By: Dr. Jonathan WoodArbovirus infections in Maine?(A mosquito-borne virus is called an “arbovirus”)This week, the Maine CDC released an alert about finding the Eastern Equine Encephalitis virus (EEE) in one of their “mosquito pools” in mid-July. This is the earliest in the season that such a virus has been isolated in Maine. West Nile Virus (WNV) and EEE are two important causes of seasonal mosquito-borne viral encephalitis in the northeast. These viruses which infect humans through mosquitos are called “arboviruses” and are worthy of our attention.In 2012, there were over 5600 proven cases of WNV in the US, about 50% of which affected the nervous system. 60% of “neuroinvasive” cases were hospitalized and 1% died. There was one case of neuroinvasive disease in Maine, which suggests that there were 30-70 non-neuroinvasive cases that were not diagnosed.EEE is much less common, with only 15 proven cases nationally in 2012. However, all of these affect the brain and 9 of 15 occurred in New England. This is a very serious disease with a death rate of 36-70%. Vermont, New Hampshire, and Massachusetts have already isolated arboviruses in 2013. These were mostly isolated from mosquitos, but also from horses and, in the case of New Hampshire, from humans. Again, these viruses can cause severe brain and nervous system disease. Since there is no specific treatment for these viruses, preventing transmission is very important. The Maine CDC suggests the following for preventive measures to protect against WNV, EEE, and other arbovirus infections:• Use an EPA approved repellent when outdoors, especially around dawn and dusk – always follow the instructions on the product’s label • Wear protective clothing when outdoors, including long-sleeved shirts, pants, and socks • Use screens on your windows and doors to keep mosquitoes out of your home • Avoid being outdoors at dawn and dusk when many species of mosquitoes are most active • Drain artificial (non-natural) sources of standing water It has been a bad year for rain and mosquitos, as any walk in the woods or visit to camp will attest. Keep safe and keep the mosquitos away! Be smart!More Information: More information on arboviral illness is available at Maine CDC’s Vector-Borne Disease website at http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/vector-borne/index.shtml. Information on pesticides and repellents is available at the Maine Board of Pesticides Control website at http://www.maine.gov/agriculture/pesticides/public/index.htm#mosquito.
By- Dr. David PrescottShould You Share Your Problems With Others? People who struggle with excessive anxiety or depression often face a dilemma. Should they talk about their concerns with other people? On the one hand, other people are sometimes able to help us to gain a fresh perspective that helps break up our worry or sadness. On the other hand, talking about a problem over and over may lead a person to conclude that their life is truly sad and that there is no solution. The Argument in Favor of Talking About Problems: One line of psychological research suggests that getting support and encouragement from others helps people with depression or anxiety work through their feelings. Particularly with depression, people often become excessively isolated and withdrawn. Historically, psychologists and counselors have encouraged people to share their difficult feelings and worries. The theory goes that keeping things bottled up inside you will only make things worse. The Argument Against Talking About Problems: On the other hand, telling a friend or family member about your worries and sadness may backfire. Reactions can vary from unsympathetic to critical or harsh. In some cases, repeatedly talking about your unhappiness may reinforce the idea that your life is in tough shape. Recent research suggests that for teenage girls, talking frequently with a close friend about personal worries actually make depression and anxiety worse, through a dynamic called co-rumination. Co-rumination is defined as the tendency to spend too much time talking over problems and dwelling on negative feelings. It appears that co-rumination leads people to feel worse, rather than better. Sometimes, talking repeatedly about a problem or negative situation can eventually drive friends away. Finding A Middle Ground for Talking About Your Problems: Like many things affecting your mental health, the best approach to talking your problems with others is to find a middle ground. People who feel isolated and alone would probably benefit from reaching out to others. However, if you find yourself stuck in a rut, having the same conversation about the same worries or negative events repeatedly, a change in tactic is probably in order. Tips for How to Constructively Talk About Anxiety and Depression: One solution to the dilemma of whether or not it will help to talk with others about your worries or depression, is to strive to have your conversations end up in a constructive or positive place. Characteristics of helpful conversations include: · Identify Small Steps Towards Action: Simply describing negative feelings such as excessive anxiety or depression may not help you feel better. Rather, think of a small step you could take to do something different to cope with your feeling or situation. · Challenge your negative thinking: The feelings we have about others or about an event in our life depend on the lens through which we view them. Challenge your typical ways of looking at other people or other events. Is there a more positive way to view things? · Let go of unattainable goals: Sometimes our frustrations come from setting a goal that is unrealistic or beyond our control. For example, your solution to cope with a person who criticizes you may be for that other person to change their attitude. Changing someone else is usually unattainable, or at least unrealistic. Try to shift your goal to something that you can control. · Distract Yourself From a Problem or a Worry: Try not to have the same worrisome conversation over and over. If you and a friend seem to always end up talking about the same problematic people or situations, purposefully direct your conversations to another topic. Or better yet, go do something to take your mind away from your worries. For More Information: American Psychological Association “Psychology Topics”: http://www.apa.org/topics/depress/support.aspx
