MEDICAL INFORMATION - Archived

Below, you will find information on the following topics:

 

GERIATRICS

Medical Segment Show 169

Air date: 5/26/02

When you get older, your medical problems tend to become more complex, and things are not always as they seem.  Forgetfulness may be caused by a thyroid problem.  Depression or falls may result from drug interaction.  Older folks have unique medical issues that require special attention from a geriatrician, so we brought you one of the leading geriatricians, Dr. James Campbell from MetroHealth.


Question: Why should someone see a geriatrician? Why wouldn’t you just go to your regular doctor?
 

Answer: People often first come to a geriatrician when regular practice is not meeting their needs. For example, if they’ve had a fall or if they have dementia.
However, there might be other reasons to see a geriatrician. These doctors have a good understanding of issues specific to aging, and won’t write problems off as being from old age. All health issues deserve to be investigated.

Question: At what age do you recommend someone contact a geriatrician?
 

Answer: Anyone over 65 can see a geriatrician. Most geriatric issues begin surfacing around 75 to 80 years old.

Question: What are some of the issues geriatrics deals with?
 

Answer:

There are lots of reasons to see a geriatrician.  Depression, drug interactions, dementia, falls, and lots more.  With the right help, you can improve your life.  Don’t hesitate—if you’re not feeling right, don’t write it off to age. Get checked out by a geriatrician.

---James Campbell, MD
Geriatrician

SURGICAL TREATMENT OF MALIGNANT  MELANOMA

 

Medical Segment Show 170

Air date: 6/2/02

Melanoma, skin cancer, can be frightening. But there’s been some exciting progress in its treatment. Dr. Bruce Averbook, a surgical oncologist with MetroHealth, will tell us about new treatments for melanoma that can save your life.

Question: What is Melanoma?

 

Answer: Melanoma is an aggressive skin cancer

Question: Is it a discoloration or a skin growth?


Answer: Melanoma can be either or both.  We look for an Irregular border, discoloration, or a change in size or diameter

Question: If you have Melanoma, can it spread throughout your body?

 

Answer: Yes - - it can start in the skin, then move to your lymph nodes, then anywhere.  It can be deadly.

Question: If a person has melanoma, do you take out the lymph nodes?

 

Answer: Removing the lymph nodes involves the risk of nerve damage, swelling in arms and legs.  There is a new procedure - - the surgeon takes only a couple of nodes, and analyzes them, testing for cancer.

Question: with this new procedure, after you test a couple of nodes, if you find cancer, what's the next step?

Answer: If cancer is found, we probably would take more of the lymph nodes.

Question: What if no cancer is found?

Answer: We could check the DNA - a more fine- tuned test

 

If you spot an unusual mark on your skin, have a doctor check it. There’s an exciting new treatment available.

 

---Dr. Bruce Averbook

 

TRAVEL MEDICINE

Medical Segment Show 171

Air date: 6/16/02

We look forward to traveling when we retire. Although most of us plan our trip itinerary with great care, we overlook our health itinerary! Here to help us map out a plan is Dr. Peter Wiest, director of MetroHealth’s Travel Medicine Clinic.

Question: Lots of people want to spend their retirement traveling. But how can they make sure that they can do so without risking their health?


Answer: That’s the purpose of our travel medicine clinic. If you are going to travel outside of the United States and Europe (mainly developing countries such as China and those in Africa or South America), the clinic can provide advice and the necessary health precautions such as information, shots and prescriptions.
They can also help after you return from your travels if you do become ill.
 

Question: What are some of the major issues/precautions travelers should take?
 

Answer: There are four major areas we look at. The first is immunization. Depending on the country one is visiting, we may need to immunize them against yellow fever, typhoid, hepatitis A, rabies or Japanese encephalitis. We also want to make sure that the traveler is up to date on his/her tetanus shot.
A second concern is precaution against insect-borne diseases, the most common of which is malaria. There is medication that can be prescribed (nefloquine), and other precautions like insect repellent, netting, air-conditioning, and covering up at night are recommended.
Thirdly, we prepare travelers to avoid traveler’s diarrhea. Tips include boiling all water and making sure that all bottled water is sealed. Avoid ice cubes. Some safe drinks are hot coffee and tea, cola, beer and wine. Eat only food that has been cooked thoroughly or that has to be peeled (such as bananas and oranges). Avoid salads—the vegetables may have been washed in contaminated water. There are antibiotics we can give you to treat yourself. If the diarrhea comes with a high fever or blood, that is more serious.
Lastly, any unique needs must be covered. For example, if you plan on being around animals or will be visiting caves, specific health needs might have to be addressed.

Question: How early should you see the travel clinic if you are preparing a trip?
 

Answer: Six to eight weeks is plenty of time. Some shots come in series that have to be done over a month, so you want to give yourself some time.

 

Before you pack your bags, pack yourself up with the right health care information. The only souvenirs you want to return with are the ones you purchased!

---Peter Wiest, MD
Director, MetroHealth Travel Medicine Clinic

10,000 STEPS TO BETTER HEALTH

 

Medical Segment Show 173

Air date: 6/23/02

Summer’s a great time to get motivated to start exercising and losing weight. But staying motivated—that’s a horse of a different color. MetroHealth’s Dr. Rita Beckford, a family physician, group fitness instructor and personal trainer, explains a new fitness program that any of us can do, 10,000 steps at a time.


Question: I’ve heard of a 10-step program, but not a ten THOUSAND step program. Is this something new? What does it entail?
 

Answer: This is the first year MetroHealth, in partnership with the Cleveland Metroparks, is involved in 10,000 Step Program for Better Health. However, these are popular throughout the country.
The idea behind this program is to get people to exercise. Everyday, we average 3-5,000 steps in our normal activities. We are trying to make it so that everyone who joins raises that number to 10,000 steps each day.
The yearlong program will kick off at the Metropark Zoo’s Senior Celebration Day.

Question: How do you join? Does it cost much to participate?
For $15, you receive an exercise kit that includes an easy-to-use pedometer (you just clip it on your belt/slacks, etc), a booklet on the Metroparks (including trails that you can use for your walking), a starter booklet (with tips, directions, motivation), and a subscription to the Metroparks newsletter, “The Emerald Necklace.”
Also, throughout the year members will receive motivational mailings and/or prizes to help them stick to the program.
You can sign up at the MetroHealth gift shop or at the Cleveland Metroparks Earthwords Nature Shops. Those are located at Canal Way, the North Chagrin and Rocky River Nature Centers, and at the Zoo.

Question: So this program wants you to get fit by walking.  Is that strenuous enough to make a big difference in your fitness? What are some of the benefits?

Answer: Yes! Walking IS a cardiovascular activity. You don’t have to overexert yourself to see the benefits. In fact, walking for 30 minutes, three times a week is enough to see results—even if the thirty minutes aren’t consecutive.
Results you might see include lowering your cholesterol and blood pressure, losing weight, better sugar control for diabetics, increased energy, better sleep, more mental alertness, and sometimes it even helps mild depression.

Question: If you are starting an exercise program, how can you make sure you’re doing it safely and will stick with it? Do you have any helpful tips?
 

Answer: Speak to Your Physician. Every time you start an exercise program, you should talk to your doctor to make sure that it’s okay for you.

My thanks to Dr. Rita Beckford for stepping up to the plate and helping us get started exercising. Join the 10,000 steps program. For $15 you get an exercise kit with a pedometer and lots of other goodies. And during the year you’ll get motivational mailings and prizes to help you stick to the program.

---Rita Beckford, MD
MetroHealth Family Physician

STATE OF THE HEART PLAN: GET HEART-HEALTHY

 

Medical Segment Show 174

Air date: 7/14/02

You’ve got a big heart—but do you have a healthy one? Most people know the risk factors of heart disease, but did you know that it’s never, ever too late to make a change for the better. Here, Dr. John Hodgson, the director of MetroHealth’s Invasive Cardiology, Heart and Vascular Center, will give us a state of the heart plan.

Question: You’ve told me that it’s never too late…but being aware of heart disease IS very important as you get older, right?
 

Answer: Yes. One-half of all adults aged 50 have cardiovascular disease. This includes hypertension, coronary disease, and stroke.  The number increases to about ¾ of those 75 years old.  Here in Ohio, we have a very high rate of heart disease, so we need to be extra attentive (There seems to be a high rate in the “dairy belt” states, so this MIGHT be linked to a diet with a high fat content.)

Question: What can you do if you find out you have heart disease? Do you have to wait until a heart problem surfaces?
 

Answer: No. At MetroHealth, we stress the need for coming up with a personalized plan for better heart health. We look to see what risk factors may be involved in your life—high blood pressure, high cholesterol, obesity, diabetes, smoking and family history.
We then develop a personalized plan that will highlight that areas/risk factors that can be altered by changing your lifestyle, medication, etc.
 

Question: Are most people aware if they have heart disease?
 

Answer: Many times, people are not aware of simple information that might make a huge difference if treated early. For example, 60% of the population does not have their cholesterol level documented. And if you lower your cholesterol, your risk of dying from heart disease drops 42%. So finding out this type of information can help you make modifications that can save your life.

Question: Wow, that’s a huge change in risk of death. Simple fixes can make that big of a difference?

Answer: Yes. People are afraid that if they discover some blockages or other signs of heart disease that it will automatically mean they need invasive procedures, such as angioplasty. But if you are stable, small modifications or medication might do the trick.
The death rate due to heart disease has leveled off since 1975, thanks in large part to the push to control high blood pressure. The point is, heart disease is treatable.

Understanding the “heart” of your own health situation is half the battle. The other half involves making healthy changes for the better.

 

---John McB. Hodgson, MD
MetroHealth Cardiologist

METROHEALTH ADVANTAGE PROGRAM

 

Medical Segment Show 175

Air date: 7/21/02

Getting older does have advantages, if you know where to look. And the MetroHealth Advantage program is one of those advantages. Here to tell you how MetroHealth works to keep seniors well-informed is Candace Carmichael, manager of the MetroHealth seniors program.


Question: MetroHealth has a program that’s directed right at seniors? Can anyone join?
 

Answer: Yes. MetroHealth Advantage is a free membership program for anyone age 55 and over.
We’ve developed a number of services and programs designed to make MetroHealth more user-friendly for seniors, to disperse health information, and to promote socialization.
We have 19,000 members, 400 of whom are active and participate in our programs.

Question: What types of social programs do you hold?
 

Answer: First, there’s our Advantage Place senior service center, located in our outpatient plaza. That’s an area that is THEIR space, where seniors can ask for assistance, drink coffee, and socialize with others.  There is also a café and a hair-care place available.
Near the end of every year we sponsor a holiday party that consists of a full breakfast, holiday gifts and entertainment. We often hold several because of large interest.
We also offer exercise classes on Mondays and Fridays at the Memphis/Fulton Senior Resource Center.

Question: But besides social events, you give out senior health information as well?
 

Answer: Yes. One of our most popular programs is our “Mornings at MetroHealth.” The program begins with a continental breakfast and then an hour’s worth of health information. Our upcoming program in August will be on hearing aids.
We also have an information line. You can call and get referrals to in-house MetroHealth doctors/programs, and those available in the community. For example, if you notice the woman down the street has a number of broken windows and can’t afford to get them fixed, we can do research in our database and see what programs she qualifies for that can help.- We can provide information on anything - Installing a grab bar in your bathroom, help getting a wheelchair, where to get free lunch.
We can provide access to First Call for Help Database
We also help people with their insurance forms, Medicare/Medicaid forms, Social Security questions and billing (we’ll talk more about that next week…)

If you are a regular at MetroHealth, there’s some great benefits, like member discounts. But even if you’ve never been to Metro, even if you don’t like to leave your home, the MetroHealth Advantage Program offers some real nice benefits, like an informative newsletter, a real helpful telephone service, educational meetings, even social and exercise programs. Take “advantage” of all the wonderful informative and social opportunities MetroHealth Advantage has to offer. Candace Carmichael will be back here next week to talk about how MetroHealth can help you with insurance and billing.
 

---Candace Carmichael

METROHEALTH ADVANTAGE PROGRAM - HELP WITH BILLING

 

Medical Segment Show 176

Air date: 7/14/02

What’s more frustrating than trying to figure out your medical bills? What are you being charged for? What’s been paid? How much do you owe? I know geniuses that have been reduced to tears trying to figure out medical billings. Today we’re going to offer some help. Candace Carmichael, manager of MetroHealth’s Advantage Program for seniors explains how that program can help with the medical bill mess.
 

Question: Why are medical bills so confusing?


Answer: There are a lot of different programs, confusing language and frequent changes.

Question: Medical bills can be overwhelming—and highly confusing. And when you get older, medical bills are also more common. Is there a way to cut down on the confusion?
 

Answer:  I work with MetroHealth, and I still find it confusing to read medical bills. Seniors shouldn’t be afraid or embarrassed to ask for help when it comes to billing, health insurance, Medicare and Medicaid.
The MetroHealth Advantage staff is available to answer seniors’ questions and help them through the maze of billing, insurance forms, and Medicare/Medicaid.
We offer literature that seniors can take home and read. We also can assist in various ways. For example, if you needed to choose a new HMO, we could tell you which ones accept MetroHealth, put you in touch with a representative, etc.
 We also have three OSHIIP counselors available to help.
Anyone can call for help - - even if you're not a MetroHealth patient
 

Question: What’s OSHIIP?
 

Answer: OSHIIP refers to the Ohio Senior Health Insurance Information Program. OSHIIP services are offered to Medicare beneficiaries free of charge.
If you were to come in having a hard time paying your medical bills, we could look at your financial situation to see if you are eligible for any number of entitlement programs, such as Medicaid.
 

Question: What makes you eligible for these programs?
 

Answer: There are limits on how much monthly income you receive, and how much total resources you have available to you in savings.
If you qualify for full-fledged Medicaid, it will pay for your dental bills, prescriptions, medical bills, eyeglasses and homemaker services—all or in part depending on your income.
To qualify for Medicaid, you must have a monthly income of no more than $492 if you are single or $837 for a married couple. Total resources can amount to no more than $1500 married, $2250 single.

Question: That’s really a small amount of money. What if you have more than that in income and savings but are still having problem paying your medical bills?

Answer: If you are not eligible for full Medicaid, you may be eligible as a Qualified Medicare Beneficiary (QMB) or a Specified Low Income Medicare Beneficiary (SLMB).
QMB is like a free Medicare Supplement policy that pays deductibles and coinsurance not paid by Medicare and your premium. The monthly income limit is $759 single/$1015 married with the total resources limit at $4000 single/$6000 savings.
SLMB has even higher limits on income and savings, and pays your Medicare premium and retroactive benefits for each of the past three months.

---Candace Carmichael

 

INCONTINENCE
Medical Segment Show 177

Air date: 8/4/02

Incontinence - -are you too embarrassed to talk about it? Many people won’t see a doctor, and don’t get it treated. Instead, they just stop living life fully. Don’t suffer in silence! For most folks, incontinence is treatable, it’s correctable. Here to help you regain control of your life is Dr. Jeffrey Mangel, director of the MetroHealth Urogynecology Department.


Question: What causes incontinence?
 

Answer: There are several risk factors to incontinence:

Question: Can incontinence be a sign of another, more dangerous medical problem?
 

Answer: Not in and of itself. However, if blood is in the urine, you might need to be tested for cancer of the bladder. Or high sugar amounts may show diabetes.
It’s more a quality of life issue.

Question: Is incontinence a common problem? Does it just have to be accepted as part of growing older?
 

Answer: It is quite common. 17 million Americans suffer from incontinence, and 17 million more have hyperactive bladders. And the population is aging—we’re only seeing the tip of the iceberg.
You do not have to accept incontinence. So many people do not go to the doctor for treatment because of embarrassment, fear that this will ultimately lead to a nursing home, or not wanting to have an operation. Instead, they give up things they love, like golfing or dancing. Many treatments are available.

Question: What are some of these treatments?

Answer: Surgery and medications are an option. At MetroHealth, we also have Pelvic Floor Therapy. This is a one-on-one class with one of our nurses that will teach you how to improve the muscles of the pelvic floor. It’s a great alternative to taking another medication or having a surgery. There are not many hospitals that offer Pelvic Floor Therapy.

---Dr. Jeffrey Mangel

DEALING WITH CAREGIVER GUILT
Medical Segment Show 178
Air date: 8/4/02

 

The thought of placing a parent or spouse in a nursing home is upsetting. But caring for someone at home can be overwhelming. Thankfully, you don’t have to try to cope alone. MetroHealth geriatrician Peter DeGolia talks about the resources available to relieve the strain on you while handling the challenges of care-giving.

Question: It seems that more and more people are caring for their loved ones at home. Is this becoming a more common trend?
 

Answer: The number of caregivers is growing because our population is aging and there are not as many affordable resources.
Also, I think a lot of people have realized what a fantastic gift they are giving their loved ones by helping them stay at home. However, sometimes the stress of care-giving can prove to be too much.

Question: What are signs that a caregiver is under too much stress?
 

Answer: Signs include lack of sleep and waking up in the middle of the night, feeling anxious, developing health problems they didn’t have before like high blood pressure, constant headaches, back pains, or gastrointestinal problems.
Another huge sign is when the elderly loved one is not receiving the kind of care that they need. They might not be turned properly or bathed often enough. This is not because the caregiver wants to neglect them—it gets to overwhelming. That’s when help is needed.

Question: Why don’t caregivers reach out for help sooner?


Answer: A lot of people feel guilty that they aren’t doing enough for their loved one. That they should be able to handle the care.
And often times, people are simply not aware of the help that is available.

Question: What are some of the agencies that can help an at-home caregiver?
 

Answer: Approach your loved one’s physician. He/She ought to be able to recommend some home care agencies.
In the Cleveland area, the Visiting Nurse Association and Benjamin Rose are two great resources, as is the Western Reserve Area Agency on Aging’s PASSPORT program.
Certain programs cater to specific needs. If you are caring for someone with Alzheimer’s Disease, call the Alzheimer’s Foundation. They offer great caregiver support groups and help.
If your loved one has a terminal illness, Hospice can help make their death at home as comfortable as possible.
Caregivers should look at respite care—it gives them a break to “recharge their batteries” by taking the senior into a nursing facility for a week.

Question: What if you can’t afford some of these services? Is there any service specific for people on a budget?

Answer: Concordia Care is available for seniors who are Medicare and Medicaid eligible and have the need for assistance at home.
It includes a Senior Center that can provide daily or weekly programming for seniors and onsite physical therapy.
This can often allow caregivers to go back to their jobs and have some normality.

Help is out there waiting for you—access it. My thanks to Dr. Peter DeGolia. If you have any questions, feel free to call his office.
 

---Peter DeGolia, MD
Geriatrician

DEALING WITH THE LOSS OF A SPOUSE

 

Medical Segment Show 179

Air date:8/18/02

When someone you love passes away, the grief can be overwhelming. Understanding the grieving process and learning coping skills can help you through this tough time. I’d like to welcome Dr. Toni Love Johnson from MetroHealth’s psychiatric department. Dr. Johnson will help us tackle this difficult subject.


Question: When someone experiences a loss of a loved one as close as a spouse, are there certain stages of grief that one goes through in dealing with the blow?
 

Answer: Yes, there are three general stages people go through.

Question: Does everybody grieve in the same way?


Answer: No, and that’s important for the mourner to recognize—everyone has their own manner and way of grieving.
Things that can affect mourning include culturally based customs, spiritual beliefs, examples of other family members, etc.

Question: If individuals grieve differently, how can you tell if something is wrong beyond “normal” grief? Should they seek help?
 

Answer: That’s difficult, because there’s not a specific time frame. But if, after a period of time, a mourner is not returning to work, family functions, or other activities, or if their manner is angry, or abusive, they may be experiencing what is called “complicated bereavement.”
Complicated bereavement is more common if the death is sudden or unexpected. If the death was after a long illness, the loved ones have had more a chance to achieve closure and get permission from the dying to move on with their life.
Grief can also be more complicated if there are ambiguous feelings about the dead. For example, if an abusive spouse has passed away, conflicting feelings of love and hate might make dealing with the death more difficult.
Beyond complicated bereavement, there is a chance of grief moving into a major depression episode. If you have suffered from depression in the past, you should be especially careful.
People should definitely seek help. Many go to their clergy—and lots of clergy members have great experience in this field. But doctors can help with the physical symptoms (sleep, energy, appetite, etc.).
 

Question: What are symptoms of depression versus normal sadness?

 

Answer:

Question: Even if someone is grieving in the “healthiest” way possible, it’s still a terribly difficult process. What are some coping devices?
 

Answer:

Feeling unbearable grief is not a sign of weakness. It’s a sign of courage. You had the courage to love someone with all your heart. But it’s tough when that person’s gone. My thanks to Dr. Toni Love Johnson. If you have questions, or could use some help, give Dr. Johnson a call. She also has offered to provide some written information about grief and depression.

---Dr. Toni Love Johnson

SCREENINGS: WHAT SHOULD YOU GET AND WHEN?

 

Medical Segment Show 180
Air date: 7/14/02

Prostate cancer, glaucoma, skin cancer, and lots of other health problems can be cured early if caught early, but are devastating if allowed to advance. Protective health screenings can save your life. Here to open the screen door is MetroHealth’s Mary Jo Slattery, a certified nurse practitioner.


Question: As we get older, health screenings become an important part of preventative and proactive medicine. But there are so many screenings—what should we have done and how often, once we pass the age of 65?
 

Answer:

Question: Are the mail-order blood pressure tests sufficient?

 

Answer: No.

 

Question: Any tests women should specifically have?
 

Answer:

Question: How about men?

 

Answer: Rectal exam and/or a PSA blood test every year for prostate cancer.

Question: You hear that seniors should get flu shots every year. Is that the case?
 

Answer: Yes. Every senior is at high risk for the flu. Another shot they might be interested in getting is Pneumovax, a vaccination against pneumonia. This you would only need once, maybe twice if high risk.
Other shots you might want to consider are the Hepatitis B vaccine and a tetanus booster shot (every 10 years).

Question: That’s a lot of tests—does Medicare pay for these?

Answer: Medicare will pay for:

Medicare will not pay for :


Doesn’t it make sense to catch health problems early? Talk to your doctor about these tests. My thanks to Mary Jo Slattery. She’s kindly offered to provide to our viewers a fact sheet about these screenings. Give a call, here’s the number.

