Monday, May 20, 2013
Causes and treatments for lupus
Lupus is called a great imitator, because the symptoms can
mimic multiple illnesses.
An autoimmune disease, the underlying mechanism of the
disease is very complex. To complicate matters any organ in the body can be
affected by lupus.
Your immune system is your body's defense system. When
healthy, it protects the body by making antibodies (blood proteins) that attack
foreign germs and cancers. In lupus, the immune system misfires. Instead of
producing protective antibodies, an autoimmune disease begins and makes
"autoantibodies," which attack the patient's own tissues. As the
attack goes on, other immune cells join the fight. These antibodies then end up
in cells in organs, where they damage those tissues. We do not understand why
this process begins.
Lupus is predominantly a female disease. Women are affected
10 times as often as men. It is a chronic disease that can first present with
joint pain and swelling. Over the course of time skin, kidney, heart and brain
can be involved.
At our Arthritis Center we provide care to multiple patients
with lupus, ranging from 18-45 years old. The majority of patients are between
20 and 30 years old. The initial symptoms can be fever, joint aches, fatigue
and just not feeling well. Skin rashes are common — they can vary from having
a butterfly rash on the face, to a generalized rash throughout the body. The
severity of the rash can sometimes coincide with the severity of disease. Sun
exposure aggravates the disease.
Our patients can also develop mouth ulcers.
Some patients get really sick. They can have significant
kidney involvement, ranging from mild protein in the urine to at times needing
dialysis and kidney transplantation. Also lung involvement can range from
pleuritis to significant fluid around the lungs. Heart involvement can range
from fluid around the heart to involvement of the valves.
Once patients come with symptoms, and after clinical exam,
we order a whole series of tests. The lab tests help us differentiate the cause
and severity of the illness. We also do X-rays and sometimes echocardiograms.
Some of our patients also need kidney biopsies.
The treatment is based on the severity of the underlying
disease. Some patients may need prednisone for the management of their illness
and others may need powerful chemotherapeutic agents. Recently a new medication
was approved — Benlysta.
Given the chronic nature of the illness, we have to monitor
our patients closely. They can have flare-ups and are at risk for heart disease. To manage our patients
we have to coordinate care with multiple specialists. Education and
coordination of care can lead to better outcomes.
Sandeep Varma, MD, is the Medical Director of the Backus Hospital Arthritis Center. To comment on this column or others, visit the Healthy
Living blog at www.backushospital.org/backus-blogs or e-mail Dr. Varma or any of the Healthy Living columnists at healthyliving@wwbh.org.
Monday, May 13, 2013
It takes a team to run a hospital
A few years ago my son worked for the Yale Repertory Theater, on the technical team: the lights, sound engineering, and constructing the sets.
We attended a few of the performances. They were excellent, and the actors were well-deserving of the standing ovation following each performance. The technical team worked so diligently to enable the actors to perform. Without them, the actors couldn’t function. But there were no accolades or ovations for the essential support staff.
The same can be true with hospitals and health care. Nurses and doctors get thank you notes, candy, and cards all the time from patients.
But too often we forget the “behind the scenes” people who enable the doctors and nurses to do their work.
For example, the greeter at the front lobby information desk that cheerfully directs you to the correct department? Or what about the cooks that prepare the food for the patients and staff, or the dietitians that ensure the appropriate diet is prescribed and nutritional needs are met for the patient? How about the maintenance people who keep the lights and technical equipment going so the surgeons can see and perform the operations?
How about the hospital photographer who films, edits, and produces educational and informative videos by clinicians? Or the communications department that creates the signage, writes the newsletters, and facilitates the all-important communication between patients, staff and community?
The surgeon couldn’t diagnose the patient’s problem without the Laboratory Techs who draw the blood and provide vital lab tests results, or the Radiology Department that provides the crucial X-rays.
If the Environmental Services Department personnel didn’t keep every room in the hospital clean, it would be disastrous. There is a Sterile Processing Department that ensures sterility of all of the surgical equipment. Can there be any more important factor in surgical success than sterility?
Electronic Medical Records are becoming the norm, but it takes a whole IT (Information Technology) Department to keep the computers functioning and electronic paperwork flowing. The Medical Records Department performs the vital function of transcribing doctor’s dictated notes, and keeping countless records safe, organized, confidential, and available.
The Biomedical Department keeps all the medical and monitoring equipment functioning properly and makes certain it is checked and serviced appropriately. If the heart monitors, oxygen, anesthesia or dialysis equipment fail, there’s big trouble in the operating room. The unit coordinators expedite the medical orders, answer the phone, and are invaluable in coordinating everything. The Social Services department connects patients to home care or outpatient services, as well as facilitates a safe return home. These are just to name a few, it would take too much space to mention every person or department — there are so many people who make the hospital function. Nobody can perform their duty without the vital involvement of others on the team.
May 12-18 is National Hospital Week, when we celebrate the dedicated staff of hospitals and health care institutions. All should “take a bow” and be recognized for the invaluable contribution each and every person makes.
Alice Facente is a community education nurse for the Backus
Health System. To comment on this column or others, visit the Healthy
Living blog at www.backushospital.org/backus-blogs or e-mail Ms. Facente or any of the Healthy Living columnists at healthyliving@wwbh.org.
Monday, May 06, 2013
A crash course on motorcycle safety
It’s like clockwork — daylight savings time comes, the weather warms up and motorcyclists quickly populate the roads of Eastern Connecticut.
Unfortunately, this sure sign of summer usually coincides
with crashes. This year is no different, especially with sand still on the
roads after a brutal winter.
In the past month alone, we have seen approximately 15
motorcycle crashes, some causing serious injuries.
Inexplicably, some of the bikers were not wearing helmets.
As a trauma nurse who sees the impact firsthand, I cannot stress enough how
important it is to wear a helmet.
Head injury is the leading cause of death in motorcycle
crashes, and motorcyclists are 40% more likely to suffer a fatal head injury,
according to the National Highway Traffic Safety Administration.
Although in Connecticut it is not a law, it is in my book.