By: Dr. Amy MoviusA reality of our increasingly hectic world is the ongoing availability of new conveniences, large and small, directed at “making life easier”. One such – seemingly small – example is laundry detergent pods. Instead of measuring/pouring liquid or powder into a washing machine, a premeasured detergent “pod” can be popped in and, presto, the laundry is good to go.There can be unintentional effects of new amenities and so is the case for laundry pods. Small children, especially less than 5 yrs., have been known to ingest them, presumably because they are colorfully attractive and a size and shape suggestive of candy. Though the membrane of these pods is very sturdy when handled, it readily dissolves when moist – think saliva. When a child puts a laundry pod in their mouth the membrane begins to melt and the pod easily bursts.Laundry pods were first marketed in Europe in 2001 and here in N. America in 2010. The cumulative experience over these more than 10 years has revealed that toxicity from these products is no small matter. The symptoms of detergent pod ingestion have consistently been reported more severe than those of “non-pod” laundry detergent ingestion. Add to that a study from the United Kingdom in 2009-2010 showing that laundry pods were the most common accidental household cleaning product ingestion, and the scope of the problem becomes clearer.So what happens when a pod is ingested? Vomiting often occurs within minutes. This can be followed by difficulty breathing from swelling of the upper airways (mouth/throat) and/or irritation lower in the lungs. Breathing may be affected to the point that a ventilator is needed to breathe for the child until this inflammation subsides. Lastly, for unclear reasons children may become very lethargic or “comatose” following pod ingestion and can require a ventilator temporarily for this reason as well. Eye and skin exposure have also been reported, though ingestion is most common.Prevention is the best tool we have. Awareness of the appeal these pods have to young children is an important first step. As such, these products should be kept both out of sight and out of reach. If a child does have a laundry pod exposure, call poison control or seek immediate medical care if the child has already developed symptoms. References:1. Center for Disease Control and Prevention, Health Hazards Associated with Laundry Detergent Pods – United States, May – June 2012. MMWR October 19, 2012. 2. Williams et al, Exposure to Liquid Detergent capsules: A Study Undertaken by the UK National Poisons Information Service. Clinical Toxicology 20123. Fraser et al, Liquid Detergent Capsule Ingestion in Children: An Increasing Trend. Letter, Arch Dis Child, November 20124. Wood and Thompson, Liquitabs – a Thorough and Comprehensive Review of the UK National Data. Clinical Toxicology 2009
By- Dr. Jonathan WoodHeat-related illness it real. Even in Maine, where thankfully we don’t experience months of extreme heat, we still experience hot days that can be dangerous or even fatal. Last week was a good example of this with daily temperatures repeatedly in the 90′s across the state.People suffer heat-related illness when their bodies are unable to compensate and properly cool themselves. The body normally cools itself by sweating. But under some conditions, sweating just isn’t enough. In such cases, a person’s body temperature rises rapidly. Very high body temperatures may damage the brain or other vital organs.Several factors affect the body’s ability to cool itself during extremely hot weather. When the humidity is high, sweat will not evaporate as quickly, preventing the body from releasing heat quickly. Other conditions related to risk include age, obesity, fever, dehydration, heart disease, mental illness, poor circulation, sunburn, and prescription drug and alcohol use.Because heat-related deaths are preventable, people need to be aware of who is at greatest risk and what actions can be taken to prevent a heat-related illness or death. The elderly, the very young, and people with mental illness and chronic diseases are at highest risk. However, even young and healthy individuals can succumb to heat if they participate in strenuous physical activities during hot weather. Gradations of heat-related illness:Heat Cramps – usually associated with strenuous activity and depletion of minerals through excessive sweating and inadequate replacement.Heat Exhaustion – can occur over time even without exercise. It results from ongoing losses without adequate replacement. Symptoms include heavy sweating, paleness, weakness, dizziness, headache, nausea and vomiting, and fainting.Heat Stroke – the most severe form. The body loses its ability to regulate its temperature. The sweating mechanism fails and the body is unable to cool down. Consequently the body temperature rises rapidly, potentially resulting in critical illness and death. Symptoms include all the symptoms of heat exhaustion except the skin is red, hot, and dry. The temperature rises quickly over 103 and confusion or unconsciousness can ensue.What can you do to prevent heat-related illness?Stay Cool· Go to an air-conditioned place if at all possible. (e.g. library, mall, senior center)· Wear loose fitting, light clothing.· Avoid being outdoors and if so, rest in shady areas.· NEVER leave children (or pets) in parked cars, even if it is “not too hot” and even if the windows are cracked. Temperatures rise frighteningly fast in this environment and can quickly result in heat stroke.Stay Hydrated· Drink more water than usual. (during exercise, drink 16-32 oz per hour)· Avoid sugary drinks and alcohol, as these cause you to lose more body fluid.· Don’t wait to get thirsty – – stay ahead of it!Stay Alert:· Know your risk factors. If you are elderly or overweight or have heart disease or high blood pressure, you need to be particularly careful and wary.· Know your medications. Ask your doctor if any put you at particular risk.· Pay attention to warnings about heat waves.· Check up on relatives and neighbors who are high risk.· Pay attention to your body. Seek medical advice early if you experience symptoms of heat-related illness.Knowledge and common sense are the keys to avoiding the dangers associated with extreme heat in the summertime!For more detailed information, visit the CDC’s “Extreme Heat Prevention Guide”
Your Health While TravelingBy. Dr. NgSummer is here. Families and individuals are planning trips to take. While people are planning on what to do on these trips, one of the most overlooked thing to plan for is health care while traveling. While we all wish to have fun, healthy and safe trips, sometimes the unfortunate may happen. One may become sick or hurt. People who travel overseas have a 50 percent chance of suffering a travel related illness. What does one do when one becomes sick or injured while traveling away from home? There are many things one can do to prepare for any health emergencies while traveling as well as once a health emergency occurs. When one is planning a trip, whether it is domestic or international, one should have a list of your current contact information. You should let someone know of your trip itinerary. One should also make a list of any health issues that you may have. This list should also include any food or drug allergies. Having a Medicalert bracelet can be helpful for those with chronic health conditions such as diabetes or seizures. One should include emergency contact information so other cans contact individuals traveling with you and someone back home. Preparing a small travel first aid kit can be very helpful. A list of your current medication would be important and pack enough of your medications to last you a few extra days beyond your trip, to account for any potential travel delays. You should consider packing your needed medication in your carry-on luggage so that you don’t miss any of your medication if your luggage gets delayed.One should check for any health alert in the area you are traveling to both domestically and internationally. One can obtain this information from the Center for Disease Control travel website.
