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Wellness Words May 2016

HealthLink Littauer’sCarol Tomlinson-Head

WELLNESS WORDS

Submitted by Carol Tomlinson, RN BS

Community Health Educator

Osteoarthritis

 

According to the Arthritis Foundation, osteoarthritis (OA) is a leading cause of disability affecting more than 27 million adults in the US. Sometimes called degenerative joint disease, OA can affect any joint but it occurs most often in knees, hips, lower back and neck, small joints of the fingers, and the bases of the thumb and big toe.

In normal joints, a firm, rubbery material called cartilage covers the ends of each bone. Cartilage provides a smooth, gliding surface for joint motion and acts as a cushion between bones. In OA, the cartilage breaks down, causing pain, swelling and problems moving the joint. Bits of bone or cartilage can break off and float inside the joint space causing more pain and damage.

OA symptoms often develop slowly and worsen over time. Signs and symptoms of osteoarthritis include:

  • Pain: A joint may hurt during or after movement.
  • Tenderness: Your joint may feel tender when you apply light pressure to it.
  • Stiffness: Joint stiffness may be most noticeable upon awakening or after a period of inactivity.
  • Loss of Flexibility: Affected joints may no longer be capable of full range of motion.
  • Grating Sensation: You may hear or feel a grating sensation when using the joint.
  • Bone Spurs: Hard lumps may form around the joint.

Factors that may increase your risk of OA include:

  • Age: The risk increases with age.
  • Sex: Women are more likely to develop OA, though it is unclear why.
  • Obesity: Increased weight puts added stress on weight-bearing joints, such as hips and knees. Also, fat tissue produces proteins that can cause harmful inflammation in and around joints.
  • Joint Injuries: Even injuries that occurred long ago and seemingly healed can increase risk.
  • Genetics: OA seems to be prevalent in some families more than others.

Currently, the process underlying OA cannot be reversed, but symptoms can often be effectively managed with a combination of lifestyle changes, therapy, medication and at times surgery. Lifestyle changes that can make a significant difference in treating OA include, but are not limited to:

  • Exercise: Increases your endurance and strengthens the muscles around the joint, making it more stable.
  • Lose Weight: Even a small amount of weight loss can relieve some pressure and reduce pain.
  • Pain Medications: Talk to your physician about over-the-counter and/or prescription meds.
  • Assistive Devices: Can make it easier to move and work without stressing your joint. Your doctor or therapist may have ideas about what devices would be most helpful.
  • Attitude: A positive health attitude will greatly affect how well OA is managed.  For example, focus on what you can do, not on what you can’t;  break down activities into small tasks that are easy to manage;  balance rest with activity;  and develop ways to manage stress.

The ability to cope despite pain and disability often determines how much of an effect OA has on everyday life! HealthLink offers “Tai Chi For Arthritis” classes. This gentle form of exercise can safely relieve arthritis pain, improve flexibility, strength, balance, mental focus, and performance of daily activities.

For more information on osteoarthritis, talk to your health care provider, contact the Arthritis Foundation at arthritis.org or 456-1203, or call HealthLink Littauer at 736-1120. You can e-mail us at healthlink@nlh.org, see our website at nlh.org, or visit our new wellness center at 2 Colonial Court in downtown Johnstown, Monday – Friday, 9 a.m. – 5 p.m. We’re your community health & wellness service of Nathan Littauer Hospital and Nursing Home.

 

NLH Gastroenterology campaign gets National nod from American Hospital Assoc.

The American Hospital Association’s Matthew O’Connor reached out to Littauer after hearing about our gastroenterology campaign – his story is in the this months issue of the associations Health & Hospital Networks.

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Using Humor to Address a Serious Health Care Concern

Nathan Littauer Hospital in upstate New York uses silly pint glasses, puzzles to help improve colon cancer mortality rates.

May 3, 2016
Unable to make a dent in colon cancer patients’ mortality rate through traditional means, a small hospital in upstate New York is adding a new ingredient to its approach: humor.The 74-bed Nathan Littauer Hospital found its home county of Fulton was near the national average for incidence, but had a higher than average mortality rate. Leaders there decided to look at their gastroenterology department, and specifically its colonoscopy procedure — or lack of procedures in this case. They staffed up from one gastroenterologist to three and opened a new endoscopy center, but something was still missing.

“Everyone knows that nobody wants a colonoscopy,” says Laurence Kelly, president and CEO of Nathan Littauer Hospital, in Gloversville, N.Y. “We said, ‘Let’s do something different and creative to get people’s attention,’ and it certainly has worked.”

