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About akavella

  • Birthday 03/09/1985

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    have lately been addicted to pinterest :)

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  1. I wrote this letter and plan on giving it to my manager the next day I work, and if things don't change then I will get a RX and doctor note for water, then they will have to make a reasonable accommodation for me. (I Have removed last names and the name of the company for privacy- however, I do I permission via email to use Amber's email here as well as to give to my manager) To Whom It May Concern: In regards to your email dated November 8, 2013 “ To clarify the “No food or drink in the work areas” I spoke with Liz P*** in Employee Health this am. She told me that the BBP Policy in IPPC under Safety has the written statement on this from OSHA regulations: On page 15 of the *** Blood Borne Pathogens Exposure Control Plan: Other Work Practice Controls: a. Mouth pipetting/suctioning of blood or other potentially infectious materials is prohibited. The emergency care method of clearing an infant’s airway called “DeLee suctioning” is acceptable if used in an emergency when no other method is available and a trap which prevents suctioned fluid from reaching the employee’s mouth is inserted in-line between the infant and the employee. b. Eating, drinking, smoking, applying cosmetics and lip balm and handling contact lenses is prohibited in any work area where there is a reasonable likelihood of occupational exposure. Prior to the consumption of any food after handling potentially infectious materials, employees shall remove potentially contaminated PPE, wash hands, and exit the work area. i. Each department may designate a “safe zone” where covered beverages may be consumed. c. Food and drink shall not be kept in freezers, refrigerators, shelves, and cabinets or on countertops or benchtops where blood or other potentially infectious materials are stored. I called and spoke with Amber J***, from the OSHA Oakland CA office (November 8, 2013), and in fact this is not a OSHA’s regulation at all, and *** has misinterpreted the regulation set forth by OSHA. Furthermore, if a “Nursing Station” has the potential to be contaminated, why is S*** subjecting their employees to Occupational Health Hazards. Why are we not using PPE at nursing stations if in fact we are exposed to hazardous materials? A nurse Station is not accessible to Patient and/or families and has mid chest high countertops where PHI is not accessible to viewers from the counter height. This counter also shields a Covered-Beverage from Droplet exposure as well and other ways of transmission, as again the beverage is covered and protected by the shield of the counter top. There is no blood or any other potentially hazardous or infections material stored at a nurse station, as that would be in direction violation of OSHA and JACHO regulations. Furthermore, regarding the safety statement required by OSHA guidelines states that it must be written in compliance of OSHA regulations. Regarding clause c. as mentioned above “Food and drink shall not be kept in freezers, refrigerators, shelves, and cabinets or on countertops or benchtops where blood or other potentially infectious materials are stored.” A nurse Station does not encompass the above mentioned; therefore covered beverages ARE permitted under OSHA guidelines. Please see the authorized attached email from OSHA Regulator Amber *** of the Federal OSHA Oakland Office Area Amanda, Per your question about having covered drinks at a nurse’s station- Federal OSHA had issued a Letter of Interpretation stating unless there is potential exposure to blood or other potentially infectious material, OSHA is fine with drinks kept covered at a nurse’s station. Potential exposure must be legitimate and if for some reason the employer has determined your nursing stations as areas where potential exposures are found, I would think there are a lot of other things they would be concerned with besides liquid consumption. I have inspected dozens and dozens of hospitals and health care facilities and I haven’t run into this issue yet. Your employer may have some legitimate concern, but I would think it’s worth exploring this issue further with the info provided below. I was unable to attach the Letter due to some technical issues on our part, but here is how you can find it: Go to www.osha.gov which is our home page Select the tab near the top that reads “Regulations” Scroll down until you see 29 CFR 1910.1030 and select it Scroll down until you see 1910.1030(d)(2)(ix) highlighted in blue. Click on the blue highlighted portion and you will be brought to a Standard Interpretation page (it’ll say there are 2 in this case). Click on that and you will clearly see the letter dated May 17, 2006. Amber *** Federal OSHA Oakland Area Office 510-6**-**** I have included the above-mentioned link for your convenience https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPRETATIONS&p_id=25506 Sincerely, Amanda RN, BSN
  2. For those of you that are working... I am a registered nurse on a very busy floor where I barely have time to get my legal breaks as it is. Recently our managers are saying that we are not allowed to have covered beverages at the nursing station (on my unit the nursing stations are covered by a tall counter in the halls and no patient access.) According to OSHA regulations: "OSHA does not have a general prohibition against the consumption of beverages at hospital nursing stations. However, OSHA's bloodborne pathogens standard prohibits the consumption of food and drink in areas in which work involving exposure or potential exposure to blood or other potentially infectious material takes place, or where the potential for contamination of work surfaces exists [29 CFR 1910.1030(d)(2)(ix)]. Also, under 29 CFR 1910.141(g)(2), employees shall not be allowed to consume food or beverages in any area exposed to a toxic material. While you state that beverages at the nursing station might have a lid or cover, the container may also become contaminated, resulting in unsuspected contamination of the hands. The employer must evaluate the workplace to determine in which locations food or beverages may potentially become contaminated and must prohibit employees from eating or drinking in those areas. An employer may determine that a particular nurse's station or other location is separated from work areas subject to contamination and therefore is so situated that it is not reasonable under the circumstances to anticipate that occupational exposure through the contamination of food and beverages or their containers is likely. The employer may allow employees to consume food and beverages in that area, although no OSHA standard specifically requires that an employer permit this. OSHA standards set minimum safety and health requirements and do not prohibit employers from adopting more stringent requirements." https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=INTERPRETATIONS&p_id=25506 With that being said, as you all know, with POTS it is crucial to drink water throughout the day, and esp for me as when i become hypotensive or feel like I am going to pass out I sit down at the station and drink my water.. So my question is, have any of you ran into this with your employers and what did you do about it? any suggestions? Is this a violation of ADA if I get a MD note requiring that I have access to water on my person at all times?
  3. scheduled to have my baby on tuesday :)