Mary Lavanway is a dietician with Hannaford. She visited out studios to share some healthy ideas for athletes.Mary’s Recovery DrinkAgain after exercise remember to replete with fluid, carbohydrates and protein with in 30 minutes of finishing your activity!Fruit Smoothie:4 oz pasteurized liquid egg substitute5.3oz Dannon vanilla Greek yogurt4 oz vanilla Almond Milk1 cup frozen Blueberries4 oz cranberry juicecrushed ice (as needed)Mix together in a blender and enjoy!
Healthy Living – July 2, 2013Dr. David Prescott – Eastern Maine Medical Center Behavioral MedicineOne In Three People are Significantly Sleep Deprived: According to the Center for Disease Control (CDC), about 30% of people who work a day shift are sleep deprived enough to experience significant impairment in daily functioning. Compared with other states, Maine ranks about the middle in terms of the number of people with sleep deprivation. The body’s need for sleep is strong: people who are sleep deprived often exhibit microsleep episodes where a 10-15 second interval of sleep occurs. We often refer to this as “nodding off.” Short and Long Term Effects of Poor Sleep: Most of us are familiar with the short term effects of poor or insufficient sleep. Common short term effects of poor sleep include moodiness, irritability, and disinhibition.In addition, chronic poor sleep is associated with a number of health problems including: · High blood pressure· Increased risk of heart disease and stroke· Depression and bipolar disorder· Obesity and DiabetesWhat Causes Poor or Insufficient Sleep? Over 70 different sleep disorders have been identified by sleep experts. Many of these require a thorough medical workup in order to be properly diagnosed. However, psychologists have found that many of the factors which contribute to difficulty falling asleep or poor sleep quality can be addressed by changing certain behaviors, thoughts, and lifestyle habits. Most people can achieve better sleep by studying their sleep habits and making some simple changes. Psychological Remedies for Improved Sleep: · Teach Your Body When and Where to Sleep: Your body responds to what psychologists call stimulus cues to prepare for sleep. These cues include time of day and place where you sleep. You can help train your body to go to sleep by having a regular bed time (stick to it!) and making your bed a place that is only for sleeping (rather than watching T.V. or reading, for example). · Get Regular Exercise: Regular exercise and activity helps relieve stress and assists you in falling asleep. Most experts suggest that you exercise at least 2-3 hours before you go to bed. · Monitor What You Eat and Drink Before Going to Sleep: Alcohol, heavy meals, or caffeine before sleeping all increase the risk of poor sleep. While alcohol may make you feel a bit drowsy, it actually can disrupt sleep. · What Are You Telling Yourself?: Many people describe being flooded with worries as soon as they try to go to sleep. Some of these worries are better left for the next day. Other worries, such as thinking “I’ll be miserable tomorrow if I don’t get to sleep” can be usefully changed through Cognitive-Behavioral Therapy. Changing thinking patterns often helps you fall asleep and stay asleep. For More Information: American Psychological Association: www.apa.org/topics/sleepNational Sleep Foundation : www.sleepfoundation.orgNIH National Center for Sleep Disorders Research www.nhlbi.nih.gov/sleep
By- Dr. Jonathan WoodAlmost 80,000 times each year people check into Emergency Departments for lawnmower injuries. More than 9,000 of those victims are children, despite the fact that the American Academy of Pediatrics strongly warns against children being anywhere near lawnmowers, much less operating them. Walk-behind mowers result largely in extremity injuries, while riding mowers often include injuries to other parts of the body, including the head and torso.How can you reduce the risk of serious lawnmower injuries to children? Here are a few common sense ideas, as well as some others you may not have considered. 1. A lawn mower is a dangerous tool. The energy of a mower blade is three times the muzzle energy of a .357 Magnum pistol, one of the world’s most powerful handguns. The blade can throw a piece of debris, like a stone or piece of wire, at speeds up to 100 miles per hour. The result – one fourth of all hand and foot injuries caused by mowers include amputations of fingers, toes, hands, or feet. And the injuries are messy and complicated.2. Children should never ride a mower with an adult. Each year a number of children suffer severe, and in some cases fatal, injuries after falling off a mower and then being run over.3. The American Academy of Pediatrics recommends that a child be at least 12 years old before operating a power push mower, and be at least 16 to operate a riding mower. These age recommendations assume that the child is large enough to physically handle the equipment. Careful instructions and review of the operating manuals should be part of the routine of teaching a child or teenager how to use the mower. Ignorance is an accident waiting to happen.4. Children should not be around a yard being mowed. Debris thrown by a mower can easily cross a yard and strike a child. Additionally, mower noise prevents operators from hearing the usual cues that children are near. Subsequently, 5 percent of lawnmower injuries to children occur when the mower backs over them because the operator does not see them. So – – clear the yard before mowing, of both debris and of children. The American Academy of Pediatrics has issued strongly stated advice about how to best prevent injuries from lawnmowers. Please refer to the following web page for a nice synopsis: AAP Safety Tips http://pediatrics.aappublications.org/content/suppl/2008/02/25/107.6.1480.DC1/p2_1480.pdfBe safe! Don’t bend the rules when it comes to lawn mowing… the risks are too great!
