Amy Badger stopped by for this month’s Fit Friday. This month she talked to Wayne about the effects exercise can have on your weight.
ARE BLOOD TRANSFUSIONS SAFE IN THE HOSPITALIZED PATIENT?
By: Dr. Joan Pellegrini
Ever since we were able to offer blood transfusions (about the 1940′s), it has been common wisdom that higher red blood cell counts are good for you. We know that red blood cells carry oxygen and some athletes use this to their advantage when they train at higher altitudes in order to increase their red blood cell level (or engage in the illegal activity of “blood doping”). If you come into the hospital hemorrhaging and your life is in danger, you may receive a life-saving blood transfusion.
David Prescott, Ph.D.
Eastern Maine Medical Center Behavioral Medicine
Health Watch – April 1, 2014
What Is a Panic Attack? Almost one in four people (22.7%) experience a panic attack at least once in their life. People who experience a panic attack for the first time often think they are going to die. It is not uncommon for someone having a panic attack to call their doctor or go to an emergency room, worried that they are having a heart attack.
MEASLES 2014: NEW REMINDERS OF OLD LESSONS
By: Amy Movius MD
This year is shaping up to be the worst for measles cases in the US for many, many years. In fact, measles was declared effectively eradicated from the United States in the year 2000 as it did not circulate within our population. This was because of the high vaccination rates of Americans.
Before the measles vaccine was available in the 1960s, there were 3 to 4 MILLION cases/year in our country resulting in 500-600 deaths and many more survivors who suffered pulmonary and neurologic injuries because of infection. In the early 2000s, the few cases still reported each year were “imported” from individuals traveling from other countries where measles still circulates. In recent years, however, more cases are being seen. 2011 was the worst with 220 cases. This also coincides with more people choosing not to vaccinate. With at least 80 cases already confirmed this year, 2014 is likely to exceed this with well- publicized out breaks in NYC and other parts of the country. Hopefully a silver lining of this unfortunate state of affairs will be a reminder of why vaccinations are so important and how much illness and suffering they prevent.
Measles is one of the most contagious infections known. 90% of unimmunized people exposed to measles will develop the illness. It spreads through the air, leaving a room “infected” for up to 2hours after the person with measles has left!! Also, an individual with measles can spread the disease 4 days before they develop the tell-tale rash – and for 4 days after the rash has disappeared. For this reason, unimmunized people exposed to measles should self- quarantine for 21 days.
Measles is also a very nasty disease. Even in developed countries like ours, 1 in 4 people who develop measles require hospitalization. Pneumonia and encephalitis (brain inflammation/swelling) are well known dangerous and potentially fatal consequences. Unfortunately, children are overrepresented in the US measles cases because the first immunization is given at 12 -15 months. The second is given around 4 years of age.
The current outbreak in our country started with measles brought in from unvaccinated persons who were traveling abroad. It has been a public health nightmare, with a domino effect of secondary cases. Some of the ways this outbreak has been found to be spread has been to other family members in unvaccinated households, hospitals and health clinics where ill individuals have presented as well as doctor’s offices, classrooms, buses and other public transportation. Potential sites of further spread also include airport and other large public places. One person the CDC has tracked may have exposed up to 100 cancer patients.
This robust spread of measles is completely avoidable. Receiving the recommended 2 doses of measles vaccine confers 99% immunity. The risk of the vaccine is minor and certainly much less than contracting the disease. THE MEASLES VACCINE DOES NOT CAUSE AUTISM. Multiple, rigorous studies from different countries have extensively evaluated this. Misinformation remains common however. Spreading of these myths can result in more unimmunized people, which can result in more measles cases as we see in NYC now. This potentially puts all children at danger. A mother of a 10 month old boy who nearly died from measles he contracted from unimmunized children put it best. “People who chose not to vaccinate their children actually make a choice for other children and put them at risk.”
I hope against hope the current outbreak of this highly contagious disease fades quickly. Meanwhile, I also hope Americans will take advantage of the lessons learned from history – before vaccinations were widely available – and get their families immunized. Vaccinations like the one for measles protect our children.
Stress in Teenagers: Patterns Rival Adult Stress
Health Watch – March 11, 2014
Dr. David Prescott – Eastern Maine Medical Center Behavioral Medicine
Teenagers in the Stress In America Survey: Each year, the American Psychological Association conducts a national survey to examine Americans’ perceived level of stress, sources of stress, and how we are coping. This year’s survey continues to suggest that most Americans find their stress level to be higher than they would like. But, this year’s survey revealed that the stress outlook for teenagers mirrors that of adults, and that stress negatively impacts the lives of many of our teens.
