Hi friends, welcome back to my channel and a special welcome if you're new here. My name is Jen, I'm a certified weight loss and nutrition coach and I'm on the WW personal points plan. Happy Wednesday, it is Wednesday, so it is what I eat in a day. I'm going to be sharing with you all of my delicious, healthy food for the day, a delicious dinner recipe, the dogs, just a really fun day today. You're going to come along with me every step of the way.  Subscribe if you're not, I would love to have you here and don't forget to click the bell right next to it because I do upload five days a week and you never want to miss a single video. Check out that description box down below for nutrition coaching. I do offer personalized macros and calories as well as one-on-one coaching if you would like to chat with me directly. Links and discounts to my favorite things and don't forget, come on over, join our community on Facebook. We are 20,000 member strong and growing. So let's jump in to what I eat in a day. Don't you look at that, I said, my friend, what you looking at? So here's my breakfast for this morning. I made these in my meal prep last week. These cottage cheese bowls are amazing. Whenever I'm feeling like I want some extra protein, healthy fats, just a really good way to start my day, I've been making these. They keep me extremely full, definitely can make it till morning snack and sometimes even lunch. So this is three quarters of a cup of low-fat cottage cheese, a tablespoon of sliced almonds and walnuts, some berries, and a little bit of cinnamon. This recipe is on my website, so I'll make sure that is linked down below for you. But this is my breakfast for this morning. So as part of my 2022 goals, I shared with you guys in my goals video. If you haven't seen that, I'll link that down below. I go over my 2022 goals, we recap my 2021 goals. I let you guys know whether or not I reached them. Part of my 2022 goals is to get in more movement. You guys know I love Jazzercise. I go three times a week. I want to go more days a week. It just doesn't always work into my schedule. So I wanted to get something for at-home workout use. I wanted something that would keep my interest, keep it peak so that I would want to continue to use the equipment, something that doesn't take up a lot of space and something that's just kind of new and fun. So I decided on a weighted hula hoop. Now I know that these are all the rage right now. They're actually part of a lot of workout classes in gyms. They're really good for your waistline and just overall toning your body and strengthening your core. So I went ahead and picked up the Enno Genes Smart weighted hula hoop. This hoop has 24 detachable knots so that you can customize the size of the hoop to fit around your waist. It not only burns fat, but it also massages your waist to relax you and give you kind of a comfortable experience when you're using the weighted hula hoop. They say if you use the weighted hula hoop 30 minutes a day for five days, you can burn 800 calories. That's quite a hefty calorie burn using a weighted hula hoop. It's super easy to use. The smart fitness hoop will not fall. Even beginners can use it. The smart exercise hoop is the easiest and most interesting way to exercise.  It's suitable for aerobics and dancing. It helps you lose weight. It regulates your gut and it's relaxing. It's comfortable to use. Men, women, children, anyone who needs to lose weight or tone up their body and strengthen their core, the weighted hula hoop definitely is a huge game changer for that. The smallest that the hoop can go is 13 of the little knots and that is for someone who's slim or for children with a waist of 26 inches or less. Then the middle of the road is 17 knots. This is for the average woman who has a waist of 33 inches or less. It has 24 knots max which is suitable for someone who has a little bit of extra weight on their body like myself and this goes up to a waist that is 47 inches. It's super, super easy to put together. It took me literally five minutes to put in the right amount of knots for me and it was super fun to use. Now I'm not the best hula hooper but I'm hoping that I will get better as time goes on and as I continue to use the weighted hula hoop. Really, really cool. Just a fun little fitness thing to have at home. I wanted to share it with you guys if you were in the market for a fun piece of at home equipment that literally is so easy, doesn't take up a lot of space and really is a lot of fun. You can buy this one right off of Amazon. It's less than $30. In fact, it's $28.99 which is such a great deal for a piece of exercise equipment for the home. I will go ahead and put the Amazon link