That’s where their humorous colonoscopy initiative comes in. Patients who schedule a colonoscopy receive a notepad filled with quizzes, puzzles and a space to write “a haiku about #2” for their frequent trips to “the office.”

The real draw is that each patient who schedules a colonoscopy gets a pint glass with tick marks to help measure out his or her laxatives for the procedure. It also makes a great beer glass for later.

The program is only five months old, but many are optimistic it will help to bring the hospital’s colon cancer rates down, including Nathan Littauer gastroenterologist Kamini Ramani, M.D., who some patients call “Dr. Innerds” because of the logo on the pint glass. “I’m hopeful we will reach our goal and at least get near the national standard,” she says.

Hospitals don’t often employ humor to tackle such serious issues, but Kelly believes it has made all the difference. “Listen to ideas that are out of the box,” he says. “You think your usual efforts will work: this is science, this is medicine, it’s preventive and the right thing, so people would say, ‘Yes, sign me up’ — but it just doesn’t work that way.”

 

 

 

Primary Care Saves Lives

Another Happy Patient!

Simply put: Nathan Littauer’s Primary Care saves lives. Listen to Mary Ann Bausewein, RN as she explains a patient’s encounter at our Mayfield Primary/Specialty Care Center…
April 2016

Wellness Words April 2016

HealthLink Littauer’sCarol Tomlinson-Head

WELLNESS WORDS

Submitted by Carol Tomlinson, RN BS

Community Health Educator

SAY YES TO LIFE!

Become An Organ, Eye & Tissue Donor

 

Organ, eye and tissue donation may not be the most popular topic, but it is one that saves thousands of lives every year. There is no age limit to becoming a donor. In fact, the oldest donor was 93! Contrary to popular belief, you don’t have to be in perfect health. Except in the case of kidney donations, your eligibility to donate organs or tissues won’t be determined until after your death.

 

According to the Center for Organ and Tissue Donation, there are currently over 100,000 patients waiting for life-saving transplants in the U.S. Every 14 minutes, another name is added to the waiting list and an average of 18 people die every day due to a lack of transplantable organs.

 

One donor can save or enhance the lives of up to 50 people. Today the heart, liver, lungs, kidneys, small intestines and pancreas can all be transplanted in individuals whose own organs are failing. Tissues that may be donated include bone, heart valves, skin, cartilage, tendons, veins and corneas.

Some examples of the uses of tissue donation include:

  • Donated bone can prevent amputation for bone cancer patients.
  • Tendons and cartilage can replace tissue lost or injured due to trauma, disease or infection.
  • Veins can be used to reestablish blood circulation after bypass surgery which can prevent heart attack.
  • Donated skin may be used to help save severe burn victims.
  • Heart valves have the ability to “grow” in younger patients, reducing the need for repeat surgeries.
  • Cornea recipients are often given the chance to see for the first time.

Truths about becoming a donor to remember include:

  • People of any age can become donors.
  • Registered donors receive the same care in hospitals as non-donors. The medical staff trying to save lives is completely separate from the transplant team.
  • Most major religions in the United States do not prohibit organ or tissue donation.
  • Donation does not prohibit an open-casket funeral.
  • There is absolutely no cost for donation.

How do you sign up to become an organ, eye and tissue donor? It’s simple!

  1. Go online to health.ny.gov/donatelife and choose the option that is best for you.
  2. Call the New York State Donate Life Registry at 1-866-693-6667.
  3. Tell your family and be sure they are aware of your decision so they can support your wishes.

YOU CAN MAKE A DIFFERENCE!   Registering to be an organ, eye and tissue donor is one of the finest and most unselfish humanitarian actions you can take. Why not take the time now to declare your wish to give the gift of life?

For more information, call HealthLink Littauer at 736-1120. You can e-mail us at healthlink@nlh.org, see our website at nlh.org, or visit our new wellness center at 2 Colonial Court in downtown Johnstown, Monday – Friday, 9 a.m. – 5 p.m. We’re your community health & wellness service of Nathan Littauer Hospital and Nursing Home.

Gazette story features Littauer provider Melissa Bown

UNUSUAL TIMING

Flu season running late this year in Capital Region

By Vanessa Langdon/For The Daily Gazette, April 6, 2016

Littauer Photo by Sara Schrum Melissa Bown, employee health/infection prevention manager at Nathan Littauer Hospital in Gloversville, pictured, expects the late flu season to die down in the next couple of weeks.

Littauer Photo by Sara Schrum
Melissa Bown, employee health/infection prevention manager at Nathan Littauer Hospital in Gloversville, pictured, expects the late flu season to die down in the next couple of weeks.

