| How to Treat Broken Ribs Posted: 13 Aug 2016 05:00 PM PDT Broken or fractured ribs usually occur from a direct blow to the chest or torso, like in a car accident, significant fall or hard hit while playing a contact sport.[1] However, some diseases such as osteoporosis and bone cancer can severely weaken the ribs (and other bones) and cause them to break merely from coughing hard or routine twisting or lifting. Although broken ribs will generally heal on their own in one to two months if you are relatively healthy, knowing how to treat them at home will significantly reduce your discomfort. In some cases, fractured ribs puncture the lungs or damage other internal organs, which can be life-threatening and necessitates emergency medical treatment. EditConfirming Your Rib Injury - Visit the emergency room for treatment. If you've experienced trauma to your chest or torso that's causing significant pain, particularly during deep breathing, then you may have broken a rib or two. This can be associated with more severe injury as well, so it's important you get medical attention. Sometimes a "crack" is heard or felt when a rib breaks, but not always, especially if it occurs where the cartilaginous end-point of the rib attaches to the breast bone (sternum).
- It's important to seek medical treatment after a significant rib injury because if a rib fractures into sharp pieces (as opposed to a hairline crack), then the risk of injury to your lungs, liver, spleen is much greater.[2] The doctor will verify the type of rib fracture and make recommendations accordingly.
- Chest x-rays, CT scans, MRI and diagnostic ultrasound are tools that your doctor may use to better understand your rib injury.
- Your doctor will likely give you a prescription for strong painkillers or anti-inflammatories if your pain is severe, or recommend the use of over-the-counter varieties at home if your pain is tolerable.
- A potentially fatal complication related to a badly broken rib is a punctured or collapsed lung (pneumothorax). A broken rib can also lead to pneumonia.
- Talk to your doctor about a corticosteroid injection. If the broken rib is stable, but causing you moderate-to-severe discomfort, your doctor may suggest an injection of steroidal medication, especially if torn cartilage is involved. A corticosteroid injection near the injury can quickly reduce inflammation and pain, allow for easier breathing and increase upper body mobility.[3]
- Potential complications of corticosteroid injections include infection, bleeding, local muscle / tendon atrophy, nerve damage and weakened immunity.
- Another type of injection your doctor may administer is an intercostal nerve block. The medication numbs the surrounding nerves and stops the sensation of pain for about six hours.[4]
- The vast majority of people with broken ribs do not need surgery — they heal quite well on their own with conservative (non-invasive) care at home.
EditTreating Your Ribs at Home - Do not wrap your ribs. In the past, doctors would routinely use compression wraps to help splint and immobilize the area around broken ribs, but this practice has fallen out of favor due to the increased risks of lung infection or pneumonia. Do not attempt to wrap or bandage your ribs.[5]
- Put ice over the fractured rib. Apply an ice pack, frozen gel pack or bag of peas from the freezer onto your rib injury for about 20 minutes every hour you are awake for the first two days, then reduce it to 10 – 20 minutes three times daily as needed to reduce pain and swelling.[6] Ice causes blood vessels to constrict, which reduces inflammation, and it helps to numb the surrounding nerves. Cold therapy is appropriate for all forms of broken ribs and essentially any musculoskeletal injury.
- Wrap the ice pack in a thin cloth before applying to the injured area to reduce the risk of ice burn or frostbite.
- In addition to sharp pain with breathing, you're likely to also have moderate tenderness and swelling over the fracture site and possibly some bruising to the surrounding skin, which signifies some damaged internal blood vessels.[7]
- Take over-the-counter medications. Over-the-counter non-steroidal anti-inflammatories (NSAIDs) such as ibuprofen (Advil), naproxen (Aleve) or aspirin are short-term remedies to help combat the pain and inflammation related to your broken rib(s).[8] NSAIDs don't stimulate healing or speed up the rate of recovery necessarily, but they can provide comfort and allow you to do basic activities of daily living or even return to work after a few weeks if your profession is mainly sedentary. Keep in mind that NSAIDs can be hard on your internal organs (stomach, kidneys), so try not to use them on a daily basis for more than two weeks. Follow the package directions for proper dosage.
