Lyme Disease Essays (1202 words) - Rheumatology, RTT,

Lyme Disease Lyme disease is a tick-transmitted inflammatory disorder characterized by an early focal skin lesion, and subsequently a growing red area on the skin (erythema chronicum migrans or ECM). The disorder may be followed weeks later by neurological, heart or joint abnormalities. Symptomatology The first symptom of Lyme disease is a skin lesion. Known as erythema chronicum migrans, or ECM, this usually begins as a red discoloration (macule) or as an elevated round spot (papule). The skin lesion usually appears on an extremity or on the trunk, especially the thigh, buttock or the under arm. This spot expands, often with central clearing, to a diameter as large as 50 cm (c. 12 in.). Approximately 25% of patients with Lyme disease report having been bitten at that site by a tiny tick 3 to 32 days before onset of ECM. The lesion may be warm to touch. Soon after onset nearly half the patients develop multiple smaller lesions without hardened centers. ECM generally lasts for a few weeks. Other types of lesions may subsequently appear during resolution. Former skin lesions may reappear faintly, sometimes before recurrent attacks of arthritis. Lesions of the mucous membranes do not occur in Lyme disease. The most common symptoms accompanying ECM, or preceding it by a few days, may include malaise, fatigue, chills, fever, headache and stiff neck. Less commonly, backache, muscle aches (myalgias), nausea, vomiting, sore throat, swollen lymph glands, and an enlarged spleen may also be present. Most symptoms are characteristically intermittent and changing, but malaise and fatigue may linger for weeks. Arthritis is present in about half of the patients with ECM, occurring within weeks to months following onset and lasting as long as 2 years. Early in the illness, migratory inflammation of many joints (polyarthritis) without joint swelling may occur. Later, longer attacks of swelling and pain in several large joints, especially the knees, typically recur for several years. The knees commonly are much more swollen than painful; they are often hot, but rarely red. Baker's cysts (a cyst in the knee) may form and rupture. Those symptoms accompanying ECM, especially malaise, fatigue and low-grade fever, may also precede or accompany recurrent attacks of arthritis. About 10% of patients develop chronic knee involvement (i.e. unremittent for 6 months or longer). Neurological abnormalities may develop in about 15% of patients with Lyme disease within weeks to months following onset of ECM, often before arthritis occurs. These abnormalities commonly last for months, and usually resolve completely. They include: 1. lymphocytic meningitis or meningoencephalitis 2. jerky involuntary movements (chorea) 3. failure of muscle coordination due to dysfunction of the cerebellum (cerebellar ataxia) 4. cranial neuritis including Bell's palsy (a form of facial paralysis) 5. motor and sensory radiculo-neuritis (symmetric weakness, pain, strange sensations in the extremities, usually occurring first in the legs) 6. injury to single nerves causing diminished nerve response (mononeuritis multiplex) 7. inflammation of the spinal cord (myelitis). Abnormalities in the heart muscle (myocardium) occur in approximately 8% of patients with Lyme disease within weeks of ECM. They may include fluctuating degrees of atrioventricular block and, less commonly, inflammation of the heart sack and heart muscle (myopericarditis) with reduced blood volume ejected from the left ventricle and an enlarged heart (cardiomegaly). When Lyme Disease is contracted during pregnancy, the fetus may or may not be adversely affected, or may contract congenital Lyme Disease. In a study of nineteen pregnant women with Lyme Disease, fourteen had normal pregnancies and normal babies. If Lyme Disease is contracted during pregnancy, possible fetal abnormalities and premature birth can occur. Etiology Lyme disease is caused by a spirochete bacterium (Borrelia Burgdorferi) transmitted by a small tick called Ixodes dammini. The spirochete is probably injected into the victim's skin or bloodstream at the time of the insect bite. After an incubation period of 3 to 32 days, the organism migrates outward in the skin, is spread through the lymphatic system or is disseminated by the blood to different body organs or other skin sites. Lyme Disease was first described in 1909 in European medical journals. The first outbreak in the United States occurred in the early 1970's in Old lyme, Connecticut. An unusually high incidence of juvenile arthritis in the area led scientists to investigate and identify the disorder. In 1981, Dr. Willy Burgdorfer identified the bacterial spirochete organism (Borrelia Burgdorferi) which causes this disorder. Affected Population Lyme Disease occurs in wooded areas with populations of mice and deer which carry ticks, and can be contracted during any season of the year. Related Disorders Rheumatoid Arthritis is a disorder similar in appearance to