down in the description box for you. I've really enjoyed it. I've had just a ton of fun with it and I can't wait to continue using it and become a much better hula hooper. So here's my morning snack. I'm going to have one of my Evolve protein shakes. I buy these on Target online. I'll link them down below for you. I've actually never seen them inside my Target so I end up just buying them online. They're really, really good. I try to drink a protein shake a day. It just helps me get in my protein. Low carb, low fat, low sugar. This one is really good. It is plant-based if you follow a plant-based lifestyle or you just like plant-based protein drink. This is going to be my morning snack. I don't know if you guys can see, but it is snowing again and it looks to me like we have plenty of snow. Hopefully you can see that. It is coming down nice big flakes. So here's my lunch for today. I'm having one of my meal preps from this last week. I have one left. This is so good, you guys. This is such a great meal prep. It's in the same video as my breakfast. I'll make sure that's linked down below but I just have some fresh green beans with a little bit of light butter, salt and pepper, some smoky seared chicken, half of a sweet potato with cinnamon and then I'm having a sugar-free lemon lime jello for dessert and I am working on my gallon of water. I'm over halfway done. So this is today's lunch.  The other two are still in bed. Is anyone gonna get up today? Are you so cozy? Yeah. Mommy covered you this morning. Yes, everybody rise and shine. I'm doing some work at my computer and I think I'm going to have a Gatorade with protein. I have been loving these. There's 10 grams of protein, 50 calories. I haven't tried the glacial cherry yet so I'm excited to have this. This will also tide me over until I have a snack a little bit later today. For an afternoon snack, I am keeping it pretty simple. I still have a little bit of these deluxe mixed nuts left over from the holidays. These are from Nut Stop. I'll put a link in the description box for 10% off. It's not an affiliate link or anything. They just gave me a discount code for you guys. So I'm going to have one serving, one quarter cup of mixed nuts. And then for some protein, I'm having my favorite meat stick. These are the next sticks. I buy these off of Amazon. This is the turkey one in the green package. You get both of these sticks for 75 calories and there's 10 grams of protein. It is such a great way to get in protein for super low calories and points. So nuts and a meat stick is my afternoon snack. See, this is the current situation. See, I've been napping all afternoon. He finally just got up. This one, oh yeah, stretched it out, bud. He got up just a little bit ago and Lola, she has come.  For tonight's dinner, I am making meatloaf muffins with barbecue sauce and I'm going to roast up some asparagus. So let me show you what's in the recipe. You'll need some fresh asparagus or whatever vegetable you would like. Salt and pepper and onion, a pound of 96% extra lean ground beef, eggs, worcestershire sauce and your favorite no sugar added barbecue sauce. I love the original from Sweet Baby Rays.  I'm going to season my asparagus with this barbecue seasoning from Trader Joe's. It's so good and I feel like it goes really well with the whole barbecue meatloaf theme and then I'll also add a little bit of salt and pepper. The asparagus is going in a 400 degree oven for probably 20 to 25 minutes or until it's roasted. So to get started on our meatloaf muffins, I've added my pound of 96% extra lean ground beef to a bowl. I'm going to add one egg. In the original recipe, it calls for a slice of bread or some breadcrumbs. I'm not eating that right now. So I'm not going to add that. Feel free to incorporate that if you would like. I'm also going to add up my finely chopped onion. One half of a cup of my Sweet Baby Rays barbecue. Two tablespoons of Worcestershire sauce and some salt and pepper. We're going in with our hands and we're going to mix this together. I always say this is the least fun part of making meatloaf meatballs. Meatloaf muffins is just digging in with our hands. I went ahead and sprayed nine of the little spots in my muffin pan here. The recipe makes nine mini meatloaves. I'm using the largest scoop, my little three scoop pack off of Amazon. I'll make sure that I link that down below for you. And I'm just going to scoop in nine little mini meatloaves. I'm going to take the flat end of my spoon and just kind of press these into place. With our barbecue sauce, I'm going to put just about a half of a tablespoon of barbecue sauce on top of each of the little meatloaves and then I'll just spread that around