Aseel Qasem

I could be anyone..

Well its multiple personality disorder day… 

If you are reading this and expecting medical information then you’re mistaking. 

This time there are no medical terms, no diagnosis, no medications, and no teaching. 

This time I am going to take you on a trip. So fasten your seatbelt… 

Imagine your self walking down the street normally and about to enter a resturant to meet friends for lunch. Just before entering the resturant, a fight breaks out between some random people out side the resturant. Any normal person would either just avoid the fight go inside the resturant or like most of stand and watch the flight and take a video. Well, that is what you and I might likely do. But, a person with multiple personality disorder would get so scared that they change into a whole different person. When I say a different person I really do mean a totally different person. One minute you are a nurse and the next you are a professional karate instructor.The change in personality is so extreme that it could  be unbelievable to us. So, when the change of personality occurs, you block out the previous personality. 

So, lets imagine the First personalty to be a 25 year old you lady and she is a nurse. The fight she saw gave her a fright that in turn triggered a personalty change. From a nurse to professional karatee instructor. Now we go back to the fight next to the resturant. I guess our karate instructor is not very self- disciplined, because she joined the fight. 

Of course in any fight someone is going to  call the police. Police comes, they break the fight, ask qurstions, arrest people. Normal police work. But, to the surprise to the police, they find out that they arrest a kid! Yes yes a kid… 

well our nurse that changed to a karate instructor turned to a kid. Well, she did not shrink in size and changed into a kid literally, we are not not talking about shape shifters her, only personalty changers. 

Fear changed the nurse to a karate instructor, and just seeing the poilce changed the karate instructor into a kid. The police find their selves dealing with a kid. A kid, a little boy 5 years in the body of a 25 year old woman. The kid just cries and cries asking for his patents. Most police men will not know what to do in cases like this, they arrest someone from a fight, by the time they get to the station they’re dealing with a kid. So, the police either call they mental hospital, a psychiatrist, or just call any number they find with the kid.

For case of the story, let say the police turned the kid to the mental hospital. Of course, they found an ID on our character. In the mental hospital, after checking the name with the records, turns out our person here is a regular patient. 

A couple of hours after being in the hospital, again comes a personality change. The real main person comes out. A 35 year old woman, and shes a cheif! When she goes back to her real personality, she is so depressed. The depression is mainly because she knows that she blocked out turned to another person with amanother life, except she doesn’t remember what happened, what she did or where she was. 

So here our main personality is the chief which is usually called a host. The term host is used because of course the person hosts the other personalities. 

In this case the host is the 35 year old chief, the protector is the karatee instructor, the nurse is the down to earth person the loving and caring, and a kid. 

So.. this is how a person with multiple personality would spend a day. Scary right. And do not forget some people have up to 10 personalities maybe more. Some have learned to control their personalities, and they know what triggers and alters their personality change. 
Well at the end.. I hope  I did not lose you with the jumping from one personality to another. This is just reading imagine living like this. .

“Fueling Life”

– what is tube feeding? 

A feeding tube is a medical tool used to assist patients that can not consume their complete nutrients orally.  There are serveral types of feeding tubes, each with it’s own special specifications and indications. It all depends on the patient’s needs and conditions.

When we talk about patients/people that require feeding tubes, what comes to minds usually are those patients that are at the last stages of their lives. But, thats is completely wrong. Feeding tubes can be used for new born babies (immature) all the way to the bedridden 100 years old folks. The duration of which these tubes are kept in the body, are either short term or long term, again all depending on the condition of the patient.
Some conditions are:

  • Disease or illness .
  • Sever pain or difficulty during swallowing .
  • Severe food allergies.
  • Physical disability.
  • Strokes.
  • Brain injuries.
  • Cancer.

Types of feeding tubes:

  1. Nasogastric tube:  it is a tube that is inserted into the nose down to the thraot and into the stomach. Can be used for feeding, medications, and also to empty the stomach. Of course the placement of the tube should be checked before each feeding.
  2. Nasoduodenal tube: which is similar to the nasogastric tube, except it goes all the way through to the first part of the small intestines, the duodenum. It is usually used when the patient is at risk for aspiration.
  3. Nasojejunal tube: again similar to the two previous tubes, except this one goes further into the small intestine; the jejunum. Usually used for patients that have chronic vomiting, or patients that aspirate food contents into the lungs.
  4. Gastrostomy tube: this tube requires surgical intervention for insertion. A hole called a stoma is made into the stomach. Into the stoma a tube is inserted with a ball that fills with water for securing placement.
  5. Jejunostomy: also requires a surgical procedure, the stoma is all the way to the jejunum.

