Healthy Living

Alcoholism affects six out of 10 adults in the greater Norwich area.  Even more staggering, 10% of these adults also partake in binge drinking.

Alice Facente is a registered nurse and clinical educator at the The William W. Backus Hospital Education Department. This column should not replace advice or instruction from your personal physician. If you want 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

Colorectal cancer is common in eastern Connecticut. Every year we see an increasing number of patients diagnosed with this condition.

Although prevention with timely colonoscopies should always be the goal, when colorectal cancer is diagnosed, surgical resection is the most important step for a cure.

Recently, minimally invasive surgery for the treatment of colorectal cancer has advanced significantly. However, despite the obvious benefits of this approach, it is estimated that only about of 25% of colon resections are done with laparoscopic, minimally invasive techniques in the United States. This is probably due to the complexity associated with these procedures.

Luckily for those living in our region, a much higher percentage of patients receive laparoscopic surgery – in my practice it is approximately 80%. The benefits associated with laparoscopic surgery vs. traditional “open” resections have clearly been established in numerous studies worldwide. They include:

• Shorter recovery times and length of stay in hospitals
• Smaller incisions result in less pain
• Fewer complications such as infections and hernias
• Possibly better outcomes for cancer patients.

Minimally invasive laparoscopic procedures can only be performed well when you have specially trained physicians and operating room staff. It is crucial that these clinicians are very familiar with the equipment, instruments, operating room set up and overall general needs to perform these complex operations.

Some hospitals also have operating rooms specifically designed for minimally invasive surgery. These rooms have high definition video capabilities, mobile monitors, and plenty of space to accommodate any equipment, including surgical robots, required for the surgery.

All of these factors combined result in higher quality care, and, most importantly, better outcomes for our patients and their families.

Dr. Sergio Casillas is a board-certified colon and rectal surgeon at Backus Physician Services, with additional training in minimally invasive colorectal surgery. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, visit the Healthy Living blog at www.backushospital.org/backus-blogs or e-mail Dr. Casillas or any of the Healthy Living columnists at healthyliving@wwbh.org

Hospitals are constantly finding ways to make its patients as safe and comfortable as possible. But patients can also play a role in this ongoing process. Here’s how:

• You might wonder why staff keeps asking your name and date of birth over and over again. This is to ensure that the right medication or procedure is given to the right patient and in the proper fashion. Be patient with this process, and know that it is our way of ensuring accuracy.

• You might not be yourself when you are hospitalized. Don’t be embarrassed or feel like you are bothering anyone – ask for help getting up or going to the bathroom if you feel unsteady.

• Don’t be afraid to ask questions of your nurses, physicians or other members of the healthcare team. We encourage you to do so.

• Our staff is vigilant about washing their hands between every patient. If you do not see this being done, please ask your healthcare provider if he or she has done so. In addition, make sure that your wash their hands and be sure to advise them that if they are not feeling well to avoid visiting the hospital. All of this helps prevent the spread of infections and other sicknesses.

• Keep an updated list of your medications and dosages, including over-the-counter medicines and herbal supplements. Try to use one pharmacy.

• Remember, most hospitals have a patient advocate. If you suspect something is wrong, or your visit is not going the way you would like, contact the patient advocate to help you.

While no one wants to go to the hospital, we want to make sure that your stay is the best it can be. Working together we can achieve this goal, and hopefully make you happier and healthier in the process.

Lauren Mallozzi is the Director of Patient Experience and Service Excellence at The William W. Backus Hospital. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, visit the Healthy Living blog at www.backushospital.org/backus-blogs or e-mail Ms. Mallozzi or any of the Healthy Living columnists at healthyliving@wwbh.org

You might have heard of the phrase “medical home.” But what does it really mean?

In short, it is developing a long lasting and meaningful relationship with a healthcare provider, a relationship that can help you stay healthy and manage any existing conditions you may have.

People without medical homes many times end up in emergency rooms, which can be too late, and costly.

In a patient-centered medical home, your care is coordinated with your doctor, who may help refer you to specialists when needed. Because your doctor knows your complete medical history, you can trust that you are in good hands and he or she can help guide you through the healthcare system when needed — including hospitals, physical therapy and home health agencies.