The streets are starting to get busy again in Bar Harbor and businesses are excited.”So far it’s good, good flow of traffic, seems like people are willing to spend. It seems good so far,” said Leon Debbah, one of the owners of Debbah’s, a gift shop on Main Street. While the weather hasn’t been ideal, having been in business for more than 50 years, Debbah’s has a pretty good idea of what’s to come.”It’s going be a great season. We see a lot of people coming in, a lot of Mainers, a lot of people excited to be here, so I think it’s going be really good,” said Debbah. After six seasons of working at Ben and Bill’s Chocolate Emporium, Matt Buckley knows there’s nothing better than the height of the season.”You just get that rush and you just work and you keep going. It’s a lot of fun especially in a place like this. A lot of nice people to work with, a lot of nice people coming in,” said Buckley. From both near and far.”We come downtown, we walk around, hit the restaurants, Acadia Park,” said Dick Deshaies, a regular visitor from New Hampshire. “We were in Boston last week for our grand daughter’s graduation and this week we wanted to see the East Coast,” said Chris Bowen from California. This coastal town is a quite different than those on the western shores.”Less hustle and bustle, this is more relaxing…and a lot more lobster,” said Bowen. Will they come back?”If we live long enough, we will certainly try,” she laughed. “We’re from Wisconsin and we’re picking up our daughter from coastal studies for girls,” said Colleen Johnson. This family wished they could extend their trip. “One more day would have been helpful there is always more you want to do and see,” said Johnson. “You get the chance to see the big water of course. It’s a little different from the Great Lakes,” said Scott Johnson. “It’s pretty much the same, just the ocean and the accents,” said Julie Anne Johnson.
Anxiety Disorders: Anxiety Disorders, which include things like phobias, obsessive compulsive disorder, or panic disorder, are among the most common types of mental health problems. About 18%, or one in five people will experience a clinical anxiety disorder in a 12-month period. Unfortunately, less than half of the people with anxiety disorders receive any type of treatment. Estimates are that about 37% of people with anxiety disorders receive any type of treatment. Social Phobia – One Type of Anxiety Disorder: One common type of phobia is termed social phobia, or social anxiety. Typically, symptoms of social phobia are first evident in the early teenage years. Social phobia impacts about 15 million Americans, and it causes everyday social situations to become fraught with anxiety and embarrassment. Defining Social Phobia: Social Phobia was long associated with being shy or timid, and its impact on people’s lives was minimized. However, in the early 1980′s, psychologists and other researchers began to focus on how social anxiety could be debilitating for some people. The essence of Social Phobia is:· Overwhelming anxiety and self-consciousness when a person interacts with others. · Intense, chronic fear of being watched and judged by others. · Extreme fear of doing things that will cause embarrassment during a social interaction. · Intense physical and subjective anxiety in most social situations: for example, feeling sick to your stomach, sweating, or racing heart. The Avoidance Trap: Many people attempt to cope with anxiety through avoidance. People with social phobia, for example, may go to great lengths to avoid social interactions. The difficulty with this approach is that the relief from anxiety is only temporary, and it often makes it more difficult for the person to engage in social interactions in the future. While the saying “face your fears” borders on overused, the principle behind this is actually good psychology!Avoidance teaches us that our anxiety can only be reduced by finding a way out of an anxious situation. Upon closer scrutiny, this is not true. There are lots of ways to reduce anxiety. However, if we avoid anxiety producing situations we never allow ourselves to learn ways to cope. Treatment for Social Phobia: All anxiety disorders, including Social Phobia, have an excellent change of improving with treatment. People with social phobia often would like to be with other people more often, or would like to reach out to friends. However, when the moment comes, they typically experience extremely high levels of anxiety and feel compelled to change their plans. Treatment can help people with social phobia overcome this pattern of fear and avoidance. The types of treatment that are effective include: · Cognitive Behavioral Therapy: Cognitive Behavioral Therapy involves identifying and changing thinking patterns which cause and perpetuate anxiety. These thinking patterns, and the behavior that follows, can be changed to break the cycle of escalating anxiety and avoidance of social interaction. · Behavior Therapy: Behavior Therapy, like systematic relaxation training, can be used to teach specific skills to reduce anxiety. It can also help people develop strategies other than avoidance for coping with anxiety. · Medications: The most commonly used medications for social phobia are anti-anxiety medications, or a class of antidepressant medications called SSRIs (selective serotonin reuptake inhibitors) often help make anxiety more manageable. Medications are often a helpful adjunct to “talk” therapies. “Behind every stressful thought there is a desire for things to be other than they are.” – Toni BernhardFor More Information: Acadia Hospital www.acadiahospital.org National Institute of Mental Health www.nimh.nih.gov/health/publications American Psychological Association www.apahelpcenter.org
Cultural Battles, Individual SolutionsBy- Dr. David PrescottIn Maine, as in the United States, about one in four children between the ages of 10-17 are obese or morbidly obese. In medical terms obesity is typically defined as a body mass index greater than 25. (Body mass index is calculated by dividing one’s weight in kilograms by height in meters.) Over the past 20-30 years, obesity rates in both children and adults have risen dramatically. Environmental Factors Contributing to Obesity: Experts in obesity and public health note that many of the factors that have contributed to the rise in obesity in both children and adults have to do with large scale shifts in our society and even in the way that our cities and towns are designed. Such factors include: · Increased number of fast food restaurants. · People dine out more frequently than in the past. · Fewer people walk to school or work. · Food and drink choices in many places are predominantly high in sugar and calories. Obesity and Mental Health Problems: While the causes of obesity may be largely rooted in societal and perhaps biological factors, the impact of obesity is felt by individuals. Examining the role of emotions in eating and obesity often helps individuals cope more effectively and improve their overall health. Common mental health problems linked to obesity include: · Depression – people who are obese are more likely to also be depressed. The relationship between obesity and depression is not completely understood, but it appears likely that they tend to develop together, without one clearly causing the