How to give the feed: 

In most cases patients with these tubes are hospitalized. In that case, there should be any worries.As the patient is surrounded by medical personnel that are solely responsible for ensuring the placement, and the functional status ofbthe tubes. And the correct feed and feeding method. And also the right way to feed. The feed could be continuous on a feeding pump, or every certain amount of hours that could be programmed on the feeding pump. Also, can be given as a bolus push. The classification and brand of feed is determined by the dietitian.

In the case of the patient uses one these feeding tubes at home, education is the most important part. And this is where the nurse plays an important part in educating the patient or the care giver. Before starting starting to educate the patient and the family and even before the insertion of the tubes, the patient must understand what’s happening. It is very important that the patient him self knows about the procedure and the purpose of it. The patient and family have to accept the change of life style that they will encounter.

What are some important health education that the patient needs to know? 

  1. The patient/family needs to know the importance of feeding and nutrition it self, and the consequences of deprivation of food and nutrients.
  2. Takeing care of the tube and handling it. Of course the education will be given according to the tube inserted.
  3. Keeping the tube and area clean all the time.
  4. Washing hands before and after handing.
  5. Knowing how to keep the tube secured, and what to do if the tube is dislodged .
  6. Learning about the feed being used and the proper way to administer it( feed pump, syringe pump, bolus)
  7. Knowing how to administer medicine through them
  8. If a feeding pump is used, the patient/family must know how to operate it.
  9. To report any kind of pain, or discharge like pus or even leakage from the site.

Bon AppĂ©tit! 

*, N. (2013, November 1). Types of feeding tubes and terms to know by the feeding tube awareness foundation. Retrieved February 8, 2017, from
Retrieved February 8, 2017, from

A Sneak Peek about Leprosy

      Leprosy is a chrinic bacterial infection that is progressive if left untreated. Leprosy affects the skin mainly, stating with uneven flat leasions. The disease also affects the peripheral nerves in the hands and feet.Even the mucus membranes are affected, which are the small opened areas in the body like the eyes, nose, and throat. The diease can spread from one person to another my droplets ( coughing, sneezing). It may affect anyone there is no age limit nor a specific population. 

     Leprosy starts off with small lesions on the skin. The lesions become numb because of the loss of sensation in them, due to the distruction of nerve endings. Mutations occur to the fingers and toes because of the loss of sensation , that my cause them to fall off. 

   A person with Leprosy disease, can be recognized by their appearances sometimes. As the disease causes very obvious deformities. Some of the signs and symptoms that can be easily noted are the skin lesions previously mentioned. Lesions have uneven edges, spreads all over the body, and the color is faded and lighter than the normal skin. The areas with these lesions will have loss of sensations and numbness. There will be extra growth of skin, that protrudes out. The protrusions of skin is dry, thick, and stiff. Patients may experience severe pain and muscle weakness, or ever paralysis. Blindness could also be cause by leprosy. Other signs and symptoms are nosebleeds, stuffy nose, feet ulcers. 

    Leprosy can be diagnosed by a skin smear. The disease can be cured and treated if medications are started fast. The treatment of leprosy consist of three antibiotics that are prescribed together. The duration of the treatment may last up to 12 months. Fortunately, the WHO took a great step to reduce the spread of the disease, and made the treatment available for everyone everywhere. 

Some nursing considerations for leprosy :

  1. Care of skin integrity.
  2. Management of pain.
  3. Self care deficit.
  4. Importance of personal hygiene.
  5. Impaired self-esteem
  6. Disturbed sleep patern.

References :

Leprosy. An update: definition, phathogeniss,classification, diagnosis, treatmeant | Actas Dermo sifiliogoráficas (English edition)

International Federation of antileprosy associations,2001, How to Diagnose and treat leprosy
NADA: nursing care plan for diseases of integumentry

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