Helmets should be worn at all times, as they are the best way to avoid head
injuries. If you don’t want to do
it for yourself, do it for your loved ones who might have to live with the
consequences. Trust me, I’ve seen
the impact this can have. Here are some tips:
• It can’t be
said enough: Always wear a helmet.
• Wear proper gear – flip flops, shorts and sandals are not
safe. Boots, jeans and leather can make a big difference if a crash occurs.
• Use eye protection.
• Be aware that other drivers may not see you in their blind
spot.
ˆ Obey speed limits.
If you are driving a car or truck, pay extra attention to
motorcycles. According to the Motorcycle Safety Foundation:
• Motorcycles are more likely to be hidden in blind spots.
Take some extra time to watch out for them.
• Don’t follow motorcycles too closely. In fact, allow more
space than you would for another care because motorcycles sometimes slow down
by down shifting, not using brakes, which means the brake light is not
activated.
• It isn’t easy to judge a motorcycle’s speed. For example,
when turning left at an intersection, assume that a motorcycle is closer than
it is.
Whether you ride a motorcycle or a bicycle, truck or
tricycle, you can make our roads safer this spring and summer by taking a few
extra precautions.
Gillian Mosier is Backus Trauma Center Program Manager for the Backus
Health System. To comment on this column or others, visit the Healthy
Living blog at www.backushospital.org/backus-blogs or e-mail Ms. Mosier or any of the Healthy Living columnists at healthyliving@wwbh.org.
Monday, April 22, 2013
Dwell on heroism, not evil, when pondering bombings
Somebody asked me, as a nurse, what my reaction was to the Boston Marathon bombing tragedy. That question gave me pause. My first reaction was fear and horror — are my friends and family safe?
That question gave me pause. My first reaction was fear and horror — are my friends and family safe? My second reaction was to say a fervent prayer for all of the victims, especially the families of the three that were killed, including the 8-year-old boy, whose sister and mother are also hospitalized with serious injuries. It’s unfathomable.
I am always suggesting to people to “look at the positive” in life. But that’s a pretty difficult thing to do when tragedies like those in Newtown or Boston occur within months of each other.
I must admit I watched in admiration as the first responders, and the fire, police and medical professionals, heroically rushed to the aid of the victims. They put their lives on the line to help others without hesitation. How could they be sure that another bomb or assault wasn’t imminent? I have always believed that 99% of people in this world are inherently good, and I’m reminded of that when I see such evidence of how noble, generous, and self-sacrificing people are in the face of tragedy.
So what are some coping mechanisms to help us deal with the recent tragedies?
• Mental health professionals advise us to limit exposure to the media coverage of the tragedy. If there is nothing we can do to help, there is no need to see the same horrific images displayed on the TV over and over again. This is true for adults, but especially children.
• If you have young children, be prepared for them to ask if such violence can occur to them. Do not lie, but repeat that it is very unlikely and that you are there to keep them safe.
• Focus on stories of heroism and generosity to help fortify our belief in humanity.
As we struggle to find meaning in the face of tragedy, perhaps it is the perfect time to reach out to family and friends and tell them how much we appreciate and care for them.
Alice Facente is a community education nurse for the Backus
Health System. To comment on this column or others, visit the Healthy
Living blog at www.backushospital.org/backus-blogs or e-mail Ms. Facente or any of the Healthy Living columnists at healthyliving@wwbh.org.
Monday, April 15, 2013
Asking three questions can make health care safer, easier
Perhaps the best piece of advice I have ever received about
negotiating the health care system is to “ask questions.” Being hospitalized can be an
intimidating experience, but if you don’t understand what is happening to you,
it intensifies the fear. How can
you care for yourself when you return home if you don’t understand your
medication regimen, or how to properly self-inject your newly-prescribed
insulin?
Health care workers often use acronyms when explaining
things. If your doctor or nurse
says you have “UTI” it really isn’t so frightening once you understand that
only means “urinary tract infection.”
Ask questions — it can make things easier, and safer.
I was hospitalized twice for short periods and still found
the experience somewhat intimidating, even though I was a registered nurse
working in that same hospital. I
didn’t take any medicine handed to me unless I asked the name of the medicine,
what it was for, and why it was prescribed for me.
Subsequent to my hospitalization experiences, I read about a
program called “Ask Me 3,” created by the National Patient Safety
Foundation. “Ask Me 3” is a
patient education program designed to promote communication between health care
providers and patients in order to improve health outcomes. The program
encourages patients to understand the answers to three questions:
• What is my main problem?
• What do I need to do?
• Why is it important for me to do this?
Patients should be encouraged to ask their providers these
three simple but essential questions -- in every health care interaction.
Likewise,
providers should always encourage their patients to understand the answers to
these three questions.
Come to think
of it, getting the answers to these three questions is probably wise for all
encounters in life. Whether dealing with health issues, childrearing, or
education pursuits, it makes sense that understanding will result in improved
outcomes.
Alice Facente is a community education nurse for the Backus
Health System. To comment on this column or others, visit the Healthy
Living blog at www.backushospital.org/backus-blogs or e-mail Ms. Facente or any of the Healthy Living columnists at healthyliving@wwbh.org.
Monday, April 08, 2013
Health can be a laughing matter
My exercise buddies and I were talking after Jazzercise
class one day. They said they
faithfully read my health columns, but one friend admitted she looked for the
ones with humorous stories in them.
She confessed that when I get “too preachy” she skims over the column,
or just skips it entirely. Another
friend agreed, and added, “We’re all going to do what we want to anyway.” Well, that stung a little bit, but they
were just doing what real friends do: telling me the honest truth, whether I
wanted to hear it or not.
I read somewhere that a child laughs 400 times a day on
average, while the typical adult only laughs 15 times a day. That is a puzzling statistic because
everyone agrees laughter feels so good.
But is it really good for us?
In my quest to provide accurate health information, I did a little
research on laughter and humor. The Mayo Clinic Health Letter reports that laughter aids breathing by
disrupting your normal respiration pattern and increases breathing rate. It can even help clear mucus from your
lungs.