other. · Binge Eating Disorder – binge eating disorder is characterized by repeatedly eating large quantities of food. When you have binge-eating disorder, you may be deeply embarrassed about gorging and vow to stop. But you feel such a compulsion that you can’t resist the urges and continue binge eating· Bulimia – bulimia is characterized by secretive eating binges often followed by purging the body of food, either by vomiting, using laxatives, or exercise. Bulimia is potentially life threatening and should be treated by a mental health professional. Psychological Strategies for Coping with Eating Problems: Whether your child has a diagnosable mental health problem like depression, or simply struggles with being overweight, psychology and mental health strategies are an important part of coping. Here are a few places to begin: · Think about what you eat and why: Most of us eat according to habits and patterns. Developing better eating habits begins by writing down what you eat and why you were eating. It sounds simple, but asking yourself “Why am I eating now?” is a helpful question. · Develop a variety of ways to cope other than eating: If your child tends to eat to cope with stress, boredom, excitement, or sadness, help them think of several things besides eating that they could do to cope. · Don’t obsess over “bad” days: Nobody is perfect at anything. If your child has a ‘bad’ eating day, move on. Try not to obsess over that particular day. · Get support from friends or family: Like all struggles, improving your health and weight is easier if you have people to support you. It is hard to imagine someone having too much support!· See a mental health professional: If your child has significant and ongoing struggles with depression, binge eating, or bulimia, s/he should be seen by a psychologist or other mental health professional for a full evaluation. FOR MORE INFORMATION: American Psychological Association Mind/Body Health: http://www.apa.org/helpcenter/obesity.aspxEastern Maine Medical Center WOW Program (Way to Optimal Weight): http://www.emmc.org/pediatric_servicesAmerican Academy of Pediatrics: http://www2.aap.org/obesity/
A teenage girl from Glenburn disappears. A body is found. Police believe it’s her. A yound man from Orono is charged with murder.TV 5 Health Advisor, and Grief Counselor, Dr. Anthony Ng joined Jim Morris on TV5 News at 5 to help.
By: Dr. Amy MoviusChances are, you have met somebody whose life has been affected by Klinefelter Syndrome, but didnâ€™t know it. In fact, they might not know it either.Klinefelter syndrome is the most common chromosomal disorder in males, and affects 1 in every 500-600 boys. This condition occurs when an extra X chromosome(s) is passed onto the baby. Whereas other disorders with extra chromosomes â€“ such as Downâ€™s syndrome â€“ produce physical findings that are obvious, Klinefelter syndrome does not. Because of this it is estimated that only 25% of these boys/men, are ever diagnosed, and less than 10% are diagnosed before puberty. This does not mean that boys with Klinefelter syndrome donâ€™t have any symptoms. All of them have abnormally small testes and low testosterone levels. They also commonly have developmental challenges, especially with speech. The â€œtypicalâ€ boy/man with Klinefelter is very tall, has narrow shoulders and broad hips, very little body hair, gynecomastia (extra breast tissue) and small testes. These patients can have behavioral and learning challenges, psychiatric disease, increased risk of some cancers, increased type II diabetes, fractures due to low bone density, and a host of other problems. They are generally sterile.Unless the syndrome is detected by prenatal testing, baby boys with Klinefelter Syndrome are rarely diagnosed. Toddlers may come to diagnosis during evaluation for speech delay, which at least 50% of patients have. Currently, patients who are diagnosed before puberty are suspected of having the more severe physical and behavior symptoms. More patients are diagnosed when puberty is delayed or incomplete. Adult men are diagnosed often when seeking medical help for infertility or develop male breast cancer.Missed diagnosis means missed treatment. Treatment of these patients should be multidisciplinary and may include speech therapists, psychologists, neurodevelopmental specialists, primary care providers, endocrinologisst, urologists and fertility specialists. All patients with Klinefelter should start lifelong testosterone therapy at puberty. This therapy can promote normalization of body proportions and more normal secondary sex characteristics. It is reported to improve general behavior and work performance and may reduce the chance of developing osteoporosis, breast malignancy, diabetes and other problems.References:1. Groth et at, Klinefelter Syndrome-A Clinical Update. J Clin Endocrinol Metab, January 2013, 98(1):20-302. Bojesen and Gravolt, Klinefelter Syndrome in Clinical Practice. Nature Clinical Practice, Urology. April 2007 Vol 4 No 4 OR www.nature.com/clincalpracticedoi:10.1038/ncpuro07753. Visootsak and Graham, Klinefelter Syndrome and Other Sex Chromosomal Aneuploidies. Orphanet Journal of Rare Diseases 2006, I:42 OR www.ORJD.com/content/1/1/424. Bojesen et al, Prenatal and Postnatal Prevalence of Klinefelter Syndrome: A National Registry Study. J Clin Endocrinol Metab 88:622-626, 2003
By: Dr. Jonathan WoodWho needs an advance directive? Everyone.What is an advance directive? An advance directive is a document that clarifies your wishes about your own health care, should you be too ill or incapacitated to speak for yourself. Even more important, an advance directive can be used to name someone who knows your wishes (your â€œagentâ€) and will be thereby authorized to make health care decisions for you in such a situation.Arenâ€™t these documents just for old people or chronically ill people? No. Advance directives are for everyone. In fact, much of the legislation surrounding this issue arose due to tragic medical cases involving young, previously healthy patients. Terri Schiavo. Nancy Cruzan. Karen Ann Quinlan. These are familiar names and all cases where national attention was brought to the issue of who should make medical decisions for those patients who are too ill to speak for themselves. These were young people in the prime of life before their illnesses. While these cases all involved dramatic â€œend of lifeâ€ decisions, advance directives are designed to allow your wishes to be followed in any case where you are incapacitated, whether it is life threatening or not. Though we would rather not think about it, any of us could become critically ill or injured at any age. So, truly, all of us need some sort of advance directive.Is this a permanent document? No. An advance directive can be changed or revoked at any time. In fact, it should be updated periodically to be sure it still reflects your wishes. Look at the Maine Attorney Generalâ€™s office website for more information on this point.Isnâ€™t it difficult to anticipate every possible decision that might need to be made? It is not only difficult, it is impossible. While many people choose to outline their choices around a few common decisions regarding life-sustaining treatment (sometimes called a â€œliving willâ€), most also choose to name an â€œagentâ€ to speak for them in all the circumstances that are impossible to anticipate. An agent is sometimes referred to as your â€œpower of attorney for health care.