 

CAPITAL REGION — Winter started late this year and so did the flu season, according to Megan Helmecke, infection preventionist with Albany Medical Center. The late season flu hitting the Capital Region is more unusual in its timing than its severity, she said.

“We had a high level of confirmed flu cases in the last weeks and [it’s] starting to decrease in the last couple of days,” she said.

The late uptick in flu cases has been reported statewide.

“We really didn’t see flu cases pick up until early February,” Helmecke said. “Seems to be we peaked in mid-March, which seems to be the same that New York state is reporting.”

The late season flu is being felt in area schools, too.

“Like the snow we saw yesterday [that] we usually see in February, it’s just hitting later than usual,” Robert Hanlon, a spokesman for the Scotia-Glenville School District, said Tuesday referring to Monday’s snowfall.

Similar to what’s being reported at local hospitals, the district is starting to see relief.

“We usually see this level in mid February — it kind of peaked last week and now we’re seeing it drop back off,” he said.

Hanlon said that this peak is nothing like the situation they saw during the swine flu outbreak.

“What we ran into with swine flu is half of a classroom would be out. It’s kind of spread out all over the place now,” Hanlon said. “Schools aren’t even required to keep track of their numbers — the only time schools were required to track numbers were [during] the swine flu.”

The outbreak at Scotia-Glenville has not required the district to do any special cleaning.

“It wasn’t across the board so we didn’t do anything more than we normally do, nothing intense, nothing with special chemicals or anything like that,” he said.

“With the flu you have to just burn it through you and recover.”

This late season flu is a strain that is protected in the vaccine, according to Helmecke, so the spread should be controlled.

“People don’t usually think of the flu in April but with the late onset, the peak is at a different time period,” she said.

At Nathan Littauer Hospital had only had nine confirmed cases of flu this season but they have heard about a late-season outbreak in the community.

“I had heard of some reports that our Lexington Community Houses had an outbreak of the flu,” said Melissa Bown, employee health/infection prevention manager at Littauer. The Lexington houses are state-run group residences for people with disabilities.

According to the state reports, the 2015 peak for the flu occurred about the first week in January for hospitalized patients and the last week of January for out patients. This year the peak was the third week in March for the state, said Bown.

“I would say we would start to see it die down overall in the next week or two and it’ll continue down,” she said.

“We should get another couple weeks of it and then we should be in the clear.”

 

The Gazette features NLH Gastro campaign front page

Trying to bring a little humor to the process, anyone getting scoped at Nathan Littauer's endoscopy facility gets a complimentary pint glass scaled with markings o measure out their laxative. Afterward, it makes an ideal beer mug.

Trying to bring a little humor to the process, anyone getting scoped at Nathan Littauer’s endoscopy facility gets a complimentary pint glass scaled with markings o measure out their laxative. Afterward, it makes an ideal beer mug.

Bringing humor to a serious issue:

Fulton County aims to boost colonoscopy participation

By John Cropley March 30, 2016

 

FULTON COUNTY — Fulton County is in the odd position of having roughly the same incidence of colon cancer as the rest of the state but a much higher death rate.

A variety of factors may be at play, but health care administrators, regulators and providers agree the most likely cause is the low rate at which county residents are screened for cancer. So the local hospital has been taking steps to make it easier to get a colonoscopy, and taking steps to convince people to go ahead and get it done.

Nathan Littauer Hospital’s endoscopy office in Johnstown, which marks its first anniversary in April, is seeing 20 patients a day, more or less clearing the months-long backlog that existed when the only place to get a colonoscopy in Fulton County was at the hospital in Gloversville.

Colonoscopies can save lives, but they’re nobody’s idea of fun. The procedure requires the patient to skip several meals, drink a gallon of laxative, and then be sedated the next day and examined with a tiny camera mounted on a long slender tube that’s inserted in the rectum.

Some may find it embarrassing.

So Littauer is spiking its outreach campaign with a bit of humor. Anyone getting scoped at Littauer gets a complimentaryscaled with markings to measure out their laxative. (In happier times, it makes a spiffy beer glass, too.) And the procedure will be performed by the Innerds, “nerdy about your innards for nearly 100 years.” (The three doctors pictured on the beer glass are approaching a century in practice, in total.)

A pencil and a humorous little work pad to use while sitting in the bathroom round out the package.

Patrice McMahon, Littauer’s vice president of primary/specialty care services, was previously the administrator for a gastroenterology practice, so she had a lot of experience with hesitant patients.

“I knew the biggest way people would deflect their discomfort over it was through humor,” she said. This colored the hospital’s outreach.

Dr. Kamini Ramani, one of the  at the new Kingsboro GI Center, said she performs 1,600 to 1,800 colonoscopies a year and considers it a crucial tool to save lives.