Technology is also a key part of a medical home. Electronic medical records are being developed to create an easier information exchange between physician offices, hospitals and even patients themselves. This increases efficiency and, in the end, improves overall health.

A lot has changed in healthcare. Previously, hospitals only cared for people when they came to the institution. Now, some of the most important healthcare occurs outside the walls of the hospital. Preventative health, aided by medical homes, is a key driver of this.

Linda Lacerte, MD, is a primary care provider at the Montville Backus Health Center. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, visit the Healthy Living blog at www.backushospital.org/backus-blogs or e-mail Ms. Lacerte or any of the Healthy Living columnists at healthyliving@wwbh.org

When I recently did an Internet search for “cigarette smoking statistics in Connecticut,” I got more than 4 million hits.

The Centers for Disease Control and Prevention website yielded so many statistics my head was soon spinning.

But here are two sentences that put it all in perspective: “Tobacco use is the leading preventable cause of death in the United States. More deaths are caused each year by tobacco use than by all deaths from human immunodeficiency virus (HIV), illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders combined.” That’s pretty shocking.

On a more positive note, a recent smoking cessation program held at our hospital — the American Lung Association program, “Freedom From Smoking” — was a great success.

More than half of the 29 people who took the seven-week course reported that they “quit for good.” Most of the others report they significantly cut down on the number of cigarettes smoked in a day. All of the participants in the program found the group support to be very helpful.

For more information about how to participate in this proven American Lung Association program, call (860) 889-8331, ext 6381, and be one of the good statistics.

Andrea Zrenda is a respiratory therapist at The William W. Backus Hospital. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, visit the Healthy Living blog at www.backushospital.org/backus-blogs or e-mail Ms. Zrenda or any of the Healthy Living columnists at healthyliving@wwbh.org

Years ago, a blood pressure of 140/90 was considered normal, but extensive research has provided evidence that this is too high.

The latest guidelines from the National Heart, Lung and Blood Institute of the National Institutes of Health say:

• Normal is 120/80 or less.

• Pre-hypertension is 120-139 systolic (as the heart beats) over 80-89 diastolic (as the heart relaxes between beats).

• Stage 1 hypertension is 140-159 systolic, over 90-100.

• Stage 2 hypertension is 160/100 or higher.

The first step is knowing what your blood pressure is. Backus Hospital conducts free, monthly blood pressure screenings on the third Wednesday of every month from 1-2 p.m. in main lobby conference room 3.

If you have high blood pressure, speak with your healthcare provider about options, which can range from lifestyle changes to pharmaceutical options.

To prevent high blood pressure, cut down on your salt intake, maintain a healthy weight and exercise daily.

These suggestions are small prices to pay, considering that consistently high blood pressure causes stress and ultimately injures the brain, arteries, eyes, kidneys and heart.

Alice Facente is a registered nurse and clinical educator at the The William W. Backus Hospital Education Department. This column should not replace advice or instruction from your personal physician. If you want 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

A common misconception is that heart failure is a heart attack. It is not. It also does not mean your heart has stopped or is even about to stop.

But it is a very serious condition. Heart failure results after an injury to the heart causes it to become weakened and pump less effectively. The injury can be sudden such as in the case of some heart attacks or gradual as a result of other chronic illnesses such as high blood pressure, high cholesterol, diabetes and obesity.

Heart failure, previously known as congestive heart failure, is a common but under recognized cardiac disease affecting nearly five million Americans. There will be up to 700,000 new cases diagnosed this year.

Feb. 12-18 is National Heart Failure Awareness Week – the perfect time to learn more about this chronic illness.

Symptoms of heart failure can be remembered by using the acronym FACES; Fatigue, Activities limited, Chest congestion, Edema or ankle swelling and Shortness of breath. If your doctor suspects that you may have heart failure, there are tests that should be ordered to best determine a diagnosis and evaluate the extent of your illness.

There is currently no cure for heart failure but there is good news -- with early diagnosis and proper treatment you can slow the progression of the disease and improve your quality of life. Due to advances in medicine there are more options available today to help treat heart failure than ever before.

People with heart failure should see their health care provider regularly, limit salt intake, weigh themselves daily, take medication exactly as prescribed, and exercise as recommended by your healthcare provider.