with my spoon so that we have the barbecue sauce mixed in and on top. These are ready to go into a 350 degree oven for about 40 minutes or until they're cooked completely through. This and the asparagus should be done pretty close to the same time. I just pulled out the asparagus and the meatloaf muffins. Doesn't all of this look so incredibly delicious. I am going to plate this up and I'll be back to share my dinner points and calories. I know what you're thinking. My meatloaves don't really look like mini meatloaves. So word to the wise, let these rest for quite a while before trying to pull them out of the pan. I pulled mine out too soon and they just kind of fell apart. They'll go down the same way. So just leave them resting a bit before you pull them out but this is my dinner. So I have some of the asparagus. This is two of the mini meatloaf muffins. I will put points and calories here on the screen. I'm really excited for this. It smells really good. It doesn't look the best. Looks pretty good right here but it smells incredible. For dessert tonight, I'm keeping it as simple. I'm going to have one of these Chobani zero sugar. This is in the flavor of vanilla. These are okay. I definitely like the two good yogurts better. I just think they have better flavor and texture but these are okay. I'm glad that I tried them out. These only have 60 calories per little cup. This is the last one that I have so I'm going to make it simple and have yogurt for dessert. Thank you for joining me on today's what I eat in a day on WW personal points. I hope you enjoyed seeing all the good food that I ate throughout the day. Utilizing my meal preps which seriously saves me so much thought when it comes to breakfast, lunch and a snack. It just makes it incredibly easy. It's ready to go. I just warm it up. It's healthy. I know exactly the points, the calories, the macros. I really enjoy meal prepping every single week.  Subscribe if you're not. I would love to have you here. I do upload five days a week so make sure you're subscribed and your bell notification is turned on. I'll make sure my weighted hula hoop from Amazon is down in the description box for you as well as nutrition coaching, links and discounts to my favorite things. And of course, my Facebook group, comment over and join us there as well. Happy Wednesday, friends and I'll see you in my next video.


is dedicating them back again. Smash the subscribe and like button if you want to see me win. If you want to see me win and get dividends, please make sure you smash the subscribe button and also smash that like button. Guess what? I got to surprise you all, baby. You guys were not, you guys were not believe what happened in today's video. Guess what? If you haven't watched yesterday's video, make sure you go watch that. But we run around the beginning. We run around the beginning, right? Guess what happened? Pop up. Guess what that is? What is that? Come over and let me know. That is the same exact order that we had yesterday. But this time, the payout is a little bit less. This is gonna be on the app that I use called Bungie. If you would like to sign up for Bungie, make sure you click the link in the description and sign up. Also, the referral code is W-S-S-V-1. Again, click the link in the description and the referral code is W-S-S-V-1. But then go ahead and get the job done and get these funds. Now, the pickup location is Florida court. We are picking up 3,000 pounds worth of flooring. It's supposed to be 150 boxes of plank flooring, but it is not. It is only 75 boxes of plank flooring. We're gonna drive 59.28 miles and receive a payment of 187.98. But the pull-up be great and get this cake. The question is this. In today's video, the customer was not there, so I have to return it back to the store. In today's video, what's gonna happen, baby? Is the customer gonna be there or not? I don't know, comment below and let me know, but we're about to go on here and scow, let's go. Just like that, we are back at our favorite store, baby. Floor decor, get to this money, don't ignore it. Are you picking up an order? Yes, sir. All right, cool. Let me see what I can do for you. I missed the order for a break. It's a Bungie order. Bungie, all righty. Are you dropping off? You picking up, right? No, I'm picking up. Is it 162? Yeah, that's what I see here. It's completed. You guys completed it, all right? Yeah, so it's in Z1, I got it for you. All right, thank you very much, boss. Just like that, y'all know what time it is, baby. Maybe second time this charm, we're gonna find out right now. Oh no, I thought I'd get some more dough. It's cold, it's cold. Don't do nothing, just stay right there. Plywood, it always does. The