Monday, August 31, 2009


New medical dramas damage perception of nurses

If imitation is the greatest form of flattery, than those in the medical field should be feeling warm and fuzzy as of late. The onslaught of medical shows on both premium and cable television is fast approaching pandemic proportions -- with no cure in sight.

Dr. Kildare made his first house call into American homes in 1961 in what is considered to be the first television medical drama. He would soon be followed by the likes of Marcus Welby, MD, as well as one of my favorite TV docs, Joe Gannon from Medical Center. While these shows were not terribly accurate in their portrayal of the medical field, they did portray the medical community in a relatively respectable light.

It wasn’t until 1972 when M.A.S.H. arrived on the scene that comedy, albeit often times dark, was added to the mix. This trend towards comedy interspersed with drama would be repeated in shows such as Doogie Howser, MD, Northern Exposure, Scrubs and House, M.D. to name just a few.

As a nurse I have enjoyed many of these shows. Yes we have to look past the blatant disregard for reality such as the IV tubing heading to nowhere or, as is the case with House, physicians who single handedly perform every conceivable procedure a patient may require. Over the years the image of nurses has been largely that of a physician’s helper who appears to be mute most of the time. The times they are a changin’ but not in the way the media would have you believe.

Today’s nurse is an active and respected member of the medical team. He or she enjoys a level of autonomy that has been earned by the profession. Many standing protocols allow the nurse to implement a wide variety of tests and procedures before the physician even enters the scene. Job opportunities run the gamut of bedside, administrative, in hospital, out of hospital, military and civilian, medicine, trauma and a whole host of other specialties. It is an exciting time to be a nurse. Why is that not portrayed in the media?

I looked forward to the premier of two new shows in particular; Nurse Jackie and HawthoRNe. Both have proved to be disturbing letdowns. My hope was that these new nurse-centered shows would help to spark an interest in this fascinating field that is so in need of new recruits. Instead they portray offensive and demeaning stereotypes that are an insult to both nurses and women.

In the case of Nurse Jackie I found a show about a drug and sex addicted woman who I certainly would not want to have caring for anyone I love. HawthoRNe seemed to be portraying nurses in a more positive light, though not terribly accurate, when the story line suddenly included a sexual relationship between a nurse and a patient. Is it nurses or the American viewers that these producers have such low opinion of?

Both shows have prompted position statements from the American Nurses Association (ANA). The ANA points out that the negative images portrayed in these shows “erode the highly valued trust of patients who rely on the expertise of nurses… these harmful images also play a role in shaping the values, impressions and ultimately career choices of young people, and may very well contribute to the nursing shortage that is reaching crisis proportions in our nation.”

TNT and Showtime missed a great opportunity; I wonder what Dr. Welby would have prescribed to remedy this.

Cindy Arpin is a registered nurse and Stroke Coordinator at The William W. Backus Hospital. This advice should not replace the advice from your physician. Email Ms. Arpin and all the Healthy Living columnists at or comment on their blog at

Tuesday, August 25, 2009


Forgiveness is a powerful healing tool

There are times in everyone’s lives when it feels hard or even impossible to forgive. Most of us realize the need for forgiveness in order to achieve a release of negative feelings and move on with our lives in a positive direction, but it is often difficult to truly allow ourselves to heal from past emotional injuries.

The first step to forgiveness is recognizing that the act of forgiving is not synonymous with condoning the hurtful event or behavior, nor does it mean you will forget what happened to you. Forgiveness simply means that you understand that holding on to anger and pain doesn’t do you any good. When you can release these feelings and free yourself from the negative energetic connections to an event, place or person, you have achieved forgiveness.

Forgiveness is more easily reached when you feel heard, respected and understood. Take the time to really listen to your hurt and sadness, directly addressing those feelings rather than burying them. Katherine M. Piderman, Ph.D., writes that we need to “recognize the value of forgiveness and its importance in our lives at a given time. Reflect on the facts of the situation, how we’ve reacted, and how this combination has affected our lives, our health, and our well being.”

Meditation is a useful tool that can help us learn to hear and understand what we are feeling. The act of meditation brings our minds to a deep state of relaxation and awareness. Meditation can be practiced in many forms, from the Christian practice of the rosary to Theravada Buddhism, which emphasizes the meditative development of mindfulness and concentration as part of the pursuit of Nirvana. Experiment with different methods to determine what works best for you.

Remember that forgiveness doesn’t always mean reconciliation, and a reunion is not a necessary product of forgiveness. The person may have died, or may have caused you physical or emotional harm. The purpose of forgiveness is to take away the power that the negative connection to that person has over you, and put you back in control of your emotions.