For more information visit www.abouthf.org

Cindy Arpin is a registered nurse and Coordinator of the Backus Hospital stroke and congestive heart failure programs. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, visit the Healthy Living blog at www.backushospital.org/backus-blogs or e-mail Ms. Arpin or any of the Healthy Living columnists at healthyliving@wwbh.org

Healthy food can be delicious and nutritious.

When I finally decided to get serious and commit to losing weight, I did a little research.

It seems that there were two things I needed to do: Eat nutritious and healthy food, but control the size of my portions.

Guidelines for portion size were a shock to me: 3 ounces of chicken or meat is the size of a deck of cards? That was only three bites for me!

One portion, or ½ cup, of cooked pasta, is the size of a light bulb. Are they kidding? My bowl of pasta was the size of the whole lamp.

One cup of salad greens = one portion = size of a baseball? I guess I had been eating basketball-sized portions of salad greens.

One portion of salad dressing is the size of a poker chip. I had poured on the salad dressing in an amount equivalent to a stack of poker chips.

Once I accepted that I would have to cut down the size of my usual portions by at least half, I realized I had to weigh and measure my food before eating it.

Then I found it was vital to log in every bit of food I ate. Dianne Rubin, leader of the “ Thin’s In” weight loss program, always says, “You bite it, you write it” and this became my mantra. I wrote down everything I ate in a log with the type of food and measurement. It kept me accountable and honest. It sure was an effective trick: I somehow resisted the urge to overeat when I knew I had to write it down.

The second challenge, making this healthy food delicious and inviting, is just as difficult. We have some help for that with our upcoming program, “Delicious and Nutritious” presented by Backus Registered Dietitian Sarah Hospod.

On Wednesday, Feb. 8 from 6:30-8 p.m, in the Backus main lobby conference rooms, Ms. Hospod will talk about healthy eating, snacking, and portion sizes, and how healthy food can still be delicious and appetizing. Register for the free program by calling 860-889-8331, ext 6381. Come join us and let her show how to make delicious and nutritious eating a reality.

Alice Facente is a registered nurse and clinical educator at the The William W. Backus Hospital Education Department. This column should not replace advice or instruction from your personal physician. If you want 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

With increased interest in “all-natural” and “organic” products, many consumers are looking for these labels, and who can blame them?

People are inundated with claims on television, radio, internet, and store advertisements that products labeled as “all natural” are safer alternatives to those which may have been chemically manufactured.

However, when it comes to medications and supplements, such as vitamins and herbs, is it really safe to say that what grows naturally is always safe?

Probably not. That’s why Backus Hospital is offering a free community education program, “Know Your Meds, Supplements, and Vitamins,” on Thursday, Feb. 16, from 6:30-8 p.m. at the Plainfield Recreation Center. To register, call 860-889-8331, ext. 6381. The presentation, part of the ongoing Enjoy LIFE (Lifelong Investment in Fitness and Exercise), will be made by Backus Hospital pharmacists Michael Smith and Kate Wheeler.

Prescription and over-the-counter medications, such as Advil or Tylenol, are manufactured by companies responsible for proving that their product is safe and effective at the labeled dose when taken according to the labeled instructions. These companies must also prove that each dose contains the labeled ingredients and will remain stable, safe, and effective until the labeled expiration date. All of this information must be submitted to the Food and Drug Administration for evaluation to ensure that what is being produced is appropriate for marketing and availability to the consumer.

Unfortunately, the same is not true for vitamins and herbal medications that can be bought over-the-counter. The manufacturers of these products are not required to follow quality and safety standards, and are not required to prove that the product is effective for the stated claim (i.e. relieve insomnia, improve memory).

As the consumer, it is impossible to evaluate consistency from tablet to tablet, and bottle to bottle. One cannot be sure exactly what is being taken with each dose.

This is not to say, however, that vitamins and herbal medications do not play an important role in overall health.

It is important to remember that vitamins and herbals should be treated just like other prescription and over-the-counter medications.

When thinking of starting a new product, it is vital to be informed as to the potential benefits, while also the risks.

Having a discussion with your physician or community pharmacist about the medications you are currently taking, as well as your medical conditions, can help narrow down which products are best for you.