Laughter is also good for your heart. It increases circulation and improves
the delivery of oxygen and nutrients to tissues throughout the body. A good
laugh helps strengthen the immune system, fighting off colds, flu, and sinus
problems by increasing the concentration of immunoglobulin A in the
saliva. And it may help control
pain by raising the levels of certain chemicals in the brain called endorphins.
Possibly most important in these stressful times, laughter
is a natural stress reliever.
Some days it’s difficult to find humor in our lives. But it’s not impossible. Front page
news is rarely humorous or even uplifting, but newspapers devote a page to
cartoons, jokes, crossword puzzles and other entertaining games. A Google search of “Funny videos”
yielded 109 million hits. Laughter
is contagious. If you watch a
funny video or read cartoons with a friend or family member, it is nearly
impossible to resist when the other person is howling with laughter. If children can find something to laugh
about 400 times a day, maybe we need to hang around them a portion of each day.
Health care is serious business, but I promised my friends
to try to consider the lighter side when I write my health columns.
So forgive me, friends, if I am “too preachy” but let’s all
make a concerted effort to find a bit of humor in our lives every single day.
Alice Facente is a community education nurse for the Backus
Health System. To comment on this column or others, visit the Healthy
Living blog at www.backushospital.org/backus-blogs or e-mail Ms. Facente or any of the Healthy Living columnists at healthyliving@wwbh.org.
Monday, April 01, 2013
Tics and Tourette’s Disorder is common but misunderstood
In my role as community education nurse for Backus, I have
coordinated countless presentations by the experts on a wide variety of topics.
When Mahmoud Okasha, MD, Associate Clinical Professor at
Yale School of Medicine and a member of the Backus medical staff, approached me
because he wanted to present a community education program about Tics and Tourette’s Disorder, I must confess I knew next to nothing about the subject.
He is the expert in this field, so I made the arrangements
for him and then did a little research. What I discovered is that in every
school in America there is likely at least one child who has Tourette’s. It is a neurological disorder
that starts in childhood and involves involuntary repetitive movements or
unwanted sounds that can’t be controlled (tics).
Tics are classified as either simple or complex. Simple tics
are sudden, brief and repetitive, like head jerking, shoulder shrugging,
sticking the tongue out, or hiccupping.
Complex tics are distinct, coordinated patterns of movements involving
several muscle groups such as touching the nose, touching other people,
flapping the arms, repeating others’ words or phrases.
He will be showing a few clips of a documentary entitled “I
Have Tourette’s, but Tourette’s Doesn’t Have Me.” Produced by the Tourette Syndrome Association, this
compelling video features children between the ages of 6 and 13 who tell their
stories about the challenges they face.
I confess I got choked up watching these courageous children share their
experiences — and how they strive
to fit in and be accepted.
The program will be held Wednesday, April 3, from 6-7:30 p.m. at
the Backus Hospital main lobby conference room.
Register for this free program by calling 860-889-8331,
ext 6381 and join us as Dr. Okasha educates us all about this unusual and often
misunderstood condition.
Alice Facente is a community education nurse for the Backus
Health System. To comment on this column or others, visit the Healthy
Living blog at www.backushospital.org/backus-blogs or e-mail Ms. Facente or any of the Healthy Living columnists at healthyliving@wwbh.org.
Monday, March 25, 2013
An action plan for asthma
More than 23 million people have asthma in the United
States, with nearly 9 million of them children, according to Medline Plus. In
fact, it is the number one reason children are absent from school.
Flare-ups, or
asthma attacks, are the most common cause of pediatric emergency department
visits. But with the right asthma management plan — and education —
asthmatics can learn to control their symptoms and flare-ups. Asthma should not inhibit our daily
activities.
Asthma is a lung condition that causes difficulty breathing.
The symptoms include coughing, wheezing and shortness of breath. Although it
may seem that an asthma flare-up happens without warning, the truth is the
flare-up has been developing over time. It is caused by:
• Swelling of the lining of the airways
• Excess mucus that results in congestions and mucus “plugs”
that get caught in the narrowed airways.
• Tightening of the muscles surrounding the airways or
bronchoconstriction.
When these three changes occur, it makes it difficult to
take a deep breath. It feels like you are breathing through a straw. You may
also experience coughing, wheezing, chest tightness, an increased heart rate,
sweating and shortness of breath.
Asthma Triggers: Learn what triggers your asthma and eliminate these
triggers. Some common triggers can
be allergies, airborne irritants or pollutants such as smoke, perfumes, strong
odors from fresh paint or cleaning solutions, respiratory infections and even
the weather.
Treatment: Asthma is treated based on its severity and triggers. Most
asthma medications are inhaled, but some may be taken in pill or liquid form.
Medications fall into two (2) categories: Rescue medications and controller
medications.
Controller Medications: Controller medications, also called “preventative” or “maintenance” medications,
manage asthma and prevent symptoms. Many people with asthma need to take a
medication every day to treat the problem of airway inflammation. They work
slowly, so it may take days or weeks for them to begin working. By taking a
controller medication regularly, you may notice that you do not need to use
your rescue inhaler as often.
Controller mediations are also prescribed to minimize any permanent lung
damage associated with having asthma.
Rescue Medications: Rescue medications act quickly to stop the symptoms but are
not long-lasting. Once they start working, they stop asthma symptoms —
wheezing, coughing and shortness of breath.
Inhaler or Nebulizer? Asthma medications can be provided by two different types of
devices – an inhaler or nebulizer. Most people use inhalers, but there are
times when a nebulizer may be needed. Nebulizers are electric- or
battery-powered machines that turn liquid asthma medication into a fine mist
that is inhaled into the lungs.
An advantage of
a nebulizer is that you can sit in one place and breathe in the mist. The
disadvantage is that they take 5 to 10 minutes to deliver the medication, are
noisy and not easy to carry around.
Inhalers, or metered dose inhalers, are portable hand-held
devices that are small enough to carry in a pocket, purse or backpack. They
deliver a premeasured puff of medication, and require the person to coordinate
squeezing the inhaler and inhaling the medication into the lungs.