weather makes it move. Kind of comment and love it now. Go ahead and get these dividends. This Plywood is always some on this Plywood. It'd be cool sometimes then, sometimes it works good to not express the floor, but sometimes it's beautiful. And just like that is game time. Time to get her on the ground, let's go. All right, here at the drop off location, someone is here today, baby, so that's a good thing. Excuse me, excuse me. How you doing, sir? Good. Question for you. Where would you like to unload, like here or the other one? Two pallets, do we have? It's two pallets. Two pallets, all right. I'm gonna have to unload manually. Oh, really? Yeah. Okay. Can I open this for you? Sure. Oh, you got all the copper and stuff? Yeah. Oh, sorry about that. There's a lot of scrap from the place. How long, so you're remodeling the whole thing? You're flipping it or what you're doing? Everything. So you're gonna resell it? No, we're moving in. Oh, that's what I'm talking about. We're gonna sell the one that we're living in. Really? Yeah. I got, we're gonna say agents too. So, if you wanna do it. I'm gonna say agents too. Oh, okay, so let me take your hand, so you know what's going on. Okay, so do you wanna go here or here?  So how long have you had this property? Since June, I think. So how long do you think you're gonna get everything done? It should be done by the end of the month. That's what I'm talking about. Yeah, we're at the end of here. This all finishing work now, pretty much. Yeah. We added a bathroom. We tore out a chair. Y'all, that was the end of the month. That was the end, dude. What's that? Well, we closed May 1st on it. Didn't really do anything. We're trying to get all the people lined up. Yeah, and then June, like, 6th, we started, basically. Really? Two months? It's basically, it's pretty much been like three, four hours working here. I mean, you can do it with an agent, so that's what you do. Yeah, I'm just paying people to do everything, you know. But I need to keep my own business run. I got my own rental properties too.  Yeah, yeah, exactly. Yeah, my time is just too divided by too much stuff right now, so I'm like. I know what you're feeling. Can you fool it? Like, there's so much going on at one time. What are you gonna be the smarts with to do this one? Because we could tie on to something, we could pull the pallet back here. Oh. But we gotta figure out what to tie on to. If this goes viral, dude. We pull a lake watch in this stuff. I know, dude, they don't have water. We're trying to, we're trying to wheel cover it. The cover's right there. You see it? This is my guy, Brent. Okay, go slow. Slow, go ahead. Believe how I learned these types of stuff. She's the first person I ever heard tell me about this because I used to pick up like the solar panels from this place called Sun Run in Illinois. And she's like, instead of doing that, why don't you just strap it to there so you can pull it out? I never had no thought. But her dad's like a huge HVAC guy. He been doing this for like, who knows, 40, 50 years. So, he know about all this type of stuff. She's talking a lot of stuff. And the crazy that we kind of, it's like we just ran into each other and we kind of did a lot of similar stuff. She's kind of crazy. If you really think about it. I appreciate you, Brent. If you need anything, just let us know. And just like that, it is the end of the video. I hope you guys enjoyed the content. Before we go, I want to say this. Huge shout out to my guy, Brent. He was super cool. It's crazy that we kind of did a lot of the same thing. We entered real estate. We also both have real estate license. He owned the gym. I used to deliver exercise equipment. It's just kind of crazy, baby. You never know who you're gonna meet while you're out there. That's why I tell you guys all the time to make sure that you talk to everybody you can so you can get some more bands, baby.  Hey, comment below and let me know if you understand what I'm saying. But I hope you guys enjoyed this video. Again, make sure you smash the subscribe button if you are not subscribed. And also, I need you guys to start smashing that like button. So we can go up on the YouTube algorithm so we can get more subscribers so I can give you all this thousand plus dollars so I can go up there and pop your collar. Why y'all wouldn't do that, baby? Why y'all wouldn't do that, baby? Just make sure you smash the subscribe button and give me a thumbs up. But do not skip those ads and like tomorrow if this is bad. Why we can make this bad? It's 2023, it's big bags, easy. We'll keep on giving a reason. I'll see you guys on next one. But go on before you already know this, DDK. And I'm on my way.