“It is still probably not being done as much as I would like to see it done,” she said.

It’s a safe procedure for most patients, Ramani said, with physical damage resulting to the colon about once every 3,000 times under ideal conditions. The risk rises under less-than-ideal medical conditions, so in some cases non-invasive tests such as CT scans are substituted for colonoscopy.

Ramani said the CT scan is good for detecting larger and cancer, but not as accurate as a colonoscopy for identifying precancerous problems. Early diagnosis is key to successful treatment, she said, because colorectal cancer takes a long time to develop but once it does it is a tough opponent to fight.

“We do try to convince people that doing a colonoscopy is a good idea,” she said. “Many patients don’t know that they can have this done, and they should be having it done.”

From 2008 to 2012, an average 49.6 men and 38.1 women out of 100,000 were diagnosed with colorectal cancer statewide, according to the state Department of Health, compared with 48.5 men and 48.6 women in Fulton County. (The rates are adjusted in the case of Fulton County, which has fewer than 100,000 residents.)

In the same period, DOH statistics show 17.8 male and 12.8 female deaths from colorectal cancer statewide per 100,000 population, compared with 23.9 male and 16.5 female deaths in Fulton County.

“Our effort is in response to that,” McMahon said.

Littauer for years had a single gastroenterologist and two endoscopy rooms. The backlog for colonoscopies was six to 12 months, McMahon said, and many people in the hospital’s service area lacked money, transportation or motivation to travel elsewhere for quicker access to the procedure.

“When you’re not screened, you don’t have the opportunity to find that precancerous polyp,” McMahon said.

Littauer set out to recruit a second and third physician — Dr. Luz Alvarez and Dr. Hamid Azizur Rehman, both previously in Amsterdam — and outfitted a new site for them to work, a former Littauer ambulatory care center on South Kingsboro Avenue Extension in Johnstown.

In April 2015, the Kingsboro GI Center began operations three days a week. Two nurse practitioners work there with the three doctors, and they perform about 20 procedures a day. The endoscopy rooms at the hospital remain in full-time use, typically for patients unable to leave the hospital.

The co-payment at the Kingsboro GI Center ranges from $50 to $100, depending what insurance the patient has.

Ramani said the colonoscopy is part of a larger picture. Healthy diet and lifestyle on the part of the patient reduce the risk of colon cancer. Rectal exams and feces tests by the family physician during the annual checkup are important for early detection, as the colonoscopy is recommended only once ever 10 years starting at age 50 for the general population.

Nathan Littauer’s efforts are mirrored in the statewide public awareness campaign by the New York Department of Health to get more people to undergo colorectal cancer screening. A DOH spokesperson said the lower-than-average screening rate in Fulton County is a likely factor in the higher-than-average death rate.

In 2013-2014, the most recent years for which data are available, the colorectal cancer screening rate in Fulton County was 59.3 percent, compared with 68.7 percent statewide, according to DOH. Surrounding counties had higher screening rates and lower death rates, DOH noted.

The state goal is 80 percent screening statewide by 2018.

McMahon cited the previously limited colonoscopy options for Fulton County’s disparity with its neighbors.

“If you put up a barrier and people really have to pursue it, it’s going to fall by the wayside,” she said. “Those barriers were here and now they’re not.”

 

The Leader Herald helps NLH educate the community on caffeine consumption

Caffeine and Children
Children, teens consuming more caffeine through ‘energy drinks’
April 3, 2016
By PATRICIA OLDER, Leader Herald

Nathan Littauer dietician Alexandra Barbieri discusses the impact energy drinks can have on children, teens and young adults

Nathan Littauer dietician Alexandra Barbieri discusses the impact energy drinks can have on children, teens and young adults

