 the Emergency Medical Treatment and Active labor Act (EMTALA) required all hospital facilities that received Medicare imbursements to screen and stabilize all persons who used their emergency room facilities regardless as to the ability to pay. Then, just a few short years later in the face of the Clinton administrations proposed Health Security Act (which, in 1993, proposed access to healthcare for every American), the Health Insurance Association of America fought back with television ads depicting middle-class American families worried about access to health care under the Clinton sponsored plan. They had cause to worry. In the 10 years between 1987 and 1997 the number of uninsured grew from 31 million to over 42.4 million as ever increasing healthcare insurance costs, responding to exploding medical care costs, forced individuals and whole families out of the ranks of the insured. In 2009, the White House held its first Health Reform Summit with key stakeholders. Shortly thereafter, President Obama releases his 2010 fiscal budget which includes 8 principles of health reform (electronic record-keeping, preventing expensive conditions, reducing obesity, refocusing doctor incentives from quantity of care to quality, bundling payments for treatment of conditions rather than specific services, better identifying and communicating the most cost-effective treatments, and reducing defensive medicine), and sets aside 634 million dollars in a health reform reserve fund while Congress continues to debate national healthcare reform options (Obama, 2009). Late in 2009 both the House and the Senate pass health reform legislation. Even so, neither the Houses healthcare reform version nor the Senates are ratified by both political bodies. Then, on February 22, 2010 the White House releases President Obamas proposal for health care reform and hosts a second Healthcare summit just 3 days later.   One week later, President Obama lays out his proposal and threatens the Senate that if need be a reconciliation process that required only a majority vote rather than the normal 60 votes to pass would be used to insure passage of the bill. Less than three weeks later, on March 21, 2010 the House of Representatives passes the Senates sponsored version of the bill the Patient Protection and Affordable Care Act (ACA), along with the Healthcare and Education Reconciliation Act of 2010 that amends the original Senate version of the Patient Protection and Affordable Care Act reflecting negotiations between the House and Senate, and sends it to the President for signature. Two days later, President Obama signs the bill and P.L. 11-148 (Patient Protection and Affordable Care Act ACA), becomes law and Obamacare is born. Does the Affordable Care Act of 2010 adequately fix the majority of the healthcare problems we face as a nation today? Or should the responsibility of individual health be on the individual? In the words of Phil Schiliro, former Director of White House Legislative Affairs The right measure of the ACA isnt whether it avoids political controversy; its whether it makes America better by achieving its five most fundamental goals: expanding health-insurance coverage, lowering costs and promoting fiscal responsibility, increasing quality through innovation, protecting seniors and delivering peace of mind to American families by guaranteeing essential rightsà ¢Ã¢â€š ¬Ã‚ ¦. With these goals in place, individuals can concentrate on lifestyles that promote health rather than worrying about getting help when efforts in this regard fail expectations. References Timeline: History of Health Reform in the U.S. https://kaiserfamilyfoundation.files.wordpress.com/2011/03/5-02-13-history-of-health-reform.pdf A Brief History of Workers Compensation, Gregory P Guyton, Department of Orthopedics, University of North Carolina, Chapel Hill, NC; Copyright  © 1999, The Iowa Orthopedic Journal https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1888620/ Medicare and Medicaid: The Past as Prologue, Edward Berkowitz, Health Care Financing Review/Spring 2008/Volume 29, Number 3 https://www.cms.gov/Research-Statistics-Data-and- https://www.cms.gov/Research-Statistics-Data-Systems/Research/HealthCareFinancingReview/downloads/08Springpg81.pdf Health is ultimately the responsibility of the individual: to what extent is this viewpoint correct? rodrigo | November 13, 2012 The WritePass Journal https://writepass.com/journal/2012/11/health-is-ultimately-the-responsibility-of-the-individual-to-what-extent-is-this-viewpoint-correct/ Who is Responsible for Your Health? Sarah Lifsey, May 14, 2015, Altarum Institute altarum.org/health-policy-blog/who-is-responsible-for-your-health ProCon.org. (2015, May 8). Is the Patient Protection and Affordable Care Act (Obamacare) Good for America? Retrieved from http://healthcarereform.procon.org/view.answers.php?questionID=001526 Remarks by the President to the AMA (June 15, 2009). Whitehouse.gov. Retrieved January 12, 2012. https://www.whitehouse.gov/the-press-office/remarks-president-annual-conference-american-medical-association