Responding To Customer Complaints On Social Media

Responding To Customer Complaints On Social Media You’re human. Mistakes will happen. Nothing is perfect and something will go wrong. Not every customer will be satisfied. This is not a failure. The best businesses are the ones that mess up and show how they fix their mistakes. They build their customer’s trust and prove they are listening to them. When a significant other makes a mistake and owns up to it, do you dump them because they messed up or do forgive them and trust them more because they were honest? Depending on the situation, you’ll forgive them and that will make your relationship stronger. It’s similar with business. Mistakes happen, but when a business owns up to it and apologizes, they’ll build a better relationship with the customer. Listen To Your Customer Complaints When customers complain, sometimes they just want someone to hear them out. They had a poor experience, and no matter how big or small it was, the least you can do is listen. What do you learn when you listen? You find out about problems that would have created more dissatisfied customers in the future. When you listen to a customer, you have an opportunity to establish a relationship with that customer. By listening to them, youll let them know you care. Just because a customer is upset doesnt mean they are a lost cause, or gone forever. Regardless of the size of the issue, let the customer know you heard their problem and understand their frustration. One of my first jobs was a clerk at a small drug store/gift shop. I was 16 and terrified when customers complained because I had no idea what to do and no authority to do anything about it. This is when I discovered if I let a customer vent their frustrations to me and apologize for their poor experience, they would always leave happier than when they came in. Business Is About Relationships It is easy to forget the fact that business is all about relationships. Relationships  with your current customers, but with vendors, former customers, clients, the community, and more. The Perfect Apology, a site dedicated to helping readers craft the perfect mea culpa,  understands this relationship connection between a business and customer. It offers the following strategy about how to protect that relationship: 1.  Look at the reason behind your business apology and  who  has been affected by the situation. 2.  Determine the most appropriate way to apologize and  when  that apology should be given. 3.  Ask and answer the following four basic questions: What are you apologizing for? Who are you apologizing to? How do you apologize? When should you apologize? When someone complains, its not the end of the relationship. Instead, its an opportunity. Its a chance to strengthen that relationship and rebuild it. Business is about relationships. Complaints are a chance to preserve and build relationships.How To Apologize Face-To-Face When I was in the first grade, a teacher of mine told us that if we were going to apologize to someone, sorry is never enough. When you apologize you should state their name, tell them what happened, tell them why it happened, and that you’ll never do it agin. As Ive been doing research on business apologies, Ive been learning this form of apology is what most businesses use. Its a five-step process. Apologize.  Actually say you are sorry. Dont say that you are sorry they feel that way but say I am sorry. State what you did wrong.  Make sure you inform the customer what your business did wrong. This is you owning up to your mistakes and taking ownership of them. Acknowledge how they are feeling.  Imagine yourself in their shoes, and let them know you understand (or are trying to understand) how the situation made/makes them feel. Express regret.  Let them know you feel bad about the situation. Promise it wont happen again. It’s hard to promise that something will never happen again, but you can at least mention how you will do your best to prevent a mistake from happening again. A crisis is never fun but it does give you an opportunity to build a lasting relationship with your audience. Of course, this is based on how you handle it. Customers Value Apology More What do customers value more? An apology or some form of monetary value in exchange for the poor experience? The Nottingham School of Economics  conducted a study and found that unhappy customers are more willing to forgive a company that offers an apology rather than monetary compensation. Why would customers be more willing to forgive a company that offers an apology? Researchers theorized that when customers hear Im sorry, it triggers an instinct to forgive. Its an instinct that is difficult for people to overcome. I have to admit that the results of this study came as a surprise for me. From my experience, I know customers always value a genuine apology. Im on the marketing team for a sandwich shop and like anyone in the food industry knows, mistakes happen. Typically when a customer complains, we apologize and offer to send them something in the mail. That something is usually a free sandwich. Well typically say something that directly addresses their poor experience, apologize for it and ask for them to give us another chance to make up for their poor experience. I believe this is a good balance between an apology and compensation. Author Bruna Martinuzzi wrote a wonderful post on the best way for businesses to apologize, sharing some great apology dos and donts. Whats the big takeaway? Don’t use the word â€Å"if†.  An apology that is â€Å"if I offended you, I’m sorry† is basically saying â€Å"I don’t understand how you can be offended, but if you are so sensitive to being offended, let me apologize.† That’s not the vibe you want to give off to your customers. You don’t want to insult them again. Just say, â€Å"I’m sorry we offended you.† That’s straight to the point and you took ownership of the situation. Don’t give excuses.  Excuses are tempting because there is usually a reason behind your actions. Yet excuses are easily one of the most annoying things about apologies. â€Å"I’m sorry I offended you, but I was just following customer policy.† Even if you have an actual reason as to why a situation occurred, refrain from making excuses. You can explain the situation, but don’t use an excuse. It will make your apology less genuine. Make it brief.  Keep your apology short. It’s easy to ramble on, but don’t. Short and sweet is the rule. This will make it seem more genuine and less about you. The sooner the better.  The time frame on giving an apology does expire. Don’t delay an apology. 50% of consumers give a brand only one week to respond to a question before they stop doing business with them, according to RightNow Customer Experience Impact Report. If possible, apologize before the customer even knows about the situation. It will make the customer trust you more. For business, trust is everything. Value the relationship.  You dont always need to be right. The value of a relationship will often overshadow your need to be right. By arguing about who is right and who is wrong, youre doing more damage. Does it matter who is right? Will it harm the relationship between you and the customer? Is it worth it? Create an apology policy.  If you have multiple employees, it can be hard to keep everyone in the loop on whats the best way to apologize. Even if you are the only person in your company, an apology policy will help keep you on track with consistent and level headed responses.  Martinuzzi points out Starbucks LATTE method for dealing with complaints.  Starbucks baristas are trained to respond to complaints by Listening (L), Acknowledging (A), (T)  Taking Action, Thanking (T), and Explaining (E). There is emphasis on listening first and only lastly on explaining what happened. Try to create an easy to remember policy that will help you and your employees deal with complaints. How To Apologize On Social Media One reason business owners dont want to go into  social media  is because they are afraid theyll be on defense the entire time. Any time a customer has so much as a mediocre experience they come flocking to their social media networks and complain. It seems like all they would do  on social media is apologize.

