NursesNotes

 Slather on that sunscreen, folks! NurseNancy subscribes to Medscape and this is part of an article that came in this week.

Have a read. And, reader, beware!

Malignant melanoma is the fastest-growing and 7th most frequent cancer in the United States (Swetter, 2003). Its incidence has tripled among Caucasians over the last 40 years (Pockaj et al., 2003), with an expected incidence of 1 in 50 by the year 2010, but only about one-quarter of cutaneous melanomas are discovered directly by physicians (Zalaudek, Ferrara, Argenziano, Ruocco, & Soyer, 2003).

Established risk factors for malignant melanoma include the following (Zalaudek et al., 2003):

Diagnosis

The Alphabet of Melanoma: ABCD Plus E, F, and Maybe G. The ABCD rule may potentially identify malignant melanoma: Asymmetry, Border irregularity, Color variegation, and Diameter greater than 6 mm (roughly pencil eraser size). Another clinical clue that can be added to the "D" is "different," as in different from the company it keeps. For example, if all of the patient's nevi are one tone of brown except for one that is much darker, that one should be scrutinized very carefully — this may be termed the "ugly duckling sign" (Fox, 2004; Grob & Bonerandi, 1998). Attention should be paid to patients who report recent changes in the characteristics of existing nevi (Rodriguez & Khachemoune, 2004). Some authors have proposed adding "E" and "F" to this scheme. The "E" is for both "evolution" (a change in a pre-existing lesion) and for "elevation" (the vertical growth of [or a vertical component to] pigmented lesions); the "F" is for "family history" as mentioned in risk factors. "G" can be added for "great numbers," because even great numbers of small nevi double the risk for melanoma (Tucker et al., 1997). Not all melanomas have all of the ABCD criteria. The ABCD (EFG) mnemonic is only a tool to help in diagnosis, not a set of criteria necessary for diagnosis (Fox, 2004).

I took this afternoon off to take the kids to the doctor for some shots and to the dentist for a general checkup and cleaning. No one needs fillings or braces at the moment. I don't know how long it will take me to find doctors, dentists etc in Halifax, so thought I better get this looked after before we leave. The decluttering is coming along swimmingly. Now we are all having a competition to see who can ditch the most stuff. I took a page out of "FlyLady" 's book and have everyone weigh what they are pitching. So far little guy is winning.

Of course he got rid of a bunch of toy trucks and his rock "collection"!! :)

Taking a line from mnash reminded me of other idiots I have encountered in my travels. Not as dangerous, albeit, but idiots nevertheless!

The last time I was flying somewhere, I was amazed at the idiots I saw. I am referring , of course, to the self important, cell phone and blackberry toting  and jabbering business class travellers. They pushed and shoved themselves in front of doddering old people with walkers and moms with strollers in order to be down the entry way first. Imbeciles.
Don't they know that they take off at the exact same time as the rest of us poor slobs in coach?

this guy was obviously hired for his acting talents.

I like to take things slow and easy. But Tblog, you have taken the meaning of "slow" to a new and different dimension!

While we wait for you to move through your paces, we are all growing old here!

Everyone has a box in their room. The box has to be filled up with stuff no longer needed or wanted. everything then gets divvied up and goes  in the garbage, the give away pile or the yard sale.
My youngest son has filled his box twice and emptied it both times! Nothing has made it to the various piles, yet!! Oh, the head ache of this move is just beginning!!
So far I have discovered(?) a whole lot of baby stuff ( the "baby" is 11, going on 12) figure skates and dance costumes that the girls wore in 2nd and 3rd grades ( were they ever that tiny?) and a whole box full of grade school paraphanelia that all the kids made at school. Drawings and pictures, mother's day cards, letters to Santa. Oh my, where did my little ones go? This move is going to be a bit of a catharsis and a real big trip down memory lane. I choked when I got to the cards all my babies made me when I was undergoing my cancer treatments.
Oh dear, at this rate, I'm never going to get moved outta here!!
On the up side, we sold our house and it gets finalized in two weeks. I'm amazed that someone would want to buy this house, it's always a little bit "stirred" looking.
Obviously these folks could look past the mess of a busy large family.

Well, some things are changed and changing. Go away for a bit , come back and find MANFan in # 2 ( way to go!) NurseNancy blown outta the top 100, and some old friends missing in action! We went away for the weekend of the 4th- house hunting in Nova Scotia, Canada. That's where we are moving to. Move date is set for the last week of August. I am planning to finish up one last course at the college before I move, so will be very busy with that! We found a nice house, in a good neighborhood with what seems to be good schools. The kids are starting to realize they are going to be leaving life long friends before too long, so are kind of sad about that. Overall, they are doing well and seem to have accepted this transfer. Our own parents are a little upset that we will be farther away but are looking forward to visiting. We are going to be living in the capital city of Halifax in Nova Scotia. It seemed like a nice city. Clean, right on the ocean and the people seem to be really friendly. It will be interesting to see how our new neighbors percieve us, as I hear that there can be some anti American sentiment in other countries. Oh well, I'm sure once they get a load of the Nurse Nancy family at our moving in BBQ, I hope we will be accepted! We already met the next door neighbors (oops I mean neighbOURS- Canada, eh!!) Seems to be a nice family in their mid forties with 4 kids close in age to our three that will be at home in the fall. Actually, only the three younger kids are making the move. The oldest girl will stay here and finish her summer job, stay with a college friend and then head back to college at the end of August. She's on the dance team there and they have a performance drill week before school starts.

I plan to stay home for a month ( at least) to get settled. I have been in contact with the main hospital there and have been offered a clinical nurse specialist position. I have to wait for my credentials to come through from CT. I hear that it takes a few months to get liscensed and to get my work permit to work there. I always wondered what it was like to be a foreigner, now I'm starting to find out!!

Anyhow, we are somewhat excited about the move, somewhat apprehensive about the unknown, and a little sad that I am leaving the job I've had for years. I hope to be able to work with HIV/AIDs patients but the population is so much smaller there that the hospitalized ones are usually not too great in number. I'll have to see and will look forward to blogging about our moving adventure as the next few weeks roll around!. We have had the movers in to do the estimates, and I am trying to go through all the stuff to clear away what we really don't need anymore.
Anyone need a ten year old baby stroller? Ten year old baby puke stains included for free!! :)