Stroke guidelines at Baptist
The Integris Cerebrovascular & Stroke Center at Baptist Medical Center is participating in the American Stroke Association’s Get With The Guidelines–Stroke program.
The goal is to improve stroke treatment and prevent future strokes.
The program was developed to help hospitals employ “science-based treatment guidelines,” according to an Integris press release. The guidelines address stroke management and prevention, and the establishment of stroke centers.
“As a GWTG-Stroke participating hospital, Integris Cerebrovascular & Stroke Center at Baptist Medical Center is encouraged to develop a comprehensive system for providing rapid diagnosis and treatment of stroke when patients are admitted to the emergency department. This includes always being equipped to provide brain-imaging scans, making neurologists available to conduct patient evaluations and using clot-busing medications when appropriate,” according to the release.
Treatment and prevention of strokes includes use of statins and anti-platelet medications, treatment of atrial fibrillation and atherosclerosis, and management of weight, diabetes and cholesterol.
Through the GWTG-Stroke program, the American Stroke Association provides Baptist with training and staff recommendations, “care maps,” discharge protocols, standing orders, and data collection and measurement tools.
According to the stroke association, approximately 700,000 people suffer a stroke each year.
For health and medical news and commentary, read The Medicine Bag blog at http://blog.newsok.com/health.
Jeff Raymond, Medical Writer
Stay healthy this winter
With influenza season arriving in Oklahoma this month, Lauri Smithee, chief of the Acute Disease Service at the Oklahoma Health Department, offers specific instructions for avoiding colds, germs and infectious diseases. Many of which involve basic hygiene.
“If you get sick, it puts you out of commission and that’s no fun, especially if you are a caregiver of children or other family members. There are important steps we all should take,” Smithee said.
Her advice:
- Wash your hands – You’ve heard this before, but washing hands before eating, after visiting the restroom, after changing diapers, after blowing your nose — is the best way to avoid illness .
- Carry hand sanitizers – Alcohol-based hand sanitizers, particularly the ones that are not antibacterial, are good substitutes for hand washing until you get home or to a location where you can wash your hands.
- Watch what you touch – Try to avoid touching things like bathroom door handles (use a towel), escalator rails, elevator buttons (use your knuckle) and pens at checkout counters (carry your own).
- Stay home – When you start to feel bad, stay home. Do not go to work, church or school, and do not visit a nursing home or hospital. This is the time you are most contagious, especially if you have a fever.
- Keep it to yourself – Sneeze into your elbow, not your hand ; if you cough or sneeze into your hand, wash your hands immediately and throw used tissue into the trash.
- Stay alert when traveling – Get all recommended traveler’s immunizations in plenty of time for trip abroad in 2008; don’t drink untreated water; if you become ill when you return home, tell your doctor where you’ve been.
– Jim Killackey, medical writer
Tips to avoid holiday hangovers
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
Diabetes and the Cherokee
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
Diabetes is seldom alone
A recent study from the University of Michigan Health System and the Veterans Administration Ann Arbor Healthcare System found 92 percent of older diabetes sufferers have at least one major chronic condition in addition to diabetes, and nearly half have three or more diseases besides diabetes.
“The sheer number, and the severity, of these other conditions appears to decrease patients’ ability to manage their diabetes,” according to a press release, which suggested doctors learn to better treat “the whole person” rather than that person’s individual ailments.
The study was published online before appearing in next month’s issue of the Journal of General Internal Medicine. Researchers used data from a nationally representative sample of 1,901 adults with diabetes who were 55 years old or older in 2002.
The researchers looked at the influence a range of medical conditions had on participants’ ability to manage their diabetes and whether the conditions were linked to diabetes.
“Patients are dealing with these issues day to day, and they’re affecting the way people prioritize and manage their own self-care,” author Dr. Eve Kerr said in the release. “Meanwhile, we physicians talk to patients about their diabetes, but not about how their heart failure or their hypertension is affecting how they manage their diabetes. These results show that we need to be treating the whole patient, but we don’t yet have systems designed to do that.”
The more diseases a person had along with diabetes, the study found, the more they prioritized the other conditions ahead of diabetes. Participants also often didn’t associate the other conditions with diabetes, such as understanding how the metabolic disorder puts them at higher risk of heart disease and stroke. Lack of awareness of the association often means diabetes sufferers don’t put enough emphasis on controlling blood pressure and cholesterol, for example.
Jeff Raymond, Medical Writer
Last Integris drive-through flu clinic
Integris Pacer Fitness Center is offering its last drive-through flu clinic of the season.
Just drive up, roll down the window, roll up your sleeve and get vaccinated.
The clinic will be from 9 a.m. to 1 p.m. Saturday in the Integris Baptist Medical Center East Parking Lot.
The cost per flu shot is $22. A pneumonia shot is $30. Medicare will not be accepted.