We all choose our own paths in life – those who are unable to forgive may live a lifetime of bitterness, anger and regret. Choosing to actively forgive others, as well as ourselves, helps us to lead lives that are full of joy, peace, gratitude and love. We all have painful events residing in our memories; forgiveness helps to lessen the pain and allows us to enjoy life by learning to focus on the good. Because of the emotional freedom it grants us, forgiveness is one of the strongest healing powers we can develop within ourselves.

Paula Novak, a registered nurse and certified Healing Touch practitioner, is the clinical coordinator for Healing Touch and Integrative Care at The William W. Backus Hospital in Norwich. This column should not replace advice or instruction from your personal physician. E-mail Novak and all of the Healthy Living columnists at, or comment on their blog at

Friday, August 14, 2009


Counting calories and exercise are keys to good health

You’ve decided you want to lose some weight. As long as you burn more calories than you consume, you can shed those pounds.

Just keep in mind that just about everything you eat or drink, except water, contains calories. And everything you do, from intense exercise to sleep, burns them.

There are approximately 3,500 calories in a pound of fat. So if you burn as little as 500 calories more a day then you consume, you can lose one pound a week.

If you attempt vigorous exercise, it may actually backfire. According to the August 2009 issue of Time magazine, exercise can stimulate hunger.

The more intense the exercise, the more we may want to eat. If we consume more calories than we just lost by exercise, any weight loss would be negated. So avoid that temptation of rewarding yourself by eating an ice cream or other calorie-ridden foods after exercising

According to a study in the August 2009 issue of the Journal of the "American Dietetic Association," people who practiced yoga gained less weight over a 10-year period than those who did not. This was independent of physical activity. They hypothesized that a skill, learned either directly or indirectly through yoga – could affect eating behavior.

Of course, exercise has other health benefits such as lowering the risk of heart and other diseases.

There are many tools available on the Internet to help you lose weight and promote good health.

Your ideal body weight can be determined using a BMI (body mass index) calculator, many of which can be found online by searching for “BMI calculator.”

The caloric content of many foods is available on their nutrition labels and on the Internet.

The calories burned for exercises can be determined by using an exercise calorie calculator found on sites such as

The more you weigh, the more calories you will burn with a given exercise. If you’re having trouble losing weight, you may wish to contact your doctor so he or she can check for diseases that can inhibit weight loss.

Dr. Paul H. Deutsch is board-certified in Internal Medicine, a member of The William W. Backus Hospital Medical Staff and in private practice in Norwich. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, go to the Healthy Living blog at or E-mail Deutsch or any of the Healthy Living columnists at

Monday, August 10, 2009


Pain reliever acetaminophen is safe if used properly

Acetaminophen, known commonly as the brand name Tylenol and by its chemical abbreviation APAP, is the most widely used medication in the country.

Although considered the safest pain reliever available, it is also the most common cause of liver failure and accidental overdoses kill more than 100 Americans each year.

These two facts are why the FDA recently convened a special panel to take another look at acetaminophen’s safety.

When can acetaminophen become dangerous? It is based on how the liver removes it from our bodies. Acetaminophen is metabolized in our liver to harmless substances that are eliminated in urine.

A single step in the process produces a toxic metabolite that in usual situations is quickly inactivated by a compound called glutathione. In an overdose situation, the body can run out of glutathione. When this occurs, the toxic metabolite begins to accumulate and liver damage can occur in just a few hours.

The question is then how much is too much? For healthy adults, the standard recommendation has always been a maximum of 1000mg per dose and a daily total of no more than 4000mg is considered safe.

Elderly persons, those with liver disease, and those whom consume alcohol on a chronic basis should take less and discuss this issue with their physician. Taking more than 4000mg per day happens all too often – usually the culprit is not keeping track of how much is in the many combination products being used.

Besides being sold over-the-counter (OTC) as a pain reliever and fever reducer in tablets, capsules, and liquids all on its own, acetaminophen is available as an active ingredient in many combination products.

Vicodin, Percocet, Darvocet, Excedrin, Vicks DayQuill, Contac Sever Cold and Flu, and TheraFlu Flu and Sore Throat are just a few of over 50 prescription and OTC products available that contain acetaminophen as just one of its ingredients.

Sometimes acetaminophen is clearly listed in the ingredient chart, other times it is “hidden” as “APAP.” Problems arise when a person uses multiple products at the same time and fails to pay attention to the total amount of acetaminophen they are receiving, an easy thing to overlook when you don’t feel well.

The FDA advisory panel has suggested a number of measures that could help decrease the risk of accidental overdoses.

The recommended amount for a single dose and total daily doses maybe lowered, extra strength tablets (500mg each) may become prescription only, and combination products may not be allowed to be produced any longer.