- Children younger than 18 years should never take aspirin because it's associated with Reye's syndrome.
- As an alternative, you can take over-the-counter painkillers such as acetaminophen (Tylenol), but they don't impact inflammation and are harder on the liver.
- Avoid movements with your torso. Some light exercise is a good idea for most musculoskeletal injuries because movement is needed to stimulate blood flow and healing. However, for the first few weeks, avoid cardio exercises that significantly increase your heart and breathing rates because that can irritate and inflame your broken rib. Furthermore, minimize the amount of rotation (twisting) and lateral flexion of your torso while your rib is healing.[9] Walking, driving and computer work should be fine, but avoid most strenuous household chores, jogging, lifting weights and playing sports until you can take a deep breath with very little or no pain.
- Take a week or two off work if you need to, especially if your job requires physical labor or lots of jarring movements.
- Ask your family and friends for help around the house and yard while you recover. Avoid lifting, and check with your doctor whether or not you should drive.
- You'll invariably need to cough or sneeze at some stage after you break your ribs, so consider holding a soft pillow against your chest to cushion the blow and minimize the pain.
- Adapt your sleeping position. Broken ribs are particularly problematic in the night during sleep, especially if you sleep on your stomach, sides or roll around frequently. Probably the best sleeping position for your broken rib(s) is on your back (supine) because it puts the least amount of pressure on them. In fact, it may help to sleep more upright in a comfortable reclining chair for the first few nights until some of the inflammation and pain subside.[10] You can also prop yourself up in bed with cushions behind your back and head.
- If you need to sleep in more of an upright position for a few nights or more, then don't neglect your low back. Placing a pillow underneath your flexed knees will take pressure off your lumbar spine and help to prevent low back pain.
- To prevent rolling onto your sides during the night, place a body pillow on either side of you for support.
- Eat well and take supplements. Broken bones need the necessary nutrients in appropriate amounts to heal properly, so eating a balanced diet rich in minerals and vitamins is a great strategy.[11] Focus on consuming fresh produce, whole grains, lean meats, dairy products and lots of purified water. Supplementing your diet with extra nutrients may also be helpful to accelerate the healing of your broken rib, so consider adding some calcium, magnesium, phosphorus, vitamin D and vitamin K.
- Rich mineral sources include cheese, yogurt, tofu, beans, broccoli, nuts and seeds, sardines, salmon.
- On the flip side, avoid consuming things that may hinder bone healing, such as alcohol, soda pop, fast food and refined sugars. Smoking also slows the healing time of broken bones and other musculoskeletal injuries.
- Getting enough calcium is important for maintaining strong bones. As prevention, aim for at least 1,200 mg daily from food and supplements.[12] For broken bones, you'll likely need more calcium per day.
- Contact a doctor immediately if you develop severe chest pain, fever, chills, shortness of breath, expansive bruising and/or cough up blood.[13]
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| How to Choose Stocks Posted: 13 Aug 2016 09:00 AM PDT So you've decided you want to invest in stocks. Where do you begin? More importantly, how do you choose the stocks to invest in? Choosing stocks can be frightening but as long as you have information and tools, you can confidently pick stocks. Get information from the companies themselves, the SEC or the Bureau of Labor Statistics. Or get information and tools from your stockbroker. Either way, you have several options for choosing stocks. EditUsing Macro Analysis - Understand how macro analysis works. Macro analysis has its basis in the large (Macro) tendencies observed in the economy. Your goal is to understand how major forces are affecting the performance of the economy. Then, base your investment decisions on your findings.
- For example, if the economy is performing poorly (inflation and unemployment are high while national output is low), avoid overpaying for stocks and be sure to diversify your stocks.[1]
- Gather data or access a graph. The most important macro indicators include: GDP (gross domestic product), CPI (consumer price indices), PPI (producer price indices), unemployment rate, interest rates (Fed Funds, prime rate, etc), inflation rate, and balance of trade. You can either download the historical data to Excel or access an interactive graph using online tools.[2]
- Observe and interpret the data. Look for the general direction that the numbers are moving in and any patterns that may emerge. Take into account: the historical data you found, current data, and news. The website will have a separate series of data already converted to percent for either Year over Year or Quarter over Quarter.