The Negative Impact of Stress Begins Before Adulthood: In 2013, American teenagers rated their level of stress higher than adults for the month prior to being surveyed. Like adults, most teenagers believe that their stress level is higher than it ought to be. Not surprisingly, teenagers report that their stress level is higher during school months than when school is not in session. And, about one-third of teenagers believe that their stress will get worse in the coming year.
Stress is Part of Life – But How Well Do Teens Cope? Most health experts agree that some level of stress is unavoidable. A more relevant question than whether or not people feel high levels of stress, is how they address it. In this area, it appears that teenagers, like adults, are more likely to use sedentary or passive coping techniques, rather than techniques which promote physical and emotional wellness. For example, frequent coping responses that teenagers use to cope with stress include:
· Playing video games (46% of teens report this as stress coping technique)
· Going online or surfing the Internet (43% of teens report this as stress coping technique)
· Watch TV or movies (36% of teens report this as stress coping technique)
· Reducing Sleep (teens with less than 8 hours of sleep per night rate their personal stress higher than teens who sleep at least 8 hours)
How well to Teens Understand the Impact of Stress on Their Health? Like adults, teenagers appear to downplay the impact of stress on their physical and emotional health. However, it appears that teenagers are less likely than adults to acknowledge that stress can have negative health consequences. For example:
· 54% of teens say that stress has little or no impact on their physical health;
· 52% say stress has little or no impact on their emotional health.
Yet, when questions are phrased in terms of specific behaviors, teenagers readily acknowledge that stress makes them more nervous, angry, and tired.
Teaching Teenagers More Effective Stress Management: Helping teenagers develop effective stress coping strategies can have lifelong benefits. Some ideas for places to start include:
1. Move your body. Physical activity is one of the most effective stress busters. That doesn’t mean you have to go for a jog if you hate running. Find activities you enjoy and build them into your routine such as yoga, hiking, biking, skateboarding or walking. The best types of physical activities are those that have a social component. Whether you’re into team sports, or prefer kayaking or rollerblading with a friend or two, you’re more likely to have fun – and keep at it – if you’re being active with friends.
2. Get enough shut-eye. Between homework, activities and hanging with friends, it can be hard to get enough sleep, especially during the school week. Ideally, adolescents should get nine hours a night. Most teens, though, are getting less. According to APA’s Stress in America Survey, teens say they sleep an average of just 7.4 hours on a school night. That’s unfortunate, since sleep is key for both physical and emotional well-being. To maximize your chance of sleeping soundly, cut back on watching TV or engaging in a lot of screen time in the late evening hours. Don’t drink caffeine late in the day and try not to do stimulating activities too close to bedtime.
3. Let yourself shine. Spend some time really thinking about the things you’re good at, and find ways to do more of those things. If you’re a math ace, you might tutor a younger neighbor who’s having trouble with the subject. If you are a spiritual person, you might volunteer at your church. If you’re artistic, take a photography class. Focusing on your strengths will help you keep your stresses in perspective.
Get help signing up for health insurance on the Federal Marketplace. Sponsored by Penobscot Community Health Care and Bangor Housing.
Tuesday, March 4th
Bangor Housing Community Center, 161 Davis Road
6:00 pm – 7:30 pm
Telemedicine – – what is it?
(And why should we care?)
By: Dr. Jonathan Wood
Telemedicine means different things to different people. We now share x-ray pictures and EEG tracings over long distances, lab values can routinely be reviewed from afar, and for many of us, our patients entire medical record is now “in the cloud”, securely available digitally to caretakers who need to see it. From anywhere! For some people, this is telemedicine. But for me, telemedicine is something much more than that.
Healthy Living – February 4, 2014
Dr. David Prescott – Eastern Maine Medical Center Behavioral Medicine
Auditory hallucinations – hearing sounds or voices that appear to come from within the mind – have been to focus of inquiry for centuries. While auditory hallucinations may represent symptoms of a significant mental illness, they also occur for reasons not suggestive of a mental illness.
How Common Are Auditory Hallucinations? Surveys of both college students and adults concerning how many people experience hearing some type of voice are surprising. For example:
· Almost 30-40% of college students report that they have heard voices while awake, and almost half of those report hearing them at least once a month.
· Between 8-12% of adults report having had at least one hallucinatory experience.