  4. what you are saying is totally me. i thought i was going crazy with my memory, forgetting things mid sentence!!!! i even got lost driving to a familiar location. it is scary, but it did get somewhat better for me, i would write my self notes, and set alarms and reminders on my phone. my specialist would get frustrated because at my appointments i would forget how i have felt over the last month, and what symptoms i had and so on, so i would write them down for him, then i would forget to bring the darn notebook to my appointments. lol, my short term memory is horrible. my long term memory is okay, as far as recalling things from the past to a certain extent.
  5. okay i couldnt help myself...so i just bought it on amazon. ill let you know what i think of it.
  6. very interesting! glad you are happy with him. keep us updated!! what is his tx plan with you besides the ocreotide.
  7. i think it might be possible if one is trained in this area, i.e. a nurse, md, medic. otherwise, no i do not recommended it do to many risks and things that could go wrong.
  8. i am really thankful for everyone on here and their willingness to listen :)

  9. thank you too all who posted. i am now 16weeks and doing great. i so far feel better now that before, maybe because i felt like i was on my death bed for so long day in and day out. now i am still on midodrine, no morning sickness. my hr has increased slightly, but not taking a beta blocker yet, my bp is still low, and my symptoms r/t pots such as dizziness, sob, and fatigue are increasing a bit, but i am not passing out yet (thank god). i seen my ep specialist and he says i am doing great, however, he is going to do another holter monitor in my third tri to see where my baseline hr is. he suspects i will need a betablocker, and warns me now that i will more than likely not be able to work in my third tri and might start passing out again, which he wants to prevent. i am open to any private messages as well if people have questions, or would like to share and exchange experiences, and appreciate the messages that i have received. it is so nice to have a place to come to and openly talk to people who understand what you are going through, so thank you for that!!!
  10. i found out i was pregnant nov 23, and am now soon to be 10 weeks on saturday. i am taking midodrine 10mg BID and tried to wean it to once a day, but was unsuccessful, hypotensive (70/40), vomiting, dizzy, etc. i just received a phone call from my ep at ucsf and he talked to the perinatologist up there and they said i can continue midodrine through my first trimester, but to switch me to florinef in my second, cause midodrine can cause growth retardation. here is the problem, i have been on flornief and was unable to tolerate it, sever headache, abd cramping, blurred vision etc, so i do not want to try this med again esp while pregnant. does anyone else have some advice or experience with this? has anyone taken midodine throughout their pregnancy? also i was taking pyridostigmine and was taken off by my ep when i found out i was pg, which made me sad and worried cause it was my miracle drug.
  11. yes going slow is key. it took many months to get to my dose. i feel that the mestinon has helped my nausea because it increases GI motility. i too have very low bp and even with the combo of these meds i cannot get my bp to over 90/60. normally i am in the 70-80/40-50. my norm before being diagnosed and having issues was 90/60, so yes the goal was to keep me from passing out, and to get me functioning by raising my bp. i am on high doses, but that is what has been working for my body, granted everyone is different. definitely start slow, and under your doctors discretion. one med a time is best just so you know if you can handle that med. i was first started on florinef, which i didnt tolerate, then started on midodrine, and then had the addition of mestinon. i also was started on a a very low dose beta blocker because my hr was so erratic, needless to say obviously i did not tolerate it at ALL, it nearly killed me i feel like. lol. anyhow, its a trial and error process unfortunately. best of luck to you!
  12. for me the side effects went away. just hang in there. i didnt think i could do it. but i did. your body will adjust to the meds. good luck!
  13. I currently take mestinon and midodrine combo. It has dramatically improved my ADL's and quality of life. I am back to work as a full time RN, and have hope again. I was originally started on midodrine 5mg BID, then increased to 5mg TID, then to 10mg TID, then 15mg BID and 10mg qpm. My doctor then added mestinon 60mg TID, and started to wean me off the midodrine, first to 15, 10, 10 then 10 TID which I currently take. He recently just weaned the mestinon to 60mg BID, and i am tolerating it well. sorry that was a mouth full. my current meds are wellbutrin xl 450mg qday, midodrine 10mg TID, and mestinon 60mg BID. When i first started mestinon, i'm not gonna lie, i was in the bathroom a lot. I had a lot of abdominal cramping and diarrhea. food went right through me. i too have the same symptoms as you, and when my bp would bottom out i would throw-up. the mestinon has tremendously helped with the nausea. hope this helps!!!! let me know if you have any questions.
  14. i believe my TRIGGER was the GARDASIL vaccine. my symptoms all began after my first vaccine.
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