I got a request a while back to do a video on how to know if you're surrounding yourself with the right people. And so that's what we're going to do today. If you're new here, I'm Sarah and I created this channel to help you build a more loving and fulfilling and beautiful life through self mastery and spirituality. And today I speak loving, uplifting and positive relationships over you. So there's a few ways to know if someone is a right fit for you in some sort of relationship, whether that's a romantic relationship, a friendship, a roommate, a job, a boss, whatever. But I truly believe that the easiest way to tell if someone should or shouldn't be in your life is by the way that they make you feel. Whether you have a five minute or a five hour phone call with this person, how are you feeling after? Do you feel lighter, happier, appreciated, loved, valued, understood? Or do you feel sad or frustrated or annoyed or angry or anxious? Realizing how you feel after you spend this time with someone is really that easy indicator of whether they are uplifting you and making you better and should be surrounded by that person or not. A lot of times after I've personally spent time or talked to someone that I know is a good person in my life that brings out the best of me, that makes me feel good, that uplifts me is sometimes I feel so good. I'm almost like buzzing a little bit. My heart feels calm, it feels safe and it feels at peace. And another thing to keep in mind is like we're all different, so we all want to feel different ways.  While for you, maybe what makes you feel the best is relationships or people that make you feel super pumped and high energy and excited. So first, you kind of have to figure out like how do you want to feel? When do you feel your best after you converse or spend time with someone? How do you want to feel? When do you feel your best? And then you just evaluate if you're feeling those emotions after you interact with someone. Another way to know if you're surrounding yourself with the right people is if they have similar values to you. Now that doesn't mean if you want to be a millionaire that you shouldn't spend time with people who is happy and content making minimum wage. But again, it all comes back to what do you want out of these specific relationships. So I think it's important to point out that we obviously have all different types of relationships. You might not want the same thing out of a parent as you do with the spouse or a sibling or boss. So it's going to be different and but only you can figure out like what you desire and what makes you feel valued and good out of each type of relationship that you have. Think about think about a personal trainer, right? Some people do really well if that personal trainer is encouraging to them. You can do it. You've got this pushed a little harder, blah, blah, blah, blah. But other people myself will thrive under a personal trainer who's kind of mean to them.  What are you doing? So you have to I know it's kind of a weird example, but like it's true. Like we all need something different from different relationships. You have to figure out what you want, what your needs are, what make you feel good. And that's going to be different from me and everyone else. And the bottom line is you just have to listen to your heart. Your heart knows, okay, you know, if you have an inkling that someone's not good for you or not right for you, they probably aren't. And sometimes we stay in relationships and again, not just romantic relationships, but all relationships for different reasons. And I want to go over four of those reasons with you right now. Also, excuse my voice. I spent the weekend with a bunch of my girlfriends in New York City and you know, take it to my body for sure. So the first reason we might stay in a relationship that's not good for us is time. Maybe there's been a relationship between you and this person for a very long time.  And you feel like because of that time spent and that relationship built, you can't just end it. You can't just walk away. But maybe you've just outgrown them or you've just gone in different directions or you just don't resonate with that person anymore. And we have to give ourselves permission that just because that person's been in your life for a long time doesn't mean they're right for you at this stage of your life. The second reason we might stay in a relationship for too long is guilt. A lot of times this can be through a parent and child dynamic where the child feels that they owe their parents X, Y and Z just because they're their parent. But if you're operating out of guilt within a relationship, no matter what type of relationship that is, either something has to change within that dynamic or it might be time to, you know, walk out of that relationship, you know, whatever is best for you, but you can't be bound to someone because you feel guilty. Okay, that's not, that's not the basis of a healthy relationship. Number three could be some type of obligatory relationship. Maybe it's a friend group or your family where