· Experiencing a hallucination does not necessarily mean that a person will develop a significant mental health problem.
Thus, hearing a voice or sound that isn’t really there can mean many different things. In his recent book “Hallucinations,” neurologist Oliver Sacks describes some of the neurological bases for hallucinations, and argues that hallucinations are simply part of the human experience. He describes stories of people in both common and extreme situations (for example, people severely injured who were miles from help) who clearly hear voices. Nevertheless, there are certain patterns of auditory hallucinations which indicate the need for mental health treatment.
Common Mental Health Problems that Involve Hallucinations: Sometimes, hearing voices or sounds is a symptom of a significant psychiatric problem. Examples include:
· Schizophrenia: In addition to auditory, visual, or tactile hallucinations, people with schizophrenia often become highly disorganized in their behavior. Typically their level of functioning at school or work declines significantly. Auditory hallucinations are the most common type of hallucination associated with schizophrenia.
· Bipolar Disorder: Bipolar disorder involves intense mood swings beyond the normal “ups and downs” of everyday life. Hallucinations may be part of the manic or depressed cycle of bipolar disorder.
· Organic Illnesses: Hallucinations may be a symptom of classis brain pathology, such as a tumor, dementia, or seizures.
· Substance Induce Psychosis: Use of alcohol or other drugs, either short or long term, can cause hallucinations.
A discovery during surgery at Eastern Maine Medical Center in Bangor has led to a nationwide recall of a device that helps prevent blood clots.
It’s called the Cordis Opt-ease Vena Cava Filter…and it’s inserted into a vein that returns blood to the heart from the legs.
Please do not get up on your roof to shovel snow if you can avoid it
Two weekends ago was a snowy time and there were public service announcements urging homeowners to clear the snow off of their roofs. Every year as it gets snowier we see these ads and every year we at Eastern Maine Medical Center treat many people with fall injuries. This particular weekend we saw 20 people in the Emergency Room who fell off their roofs and 6 were admitted with serious injuries.
By- Dr. Jonathan Wood
When is someone dead? It seems simple, but clearly it is not.
This is the question circulating the country right now around the case of an unfortunate young girl in California who was declared “brain dead”, but whose family insists that she is not dead. This case is sad and unfortunate, perhaps made more tragic by the girl’s age and by the fact that her brain injury resulted from complications of a seemingly “routine” operation. Unfortunately, the situation has become even more tragic because of the confusion around understanding her death. This confusion is very important to discuss because this type of misunderstanding is more common than many people realize.
Amy Badger, was in for this months Fit Friday. She talked with Wayne about tips on eating and hydration tips for working out.
Amy Badger, was in for this months Fit Friday. She showed Wayne and Joy how to do push ups, and how to modify them to your fitness level.
By- Dr. Amy Movius
Frostbite is something everyone is Maine should know a thing or two about. With single digit temperatures expected this week, it’s a good time to review some frostbite facts. Frostbite is when body tissues literally freeze, and ice crystals form inside cells. If the skin is the only tissue frozen it is “superficial” frostbite. Deep frostbite occurs when all tissue layers are involved. Ironically, frostbite is classified by degrees, similar to burns.
By: Dr. William Sturrock
Osteoporosis is a disease that affects over 45 million Americans, and is found in 55% of the population over age 50. It is found more frequently in women however has been recently recognized as also occurring in men as well particularly over age 65. There has been good research which shows that there are many conditions predisposing to unhealthy bones which can result in osteoporotic fractures to include cigarette smoking and postmenopausal status, long-term COPD or inflammatory bowel disease, heavy alcohol consumption, decreased physical activity, seizure disorders and certain cancers particularly prostate cancer. Recently with the recognition that many men also demonstrate low testosterone levels as they age, it has been shown that a good percentage of these individuals will also have osteoporosis unless treated. There are also studies suggesting that high consumption of carbonated soft drinks and other problems associated with nutrition will increase risk for unhealthy bones.
Because prevention is much smarter than waiting for problem to develop, many experts have recommended increased calcium intake as well as vitamin D, which is essential for bone metabolism.
Experts recommend that at least 1200 mg of calcium with 600 units of vitamin D for adults under 65 and 800 units for older adults should be taken by patients at risk. There is an interesting fact of human physiology that exposure of our skin to sunlight will actually allow us to manufacture vitamin D, and some individuals have tried to increase the vitamin D levels by getting more sun. Unfortunately the American Dermatology Association does not recommend increasing our sun exposure, due to the risk of skin cancer.