â€ Naming an agent who knows you well and knows your philosophies of life is an extremely important aspect of creating an advance directive. Specifically naming this agent is critical to having medical professionals act in your best interests while you are incapacitated. It also helps your family more easily and compassionately cope with your illness during such unfortunate events, which are often a time of great stress for your loved ones.What if my agent is unable to fulfill that duty? Typically, people name a list of several people who will be asked to step in if their first agent is unable or unwilling to act on their behalf. Considering this possibility can be an important part of creating your advance directive, but is not essential.Where do I find an advance directive form? Any signed statement, witnessed by two other people, will be accepted for naming a health care agent in the State of Maine. However, the best approach is to use an advance directive form created specifically for this purpose. One can be found in your primary care physicianâ€™s office, at any hospital, or at this website. Though the Maine form is long, only Part 1 needs to be filled out in order to name an agent. Part 6 needs to be completed as well, as this is where the signatures are placed (yours and your witnessesâ€™). A notary is not required in Maine. However, to ensure that your advance directive will likely be accepted in other states, it is a good idea to have the signatures notarized, if possible.Advance directives are basic and necessary. With medicineâ€™s increasing capacity to effectively treat critically ill patients, having a health care agent is essential to ensuring that your values, preferences, and wishes will be heard and followed.More information about advance directives can be found at the Maine Hospital Association website.
By- Dr. Joan Marie PellegriniIn today’s complex medical world it is no longer acceptable to be a passive participant in your medical care and to leave all the decision making to the physicians. Patients with complex medical issues may be seeing multiple providers and also may have their care at more than one institution. There are many medical conditions and medications that require a significant amount of patient education. It is for these reasons that many patients now need to be more involved in their care and their medical decisions. Self-advocacy is the ability to recognize, understand, and effectively communicate your needs to other people, including friends, family members, social workers, and medical professionals. Being an advocate for yourself means being actively involved in getting what you want and need.Below is a list of suggestions that I have for being more actively involved in your healthcare. I do not expect that you would need all of these suggestions but rather you select the ones that make sense for your level of medical complexity.-) Write down a list of questions/concerns you may have before your appointment. You may want to do some research before your appointment so that your questions will be more targeted and appropriate.-) Take notes during your visit with the doctor.-) Designate someone who can call on your behalf. You will need to list this person in your record and will need to sign a consent for your providers to discuss your care with this person. This person should also go with you to your appointments so that they can also listen to what is being said. This is particularly important if you have a complex medical issue or if you will be receiving upsetting news.-) Get a folder that has separators or use a journal. In this folder you will keep your medical information. You should have sections for contact information for medical providers, list of diagnoses, imaging results, laboratory results, list of visits and what each visit was for. This folder would also be a good place to keep your advanced directive.-) Write down your diagnoses at each visit and make sure you understand what they are. During your visit is an excellent time to ask your provider what web resources they would recommend for you to gain further knowledge.-) Every time you have a test or something with a result, make sure you obtain a copy. Do not assume that everything is OK if you hear nothing. Before each test is ordered, ask your provider what time frame you should expect to hear the results. Understand what the results mean and what the next step is.-) Ask about your medications. Verify the dose and timing. Verify that you know what each medication is prescribed for. Educate yourself on the side effects and interactions with food or other medications. Much of this can be researched on the web before your appointment so that you can ask specific questions directed at your needs.-) If your condition is complex, it is acceptable to ask your provider if a second opinion might be beneficial. If they agree, they could also make some recommendations.-) If you are having a procedure done, there are a few other questions you should ask:+) what can you do to prepare for the surgery? What can you do before or after surgery to optimize the outcome?+) what are the options available? Is not undergoing a surgery an option?+) what are the risks and how likely are they to happen? If there is a complication, what will happen or what will need to be done?+) has the provider done many of these procedures? For some procedures, there are online resources that will educate patients on national quality initiatives and how to choose a hospital that offers best practice.+) for most procedures, the patient is better served to have the procedure close to home. However, this may not be the case for complex procedures. You will need to balance the risk of being far away from your physicians and support network versus obtaining specialized care that may not be provided close to your home. Your primary care provider can help you with some of this discussion.-) If you are being admitted to the hospital, ask if your advocate can be present during rounds so that all of your questions can be answered and so that you will understand the plan of care. If you do not feel you need someone present, consider taking notes so that you may understand what the goal is for the day and the plan of care. If your care involves multiple specialists, write down their names and specialty so that you may understand what the role is of each member of your team.-) If your provider is referring you to a specialist you should understand what is the question or problem that the specialist should address. If you are seeing multiple specialists you may want a copy of their consult note so that you can keep track of who you are seeing and for what purpose.-) Know your health care plan. Understand what bills you will be responsible for. Ask if there are resources available such a manager for chronic disease, nutrition counseling, reimbursement for gym membership, or other wellness resources.-) Speak up if you do not feel your needs are being met. If you still cannot get satisfactory assistance, ask to speak to a manager. If this do not work, there may be a Patient Relations Representative or Patient Ombudsman who could assist you.