obviously everyone's very intertwined. So you know that you're going to be around this person a lot or maybe everyone else loves them, but you don't. So you feel this obligation to be friends with this person even though you don't really want to be because you see them so often. But if you're not operating in a type of relationship out of love and wanting to be there, you're not doing yourself any justice and you're not doing the other person any either. It's best to just be honest and you don't necessarily have to go out of your way to like tell someone off or say you don't want to be friends with them anymore, but sometimes just kind of letting it fall into place, taking a step back. If you feel obligated to invite this person to go to lunch, maybe don't. Okay, and you can just take it step by step. It doesn't have to be this dramatic thing, okay, but you don't have to be friends or be okay with someone just because other people that you love do. And the last reason we might keep someone in our life that we shouldn't is a lot of us have it and that is people pleasing. We're afraid of how someone is going to view or judge us if we walk away from a relationship or a job or whatever it may be, or if we don't do something or if we don't go somewhere because we don't want to be around someone who we don't want to be around.  So if you're surrounding yourself by the wrong people, you're doing yourself so much harm. So if you have any more questions about this, please drop it in the comments below. And if you want to learn more about the type of people to keep in your life, let me know. Don't forget to like and subscribe so we can hang out again next week. I love you guys so much. And don't forget, be limitlessly yourself.


This is FDA Patient Safety News brought to you by the U.S. Food and Drug Administration. In this edition, we'll take a look at a device to treat the symptoms of Parkinson's disease, tips on how to avoid adverse events when vacuum extractors are used in childbirth, and information on electrical muscle stimulators that claim to improve your appearance. These stories and more are on this edition of FDA Patient Safety News. Welcome to FDA Patient Safety News. For the U.S. Food and Drug Administration, I'm Mark Barnett. And I'm Anita Reiner. In this series of broadcasts, we're talking about patient safety when it comes to using medical devices from surgical implants to diagnostic kits. About new devices that can improve patient care and affect patient safety. About potential safety problems and tips on how to avoid them. You can get more information about any of the stories in this broadcast from our FDA Patient Safety News website. That's www.fda.gov.cdrh.psn. Let's start with our new products bulletin board and tell you about some of the new devices FDA recently approved. FDA recently approved the expanded use of an implanted device that's used to control the symptoms of Parkinson's disease. The device, which is a deep brain stimulator, is called the Activa Parkinson's Control System and it's manufactured by Medtronic Incorporated of Minneapolis. The device sends a constant stream of electrical impulses to the brain and this can alleviate the symptoms of Parkinson's disease in some patients. The product was previously approved for unilateral implantation in the thalamus and that meant that it could control tremors on one side of the body only. The new approval allows bilateral implantation, which will help control symptoms on both sides of the body. The device is used in patients with advanced, levodopa responsive Parkinson's disease who have movement related symptoms that are not adequately controlled with medications or who experience intolerable side effects for medications. The Activa System consists of two sets of four electrodes that are implanted bilaterally in the brain. They're connected by leads that run beneath the skin to pulse generators implanted on each side of the chest. Electrical pulses are sent by the pulse generators to the globus pallidus or subthalamic nucleus where they block signals from the brain and thus may alleviate the symptoms of Parkinson's disease. The patient can turn the Activa System on or off by holding a small magnet over the area where each pulse generator is implanted. The generators will need to be surgically replaced every few years depending upon the stimulation needs of the patient and this can usually be done under local anesthesia. In clinical studies with this device before it was approved, some patients derived significant benefits, but the individual results varied a great deal and so the results for any individual patient can't be predicted in advance. Almost all the patients enrolled in the study experienced one or more serious adverse events which ranged from bleeding into the brain and device-related infection to weakness and hemoclegia. The manufacturer is going to conduct a three-year study to evaluate long-term clinical results. Now we want to talk about two recently approved devices used to treat congenital heart defects. Both devices are occluders that close an