Northwest Arkansas Photos and Videos

After much encouragement from my wife I recently decided to post some of my photos online through a local tv station. Please visit http://ulocal.4029tv.com/sam_mcmillan and make comment to my photos.

Get $25 from my online investing broker

I really like investing with ShareBuilder because they make it easy and affordable for everybody. There.s no account minimum and no inactivity fees. Plus you get $25 when you start investing (and I'll get some investing credits). Visit http://www.sharebuilderfriends.com/url/redirect?l=-21648190940983535621&i=34c6be1d7547dfcc934687647abf382b

First-time home buyer tax credit extension approved

First-time home buyer tax credit extension approved

Posted using ShareThis

Principles of Wisdom

When a culture can measure its history in millennia rather than in centuries, there are sure to be very strong traditions which underlie the stability of the culture and act as binding forces to keep the minds and hearts of the people together. When traditions produce excellence over countless generations, a great deal of confidence develops in the people who are a part of that culture. This is because the traditions continually benefit the people who are part of that culture. When something is seen to bring harm to a culture, it is identified and rejected. Obviously, when a culture has survived and flourished for thousands of years, it arrives at many points of wisdom which it would not sacrifice at any cost. There are traditional principles for ruling, farming, healing, raising families, and resolving disputes. Although these traditions constantly undergo examination and evolution, the underlying principles rarely change. When a set of underlying principles is kept intact despite the evolution of a tradition, it is because they have been recognized to contain wisdom. Ancient traditions preserve essential principles which enable a culture to evolve along pathways that are marked and shepherded by principles of wisdom.

While America is a very young country compared to say China, I believe our past culture is being threatened by Obama's new Progressive Movement. This movement is a threat to our founding fathers original design for America. I am not comfortable with this new Progressive Movement because it threatens the traditions of America's Foundation.

BE THE BEST YOU CAN BE – STAND TALL ABOVE THE REST

Degree(s). The type of degree or number of degrees a professional has attained indicates their exposure to academic education, their ability to assimilate that body of knowledge and their ability to perform successfully in an academic or research setting. A degree in respiratory therapy is not by itself a good indicator of professional skill, competence or compassion.

License(s). Having a license is the first indicator that a professional has demonstrated competence to practice. The fact that a person has a license does not mean the professional is truly competent. It does mean they met the required educational and training requirements, passed a licensing examination, have met the necessary supervision requirement for licensure, and that they are meeting the required continuing education requirements.

Affiliation(s). Affiliations reflect what organizations or institutes a professional has joined or
is involved with. Affiliations alone are not good indictors of professional competence, but can
help you to identify those professionals who support and participate in activities that demonstrate their professional interests.

Background & Experience. Knowing where a professional has worked, their background and their experience can help you understand their skills and what talents they bring as a practitioner. In general, the more rich a professional's background the greater will be his or her ability to recognize a range of problems and potential solutions. Dealing with complex problems, especially crises and emergencies, usually requires the involvement of professionals with credible experience in these areas.

A true Practitioner continues to be involved in their profession outside of their normal working hours. They are committed to their profession. They are continually striving to gain more knowledge and keeping up with current trends. They are actively involved in their professional organization.

A respiratory therapist who is licensed as a practitioner but lacks motivation to advance is like a stagnating pool of water. Only doing what is minimally required to keep their license active is not acceptable in today’s world of ever changing health care.

BE THE BEST YOU CAN BE – STAND TALL ABOVE THE REST

The Difference Between CPAP & BiPAP

It should be noted that there's disagreement among the literature as to whether CPAP is a form of NPPV. CPAP provides oxygenation but not ventilation, which is the actual movement of air into the lungs. CPAP augments ventilation, which should qualify it as a form of NPPV.

CPAP is a continuous pressure provided above ambient pressure, which helps prevent alveoli from collapsing and augments ventilation. This pressure remains relatively constant through each phase of the respiratory cycle, varying only slightly as the patient breathes.

Because the pressure is the same throughout all phases of the respiratory cycle, the patient must overcome the pressure during expiration.

NOTE: CPAP is limited by the patient's ability to breathe and would be ineffective in those who can't generate a strong enough tidal breath on their own.

BiPAP also provides CPAP, but it also detects the patient's inspiratory effort and delivers greater pressure during inspiration (see Figure 2). This is similar to squeezing the bag while assisting a patient with breathing. At the end of the inspiratory phase, the pressure drops back to the preset level of CPAP.

