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Medscape
40 minutes ago
- Medscape
5 Things You Need to Know When Treating Gout
Welcome to Rheum With a Viewpoint . My name is Dr Arinola Dada, and I've been practicing rheumatology for 20 years. Let's talk about five things you need to know when you're treating patients with gout. 1. Your patients have been taking anti-inflammatory medications when you were not looking. It's possible that your patients may have some kidney damage, so when they call you on Saturday night to report an acute attack of gout and your first instinct is to order indomethacin, take a pause and consider trying something else. My go-to medication is prednisone. 2. How much prednisone should you give your patient? The secret in the world of rheumatology is to go slow. You can start with 40 mg/d of prednisone for 4 days, then taper down to 30 mg/d for 4 days, then 20 mg/d for 4 days, and continue to reduce in that fashion. That secret sauce is going to help you treat your patient's acute gout. 3. When should you start allopurinol? You should not start allopurinol during an acute attack. Remember, allopurinol does not treat acute attacks. Allopurinol is there to help lower uric acid levels in the blood. It's useful for prevention and management, but you want to start allopurinol after an acute attack of gout has settled. If the patient is already on allopurinol, they can continue taking their medication without adjusting the dose. Simply treat the acute attack. 4. Women tend to get tophi in their fingers. You may want to look closely if you have a female patient with suspected gout. Patients report that this acute pain feels like somebody smashed their finger with a hammer. That kind of complaint would give you insight that your female patient may actually be experiencing gout in her DIP joints or inside her Heberden nodes. 5. Remember that when patients have tophi, they may not be able to feel it. Talk to your local radiologist to see if you can order a dual-energy CT (DECT) scan. It really helps differentiate between gout and pseudogout.
CBS News
40 minutes ago
- CBS News
RV fire in West Oakland near I-880 prompts large response
Firefighters in Oakland battled a large fire burning a recreational vehicle Monday afternoon just south of Interstate Highway 880, the Fire Department said. The fire was burning in the area of 3rd Street and Adeline Street in West Oakland, an industrial area dotted with homeless tents and RVs. The Fire Department said in a social media post that multiple engines and trucks were responding and that the fire was impinging on a commercial building. This is a breaking news update. More information to be added as available.
Health Line
an hour ago
- Health Line
Drained from Work? 9 Ways to Restore Your Work-Life Balance
Feeling tired from work is common and can be caused by many different factors. Fortunately, there are several steps you can take to reduce fatigue and maintain a healthy work-life balance. Work can wear you out, whether your job requires physical labor or not. There's more than one way to feel tired, and the daily demands of your job can leave you physically and emotionally weary, even if you spend your days behind a desk. Other stressors — such as relationship issues, financial worries, or health concerns — can intensify the strain. You may also find yourself stressed as a result of navigating the changes stemming from the recent pandemic, such as adjusting to hybrid work or a return to the office. Long story short, it's all too common to feel tired from working, especially during times of crisis and difficulty. You may not be able to quit your job altogether, but you don't have to watch your energy reserves slowly dwindle away, either. How to spot work fatigue There are several ways to recognize burnout. A few of the most common symptoms of work fatigue include: feeling depleted or exhausted having negative, pessimistic, or cynical feelings about your job finding it difficult to complete tasks or be productive feeling less confident about your work If you experience any of the symptoms listed above, it may be time to start identifying any factors that may contribute to your fatigue and consider making changes to your routine to maintain a healthy work-life balance. Identify changes you can make yourself If work has you feeling a little more exhausted than usual, a good first step might be to examine any habits potentially contributing to your fatigue. Maybe you feel too worn out after your shift to do anything except relax in your favorite chair with your phone. You regularly stay up late to give yourself more time to relax, but you find it hard to drift off when you finally make it to bed. Even though you want to get out for a hike, see your friends, and make time for meal planning and cooking, you just can't seem to find the energy. Small changes can be key to reducing fatigue and preventing burnout, including: eating a variety of balanced and nutritious meals getting enough sleep each night practicing stress-relieving techniques like yoga, meditation, or journaling Regular exercise can also make a difference, as backward as this might sound. If you aren't up for a full workout, no problem. Even a brisk walk around the block can help boost your energy levels and mood. Leave work at work You might feel more informed and prepared to deal with challenges when you leave work devices on throughout the evening and weekend or if you continue to check your email after clocking out for the day. When coworkers or customers know you can always be reached, however, it often becomes close to impossible to fully 'leave' work, especially when you're working from home. If you're always on the clock, you'll never find the time to recharge. If you're expected to handle work concerns outside of your scheduled hours, talk with your supervisor about setting some clear boundaries around times you aren't available. Perhaps your heavy workload often requires you to work late. Sometimes, this is just part of the territory. But consider whether you tend to volunteer for extra work to keep others happy or avoid guilt trips. If so, polite refusals when you're at capacity may serve you better in the future. It's also a good idea to discuss options for workplace