Coping With Disasters and Traumatic EventsBy- Dr. David Prescott â€“ Eastern Maine Medical Center Behavioral MedicineCommon Reactions to a Disaster or Traumatic Event: People who experience a disaster or traumatic event directly are often initially in a state of shock. Psychologists view this as a protective reaction that is adaptive in the short term. People often appear detached or numb immediately after a disaster. For people hearing about the disaster through news media, the immediate reaction is often one of fear and anxiety, as such events threaten our sense of safety and often feel beyond our control. What Determines How People React to a Disaster? For everyone, the closer you are to a disaster, the longer it typically takes to recover. People directly affected, particularly those who were injured or saw others injured, are likely to feel the effects the longest. People who were indirectly affected are more likely to feel the effects if they feel closely connected to the event, for example if they knew someone there or have experienced similar trauma at another time in their life. In general, the factors which seem to impact peoplesâ€™ reactions include: â€¢ The degree of intensity and loss. Events that last longer and pose a greater threat, and where loss of life or substantial loss of property is involved, often take longer to resolve.â€¢ A person’s general ability to cope with emotionally challenging situations. Individuals who have handled other difficult, stressful circumstances well may find it easier to cope with the trauma.â€¢ Other stressful events preceding the traumatic experience. Individuals faced with other emotionally challenging situations, such as serious health problems or family-related difficulties, may have more intense reactions to the new stressful event and need more time to recover.Coping Strategies for a Disaster That Are Most Helpfulâ€¢ Share and acknowledge feelings you may experience: Sharing your reactions to a disaster with someone who is supportive is an important way to begin to work through your feelings. â€¢ Reestablish Routines: Disasters disrupt our sense of what is normal. Within reason, it is helpful to most people to reestablish routines that are familiar and help give structure to their day. â€¢ Find active ways to cope with your distress. Watching a disaster from a distance often leads to feelings of helplessness. Psychologists have found that even small active coping strategies can help people feel better. For example, you might participate in a remembrance or volunteer at an organization that helps people in your community. â€ƒCoping Strategies that Do Not Help: â€¢ Avoid reactions that become part of the problem such as drinking or using drugs: Sometimes, progress in coping with a disaster can occur simply by avoiding coping strategies that lead to bigger problems. Excessive drinking or using drugs make the problem worse in the long run.â€¢ Overexposure to Media Reports: While many people desire the most up to date information after a disaster, prolonged watching of news reports may only make things worse. Take a break and try some other type of activity if you find yourself tuning in for extended periods of time. â€¢ Worrying about â€œWhat Ifâ€: It takes time to feel normal again after a disaster. Speculating about the disaster and other problems that might arise is usually not helpful. Realize that feelings of anxiety and sadness are normal, but they do not mean that another disaster is about to occur. Special Tips for Children: Talk with your child. Talking to your children about their worries and concerns is the first step to help them feel safe and begin to cope with the events occurring around them. What you talk about and how you say it does depend on their age, but all children need to be able to know you are there listening to them.â€¢ Find times when they are most likely to talk: such as when riding in the car, before dinner, or at bedtime.â€¢ Listen to their thoughts and point of view: don’t interrupt â€” allow them to express their ideas and understanding before you respond.â€¢ Remind them you are there for them to provide safety, comfort and support. Give them a hug.Keep home a safe place. Children, regardless of age, often find home to be a safe haven when the world around them becomes overwhelming. During times of crisis, it is important to remember that your children may come home seeking the safe feeling they have being there. Help make it a place where your children find the solitude or comfort they need. Plan a night where everyone participates in a favorite family activity.For More Information: American Psychological Association Help Center Click here
Been sneezing a lot lately? That’s not unusual this time of year. TV5 Health Advisor Doctor Erik Steele spoke to Jim Morris on TV5 News at 5 to help us with our spring allergies.
The Searsport Planning Board begins deliberations tonight on a proposed propane tank project.The group “Thanks But No Tank” is against DCP Midstream’s plan to build a 22 million gallon propane tank at Mack Point.Supporters of the project say it will create local jobs and stimulate the local economy.The planning board has held several public hearings and will now determine if DCP’s plan is in compliance with the town’s ordinances and can begin construction.That meeting begins at 6:30 at Union Hall.