Sometimes when
using an inhaler the medication will reach the back of the throat but not go
down the lower airways -- where it
needs to go to be effective. Dr.
Thinesh Dahanayake, a pulmonologist at Pulmonary Physicians of Norwich and
member of the Backus Medical Staff, suggests most individuals use a device
called a spacer when using an inhaler. According to Dr. Dahanayake, a spacer is
easy to use and delivers the medication more effectively into the lungs, rather
than in the mouth or throat.
Keep Your Inhaler Clean: Dr. Dahanayake also advises patients to keep their inhalers
clean. If you see powder in or around the hole, clean it by removing the metal
canister from the L-shaped plastic mouthpiece. Rinse the mouthpiece and cap in
warm water, let it dry overnight and then put the canister back inside and
replace the cap.
Asthma Action Plan: Your physician may provide you with an asthma action plan
and peak flow meter. A peak flow meter is an easy-to-use handheld tool that
measures breathing ability. If your peak flow readings are dropping, this is a
sign of increasing airway inflammation, which can mean that you are not taking
in a “normal” amount of air.
Your asthma action plan will have a green zone, yellow zone
and red zone with a range for peak flow meter readings. Peak flow meter
readings that fall in the green zone means the airways are open. A reading in
the yellow zone means that there is a potential for an asthma flare-up and a
reading in the red zone means the flare-up is serious and treatment is needed
immediately, possibly a trip to your doctor or emergency department.
Controlling your asthma is as easy as 1…2…3… 1) Know what triggers your
asthma; 2) take your medications as prescribed; 3) follow your action plan.
Lisa Cook is a community education nurse for the Backus
Health System. To comment on this column or others, visit the Healthy
Living blog at www.backushospital.org/backus-blogs or e-mail Ms. Cook or any of the Healthy Living columnists at healthyliving@wwbh.org.
Monday, March 18, 2013
Early treatment of Tourette's syndrome
Once considered a rare and sometimes strange disorder, some
experts estimate that Tourette’s disorder impacts nearly 4% of young people
between the ages of 5-18.
We are learning more about this disorder, which typically
begins in childhood. Thankfully it is treatable, and we are beginning to break
down barriers and reduce stigmas attached to these patients through
education.
One of the reasons Tourette’s is so misunderstood is because
its symptoms can be seen and heard. Tics — rapid, repetitive muscle contractions
(movements) or sounds that are involuntary — are common signs of Tourette’s, and present themselves in
various ways:
• Simple motor tics: Involve one or a small number of muscles,
for example eye -blinking, grimacing, etc…
• Simple phonic tics: For example, sniffing, grunting, yelping and snorting.
• Complex motor tics: Contraction of several muscle groups and
can mimic normal movements, for example knee bending, hopping, simultaneous
extension of arms and legs, etc…
• Complex phonic tics: Includes words or phrases like “Hi,” “I love you,” or obscene words.
Repetition of someone else’s words is another common example.
Tics most commonly affect the face, head and neck, then
limbs and trunk. Examples include blinking, raising eye brows, winking,
grunting, snorting or clearing the throat.
Emerging data support the notion that tic disorders are
genetic and involve disturbances of neurotransmitters in the central nervous
system.
There is a close association between Tourette’s and Obsessive Compulsive Disorder and
Attention Deficit Disorder.
Treatment of tics includes a combination of prescription
drugs (including Risperidone, Clonidine, Guanfacine and Imipramine),
psychotherapy (behavioral therapy, habit reversal, awareness training, family
therapy) and education (support
groups and teaching families and teachers).
Research into Tourette’s continues. There is currently a
clinical trial involving Aripiprazole , which has been on the market to treat other disorders like
bipolar, schizophrenia and depression,
which could have potentially excellent results. Progress is being made,
and outcomes are improving.
Mahmoud Okasha, MD, is a psychiatrist with the Backus Medical Staff and an Associate
Clinical Professor at the Yale University School of Medicine. To comment on this column or others, visit the Healthy
Living blog at www.backushospital.org/backus-blogs or e-mail Dr. Okasha or any of the Healthy Living columnists at healthyliving@wwbh.org.
Monday, March 11, 2013
Is it normal forgetfulness or Alzheimer’s?
Haven't we all misplaced the car keys occasionally or drawn
a blank on someone's name just as we were about to make introductions?
Sometimes we feel frustrated at this occasional
forgetfulness. Sometimes we worry if it could be a sign of early Alzheimer's
Dementia.
Recently, a
vital, vibrant lady who is in her early 80s described some episodes of
forgetfulness and asked me if she could be "getting Alzheimer's."
I reassured her
that what she was experiencing was common for someone of any age. But I decided
to do a little research to prove my assertions. I checked out the Alzheimer's
Organization website www.alz.org
Here are some signs of Alzheimer's compared with typical age-related changes:
Here are some signs of Alzheimer's compared with typical age-related changes:
• The most common sign of Alzheimer's is memory loss,
particularly forgetting recently learned information. Asking for the same
information over and over is another significant sign. Normal age-related
change would be forgetting an appointment or event, but remembering it later.
• We all lose things from time to time and that can be frustrating,
but it's pretty normal. Misplacing things and being unable to retrace steps to
find them is a sign of Alzheimer's.
• Losing track of the date or the season is a sign of Alzheimer's.
It is a typical age-related change to forget which day it is and remember it
later.
• We all make a bad decision once in a while. If poor
decision-making and bad judgment becomes routine, further investigation is
warranted.
• A typical age-related change is sometimes forgetting which
word to use. A sign of Alzheimer's would be difficulty having a conversation.
I was going to add something to this list, but now I don’t
remember. Hopefully I’ll remember it later.
Alice Facente is a community education nurse for the Backus
Health System. To comment on this column or others, visit the Healthy
Living blog at www.backushospital.org/backus-blogs or e-mail Ms. Facente or any of the Healthy Living columnists at healthyliving@wwbh.org.