Each of these recommendations has pros and cons and the FDA has yet to act upon them. In fact they it may choose to not make any changes at all.

How can you protect yourself and your loved ones now?

Remember that acetaminophen is still the safest pain reliever for healthy adults and should continue to be used for mild to moderate pain.

The most important thing is to check each of your medications that you are using for pain or fever relief for the amount of acetaminophen or APAP that is contained in each dose. Add up the amounts and be sure to intake no more than 1000mg in any 6-hour period or 4000mg in 24 hours. Pay special attention when using multiple pain or cough and cold products at the same time.

Staying below these limits will help ensure your safety.

Michael Smith is a pharmacist and Clinical Coordinator in the Department of Pharmacy Services 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, go to the Healthy Living blog at or e-mail Smith and all of the Healthy Living columnists at

Tuesday, August 04, 2009


Fruits and vegetables are great sources of antioxidants

What food has the highest antioxidant content? I am not going to tell you and it probably does not matter.

Antioxidants are found in all plant foods. There are numerous antioxidant compounds -- thousands have been identified including Beta-carotene, Vitamin C, Vitamin E, Selenium, and phytochemicals such as lycopene, lutein, flavonoids, reversitol, anthocyanins.

An orange contains at least 170 known different antioxidants. They are concentrated in the pulp and skins of plants, so whole foods would have a higher concentration than juices or peeled foods.

Some antioxidants are broken down by cooking and heat and some are released from the plant cells by cooking. A good example of this is lycopene in tomatoes.

What is an antioxidant? Antioxidants protect plants for oxidative damage from the sun, damage by insects and from oxygen made inside the plant through photosynthesis.

People are not plants, but antioxidants help them too. The cells in your body burn oxygen, producing free radicals. These are not escaped hippies, but rather unstable molecules that can cause damage to cells and DNA. Antioxidants sweep up these unstable molecules and render them harmless. Ultra violet light and smoking also produce free radicals.

When you cut an apple in half and it turns brown, this is damage from the oxygen in the air to the apple. If you dip the apple in orange juice, the apple will stay white, this happens because the Vitamin C in the orange juice protects the cells of the apple from damage.

Many locally grown and common foods are good sources of antioxidants: Delicious Granny Smith apples, cherries, blueberries, pecans, potatoes (skin on) and dried beans.
Herbs, spices, coco, nuts and tea are also good sources of antioxidants.

Antioxidants are measured in the lab, getting an ORAC rating (oxygen radical absorption capacity).

Each lab’s method differs, making ORAC values vary. ORAC values are based on 100 grams (3.5 ounces of food), not on commonly consumed amounts or recommended portion sizes.

ORAC value of Acai berries is based on a freeze-dried product weighing 100 grams. Think about how much popcorn it would take to weigh 3.5 ounces (about 3 1⁄2 cups); that is why the ORAC value is so high, a huge amount of berries are being measured. Another problem with ORAC ratings is that is does not measure actually usability in the body.

There is much that we do not know about antioxidants. We do not know how much antioxidants per day are needed to prevent disease.

Antioxidants have been linked with lower rates of heart disease, eye health and some types of cancer. We also do not know if the effects are related to the antioxidants alone or the whole plant food.

Fruits, vegetables, whole grains, nuts and seeds have value beyond antioxidant content; they are good sources of dietary fiber, vitamins, minerals and fatty acids. These whole food components likely work together. For this reason getting antioxidants in a pill or supplement form is probably not as beneficial as getting antioxidants from whole foods.

Get your antioxidants by eating whole plant foods and whole grains. Aim for more than five servings of fruits and vegetables per day with an optimal goal of seven servings per day.

Vary the types and colors of plant based foods that you eat. Antioxidant value of processed foods (flavored beverages and yogurts) containing added antioxidants and fruit extracts are more of a marketing ploy than a healthy addition to your menu. Many of these products are high is sugars and calories and just plain do not taste as wonderful as a fresh ripe watermelon or sugar snap peas. Instead enjoy plain yogurt with a fresh peach, a sprinkling of walnuts and a teaspoon of honey.

Homemade iced tea with lemon is a good choice for an antioxidant-rich cold drink. Fill your plate with rainbow colors; greens (kale, broccoli, kiwi) orange (carrots, squash, cantaloupe) yellow (grapefruit, yellow beans) purple (eggplant, plums, blueberries), red (tomatoes, watermelon, cranberries) and white (cauliflower, apples, onions).

Mary Beth Dahlstrom Green is a dietitian at The William W. Backus Hospital. This column should not replace advice or instruction from your personal physician. E-mail Green and all of the Healthy Living columnists at or comment on their blog at

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