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Looking forward to imbibing a few this holiday season? The National Headache Foundation has a few suggestions:

-If you drink, do so in moderation

-Try to sip your drink slowly

-Mixed drinks containing fruit or vegetable juices will probably have less effect than straight alcohol

-Avoid red wine, as it contains chemicals that may cause headaches

-Reduce the number of alcoholic beverages you consume

-Eat some honey or drink some tomato juice

-Drink fluids containing minerals and salts

-Drink a cup of coffee

-Take ibuprofen

-Alternate beverages between alcoholic and non-alcoholic beverages

-Eat greasy food before imbibing

The foundation suggests trying this “champagne fooler.”

-1 1/3 cups apple juice

-1 teaspoon lemon juice

-12 ounces club soda

Chill four glasses.  Mix together apple juice and lemon juice.  Add club soda and stir gently to blend.  Pour into glasses and serve immediately.  Yields four servings.

Jeff Raymond, Medical Writer

I spent a recent Monday in Tahlequah talking to Cherokee Nation staff about diabetes. As is often the case, I had to leave out a lot of stuff. So I thought I’d share some of it here.

If you need a refresher, the story is here.

Dr. David Randall, chief of podiatry for the tribe, estimated 5 to 10 percent of diabetics are at risk of developing foot ulcers, about one-fifth of which lead to amputation.

Randall also said he thinks many people in the tribe’s 14-county jurisdictional area see others undergo procedures related to diabetes or suffer from its complications, increasing awareness of the disease and how to take care of oneself. He pointed out the tribe’s employee wellness program and the positive signs he has seen among his patients, most notably a “significant decrease” in amputations.

Diabetes Program Director Teresa Chaudoin said practically every Cherokee has a diabetic in the family. When she came to work for the tribe in 2001, her focus was largely clinical — after all, it was the most pressing. Later, she dove into prevention. Now the tribe has dietitians at each of its clinics and reports more people are able to manage their blood sugar.

“We’ve worked here to build a comprehensive, integrated program,” she said.

Lisa Pivec, director of community health promotion for the tribe, emphasized that losing weight, stopping smoking, eating well and taking appropriate medications worked to reduce chronic illnesses other than diabetes.  One of the tribe’s wellness initiatives, called Wings, began with walking and running but now includes bowling, stickball, dancing and other activities.

Wings members, of which there are more than 1,000, receive admission to 24 races a year. Members have reported a one-point drop in body mass index over nonmembers. Sounds like very little, but big health improvements can be in small numbers. Planned activities often suit the tribe’s rural citizens.

“A lot of our communities are very rural and they may need structured events,” Pivec said.

For health and medical news and commentary, visit The Medicine Bag blog at http://blog.newsok.com/health.

Jeff Raymond, Medical Writer

U.S. hospitals charged $873 billion in 2005 — a nearly 90 percent increase from the $462 billion charged in 1997 — according to the Agency for Healthcare Research and Quality. The inflation-adjusted 2005 bill represents the amount charged for 39 million hospital stays.

With an average annual growth rate in hospital charges of 4.5 percent, researchers predict the bill will reach $1 trillion by 2008.

AHRQ also found:

-Medicare paid $411 billion of the national bill, followed by private insurance ($272 billion) and Medicaid ($124 billion). 

-The uninsured accounted for $38 billion. 

This is taken from the AHRQ report:

For more health and medical news and commentary, read The Medicine Bag blog at http://blog.newsok.com/health.  

Jeff Raymond, Medical Writer

Many patients who have had nuclear medicine procedures don’t realize they can set off radiation alarms, a new study from the Centers for Disease Control and Prevention and the Agency for Healthcare Research and Quality found.

The study appears in this month’s issue of The Journal of Nuclear Medicine.

Twenty million nuclear medicine procedures are performed annually in the United States. They are used to detect and evaluate heart disease, brain disorders and cancer. They also are used to treat overactive thyroids and some cancers.

To quote the journal:

“Patients who receive radiopharmaceuticals in the course of diagnosis or treatment are often released when their bodies still contain elevated amounts of radioactive material. These amounts are sufficiently high to be detected by sensitive radiation monitors for days or even weeks after administration.”

However interesting this may be, the study actually examined how often doctors tell patients about the potential to trigger an alarm.

The study found room for improvement was needed.

“Patients undergoing diagnostic procedures are less likely than patients undergoing therapeutic procedures to be informed that they could activate radiation alarms in public places,” Armin Ansari, a health physicist in the radiation studies branch of the CDC, said in a press release. “We also found that many health care professionals who administer radiopharmaceuticals to patients — or who communicate with them regarding the radiation safety aspects of their procedure — have not had any formal or systematic training in patient education, communications or counseling.”

The study, done in collaboration with the Nuclear Regulatory Commission, examined patient release procedures and practices among 66 health care facilities in 12 states. Participating facilities perform a range of procedures including cardiac stress tests; positron emission tomography; bone, lung and renal scans; thyroid uptake studies; whole body scans and brachytherapy.

The study found that health care professionals — especially those in outpatient clinics and those performing only diagnostic procedures — could better inform and counsel patients before discharge or release.

“If patients plan to travel, they should make sure they have documentation on hand specifying their procedure and that the documentation includes a contact phone number for verification, if necessary,” Ansari said.

Washington University in St. Louis provides patients with wallet cards that detail the source of their radiation exposure should they be traveling, according to the release.

Jeff Raymond, Medical Writer

Rates of visits by the elderly to emergency rooms are outpacing those of other groups, which could lead to “catastrophic overcrowding,” according to a study this week in the Annals of Emergency Medicine.

“Seniors are using the emergency department more and more frequently, and given the needs of this population and the nature of their medical problems, the current state of overcrowding is likely to continue to escalate dramatically,” Dr. Mary Pat McKay of The George Washington University Medical Center said in a press release.  “These patients tend to be sicker and are more likely to be admitted from the emergency department to the hospital, but with many hospitals running a deficit of inpatient beds, I don’t see where these patients are going to go.”

Researchers studied ER visits from 1993 to 2003, and found that visits per 100 people 65 and older increased faster than the visit rate for any other age group, with an overall increase of 26 percent during the study period.

“People aged 65 and older are the fastest growing segment of the U.S. population. As emergency patients, they use the most resources, stay the longest, and are the most likely to be admitted to the hospital of all emergency patients.  Researchers conclude that emergency department visits in the United States for patients between 65 and 74 could nearly double from 6.4 million in 2003 to 11.7 million by 2013,” according to the release.

AARP Policy Director John Rother called on elected officials to “heed the warnings” of the report and recognize that the health care system must deliver appropriate, affordable care.

 “The trends released today underscore the need to make sure emergency departments can meet the demand for care by older people, but we also need a better understanding of why emergency room use by older people is on the rise and why these patients may not be getting care from their personal physicians,” he said in the release.

The study suggests older Americans are having more genuine emergencies, rather than increasingly visiting the emergency department.

For health and medical news and commentary, visit The Medicine Bag blog at http://blog.newsok.com/health.

Jeff Raymond, Medical Writer