Monday, March 04, 2013
Improve health by washing away germs
Some might consider me a “germaphobe.” I consider myself safe.
In fact, many of nurses are commonly accused of being
obsessed with washing our hands. That’s a good thing.
I’ll get back to what we do in the hospital in a moment. But
here is something for you to consider:
Only one-third of people take the time to wash their hands after going
to the bathroom, according to a study by the American Society for Microbiology.
During National Patient Safety Awareness Week March 3-9,
hand washing is an appropriate topic. It’s the most important thing you can do
to stop the spread of germs — during flu season and throughout the year, inside
the hospital and out.
Outside the hospital, here are a few tips:
• Keep your kitchens and bathrooms clean and free of clutter.
• Sponges are filled with germs. To combat this, wet the
sponge and microwave it on high for a minute.
• Take care of leftovers as soon as everyone is done eating.
• After washing dishes, clean the counters, faucets and sink.
• Wipe down your bathroom every day.
• Don’t just rinse your hands with water — soap should be used
after going to the bathroom, before and after cooking and eating, etc…
• Use the first stall in a public bathroom — it has fewer
germs because people tend to pick others for privacy reasons.
• Don’t put your bags on the floor of a public bathroom — it
is loaded with bacteria.
In our
hospital, we have a policy of “wash in, wash out.” This means that staff
entering patients’ rooms are required to wash their hands when they enter and
when they leave.
This is the single most important thing we can do to prevent
the spread of infection in our hospital. We monitor this on a regular basis,
and while I’d like to say there is 100 percent compliance, we are not there
yet.
That’s where you come in. If you are a hospital patient,
friend, or family member, I urge you to be a partner in your care. Be
observant, and if you witness a staff member who does not observe this protocol
do not be afraid to speak up. In fact, we encourage it.
Beth Sullivan is an infection control nurse for the Backus
Health System. To comment on this column or others, visit the Healthy
Living blog at www.backushospital.org/backus-blogs or e-mail Ms. Sullivan or any of the Healthy Living columnists at healthyliving@wwbh.org.
Monday, February 25, 2013
The health benefits of optimism
At the Vietnamese restaurant, my cookie fortune read, “Your
life will be happy and peaceful.” My husband laughed and said, “It figures you would get that fortune.”
He is a
self-admitted pessimist, and I suspect my upbeat, positive attitude gets a
little annoying sometimes. But I
firmly believe there are health benefits to optimism. I decided to Google “health benefits of optimism” and got
1,120,000 hits.
A 2011 Mayo Clinic article reported that researchers
continue to explore the effects of optimism on health. Positive thinking may
provide these health benefits:
• Increased life span
• Lower stress levels
• Lower rates of depression
• Greater resistance to common colds
• Better psychological and physical well-being
• Reduced risk of death from cardiovascular disease
• Better coping skills during hardships and stressful times.
It's unclear why people who engage in positive thinking
experience these health benefits. One theory is that having a positive outlook
enables you to cope better with stressful situations, which reduces the harmful
health effects of stress on your body. It's also thought that optimistic people
tend to live healthier lifestyles — they get more physical activity, follow a
healthier diet, and usually don't smoke or drink alcohol in excess.
This would be bad news for pessimists, except renowned
psychologist Dr. Martin Seligman promotes the idea of “learned optimism.” He outlines a series of steps
pessimists can take to re-think their approach to problems and stressful
situations; view them as opportunities instead of negative forces. It’s an
attitude adjustment that takes practice. There is a choice to be made: view life
by looking at the positive side.
I’ve decided it is my mission to convert my husband to
optimism. When I shared that with him, his reply was, “Good luck with that one.” Clearly, I have a lot of work to do!
Alice Facente is a community education nurse for the Backus
Health System. To comment on this column or others, visit the Healthy
Living blog at www.backushospital.org/backus-blogs or e-mail Ms. Facente or any of the Healthy Living columnists at healthyliving@wwbh.org.
Monday, February 18, 2013
Keeping the house too cold can result in hypothermia
Oil prices have risen to more than $4 per gallon, so it’s no
big surprise people are lowering the thermostat.
However, lowering the thermostat too low can have severe
consequences.
Individuals
often think of hypothermia as a condition that occurs with overexposure to the
frigid outdoor conditions. But
hypothermia can occur when the temperature is set too low in your house or
apartment — even when temperatures are above 40 degrees.
Certain illnesses, medications and lack of basic activity
can make it difficult for your body to stay warm. Nader Bahadory, DO, an
emergency department physician, describes hypothermia as simply a condition
that occurs when body temperature falls below its 98.6 degrees.
Early signs of hypothermia include cold feet and hands, a
puffy or swollen face, pale skin, shivering (in some cases a person with
hypothermia does not shiver), slower than normal speech, slurring words, acting
sleepy, and confusion.
According to Dr. Bahadory, as hypothermia progresses, the
person may experience trouble walking, become clumsy, have stiff or jerky
movements, have slow and shallow breathing, slow heartbeat and blackout or lose
consciousness.
Dr. Bahadory provides the following suggestions to prevent
hypothermia.
• Keep your living areas warm. If you are not using certain
rooms close them off from the living areas, keep vents and doors closed, and
place a rolled towel in front of doors to keep out drafts. Keep the heat in by
closing the blinds and curtains. This will also help keep the cold air out.
• During the day, wear warm clothes, put long johns under
your clothes, wear socks, and place a blanket across your legs when sitting.
• When sleeping, use extra blankets, wear a hat and long
johns under your pajamas.
• Stay indoors on those cold and windy days. If you have to
go outside dress for the weather and wear warm clothes. Dress in loose layers
of clothing, put on a hat, scarf and gloves. You lose a lot of heat when your
head and neck are uncovered.
• Most importantly, if you live alone, ask family, friends
or a neighbor to check on you during cold weather.
What do you do if you think someone has warning signs of
hypothermia?
Having a body
temperature below 95 degrees is a medical emergency. The first step is to call 911.
Then wrap the person in a warm blanket. Your goal is to warm the core parts of
the victim like the chest, neck, head and groin. Do not rub the person’s arms or legs, do not use a heating
pad, and do not try to warm the person in a bath.