Relationships Essay Example | Topics and Well Written Essays - 1000 words

Relationships - Essay Example He taught me how to write before I went to school; every day; he would come home and sit with me on a small chair and table next to his huge study desk. At first, I would play around in the room running around and sometimes upsetting him with my toy cars. Most times, he would smile understandingly and after he was done working, I would help him tidy up the room. However, he gradually started insisting I sit still and he would then teach me how to print out letters, words and eventually sentences. At first, I did not like the restrictions involved while he was teaching me, but I gradually got used to them. In addition, when my father wants you to do something, it is easier to do it than resist him since he will inevitably wear you out. This was the first lesson I learned about him that informed most of my interactions and sometimes-even fights with him. I began school at a slightly older age than most of my colleagues, but when the teachers realized I had been homeschooled, they put m e in an accelerated program and I soon caught up with my peers. However, my father’s involvement in my life went beyond academics since he was an ardent sports fan and particularly loved football. Every Sunday, he would take me with him to the local stadium and we would watch the game and cheer his favorite team, which soon become our favorite. Sometimes when he came from work early, we would kick around a ball at the yard outside our house and then I would either join him in his study or watch TV in the den as he worked. One thing that he and I both loved apart from football was reading. He was a voracious reader and his study was filled with hundreds of books from all over the world; I had taken to perusing through some of those as I grew older and when he noticed my interest he bought me several children’s versions which I enjoyed immensely. By the time, I was 13, I had started reading most of the original works in his collection