Some vitamins and herbal medications, although “all natural," can and do interact with many prescription drugs and increased monitoring may be needed.

It is important to remember that all natural does not necessarily mean safe. The human body does not differentiate between an “all-natural” product and one that is man made, thus the body breaks down and processes both products in a similar fashion. A discussion with your physician and/or community pharmacist is the best way to determine which products, whether prescription or over-the-counter, are best for you, taking into account all medical conditions and current medications.

Jillian Asselin, PharmD, is a pharmacist at The William W. Backus Hospital. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, visit the Healthy Living blog at www.backushospital.org/backus-blogs or e-mail Ms. Asselin or any of the Healthy Living columnists at healthyliving@wwbh.org

Major Depressive Disorder is a common disorder affecting about 16 million to 18 million Americans in any one year at a cost of $82 billion. This is a leading cause of disability, and a crippling disease that leads to major disturbances in one’s life — affecting patients in their work, family, and social life.

“Having depression made me feel like I was an awful person. I did not want to leave my house or be with my family or friends. I would not go to work because I could not bring myself to get out of bed in the morning. Sometimes I would only sleep a few hours of the night and wake up repeatedly. When I was awake I could not focus on anything. I felt completely empty; I could not enjoy anything. Food was tasteless and I lost a lot of weight. I was continuously fighting to get through another day.”

This was a quote from a depressed, 55-year-old female patient. This married woman was treated by her primary care provider with Zoloft for months without any improvement. She was then referred to me. The antidepressant was switched to another antidepressant (Effexor XR), and she began psychotherapy.

Her mood improved to some degree but she still complained of lack of motivation, poor energy, inability to enjoy hobbies (crossword puzzles, cooking, and her three grandchildren who previously were her pride and joy).

After a year of treatment with minimal improvement, I suggested Transcranial Magnetic Stimulation (TMS). The patient agreed and within three weeks she was back doing crossword puzzles, and cooking. Within four weeks she was spending a lot more time with her grandchildren — she looked forward to going to work, her concentration was much better, she reconnected with her friends, enjoyed going out to dinner with her family, gained back the weight she had lost and felt her life was meaningful again.

TMS is the latest non-pharmaceutical treatment modality for major depressive disorder that does not respond to other treatments. In a large clinical trial done by the National Institute of Mental Health involving over 4,000 patients, it was found that only 30% of patients treated with antidepressants were totally free of any symptoms of depression.

TMS works by stimulating key neurons in the brain that are believed to be involved in the pathophysiology of depression. Unlike antidepressants that are swallowed and circulate in the body, TMS delivers high intensity focused magnetic pulses that lead to the formation of electrical currents, which are transmitted to deeper structures in the that are also associated with symptoms of depression.

The electric impulses stimulate the neurons to increase neurotransmitters (much like antidepressants) that are lacking in depressed individuals. Unlike medication, TMS does not lead to side effects (weight gain, sexual dysfunction, sedation, gastrointestinal problems) and unlike Electro Convulsive Therapy it does not require anesthesia or muscle relaxants and does not lead to any memory problems. It is an effective treatment that is safe and non-invasive.

Typically the patient will drive to the office, will receive the treatment while lying in a comfortable reclining chair (similar to a dentist chair) will be awake and alert during the session (40 minutes) and can drive back to work or home. The course of treatment is approximately 20-30 sessions and is given five days a week, Monday through Friday. Some patients may require “booster” session after six months and some may need to continue on an antidepressants, but will definitely require less pharmacological intervention than prior to TMS treatment.

Mahmoud Okasha, MD, is a physician with Comprehensive Psychiatric Care of Norwich. This column should not replace advice or instruction from your personal physician. If you want 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

It might sound odd at first, but hospitals are actually working to keep patients out of the hospital.

Gone are the days when hospitals only took care of you when you are sick. To improve the community health, prevention is the best medicine.

At a time when many people don’t have medical insurance and only seek care when they absolutely have to, many people are seeking their care in hospital emergency departments. This is not healthy, and very costly.

That’s why the concept of “medical homes” is so important.