---Mary Jo Slattery

 

OSTEOARTHRITIS
Medical Segment Show 181

Air date: 9/1/02

Do you have pain in your knees, hips, or hands? Osteoarthritis can be painful, even disabling. But MetroHealth’s John Sontich, an orthopedic surgeon, is here to tell us about the latest treatments.

Question: What is osteoarthritis and how does it differ from other types of arthritis?
 

Answer: Osteoarthritis is caused by long-time wear and tear on the joints and joint alignment problems. These can cause the degeneration of the cartilage between the bones, and bone-on-bone wear causes pain.
This can happen in any joint in the body, but most often occurs in the knees and the hips.
Inflammation can occur due to wear and tear, but that’s not the main CAUSE, as it is in other types of arthritis.

Question: What are some of the causes/risk factors?
 

Answer: Osteoarthritis can run in families. There is a high weight among the obese, and an injury to the joint in the past can cause this condition later in life.

Question: What are some of the symptoms?
 

Answer:  The onset of pain is slow and gradual in osteoarthritis. The pain is achy, not knife-like. The joint feels stiff and you lose motion. It may feel worse on a rainy day.  An x-ray is needed to confirm diagnosis.

Question: What steps can one take to prevent osteoarthritis, if any?
 

Answer: Weight loss can help.  Exercising can help, especially biking, swimming and low contact weight lifting. These activities help build muscle without putting a lot of pressure on the joint
Weight loss and exercising can actually help AFTER the diagnosis as well.

Question: What if you have osteoarthritis and that’s not working, how else can it be treated?
 

Answer: Organized physical therapy can be beneficial.
Anti-inflammatory drugs can help. These can range from aspirin to prescription drugs like Celebrex. This will help the pain, but not the wear and tear. However, side effects of these medications include stomach upset and ulcers.
A combination of chondroitin sulfate and glucosamine (over-the-counter supplements) has been found to be as effective as prescription anti-inflammatory drugs without the side effects. However, these are not covered by prescription plans and might cause an elevated triglyceride levels. Be sure to be monitored by your doctor.
 

Question: What about surgery:

 

Answer: If the above treatments do not help, joint replacement might be needed. This surgery can restore function and eliminate pain.  Replacements used to last about 10 - 15 years. IMPROVEMENTS: Now they last longer, maybe 20 years.  Then the replacement can be re-done, but it is never as good.  So this is best for older persons.

We can even sometimes do partial joint replacements

 

Question: I hear there's an exciting new procedure?


Answer: If a patient is under 65, a procedure called oestomy. This is a realignment of the knee. It has been used in Europe more.  We can realign joint, like rotating a  tire that was losing tread on 1 side. This procedure can give 10 - 15 years relief

Joint pain can be miserable. Don’t suffer in silence. There are medications that can relieve pain, at least for a while. And in more serious cases, there are some exciting new surgical techniques can work wonders. My thanks to Dr. John Sontich of MetroHealth. For more information, call the number coming right up.

---John Sontich, MD
Orthopedic Surgeon

MINIMALLY INVASIVE SURGERY
Medical Segment Show 182

Air date: 9/7/02

Have you seen the Austin Powers movie, with Mini Me? Well, now there’s mini surgery. Mini incisions, mini pain, mini hospital stays, mini recovery periods. All that can add up to maximum benefits for your health. Here to discuss minimally invasive surgery is a giant in his field, Dr. Mark Malangoni, Chairperson of MetroHealth’s Department of Surgery.


Question: What is minimally invasive surgery? Are we talking about laser surgery when discussing this?
 

Answer: Minimally invasive surgery is surgery done with smaller incisions than an open surgery. A balloon may be inflated through a smaller opening so that the surgeon has enough room to perform the surgery.
This is not typically laser surgery now, though that’s what it was often called when it began. It used to be that lasers were used to make precise cuts and to coagulate blood in minimally invasive surgeries. Now those procedures can be done without the use of a laser—which is safer and less expensive.
Most minimally invasive surgeries are focused around the abdomen, though they can pertain to the chest, neck, etc.

Question: What types are surgeries are we looking at?
 

Answer: One of the first minimally invasive surgeries performed was gall bladder surgery. This is actually the model that surgeons have taken into other areas.
Hernia repair is another common minimally invasive procedure.

Question:   What are some of the benefits of minimally invasive surgery compared to open surgery?
 

Answer: Fifteen years ago, if you had your gall bladder removed, you’d be in a fair amount of pain. There would be a disruption in the functioning of your intestines, plus your appetite would be affected.
In minimally invasive surgery, there is a smaller incision and therefore less pain. Research has shown that less pain leads to less overall discomfort, less disruption of bodily functions (i.e. the intestines and appetite), and allows for a quicker recovery time.

Also, quicker recovery time.  Previously, recovery after gall bladder surgery was 8 - 10 weeks.  With a minimally invasive procedure, recovery can be as short as 10 - 14 days.

Question: That sounds great. Is there any reason someone might NOT opt for a minimally invasive surgery?

Answer: These reasons can differ from surgery to surgery. For instance, with a laparoscopic hernia repair, a general anesthetic that is not as light as the old, open surgery approach is used. This might not be a good idea for someone with heart or lung disease.
It also requires a catheter in the bladder, which might affect the frequency of urination after surgery. This affects men more than women.
The inflated balloon might cause some small blood vessels to bleed after surgery. While this bleeding is seldom serious, it can cause bruising and discomfort in the lower abdomen.
Of course, you should thoroughly discuss all concerns with your doctor before surgery.

Sometimes less is more, at least in the world of surgery. The progress that’s been made is truly astounding. Mini cameras and robotics, they can cut your recovery time by weeks . . . wow! My thanks to Dr. Mark Malangoni. If you have questions, his office is offering to send a free brochure to Golden Opportunities viewers. Give MetroHealth a call.

---Mark Malangoni, MD
Chairperson, MetroHealth Surgery

 

VOLUNTEER OPPORTUNITIES
Medical Segment Show 183
Air date: 7/14/02

Volunteering at a hospital used to mean dressing up in one of those cute red and white striped aprons and pushing a book cart from room to room. That was then. Here to tell us about the many new ways you can earn your volunteer stripes, without putting on an apron, is Becky Moldaver, manager of Volunteer Services for MetroHealth.


Question: What are some of the volunteer opportunities available through MetroHealth?
 

Answer: There is a wide range of opportunities around the MetroHealth system, including both our east and west side locations.
Often, volunteering at a hospital makes one think of working at a gift shop. That is a possibility.
Directly assisting patients is another opportunity. This can include bringing an activity or library cart around to patients’ rooms and visiting. You can help out with arts, crafts, games and other recreational activities for longer-term residents of Prentiss Center. Or you can help at our outpatient Cancer Care Resource Center, giving people printed material and access to resources available.
People might be concerned about the spiritual needs of our patients. They could join our Pastoral Care unit, making initial visits to patients, referring them to chaplains if needed or pushing patients to services.
Finally, if you have a specific interest in gardening, art or music, you could volunteer for our horticultural or art/music therapies.

Question: Are there any opportunities to work with children?
 

Answer: Yes. Our Child Life program encourages volunteers to play with kids and read them stories. They help kids do “normal” things while staying at the hospital.
At some of our Community Health Centers, MetroHealth is involved with the Reach Out and Read program (ROAR). Here, volunteers read to well children in the community, encouraging their families to pick up the habit. The program also offers age appropriate books for kids to take home and start their own library.

Question: How do people sign up for the program? Is the application process difficult?
 

Answer: You sign up by calling or emailing our Volunteer Services. We will mail you out an application for you to complete and bring to your interview.
We interview all perspective volunteers, and they go through an orientation so they can choose what they’d like to do.
All volunteers must have a TB test and go through a criminal background check.

Question: How long of a commitment is volunteering?
 

Answer: We ask for a minimum three- to six-month commitment.
Most volunteers come once a week for three to four hours. Of course, you could come more often if you’d like. Most people volunteer 1 - 2 times per week for 3 - 4 hours a day.

Question: Why volunteer? What would you say to someone who’d like to but who is afraid of not knowing anybody, not doing a good job, etc.?
 

Answer: First of all, we have a very diverse group of volunteers. People from all walks of life help out, and you can meet some very interesting people.
Helping at a hospital allows you to make a difference in someone’s life at a time when it’s meaningful. People really appreciate the little things you do when they’re not feeling well.
A lot of our volunteers are newly retired—volunteering gives some structure to their newfound free time, helps them keep in touch with the community and meet new people.
We are a station of the Retired and Senior Volunteer Program of Greater Cleveland (RSVP).
We do offer some tangible discounts as well.

Hospitals are a place to better yourself—even if you’re not sick. My thanks to Becky Moldaver for telling us how volunteering can help yourself and others.  I really want to encourage you to pick up the telephone and call MetroHealth. This institution is a community treasure. It provides the highest quality care to some of the most ill and injured folks in our community, without regard to ability to pay. You can truly help others, and have a rewarding experience yourself, by volunteering just a few hours a week. Pick up the phone. Here’s the number to call.

---Becky Moldaver

GLAUCOMA - THE SILENT THIEF
Medical Segment Show 184

Air date: 9/21/02

Glaucoma is a leading cause of blindness in older adults. But did you know that about half of all people with glaucoma are totally unaware that they have the disease, until it’s too late. Here to help us focus on how to detect and treat glaucoma is Dr. Tim Steinemann, Director of the Eye Clinic and Chief of the Division of Ophthalmology at MetroHealth.


Question: What is glaucoma? What are the symptoms?


Answer: Glaucoma is a condition in the eye in which the inner ocular pressure is too high. This pressure causes irreversible damage to the optic nerve, which can result in blindness.
There are NO symptoms early on in the disease, which is why we call it a silent thief.
It causes a narrowing of the visual field—the peripheral vision closes in. To get an idea of what that is like, make your hands into binoculars and try to walk around without your peripheral vision—it’s very difficult.

Question:   What causes glaucoma?
 

Answer: The cause of high pressure in the eye is largely unknown, though there are some risk factors to watch out for.
Glaucoma is very much a disease of older people.
It is the leading cause of blindness in the African-American and Hispanic populations.
High inner ocular pressure is probably an inherited trait, so your family history is important.
Diabetes is a risk factor.
A past injury to the eye could cause glaucoma.

Question: If there are no symptoms in early glaucoma, how can you be diagnosed before damaging vision loss occurs? What about prevention?
 

Answer: People aged 40 and over should have an eye exam every year or every other year.
By the age of 65, the number of glaucoma patients goes up dramatically. You should have an eye exam each year, even if you’re not having problems with your vision.

Question: Can glaucoma be cured?

Answer: No, but it can be controlled.
Once vision loss occurs, it is irreversible. But for the vast majority of glaucoma patients, vision loss is preventable through the use of eye drops.
Sometimes multiple eye drops are necessary, and in rare cases surgery is needed to relieve the pressure in the eye.
Two problems that can arise in treatment are cost and compliance. The eye drops are expensive, especially for seniors on a fixed income. And taking the drops does not make you eyes feel any better or your vision improve, so people are lax in taking them. However, they are vital to not losing MORE vision.

Question: I understand MetroHealth has a special doctor for those with glaucoma?

Answer:  Yes, we have a full-time glaucoma specialist on-staff (Dr. Julia Whiteside).

If you’re over 40, don’t shut your eyes to the dangers of glaucoma. If it’s caught, it’s treatable. My thanks to Dr. Steinemann for focusing our sight on the importance of testing and treatment. MetroHealth has an informative brochure on glaucoma, available free. We’ll put the number to call on the screen. If you can’t read it, you’d better call Dr. Steinemann, FAST!

---Tim Steinemann, MD
MetroHealth Ophthalmologist

 

SLEEP DISORDERS AND AGING
Medical Segment Show 185

Air date: 10/5/02

Isn’t it amazing how kids fight going to sleep, yet we adults often find ourselves fighting to get to sleep? A good night’s sleep seems a lot harder to come by as we get older. But tossing and turning all night does not have to be the norm. Here to wake us up to our options is Dr. Dennis Auckley, a sleep specialist from MetroHealth.


Question: Do older people need less sleep? It appears that many seniors DO sleep less. Is that normal?
 

Answer: It’s not clear if seniors actually need less sleep. This is a complicated issue affected by lifestyle changes, individual expectations, and body rhythm changes. The body rhythm cycle often changes as you get older and sleep is may be redistributed: you may want to go to bed early, awaken earlier, and take naps during the day.
There is nothing “wrong” with any of this—unless you feel that it’s disturbing your quality of life, not allowing you to do what you want.
However, primary sleep disorders are more common in seniors and, if symptoms of one these conditions are present, further evaluation is warranted.
In addition, medical illnesses and medication use, both more common in seniors, may affect the quality of your sleep.
Don’t simply accept sleep problems as a regular problem of aging—there IS help.

Question: …Now, you’ve been nice enough to make a list of some of the most common sleep disorders. Let’s go through them, starting with Sleep Disorder Breathing.
]
Answer: Sleep Disorder Breathing is one of the most common problems effecting sleep. When the person suffering from this falls asleep, their airway narrows or collapses. This causes a fragmentation of sleep—the person awakens briefly to reopen the airway and breath normally. This occurs recurrently during sleep (though most individuals don’t realize this is occurring).
Symptoms include loud snoring, morning headaches, unrefreshing sleep, or inappropriate sleepiness (ie falling asleep while eating, reading, etc.). Other associated symptoms and conditions may include gastroesophageal reflux (heartburn), impotence, hypertension, anxiety and depression.
Conditions that make this more common include being significantly overweight, thyroid disorders, congestive heart failure and strokes.
For diagnosis, you have your breathing monitored during an overnight sleep study. Treatment options are varied, and can be as simple as weight loss and changing sleep positions to more aggressive treatment such as surgery or the use of a CPAP mask. CPAP, probably the most commonly prescribed therapy, stands for continuous positive airway pressure and is designed to blow air into the upper airway to prevent collapse. [CPAP mask]

Question: …I know a lot of seniors complain of insomnia.

Answer: Yes. There are two broad classifications of insomnia—sleep-onset insomnia (having problem trying to fall asleep) and sleep- maintenance insomnia (trouble staying asleep.)
Insomnia can greatly affect the quality of life, causing irritability, anxiety, depression and a poor sense of well being.
Evaluation of this complaint generally requires a very thorough history and physical examination. Occasionally, objective testing is warranted, but this is often not necessary.
Treatment will often depend up the cause, which may include medications, depression, or poor sleep hygiene (using caffeine/nicotine near bedtime, too many animals in bed, etc.).
Often insomnia can be treated by modifying behavior instead of sleep-inducing medications.
DON’T accept insomnia as part of aging.

Question: Next on your list is Restless Leg Syndrome.

Answer: This is a condition that can prevent you from falling asleep—upon retiring to bed, your legs may ache or burn, making you want to move them.
The sensations are often relieved by rubbing or walking around.
Kidney failure, diabetes or chronic anemia can be associated. Treatment is often based on treating the underlying condition, though certain medications can be highly effective.

Question: The last point on your list is periodic limb movement. What can you tell us about that?

Answer: With periodic limb movement, legs twitch while sleeping, awakening the person briefly and resulting in fragmentation of sleep.
Sleep is generally unrefreshing and daytime sleepiness may result.
The diagnosis is generally made by history in conjunction with an overnight sleep study.
Treatment with medications can be effective.

You can do more than just dream about a good night’s sleep. If you’d like an informative brochure about sleep disorders, give Dr. Auckley’s office a call. The number’s coming up. My thanks to Dr. Dennis Auckley.

 

---Dennis Auckley, MD
Sleep Specialist

IMMUNIZATIONS - WHAT TO GET AND WHEN
Medical Segment Show 186

Air date: 10/12/02

Flu season is about to fly in. Should you get a flu shot? Can it make you ill? Here to explain how a little pain can bring a lot of gain is Mary Jo Slattery, a certified nurse practitioner at MetroHealth.

Question: Now that it’s fall, it’s officially flu season. Are we talking about the stomach flu here?
 

Answer: The flu is NOT an intestinal disease—it’s a serious respiratory disease marked by a high fever, muscle aches, and a bad cough. It can lead to pneumonia.  20,000 people die each year from complications of the flu.

Question: So getting a flu shot each fall is really important?

Answer: Yes. Everyone over age 65 should get a flu shot every fall, usually in late October or November.
Caretakers of the elderly should also get the flu shot yearly, regardless of their own age. Also, anyone with respiratory or cardiac disease, or a chronic disease such as diabetes, should receive a flu shot.
There should not be a shortage this year.

Question: I know some people are reluctant to get the flu shot because they believe it makes them sick—is that true?
 

Answer: No. You are not being given a live virus—it cannot make you sick. If you get sick after receiving a flu shot, you were already on your way to getting sick beforehand.

 

Question: How long does the flu shot last?

 

Answer: 1 Full season.

Question: The next immunization you want to mention was the pneumonia vaccine.

Answer: Yes. This is a vaccination you receive one time (most likely) in your life. It protects you from the most deadly strains of pneumonia, though not ALL pneumonia strains. Everyone age 65 and over should have this.

Question: Are there are other shots that you should be aware of—like your tetanus booster?

Answer: Yes. A tetanus shot prevents lockjaw (which affects the nervous system). You need a booster every 10 years. If you have a dirty wound, and it’s been more than five years from your last tetanus booster, you should be re-immunized.

Question: And the last vaccine on your list is the hepatitis B vaccine.

Answer: Yes. This one is not for everyone—it’s only required for those with an exposure to blood. If you are working or volunteering in healthcare, or are sexually active with multiple partners, you might consider this.

Question: Are these vaccines covered by Medicare?

Answer: Yes, all are covered.

Don’t let the flu or other ailments get you down this year. My thanks to Mary Jo Slattery for giving us a shot in the arm when it comes to immunizations. For a brochure on flu and pneumonia shots, or to set an appointment, here’s the number to call.

 

---Mary Jo Slattery

Certified Nurse Practitioner

 

NEW TREATMENTS FOR COLON CANCER
Medical Segment Show 187

Air date: 10/19/02

Advanced colon cancer is real hard to treat, but the future is now looking brighter. Exciting new treatments are coming down the pike. And Cleveland is playing a major role. Here to enlighten us is Dr. Timothy O’Brien, Director of MetroHealth’s Cancer Care Center.

 

Question: I What are the stages of colon cancer?
 

Answer: Colon cancer has four stages—the first two depend upon the depth of the cancer’s penetration into the colon’s wall. The third marks when the colon’s lymph nodes become cancerous. Stage Four colon cancer—the stage we are talking about—is when the cancer has metastasized, entering the bloodstream and perhaps spreading to the lungs or liver.

 

Question: How do you treat each stage, and what is the success rate?

Answer: The 1st 3 Stages are treated with surgery, then chemotherapy.
Stage 1 - 85 -90% success rate
Stage 2 - 70 - 80% success rate
Stage 3 - 60 - 70% success rate
Stage 4 - Not curable
Stage four colon cancer used to require systemic treatment—chemotherapy pumped through the body.
Here’s where the new treatment comes in: chemotherapy can be likened to an atomic bomb—it kills everything in its path, including normal cells. This is why there are so many side effects.
The new agents are like smart bombs—they search out new cancer cells and only attack them.

Question: And MetroHealth took part in a study of these drugs?
 

Answer: Yes. We did trials on a drug called Arissa that has not yet been approved. Although the results are not in, they are promising.
We will be starting other trials and are looking for people with stage four colon cancer to participate.

Question: These new developments are very exciting! But the best course of action is to catch colon cancer early with screenings, isn’t it?

Answer: Yes. The standard screening for colon cancer is to test the stool for microscopic blood. However, this screening can miss about 20% of colon cancer cases.
There is now evidence that a colonoscopy can reduce mortality by about 25%--but it’s more aggressive and more expensive.

Question: When should you start getting tested?

Answer: Around age 50, unless you are at high risk.
High risk includes having a first degree relative with colon cancer, having an inflammatory bowel disease, or if you’ve previously had a non-malignant polyp.

Catching colon cancer early is our goal. But new treatment options offer hope even for those with advanced cases. If you’ve been told there’s not much hope, don’t give up. Please call MetroHealth to get involved in one of the current studies. Or if you just want more information, here’s the number.

---Timothy O’Brien, MD
Dir., Cancer Care Center

 

NECK AND THROAT CANCER - RAISING AWARENESS

 

Medical Segment Show 188

Air date: 10/26/02

You have a persistent sore throat. Maybe a hoarse voice. Or a mouth sore that keeps coming back. It’s nothing, right? Probably. But any one of these cold be a symptom of neck or throat cancer. Here to tell us what to look for is Dr. Rod Rezaee, Director of MetroHealth’s Department of Head and Neck Oncologic and Reconstructive Surgery.


Question: We’re talking about neck and throat cancer today. What types of cancer do you mean by that?
 

Answer: Cancers of the throat include tonsils, tongue, palette and voice box cancers. Throat cancers can spread into the lymph nodes in the neck. Cancer can also affect the thyroid, parathyroid and salivary glands.

Question:   What are some of the symptoms that can point to these types of cancer?
 

Answer:

Don’t ignore dentures that don’t fit even though they’ve been readjusted recently. This is often a sign.
There’s no blood test to screen—you need a physical exam. If you feel something unusual, get it checked out.
 

Question:   What are some of the risk factors?
 

Answer:  Although neck and throat cancer can affect anyone, it is more prevalent in people aged 55 and up. There’s a higher incidence with excessive smoking (several packs a day) or use of alcohol for extended periods of time. Certain environmental or workplace experiences can affect the risk.

Question: What are some of the treatments available?
 

Answer: The type of treatment depends upon where the cancer is and how advanced it has become.  Radiation, chemotherapy, surgery, and combinations of the three are possible treatments.

Question: Are some people reluctant to seek surgery as treatment out of fear of losing their voice or their ability to swallow?

Answer: Yes, and that’s unfortunate because these cancers are very treatable when caught early. We use a team approach to treatment, and a lot of advances have been made to help lessen the risks to speaking/not swallowing.  We have prostheses that can be used in place of the voice box. With therapy, one can learn to speak again. Tissue, like bone, muscle and skin, can be transferred to replace portions of the tongue or other areas of the neck/throat.

Cancer is a hard word to swallow. But new advances have helped to make treatment less traumatic. Early diagnosis is key. Don’t wait if you think something might be wrong.  My thanks to Dr. Rod Rezaee. His office has some free literature on neck and throat cancers, call to get it.