- If not, you can determine the percentage of change for an indicator. For example, divide the nominal GDP (in numbers) of one year by the value from the previous year. This gives you the GDP growth percentage for Year over Year.
- Pick your stocks. Investing in a broad based stock or stock alternative might be the most convenient with this method of analysis. Select a group of stocks that reflect the movement of the broader economy and track an index like the Dow Jones Industrial average or S&P 500.[5] This approach allows you to enjoy the growth of stocks in the US in general without risking all your money on one or just a few stocks.
- Understand that macro analysis doesn't specifically help you decide which individual stocks to buy. Instead, it simply lets you understand the performance of the economy. For example, you may want to buy stocks when you think the economy will improve and sell when you think it will deteriorate.
EditUsing Fundamental Analysis - Decide if Fundamental Analysis is best for you. To use fundamental analysis, you need to determine what you think the stock is really worth, or its estimated value. This won't necessarily be what the stock is currently being traded at. If you decide the value is higher than the current stock price, buy. If you think the value is less than the stock price, sell.[6]
- Don't expect clear results. The value is subjective and other investors often come to different conclusions.
- Look at the variables. To determine the current and future value of a company, here are a few variables to look into:[7]
- P/E (price to earnings ratio) - a negative ratio may suggest that the company isn't profitable
- EBIDTA (Earnings before interest depreciation, tax and amortization) - this is a form of net income with much of the accounting already taken into consideration
- free cash flow - this represents money that the company has to pursue opportunities that may increase their stock's value
- debt ratio - this is a percentage of the company's total debts to assets
- Gather the data from the Securities and Exchange Commission (SEC). You can find the information in the company's SEC filings or earnings reports. Order a company report by contacting the Investor Relations area of the company. Their contact information will be available on their website, which may even offer a link to download the reports.
- You can also use the EDGAR (Electronic Data Gathering Analysis and Retrieving) system of the SEC to view or download this information.
- Search for information. Full-service brokers, research firms, and the internet are full of free and for-purchase reports.
- Note that many online brokers limit public information available.
- Pick your stocks. Once you have all the information you need, make a decision about the value of the company you're considering. Use the data to determine the value of the company. Then, buy stocks based on future projections of earnings or good news about the company.
- You can try using relative value to compare similar assets of different companies. When doing so, try to stay within the same sector when choosing companies to compare. For example, you may want to compare Apple, IBM, Lenovo and Hewlett Packard - Compaq.
EditConsidering Technical Analysis - Decide if Technical Analysis works for you. Unlike fundamental analysis, technical analysis, or charting, doesn't focus on estimated value. Instead, it charts the price movements in the stock market. This way, short-term trends emerge and you can use them to make subjective decisions about the future value of a stock.[8]
- Most technicians are traders, not investors, so long term trends are not useful for their investing decisions. Price movements are used to determine short-term investor psychology since prices move on rumors, misinformation, and unexpected news.
- Check out online tools and charts. One place where you can educate yourself is at Stockcharts.com.[9] They have simple, free, comprehensive and in-depth materials available online to understand Technical Analysis.
- Investopedia has an interesting article which can help you to investigate what software packages are available and what best suits your needs.[10]
- Use a stockbroker. Many brokers offer some guidance and tools on their sites. If you are interested in technical analysis you will want to investigate what each broker offers. Visit their websites and talk to them to find out what tools they offer.
- Full-service brokers offers a variety of advice, tools, and information to investors. They will charge more for their services than discount or online brokers. Online brokers vary considerably in the services offered, customer service, and commission fees. Know what you're looking for in a broker and research the broker's background before selecting one.[11]
- Pick stocks. Use the information you've gathered and the advice from your stockbroker to choose stocks. Understand that the data can be contradictory and confusing.
- Refer to Benjamin Graham and David Dodd's book, "Security Analysis" for more information on fundamental analysis. Read Robert Edwards and John Magee's book, "Technical Analysis of Stock Trends," for a good overview on choosing stocks.
