Practical Pointers: Dreaming, Heartbeats, Lactation Practices, and Ester Allergies

Perchance to Dream Tossing and turning because of unfamiliar bedding in a strange environment can affect the validity of sleep study results. One way to reduce this effect is to have patients use their own pillows and blankets. — Michael G. Pierik, MD  Wakefield, RI Keeping Abreast of Best Lactation Practices To foster equal stimulation and drainage of both breasts, advise lactating mothers to alternate the breast they begin nursing with at each feeding. To keep track of which breast to begin with, tell them to fasten a safety pin to one side of their nursing bra and move the pin to the opposite side after each feeding. Also remind them to nurse the infant at both breasts each time they breast-feed. — Sheryl Stone Clay, RN, BSN Mason, Ohio A Heartbeat Away I tell my cardiac patients that they need not just 1 prescription of nitroglycerin, but 2 or 3. I suggest they keep one bottle at home, one at work, and one in their purse or gym bag. In addition, I advise patients to tell their racquetball or tennis partner where the nitroglycerin is in case they lose consciousness and need to have it put under their tongue. — Richard A. Honaker, MD Carrollton, Tex Allergic to Ester? Some patients are allergic to estertype anesthetics, such as procaine. In addition to substituting an amidetype anesthetic (such as lidocaine) in such patients, avoid using a multidose vial of any anesthetic; these all contain a paraben preservative that is clinically similar to ester-type local anesthetics. Single-dose vials do not contain preservatives. — Bruce Becker, MD Bloomsburg, Pa