---Dr. Rod Rezaee

 

HEARING LOSS AND HEARING AIDS
Medical Segment Show 189

Air date: 11/2/02

TURN UP THE TV! STOP MUMBLING! Hearing loss can be confusing and frustrating. It can also be a sign of aging that we’re not ready to accept. But listen to this: New technologies are making it easier to hear, and hear well. MetroHealth’s Dr. Joseph Carter will make it crystal clear how our hearing can benefit from new computer technology.

Question: What causes hearing loss? Why is it common among seniors and how does it affect them?

 

Answer:  You are born with the most hearing you will ever have, and it diminishes over your lifetime, due to noise (nerve damage) and heredity.
Hearing loss is very common for all ages, but even more so with seniors. We tend to take much better care of our eyes than our ears.  Hearing loss can sneak up on you because it is gradual.  It can be very isolating for older people. They tend to withdraw from company, and it really affects the quality of life.

Question: What can be done to lessen the effects of hearing loss?


Answer: Having your hearing screened regularly is important. Once every 2 to 3 years is good if you have had no problems in the past. If your hearing is changing, have the screening done every year.
There are adaptive measures we can take to lessen isolation—special telephones, hearing devices that can help you hear while at a special event, religious service, etc.  And hearing aids today are much smaller and much better.

Question: So many seniors who have poor hearing refuse to wear a hearing aid. Why?

 

Answer: They may equate hearing loss with age and be reluctant to admit it.  They may also have what I call the “Aunt Lil” effect. Aunt Lil had a hearing aid that was a big box that whistled all the time. But hearing aids nowadays are very different.

Question: How are the hearing aids different?


Answer: They are significantly different from three to four years ago.  Now, digital aids are available. These work like a small computer. Instead of simply amplifying the sound like the old analog models, the new digital hearing aids can reduce background and environmental noises to give you a purer, cleaner, and more natural sound.  They are much smaller and do not whistle.

Question: Are these covered by Medicaid?
 

Answer: That’s the catch. Medicaid has a $200 cap on hearing aids, and the digital models run from $500-$3500. However, the prices are going down and there may soon be a low-end digital model available in the $200 price range.
 

Question: How do you choose the right hearing aid?

Answer: With the help of an Audiologist.  The choice of a hearing aid depends on your needs, budget, physical ability to press buttons/nobs and your lifestyle. For Example, arthritis limits the ability to use tiny in-canal aids.

We should be all ears when it comes to learning about the latest in hearing technology. Don’t tune out of life. New advances have made hearing aids less visible and more effective. If you think you might benefit from a new hearing aid, or if you’d simply like more information, give a shout out to Dr. Carter. I’m certain he’ll be listening.

---Joseph Carter, MD

WEIGHT LOSS AND SENIOR FITNESS

 

Medical Segment Show 190

Air date: 11/9/02

Everyone, except my wife, is fighting the battle of the bulge. These battles don’t end as you get older, it just gets harder. Weight loss and exercise are important to your health. Here to work out the answers to the weight loss question is MetroHealth Exercise Specialist, Michael Bichsel.


Question: As we get older, does that mean we should worry about exercising? Should we just give up on the idea of losing weight?


Answer: We all have different activity levels, and exercise programs should always be modified to fit your own personal situation, regardless of your age.
However, as we get older, we do become less active. It is therefore important for seniors TO exercise, to gain more control over their lives and their health.
It’s important to talk to your primary care doctor before beginning an exercise or weight loss plan. Don’t succumb to fads on TV—talk to your medical doctor and use them as a guide.

Question:   What are some reasons seniors should seriously consider weight loss as a goal if needed?
 

Answer:  Weight loss can increase flexibility. Flexibility usually decreases with age, leading to more aches, pains and tight muscles (more strains/pulls).
Losing weight can help control blood pressure, cholesterol, diabetes, heart disease, and avoiding stress.
Exercise will be the most beneficial medication you’ll ever take.

Question:   When you’re exercising specifically to lose weight, what do you have to keep in mind?
 

Answer:  Focus on aerobic activities to burn maximum calories. 

Do something you enjoy, whether it be walking, stepping, riding a bike, swimming, dancing, etc. If you don’t enjoy it, you won’t keep up with it.
Be sure to warm-up and cool-down so that you avoid injury.

Question: How long and often should you exercise?
 

Answer: A minimum of three days per week.  Twenty to sixty minutes a day. This is something that you build up to slowly.

Question: At MetroHealth you have a special weight loss program?

Answer: Yes, we have a twelve-week program where participants come in twice a week to meet with a dietitian, someone from the psychology department, and an exercise specialist.

The holidays are coming, which means lots of good food. Get your weight, and health, under control now. MetroHealth offers a great diet program. You get education, training and exercise twice a week. Watch those pounds fall right off. This program is open to anyone. And if you’ve had a heart or lung problem within the last year, Metrohealth also has a 3 day a week specialized exercise program. They also offer a free weight loss brochure. Here’s the number to call.

---Mike Bichsel
MetroHealth Exercise Specialist

 

SMOKING CESSATION
Medical Segment Show 191

Air date: 11/16/02

If you’re a smoker, it’s likely that you’ve tried to quit, at least once, or twice, or ten times. We’re here to light up your interest one more time. Here to help you breathe easier is Faye Garretson, a registered respiratory therapist from MetroHealth.

 

Question: We all know that smoking can result in lung disease. How pervasive is lung disease?
 

Answer: Smoking is a major cause of lung disease.  Over 25 million people in the U.S. have lung disease.  Approximately 1000 people will die today from lung disease.
 

Question: I've read that over 25 million Americans have lung disease, and smoking is a major cause.  What kinds of lung disease are we talking about?


Answer:  Emphysema, Bronchitis (COPD), and lung cancer.


Question:   If you’ve been smoking for years, isn’t the damage done already? Can quitting smoking really help?
 

Answer: Yes! The benefits can start quickly. In 20 minutes, your blood pressure will return to normal.  In two days, your sense of smell and taste will return.  In two weeks, your lung function will increase 30%.  In one year, your risk of heart disease is cut in half compared to smokers.

Question:   That is really quick. But quitting is difficult. What suggestions do you have?
 

Answer: Tell your friends that you plan to quit and get their support.  Use aids like gum, patches, or medicine that help curb your appetite for cigarettes. Change your routines to avoid the times and places that make you crave a cigarette.  Join a support group, like the Smoking Cessation program at MetroHealth.
 

Question: Can you tell us a little bit more about that support group?
 

Answer: It’s a support group with other people who are also trying to quit.  Those who qualify can receive free patches or gum to help with the physical cravings.  All our instructors are certified by the American Lung Association.  The program cost is very low and in some cases free.  We have a 50% success rate.

 

Question: What if you already have lung disease? What help is available then?

Answer: MetroHealth has a pulmonary rehabilitation program that aims to restore independence, increase ability to exercise, reduce the frequency of urgent doctor visits and hospitalizations, and improve your quality of life.
 It’s designed for those with emphysema, asthma, pulmonary fibrosis, and other lung diseases.
 It focuses on proper diet, breathing and relaxation techniques, medications, conserving your energy, adjusting to your illness, home exercises and stretching.
 
 No ifs, ands, or butts (that’s butts with two T’s). You can snuff out smoking and improve your breathing. If you want to kick the habit and breathe easier, call MetroHealth. Ask about the programs to quit smoking, and to breath better. The call may change, and prolong, your life. My thanks to Faye Garretson.

CONCORDIA CARE AND THE "PACE" PROGRAM
Medical Segment Show 192

Air date: 11/23/02

If you had the choice, wouldn’t you rather stay at home, instead of going to a nursing home? Many seniors would be able to stay home, if they could just get some low or no cost assistance. I think you’ll be pleased and surprised to learn that help is available! Janis Faehnrich, president and CEO of Concordia Care, will explain how you or your loved one can get the help that’s needed to stay at home.


Question:   What is Concordia Care? What is your mission?
 

Answer: Concordia Care is a PACE program. PACE stands for the “Program of All-inclusive Care to the Elderly.” It aims to allow seniors to stay in the community because of its coordinated medical care, an adult day health center, and its activities and support in the home.
Concordia Care also provides clinical and in-home care.
Our two chief goals are to allow seniors who may need extra assistance with their activities of daily living to remain living in their own homes as long as possible, and to help our participants remain out of the hospital and the nursing home by providing quality, coordinated medical care.

Question: How does someone qualify for Concordia Care services?
 

Answer: First, you must be 55 years old or older and live in Cuyahoga County.  You must also need assistance with bathing, dressing or chores, or have some memory problems.

Question:   What makes Concordia Care’s program different from other help that is available?
 

Answer:  We provide very coordinated service, which is planned and provided by our multi-disciplinary team of providers. Working in partnership with you and your family, they create an individualized plan of care that covers each person’s health care needs for as long as they remain enrolled in Concordia Care.

Question: What do you mean by a multi-disciplinary team? Who would be included?
 

Answer: Primary care physicians, nurses and health care aides, van drivers, chaplains, social workers, dietitians, and physical and occupational and speech therapists, as well as recreation therapists.

Question: Can you give us examples of people who could benefit from Concordia Care’s services?
 

Answer: If a person needs help with everyday personal care and has a health condition that needs regular medical attention, Concordia Care may be the answer. For example, a man may be to cook for himself; however, he does not always follow his diabetic diet or take his medications. He may also needs assistance with bathing and shopping. Concordia Care could help him with these needs.
Another example is Mrs. W. She is able to dress, feed and bathe herself. However she would be unable to do these tasks if someone did not tell her the specific steps to take. She needs constant supervision and reminding.
Other examples of others that would not only qualify but also benefit include:

Question: What is the Cost of Concordia Care? Who pays for the program?
 

Answer: Concordia Care accepts Medicare and Medicaid and private pay.

Question: So you can get free services if you meet the Medicaid rules?

Answer: Yes.

Question: You have 205 people in the program already.  How many more places are available?

Answer: our limit is 240, so 35 spots are open.  If you're interested, you'll need to move quickly.

Concordia Care can help you get low or no cost care so that you or a loved one can remain home, and out of a nursing home. My thanks to Janis Faehnrich for explaining this little known program to us. If you think you or a loved one could benefit, give Concordia Care a call. And hurry. There’s not many open spots left.

---Janis Faehnrich RN, MSN, MBA
Concordia Care

CAREGIVERS
Medical Segment Show 193

Air date: 11/30/02

Last week we introduced you to an important but little known program called Concordia Care. This low or no cost service can provide comprehensive medical and personal care so that you or a loved one can remain home, and out of a nursing home. Today, in honor of National Caregivers Month, we’ll talk more about this unique caregiving program.


Question: Kelly, caregiving is becoming a more common occurrence in the home. Why are more adult children of seniors finding themselves in that situation?
 

Answer: Due to medical advances, people are living longer lives, but often with chronic illnesses that require care.  It’s also a volume issue—our population is aging. There are more seniors than ever before.  Based on those two facts, caregivers today are more vocal about asking for assistance, which is where Concordia Care can step in.

Question:   What kinds of assistance with caregiving does Concordia Care offer? Is it at home or at Concordia Care? Where are you located?
 

Answer: Concordia Care uses a team of professionals (social workers, homecare experts and medical experts) to determine the care the senior currently needs and to plan for future needs that may arise. It’s like “one-stop shopping” to help seniors live in the community longer.
Most seniors come into our center in Cleveland Heights for adult day care services. We provide transportation to and from the center, and for medical appointments. This allows family caregivers the ability to go to work, run errands, etc.
We do offer some homecare on the weekends to give caregivers some free time. We work with the family to see what they need—the program is very family-driven.
After you have been with the program for six months, you are eligible for one week of respite (with the senior in a respite facility) per year.

Question: Vanessa, tell us about your experience as the primary caregiver of your mother. How did Concordia Care help you and your mom?
 

Answer: My mom was diagnosed with Alzheimer’s disease in 1995. After 4 years of staying at home with the help of my siblings and a private caregiver, we moved my mom into my home and became her primarily caregiver. That was four years ago.
She now requires around-the-clock care; however, I am a teacher and work during the day. I’m also a mother of two, and my children have needs as well.
Mom attends Concordia Care Day Health Facility while I am at work.
 

Question: Describe a typical day for your mom.

 

Answer:

 

Question: Is Concordia's day care program like a day care program for kids?

 

Answer: No. All of the health care included


Question: It’s a wonderful service. Now Kelly, who’s eligible for help from Concordia Care, and how does the fee structure work?
 

Answer:  We service all of Cuyahoga County. Patients must be 55 years old or older and have either physical needs or memory problems.
We receive funding under a Medicaid waiver in the state of Ohio. We are also funded by Medicare and by private payments. Since there are several different ways to pay, it is best if you give us a call.

Question: Should families wait to call Concordia until they're in a crisis?

Answer: No. If families wait too long, they'll be too burned out to provide any support. Call early on, and Concordia can help advise.

Question: Vanessa, without Concordia, would you have been able to keep your mother at home?

 

Answer: No! She’d be in nursing home.

If you are caring for a loved one, celebrate National Caregivers Month by caring for yourself. Check into getting some help. Even if it’s simply to free up time to run errands, or to take a coffee break. Call Concordia Care for help. My thanks to Kelly Cervenka and Vanessa Nichols for sharing their experiences with us.

 

ADULT ASTHMA
Medical Segment Show 194

Air date: 12/7/02

True or false. If you never had asthma as a kid, you’ll probably never get it as an adult? If you answered true, like I did, guess what? We’re wrong. You never outgrow the risk of asthma. So we need to learn about the symptoms and treatment options. Here to help us breathe easier is MetroHealth family physician, Dr. Monique Robinson.


Question: I thought asthma was mainly a children’s disease. What is asthma and how does it develop?
 

Answer: Asthma is a chronic inflammatory disease that makes the air passages of the lungs narrow and swell.  It often begins in childhood but can develop at any time in life. It is associated with allergies and family history. These individuals often have coexisting sinusitis, nasal polyps, and sensitivity to aspirin. Certain particulates in the environment may make it more prevalent, although the connection is not definitely known. In the adult population, certain occupational exposures to such things as plastic resins can cause people to develop asthma.

Question: What are some of the symptoms of asthma? How is it diagnosed?
 

Answer: Symptoms include wheezing, shortness of breath, cough, chest tightening, scratchy throat, awakening at night with coughing or shortness of breath, and inability to exercise due to shortness of breath.
These symptoms can be caused by allergen triggers such as pollens, trees, grass or mold, dust mites, furry or feathered animals, cockroaches, medications or food, or irritant triggers like tobacco or wood smoke, viruses, strong odors or perfumes, cold weather, exercise, emotions or heartburn.
Diagnosis is based on these symptoms, a physical examination, lung function testing, and family history.
Going to a doctor for a diagnosis is imperative. Several conditions mimic asthma, such as chronic bronchitis, emphysema, heart disease, upper airway obstruction, pulmonary embolism, and lung cancer, so it is important to have a thorough evaluation. It is also very important for the patient with asthma to monitor their lung function daily with a peak flow meter.

Question: Once a diagnosis is made, how is adult asthma treated?
 

Answer: You’ll often be given two main types of medication: controllers and relievers.
Controllers are long-term medications. Inhaled steroids prevent asthma symptoms by decreasing inflammation. Long-acting beta agonists keep the airways open for about 12-hours at a time and should be prescribed in conjunction with inhaled steroids.
Relievers, such as Albuterol (available in inhalers and liquid aerosol) give you rapid assistance in the middle of an attack.

Question: Are there any special concerns seniors should have if they suffer from asthma?
 

Answer: Some asthma medications can cause side effects such as tremors and rapid heartbeat. One pill, Theophylline, may cause a myriad of side effects and can possibly interact with other medications like antibiotics and heartburn medication. Prednisone, given short term, can lead to confusion, agitation, changes in blood sugar levels, increased blood pressure. Osteoporosis, cataracts and glaucoma can be long term. This can also me true with high dose inhaled steroids.
Medications prescribed to treat other health problems may cause adverse effects for patients with asthma. Arthritis medications can cause problems for those with aspirin sensitivity and certain high blood pressure medications (non selective beta blockers), if on asthma meds, might cause the airways to narrow. Other medicines, known as ACE inhibitors may cause a cough, which may or may not suggest that a patient has asthma.
In other words, make sure your doctor is aware of ALL the medication you are currently taking to check for any interactions.
If you have asthma and are being treated with oral or inhaled steroids, it is recommended you should get your eyes tested yearly for glaucoma and cataracts. It is also strongly recommended that adult asthmatics over the age of 65 get the influenza vaccine annually, as viruses are one of the strongest triggers for asthma.

There are many types of asthma medication delivery systems available.
Physicians need to take into consideration whether or not the elderly asthmatic may also have difficulties using certain medications due to arthritis, insufficient inspiratory capability or short term memory problems. Written instructions and demonstrations are extremely helpful and recommended.

An active life shouldn’t leave you breathless. Seniors with asthma have special needs. So take a deep breath, and then take action. Give MetroHealth a call for more information or a free brochure.

---Dr. Monique Robinson.

NEW DEVICE IN RADIOLOGY

Medical Segment Show 195

Air date: 12/14/02

Cancer’s a scary topic. But there’s an exciting new device to detect cancer. Here to tell us about this significant advance in cancer detection and treatment is Dr. Anthony Minotti, Chairman of MetroHealth’s Radiology Department.


Question: There’s a new advancement in detecting cancer. Tell us about it.
 

Answer: A new device called the PET-CT has been developed.  It is used when someone is suspected of having cancer, to further pinpoint where the cancer is so that it can be effectively treated, and to monitor and evaluate how well treatment is working in cancer patients.
MetroHealth has the only PET-CT in Ohio. There are only 40 currently in the country.

Question:   We have some footage of the PET-CT. Can you explain what’s happening?
 

Answer: Sure. A patient is injected with a small amount of radioactive material. They lay on the PET-CT camera for about 30 minutes. Then we compile the data.
 

Question: How does the PET-CT differ from and improve upon similar tests used in the past?
 

Answer: The most common imaging test is the CT scan. It’s similar to a modern x-ray—you sit on a table and move through a donut-shaped device that takes a picture of your body’s internal organs. This test looks at the size and shape of your organs. Cancer tends to abnormally enlarge organs or change their shape. However, a CT scan wouldn’t show cancer until the cancer has changed the size of an organ.
The PET-CT scan looks at the function of cells within your body organs by detecting how much energy the cells of the body are using. Cancer cells tend to use more energy than normal cells, and thus can be relatively easily identified.
By looking at both size and function, we can more accurately pinpoint the presence and location of cancer in the body.  While both CT and PET scans have been available separately, much better and more accurate to do in one test.

Question: Who is this test helpful for? Are there any side effects?
 

Answer: The PET-CT is effective for the majority of cancer patients.  There is no more exposure to radiation than is present in other imaging test used in the past.
 

Question: Is this test covered by insurance?
 

Answer: In general, yes. It is reimbursed by Medicare and other major insurance companies.

 

---Anthony Minotti, MD

BEATING THE WINTER BLAHS
Medical Segment Show 196

Air date: 12/28/02

Summer seems to go by so quickly. And winter, well, it seems just to drag on and on. Although we’re ready to start a new year, we have a long way to go before winter’s over. But just because the weather is dismal doesn’t mean you have to be. Here to help us beat the winter blahs is psychiatric clinical nurse specialist Roseanne Radziewicz from MetroHealth.


Question: Winter is a season full of fun—until the holidays are over with. Then the long winter months can take their toll. What can we do if we are feeling the winter blahs?
 

Answer: If the winter is getting you down, there are some things you can do to help keep your spirits up.

Question: Does our diet affect our mood in winter?

 

Answer: Yes. Carbohydrates are too heavy. Eat fruits and vegetables, avoid too much sugar.

 

Question: Now, it’s important to talk to your doctor because there’s an actual disorder that can be tied to winter weather, correct?
 

Answer: Yes. Seasonal Affective Disorder (SAD) is a possibility. The pineal gland in your brain produces melatonin, and production goes up when it’s dark outside. Increased levels of melatonin can cause you to want to sleep a lot and eat more than usual.
Symptoms of SAD include less energy (even with lots of sleep), mood changes, little control over your appetite, less productivity/creativity, memory problems, less social interaction, and less of an ability to cope with life.
Symptoms must occur three years in a row before a diagnosis of SAD can be given.
 

Question:   What can be done to help people with SAD?
 

Answer: Many of the things I mentioned for curing the winter blahs, but with more of an emphasis on light therapy and medication.
People with SAD should sit by a bright light for 15 minutes in the morning and 15 minutes in the evening.
They can also use a dawn stimulator that allows you to wake up to light by gradually increasing the light in the room starting one half hour before you have to get up.

 

Question: Will any light work for light therapy?

 

Answer: You should use a full spectrum light, not a fluorescent

Question: How long should we sit by a light?

Answer: 15 Minutes to 3 hours, twice a day.

Question: Is longer better?

 

Answer: Not necessarily, it depends on the person.


Question: What is a dawn simulator?

Answer: It's like an alarm clock.  It gradually increases light in the room before you get up.
 

Question: How can you tell if your depression goes beyond the winter blahs? What can you do?

Answer: Six percent of the population is depressed, and double the amount of women suffer from depression than man.
Symptoms, especially in older people, include:

If you think you may be suffering from depression, talk to your doctor. They should be able to refer you to a mental health professional.
Treatment can include medications, relaxation, talk therapy, and support groups.

If you have the winter blahs, or worse, don’t wait for spring. Start the new year by taking Roseanne’s tips, get more light, stay active, and see a doctor. The winter might be long, but it doesn’t have to be miserable if you get help. Roseanne has brochures available on light therapy and seasonal affective disorder. Give her a call.

 

BARIATRIC SURGERY
Medical Segment Show 197

Air date: 1/4/03

People Magazine called him the “Incredible Shrinking Man.” The Today Show’s Al Roker lost a lot of weight with bariatric surgery. If you gained a few pounds over the holidays, should you consider getting your stomach stapled? Here to weigh in on this weighty subject is MetroHealth’s Raymond Gagliardi, a heavyweight in the field of bariatric surgery.


Question: Bariatric surgery has been all over the news lately, particularly with Al Roker coming forward and talking openly about his recent surgery. What procedure did he have done?
 