Recently our ability to measure vitamin D levels and has added some additional confusion because many individuals living in northern climates can have an abnormally low levels due to the fact they are having much less sun exposure. In addition there have been a lot of suggestive connections between low vitamin D levels and conditions such as fatigue and depression. This has led some clinicians to recommend patients try to take vitamin D for these conditions as well, and there has been much increased vitamin D testing without clear guidelines for treatment. There is a well-known endocrinologist from Bangor, Clifford Rosen MD who has been working with the National Institutes of Health on the issue of what levels of vitamin D are ideal, and whether clinicians should be using it to treat conditions other than osteoporosis. I agree with his previous recommendations that at this point we should not have any false expectations that vitamin D is a primary therapy for conditions such as fatigue or depression. He also has questioned the wisdom of high-dose vitamin D treatment for patients whose levels are close to normal.
By: Dr. David Prescott, Ph.D.
Seasonal Depression Impacts Many People: People who live in areas where daylight hours in winter are extremely short are more likely to be impacted by seasonal affective disorder, or seasonal depression. According to the American Psychiatric Association, 10-20% of people in America feel more depressed with the onset of winter. A true diagnosis of seasonal affective disorder is less common, with estimates ranging from around 1% to 10% of the population during the winter, partly depending on the latitude at which you live.
By- Dr. Amy Movius
Halloween costumes aren’t just for trick-or-treaters. Whether young – or just young at heart – dressing up at Halloween is fun! Cosmetic contact lenses of different colors and designs are a costume accessary that is growing in popularity. These lenses do look pretty cool and the selection seems endless. A Google search of “Halloween contact lenses cheap” returned almost 4 million results! Besides on-line, these lenses may be found in beauty supply stores, costume or specialty stores, and even at convenience stores and flea markets. They can also be quite inexpensive. Great, right?
By: Dr. David Prescott
What is ADHD? Attention Deficit Hyperactivity Disorder, or ADHD, is one of the most common mental health problems diagnosed in children, with lower prevalence among adults. Estimates of its prevalence in children and teenagers typically range from a low of 5% to a high of 10%.
Sudden Infant Death Syndrome (SIDS) is the leading cause of infant death in the United States. The Safe to Sleep campaign aims to change that. TV5 Health Advisor Dr. Jonathan Wood joined Jim Morris on TV5 News at 5 to talk about it.
LONG-TERM USE OF PROTON PUMP INHIBITORS
By- Dr. Joan Marie Pellegrini
PPI’s (Proton Pump Inhibitors) is a class of popular drugs used to treat GERD (Gastro esophageal Reflux Disease). Some trade names for these drugs are Nexium, Protonix, Prevacid, and Prilosec. These drugs have been on the market for decades and considered quite safe. They are used to reduce the acid in the stomach. In general, their use is indicated for 2-8 weeks to treat esophagitis, gastritis and other acid-related conditions. However, many patients are on these drugs for years and even decades. PPI’s are the 3rd most commonly prescribed medication at over 100 million prescriptions per year. There does not appear to be any problem with short term use. However, there is rising concern for long-term use.
Data has suggested that long term use can impair absorption of nutrients from the stomach. In particular, calcium and iron are better absorbed in an acidic environment. With long term absorption problems, a patient can develop anemia (low blood counts) and be at increased risk of fractures. Other problems associated with PPI use are increased flatulence, possibly an increase in the risk of some infections such as C difficile colitis and pneumonia, a decrease in effectiveness of some drugs (Plavix is one of these drugs but the data on this is confusing and controversial).
PPI’s have not been shown to reduce the risk of esophageal cancer as was once thought. The PPI helps to relieve the symptoms of reflux but does not actually cure reflux.
Many experts feel that if every patient were to adhere to guidelines to modify their diet, exercise, and manage to lose weight that up to 90% of patients on PPI’s would not actually need the medication.
Clearly there is a role for PPI’s. Since their introduction they have been considered a fantastic drug. PPI’s have dramatically reduced the rate of complications from acid-related disease such as ulcers and gastritis.
Therefore, if you have been on one of these drugs for a long time, it is my recommendation that you have a discussion with your physician about its use. Are you suffering any of the adverse side effects? Is the drug effective for you? Is there another alternative? Do you actually need a PPI? Would now be the time to start a diet and exercise regimen that may help with some of your symptoms (many overall benefits!)?