By following these simple suggestions, you can prevent
yourself, your loved ones, or even your neighbor from developing hypothermia.
Stay safe and warm.
Lisa Cook is a community education nurse for the Backus
Health System. To comment on this column or others, visit the Healthy
Living blog at www.backushospital.org/backus-blogs or e-mail Ms. Cook or any of the Healthy Living columnists at healthyliving@wwbh.org.
Monday, February 11, 2013
Know the signs and symptoms of a heart attack
Last month a friend of mine had a heart attack. He didn’t recognize the early signs
because they weren’t typical, like the crushing chest pain people often
describe as “an elephant standing on my chest.”
Several people have died while shoveling snow during the
blizzard this past weekend.
Perhaps they experienced unusual symptoms and ignored them because
didn’t recognize they were having a heart attack. Perhaps they had crushing chest pain, but it was too late to
call emergency medical responders.
A heart attack strikes someone about every 34 seconds. It occurs when the blood flow that
brings oxygen to the heart muscle is severely reduced or cut off
completely. This happens because
the arteries that supply the heart with blood have become thicker and harder
from a buildup of fat, cholesterol, and plaque. Often, the symptoms in men and women are
different. Here is what to look
for:
• Chest pain. Discomfort in the center of the chest that lasts
more than a few minutes; uncomfortable pressure, squeezing, fullness or pain.
• Indigestion
• Shortness of breath
• Cold sweats
• Nausea
• Lightheadedness
• Pain in other areas such as one or both arms, the neck, jaw,
back or stomach.
As with men, women’s most common heart attack symptom is
chest pain or discomfort. But some
women have no acute chest pain and are somewhat more likely than men to
experience some of the other symptoms such as:
• Back pain
• Jaw pain
• Shortness of breath
• Nausea or vomiting
• Dizziness.
Why do people delay seeking medical attention when they are
having heart attack? Often, they
don’t recognize the signs or attribute them to other causes. My friend had a rather severe case of
indigestion, took some antacid, and felt a little better. Fortunately, he did call his doctor to
report it, and was subsequently seen and treated appropriately in the ER.
My mother had a similar experience a few years ago. She was doing some heavy housecleaning
when her upper back started to hurt.
She thought she pulled a muscle, so she didn’t do anything about it.
When she mentioned the upper back pain to my sister, she wisely told Mom, “that
could be cardiac: I think you
should call your doctor right away.” Sure enough, my mother was evolving a heart attack,
and my sister’s quick thinking may have saved her life.
My colleagues in the ER admit it is sometimes tricky for
people to recognize the signs of a heart attack. They readily agree people can’t come to the ER every time
they feel dizziness or nausea, but if it is accompanied by one or more of the
other signs, don’t delay. Seek emergency medical attention if the symptoms persist more than
five minutes, and let the
professionals evaluate and decide if you are indeed having a heart attack. It truly is “better to be safe than
sorry.”
Monday, February 04, 2013
Top 10 tips for a healthy heart
On his late-night TV show, David Letterman often presents
his popular “Top Ten” lists. I find them enjoyable and entertaining. My charge is to write about health
topics, and it’s not so easy to make them entertaining. I guess I can only hope to be
informative and useful.
In that spirit,
and with Valentine’s Day just around the corner, I offer my “Top 10 Tips for a
Healthy Heart.”
10. Eat more fish and fiber rich foods like whole grains and legumes.
9. Eat less salt, sugar and fat.
8. Take medicine as prescribed. Keep them organized in a pillbox.
7. Get your blood pressure checked at least once a month.
6. Incorporate exercise into every day. Regular exercise will decrease your blood pressure and help you achieve or maintain a healthy weight.
5. Watch what you drink. Avoid diet sodas and caffeine. Limit daily alcohol to one drink for women, two for men. Water is still the best beverage choice.
4. Manage stress. We all have stress in our lives from one source or another and scheduling some fun or relaxation around it will stop it from taking over.
3. Laugh a lot. According to research from University of North Carolina, when you watch a comedy show or just laugh, your arteries expand with 22% more blood flow.
2. Fill half your plate with vegetables and fruits. The more colorful, the better. Visit www.chooseMY PLATE.gov for more information about this recommendation.
1.Think positive. Research suggests that positive emotions
such as optimism are associated with lowered production of the stress hormone
cortisol, better immune function, and reduced risk of chronic diseases. Make a
resolution to view the cup as half full instead of half empty. This comes
naturally to optimists, but it can be a learned behavior for pessimists. And the health benefits make it worth
it!
Monday, January 28, 2013
Help your children develop the right friendships
Your 11-year-old daughter comes home in tears. She tells you
the girls she’s been friends with forever are leaving her out of the group. She
doesn’t know what she has done wrong. She’s confused, and nervous about
returning to school because, “I don’t have any friends.” You are also confused
because your daughter is outgoing, personable, and fun-loving.
Friendships are important to the development of a child.
They help children be independent from the family and provide them with the
building blocks to develop mutual and trusting relationships. The pre-teen and
teen years are a time when children attempt to figure out how they want to fit
in as well as how they want to stand out from the rest of the group. It ‘s
natural for children to be concerned about fitting in, being popular, hanging
out with the cool, pretty or popular classmates and feelings of insecurity.
Cliques are common in middle and high school. According to girlshealth.gov,
a clique is a group of friends that all dress and act in a certain way. Cliques
are also “exclusive,” meaning that not everyone who would like the join the
clique can. In a clique, everything is done together; they go to the mall
together, they eat lunch together at the same table and are often active in the
same school activities. Cliques involve lots of rules, either implied or
clearly stated; such as wearing specific brands of clothing or participating in
certain activities.
Cliques and group friendships are extremely different.
Friendships develop from shared interests in sports, classes, activities, and
coming from the same neighborhood. Groups of friends do not exclude others from
joining their activities, they also allow members to socialize and hang out
with others not within the group without worry about being thrown out of the
group.
What can a parent do to help? Here are a few pointers:
• Talk about your
own experiences.