Think of it as “one-stop shopping” for your healthcare needs. In a patient-centered medical home, your care is coordinated through a real partnership with your doctor — your “personal physician.” Because the doctor knows you and your medical history, you can trust him or her to be responsible for all your healthcare needs. This includes arranging care and sharing health information with other qualified providers — specialists, hospitals, home health agencies, rehab specialists, nursing homes, or hospice.

In the medical home model, your care can be more effective, more efficient — and therefore safer. We have all had experiences where a test needed to be re-done, or a doctor didn’t know the results. Technology — backed by caring personal physicians — can create smoother transitions between the hospital, physicians and specialists. This is naturally linked to better overall health, disease prevention and greater patient satisfaction.

You can learn more about medical homes at our next Enjoy LIFE (Lifelong Investment in Fitness & Exercise program on Jan. 19 at 6:30-8 p.m. in the Plainfield Recreation Center. To register, call 860-889-8331, ext. 6381.

When people wait to seek healthcare until it is an emergency because they are without insurance or don’t want to pay a deductible, many times it is too late and their illness has progressed to the point where it is serious and possibly untreatable. Having a medical home can help patients lead healthier lifestyles, and prevent more serious illnesses.

Some of the most important healthcare now occurs before you ever get sick. Having a medical home provides a foundation for this.

Alice Facente is a registered nurse and clinical educator at the The William W. Backus Hospital Education Department. This column should not replace advice or instruction from your personal physician. If you want 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

Good communication with your primary care doctor or nurse practitioner may be the most important factor in getting good health care.

You want a doctor who will listen carefully to your concerns, answer your questions, and explain things clearly and fully.

Asking questions is key to good communication with your doctor. If you don’t ask questions, he or she may assume you already know the answers or just aren’t interested in getting more information.

But communication goes two ways; It’s very important to feel comfortable discussing your concerns, especially sensitive issues. It is critical not to keep secrets – your primary care provider needs to know your health habits like alcohol or tobacco use, signs of anxiety or depression, incontinence, memory problems, sexual risk factors and behaviors. It’s also in your best interest to be honest if you are adhering to your prescribed medication regimen or treatment.

Our next program in the Enjoy LIFE (Lifelong Investment in Fitness and Exercise) series is “Getting the Most Out of Your Doctor Visit” on Thursday, Jan. 19, from 6:30-8 p.m., at the Plainfield Recreation Center.

Dr. Ramindra Walia, Medical Director of United Community & Family Services (UCFS) based in Norwich and a member of the Backus Medical Staff, will discuss how to choose a primary care provider, why it’s important to have a “medical home” and how to talk to your doctor.

This program is free, but registration is required by calling 860-889-8331, ext. 6381.

An Access to Care specialist will be available to talk about obtaining health insurance. At a time when many people don’t have medical insurance and only seek care when they absolutely have to, Backus and UCFS have partnered to station these specialists in the hospital’s emergency department to reach to identify uninsured and under-insured patients and link them with government insurance programs and health centers like UCFS that will help them establish “medical homes.”

Full-fledged, patient-centered medical homes provide comprehensive primary care that encourages relationships between patients, physicians and families. This model has been endorsed by many of the nation’s largest primary care physician associations, including the American Academy of Physicians, American Academy of Pediatrics, American College of Physicians and American Osteopathic Association.

In a nutshell, medical homes promote access to coordinated, personal, high quality and less costly care. For example, how many times have you ever been in a situation where you have had a test, but your doctor or the hospital doesn’t have access to it because it was performed somewhere else? Medical homes allow for patient information to be easily shared by providers, many times electronically.

As care becomes more coordinated and information is streamlined, patients have smoother transitions between hospitals, physicians and specialists. Communication increase, preventative health develops and overall health improves.

As the healthcare landscape continues to evolve, this kind of preventative medicine will become increasingly important.

When people wait to seek healthcare until it is an emergency because they are without insurance or don’t want to pay a deductible, many times it is too late and their illness has progressed to the point where it is serious and possibly untreatable. Having a medical home can help patients lead healthier lifestyles, and prevent more serious illnesses.

It also lowers costs. We all lament how expensive healthcare is, and how insurance coverage is becoming increasingly cost prohibitive. One of the reasons is the fragmented nature of healthcare, and also the fact that people with insurance inevitably pay for those without it.