The term “BiPAP” is actually the trade name for the biphasic positive airway pressure device developed and sold by Respironics. Today, however, it's commonly used to describe biphasic positive airway pressure. Other names include bilevel (or biphasic) airway pressure, bilevel (or biphasic) positive pressure, bilevel (or biphasic) CPAP, bilevel (or biphasic) pressure support, among others.

CPAP machines are generally capable of delivering only CPAP, whereas BiPAP machines can deliver either CPAP or BiPAP. Respiratory care practitioners and emergency physicians report that BiPAP provides a greater level of control than CPAP. So it's not uncommon for a patient to be removed from the prehospital CPAP device and placed on a device capable of BiPAP. Usually the patient is kept on CPAP until blood gases are obtained. Once blood gas measurements are evaluated, BiPAP is initiated at settings that will provide the best gas exchange and optimum cardiopulmonary performance.

A 1997 study suggests that BiPAP improves ventilation and vital signs more quickly than CPAP. So in systems where transport times are long (e.g., rural areas), it may be beneficial for patients to be placed on BiPAP rather than CPAP. Improvements in ventilation and vital signs would occur sooner and can be maintained for the duration of the transport. However, the study also revealed an increase in the incidence of myocardial infarction in those patients placed on BiPAP. Thus, it's necessary for the provider to reassess the patient frequently.

Benefits & Drawbacks

BiPAP and CPAP are beneficial because they decrease the need for endotracheal intubation, thereby lessening the complications associated with intubation. These include pneumonia, upper-airway injury and prolonged ICU and hospital stays. Additionally, although the use of NPPV is recommended for relaxed, non-combative patients, the use of these forms of NPPV doesn't generally require sedation.

Complications of BiPAP and CPAP are typically minor and include injury to tissues where the mask makes contact with the face. This risk is especially true for older patients who typically have thinner skin.

Other complications include gastric distention, aspiration pneumonia, hypotension and pneumothorax. For these reasons, NPPV shouldn't be used on patients who have undergone recent facial surgery, have excessive secretions, are experiencing gastrointestinal bleeding or don't have the ability to protect their own airways.

When treating patients in the Emergency Department it is better to institute BiPAP because patients are generally more likely to need ventilatory assistance.

Please Don't Intervene In Saving My Life - Let Me Die Naturally.

As I draw nearer to the end of life on this old earth it is with regret I find myself having to explain why I want No-Intervention in regards to saving my life.

I have been in the health care arena for more than 45 years. I have seen hundreds upon thousands of people both blessed and cursed by our medical system. Times were much simpler in the 1950's when my father passed away. He simply died in his sleep most likely of a massive myocardia infaract. There was no CPR, no rushing him to the Emergency Room, and no Cardiac Surgeons.

When I was 10 and throwing a neighborhood paper route, one of my customers asked me to check on her husband. He had been in the bathroom and had slipped from the toilet onto the floor. She asked that I help him up. When I entered the bathroom it was immediately apparent he was dead. I left him on the floor and told her, it appeared he was dead.

When my mother was in her early 80's my brother Frank called all the brothers and asked if we wanted mother on life support. I told him Mother had a good life and if it were time for her to pass - please let it happen naturally.

And now as I near the end of my life please let it be naturally. Do Not placed me on a ventilator to sustain my life. Do Not let a knife near my chest to make my heart last a few years longer. Do Not poke needles into vital organs to obtain tissue samples for biopsies. If I have a life-threatning disease like cancer please don't radiate me and don't cut on me. Just keep me pain free and please Do Not place me on oxygen which only would prolong my pain and suffering.

You might think I am crazy for wanting a natural death but think of it this way. To this point in time I have lived a 5 dozen plus years. I have loved each and every second of my life and if there comes a time that I cannot continue to enjoy each and every second of life I don't want to live. It is just that simple.

Quality of Life is very important to me and there is NO DOCTOR that can guarantee Quality of Life after cardiac surgery. And NO DOCTOR that can guarantee Qualtiy of Life after poking my prostate and stirring up a potential cancer. There is NO DOCTOR that can put back together my stomach or any other part of my body like GOD intended it to be the first time.

Having Open Heart Surgery at 65, 70, 75 or 80 years of age is NOT what I want to do. The most I can expect is 6 months of hell recovering, a huge medical bill that I can not afford and if I'm really lucky perhaps another 1-15 years of living in pain and most likely on medications I don't want to take. Do you see my point?

Now don't get me wrong. Life is Precious! But Life is Not Precious if I'm in pain everyday to the point where I can not enjoy all that life has to offer.

Please Don't Intervene In Saving My Life - Let Me Die Naturally.