abnormal opening between two chambers of the heart and both are positioned using catheters. That means they can provide an alternative to open-heart surgery. Although these devices are used mainly in young children, they have also benefited adult patients. The first device is the cardioseal septal occlusion system made by NMT Medical Incorporated of Boston. It's intended to treat complex ventricular septal defects in patients who are at high risk for standard surgical closure because of anatomical conditions or their overall medical condition. This device had already been approved for limited marketing under the FDA's Humanitarian Device Exemption. This is a special clearance that makes devices available for patients with rare medical conditions. The new approval removes the limitation on marketing of this device. The cardioseal system has two parts, a delivery catheter and a permanent implant. The implant is actually an occluder that closes the defect and prevents blood from the two ventricles from mixing. It looks like two little umbrellas set edge to edge. Each umbrella has special spring coils. This allows the device to be collapsed and advanced into the catheter, which is then threaded through the blood vessels to the defect in the heart. When the occluder is in the correct position, the two umbrellas are opened so that there's one on each side of the defect. The spring coil design creates a slight tension that helps hold the umbrellas in place around the defect. And over time, tissue grows into the fabric of the umbrellas and the implant becomes part of the heart. The other device is the amplacer septal occluder made by AGA Medical Corporation of Golden Valley, Minnesota. This device is used to repair atrial rather than ventricular defects. The device consists of two disks of wire mesh linked by a short connector with the same diameter as the defect in the heart. The device is filled with polyester fabric, which promotes the formation of clots and thus helps to close the defect. Using a special delivery system, the device is fed through a small catheter inserted through a vein in the groin. When the device is passed through the defect, the distal disc is released, the device is pulled against the defect, and then the proximal disc is released. This sandwiches the defect between the disks. After deployment, the device is released by unscrewing it from the delivery cable. Eventually, tissue grows over the device, and that closes the defect. Although a variety of factors influence proper patient selection for these two devices, in general, they should not be used in patients with thrombus formation near the implant site or with certain active infections or coagulation disorders. The FDA is requiring both companies to continue to study their products for five years to better assess long-term safety and effectiveness. Now let's talk about specific ways to protect patients. FDA has alerted health professionals to the possibility of serious adverse events after the use of vacuum extractors to assist in childbirth. A vacuum extractor applies suction to the fetal scalp during childbirth to facilitate delivery. An FDA article in the January issue of Nursing 2002 notes that infants delivered with this device commonly developed fluid in the scalp or a limited subperiosteal hemorrhage, and that these typically resolve spontaneously. But the FDA has received reports of much more serious complications, including sub-galeal hematoma and intracranial hemorrhage. And although these are rare, they can be fatal. To protect patients from harm, two things are important. First, in order to minimize the chance of an adverse event happening, it's important that people using these devices do so properly. And second, in order to minimize the possibility of serious damage to the infant when an adverse event does occur, it's important that people caring for vacuum extracted newborns monitor them for warning signs. First, let's talk about safe use. FDA stresses that users should be trained properly and that they follow the manufacturer's instructions regarding things like positioning the vacuum cup, how much vacuum strength to use, and how long to continue the treatment. Also, the recommended technique for these products is to apply steady traction in the line of the birth canal and not to rock or twist the device, which can be dangerous. And now let's talk about monitoring. Here, FDA recommends alerting an infant's caregivers that vacuum extraction was used and instructing them to watch the infant for several days for possible problems. One way to be sure that that's done is to note the use of a vacuum extractor in the infant's chart. And remember, parents should be instructed to look for warning signs, too. These signs include swelling of the head and neck, hypotension and pallor, lethargy, irritability, convulsions, rapid breathing and tachycardia. For a more complete list and discussion, look under this story on our website. And now for the portion of the broadcast that we call Journal Scan, where we talk about recent publications that are particularly