Answer: He had a gastric bypass, which is called stapling your stomach in layman’s terms. The actual procedure is more complicated than that.
In gastric bypass surgery, we restrict the stomach and re-route the intestinal flow. Most patients lose 60-80% of the body weight they need to in 18 months to two years.

Question: When would a person reach the point where bariatric surgery would be a good idea?

 

Answer: Bariatric surgery is used to treat morbid obesity. This is when a person has roughly 100 pounds or more to lose, a body mass index of over 40, and medical problems that can be directly linked to their weight.
Such problems include high blood pressure, diabetes, and sleep apnea.
This is not cosmetic surgery.

Question:   Are there risks to this surgery?
 

Answer: There are risks to any surgery. Gastric bypass can lead to mal-absorption of vitamins and minerals we need to stay healthy.
Also, risk seems to increase with age, and traditional thinking was that bariatric surgery was not for people over 50. But that’s changed now with a new procedure.

Question: Can you explain this procedure to us?
 

Answer: Yes, it’s called the Lapband, or a laparoscopic adjustable gastric band. The band is like an inner tube that can be placed around the stomach through laparoscopic surgery. This means that there is no large incision, just tiny puncture sites, and a fiber optic TV camera.
After eight weeks, the inner tube is inflated, restricting the stomach.

Question: Why is this better for seniors? Are there any drawbacks?
 

Answer: There’s a shorter recovery period and no cutting or stapling of the stomach and intestines.  Also, No mal-absorption of vitamins, as with previous bariatric surgery.
People tend not to lose as much weight with the Lapband procedure; however, losing a smaller amount will still likely improve any medical problems the person may have had.

Question: Do insurance companies pay for these procedures?

Answer: Almost all private insurance companies will pay for gastric bypass surgery.
 Medicare will pay for some gastric bypass procedures. State Medicaid is not as willing.
 The Lapband is a new procedure and many insurance companies have not decided whether they will pay for it.
 
 Whether or not to have bariatric surgery is a weighty decision. But it can help resolve some serious medical problems. For more information on gastric bypass and the exciting new lapband procedure, call Dr. Gagliaridi’s department at MetroHealth.

 

SENIOR FITNESS
Medical Segment Show 198

Air date: 1/12/03

You exercise your right to vote. You exercise your freedom of speech. How about exercising to preserve your health? Here to tell us how seniors vote with their feet for good health, is Diane Brick, certified Senior Fitness Instructor at MetroHealth’s Senior Resource Center, and Director of the Recreation Department for assisted living at The Greens Adult Living Community.


Question: Lots of our viewers right now are thinking " I know exercise is important, but I have a bad back, joint pains, poor balance - I just can't do it."  Aren't these the very people who should be exercising?

 

Answer: Yes. And there are lots of exercises especially for people with bad backs, joint aches, poor balance and physical limitations.
 

Question: Why is it important for seniors to keep active and exercise?
 

Answer: I asked seniors in my exercise class why they find fitness important, and they cited building strength, alleviating back pain, and improving their balance.
Other important issues are weight control and improving flexibility.

Question: Should seniors be afraid of exercising—of overdoing it?
 

Answer: Before starting any exercise plan, you should see your doctor for permission and to find out any restrictions or modifications that should be made to your exercise plan.

Question: What are some important modifications for seniors to watch out for? How can your exercise routine be made safer?
 

Answer:

Question: How often should you exercise? How hard is it to stay motivated?
 

Answer: Cardiovascular exercises (aerobics) can be done daily. You can rest one day a week.
You should wait a day between weight training exercises.
Motivation can be difficult. Make exercise fun.  Joining a class may help.
In our classes we exchange cookies, share jokes.
Give yourself rewards - - like vacation, or hot fudge sundae.
have pictures of grandkids that you want to be able to pick up visible.
 

Question: You teach classes through MetroHealth that are open to the public.  Tell us.

Answer: We have a program at MetroHealth called Lite n EZ Exercise, Monday and Friday mornings at the Senior Resource Center on Memphis Road in Cleveland.  We work on balance, easy cardiovascular exercise, strength building, resistance training and balance.
$3/person for one hour
Lots less expensive than joining a health club. Fun!

Question: Is twice a week at a class enough?

 

Answer: No. You should exercise at home, too.

Question: You don't need a lot of expensive equipment to exercise at home?
 
 Answer: No. You can use therabands, weights. But don’t need to spend much.
 
 You have lots of aches and pains? Don’t let that be just a “weak” excuse. You can still exercise. In fact, right now, why not exercise your finger, and give Diane a call.

 

NUTRITION: ADJUSTMENTS SENIORS NEED TO MAKE TO STAY HEALTHY
Medical Segment Show 199

Air date: 1/19/03

One week, eggs are bad for cholesterol. The next, eggs are okay if eaten in moderation. First red wine is good for the heart. Then we hear that drinking’s bad. Dietary do’s and don’ts can be so confusing, it’s almost enough to make us lose our appetites. In fact, it’s almost as confusing as the laws we discuss. Nah, not that confusing. Here to sort out the wheat from the chaff when it comes to nutrition is MetroHealth dietician, Cinda Chima.


Question: We’ve been told again and again what to eat and what not to eat—it can be confusing! And seniors have their own special dietary issues. What is the main issue facing seniors when it comes to diet?
 

Answer: Seniors' energy needs drops while the need for certain vitamins and minerals increases. Therefore, they need less calories and more nutrients.

Question:   How can one do that—eat less but make sure that their nutrient intake remains high?
 

Answer: The best way is to cut back on empty calories. Stop drinking beer or non-diet soda. Eat smaller portions of dessert. Eliminate fats from your diet, like butter, margarine, gravy and sour cream.  Instead, eat Nutrient Dense food—foods that are low in calories yet high in nutritional value. An example would be broccoli.

Question:   What specific nutrients do you find seniors need more of?
 

Answer: The nutrient that seniors most commonly need more of is water. Many restrict water due to diuretics and fear of incontinence, but most seniors need 7 to 8 glasses of water a day, regardless of thirst. Thirst is less reliable as you age.
Often, seniors need more of the B vitamins, which tend to not absorb well as one ages. They can often be found in fortified breakfast cereals. Your need for higher amounts of B6 vitamins goes up after age 50, and not having enough B12 can be linked to heart disease.
Calcium needs go up, even if you find it harder to digest milk.
Iron needs go down in post-menopausal women. Having too much iron can be linked to heart disease.
 

Question: That’s a lot to remember—do you recommend taking an everyday vitamin?
 

Answer: Although it is better to get the nutrients from food, taking a vitamin is a good idea.
You should look for vitamins that contain 100-200% of the daily, recommended value of nutrients.
We can look at Centrum vs. Centrum Silver—senior needs are accounted for.
 

Question: Should seniors see a dietitian regularly? Answer: Seniors should see a dietitian if they are put on a restricted diet, such as a low salt or a diet for diabetes. People are not well educated in following these and think that if they don’t add salt, or just eliminate the ingredient sugar they are following doctor’s orders.
 See a dietitian if your spouse has a restricted diet and you do the cooking.
 If a senior loses weight without trying, that is a warning sign and you should see a doctor.
 If you are taking medications and using supplements you should check with a dietitian about any drug/food combinations that could be harmful.
 
 We really are what we eat. And eating the right foods can help you feel healthier and be healthier. If you have questions about food and diet, give Cinda’s office a call.

 

INTERACTIONS OF DRUGS AND FOOD
Medical Segment Show 200

Air date: 1/26/03

Your medications are there to help you. But if you’re not careful, they actually can hurt you. Medicines can mix with the foods you eat and other drugs you take, to become harmful. Here to help us avoid this prescription for problems is Dr. Michael Harrington from Metro Health.


Question: If we are taking prescription medicine, what should we look out for? How can we know if a drug we take will mix poorly with a certain food or other medication?
 

Answer: Read the labels and information given to you by your pharmacist. That information should tell you if any interactions are likely.

Question:   What are some common examples of foods that can mix with medication?
 

Answer:

In general, foods can decrease or increase the absorption of medications. Read the label and make sure you take the medication with or without food—whichever is correct.


Question: Lots of people are using herbal supplements today.  Can these cause problem interactions with medications?

 

Answer: Yes. Example: Ginko Balboa for memory. If you are already taking a blood thinner, Ginko also makes blood thinner.

 

Question: Most of us think over the counter means safe.  Can OTC drugs interact with our prescription drugs?

 

Answer: Yes.
Ex.: OTC cough & cold medicines should not be mixed with blood pressure prescriptions. They can raise BP dramatically.

Ex.: Don’t take Benadryl or Tylenol PM if you have dementia. It will cause more confusion.

Ex.: Mixing prescription & OTC arthritis medicines (Aleve & Ibuprofen). Increase chance of ulcer.

 

Question:   Does that mean that we should entirely stop eating these foods if on medication?
 

Answer:  Not necessarily. Usually you just have to separate them from each other. Drink grapefruit juice an hour before or after taking the medications—not at the same meal.
As always, check with your doctor.

Question: Can different medications you are prescribed mix with each other?
 

Answer: Yes. Polypharmacy is a risk. Bad drug interactions can increase the side effects.
For example, cough and cold medication should not be mixed with blood pressure meds. If you suffer from dementia, you should not take Benadryl (or something like Tylenol PM that has Benadryl in it).

Question: What can we do to avoid mixing the wrong drugs together?

Answer:

A spoonful of sugar might help the medicine go down. Or it might cause a dangerous interaction. To find out for sure, read the labels on your medicines and talk to your doctor. If you’d like more information on drug interactions with food and medicines, call Dr. Harrington’s office. They’ll send you out a helpful information packet.

 

 

MetroHealth Line

 

Medical Segment Show 201

Air date: 2/2/03

You’re not feeling well. But you don’t want to bother your doctor, and it would probably take a day or two to get a call back anyhow. Where can you turn for medical advice? Some of you have parents or grandmas that know everything about aches and illnesses. But if you’re not so lucky, there’s a grandma substitute available, at the MetroHealth System. Margie Carroll is manager of the MetroHealth Line, and she’s here to tell you how to get quick and easy help in your time of medical need.


Question: What is the MetroHealth Line? What services are available through it?
 

Answer: The MetroHealth Line is a 24-hour nurse call center that can provide you with the most up-to-date health information right over the phone.
We can provide you with information on a wide range of health and medical topics, help you find a physician through our physician referral service, sign you up for one of our educational programs, and more.
The MetroHealth Line can work as the nurse in the family you call to ask questions. We’re there to hold your hand.
It’s a free service provided by the MetroHealth System.
It’s not an emergency line.

Question:   What kinds of calls are typical? How can you help?
 

Answer: Many seniors call because they’ve forgotten to take a medication and want to know what to do. We can advise.
People often call asking for better guidelines for a chronic illness, such as diabetes. We can direct them to someone who can help.
Advice for general aches and pains.
Often, seniors don’t want to bother their doctor with questions. We can listen to their symptoms and either give them homecare instructions (and tell them to call back if symptoms do not improve) or page the doctor for them if warranted. We will call back to follow up, see how things are going.
Finally, people call the MetroHealth Line for help maneuvering through the system, accessing appointments, asking what kind of doctor to call for specific problems, etc.

Question:   Who can call the MetroHealth Line?
 

Answer: Anyone in Cuyahoga County can call. You do not have to be a patient in the MetroHealth System.
The Line is especially helpful for patients because we can page their doctors, look up their records, etc.
We get lots of calls from seniors (270/month), and from people who are caregivers and are calling for a spouse, parent or grandparent.

If you’re not feeling well, call the MetroHealth Line. If you’d like advice about caring for yourself or a sick spouse or parent, stop worrying and call the MetroHealth Line. We’ll give you the number in just a moment. And to make sure you won’t forget the number in the future, we have it right here on a refrigerator magnet. Call the number and get your own free magnet reminder now.

THE LATEST IN HEARING AIDS
Medical Segment Show 202

Air date: 2/9/03

Hearing loss can be isolating and hard to accept. Folks often become depressed and withdraw from social interaction. You don’t have to suffer in silence. Today Dr. Julie Bonko wants us to hear about the newest hearing aid technology. The news should be music to our ears.
 

Question: What causes hearing loss is older adults? Who is at risk?
 

Answer: Hearing loss is the third most prevalent chronic condition among seniors - only arthritis and hypertension are more common problems.  Of the 38 million Americans with hearing loss approximately 60% are over the age of 55.  It is estimated that by the age of 70 nearly half of all adults are experiencing partial hearing loss and that by the age of 80 some studies have indicated that the incidence rises to 90%.
I think it’s important that people with hearing loss realize that they are not alone and that there is help available.

Question: How often should seniors have their hearing evaluated?
 

Answer: Seniors should have their hearing evaluated annually after their initial hearing test just to make sure that if they have hearing loss, it is not progressing and to make appropriate hearing aid adjustments.   Of course, if they feel there has been a change in their hearing or if family members are noticing a problem, they should have their hearing checked at that time.

Question: If hearing loss is discovered, what can be done?
 

Answer: The first thing to do is to assess whether the hearing loss can be medically or surgically treatable.  If the hearing loss cannot be medically or surgically treated, hearing aids and/or assistive listening devices are recommended as appropriate.
Recent advance in technology, such as digital programmable hearing aids allow us to fit almost every type of hearing loss.  Hearing aids used to be analog—they would amplify the sound and send it back to your ear. Now they are digital, like a mini-computer. It’s like comparing a vinyl record recording to a CD.

Question: Does this new technology allow the hearing aids to be smaller? Does that convince more people to get an aid if they need it?
 

Answer: The smallest hearing aids are available in both analog (traditional) and digital technologies; however, they are not always appropriate for everyone.  We must consider many things when fitting a hearing aid such as: vision, manual dexterity, type and degree of hearing loss and communication demands.  Sometimes people are resistant to wearing hearing aids because they feel it is an outwardly visible sign of aging. However, what people fail to realize is that asking for frequent repetition or frequently misunderstanding what is said are much more obvious than simply wearing a hearing aid.  More importantly, seniors who have a hard time hearing often withdraw from activities out of frustration. Wearing a hearing aid- restoring ease of communication- can bring them back into the community.

Question: Once you have a hearing aid, should you still go for regular appointments to check your hearing?
 

Answer: Once a patient has completed their 30-day trial period they should return as needed to their audiologist for any hearing aid concerns and for annual check-ups

Question: There are lots of ads for hearing aids.  You have your clinical doctorate.  The folks in Metro's audiology department have a very high level of training and education.  Do you get that same level of expertise and education when you buy from an ad?

Answer: Not always. Some have no more than high school degree. Need to be very careful. You don’t just want to buy a piece of equipment. You want to be sure you get a full auditory evaluation, and have the aid made to deal with your precise hearing loss. You need a professional to help.

Don’t let Dr. Bonko’s advice fall on “deaf ears.” Get your hearing checked by an experienced professional. Visit the MetroHealth Hearing Aid clinic. If you’d like an informative brochure on the latest advances in hearing options, call the number that’s up next.

 

PREVENTING FALLS
Medical Segment Show 203

Air date: 2/16/03

Balance in our lives is important, whether it means balancing our checkbook or keeping our balance. As we age, we are more prone to falls. But we have tips to help you avoid tipping over. Here to keep us on our toes is MetroHealth’s very steady Occupational Therapy Assistant Sue Alexander.


Question: What are some of the reasons seniors are susceptible to falls?
 

Answer: It’s largely due to muscle weakness in the legs. Also, bad posture can cause falls. As gravity pushes the head forward, your body become out of alignment and that can cause falls.   As you get older, your balance and your vision may become poorer as well.

Question: What can we do to help prevent falls?
 

Answer: Ironically, working on your sitting habits can help prevent falling.

Question:   Seniors often stumble when they first get out of a chair. Any tips?
 

Answer: Before you stand up from a chair, spend some time rotating your ankles in circles. This sounds strange, but when you rotate your ankles, the fluid that surrounds them sends a signal to your inner ear. This reminds your brain where your feet are, so that when you stand up you don’t topple from poor circulation.
When about to stand, scoot to the edge of the chair, make sure both feet are under you, and hold on to the chair as you lift yourself. Rock back and forth a few times to gather momentum if you need to.

Don't jump up to answer the phone.
Stretch and stand awhile before taking your first step.
 

Question:   Once standing or walking, how can we help keep our balance?
 

Answer:

Question:   What can we do if we feel ourselves starting to fall?
 

Answer: Bend your knees and crouch.  This will lower your center of gravity, making you closer to the ground if you DO fall and perhaps even stopping the fall.

Question  What can we do around our house for safety? To make us stronger so we don’t fall?

Answer: 

Don’t let balance problems trip you up. Sue has been kind enough to offer Golden Opportunities viewers two helpful brochures on falls prevention. Give MetroHealth a call.  My thanks to Sue Alexander.

 

STROKE REHABILITATION
Medical Segment Show 204

Air date: 2/23/03

Stroke is the number one cause of long term disability. Survivors face a challenging road to recovery. But teamwork can help smooth over the bumps. Today we’re fortunate to have the captain of the team, Dr. Asikin Mentari, Director of Stroke Rehabilitation at MetroHealth.


Question: After a stroke, recovery can be long and difficult. What length of hospital stay are people traditionally looking at?
 

Answer: Stroke patients tend to stay in an acute hospital setting for 3 to 4 days.  After that stay, they are moved into acute stroke rehabilitation, which lasts on average 20-21 days.
At MetroHealth, we have an 18-bed unit, and have been running stroke rehabilitation for 50 years.

Question:   What types of recovery/rehabilitation takes place?
 

Answer: The stroke rehabilitation team focuses on enhancing the quality of life of stroke survivors and their family or significant others. 

Question: I know that MetroHealth has a special area that specifically helps stroke survivors reintegrate.
 

Answer: Yes, Easy Street. Easy Street is a simulated town that gives survivors the opportunity to practice everyday activities.  They can practice getting in and out of a car, negotiating a curb, banking, using an ATM, shopping, and even eating at a restaurant.  We have four pictures of Easy Street—someone approaching a curb, getting out of a car, shopping, and using a treadmill (Body weight assisted ambulation).

Question:   Can most patients benefit from stroke rehab?
 

Answer: Approximately 80% of stroke survivors can benefit from the stroke rehabilitation program.  If the patient will have 24-hour family support (which is vital), 86.7% were discharged to their home after stroke rehab, not another nursing facility.  This is compared to 28.6% of patients without that kind of family support.
 

Question: You can continue rehab on an outpatient basis?

 

Answer: Yes.

Question: MetroHealth has a specialized stroke rehab unit.  Do all hospitals?

 

Answer: No. MetroHealth's Easy Street is unique.

 

After a stroke, the road to recovery is far from an “Easy Street.” But with family and medical support, a good team approach, and facilities like MetroHealth’s Easy Street, survivors can improve their quality of life. Dr. Mentari is offering a free fact sheet about stroke rehabilitation. To get one, or for more information about MetroHealth’s stroke rehabilitation unit, call the number.

 

THE ROLE OF A PUBLIC HOSPITAL
Medical Segment Show 205

Air date: 3/2/03

If you have to get sick, you’re in luck. Cleveland is probably one of the best medical centers in the country. Maybe our least known but brightest gem is a public hospital. Here to explain the role of a public hospital is Dr. Ben Brouhard, Executive Vice President and Chief of Staff of the MetroHealth system.


Question: What is a public hospital? How does it differ from other hospitals?
 

Answer: MetroHealth is a Public Safety Net Hospital.  What separates us from other hospitals is our mission: to care for our constituents regardless of ability to pay. We’ve been in existence, under various names, for over 160 years.  We specialize in care, education and research.

Question:   Who are your constituents?
 

Answer: The residents of Cuyahoga County.  The county owns MetroHealth, and the hospital is managed by the County Commissioners.  However, of our $550 million budget, less than 4% actually comes from the county.

Question:   You mentioned care, education and research. What did you mean by care?
 

Answer: MetroHealth strives to offer a variety of service. Like most Safety Net Hospitals, we specialize in services that are labor intensive and are not well-reimbursed.  These include trauma, intensive care, neonatal care, and our burn unit.  (Stuff other for-profit hospitals don’t want to do)

Question: What about education?

 

Answer: MetroHealth is a teaching hospital. We have 350 residents that we train.  We have 40% of 3rd year medical students from Case Western Reserve University, and a number of fourth year students from around the U.S. and the world.

Question:   And research?
 

Answer: We have the General Clinical Research Center, which is involved in clinically based, patient-centered research.

Question: Since you’re owned by the county, MetroHealth has a lot of community connections, correct?
 

Answer:  Yes, we have our Centers for Community Health, that focus specifically on the city of Cleveland, including the Clement Center on E. 71st, which has been open for 50 years.  We run the City Clinics.  We have suburban medical centers in West Park, Brooklyn, and Strongsville.  We have working relationships with the Mental Health Board and the Cleveland Hospital Association.

 

Question: If there were no MetroHealth, what would that mean to our community?

 

Answer: If you were in an accident, there would be no level 1 trauma center.  There would be a lack of ER facilities. UH & Clinic couldn’t handle, and don’t offer Metro’s level of service. It would be a disaster.

 

Question:   MetroHealth is such an asset to Cuyahoga County—what can we do to help?

Answer: Support us. Tell people.  You can support the Health and Human Services levy in the May elections. We receive some general funds from there.  It will be on the ballot for Cuyahoga County residents.
 
 Although it’s not Thanksgiving, we should all give thanks that we have MetroHealth here in our community. High quality medical care, without regard to your ability to pay. What a concept! And MetroHealth has a wonderful program designed specially for seniors all around the county. This program is worth, checking out. My thanks to Dr. Ben Brouhard.

APPROPRIATE TREATMENT FOLLOWING A HEART ATTACK
Medical Segment Show 206

Air date: 3/9/03

Learning to be heart smart becomes even more important if you’ve survived a heart attack. You don’t want to have another. How can you be sure you’re doing everything you can? Here to give us a heart healthy dose of advice on treatment plans after a heart attack is Dr. William Lewis of MetroHealth’s Heart and Vascular Center.


Question: We’ve heard the warning signs of heart attacks, and how to prevent them, but what about after one happens? What happens then? How long does one stay in the hospital?

 

Answer: The hospital stay depends about many factors individual to each case, but the average stay before a patient is sent home is 2-3 days.

Question: That seems awfully fast. When a patient gets home, they do have to make some lifestyle changes, right?
 