Most Common Type of Mental Health ProblemBy- Dr. David PrescottMore than 40 million Americans have Anxiety Disorders: Nearly 18% of American adults experience some type of clinical anxiety disorder. This makes anxiety disorders one of the most common types of mental health problems. Learning the different types of anxiety disorders is an important step in overcoming them and reducing the negative impact of anxiety on your life. Normal Anxiety vs. Anxiety Disorders: It is entirely normal for people to experience anxiety. In fact, many of us perform better (for example at work, school, athletics) when we are mildly anxious. The line between normal anxiety and an anxiety disorder has to do with the intensity of anxiety, the frequency of periods of extreme anxiety, and how much anxiety interferes with your daily activities. When anxiety becomes intense, frequent, and prevents you from completing your work, family commitments, or daily tasks, it may be time to seek help. Types of Anxiety Disorders: Social Phobia: Social phobia (most common type of anxiety disorder) is a strong fear of being judged by others and of being embarrassed. People with social phobia are afraid of doing common things in front of other people. For example, they might be afraid to sign a check in front of a cashier at the grocery store, or they might be afraid to eat or drink in front of other people, or use a public restroom. Most people who have social phobia know that they shouldn’t be as afraid as they are, but they can’t control their fear.Panic Disorder: Panic disorder involves sudden, intense and unprovoked feelings of terror and dread. People who suffer from this disorder generally develop strong fears about when and where their next panic attack will occur, and they often restrict their activities as a result. The most common age of onset for panic disorder is in the early twenties. Generalized Anxiety Disorder (GAD): People with GAD are extremely worried about these and many other things, even when there is little or no reason to worry about them. They are very anxious about just getting through the day. They think things will always go badly. At times, worrying keeps people with GAD from doing everyday tasks. Often, people with GAD will visit their doctor for problems like headaches or difficulty falling asleep. Obsessive-Compulsive Disorder: True obsessive-compulsive disorder (OCD) occurs less frequently than other types of anxiety disorders, impacting about 1% of the adult population. People with OCD feel the need to check things repeatedly, or have certain thoughts or perform routines and rituals over and over. Examples of common compulsions include washing hands or cleaning house excessively for fear of germs, or checking work repeatedly for errors.Post-Traumatic Stress Disorder: Someone who suffers severe physical or emotional trauma such as from a natural disaster or serious accident or crime may experience post-traumatic stress disorder. Thoughts, feelings and behavior patterns become seriously affected by reminders of the event, sometimes months or even years after the traumatic experience. Unfortunately, many new cases of post-traumatic stress disorder have occurred in people who served in combat situations. The current prevalence of PTSD is estimated to be around 7.7% of the population. Treatment for Anxiety Disorders:Treatments for anxiety disorders include counseling, or psychotherapy, and for some people medications. Counseling techniques for anxiety disorders are highly effective, and typically involve changing anxiety provoking thought patterns, or learning to encounter a feared situation in a state of increased relaxation. Medications for anxiety disorders may include specific medications to reduce physiological anxiety, or for some people antidepressant medications. Antidepressant medications often take a few weeks before they have their full benefit. For any type of treatment, people may contact a licensed psychologist or other mental health professional, or talk with their primary care physician. FOR MORE INFORMATIONAmerican Psychological Association: www.apa.org/helpcenter National Institute of Mental Health: http://www.nimh.nih.gov/
HAND WASHINGAmy Movius MDThe influenza season was rough this year, filling Maine hospitals to capacity. Warnings about new “superbugs” are in the media nationally and abroad. Several schools across the country (including our neighbor Vermont) have temporarily shut down because of rampant stomach flu, which is making the rounds locally as well. How do you keep yourself healthy?? Wash your hands!Hand Washing is the single most important thing you can do to prevent illness. Most of us use our hands constantly. Infection (germs) can be transferred to our hands by everything we touch. This infection can then be transferred into our bodies by touching our eyes or nose or mouth. Of course, if you already have an infection you can likewise spread it to everything you touch. These germs can then be picked up by others and so the infection goes around and around. It is estimated hand washing with soap could prevent 1 out of 3 cases of childhood diarrhea and 1 out of 6 cases of childhood respiratory infection worldwide (2,3).People tend to think they are more conscientious about hand washing than they really are. One study found that, even though over 90% of adults reported always washing their hands after using a public restroom, only about 4 out of 5 were actually doing it. In middle and high schools, less than 60% of girls and 50% of boys were observed to clean their hands after using school restrooms. People routinely admit to less hand washing after using their home bathrooms. Hand washing can dry and chap the skin. If skin irritation becomes a problem, pick a mild soap and moisturize after each washing. Sometimes there is no washing facility nearby. Keeping waterless soap or sanitizer (at least 60% alcohol) available is an alternative in this circumstance.Below is a list for when and how you should wash your hands – and gently remind others to do so if needed.Before: Eating After: Using the bathroom (or diaper changing) Blowing nose/coughing/sneezing Touching animals Touching pet food/treats Touching garbage Outdoor activitiesBefore and After: Preparing or serving food Taking care of a cut or wound Visiting/caring for anyone who’s sick How: Use any type of soap and warm running water Wash all of your hands: front and back, fingers, nails, wrists Wash for at least 20 seconds, or two rounds of “happy birthday” Rinse well and pat hands dry with a clean towel Use paper towels to turn faucets and door handles in public bathrooms1. www.cdc.gov/handwashing/ – Cached2. Ejemot RI, Ehiri JE, Meremikwu MM, Critchley JA. Hand washing for preventing diarrhoea. Cochrane Database Syst Rev. 2008 Jan 23:(1):CD004265.3. Burton M, Cobb E, Donachie P, Judah G, Curtis V, Schmidt WP. The effect of handwashing with water or soap on bacterial contamination of hands. Int J Environ Res Public Health. 2011 Jan:8(1):97-104. >