• Remind your child that things quickly change.
• Find books, TV
shows and movies that have strong messages about facing rejection and standing
true to your own morals and values.
• Try to enroll
in out-of-school programs and activities to foster friendships apart from
school.
With reality TV shows promoting rejecting others, as well as
deceitful and rude behavior, try to discuss ways to empower your children to
stand up for themselves or others. Talk about the real secret to being popular:
being the kind of friend they would want — one that is kind, respectful,
supportive, caring, trustworthy and fun.
Lisa Cook is a community education nurse for the Backus Health System. To comment on this column or others, visit the Healthy Living blog at www.backushospital.org/backus-blogs or e-mail Ms. Cook or any of the Healthy Living columnists at healthyliving@wwbh.org.
Monday, January 14, 2013
Cold weather can cause problems with feet
For people with diabetes, the winter months are a time when more attention than usual should be given to the feet.
Diabetics are at risk for having reduced blood flow to the lower extremities, and the cold weather compounds this problem. The dry weather from being inside also makes the skin more susceptible to drying and cracking. Also, diabetics have decreased sensation to the lower extremities which makes for a decreased awareness of issues which may be of concern with their feet.
Fortunately, there are steps that diabetics can take during the winter to minimize foot problems.
Many people use heating pads and warming blankets. Because of the decreased sensation or
neuropathy of diabetes, these devices can cause significant foot injuries and
should be avoided. If they are
used, the temperature of the devices should be checked with the elbow as the
sensation is not decreased as it is in the fingers and toes.
Here are some cold weather tips that will help diabetics and
just about anyone:
• Check winter shoes for proper fit to avoid tightness and
resulting injuries.
• Wear clean, dry
socks made of a natural fiber such as cotton to reduce irritation.
• Use moisturizing lotion on feet to increase comfort and help
exfoliate rough skin and avoid skin cracking, which may result in
ulceration.
• Pat your feet dry, don’t rub after bathing or showering.
• As with any
time of year, diabetics need to exercise great caution when trimming nails to
avoid trimming them too short. If
you must clip, work on toes that have been soaked in warm water for a few
minutes. Hard dry nails can split
and lead to problems.
• Routine exercise can be difficult during the winter months,
but it is important for diabetics because it will increase circulation. Lack of
exercise and activity can cause havoc with blood glucose levels, and extra
weight is not good on your feet. It is also important for diabetics to avoid
going barefoot in the house and to obtain a good fitting pair of slippers.
• Diabetics should check their feet daily, especially after
being outside and exposed to the cold, paying particular attention to any
changes in color and shape, cuts, swelling and infected toenails. In the event that a sore develops that
doesn't heal in a couple of days, or you have tingling in your feet that
doesn't stop or have no feeling in your feet, call your doctor for an
appointment. These things can be
problems with diabetics and ignoring them can lead to greater
problems.
Dr. Mark Tramontozzi is a member of the Medical Director of the Backus Health System Wound Care Center. To comment on this column or others, visit the Healthy
Living blog at www.backushospital.org/backus-blogs or e-mail Dr. Tramontozzi or any of the Healthy Living columnists at healthyliving@wwbh.org.
Monday, January 07, 2013
Enjoy New England's winter, but beware of snow shoveling dangers
Snow in New England is picturesque and makes winter special,
but I always feel a little sadness when it starts to accumulate. Many years ago, my father suffered a heart attack and
died immediately after shoveling our long driveway by hand. He had just celebrated his 59th birthday and thought he was in good
health. You can bet that I convinced my husband to buy a snowblower as soon as
we became homeowners in New England.
In the effort to help other families and avoid the heartache our
family and others have endured, I offer some safety information. Approximately 16,500 people are treated
annually in hospital emergency rooms for injuries that happened while shoveling
or removing ice and snow manually, according to the U.S. Consumer Product
Safety Commission,
All that bending and heavy lifting can put men or women at
serious risk for injury. Snow removal can be especially dangerous if you do not
exercise regularly.
First and foremost, check with your doctor. Because this
activity places high stress on the heart, you should always seek your doctor’s
advice and approval before shoveling or snow blowing. If you have a medical
condition or do not exercise regularly, consider hiring someone to remove the
snow. Take it from me: the cost will
be well worth it when you consider the alternative.
The American Association of Orthopedic Surgeons has some
tips for snow shoveling:
• Warm-up your muscles. Shoveling can be a vigorous activity.
Before you begin this physical workout, warm-up your muscles for 10 minutes
with light exercise.
• Pace yourself. Snow shoveling and snow blowing are aerobic
activities. Take frequent breaks and prevent dehydration by drinking plenty of
fluids. If you experience chest pain, shortness of breath, or other signs of a
heart attack, stop the activity and seek emergency care immediately. I suggest
keeping your cell phone in your pocket when outside shoveling.
• Proper equipment. Use a shovel that is comfortable for your
height and strength. Do not use a shovel that is too heavy or too long for you.
Space your hands fairly wide on the tool grip to increase your leverage.
• Proper lifting. Try to push the snow instead of lifting it.
If you must lift, do it properly. Squat with your legs apart, knees bent, and
back straight. Lift with your legs. Do not bend at the waist. Scoop small
amounts of snow into the shovel and walk to where you want to dump it. Holding
a shovelful of snow with your arms outstretched puts too much weight on your
spine. Never remove deep snow all at once. Do it in pieces.
• Safe technique. Do not throw the snow over your shoulder or
to the side. This requires a twisting motion that stresses your back.
Observe these snow removal safety tips, make some snow
angels, and then sit back and enjoy the beauty of snow in New England!
Monday, December 31, 2012
Follow your heart to a healthier life
When my children became adults they moved to Utah and
California to pursue their dreams.
Consequently, my husband and I spend a lot of time on
airplanes, visiting them as often as possible.
In an effort to
pass the time, I like to be friendly and engage my seatmates in conversation.
Unless, of course, the person pulls a hood over their face and pretends to
sleep even before take-off. I can
take a hint. But in most cases my
experience has been very positive.