Answer: Yes, there are a lot of changes to be implemented, and patients are usually very agreeable to reading through literature/learning new lifestyles after an event such as a heart attack.
Patients also can’t be afraid to ask questions—they are their own best advocate.
 

Question: After We've had a heart attack, what can we do to protect against another one?

 

Answer: 3 Priorities: Medications, lifestyle changes and education.


Question: Let's start with the medications.  What should post-heart attack patients be taking?


Answer: 100 percent of those who have had a heart attack should go home on betablockers (Block adrenalin.
Heart uses less oxygen) and aspirin (reduces clots). Currently, only 50 percent are sent home with betablocking medication and only 75% are told to take aspirin.
You should also ask your doctor about lipid lowering medication.  Most should take lipid lowering medications, like Lipitor. Statins. They lower bad LDL cholesterol.

Question:   Why the discrepancies? Why aren't all patients sent home on these medications if they should be?
 

Answer:  Hard to say. We’d like to have all the doctors on the same page.  At MetroHealth, we participate in an American Heart Association program called “Get With the Guidelines” where we talk about the care/medications patients should have after experiencing a heart attack.

Question: The second item on your list is to take a look at your practices. What do you mean by that?
 

Answer: These refer to lifestyle-changing practices that are important for the health of patients who have had heart attacks.
You must stop smoking.
You should also get involved in cardiac rehabilitation. Cardiac rehab involves an exercise program and education (on heart disease, diet, etc).

Question: And the third category on your list is knowledge.
 

Answer:  Yes. If you’ve survived a heart attack, or even if you have never had a heart attack, there is certain information you need to learn.
What is a normal blood pressure level? Below 135 over 85.
You should ask what your bad cholesterol, or LDL, is. A healthy cholesterol level for someone who has had a heart attack is below 100.

Follow Dr. Lewis’ tips to cut your risks after a heart attack. Take the right medications, get into a cardiac rehab program, and educate yourself. My heartfelt thanks to Dr. William Lewis for helping us to “get with the guidelines” today. For more information, or to get an informative brochure from the American Heart Association, call the number that’s up next.

 

BURN CARE CENTER: SENIOR PREVENTION
Medical Segment Show 207

Air date: 3/16/03

Remember Smokey The Bear warning kids about fire safety? Well, children aren’t the only ones who need reminders about the dangers of burns. Here to fire us up on the importance of burn prevention is Lynne Yurko, Nurse Manager of the MetroHealth Burn Care Center.

 

Question: Seniors have unique needs when it comes to the prevention of burns. What can we do/know to prevent burns from happening?
 

Answer: One major area that requires a close look at safety is kitchen and cooking activities.

Question:   I imagine that smoke detectors are vital to burn prevention.

 

Answer: Yes. There should be a smoke detector on every floor of a house and by every sleeping area. If there is a smoker, a detector should be place in that person’s bedroom.  Check your batteries every time you change your clock forward or backward.  Do not take batteries out of your smoke detector to use in your radio, remote control, etc. You always mean to replace them, but quite often forget .
 

Question:   What if there is a fire? What can we do to keep safe?
 

Answer: I’m sure you remember being told to “Stop, Drop and Roll.” However, seniors often lack the flexibility to do that, or might be confined in a wheelchair. 

Question: What should you do if you do get burned? What should you not do?
 

Answer:

Question:   MetroHealth has a burn care center. Tell us about that.

Answer: The MetroHealth Burn Care Center has serviced Northeast Ohio and Erie, Pa. since 1970. We work closely with the American Burn Association, deal with both adult and pediatric burns, and are the only burn center in the Cleveland area.
 We help patients from the start of the injury, through rehabilitation, and then after with support groups (including camps for children).
 This September we are hosting the World Burn Congress for survivors of burns.
 
 Fire and burn prevention is crucial. MetroHealth has the only burn center in the Cleveland area. We are very fortunate to have this resource available. If you have questions or you would like a free brochure, or if you’re interested in a support group for burn survivors, call the MetroHealth Burn Center.

 

HOW TO STAY ACTIVE DURING RETIREMENT
Medical Segment Show 208

Air date: 3/30/03

Give me a soft sofa, a television with a remote, a big bottle of soda, and a huge bag of chips, and I know my retirement will be Hog Heaven. That’s what lots of folks think before they retire. But after, those never-ending vacation days can grow a bit stale. Here to help us keep your outlook on retirement life fresh is Dr. Holly Perzy, Director of the MetroHealth Strongsville Medical Group.


Question: Do most people have a hard time adjusting to retirement after working for many years?
 

Answer: Some people really do. Depression is a common response. Many people feel that work is what gives a great deal of value to their life. At retirement, feeling “devalued” can lead to depression.  People have to learn to find new missions and goals. After all, you retire from your job, you don’t retire from life.

Question:   How can people help themselves make that adjustment?

Answer: First, we look to see if a person is remaining “mentally” active, using their cognitive skills. Our mind begins aging when we’re in our 20s, and continues on, but there are steps we can take to combat that. The more active your brain is, the less cognitive skill you lose.

Question: I would imagine that keeping socially active is really important part of staying active after retirement.

Answer: Yes. Get involved with activities you enjoy. Join a book club, go to plays or concerts, or play chess.

Remain in contact with people who share different opinions, ages and backgrounds. Engaging in discussion and debate keeps your mind sharp.
Staying active physically enhances your cognitive abilities. That’s why staying physically active is also vital after retirement.
 

Question: What kinds of physical activity do you recommend?

Answer: Go to your doctor and find out your physical guidelines.  Exercising with others increases the chance that you will stick to an exercise program.  Exercising slows down aging. Lack of exercising decreases muscle strength and increases bone less. These can lead to falls, which are very dangerous to seniors.
Staying active can also improve your sleep quality.

Get off the sofa, put down the soda and chips, and turn off the TV, after our show is over. Staying active in retirement takes some effort, but it can be your fountain of youth. Dr. Perzy is offering a list of free resources for more information about active retirement. Call the number that’s coming up. My thanks to Dr. Holly Perzy.

 

SHINGLES: WILL I GET THEM?  WHEN AND WHY?

Medical Segment Show 209

Air date: 4/6/03

If you’re a fan of late night talk shows, you might have been surprised to see Bruce Willis hosting The David Letterman Show. David wasn’t at his desk because he had shingles. But what exactly are shingles, and how can you escape the pain? Here to explain is MetroHealth Dermatologist Dr. Judith Walker.


Question: What are shingles? What causes them?
 

Answer: Put simply, shingles are chicken pox coming back to haunt you. The virus that causes chicken pox remains in the nerve roots of your body.  The virus can become active again if your immune system drops due to stress, illness or chemotherapy.  Twenty-five percent of people who have had chicken pox will develop shingles in their lifetime.

Question:   What are the symptoms? How can you tell if you have shingles?


Answer: The main symptom is sharp pain. That is the first symptom to appear at first, leading shingles to often be misdiagnosed as a heart attack, gall bladder disease, or appendicitis.
After 24-48 hours, the first blisters appear.  These look like a dewdrop on a rose petal—a blister on a pink background.  The blisters appear on one side of the body, either on the face/neck, chest, or leg/thigh.  The blisters can last 10-14 days. Once they crust over, they are no longer contagious.

Question:   Are there any lingering results of the disease?

 

Answer: Patients may experience post herpetic neuralgia. This means that the pain of shingles can linger for up to six months (or even more) after the shingles disappear.

Question: Is there any way to combat post herpetic neuralgia?

 

Answer: Pain relievers can be prescribed if it occurs.  There are new medications (viral medications) that can lessen the likelihood of post herpetic neuralgia if taken early in the disease.  Again, the main issue is diagnosing the shingles early enough, which can be difficult to do.

If you’ve had Chicken Pox, then pain plus blisters probably means shingles. Don’t be a chicken. Run to the doctor, because if it’s caught early, you can duck the worst effects. If you wait too long, your goose may be cooked. For more information, call MetroHealth. They have a nice brochure they will send out. Free. My thanks to Doctor Judith Walker.

DEAF-TALK
Medical Segment Show 211

Air date: 4/20/03

An emergency room visit can be a stressful experience in the best of circumstances. But what if you are very hard of hearing or deaf, and you can’t hear the doctor? Today’s technology has made it possible for hearing impaired patients to talk to their doctors within minutes. Here to explain is Mark Lehman, Manager of Social Work at MetroHealth, and Bob Fisher, President of Deaf-Talk.


Question: When a patient walks into a doctor’s office, it’s vital that he or she can communicate to the doctor, describing their symptoms and concerns. But what it the patient is deaf? Mark, how has the hospital dealt with this disability in the past?
 

Answer: Hospitals are required to provide communication accommodation for their patients. While interpreters for different spoken languages can often be contacted immediately over the phone, this process does not work for the deaf.
If a deaf person has an appointment scheduled, an interpreter can be brought in to facilitate the language barrier.
However, not all trips to the doctor are by appointment. Emergency room situations can arise, and it might take several hours for an interpreter to arrive at the hospital for an unscheduled visit. This can affect the quality/speed of care the patient receives.

Question:   Bob, your company has a way to combat that delay, correct?
 

Answer: Yes. Deaf-Talk is a 24-hour, 7-day per week interpreting service available over video broadcasting, now available in more than 100 hospitals nationwide.
Participating hospitals are equipped with carts containing a television monitor, microphone, camera, and video unit. When an interpreter is needed, the hospital contacts Deaf-Talk and a video link can be made almost immediately, bridging the gap when an onsite interpreter is not available.
We also have interpretation for spoken foreign languages.

Question:   You’ve brought a photo of what one of these carts looks like. Can you explain what we are seeing, and how this works?
Answer: Yes. Here you can see the TV screen with the interpreter visible. Usually, the screen is situated just off the shoulder of the doctor so that the patient can look at the doctor while he/she is talking.
There is a flexible camera on the cart so that the patient can be seen head on, even if they are lying down on a bed.
Also, signs do not exist for more complicated names of diseases or medications—they must be finger-spelled. That is more difficult to see on camera, so there is a keyboard available. The patient can read the text and then a shortcut sign can be created. This feature is also helpful if the doctor has an accent and the interpreter has a hard time understanding him/her.

Question:   Mark, MetroHealth now has Deaf-Talk available for their hearing-impaired patients?
 

Answer: Deaf-Talk has been available at MetroHealth since September of last year. We were the first hospital in Ohio to implement this service. We held an open house where Deaf-Talk was unveiled to our deaf population (numbering about 100 patients).
It has already been used 30-35 times since its implementation, most often in emergency room situations.
It will be available in our emergency room, outpatient clinics, and inpatient nursing units.

You want your doctor to know where it hurts. And you want to be able to hear: “It’s going to be okay.” MetroHealth and Deaf Talk make this possible for the hearing impaired in Cleveland. For more information on this wonderful service, call the number that’s coming up. My thanks to Mark Lehman and Bob Fisher.

 

HEALTH AND HUMAN SERVICES REPLACEMENT LEVY
Medical Segment Show 212

Air date: 4/27/03

It’s that time of year again. Time to get out and vote. The May 6 election has an important issue for seniors on the ballot, the Heath and Human Services Replacement Levy. Here to explain how passing this levy will help you and your family is MetroHealth’s Dr. James Campbell.


Question: There’s an important levy on the May ballot. Can you tell us about it?

 

Answer: The Board of County Commissioners has placed on the May 6th ballot an enhancement of the expiring Health and Human Services levy to partially offset state cuts and to continue proving services to those in need.   The $4.9 million replacement levy on the May 2003 ballot will take effect in 2004 and will have a five-year life expiring 2008.

It is a county levy for health and human services. This levy is 40% of the county’s revenue for these services.  It's a part renewal (average about $5/month) and part new (average $3/month).
 

Question: The majority is a renewal.  Does that mean it just replaces and existing levy?

 

Answer: Yes. No new tax. It’s been years since the levy was adopted, with no increase.

 

Question: Why are we talking about a county levy?  Doesn't the state pay for health and human services?
 

Answer: The State's in a mess.  Since 2001, funding from the State of Ohio has been reduced by over $100 million that the county uses to provide vital health and human services to families, children, and seniors.  These reductions have affected the services that Cuyahoga County provides to vulnerable seniors, abused and neglected children and families transitioning from welfare to work. The State legislature is currently considering almost $9 million in additional cuts.
 

Question:   Where does the money go? What services does this levy include?

 

Answer:

Question: How many people are actually helped by the funds generated by this levy?

 

Answer: Virtually every family is touched.

 

Question:   What will the levy cost?

 

Answer: The cost to the owner of a $100,000 home will be $150.06 per year.
 

Question: Why is the 2003 replacement levy critical?

 

Answer: The levy-generated dollars provide the largest share of local support for programs through which county government and local agencies address the needs of our most vulnerable citizens.  Availability of services is also maintained for those times when any resident of the County may need assistance in dealing with trauma or crisis.
 

Question: What happens if this levy doesn't pass?

 

Answer: We can try again in November.  But the forward thinking projects would have to come off the ballot, like the convention center.  If it doesn’t pass, think of a business losing 40% of its revenues. Disaster.

The State’s budget scissors are busy cutting holes in many important safety nets. If you want vital health and human services to continue in Cuyahoga County, please go to the polls on May 6th. And vote for Issue 15. For more information about the Health and Human Services Replacement Levy, call MetroHealth Advantage.

 

HEALTH AND HUMAN SERVICES REPLACEMENT LEVY, part 2
Medical Segment Show 213

Air date: 5/4/03

A catastrophic burn center, Life Flight, services to protect seniors from abuse, homeless shelters, foster care for children. If you believe health and human services like these are important, and I hope you do, the Health and Human Services Replacement Levy must pass this Tuesday. Here to explain is Dr. James Campbell from MetroHealth.


Question: We welcome back Dr. James Campbell from MetroHealth Geriatric department. Dr. Campbell, last week you discussed the Health and Human Services Replacement Levy that’s on the May 6th ballot. Can you go over that real quickly?
 

Answer: This May 6th, Cuyahoga County voters will be asked to support issue 15, to keep Health and Human Services for tens of thousands of citizens in every community in the county.
Issue 15 is for children, seniors and people who need health care and other services.
 

Question:   Today I thought we’d focus on the services that would be affected by this levy.
 

Answer:  First, MetroHealth Medical Center. This includes our Comprehensive Burn Care Center, Metro Life Flight, and the level one trauma center.
Services for seniors, so they have home health care, can continue to live independently in their homes, and be protected from abuse and exploitation.
Services for children, such as promoting health and development for prenatal babies through 5 year olds, foster care for abused children, and treatment for emotionally disturbed youth.
Other crucial services, such as quality childcare, mental health counseling, rehabilitation from crippling injuries and strokes, emergency shelters for homeless people, drug and alcohol abuse prevention and treatment, etc.
 

Question:   What’s at stake without passing issue 15?
 

Answer: Without issue 15, our health care safety net is at risk. MetroHealth will not be able to adequately serve more adults as they lose medical coverage. As a result of State cuts, around 7,000 working parents will lose medical coverage and another 100,000 adults will lose other vital medical services.
More than 1,000 seniors per year would lose their ability to live independently at home. Additionally, in-home services for thousands of frail, low-income adults would be jeopardized potentially leaving many more seniors vulnerable to neglectful or dangerous living conditions.
Support for more than 10,000 children and young adults would be cut.
 

Question:   What’s the bottom line concerning this levy?
 

Answer: Issue 15 is a sound investment on behalf of vulnerable children, seniors, and others who need health and human services.
Your vote for Issue 15 will bring $170 million from the State of Ohio. For the average county homeowner, the added cost is under $8 per month, in Cleveland, it’s under $3 per month to maintain a caring, compassionate, safer community.

Question: How do you tell someone who's feeling the pinch in these tough economic times to vote for this tax?

Answer: Tough times may mean you have less in IRA, or less in savings for entertainment. That’s real. But others are looking at losing medicine, vital health services. $150 is a lot. But if you think times are tough for you, there are people in life and death dire straits. They can’t do without the services provided by this levy.

Question: Do I understand that passing the levy actually brings in more state money?

Answer: Yes. The money we put in is matched by the State. Levy generates $170 million from the State.

This Tuesday’s the day to make your voice heard. Providing for our critical health and human services for years to come is in your hands. Please, get out and vote for Issue 15, for seniors, for children, for all of us.

 

REVERSING THE RISK OF HEART DISEASE
Medical Segment Show 214

Air date: 5/11/03

Half of all American adults have high cholesterol levels. Cholesterol leads to heart disease, which kills more than a million Americans every year. That’s more than all cancer deaths, combined! You don’t have to become one of these scary statistics. Here to explain how to reverse our risk of heart disease is Dr. Frederick Shaw from MetroHealth’s Heart and Vascular Center.


Question:   When talking about risk factors for heart disease, we have heard a lot about cholesterol—good cholesterol, bad cholesterol, what our level should be, etc. When is cholesterol good and when is it bad?
 

Answer: Cholesterol is the major building block in certain hormones in the body. It’s even a component of all cell membranes in the body.
Your body naturally creates cholesterol (in the liver), but the overproduction of cholesterol (due to genetics and other factors such as obesity and smoking) can lead to fatty deposits that cause a narrowing of the blood vessels.
If this condition occurs in the heart vessels it partially limits the blood flow of oxygen and nutrients to the heart causing the deprived heart muscle to signal chest pain (angina). If the interrupted flow is severe or prolonged, it can cause a heart attack.
The same process in the arteries supplying the brain causes stroke.
 

Question:   What is a “normal” cholesterol level? Are there any symptoms to high cholesterol?
 

Answer: There are no symptoms. The only way to know if you are at risk is to have a blood test.  You should be aware of your LDL cholesterol level (low density lipid). If you do not know it, ask your doctor for a blood test.
A “normal” cholesterol level for someone without significant risk of heart disease is 130 or below.
If you already have had heart problems, are diabetic, smoke, have hypertension or a family history, your LDL level should be 100 or below.

Question: Are there certain body types that pose higher risks?

Answer: Yes. An "Apple" shape is worse than a "pear".
 

Question:   Is high cholesterol a widespread problem?
 

Answer: About half of American adults have cholesterol levels higher than desirable.  Heart disease kills almost 1 million Americans each year, more than all cancer deaths combined. And this is a largely preventable condition.
 

Question:   So what can we do to lower our risk of heart disease?
 

Answer: Smoking damages the walls of blood vessels and also increases the accumulation of fatty deposits. Those who smoke need to stop and those who don’t should not consider starting.
Weight Reduction. Obesity increases triglycerides and lowers “good” cholesterol. Not all obesity carries the same risk: People who are pear shaped are at a lower risk than those who are apple shaped.
Also consider changing your diet and exercise. Cholesterol occurs in foods derived from animals (meat, eggs, and cheese). Also, increasing activity increases “good” cholesterol. Choose an aerobic activity, like brisk walking, and build up time and frequency to 30-45 minutes, 3 times per week.
 

Question: What medications are available? How well do they work?

Answer: A medication grouping called “statins” are the “best” medications to take if your cholesterol is too high. Examples are Lipitor and Zocor.  They work directly with your liver to block the formation of cholesterol, and can reduce LDL cholesterol by up to 40%.  Statins also decrease inflammation of the plaque in your vessels, making it less likely to burst and cause a heart attack.  Side effects are very rare.  High cholesterol is VERY treatable if you are aware of the condition. Again, find out!
 
 Let’s get to the “heart” of the matter. Check your cholesterol periodically. If it’s high, watch your weight, exercise, and ask your doctor about medications. For more information on how you can lower your risk of heart disease, give MetroHealth’s Heart and Vascular Center a call. My thanks to Dr. Frederick Shaw.

 

PAIN IN THE ELDERLY
Medical Segment Show 215

Air date: 6/1/03

Every year, our aches and pains seem to get a little worse. For many folks, pain can actually prevent them from fully enjoying life. You may not realize it, but help is available. You don’t just have to complain. Here to explain how we can manage our pain and put it on the wane is Dr. Peter DeGolia, a geriatrician at MetroHealth.


Question:   How common is pain in the elderly? Do we just have to accept pain as we get older?
 

Answer: It’s very common. 25% to 50% of community seniors and 45% to 80% of nursing home residents complain of pain.
 

Question: What causes this pain? Is it mainly arthritis?

Answer: Arthritis seems to be the most common type of pain. Osteoarthritis is much more common than rheumatoid arthritis.

Lower back pain is also common and can be caused by a degenerative disease of the spine.
Cancer pain is also very common among cancer patients.
 

Question:   Is all pain able to be diagnosed? If not, any idea why?
 

Answer: Pain is a subjective symptom. There is not a specific laboratory or x-ray test that can confirm or deny pain. It is essential that the health care provider believe the person who complains of pain. We can ask specific questions, perform specific examinations and tests to help better understand the pain, what causes it, etc.
It is VERY important for a patient to communicate with their doctor about pain.
There are four types of pain:

  1. Physical pain: somatic (bone, soft tissue), visceral (organs) and neuropathic (nerves). This is the type of pain that we most often think about and focus on when we discuss “pain in the elderly.”

  2. Psychological pain: depression, anxiety. Recognized more often as being very common and undertreated, especially in the elderly.

  3. Social pain: isolation, loneliness, lack of family. This is an important issue as one approaches situations where one cannot live independently or is approaching the end of their life.

  4. Spiritual pain: searching for the meaning in life. This often becomes an important problem near the end of life, or if one is diagnosed with a terminal disorder, or if one is suffering greatly.

Question: What are some myths patients have about pain?

Answer:

Myth #1: Pain medication cannot really control pain

(it can).
Myth #2: Good patients avoid talking about pain (good patients should).
Myth #3: Complaining about pain could distract a doctor from curing the real problem.
Myth #4: It is easier to put up with pain than with the side effects that come from pain medicine.

Question:   Do certain risk factors seem to correlate with pain in the elderly?
 

Answer: Important risk factors are chronic health problems in general, and specific health problems such as cancer, osteoarthritis, poorly controlled diabetes mellitus and poorly controlled hypertension. A previous fracture or trauma also is a risk factor.
 

Question: Any treatment? Any medications that can lessen pain?

Answer: There are excellent treatments available for most people. Over 90% of cases involving pain should be able to be satisfactorily treated. Pain may not be resolved completely, but a reduction in pain to a level that allows improved individual function and quality of life possible.
Key medications include:

You don’t just have to accept pain. Go to a doctor with experience in pain management. There is help available. My thanks to Dr. Peter DeGolia.