Those without insurance many times only seek emergency care, which hospitals must provide regardless of a person’s ability to pay. But emergency care is more expensive, and many times less effective. Clinicians in emergency room environments are great at what they do – treating emergent issues.

But some of the most important healthcare occurs before you ever get sick. This can only occur when there is a healthy, long-standing relationship between patients and their healthcare providers.

Alice Facente is a registered nurse and clinical educator at the The William W. Backus Hospital Education Department. This column should not replace advice or instruction from your personal physician. If you want 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

The tragic house fire in Stamford on Christmas Day was a sobering reminder to us all of the fragility of life.

According to the National Fire Protection Association, 482,000 structure fires occurred in the United States in 2010, resulting in 3,120 deaths and more than 17,000 injuries. Here is essential fire safety advice we all should heed:

• Formulate and practice a home fire escape plan that everyone, even the children, understands. Pull together everyone in your household and make a plan showing two ways out of each room, including windows. Don't forget to mark the location of each smoke detector. Determine a place to meet outside to make sure everyone in the family is accounted for. Have a practice fire drill at least twice yearly.

• Have smoke detectors installed on every level of your house, including the basement. Test batteries by pushing the button on the alarm, ideally once a month. Change batteries twice a year, each fall and spring when we change the clocks for daylight savings time. A smoke detector is worth so much, possibly a loved one's life, yet is so inexpensive. More than 90 percent of fire deaths occur in residential dwellings between 11 p.m. and 6 a.m. when occupants are asleep. Smoke detectors alert occupants when a fire is still small and there is still time to escape.

• Take extra care when burning candles in the home. Never leave burning candles unattended. Make sure the flames are not near anything combustible, including curtains or lampshades.

• Space heaters can be hazardous. Again, never leave unattended or place them near anything that could burn, including shoes or furniture.

• Carbon monoxide detectors are potential life-saving devices. Install carbon monoxide detectors on all levels of your home, especially near sleeping areas, advises Fred Potter, Backus Hospital’s Coordinator of Emergency Medical Services.

• Norwich Deputy Fire Marshal Jake Manke advises every household to have a working fire extinguisher in a readily available and reachable location. Check the battery gauge and be familiar with how to use it. But he stresses the most important thing is to get everyone safely out of the house and call 911, allowing the professionals to fight the fire.

The National Fire Protection Association is the standard for accurate information in the fire safety field. Family fire safety plans and other vital information is offered at its website: www.NFPA.org.

Let’s all work to protect our families as we look forward to a healthy and safe New Year.

Alice Facente is a registered nurse and clinical educator at the The William W. Backus Hospital Education Department. This column should not replace advice or instruction from your personal physician. If you want 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

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 that may be of concern.

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 such devices should be checked with the elbow as the sensation is not decreased as it is in the fingers and toes.

• Winter shoes should be checked for proper fit to avoid tightness, which can lead to foot injuries. Clean, dry socks made of natural fiber such as cotton should be worn to reduce irritation.

• Moisturizing can help comfort and exfoliate rough skin, and prevent skin cracking.

• Feet should be patted dry and not rubbed after bathing or showering.

• As with any time of year, diabetics need to be cautious when trimming nails to avoid cutting them too short. If you must clip, work on toes that have been soaked in warm water for a few minutes and are softer. 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 increases circulation. Lack of exercise and activity can cause havoc with blood glucose levels, and extra weight is not good for your feet.

• It is also important for diabetics to avoid going barefoot in the house – use a good-fitting pair of slippers.

• Diabetics should check their feet daily, especially after being outside and exposed to the cold. Pay 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. Ignoring these symptoms can lead to larger health issues later.

Mark Tramontozzi, MD, is the Medical Director of the Backus Wound Care and Hyperbaric Oxygen Therapy Center, which is located in the Backus Outpatient Care Center on Salem Turnpike in Norwich. This column should not replace the advice of your healthcare provider. If you want 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

“If people are healthier, they are generally happier. If people are healthier, they are likely to be more productive. If people are both happy and productive, the economy will follow suit.” This is the opinion of Jeffrey Levi in a recent column in the Huffington Post.