I have met the most fascinating people.
Our most recent trek was to San Francisco, a six-hour
flight. The window seat was
occupied by a woman of about 55 years old who was on her way to a small
business seminar in San Francisco.
She was a genuinely happy person, with a positive attitude
who revealed that in the past she had a very responsible job that she
hated. She earned a good salary,
but had no job satisfaction. Her husband was deceased and she was raising her
two children alone. She seemed to be constantly sick from one illness or
another.
As soon as they
were grown and on their own, she quit her job to pursue her dream of owning her
own business. It was a struggle
getting started, and she still doesn't make as large a salary as she once did,
but she said her physical health improved dramatically once her emotional
health did. "I wouldn't go
back to a job I hated for all the money in the world."
Coincidentally, the in-flight magazine featured an interview
with actor Hugh Jackman. He told of his early life and career and how he acted
strategically instead of making choices from the heart. "I wish someone had told me
earlier that it's OK to follow my bliss," he said.
When I worked for Hospice, I often asked my patients if they
had any words of advice for me. It
was no secret that they were at the end of life, and they invariably said they
wished they had started working on their "bucket list" earlier. The
most content people were able to say they truly enjoyed their family, friends
and occupations. It was sad to
witness people who didn't pursue their dreams and sorely regretted it.
Colin Powell has been quoted as saying, “A dream doesn't
become reality through magic; it takes sweat, determination and hard work.” Indeed, it is not always easy, but my
children are pursuing their dreams and we have never seen them happier.
Hugh Jackman said, "whatever we do in life, if it's
from the heart, the result is irrelevant. It's the journey that matters. I'll
only follow my heart from now on."
Sounds like good advice for us all.
Alice Facente is a community education nurse for the Backus
Health System. To comment on this column or others, visit the Healthy
Living blog at www.backushospital.org/backus-blogs or e-mail Ms. Facente or any of the Healthy Living columnists at healthyliving@wwbh.org.
Monday, December 24, 2012
Reassure your children following Sandy Hook shootings
It is not a stretch to say that almost everyone in the state
and our nation is shocked and saddened by the Sandy Hook Elementary School
shooting in Newtown that killed 20 children and six adults.
These events
can be frightening for children and parents, especially when they occur
relatively close to our own community.
While young children may not fully grasp the intensity of the event,
questions arise and our children need to be comforted and have their questions
answered.
While we are all trying to regain our strength and continue
to support our loved ones, here are few tips that might help parents and
guardians:
• Reassure your children that they are safe in their home and
in their school. Emphasize that schools are safe and secure.
• Make time to talk with your children and validate their
feelings, whatever those feelings may be. Explain that all feelings are ok when
a tragedy occurs. Let children talk about their feelings and help put them into
perspective. Children may not always express themselves readily. Watch for
clues, for example clinging more than usual, and encourage them to talk..
Observe for any changes in behavior, sleep pattern and appetite.
• Keep your explanation appropriate to the age of the child.
Elementary school kids need brief, simple information and lots of reassurance.
Middle school children will need more details about whether they are truly safe
and what is being done to keep them safe. High school students will need to be
aware of their environment and follow safety guidelines. They should
communicate any strange activity or possible loophole in the security that they
see to appropriate authorities.
• Review safety procedures, including following guidelines and
knowing whom to go to when they feel threatened.
• Limit exposure to continuing media coverage. Often in cases like this, media can
inundate us with graphic images that can be disturbing for children as well as
adults.
• Maintain a normal routine. Keeping a regular schedule can be
reassuring. Encourage children to eat healthy and get plenty of sleep. Ensure
that they keep up with their school work and extracurricular activities, but
monitor for any sense of being overwhelmed.
If you are concerned or need further information, your
pediatrician can offer further
suggestions and resources.
Dr. Ravi Prakash is a member of the Backus Hospital Medical Staff and a private practice
pediatrician. To comment on this column or others, visit the Healthy
Living blog at www.backushospital.org/backus-blogs or e-mail Dr. Prakash or any of the Healthy Living columnists at healthyliving@wwbh.org.
Tuesday, December 18, 2012
The costs of smoking go even beyond your health
There can't be one person left in the world that doesn't know smoking is a health hazard. The effects of tobacco and nicotine have been well documented:
Lung cancer, bladder cancer, asthma, emphysema, circulatory
problems, not to mention prematurely wrinkled skin, bad breath, yellow teeth,
and tooth and gum disease.
Yet the Centers
for Disease Control and Prevention statistics reveal that in Connecticut, 15.9%
of the adult population — over 428,000 individuals — are current cigarette smokers,
and 9.8 % of youth ages 12-17 years smoked a cigarette in the past month.
Backus Health System Registered Respiratory Therapist
Annette McDonald, one of the certified facilitators for the American Lung
Association "Freedom From Smoking" cessation classes, has prepared a
list delineating the consequences of smoking on the wallet. This might provide more of an incentive
to quit.
At $8.50 per pack, if you smoked one pack per day it costs:
• $59.50 per week
• $255 per month
• $3,102.50 per
year
• $15,512.50 in five years
• $31,025.00 in 10 years
What can you buy if you saved that money instead of smoking?
• One pack of cigarettes = eight songs for your iPod on iTunes
at 99 cents per song
• In one week you would have enough money for dinner for two.
• In one month you would have enough money for a car payment.
• In one year you would have enough money for a vacation.
• In 5 years you
could buy a compact car.
• In 10 years you would save enough for a down payment on a
house.
When some people see these figures, it can have a bigger
impact than hearing health hazard statistics. No matter how you look at it — the cost of smoking is
not worth it, healthwise or in our pocketbook.
Start the new year right by taking a smoking cessation
class, which are offered at local hospitals. Quit smoking and start reaping the
health as well as the financial benefits.
Alice Facente is a community education nurse for the Backus
Health System. To comment on this column or others, visit the Healthy
Living blog at www.backushospital.org/backus-blogs or e-mail Ms. Facente or any of the Healthy Living columnists at healthyliving@wwbh.org.