 

MOOD DISORDERS ASSOCIATED WITH STROKE

Medical Segment Show 216

Air date: 5/18/03

Actor Kirk Douglas has spoken openly about the emotional difficulties he’s had coping with a stroke. He’s not alone. Though family and friends often focus on the physical limitations of the stroke victim, many patients themselves have emotional turmoil to work through. Here to discuss the emotional fallout after a stroke is Dr. Elizabeth Dreben, Rehabilitation Psychologist at MetroHealth’s Department of Physical Medicine and Rehabilitation.


Question: When someone we love suffers a stroke, we tend to focus on the physical ramifications. However, the stroke victim is also dealing with emotional fallout as well, correct?
 

Answer:  Yes. Stroke is an emotional assault. It comes out of nowhere—as sudden as an accident—and the stroke patient is dramatically changed afterwards. The emotional fallout on both the patient and the family is similar to that of someone paralyzed after a car accident. Yet while “outsiders” seem to understand how difficult becoming paralyzed after an accident may be, they often don’t understand that strokes can cause the same kind of emotional response in a patient.
A stroke victim can experience anxiety and depression, as might be expected. These emotions, however, do not always appear immediately. At first, they don’t understand how truly long term their physical damage might be. However, at times family members may sense the extent of damage earlier and have their own emotional reactions.
The hope is that by improving adjustment early this helps the person avoid serious depression later on. As the rehabilitation psychologist on the stroke team my role is to help patients to adjust and cope with their new physical disabilities. Family members get help to deal with their upset from the social worker on the team.
 

Question: What kind of changes and limitations might these patients be grappling with?
 

Answer: Physical problems. For example, their right arm might be paralyzed and they have to learn to dress, eat, etc. with their left hand only.
Another major problem area is communication. Sometimes speech can sound unclear or very slurred due to weakened facial muscles, even if the person is using the correct words. This condition is called dysarthria. A stroke patient may also have what is called aphasia, the language skills are impaired so that the patient strings words together that do not make sense, or makes incorrect word substitutions or does not understand what others are saying to them.
Both physical and communication problems can cause embarrassment, anxiety, and discouragement that might stop people from working on their therapy and being social. Sometimes patients become so depressed that they withdraw and do not effectively participate in rehabilitation. If this occurs, antidepressant medication can be very helpful so the person can get back on track.
 

Question: How do you help a patient start adjusting to their new condition?
 

Answer: As soon as they move from a medical floor to in-house rehabilitation, we try to get them to feel as “normal” as possible. We encourage them to dress in their own clothes and start an active, full schedule aimed at helping them regain their independence. The stroke team tries to help people regain a sense of control in their lives even if they do not have full control over their bodies.
MetroHealth has been involved in Stroke Rehabilitation for 50 years. Our stroke rehabilitation includes some special areas in addition to the core areas of physical, occupational, and speech therapy. In addition, MetroHealth (and this is not common) also offers rehabilitation psychology, vocational services, art and recreational therapy.
Art therapy is most helpful to people who have problems with communication. It allows them to express themselves and their pent-up feeling. If the patients are not physically able to create the art themselves, they can collaborate with the art therapist.
Recreational therapy puts patients in “normal” situations and gets them used to socializing with their new physical limitations. It helps them overcome any embarrassment or awkwardness and practices skills learned in their therapies. For instance, they might play a game of bingo with one-on-one assistance from former stroke patients who are now volunteers.

Question: I’d imagine that overcoming embarrassment and having a good attitude can only help with recovery, right?
 

Answer: Definitely! A patient can regain a good deal of neurological improvement (such as some feeling and/or movement in an arm or a leg), but if they are not able to put forth their best effort in therapy, they might not get as much function out of their overall body.
Pushing through fatigue to work on therapy is important. It also gives the patient hope and stops them from feeling helpless. They are taking an active part in their recovery, regaining a level of control over their lives. The goal is psychological adjustment to physical disability.

There’s so much to talk about with Dr. Dreben. People focus so much on physical rehabilitation after a stroke, and that’s important. But sometimes, emotional treatment gets short shrift. And it shouldn’t. Dr. Dreben has kindly offered to provide a free brochure about stroke rehabilitation.

 

DISCOUNTED EYEGLASSES

Medical Segment Show 217

Air date: 5/25/03


I know that an optimist is a person who sees the world through rose-colored glasses. But who do you see if you just plain have trouble seeing? An optician, optometrist, or an ophthalmologist? We’ll help you see your way to the answer. And we’ll help you set your sights on discounted eyewear. Here to share her insights is Candace Carmichael, manager of the MetroHealth Advantage Program.

Question: Why is it important to have early eye exams?

Answer: If you have a known family history of glaucoma, macular degeneration, and/or diabetes, it is important to have your eyes examined regularly.
Vision changes with time, so the need for updating your eyeglasses should become routine.
Cataracts are a common cause of vision loss in older adults. Early on, changing eyeglass prescriptions can help. Eventually, surgery may be necessary to improve vision.
 

Question:   At what age should you begin to schedule regular eye exams? How often?
 

Answer: After the age of 40, your vision usually begins to change if it hasn’t already. This is probably a good time to start.
If you aren’t experiencing any changes, it is recommended that you begin getting regular eye exams at the age of 60.
At that point, one should get their eyes examined every year, unless directed otherwise by their doctor.
 

Question: Where should one get an eye exam? Is getting new glasses enough?
 

Answer: I think it’s important to distinguish the difference between an optician, an optometrist and an ophthalmologist.

Question: Eyeglasses can be pricey, especially on a senior budget. Does Medicare cover eyeglasses?

Answer: The only eyeglasses Medicare covers are glasses that might be needed after cataract surgery.   However, there is discounted eyewear available.
 

Question: Can you tell us about that?
 

Answer: Discounted lenses and frames are available for seniors at W.A. Jones Optical.  They are located at MetroHealth Medical Center and at various other locations.  If you call MetroHealth, we can send you a flyer describing the discounts and a list of Jones Optical locations. Or you can check out their website at www.wajonesoptical.com

I’d like to thank Candace Carmichael for opening our eyes to the need for regular visits to the Ophthalmologist, and to the availability of eye-popping discounts on eye wear. Call the number that’s coming up to receive a free flyer detailing the discounts and where to find a Jones Optical near you. I’m optimistic that this flyer will help you save some money.

 

HIDDEN SALTS IN FOOD
Medical Segment Show 218

Air date: 6/15/03

Why is it that so many of the foods we like the most are bad for us? I love salt, but we tend to take in way too much sodium. And not just because we are too heavy handed with the salt shaker. Sodium is hiding in lots of our foods. Here to help us break the salt habit is Cinda Chima, Director of Clinical Nutrition at MetroHealth.

Question: Why is Sodium bad?

Answer: It causes inelasticity of blood vessels.


Question: We know that low-sodium diets are healthier, but sometimes they are necessary. What health conditions require a person to follow a low-sodium diet?
 

Answer: High blood pressure, heart failure, kidney or liver diseases require a patient to follow a low-sodium diet.

Question:   Is a low-sodium diet easy to follow? You just stop adding salt, right?
 

Answer: A low-sodium diet is perhaps the most difficult diet to follow in today’s marketplace. It’s a good idea to consult with a dietitian if you are required to go on a low sodium diet.
About 70 percent of our sodium intake comes from processed foods that have added sodium. Therefore, a low-sodium diet requires MUCH more than simply pushing away the saltshaker.
We need 500 mg of sodium each day. The average person gets 2000-7000/day, amounting to 3 ½ pounds of sodium per year. Low sodium diets range from 2000-4000 mg of sodium.

Question:   What foods are high in sodium?
 

Answer:  Convenience foods (canned, processed, or frozen), condiments and sauces, and many restaurant foods.
Some specific examples include processed cheese, canned soup, bacon, cold cuts, canned tuna, instant rice mixes, vegetable juice, bread stuffing mixes, sauerkraut, pickles, pancakes and waffles (baking soda).
Some medications (sodium bicarbonate) and chewing tobacco are also high in sodium.

EXAMPLES:


Question:   What foods can you eat on a low-sodium diet?
 

Answer: Fresh, home prepared meals. Meat that you prepare (broil or grill) yourself. Fresh fruits and vegetables.

Question: What about salt substitutes, or light salt? Are

those healthier alternatives? Won’t the food taste bland?
 

Answer:  Most salt substitutes contain potassium chloride. It’s a good idea to talk to your doctor before using them, because certain blood pressure medications or kidney problems might make that problematic.
Light salt is still salt, so you must still be careful.
Freshly prepared food will taste better than canned/frozen food labeled “low sodium.” You will eventually get used to food with less salt.

Question: Low sodium diets are tough to follow.  Is there help available?

Answer: Yes. See a dietician.

We eat too much salt. Well, not me, but other people. It’s especially difficult to keep our sodium intake down because lots of foods have hidden salt. This is really serious. Your health is at stake.

 

AGING AND THE HAND
Medical Segment Show 219

Air date: 6/22/03

Raise your hand if you’ve thought about how to keep your hands healthy. I don’t see many hands raised out there. It’s true, we take our hands for granted, until they grab our attention with pain or weakness. Here today to give us a helping had with hand care is Dr. Michael Keith from the Department of Orthopedics at MetroHealth.


Question: I think most people take their hands for granted—until they don’t work as well as they used to! What ailments can affect our hands as we age?
 

Answer: Arthritis is probably the one most people think of when it comes to their hands. Osteoarthritis can enlarge the joints of the fingers. Arthritis can also cause the base of the thumb to be pained and deformed.

Question:   Are there any other conditions that can cause problems?

Answer: Numbness and tingling can be caused by a variety of reasons:

  1. Carpal tunnel, the swelling of the tendons that surround the wrist. This may be caused by the pressure placed on the hand through cane and walker use.

  2. Sensory loss due to diabetes.

  3. “Pinched nerve.” The weakening of a disc that causes bony prominences or spurs to press on the nerves.

Question: How can arthritis and these other conditions be treated?

Answer: First, you should consult your doctor and have x-rays to determine what is wrong.  You might be put on medication (which should be monitored for side effects like stomach upset and high blood pressure—don’t self-medicate). Splints and bracing may help.  Sometimes surgery is needed.  Exercises are VERY helpful.

Question: Can these exercises be helpful even if we don’t suffer from the conditions we’ve mentioned? Can they help the normal loss of dexterity that comes along with aging?

Answer: Yes. Low-impact, isometric exercises can help with weakening simply caused by the aging process.  This weakening can include tremors, loss of a good grip due to less muscle strength in the forearms, and strain on the hands due to them becoming part of locomotion (using cane/walker).

Exercises can also help with shoulder strength, especially rotator cuff problems that can impede reaching overhead.

Let’s give Dr. Keith a hand. His handy tips can help you get a good grip on coping with hand pain. For a free brochure, or maybe I should call it a “hand out,” give Dr. Keith’s office a call.

 

CELIAC DISEASE
Medical Segment Show 220

Air date: 7/13/03

Do you have anemia? How about joint pain? Are you lactose intolerant? Do you suffer from osteoporosis? Believe it or not, your problems might stem from eating bread, cereal, or crackers. Here to help us separate the wheat from the chaff with respect to information about celiac disease is Trisha Lyons, a Clinical Dietician from MetroHealth.

Question: What is celiac disease? How is it treated?
 

Answer: Celiac disease is an inherited disorder in which a person is permanently unable to process any foods containing even slight amounts of wheat, rye, or barley.
Symptoms can first develop at any point in a person’s life up through the late decades.
Before diagnosis and treatment, it damages many organs in the body, including the gastrointestinal tract.
It is considered an autoimmune disorder because the body destroys its own tissues when a person with this disease eats anything containing those grains.
The treatment is to completely eliminate those grains from the diet. This is called the gluten-free diet. No surgery. No medication. “Just” diet, a very strict diet.
As an example, wheat is one of the grains a person with celiac disease must eliminate, so all foods made with wheat or all-purpose flour must go. This includes pasta, bread, most cereals, baked goods, and the list goes on. This is challenging but it can be done with education and planning. Those same items made with alternative flours can be purchased but they are expensive, usually not found in local grocery stores, and do not always compare in quality or taste. The diet is extremely challenging, but the consequences can be devastating if the diet is not followed.
 

Question: I've never heard of celiac disease before. Is it uncommon?
 

Answer:  We now know that celiac disease is far more common than many other diseases which we are all familiar, yet many have never heard of it.  A recent large-scale study conducted in 32 states estimated that up to 2.2 million Americans have this disease, yet only a small fraction of them have been diagnosed.
It takes an average 11 years to receive a celiac diagnosis in this country according to a study out of Columbia University which means many years of suffering for those people.

Question: What are some of the signs that might point to celiac disease? How is one tested?
 

Answer: The devastating thing about this disease is the damage it does before diagnosis. Some examples include osteoporosis, anemia, infertility, miscarriage, stunted growth in children, the development of other autoimmune disorders, certain types of cancer, and the list goes on.
One of the most common signs in adults is anemia, which is usually due to poor absorption of iron or folate. Other signs are fatigue, bone and joint pain, constipation, recurring abdominal bloating and pain, diarrhea, lactose intolerance, skin problems, depression, and seizures to name a few. Remember, this disease affects many organs in the body and symptoms are varied, which is part of the reason for the delay in diagnosis. Many are told they have “irritable bowel” before their true diagnosis is made.
First, I recommend people read about this disease at their local library, on the internet, or by reading the fact sheet which will be made available.
To then determine if one has this disease, your doctor will check your blood for a particular panel of antibodies, not blood work which is ordered routinely. This is the first, simple step.
It should be mentioned that a person should NEVER put him/herself on the gluten-free diet without confirming the diagnosis first.
 

Question: If diagnosed, where can we go for help?
 

Answer: Find a dietitian who knows this disease and diet well. Since the gluten-free diet is the SOLE treatment for the rest of a person’s life, they really must see someone who can teach them what they need to know. I was diagnosed with celiac 3 ½ years ago and have studied the disease extensively. As a dietitian with this disease, I am able to help people adjust to the daily challenges of its life-altering treatment.
Find a doctor who has studied the disease. The study of CD during that past 10 years has vastly improved our knowledge of it. You need to be certain your doctor is current, as well.
Also, get involved with a local support group. I belong to a terrific group here in Cleveland.
Resources for learning are plentiful. There are books, cookbooks, hundreds of medical journal articles, and national organizations all devoted to this disease. A local author named Bonnie Kruszka has recently published a book called “Eating Gluten-Free with Emily.” It is an excellent resource for all families affected by this disease with children.

Man does not live by bread alone. That bread you’re eating may be killing you. You may have See-lee-ack disease and not even know it. This devastating illness is a lot more common than most people realize. As you can tell, Trisha is passionate about this subject. She’s pulled together some very useful information. If you have anemia or joint pain or osteoporosis or you are lactose intolerant or have abdominal pain or any of the other signs Trisha has described, give her a call. Find out more.

 

SUDDEN CARDIAC DEATH
Medical Segment Show 221

Air date: 7/20/03

You’re under arrest. Hearing those words is enough to make a strong heart stop. But if you’re under cardiac arrest, you’re really in trouble because your heart has stopped. Here to help us prevent cardiac arrest from becoming a death sentence is Dr. Elizabeth Kaufman, a Cardiac Electrophysiologist from MetroHealth’s Heart and Vascular Center.


Question: How common is sudden cardiac death?
 

Answer: It’s estimated that 300,000-400,000 Americans die from sudden cardiac death each year.
 

Question: Is sudden cardiac death the same thing as a heart attack?
 

Answer: No. A heart attack is caused by a blocked artery. The patient might feel chest pains or feel ill, go to the doctor, and find out they are experiencing a heart attack without a cardiac arrest.
Sudden cardiac death is the same as a cardiac arrest, and is caused by an abnormal heart rhythm.
When someone has a cardiac arrest, the chance of survival is not real high. Unless they are resuscitated very rapidly with a defibrillator, they will likely die. So our job is to predict those at risk for a cardiac arrest.
 

Question: What are some of the risk factors?
 

Answer: Someone who has had a big heart attack in which there has been a big loss of heart muscle function (ejection fraction).
Also, if someone has had a big heart attack, or has heart disease, and is experiencing dizziness or fainting spells. These are signs to see a doctor immediately for testing.
 

Question: What types of tests will you run on such a patient?
 

Answer: There are non-invasive tests where a patient would where a monitor for 24-hours or walk on a treadmill while a computer looks for a certain change in their EKG.
There is also an invasive test called an electrophysiologic test. This is what Vice President Cheney had done after a series of heart attacks.
 

Question: If you are found to be at risk, what can be done to prevent sudden cardiac death?

Answer: Low-risk patients will be put on an aspirin/day, a betablocker, or an ace-inhibitor.
 High-risk patients will be put on the above medication, but will also be fitted with an implantable defibrillator that can shock them if their heart goes into cardiac arrest. This is what the vice president has. The defibrillator is checked every three months by your doctor, and acts as an “insurance policy” against sudden cardiac death.
 
 We might not be able to see into the future. But today’s medical advances are helping us gain insight into sudden cardiac arrest, and helping us to prevent it. For more information, give MetroHealth a call. My thanks to Dr. Elizabeth Kaufman.

 

50 YEARS OF REHAB AT METRO HEALTH
Medical Segment Show 222

Air date: 7/27/03

A stroke, fall, and other illness or accident can be terribly debilitating. New rehabilitation techniques and equipment can absolutely work wonders. MetroHealth’s Center for Rehabilitation has been helping people regain control of their lives for 50 years. Here to look back with us at the tremendous progress that’s been made in rehabilitation is the Center’s Medical Director, Dr. Gary Clark.

Question: This year, MetroHealth celebrates 50 years of offering rehabilitation to the community. What was rehab like when MetroHealth opened their facility?
 

Answer: The first facility was at Highland View Hospital on Cleveland’s east side.  It focused on rehabilitation for polio, stroke, and other chronic diseases. Twenty-five years ago, that facility closed and the rehabilitation was moved to the Metropolitan General Hospital—now MetroHealth. So it’s both our gold and silver anniversary, in a way.

Question: Tell us about improvements in adaptive equipment.

Answer: Lots: e.g., one handed tools, long handle reachers, elevated toilet, grab bars. You can adapt your home to accommodate physical limitations.
 

Question:   In what ways has the Center for Rehabilitation grown? What are its main focuses now?
 

Answer: We now have three inpatient units, totaling to 68 beds. Currently, our staff includes 16 physiatrists (physicians specializing in physical medicine and rehabilitation), 5 clinical psychologists, 35 rehabilitation nurses, 78 physical, occupational and speech therapists, 5 vocational counselors, 4 recreational, art and activity therapists, 38 administrative and support staff, as well as social workers and rehabilitation case managers, all of whom work together as a team to provide a continuum of care for patients and their families.
There are three distinct units that serve patients with traumatic brain injury, spinal cord injury, and stroke. Having a separate rehab unit dealing specifically with stroke is rare—most are for mixed disabilities.
We offer a range of activity, recreational, art and music therapies that augment and further support the “traditional” physical, occupational, and speech therapies. We also offer vocational and psychological counseling.
Our outpatient program gives continuing therapy to 150 or more patients each day to further improve their functioning and to help them gain independence.

Question:   I know that you are also involved in research. What are some of the newer technologies we will be seeing in rehabilitation work?
 

Answer: Many innovations are being made in Functional Electrical Stimulation, or FES. This uses electricity to stimulate or replace nerve and muscle function after a brain injury, spinal cord injury, or a stroke.
Applications of FES include:

  1. Relieving shoulder pain after a stroke.

  2. Helping gain control of the foot after a stroke.

  3. The FREEHAND System is an implantable “neuroprothesis” that uses FES to enable people with paralysis from spinal cord injury to regain functional use of their hand and arm.

  4. VOCARE involves an implanted stimulator that restores control (continence) of bowel and bladder for individuals after spinal cord injury.

Question:   MetroHealth is a teaching hospital. Does that apply to the Center for Rehabilitation as well?
 

Answer: Yes, we are partnered with Case Western Reserve University and have residents who are training to be specialists in physical, occupational, or speech therapy. The road to recovery through rehabilitation is undeniably difficult. But the progress made over the last 50 years has been nothing short of miraculous. Metro Health is offering a free, informative brochure that talks about the rehabilitation options that can lead to independence.

 

STROKE
Medical Segment Show 223

Air date: 8/3/03

Minimizing the damaging effects of a stroke doesn’t require a stroke of good luck. Knowing the facts about strokes can make a difference. Here to explain is Dr. Joseph Hanna, Chairperson of Neurology at MetroHealth Medical Center. I’m not just “stroking” his ego when I tell you he is one of the top docs in the field.

Question: What is a stroke? What causes it?

Answer: A stroke is a malfunction of the brain caused by a disturbance in the blood supply to that organ.  85% of strokes are caused by blood clots. 15% of strokes are caused by a rupture of a blood vessel in or around the brain. Although this type is less common, it has a higher mortality rate.

Question: What are some of the risk factors for stroke?

Answer: High blood pressure, smoking, high cholesterol, diabetes, atrial fibrillation, and pregnancy.
 

Question: Today our focus is on women and stroke. Are females at a higher risk?

Answer: Although there is equal prevalence of stroke among men and women, women are more likely to die from a stroke. Generally, women are older when they have one.  There are more female smokers than ever before.  Most strokes in females are caused by atrial fibrillation, and that creates a larger, more deadly stroke. Atrial fibrillation is an irregular heartbeat where the atrium, rather than contracting regularly, quivers like Jell-o. This quivering causes the blood to pool, which can form a clot that may travel to the brain. This is a condition more common among women.

Although this program is largely for seniors, it is important to mention that women in their 2nd or 3rd trimester of pregnancy, or who have just given birth, are at a greater risk for a stroke because they are more prone to clotting. Anyone in this condition with an unexplained headache should see a doctor.
 

Question: You mentioned a headache—what are some of the symptoms of a stroke?

Answer: An unexplained headache, weakness, numbness, loss of vision, impediment of speech, or trouble walking or with balance. It is so important that, if you have any of these symptoms, you call your doctor right away. You have approximately three hours from the onset of symptoms to get successful treatment, but obviously the sooner you are treated, the better.

Question: How much difference does it make to start treatment within three hours?

Answer: Improve results by 40%.