I couldn’t agree more. It certainly seems logical — smoking leads to a wide range of complications that can lead to lost time at work.

But how do we begin the fundamental task of getting healthier? Here are some startling statistics:

We all know that smoking contributes to a multitude of health problems.

The state Department of Public Health issued a fact sheet entitled, “A Quick Look at Smoking In Connecticut” revealing some staggering statistics:

• More than 450,000 adults in Connecticut smoke cigarettes, which translates into 17% of adults — 18.9% of men and 15.2% of women, according to the state Department of Public Health.

• Even more startling is what we found in eastern Connecticut. A community health needs assessment telephone survey conducted by a national research firm on behalf of Backus revealed that nearly have of the region’s adults have smoked at least 100 cigarettes in their lifetime.

• Approximately 40% of those who answered the telephone survey are regular smokers.

Since 2012 is almost upon us, it’s the perfect time to make a New Year’s resolution to quit smoking once and for all.

Backus Hospital is sponsoring the highly successful American Lung Association smoking cessation program entitled, “Freedom From Smoking.”

Led by certified facilitator Annette McDonald, a Respiratory Therapist at Backus, the seven-week sessions start Tuesday, Jan. 10 and run until Feb. 24 (Week 4 is Quit Week so there is a second session that week on Thursday, Feb. 2). They are held at the Backus Outpatient Care Center on Salem Turnpike in Norwich from 6-8 p.m.

Participants must pay $50, but they receive the $50 back if they attend all eight sessions. We did this because our past experiences with smoking cessation classes show that if there is a monetary stake, the chances of completing the program are much higher. Any money that is not refunded goes toward the course materials for participants.

For more information, or to register for the program, call 860-889-8331, ext 6381.

Let’s all do our part to improve the economy — and our region’s health — by quitting smoking in 2012.

Alice Facente is a registered nurse and clinical educator at the The William W. Backus Hospital Education Department. This column should not replace advice or instruction from your personal physician. If you want 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

Millions of people nationwide suffer from carpal tunnel syndrome, which is caused by repetitive movements of the hand and wrist.

In addition to the pain it inflicts, carpal tunnel syndrome is also a leading cause of people missing work. It results in millions of dollars in workers’ compensation costs each year, according to the U.S. Department of Labor.

It is most common in people who perform repetitive motions of the hand and wrist, especially those who do a lot of typing. Sewing, driving, use of tools, playing musical instruments and some sports can also cause pressure on the median nerve, which ultimately causes the numbness, weakness and tingling of the hands and fingers associated with this syndrome.

There are ways to reduce the chances of acquiring carpal tunnel syndrome. For example, your doctor might recommend an occupational therapist or ergonomic expert who can observe your working conditions and habits and make recommendations on usage and placement of equipment, such as your mouse pad or keyboard.

If you do have carpal tunnel syndrome, treatment can include medications, wearing splints, physical therapy and hot and cold compresses. However, if these treatments do not help, surgery should be considered.

Endoscopic carpal tunnel surgery is an effective, low-risk procedure. Technology has progressed to the point where it can be completed in 6-10 minutes, with no hospital stay.

Using an endoscope with a camera attached, the surgeon guides the tube through a small incision in the wrist. The surgeon is able to see structures in the wrist and cut the transverse carpal ligament, which releases the pressure on the median nerve.

This minimally invasive technique is just as effective as traditional open surgery. Its benefits include less pain and faster recovery times.

Thomas Cherry, MD, of Backus Physician Services, specializes in cosmetic and hand surgeries. This column should not replace the advice of your healthcare provider. To contact Dr. Cherry, call 860-425-5300. If you want to comment on this column or others, visit the Healthy Living blog at www.backushospital.org/backus-blogs or e-mail Dr. Cherry or any of the Healthy Living columnists at healthyliving@wwbh.org

Healthcare professionals are so accustomed to using acronyms that we forget that not everyone understands us when we explain things. When I was in nursing school and learning what seemed like a million acronyms, we never tired of creating new names for the terms.

We amused ourselves by devising names for that long-anticipated goal of Registered Nurse: RN came to be known as Real Nuts, Really Nosy, Rotten Neighbors, Respectable Nerds, Roasted Nuts, Reacts Negatively, Respects Nobody or Rusty Nails.