GLOVERSVILLE -With slick advertising campaigns, many regularly featuring high-level athletes promoting their accomplishments and posing with a can of the latest energy drink, children and teens are caught up in the craze and are buying into the marketing they must have it. As a result, more adolescents are consuming large amounts of caffeine, and the consequences, say experts, can be serious.
“The most recent study shows 73 percent of kids are consuming caffeine and those studies are showing kids are now drinking more energy drinks,” said Alexandra Barbieri, registered dietician at Nathan Littauer Hospital and Nursing Home. “These studies are showing kids are consuming more energy drinks and these kids are ingesting one to three of these drinks at a time and not drinking enough water.”
Barbieri said that while the effects of caffeine on teens and children has not been studied enough to draw any solid conclusions on the health ramifications, she did cite some studies which show drinking caffeine produces an increase in heart rate, blood pressure and irritability.
“Unfortunately, caffeine has not been studied too much in adolescents, only adults,” said Barbieri. “However, a study I found did show a relationship between students who drank energy drinks resulted in insufficient sleep duration. Caffeine can also cause increased heart rates and elevated blood pressure.”
Continuing, she said energy drinks have between 142 mg. and 240 mg. of caffeine for 16 fluid ounces, with the daily national suggested amount not to exceed 400 mg. One cup of coffee can have between 95 mg to 200 mg. of caffeine.
“[The toxicity] is dose dependent – how it affects one 15-year-old could affect another differently,” said Barbieri. “But caffeine toxicity can come with only two cups of coffee – imagine what these energy drinks can do.”
According to the American Academy of Pediatrics, the maximum amount of caffeine for adolescents is no more than 100 mg. a day.
A study published in the Journal of the American Medical Association in November 2015 found that a single 16 ounce energy drink – they used Rockstar for the study-released the stress hormone norepinephrine by 70 percent. The hormone is released during times of increased stress, such as testing time for college students. It also showed increases in blood pressure and heart rates.
Continuing, Barbieri said one of the issues adolescents face with the energy drinks is the marketing and government regulation.
“They are mostly marketing to young, adolescent boys and the [Federal Drug Administration] does not regulate [energy drinks] since they are considered diet supplements because of the addition of herbal supplements,” said Barbieri.
The energy drinks, such as Rockstar, Monster and AMP, have ingredients such as ginseng, guarana and milk thistle.
She said consumers, especially parents, need to be aware of what they are buying and what their children are buying.
“Parents need to know the difference between sports drinks and energy drinks,” said Barbieri. “Sports drink are good for hydration. Energy drinks – we don’t know the long-term consequences. They are full of sugars and caffeine”
She said one of the scariest aspects of the energy drinks is the easy availability to anyone.
“I was told [by a store clerk] that a two-year-old with two bucks could buy one,” said Barbieri.
She said one energy drink is even named Cocaine.
“Tell me what you think that name implies,” said Barbieri.
Continuing, she said parents can help by being aware of what their children are drinking when not around them.
“People follow suit with what other people are doing and the magic question is how do we get kids back on board,” said Barbieri. “Looking at alternative sources of energy is important and thinking how are you going to hydrate yourself after an athletic activity.”
She said today’s fast-track lifestyle lends itself to helping keep children from buying into the marketing of the energy drinks.
“Kids wants what is free, convenient and fast. The more you load up in the house, the less likely they will reach for [energy drinks,]” Barbieri said. “If we give them something easy and reliable and convenient, they’ll reach for it.”
Coconut water, she said, is one good source of hydration for kids after an athletic event.
“They need the electrolytes with prolonged physical activity, but they can even use sodium-fortified coconut water,” said Barbieri, adding that parents can look at the first three ingredients of any drink to get an idea of what their children are consuming.
“There have been overdoses on Rockstar, Red Bull and caffeine shots,” said Barbieri. “In other countries, like Turkey, Australia and Denmark they are actually banned or have warning labels.”
Cheryl McGrattan, vice president of marketing for Nathan Littauer, said parents will ask a child what they had for lunch, but not what they are drinking throughout the day.
“It is common for a parent to ask ‘What have you eaten for lunch today?’ but not what have you had to drink,” said McGrattan. “How frightening is it an 8-year-old can take their $3 and buy a Red Bull?”
Locally, energy drinks are not available in local schools, although they are at Fulton Montgomery Community College.
“We really do not use them because they are not allowed by the federal guidelines for the ala-carte menu,” said Teal Carpenter, nutrition director for Gloversville Enlarged School District.
She said that a vending machine at Boulevard Elementary has the sports drink Gatorade G2, but only because the gymnasium and school field are used for athletic practices and events.
“There is Gatorade in the vending machine outside the Boulevard gym because of team practices and we do sometimes use it at the high school vending machines, but other than that, we offer 100 percent juice, water and milk,” said Carpenter.
Gatorade is considered a sport drink.
Dustin Swanger, president of Fulton Montgomery Community College, said energy drinks were available to students attending the college.
“My position is they’re in college and it is not like they’re young children attending school in school district,” said Swanger. “They’re adults and they are going to buy them at the store or on campus.”
Barbieri said the key for parents is to become aware of what their children are consuming outside of the home.
“We can look at alternative sources of energy and rely on whole foods,” said Barbieri. “There is water, green tea and green tea smoothies and chocolate milk. We just have to think how we are going to get our kids back on board and drink what is good for them, not what is being marketed to them.”

The Leader Herald, Sunday, April 3, 2016

The Leader Herald,
Sunday, April 3, 2016