Don’t wait until the stroke of midnight to find out more about strokes. By knowing the symptoms and taking quick action, you can reduce the harm. For a full fact sheet about stroke, give MetroHealth a call.

 

COMMON HOSPITALIZATION HAZARDS FOR SENIORS
Medical Segment Show 224

Air date: 8/10/03

We go to the hospital to cure what ails us. And that’s the way it usually works. But sometimes hospitals can create health hazards. Here to offer helpful hospital health hints for avoiding hospital harms is Doctor Carolyn Da-ZEE-wiz, a geriatrician at MetroHealth.

Question: When seniors visit the hospital, they are at a greater risk for certain hospital hazards than other patients. What is probably the most dangerous of these hazards, and how can one combat this danger?

Answer: Often, the biggest problem facing hospitalized seniors is a breakdown of communication between the patient’s primary physician, the hospital emergency staff, the hospital doctor, and the step-down unit often necessary after hospitalization. All of the people involved may not have a complete medical history of the patient—this is especially the case when it comes to emergency situations or snowbirds who are out-of-town when a medical crisis arises.
Your primary physician can give you your medical history, results of recent lab work, list of your medications, etc. This list could be posted on your refrigerator and given to your family members in case of an emergency.
The best way to ensure that your information gets to the important people QUICKLY during a hospitalization stay is to have your family give copies of your medical history to the emergency room staff, the hospital doctor, and the nursing staff.
 

Question:   Are there any other risks? Could mobility be an issue if seniors are forced to stay in bed for a long period of time?

Answer: Yes, loss of function due to bed rest happens relatively quickly when dealing with seniors. It often means that a senior patient is not able to go directly home after a hospital stay, but rather to a step-down unit.
Again, family involvement is extremely important. If family members can take shifts staying with someone in the hospital, there’s less likely a chance that the patient will try to get out of bed to use the restroom/get water without calling the nurse and falling.
Also, the patient’s medical history ought to be given to the step-down unit as well.

Question: Those are physical risks. Are there any emotional or cognitive risks?

Answer:  Seniors may suffer an acute cognitive change, or delirium, that will often persist after hospitalization. A hospital setting can be very confusing, due to the illness itself, the effects of medications, and an environment with a lot of lights and unfamiliar sounds.
Delirium can also be a symptom of other medical problems such as dehydration and impaction. However, it is important that the FAMILY tell the doctor is there is a cognitive change with the patient. The doctor, especially in a hospital setting, may not be away that the person is usually “sharper.”
 

Question: What about infections or pressure sores due to hospitalization?

Answer: Those do happen, but they are the known and expected risks of a hospital stay, and personnel know how to prevent/treat them. It’s communication with the doctors through the family that can help prevent the more “silent” hazards.

Family should try to be there when the doctor visits the patient—have questions and write down the answers!

A hospital stay can be hazardous to your health. But with these helpful tips, you should be able to protect yourself or a family member. For an informative brochure about how to protect your health in a hospital, call the number that’s up next.

 

NEW AND CONVENTIONAL CATHETER INTERVENTIONS FOR TREATING HEART DISEASE
Medical Segment Show 225

Air date: 8/17/03

 20 years ago, the Cardiac Kids played at Cleveland Stadium. Now the phrase “Cardiac Kids” could refer to you and your friends. Heart disease unfortunately becomes a dangerous problem as we get older. But it’s encouraging to know that there’s a new game plan that’s proving to be even more effective at stopping trouble than a “Hail Mary” pass. Here to coach us is Dr. John Hodgson, Director of Invasive Cardiology at MetroHealth’s Heart and Vascular Center.

Question: Heart disease should be looked for and monitored seriously for seniors, correct?

Answer: Yes. Coronary heart disease (clogging of the arteries) is the number one killer in our country. Here in Ohio, we have a very high rate of heart disease, so we need to be extra attentive

Question: If heart disease leads to blocked arteries, one of the traditional methods of unclogging the artery is through the use of stents. Can you explain?

Answer: A stent is a tiny metal scaffold and is placed during surgery to keep the artery open and blood flowing. This procedure is very effective initially, but 15-30% of patients may need a second procedure due to re-narrowing of the artery.

Question: But now a new change has made this procedure more effective?

Answer: Yes, now we are using what is called a drug-eluting stent, which lessens the chance of needing a repeat procedure by 80 percent. A drug is added to the stent that hinders the growth of tissues so that the arteries do not re-narrow after the procedure has been completed. Right now, we are using Sirolimus, an anti-cancer drug that stops cell proliferation and has been approved for use in stents. They are very expensive and must be used for high-risk situations. Later this year, we hope that another drug will be approved. This would use paclitaxel, the active ingredient in Taxol, a chemotherapy drug used in the treatment of breast cancer.

There’s a rookie procedure that scores a touchdown against heart disease. To get the extra point, call MetroHealth’s Heart and Vascular Center for more information. The number’s up next. My thanks to Dr. John Hodgson.

 

ARM AND LEG RECOVERY AFTER A STROKE
Medical Segment Show 226

Air date: 8/24/03

In prior shows, we’ve talked generally about the importance of rehabilitation for survivors of accidents and strokes. Today we’re going to focus in on the valuable new techniques developed for arm and leg recovery. Here to give us a helping hand is Doctor John Chae, physician from MetroHealth’s Center for Rehabilitation.

Question: Why are the limbs so affected by stroke?

Answer: Large areas of the brain are dedicated to the control of arm and leg function.   Stroke can cause disruption of the blood supply in any of these areas, which causes weakness and in-coordination.

Question: Limbs are affected mainly on one side of the body or the other. Why?

Answer: Nerves from one side of the brain cross to the other side at the base of the brain. Thus, in general, the left side of the brain controls the right side of the body, and the right side of the brain controls the left side of the body.
Stroke usually affects only one side of the brain; therefore, only one side of the body is generally affected.
 

Question: What can be done to help survivors regain functionality in their legs and their arms?

Answer: We try to force the use of the weak limbs.

Question: Does that mean moving their arms and legs for them?

Answer: No. It must be movement related to THEIR muscles in order to be effective.

Several therapies are currently in the experimental stage and are showing positive results. I expect that in 5-10 years, some of these treatments will be standard treatments:

  1. Forced Use Therapy: Only works if the patient has regained some use of their hand and therefore is applicable to only a small portion of stroke survivors (5%). We bind up the good hand so they are forced to use the other.

  2. Robotic Arm: A patient’s arm is placed in a robotic arm, which is connected to computer screen. The patient tries to manipulate a cursor on the screen by moving the arm. If the patient is unable to perform the task or is having difficulty, the robotic arm assists the patient.

  3. Weight Supported Ambulation: This therapy helps those who are trying to walk again. A parachute harness is used to lighten a person’s weight by 30%, allowing them to move their legs more easily. They then use the treadmill to practice walking.

  4. Electrical Stimulation: Using electricity to stimulate muscles that cannot move or amplify minimal movement.

Question: Do these therapies have to begin immediately after a stroke?

Answer: Well, they are still experimental, but we believe that they are more effective if they are started early (about three days after—any earlier than that is too soon and may be harmful).  This again underlines the importance of getting a stroke patient into rehabilitation as soon as they are medically stable.

I’m not going out on a “limb” by saying that stroke rehabilitation can give you a “leg up” on reclaiming your life. For more information, call MetroHealth’s Center for Rehabilitation.

 

WEST NILE VIRUS
Medical Segment Show 227

Air date: 8/31/03

Have you heard the public service announcements warning us that a simple mosquito bite could be deadly? West Nile virus has become a major health hazard, especially for the elderly. Dr. Jennifer Hanrahan, Chair Person of Infection Control at MetroHealth Medical Center, will provide advice to take the sting out of this deadly disease.

Question: Where did West Nile come from? It seems to have appeared out of nowhere in recent years.

Answer: The first case was described in Uganda in 1937. Outbreaks followed throughout Africa over the next three decades. Starting in 1994, outbreaks were described in Europe, the Middle East, North Africa.  In 1999, West Nile arrived in New York City, possibly through migratory birds or the importation of an infected animal.

Question: How is West Nile spread? Is it only through mosquitoes? Why are we told to be on the look out for dead birds?

Answer: The transmission pattern is usually as follows: an infected mosquito stings a bird. West Nile multiplies much more quickly within birds than in other animals. Another mosquito feeds off an infected bird and then moves on to a human.
Other ways that the virus can be transmitted include blood transfusion, from mother to baby during pregnancy. By far the most common way is from the bite of an infected mosquito.

Question: West Nile is all over the news, and it sounds scary. What is the actual danger?

Answer: Very few people who are infected with the West Nile virus become seriously ill, and even fewer die.

Last year, the Cuyahoga County Health Department went door-to-door gathering random blood samples for people older than 5, and they discovered that 6-12% of the population was infected with the virus. Somewhere between 1 in 240 to 1 in 380 people actually had symptoms of the virus.
However, the disease is growing on a worldwide level, and those over the age of 50 do have a higher chance of a bad outcome. So practicing prevention is important.
 

Question: What can be done to prevent the spreading of West Nile?

Answer:  When you go outside, wear mosquito repellent. Adults should find a product that has at least 10% deet (an ingredient). A product with 10% DEET will last about 2 hours. The repellent should be reapplied if you are outdoors for more than two hours. Products containing more DEET provide longer protection.
Eliminate sources of standing water. Change birdbaths frequently. Empty the saucers underneath potted plants often.
Check your window screens for holes that might let mosquitoes into your house.
Wear long-sleeved shirts outdoors during mosquito-feeding times or just avoid being outdoors then—at dawn and dusk.
 

Question: What are some of the warning signs that you might be infected with West Nile?

Answer: Again, most people won’t become sick at all.  If you do become ill, most likely it will seem like a viral infection, a bad case of the flu consisting of a fever, headache, and nausea.  The more dangerous illness is West Nile Meningitis, which consists of high fevers, headaches, a stiff neck, confusion, and muscles weakness in the arms and legs. If you have these symptoms, you should be evaluated by a physician.
The main point is to get medical attention for the types of symptoms that you would normally see a doctor for. If you have a mild illness for which you normally wouldn't go to the doctor, there's no special need to get checked for West Nile.
 

Question: When is the most dangerous time of year?

Answer: In NE Ohio, August and September.  In warm climates, through December.

Mosquitoes have always been annoying, but now they can be deadly. Follow Dr. Hanrahan’s tips, use mosquito repellant with Deet. And if you feel real sick, go see the doctor. For more information, or a free fact sheet about West Nile, call MetroHealth. My thanks to Doctor Jennifer Hanrahan.

 

ASTHMA IN SENIORS
Medical Segment Show 228

Air date: 9/7/03

Does shortness of breath make it harder for you to play with your grandkids or walk to the store? Is coughing keeping you up at night? If breathing easy is not so easy anymore, adult onset asthma could be the reason. Asthma is not just a kid’s disease. Joining us on our airways to talk about opening your airways is MetroHealth allergist Dr. Marta Vielhaber.

Question: Most often, we hear asthma spoken about in regards to children. Is it a major problem for seniors?

Answer: Yes. The highest death rate for those with asthma is among people over 65 years old. It’s also the fastest growing group of asthmatics, and is becoming a public health problem.
Whereas childhood onset asthma triggered by allergens, adult onset (those 40 and over) is not.  Adult asthma is more common in women than in men. In the U.S., it’s also more prevalent in African-Americans, Hispanics, and those who live in lower socio-economic areas.
 

Question: If it’s so prevalent and so dangerous, why have we not heard a lot about it?

Answer: Seniors tend to tolerate the symptoms of asthma for a longer period of time, delaying diagnosis.  They simply accept that they are out of breath a lot and can no longer sing in the church choir, dance at a wedding, clean their house, or even sleep through a night without coughing (attacks are more common in the evening).  That does not have to be the case! Most asthmatics can leave a full functioning life with proper medication.

Question: Is asthma difficult to diagnose?

Answer: Asthma mimics several diseases that seniors may have, such as heart failure, pulmonary embolisms, and smoker’s lung.  Once those other illnesses have been excluded, spirometry is used to diagnose asthma. The patient is asked to breath into a tube, and this machine measures the force and speed of the breath. Medication may be added to see if the airways improve. Medication will help those with asthma, but not those with smoker’s lung.

Question: What about treatment?

Answer: Quick reliever type of medicine, such as bronchodilators, attempt to stop and relieve asthma symptoms once started by opening constricted breathing passages. This type of medication may keep an asthma attack from worsening. However, quick reliever medications are not meant to be used to stop episodes on a daily basis.
Another category of medications, known as inhaled steroids, which are preventative in nature, are recommended to keep asthma symptoms from starting. They work slowly over days and weeks to reduce swelling in the lung passages. These medications are taken daily even when you breathe and feel well.
Medication will hopefully lead to these treatment goals:

  1. To participate fully in physical activities.

  2. Do not miss work due to asthma.

  3. To avoid severe asthma symptoms.

  4. To sleep through the night.

  5. To avoid emergency room visits because of asthma.

  6. To reduce allergy triggers such as, dust, pollens, smoke, etc.

Question: Do seniors respond well to the medications?

Answer: Even in most severe cases, 2/3 can be controlled.

Question: Is adult onset asthma triggered by allergies?

Answer: Sometimes. But also irritants to lungs like colds, flu, viruses, strong perfume, cold air.

Question: Do you ever recommend people move to Arizona?

Answer: Was popular in 1950s. Not today.

Question: Who treats asthma?

Answer: At MetroHealth we use a team approach. Respiratory therapists and nurses, pulmonologists, allergists, and pulmonary rehab specialists.

If you’re having trouble breathing, it can color your whole outlook on life. Adult asthma could be the cause. And the correct diagnosis might, just might, have been missed. Take a deep breath and give MetroHealth a call.

 

VARICOSE VEINS
Medical Segment Show 232

Air date: 11/9/03

Are you vain about your veins? If you can’t stand the way they look, and the pain they cause, you’ll want to stand up and listen to our next guest. Here to explain the various ways varicose veins form, and the newest treatments available, is Dr. John Mo-Ad, a vascular surgeon from MetroHealth.

Question: What are varicose veins? What causes them? Who is susceptible to getting varicose veins?

Answer: Varicose veins are the bulging out of veins in the superficial area under the skin, most commonly found in the legs.  They are caused by increased pressure on the veins. Pressure can be caused by excessive standing. People who have jobs that require long bouts of standing are at higher risk for varicose veins.
Those with deep vein thrombosis (blood clots) are more likely to have them as well. Their deep veins are not draining, leading to the bulging of more superficial veins.
Varicose veins often appear during pregnancy or in women who have had multiple pregnancies.  Their occurrence also seems to be genetic, although that link is not fully understood.

Question: Is this just a female problem?

Answer: No, but women more prone, and more concerned.
 

Question: Are varicose veins dangerous? What are some of the effects of having them?

Answer: The veins are not dangerous in and of themselves, though they MAY indicate deep vein thrombosis, a potentially dangerous condition.
Varicose veins can cause aches and fatigue in the legs, and sometimes can be painful or cause swelling.  Occasionally, the skin breaks and bleeding occurs. Pressing on the wound to stop the bleeding is required.
 

Question: Are these the same as spider veins?

Answer: The underlying cause is the same. Varicose veins, however, balloon to 1-1 ½ inches in size. Spider veins are the smaller, microscopic veins that balloon to a much smaller size.

Question: How can they be treated?

Answer: One can counteract the increased pressure and alleviate symptoms by elevating one’s legs regularly or by wearing compression stockings.  Extreme cases can require localized treatment—stripping and excision of the veins.

Cosmetic laser surgery or injections are used mostly for spider veins. Recurrence of varicose/spider veins is common, so I recommend wearing compression stockings even after these procedures.
 

Question: Will vein stripping harm your circulation?

Answer: No. There are two parallel systems of veins in your leg. Only one is needed.

Question: Can these be done on an outpatient basis?

Answer: Injections – in the office.  Vein stripping – same day surgery

Varicose veins can be unsightly, and uncomfortable. Take a load off your mind and your legs. Talk to your doctor about your options. For more information about the latest and best ways to get rid of those very visible varicose veins, give MetroHealth a call.

 

HYPOTHERMIA IN THE ELDERLY

Medical Segment Show 233

Air date: 11/30/03

Here’s a chilling fact: 750,000 Americans freeze to death each year. Most are elderly. Here to give us the hard, cold facts about hypothermia is an expert who’s been a warm friend to our show, Clarence Moore. Clarence is MetroHealth’s coordinator for emergency services.


Question: What is hypothermia?

Answer: Hypothermia is dangerously low body temperature, below 95 degrees Fahrenheit (35 degrees Centigrade). When the body temperature falls, all of the organs of the body are affected.  It’s also called low body temperature or cold exposure.

The most common EMS calls involving the elderly are thermoregulatory emergencies - about 750,000 winter deaths annually.

Question: Who is most at risk?

Answer: People most likely to experience hypothermia include those with the following conditions:

  1. Very old, very young

  2. Chronic illness, especially heart or circulation problems

  3. Malnourished

  4. Overly tired

  5. Under the influence of alcohol or other drugs, including prescription medication.

Question: What causes it? What are some of the symptoms to look for?

Answer: Hypothermia occurs when more heat is lost then the body can generate. It is usually caused by extended exposure to the cold. Common causes include:

  1. Being outside without enough protective clothing in the winter.

  2. Wearing wet clothing for an extended period of time in windy or very cold weather.

  3. Heavy exertions, or poor fluid or food intake in cold weather, even in above-freezing temperatures.

  4. A poorly heated house in the winter.

Symptoms include sluggishness, confusion, drowsiness, loss of control of fine finger movements, blue color of the fingers and toes, shock, slowing of breathing, slurred speech, and weakness. Often, those with hypothermia do NOT shiver.

Question: You’ve brought a list of dos and don’ts. Let’s go over them.

Answer:

DON'T:

DO:

Question: How can we prevent hypothermia?

Answer:

Question: If you can't afford to heat your home or apartment, is there help available?


Answer: Yes. Government subsidies are available for low income persons. Call local city hall or the gas or electric company.

Don’t be left out in the cold. Use Clarence’s tips to protect yourself. If you can’t afford high heating bills, there may be assistance, subsidies, available to you. A very warm thank you to Clarence Moore.

 

CONGESTIVE HEART FAILURE
Medical Segment Show 234

Air date: 12/7/03

A big heart, figuratively speaking, is a good thing. But an enlarged heart, literally speaking, is dangerous. If you’re feeling tired, and have shortness of breath, you could be suffering from an enlarged heart due to congestive heart failure. Here to discuss the warning signs, and the latest treatments, is Dr. Otto Costantini, director of the Arrhythmia Prevention Center at MetroHealth.

Question: Everyone has heard about congestive heart failure, but what does it actually mean?

Answer: It’s the inability of the heart to supply the rest of the body with the oxygen and nutrients it needs. The heart has become enlarged and weakened, making it not pump well.
 

Question: It's not the same as a heart attack?

Answer. No.

Question: Your heart is weakened, but it doesn't actually fail?

Answer: No.

Question: What causes congestive heart failure?

Answer: In our country, the two most common causes are heart attacks and high blood pressure.  Other causes are alcohol abuse, viruses, and inherited genetic disorders.
 

Question: Can you live with it?

Answer: You can live with congestive heart failure with certain limitations, and taking medication.  Limitations/symptoms include shortness of breath, fatigue, and inability to do more strenuous activities.  It is important to note that people with enlarged hearts are at risk for bad heart rhythms, leading to sudden cardiac death/cardiac arrest. So treatment is very important.
 

Question: What kind of treatment is available?

Answer: Medications, either oral or through an IV.  Left Ventricular Assist devices, which are mechanical pumps implanted in the heart to replace the heart activity. This usually bridges the gap until…A heart transplant is available.
New therapies are being developed involving stem cell research. The idea being investigated is injecting stem cells into the damaged heart to create new, normal heart muscle cells.
 

Question: Do the medications cure the disease?  Is there any cure?

Answer: No.
 

Question: How far away is the use of stem cells?

Answer: They are being used now in some places, in some patients.

Question: How can one prevent congestive heart failure?

Answer:

 “Oh you gotta have heart”. Okay, I’ll promise not to sing, if you promise to take care of yourself. Treat your blood pressure, exercise, watch your weight, and stop smoking. If you already are suffering from congestive heart failure, there’s help available. Doctors are developing new treatments. For more information, or a free fact sheet, call the number that’s up next. A hearty thanks to Dr. Costantini.

 

HEALTHY EATING DURING THE HOLIDAY SEASON
Medical Segment Show 235

Air date: 12/14/03

During this time of year, with all the festive gatherings, it’s easy to start looking a lot like Santa. Here to help us turn our eating from naughty to nice, and healthy, is Dr. Rita Beckford, a family physician from MetroHealth.


Question: Sometimes it seems like this ‘tis the season to gain weight. Do people really typically gain weight during the holiday season?

Answer: Yes. The average weight gain between Thanksgiving and New Year’s is five pounds.
 

Question: Is it hopeless or is there some way we can avoid this?

Answer: The best way to avoid weight gain is to have a plan. There are some simple things you can do to help stop weight gain from occurring.  If you are doing the cooking, there are some steps you can do to minimize the calories. And if you are going to a party, you can bring a healthier dish and make healthy choices when picking out food.

Question: Let’s get started. Hors d'oeuvres are particularly tempting…and an easy way to consume a lot of calories.

Answer: Yes. Lots of times we get to a party early and start munching. Try to always come with a friend and enjoy the company instead of concentrating on the food.  Hors d’oeuvres to avoid include those that are fried and those that are cheesy. Wingdings/chicken wings are fried and then come with a fatty sauce. Little quiches have high calorie cheese and their crusts often are fatty (containing shortening).  Avoid white and cheesy sauces. Stick to tomato-based ones.  Do choose: veggies with low-fat dip and even a seafood platter. Shrimp cocktail and crab claws are very low in fat—and cocktail sauce is fat free.

Question: What about the main course?

Answer: Perhaps the biggest mistake most people have with the main course is portion control. In today’s “supersized” world, we have a warped view of what a normal portion looks like.  A normal portion of meet is the size of your fist—three ounces. At restaurants, you often get 12 ounces.  Turkey is a great, healthy meet, but if you are cooking it, make the dressing separately and then stuff the turkey after draining out the oils and the fats from the inside.  Be careful with gravy intake. Put it on the side.

Ham is a good low-fat choice for a main course as well, but it’s not for someone on a sodium-restricted diet.
 