relevant to patient safety. This time, we want to call your attention to an alert issued by the Institute of Safe Medical Practices in November of 2001. This alert described a patient who died when his IV tubing was mistakenly connected to the inflation port on the cuff of his tracheostomy tube. It should have been connected to the central line IV catheter. When the IV infusion pump was turned on, the tracheostomy cuff filled with fluid. This caused the tracheostomy tube to become obstructed and the patient suffocated. The ISMP report discusses how such an unusual event could occur. In other words, how could someone mistake a tracheostomy inflation port for a triple lumen IV catheter? Among the factors they listed were the fact that the patient had just been transferred to a medical unit where tracheostomy tubes were rarely used, that the light in the room was dim to avoid waking the patient, and that the patient's triple lumen catheter was not secured so the tubing hung down at the same level as the tracheostomy cuff tubing. The report notes that this case belongs to a larger class of errors that can be called wrong tube, wrong hole, wrong connector. And it gives several recommendations to avoid these kinds of errors. For example, when the patient has more than one kind of tubing that could be attached to a port of entry into the body, attach an identifying label to each tube near the end that's inserted. Before administering drugs or other products, trace the tubing from the source to the connection port to be sure the connections are correct. If you're administering high alert medications where the patient is high risk, you'll check all line attachments with another practitioner and monitor patients so as to detect errors quickly and minimize their consequences. And now for a new segment in FDA Patient Safety News. It's called Patients Are Asking, and it gives information that you may want to pass along to patients about medical products they may be using at home or at work. Today we want to talk about electrical muscle stimulators, the kinds of devices that are sold over the counter to tone the muscles, particularly those in the abdomen. Some of your patients may be asking about whether these products work and whether they're safe. Because these muscle stimulators are considered to be medical devices, FDA is responsible for regulating them. Most of the ones FDA has reviewed are for use in physical therapy and rehabilitation under the supervision of a healthcare professional. They're used for such things as muscle reeducation, relaxation of muscle spasms, increasing range of motion and preventing muscle atrophy. If a company chooses to sell its device directly to consumers, it must show FDA that the device is safe and effective for its intended use. For up-to-date information on which of these over-the-counter products has been cleared by FDA, go to our website. Mark? Thanks, Anita. Now let's get back to whether these kinds of products actually work. They generated a lot of advertisements and infomercials. Some of the ads claim that they tone and firm and strengthen the abdominal muscles and that they'll give you rock-hard abs. Some of them also claim to provide weight loss and a smaller waist size. If a patient asks about these claims, you should advise them that although these devices may strengthen or tone muscles to some extent, they're not going to produce a major change in your appearance all by themselves. And none of these products have been cleared for weight loss or for reducing waist size. Now what about the issue of safety? Patients should be advised that there have been reports of shocks, burns, bruising, skin irritation, and pain while the device is being used. There have also been several incidents where the muscle stimulator interfered with implanted devices such as pacemakers and defibrillators. It's also possible that among the muscle stimulators not cleared by the FDA, some of them might not comply with electrical safety standards and, of course, that raises the possibility of shock or electrocution. To learn more about electrical muscle stimulators or to report a problem with one of these devices, please visit our website. Anita? Thanks, Mark. Well, that's all for this edition of FDA Patient Safety News, but we'll be back next month with another edition. So watch for us. Until then, for the U.S. Food and Drug Administration, I'm Anita Reiner. And I'm Mark Barnett. Remember, you can get more information on all the stories you've seen here today and also find out how to purchase video tapes of these broadcasts by visiting our website. You can also use the website to tell us what you think of these broadcasts. We really want your comments. Tell us what you like, what you don't like. Tell us what kinds of things you'd like to see more of. You know, we want these broadcasts to be useful and we're going to use your comments as we design future ones. We also urge you to use the website to report problems you've encountered with medical devices. That's how we learn about problems so we can alert others. See you next time.