Our friends in medical school were striving to be MDs, or Mentally Developing.

Then there are the diseases. That opened up a whole new world of acronyms. For example, COPD, which stands for Chronic Obstructive Pulmonary Disease, became Can Order Pizza Delivery. Coronary Artery Disease, CAD, was an easy one: Cats Attack Dogs. Short of Breath already had a great acronym: SOB. So what do you think DJD stands for? Degenerative Joint Disease really means Delicious Jelly Donuts.

If someone tells you that you have CHF, they may mean Congestive Heart Failure, but you know in reality you Can’t Hide Flatus.

Working in the hospital setting brought another set of acronyms and code words to decipher. For example, RRT means Rapid Response Team, but I was so accustomed to re-naming it, I called it Really Rotten Teeth. When “Code 8” was paged overhead, I wondered what happened to Codes 1 through 7.

Then we came into the age of email and texting abbreviations...don’t get me started on that...LOL!

Alice Facente is a registered nurse and clinical educator at the The William W. Backus Hospital Education Department. This column should not replace advice or instruction from your personal physician. If you want 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

Over the holiday weekend, there was some good news to report on Connecticut roadways: There was a significant decrease in arrests and tickets related to driving under the influence, seat belt violations, speeding and other moving violations.

This might very well have to do with the many efforts aimed at educating the public. For many, the messages have finally sunk in. You just don’t see as many people driving under the influence or not wearing their seat belts.

For the most part, we have seen this trend at The William W. Backus Hospital as well. As Trauma Program Manager, the statistics do seem to show a decrease in car crashes related to these reckless behaviors.

Unfortunately, there is one area where the news isn’t so good. We continue to see many people hospitalized and/or injured due to distracted driving. Whether it is talking on the phone, sending a text or even drinking a cup of coffee, these behaviors continue to cause tragedy on our roads.

Nationally, approximately 40 percent of teens report being in a car at some point with a driver using a cell phone. And as cell phones have moved into the age of smart phones with texting and internet access, the temptations have only increase.

What can we do about this?

First, all of us must continue to do our best to educate young people on the dangers of distracted driving.

In recent years, we have modified our Be Aware program at Backus to include this message. Previously, this program focused only on showing teens the dangers of driving under the influence, speeding and seat belts.

But distracted driving can be just as deadly. Some of the worst crashes – and major tragedies – I have seen in recent years are related to distracted driving.

It all starts with educating our youth, combined with laws banning cell phone use while driving and enforcement. We need distracted driving to be taken as seriously as other moving violations. Lives depend on it.

Gillian Mosier is a registered nurse and manager of the Backus Trauma Program. This column should not replace advice or instruction from your personal physician. If you want 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

Podiatrists deal with many foot conditions -- sports injuries, fractures, bunions, arthritis pain, and lower extremity wound care.

With the weather turning colder, there is an increase in some of these.

That is because in the summer, we allow our feet to stretch out and even slightly widen in open, loose-fitting shoes. As the weather changes, the shoes become more constrictive, which increases many issues from bunion pain to joint pain to numbness and sores and ingrown toenails. Proper shoe-fitting is a simple key to decrease rubbing pressure that can increase the chance of developing a problem.

During the colder weather, there is decreased humidity in the air, which can increase dry, cracked skin throughout the body. Specifically on the feet and legs, these cracks can open, bleed and become infected. Proper skin hydration lotions, a bedside humidifier and limited barefoot time are simple preventative measures that help reduce these issues.

Another concern during the winter months is for people with poor circulation, neuropathy or diabetes. There is already decreased circulation to the legs, and in the colder months, not protecting with appropriate garments can lead not only to increased symptoms, such as pain, color change and burning, but could even lead to sores, infections and amputations.

If you’re experiencing any of these conditions, you should seek medical attention before the problems become worse.

Dr. Eric Levine is a podiatrist who is on staff at the Backus Wound Care and Hyperbaric Oxygen Therapy Center. This column should not replace the advice of your healthcare provider. If you want to comment on this column or others, visit the Healthy Living blog at www.backushospital.org/backus-blogs or e-mail Dr. Levine or any of the Healthy Living columnists at healthyliving@wwbh.org