support with your supervisor or human resources office. It's tough to be productive when you feel drained or burned out. When you show up rested and energized, on the other hand, everyone benefits. Ask for help When you have too many tasks to complete realistically without support, it never hurts to ask for help. You might worry that requesting support suggests weakness or incapability, but remember: Your employer likely wants you to do the best job possible. They can't support you in achieving that goal unless they know how you're really doing. Here are a few other tips: Talk with your supervisor: When you have too much work to complete alone, an informed supervisor can help by reassigning specific tasks or finding a co-worker who can assist you. Avoid taking on responsibilities you can't handle: Accepting extra work may seem like a good way to earn respect and positive regard, but this won't do you any favors if it leaves you exhausted and miserable. Stay present: It's important to make an effort to avoid letting your usual responsibilities slide and avoid checking out at work, even when you feel tired or bored. Knowing you did your best can promote a sense of accomplishment and leave you more motivated. Spend your free time on rewarding hobbies After a long workday, you might lack the energy for anything beyond a night of Netflix. Still, challenge yourself to do something different from time to time, particularly when you feel the most drained. Watching TV or playing video games might feel relaxing, and there's nothing at all wrong with catching up on a show or two. Yet more purposeful hobbies can often feel more rewarding and leave you with a sense of deeper satisfaction. To feel more rejuvenated by your time off, consider starting a garden, picking up a book, or doing one thing to improve your living area every day. Other possibilities might include: creative pursuits, such as art, music, writing, or crafts DIY or home improvement projects spending time outdoors academic study, such as learning a new language or taking a class Make a self-care plan Prioritizing physical and emotional needs is an important part of creating a balance between your work and personal life. Taking good care of yourself can improve resilience and strength, making it easier to manage challenges as they come up. When you feel physically and emotionally sound, it usually becomes easier to maintain a positive outlook and fend off the feelings of irritability, hopelessness, and pessimism that often accompany persistent exhaustion and stress. While getting enough sleep and eating well do have an impact, self-care goes beyond these basic needs. It might involve: a hot bath with relaxing music to unwind a quiet night at home instead of a big party with friends yoga, meditation, and other mindfulness practices regular contact with your closest friends Talk with loved ones Keeping stress to yourself can isolate you and make you feel worse. You might worry you're burdening others by talking about what's going on, but think about how you'd feel if a loved one were in your position. You'd probably want to help them however you could, right? Friends and family might not have the ability to directly relieve your fatigue. However, they can still offer support by listening and helping out in small ways, especially if you're vocal with them about what you need. Your roommate, for example, might motivate you to get up and make dinner by inviting you to help them out with a new recipe. Your mother might drop by with a bag of groceries when she knows you've had a long week. Simply knowing you have support from your loved ones can increase feelings of belonging and connection, making it easier to detach from work when the day is done. Feeling less tethered to your job can, in turn, help you relax and recharge more successfully. Break up the monotony Just as repetitive tasks can lead to yawning and zoning out, an easy but monotonous workday can leave you feeling drained and mentally numb. Changing up your typical routine can make a big difference. Some things to try: Switch the order of your daily tasks: Work on less challenging tasks in the morning when you feel freshest and less likely to zone out. Save more stimulating tasks for the afternoon to keep you out of a post-lunch stupor. Be mindful: Take a few minutes of each break for a quick meditation, walk, or breathing exercises. These can help you feel more refreshed than other break activities, like catching up on social media or scrolling through the latest news. Consider alternative workstations: You could use a standing desk or replace your chair with an exercise ball. If possible, vary your environment throughout the day by working outside or near a window on sunny afternoons. Talk with your supervisor about flexible scheduling: Some people find they work better at certain times of day and prefer an earlier or later start. Others prefer to work 4 longer days to take a 3-day weekend. Evaluate options for the future You've taken steps to address your tiredness, but workplace circumstances continue to drain you, and your employer has been less than supportive of efforts to create change. What next? It may be time to consider another job or career, one that allows you to maintain a healthy work-life balance. Without this essential balance, the situation will likely only get worse. You might find it hard to 'show up' mentally even when you're physically present, and you may take little pride in your work. Your emotional well-being and relationships with family and friends may also bear the burden of your exhaustion. Get professional help Sometimes, lingering tiredness is just a normal outcome of working, but exhaustion—physical or emotional—has other causes, including exhaustion. If you have other unexplained symptoms, including pain, changes in appetite, or stomach distress, it's a good idea to talk with your healthcare professional to rule out other concerns. A therapist can help you explore reasons behind tiredness accompanied by mental health symptoms, including: mood changes hopelessness thoughts of suicide If you're thinking of a career change, your therapist can offer career guidance and counseling as you make the switch. At the very least, they can direct you toward helpful resources.