- Warren Buffet and friends would get together every couple of years and ask each other the following question: "If you were marooned on a deserted island, and you could somehow invest all your money in one stock for ten years while you awaited rescue, what stock would it be?" Buffet says this scenario helps them to focus on long-term stock purchases rather than short gains and quick exits.
- Do not buy a stock without seriously thinking about it first. Imagine buying a stock, only to see it fall 10% the next day. Would you think you had made a mistake, or would you still believe in the stock? Assuming you still believed in it, the drop in value would simply mean you now had the chance to buy more of it at a better price. Don't buy a stock in the first place unless you have that kind of confidence in it.
- Do not buy stocks on impulse. Buy only after in-depth research.
- Don't sell when a stock falls unless you're sure it's only going to drop further. Panic selling is a common pitfall in the markets and a major reason some investors lose money.
- Don't place overnight orders. The stock might rise and open higher and you'll spend more money than you intended to.
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| How to Clean Your Teeth After Wisdom Teeth Removal Posted: 13 Aug 2016 01:00 AM PDT Having your wisdom teeth removed by a dentist or oral surgeon requires thorough post-operative care to ensure a full and speedy recovery. If you don't clean your teeth and mouth properly, you could end up with an infection or painful inflammation known as "dry socket" (alveolar osteitis).[1] Dry socket occurs in about 20% of lower wisdom teeth extractions, so you will want to make sure you take extra precautions after your surgery. You'll need to care for your mouth for at least a week after your wisdom teeth removal using a few simple processes that don't require much time or effort. EditCleaning Your Teeth - Change gauze as instructed by your doctor. After your surgery, your doctor will pack your mouth with gauze over the surgery site. You can generally replace these after an hour or so, if you need to. If you continue to bleed, change your gauze packs every 30-45 minutes and apply gentle pressure.[2] You should not bleed for more than a few hours after surgery. If the bleeding continues for much longer than that, contact your doctor or dental surgeon.[3]
- It's normal to see a little blood oozing from the site for 24-48 hours after surgery. This oozing should be mostly saliva with just a few traces of blood. If you see significantly more than that, this is excessive bleeding and you should call your doctor.[4]
- Avoid brushing your teeth for the first day after surgery. Do not brush your teeth, spit, or rinse with a mouthwash for the first day after surgery. This can disrupt the healing process and lead to conditions such as dry socket or infection.[5]
- The first 24 hours after surgery are very important for the healing process. Brushing your teeth or other cleaning measures may disturb the stitches or interfere with blood clotting, which can prolong healing or cause infection.[6]
- Avoid brushing the surgical site for 3 days. Avoid brushing the area where you had your wisdom teeth removed for three days after surgery. Instead, you can rinse out your mouth with ½ cup warm water and a pinch of salt beginning the day after your surgery.[7]
- Do not spit the saline rinse out. Instead, gently tilt your head from side to side to allow the water to wash the area, and then tilt your head to the side to allow it to drain.
- Brush your other teeth very slowly and carefully. On the day of your surgery, resume brushing your teeth very gently. Be sure to avoid the surgery site so that you don't irritate it or disrupt the blood clots that protect the surgery site.[8]
- Use a soft-bristled toothbrush and gently and slowly brush your teeth using small circular motions.[9]
- Do not spit out toothpaste for the first few days after your surgery. Spitting could disturb the blood clot that needs to form over the wounded gums. Instead, use a saltwater rinse or antiseptic mouthwash to gently rinse your mouth, and then allow the rinse to drain by tilting your head to the side.
- Resume your usual brushing and flossing routine the third day after surgery. Once you've reached the third day post-op, you can resume your regular brushing and flossing routine. Continue to be gentle with the site of your surgery so that you don't irritate it.[10]
- When brushing your teeth, remember to also brush your tongue in order to remove food particles and bacteria, which could enter the wounded gums and cause an infection.
- Watch for infection. If you follow your doctor's order and keep your mouth and teeth clean, this will minimize the risk of infection. It's important to look for the signs of infection, though, and contact your doctor if you see any of them to avoid post-operative complications.