Jeff Raymond, Medical Writer
Depression by job
As I looked through the 1,200 e-mail messages I accumulated during my vacation, I ran across this.
According to data from the National Survey on Drug Use and Health released last month, full-time workers ages 18 to 64 in the “personal care” and “service occupations” had the highest rates of depression, followed closely by food service. The survey used 2004-06 data to determine depression rates by occupation.
During this time, an annual average of 7 percent of full-time workers ages 18-64 experienced a “major depressive episode” in the past year.
For women, the highest rates of depression were in food preparation and service occupations — 14.8 percent. For men, the highest rates were in arts, design, entertainment, sports and media — 6.7 percent.
The unemployed had higher rates of depression than did those employed full time and part time.
U.S. companies lost an estimated $30 to $44 billion a year because of depression-related lost productivity, absenteeism and low morale, according to a press release on the study.
And, of course, depression rates vary by occupation and industry. Seems obvious, but it’s interesting to see research bear it out.
Occupations with the lowest rates of depression were engineering, architecture and surveying; life, physical and social sciences; and installation, maintenance and repair.
As this is a health care blog, 9.6 percent of health care practitioners and technical personnel reported being seriously depressed.
I have one observation to make on the men’s end: Many people wind up in arts-entertainment-media jobs straight out of college, with stars in their eyes. When they find out how little money they’ll make, and realize how incredibly competitive the job markets are, they get down.
Take, for example, a dream job as a trainer with a professional sports team. Now imagine having to deal with the debt of a master’s degree, frequent travel, little respect and a paltry salary. That’s just one example I’m personally familiar with.
Wanna talk? E-mail me at jraymond@oklahoman.com.
Jeff Raymond, Medical Writer
More evidence of the obesity crisis
Maybe you’ve seen this story, but it certainly caught my attention: Tons of kids are taking the “little purple pill” we hear about all the time.
The Associated Press reported Oct. 4 that young children’s use of heartburn drugs has surged 56 percent from 2002-06.
The story rightly put the blame on obesity and overuse.
A survey by Medco Health Solutions, a New Jersey-based pharmacy benefits management company, examined U.S. prescription data from 2002-06. The survey suggested more than 2 million children used drugs for digestive or gastrointestinal complaints last year, The AP reported.
Medco estimated 3 percent of children 4 years old and younger were taking these drugs last year. This was a 56 percent increase, the highest among any child age group.
Acid-reducing drugs, called proton pump inhibitors, are the most commonly prescribed drugs for GI problems, The AP reported. They are used for acid reflux and gastroesophageal reflux disease. Heartburn and acid reflux is common in children and often goes away with time or lifestyle changes.
The story dealt only with prescription drugs, not those available over the counter, which many are.
Jeff Raymond, Medical Writer
Barriers to TB treatment
Here’s a window into why tuberculosis is so devilishly hard to treat and eradicate.
The Sept. 7 “Bulletin of the World Health Organization” explains how researchers in Tomsk, Siberia, studied success and adherence to treatment among a group of 237 Siberians.
The Russian Federation has been hit hard by TB, and Tomsk had one of the world’s highest rates of multi-drug-resistant TB.
Substance abuse was strongly correlated with non-adherence to treatment, researchers found.
No surprise to me, but this is documented, not conjecture.
Patients who began treatment in the hospital or were hospitalized during their treatment were more likely to develop drug-resistant TB. Researchers speculated the patients harbored a drug-resistant strain that emerged upon treatment or contracted the strain while hospitalized.
I’m sure there are similar studies published elsewhere, and I wouldn’t be surprised if they say the same thing.
Drug-resistant TB and sloppy adherence or lack of adherence to treatment go hand in hand. While this study was interesting for looking at the correlation with alcohol use and other substance abuse, the same likely would apply to many of Americans who are most vulnerable to TB — especially IV drug users.
Although researchers are working in quicker-course TB drugs, the current drugs take months and must be taken regularly. In the past, sufferers were locked in sanatoriums. Today, they’re followed by health department personnel, not an easy task when the person is transient.
A positive point emerged from the study, too: Most patients completed treatment, and relatively few contracted drug-resistant TB.
Something to think about.
Jeff Raymond, Medical Writer
Free prostate cancer screenings
OU Medical Center and OU Physicians will offer free prostate cancer screenings Saturday for men ages 40 to 70.
The screenings will be at the OU Physicians Building, 825 NE 10th St. Registration is required and is available by calling 271-5000.
The screening consists of Prostate Specific Antigen (PSA) blood tests, funded by the Medical Center Volunteers Inc. and Digital Rectal Exams (DRE) performed by urologists.
Prostate cancer is the number one cancer affecting men in Oklahoma and is the second leading cause of death due to cancer in the United States. Each year, more than 500 Oklahoma men die from prostate cancer. The American Cancer Society recommends men 50 years old and older should have a screening once a year.