Question: Is there a low-fat way to enjoy desserts?

Answer: If you are doing the baking, there are ways to substitute ingredients to make recipes healthier. Using Splenda or NutriSweet instead of sugar, brown sugar instead of white sugar (it digests easier) or applesauce instead of oil can help lower calories.

If you are eating pie or cobbler, eat the filling and not the crust. The crust contains fattening shortening.
If there’s a dessert or cookie you really love, have a small portion. Don’t deprive yourself, but be careful elsewhere.
 

Question: Can beverages be a calorie trao?

Answer: Yes.  Eggnog’s a killer!  If you have a favorite eggnog recipe, consider switching out a quarter of the cream with skim milk.  Wine, beer, sodas all add calories. Switch to diet soda.

Question: Any last minute tips?

Answer: Don’t forget to exercise.  When you’re holiday shopping, do a few extra laps around the mall.


Don’t eat until you’re as stuffed as the turkey! Follow Dr. Beckford’s healthy holiday eating tips and end this festive season feeling and looking great. My thanks to Dr. Beckford. For more of her healthy eating tips, call the MetroHealth Advantage line.

 

DEMENTIA

Medical Segment Show 236
Air date: 12/28/03

We all have “senior moments,” times when simple facts simply slip our minds. But if you or someone you love is really starting to struggle with memory issues, where do you turn for help? Here to discuss dementia is Dr. James Campbell, a geriatrician at MetroHealth.
 

Question: Should dementia just be accepted as a normal part of aging?

Answer: No. 80% of people over the age of 85 have nothing wrong with their memory.

Question: Then what causes dementia in some people? Is it all Alzheimer’s disease?


Answer: More than one disease causes dementia—it’s complicated.   For people who get dementia young (65 and under), there’s likely a genetic component.  Dementia in older people is more likely due to wear and tear, including stroke, low thyroid, and B12 deficiencies.

Not all dementia is Alzheimer’s disease, though it is the most common form.

Question: What are some of the early signs and symptoms of dementia?


Answer: It’s more than simple memory loss—it’s very much a functional issue. Is someone having trouble balancing their checkbook all of the sudden? Are they forgetting to keep fresh food in the house? Problems such as THESE may signify dementia.


Question: If a loved one is having those problems, what should you do?


Answer: Bring them to see a doctor who specializes in memory, like a geriatrician or a neurologist.

Question: Can anything be done once dementia has been diagnosed?


Answer: Yes. First, one must remember that dementia can sometimes span 20 years, and it’s a progressive disease. The needs of patients at the beginning of the progression vary greatly from those with advanced dementia. A geriatrician or a case manager can evaluate the patient and recommend certain assistive services that would be appropriate to their current needs. Patients should be re-evaluated frequently.
Dementia patients do not have to immediately be sent away to a nursing home. A safe environment can often be created in their own home, especially in the early stages. For example, no gas stoves, but a microwave instead. Or looking the basement door.
There are many programs to help with supervision of someone with dementia, from medic alert buzzers to friendly visitor programs to senior centers to assisted living facilities and nursing homes.

Question: Is there a benefit to catch and treat dementia early?

Answer: Yes. We can control blood pressure, cholesterol, depression and give the dementia medications.

Question: What are some of the early signs?

Answer: Problem balancing checkbook, forget fresh food in home, put clothes on oddly, sudden poor hygiene.
 

Question: What about medications? Any movement on that front?


Answer: There are medications that seem to be somewhat effective for a subset of patients.

Dementia caused my low thyroid activity and B12 deficiencies can be treated relatively easily.
Sometimes, dementia is caused (and worsened) by a series of mini-strokes. Medications and lifestyle changes to lower the risk of future strokes is beneficial.
Drugs such as Aricept and Exelon can help Alzheimer’s patients, and research continues. In fact, a new drug that may help advanced Alzheimer’s is likely to become available in the U.S. this month.

Question: In addition to treating dementia, do you as a gerontologist get involved in helping the patient and family cope?

Answer: Yes. We can help deal with housing and socialization issues and try optimize the quality of life.


Memory problems can often be treated, even cured. New medications can delay the process. And lots can be done to improve quality of life. There’s help available. Call MetroHealth for more information. My thanks to Dr. Campbell.

 

THIS YEAR'S FLU
Medical Segment Show 238

Air date: 1/11/04

Are you “sick” of hearing about this year’s flu epidemic? Well, get used to it. This season’s sneezes and sniffles are just getting rolling. Here to give our efforts to stay healthy a shot in the arm is Mary Jo Slattery, clinical nurse practitioner from MetroHealth Medical center.

Question: We’ve heard a lot about the flu this year. Is it worse than normal? Who’s getting sick?

Answer: The flu really isn’t more prevalent this year. There’s more media coverage, and that’s why there’s a great fear in the population.  In addition, more flu shot was actually manufactured this year than last.  However, the flu USUALLY peeks from late-December through February. This season, it began in November.  Also, a greater number of children have gotten the flu, and horrible secondary infections, and that has made the news.

Question: If you got a flu shot, are you protected?

Answer: Partly. Fuji strain was not covered by the shot.
 

Question: So even with the show, you may still get the flu?

Answer: Yes.

Question: Is it too late to get a flu shot? What about the nasal vaccine that’s been in the news? When should you start getting flu shots in the first place?

Answer: The flu season lasts until April, so it’s not really too late. However, by this time, the vaccine is hard to find, especially with the early onset this year.  Everyone over the age of 65 should get a flu shot, unless they have an allergy to the vaccine, or eggs, or have a history of Guillian-Barre disease.  The new nasal flu vaccine is not recommended for anyone over 50. You really have to be in perfect health, because that uses a live virus.

Question: If you haven’t got a shot, what can you do to avoid getting sick?

Answer: Avoid crowds and sick people. Feel comfortable to tell people who are sick not to visit you.  Wash your hands frequently. The flu is transmitted via droplets from coughs and sneezes, and these droplets most often find their way to hands.

Question: Is there anything you can do once you are sick to prevent it from getting out of control?

Answer: Contact your doctor immediately. If you begin taking certain medications within the first 48 hours, the severity of the flu can be greatly lessened.  The flu is most dangerous for young children, those with acute and chronic illnesses, and the elderly.

Question: That’s quick. How can you be sure you have the flu and not something else, like the common cold?

Answer: You “catch” a cold—you feel it coming on slowly. It often is not accompanied by a fever, or only a low-grade one, and you don’t feel like you’ve been hit by a truck.
The flu has a sudden onset—you feel fine and then all of the sudden you’re ill. One gets a fever, terrible body aches, and a cough.
Vomiting and diarrhea are not typical flu symptoms for anyone outside small children. There is no such thing as the “stomach flu.” That’s mostly food poisoning or an intestinal virus, not influenza.

Question: How long does the flu last?

Answer: 5 - 7 days.
 

Stay away from sick people and wash your hands. If you suddenly feel like you’ve been hit by a car, don’t delay--see your doctor. Getting medicine quickly can at least reduce the severity of the flu. And next year, get your shot. For more information, give the MetroHealth Advantage Line a call. The number’s next. My thanks to Mary Jo Slattery.

 

THE IMPORTANCE OF CARDIAC REHABILITATION

 

Medical Segment Show 239

Air date: 1/18/04

Planning on taking off some weight, and maybe getting into better shape? This is particularly important if you’ve had a heart attack, bypass, angina, or some other heart disease. How’d you like a diet and exercise program designed specially for you, at no cost? Just listen to what our next guest has to say. Sue Rupert is Practice and Exercise Specialist for MetroHealth’s Department of Lifestyle, Fitness and Rehabilitation.

Question: What is cardiac rehabilitation? Who is it appropriate for?

Answer: Cardiac rehabilitation is a program that helps patients manage their heart disease through education and promoting lifetime exercise.  It’s appropriate for anyone who has had a heart attack, bypass surgery, angina, balloon angioplasties and stents, cardiac arrhythmias, or congestive heart failure, regardless of age.  You must be referred by a physician, so if you fit in that category and are interested, talk to them about it.

Question: Do doctors generally suggest this to patients or should you raise it?

Answer: Only 25 - 30% get referred.
 

Question: What about individuals who have cardiac risk factors, like high blood pressure? Should they consider it?

Answer: The specific program is really for people who already have heart disease, but participating in an exercise program is great preventative medicine for those with risk factors.  First, tell your doctor you are interested in starting an exercise program.  Often times, if you join a local rec center or YMCA, the staff can help you plan an exercise program that’s appropriate for you.

Question: What are some of the specifics of the cardiac rehab program?

Answer: The program meets 3 times per week for 12 weeks. It consists of 30-45 minutes of exercising and about 30 minutes of educational material.
The classes include information on:
1.) Picking the right exercise equipment.
2.) How hard to exercise.
3.) Different types of heart medication.
4.) How to properly use angina medication.
5.) When to call the doctor or EMS.
6.) Pastoral care and support group information.
7.) Dietitian assistance.
8.) Smoking cessation assistance.
9.) How to take your pulse.

Question: What’s considered a normal pulse or heart rate?

Answer: Normal is a wide range, usually spanning from 60-100 beats per minute. However, medication my cause your pulse to be somewhat outside that range normally.

Question: What about the exercise component?

Answer: Its main purpose is to gradually increase a participant’s fitness (or aerobic) level and to get patients into the habit of lifelong exercise.  It takes about 4-6 weeks to notice an increase in the fitness level.  Participants wear a heart monitor while exercising and other vital signs, such as blood pressure, are monitored throughout the session.

Question: How does this differ from exercising on our own, or going to a place like Bally's?

Answer:

Question: What's the benefit of close monitoring?

Answer:

Question: Is cardiac rehabilitation covered by insurance?

Answer: Most private insurance companies will cover cardiac rehab for those with heart disease, at least somewhat.  Medicare covers 100 percent of cardiac rehab for those who have had a heart attack, bypass surgery, or angina.  Without coverage, sessions cost $140 per visit.

Question: If you're feeling fine now, but had a heart attack before can you still qualify for this program?

Answer: Yes. Within 12 months.

Question: Is a 12 week rehab program sufficient?

Answer: During the 12 weeks, we work to establish a plan for home exercise.

If you have cardiac disease, be heart smart. Talk to your doctor about cardiac rehabilitation. This is a wonderful program: diet advice and closely monitored exercise, for free. For more information, give MetroHealth a call. Ask for this informative brochure. The number’s up next. My thanks to Sue Rupert.

 

CARBON MONOXIDE POISONING

 

Medical Segment Show 241

Air date: 1/25/04

It seems that every winter brings tragic news reports of families injured or killed by faulty furnaces or space heaters. Carbon monoxide can be deadly if it goes undetected. We’ve “detected” a general lack of understanding of the dangers. So here with some useful protection tips is Dr. Charles Yowler, director of MetroHealth’s Comprehensive Burn Care Center.

Question: What is carbon monoxide?

Answer: Carbon monoxide is a colorless, odorless, poisonous gas produced by the incomplete burning of solid, liquid, and gaseous fuels.

Question: What are the most common ways you can be exposed to it? Why is it so dangerous?

Answer: The most common danger is furnace problems in the home. Also, fireplaces and running cars in enclosed areas are dangers as well.  Other ways? Turn on gas oven to generate heat at night.  Also kerosene space heaters.
Hemoglobin, which carries the oxygen in your blood the gives your body energy, would rather bind to the carbon monoxide, which does NOT give your body energy.
Those who die of carbon monoxide poisoning die of asphyxiation due to lack of oxygen.
 

Question: What are the symptoms of carbon monoxide poisoning?

Answer: If there is a small carbon monoxide leak in your house, you may start exhibiting symptoms that are similar to the flu, but without the fever: headaches, fatigue, shortness of breath, nausea, dizziness, lightheadedness, and irritability.
One should be aware of suspicious symptoms: you wake up with a headache, feel fine when you go to work or out shopping, but the headache returns when you arrive home. That should send out a warning bell.
Most CO deaths occur because a major CO leak occurs at night while you are sleeping, and no symptoms are exhibited while awake. Symptoms of excessive exposure to CO include unconsciousness, seizures, and heart arrhythmias.
 

Question: Can it be treated?

Answer: CO poisoning is diagnosed with a blood test, and can be determined in a matter of minutes.
Treatment entails identifying the source of the poisoning and fixing the situation. If you have mild symptoms of CO poisoning, you’ll be fine once you are no longer breathing it in—it will be out of your blood in 4-5 hours.
Severe symptoms are often treated by giving the patient oxygen, putting them on breathing machines, etc.
 

Question: So why do people die?

Answer: Kills at night while asleep.
 

Question: You wouldn't wake up?

Answer: No.

Question: What steps can you take to prevent carbon monoxide poisoning?
 

Answer: Having a working CO detector in your home is of the utmost importance, since most CO DEATHS occur with a huge leak developing overnight.
Have your furnace checked on a yearly basis to make sure all is working properly.
 

Question: Where do you put a CO detector?

Answer: Bedroom.

Question: What do they cost?

Answer: $50 or less.

Buy a carbon monoxide detector, and make sure your furnace is working properly. If you’re getting flu-like symptoms at home, then you feel better when you’re out, see the doctor. You may have carbon monoxide poisoning. For more information, give MetroHealth a call. My thanks to Dr. Charles Yowler.

 

PREPARING FOR SURGERY

Medical Segment Show 241

Air date: 2/1/04

Eons ago, when I was a Boy Scout, our motto was “Be Prepared.” 40 years later, that philosophy still works. But now, instead of applying it to things like carrying a pocket knife to cut rope, today it applies to things like being prepared when a surgeon’s ready to cut us! Here to tell us how we can all be good scouts and prepare for surgery is Andrea Gallup, clinical nurse practitioner in MetroHealth’s Department of Pre-Surgical Evaluation.

Question: You’re having a surgery—how can you feel prepared? What questions can you ask your doctor to feel like you have a good idea of what to expect?

Answer: Ask about the expected recovery period. Will you need help at home? Should you stay with a relative? What limitations should you expect and how long will they last?
Find out what type of anesthetic will be used: local or will you be put to sleep?
Ask about any dietary restrictions or any medication you should/should not take before and after surgery.
Find out if you need an appointment with your primary care physician or a specialist before the surgery occurs. This step is often missed and causes many surgeries to be canceled.

Question: Is there any information you should GIVE your doctor prior to surgery?

Answer: Have the name and number of your primary care physician and any specialist handy.  Bring a list (or the bottles) of any medication you take, including those purchased over the counter.  Tell them is you’ve had previous problems with anesthesia or any other post-surgical problems.

Question: What should you bring with you to the hospital? Anything that can help you be comfortable?

Answer: Bring your own toothbrush. Even bring your own hygiene products (i.e. soaps, lotions) if you’d like.  You can bring your own robe if you’d like, plus slippers or socks.
Crossword puzzles, books, anything like that is a good idea.
If you have sleep apnea and use a machine at night, bring it with you.
If possible, have a family member bring your hospital bag up to your floor when you are admitted rather than having it moved around during surgery.
Don’t bring expensive watches and jewelry

Question: What about preparing yourself emotionally for a surgery? What can you do to help yourself cope?

Answer: In the patients I see, I find that those who are prepared for the surgery physically and who have gathered the most knowledge about the procedure are much more emotionally prepared to undergo the surgery. Ask your surgeon questions. Find out what’s going to happen.
 Be well-organized at home too. Make sure your pets are going to be fed and that other responsibilities are taken care of (bills paid, mail, milk, etc.). That will help a lot.
 Friends can help. If they ask what they can do, don’t be too
 quick to say “nothing.”
 
 No one enjoys surgery. But making sure you’re prepared can certainly make it less frightening. And I say that on my Scout’s honor! Andrea Gallup has prepared an information sheet with lots of good tips. If you’d like one, call the number coming up.

 

SELF-DEFENSE FOR SENIORS

 

Medical Segment Show 242

Air date: 2/8/04

Could you defend yourself in an emergency? Do you have to be a karate expert?  Here to give us some simple defense tips for seniors is patrolman Jim Bellflower from the MetroHealth Police.

Question: Seniors, and everyone, really, need to watch out for their own safety. Today we’ll look at some safety tips. Let’s start with what you can do to keep safe inside your home.

Answer: Lock your house. Get deadbolts in both the front and the back.  Leave some lights on all night, both inside the house and outside. Robbers are much less likely to hit a house with the lights on.
Make sure you can dial 911 in the dark. The best way is to get a phone with a lit number pad. If you must call 911, stay on the line so that the dispatcher can continue to ask you questions.
People often ask if it’s better to have a gun or a big dog. A big dog is much safer.
 

Question: What about when you’re out and about? How can you protect yourself there?

Answer: Be observant. Watch what’s happening around you and stay focused. Again, robbers chose people who are distracted.

Wear your purse under your coat. Only keep small amounts of cash and items you don’t care about losing in your purse. Keep credit cards and other valuables in an inside pocket of your coat.
Walk with your keys between your fingers. That can make a quick and easy weapon if it is needed.
 

Question: That’s a good point—what if someone DOES attack you? Should you carry something like mace or pepper spray?

Answer: Mace and pepper spray are not allowed in certain municipal buildings, in airports, etc.  However, you CAN carry a small bottle of hairspray, and that can be just as effective. It works for about 10 minutes and works well.

Question: Are there times we should not try to physically defend ourselves?

Answer: Yes, if the other person has a weapon or is a lot larger. Scream and yell fire (not rape).

You don’t have to be a superhero to protect yourself. Common sense tips and some simple moves can help. My thanks to Patrolman Jim Bellflower.

 

BURN PREVENTION
Medical Segment Show 243
Air date: 2/15/04

Last week was Burn Prevention Week. It burns me up when people take their fire safety for granted. In our own homes, common situations can have dangerous consequences. Here to give us fire safety tips are two people who have first hand experience. Leslie Grano and Paul Shafer are both burn survivors, and both serve as volunteer facilitators for MetroHealth’s New Beginnings Burn Support Group.

Question: The first week of February was Burn Prevention Week. What are some tips you can give us to prevent accidental burns?

Answer: Kitchen accidents are a major cause of burn injuries.

Other areas people sometimes do not think about:

Question: If a burn occurs, what should you do?

Answer: Go to the emergency room, especially if it blisters. It’s very hard to describe how bad a burn is to a doctor over the phone.

Do NOT apply butter!

Question: I know that both of you are burn survivors. Can you tell us a little bit about your accidents?

Answer: (Leslie) Four years ago (age 44) I caught my sleeve on fire on the stove, cooking rice, and my sweater caught fire, shirt melted onto my body. Someone was at home and rolled me in a kitchen rug.  I was in MetroHealth’s burn unit for 6 weeks (3 weeks in a coma) and was in rehab for 18 months. I had 475 stitches and have had 18 reconstructive surgeries.
 

(Paul) I was injured in an explosion of a steel melding furnace. Had extensive burns over 40-50% of my body. It took 23 months to recover.

Question: You are involved in a burn support group called New Beginnings. Can you tell us a bit about it?

Answer: Paul, along with some other survivors, started this group in the early 90’s. Volunteers had visited him when he was in the hospital to give him support, and he found it so beneficial that they wanted to continue with a support group.
The group, which is free, meets every Thursday morning and the last Tuesday evening of every month at MetroHealth.
The group offers support from the beginning (people’s fears of what will happen when they first leave the hospital, fear of social situations, etc.) to throughout the years (there are very often many surgeries that may need to occur years after the burn occurred).  MetroHealth itself offers vocational training to help survivors make career adjustments due to their injuries.  The support group is open to burn survivors, families, and friends.  Free! Refreshments, too!  Come even years later, even if treated in another hospital. Burns can be caused by situations we find ourselves in every day. For more information on burn prevention, or to find out more about the New Beginnings Support Group, give MetroHealth a call. My thanks to Leslie Grano and Paul Shafer for sharing their painful stories, and for providing us with helpful tips.

 

SANDWICH GENERATION
Medical Segment Show 244

Air date: 2/22/04

Here’s a thought that’s hard to swallow. We boomers used to be part of the Pepsi Generation. Now we’ve graduated to the Sandwich Generation. But what’s that really mean? Here to make sure we can cut the mustard if we’re stuck in the middle is Kelsey Loushin, program coordinator for MetroHealth’s First Choice Employee Assistance Program.

Question: What do we mean by sandwich generation?

Answer: The sandwich generation refers to adult children who have families of their own and who are faced with caring for both their parents and their children.

Question: What challenges do people caught in the middle of the sandwich face?

Answer: Many. Time crunches, emotional and financial stress, guilt, etc. Adult children often try to take everything on themselves. They feel that it’s disrespectful to reach out for help. They think, “Mom took care of me when I was small, so I should be able to take care of her.” They don’t realize that the situation is very different.  Often, they are so concerned about maintaining their parents’ quality of life that they ignore their own quality of life.

Question: Can you give us an example?

Answer: Sure. A woman I know with kids of her own whose parents live in Virginia. She works, comes home, and gets on the phone trying to help her parents. Then after that she has to take care of her own family. It’s difficult.

Nowadays, many adult children live in a different state from their parents, or several hours away. The parent may still rely on the child—rather than their own community—because they trust them. But the child may not know the law in another state or may have a difficult time accessing services from afar. Very often they have to travel to their parents, and that can even start affecting their employment.

Question: Why has this become more of a problem now than it was 10 years ago?

Answer: Parents living longer, boomers having kids later, two working parents more common.
 

Question: Is this primarily a woman's issue?

Answer: More women are care givers. But affects everyone.

Question: Where can someone turn for help coping with these challenges?

Answer: One resource people often forget about in these situations is your company’s employee assistance program. Most employers offer such a program to their employees. If your company contracted with FIRST CHOICE, for example, we would be able to help you access information. In the “out-of-state” example above, we could help locate resources for your parents—not just finding nursing homes but finding at-home care, help for grooming hair, help around the house, etc.

Question: What if their company does not offer employee assistance?

Answer: If your employer does not have an employee assistance program, your Area Agency on Aging is a good resource. Also, hospitals often have senior programs that can help, like the MetroHealth Senior Advant

Question: You've offered to help?


Answer: Yes. If viewers are looking for resources here or out of state, call us and we’ll try to help.
 

If you find yourself sandwiched in, there’s help available. Check with your employee assistance program. If your employer doesn’t have one, call Kelsey Loushin at MetroHealth. She’s kindly offered to help you identify the resources you need.