- See your doctor immediately if you experience problems swallowing or breathing, have a fever, see pus near the surgery site or in your nose, or have swelling that worsens.[11]
EditCleaning Your Mouth - Rinse your mouth with salt water. The day following your surgery, start using a simple solution of salt water to help keep your teeth and mouth clean in between brushing. This will not only help keep your mouth clean, but also help reduce inflammation.[12]
- Make a salt solution by dissolving 1/2 teaspoon of salt in an 8 oz glass of warm water.
- Gently swish around a mouthful of the saline solution for 30 seconds. Don't spit it out: tilt your head to the side and allow the water to drain. This will avoid disturbing the empty tooth socket.
- Rinse with the salt water after every meal to help clear out debris in your mouth.[13]
- You can also use a mouthwash to rinse your mouth if it doesn't contain alcohol, which can irritate your surgery site.
- Use an irrigator to rinse your mouth. Your doctor may provide you with an irrigator, or a small plastic syringe, to rinse out your mouth. Use this after meals and at bedtime if your doctor advises this treatment.[14]
- Your doctor may prescribe the irrigator only on the lower extraction sites. Make sure to follow his or her instructions.
- You can use the simple saline solution to fill the irrigator.
- Make sure to get the tip of the irrigator close to the surgery site flush it out. You can also use it to flush out your teeth. This may be slightly painful, but keeping your mouth and the surgery area clean will help reduce the chance of infection or dry socket.[15]
- Do not use a waterpik or water flosser. The water pressure from these tools is too great to use immediately after surgery and could disturb your tooth socket, delaying healing. Unless your dentist specifically recommends otherwise, don't use a waterpik or water flosser for one week after having your wisdom teeth removed.[16]
EditCaring for Your Mouth after Wisdom Teeth Removal - Do not use a straw. For the first few days after surgery, don't use a straw to sip beverages or foods like smoothies. The suction could disturb the healing process.[17]
- Drink plenty of water. It's important to make sure that you drink plenty of water after your surgery. This will keep mouth moist and help avoid dry socket and infection.[18]
- Avoid caffeinated and carbonated beverages during the first day.[19]
- Avoid alcohol for at least a week after surgery.[20]
- Avoid hot drinks. Hot drinks such as tea, coffee, or cocoa could dislodge the blood clots forming in the empty socket where your wisdom tooth was. These blood clots are necessary to the healing process.[21]
- Eat soft or liquid food. Don't eat anything that could get caught in the empty sockets or disrupt clotting. Use your other teeth to chew, if you have to chew your food.[22] This will minimize the amount of food that can get stuck in between your teeth and potentially cause infection.[23]
- In the first day post-op, eat foods like yogurt and applesauce, which won't irritate your mouth or get lodged in your teeth, which could cause infection. Soft oatmeal or cream of wheat are other good options.[24]
- Avoid, hard, chewy, brittle, very hot or spicy foods that might irritate the surgery site or get lodged in your teeth, making the conditions ripe for infection.[25]
- Rinse with warm salt water after every meal for the first week following surgery.[26]
- Avoid tobacco. If you smoke or chew tobacco, avoid them for as long as possible. Doing this will help ensure a full and timely recovery and also keep infection and inflammation at bay.[27]
- Consuming tobacco following oral surgery can delay healing and also increases your risk for complications such as infection.[28]
- If you smoke, wait at least 72 hours to have a cigarette.[29]
- If you chew tobacco, don't use it for at least a week.[30]
- Take pain medication. It's normal to have pain for a few days following the removal of your wisdom teeth. Use either over the counter pain relievers or a prescription pain medication to help alleviate pain and some swelling.
- Take NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen or naproxen. These will help alleviate some of the swelling associated with the surgery. You can also use acetaminophen, but this does not manage inflammation.
- Your doctor may prescribe a pain medication if over the counter pain relief doesn't work for you.[31]
- Use an ice pack for swelling and pain. You'll likely have some swelling for a few days after surgery. This is normal and applying an ice pack to your cheeks will help reduce swelling and pain, including around your teeth.[32]
- The swelling usually goes away after 2-3 days.[33]
- Patient should relax and avoid strenuous activity or exercise until swelling resolves.
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