Thursday, May 29, 2008
There are no quick fixes in health care

By Dr. Anthony Policastro

One of the side effects of ADHD medications is appetite suppression. We follow the children's weight carefully. I like to take children off medication for the summer so they can have some catch up weight gain. Recently, I told a mother that we would be stopping the medication for the summer because of her child's weight loss. She asked if she could continue it during the summer because he was overweight. I advised that this was the wrong way to lose weight. We are a society looking for quick results. We have fast food restaurants. Those restaurants have drive through windows. There are drive through ATM's. We have EZ-Pass to get through tollbooths quickly. People naturally think that health care should be the same way. There should be a quick fix for everything. When I was a medical student, I spent time doing internal medicine. We had patients with lung cancer that wanted to be cured. We had patients with emphysema that wanted to be cured. We had patients with cirrhosis of the liver that wanted to be cured. It took years of smoking and drinking for them to get to that point. There was no magic cure for what they had done over the years. I solved the dilemma by becoming a pediatrician instead of an internist. Proper diet is the best way to handle weight loss. Diet pills do not fix the underlying eating problem. Obesity surgery requires a strict diet after the surgery to be successful. There are no quick fixes. Exercise is important to maintain your heart in good shape. There are no 10-minute exercises that can give you the benefit your heart needs. When the heart fails, it is too late for exercise. Patients with diabetes may ignore their condition for years. It will ultimately affect all parts of their body. They may have a stroke. They may have a heart attack. They may have kidney failure. They may have blindness. They may lose a foot or leg to gangrene. Once these symptoms start showing up, the damage is done. There are no quick fixes to reverse the damage. All we can do is slow it down. There is not a drive through solution to good health. There are no magic pills that provide quick cures. It is an every day proposition. A long-term approach is necessary. The best time to start is today.

Delaware works to lower infant mortality rates with new programs

The Delaware Division of Public Health (DPH) announces that Delaware is on the right track in its efforts to reduce infant mortality. In its annual report to the Governor, "The Birth of Change - Healthy Mothers, Healthy Babies," the Delaware Healthy Mother and Infant Consortium (DHMIC) reported that programs and policies being implemented will enable Delaware to see, over time, a decrease in the number of children born premature or too small to survive the first year of life and to eliminate the disparity in poor birth outcomes between African Americans and Whites. Infant mortality elimination programs are targeted to geographic areas of the state with the highest rates of infant mortality and where the disparity between African Americans and Whites is the most significant. These include:
  • Preconception care -- the path to healthy infants is through healthy women; Reproductive health services;
  • Assessment and interventions for psycho-social needs; Nutrition counseling;
  • Screening for and referral to smoking cessation programs;
  • Referral to alcohol and drug treatment programs; and
  • Chronic disease counseling.
  • According to state statistics for the period 2001-2005 (the latest for which statistics are available), the overall infant death rate in Delaware stands at 9.2 [1] deaths per 1,000 live births. At 17.1 deaths per 1,000 live births, the rate for African Americans is over two times as high as the rate for Whites, which stands at 6.8. The Hispanic rate is 7.2 deaths per 1,000 live births. In 2004, Governor Minner declared that infant mortality rates in Delaware were unacceptable and signed an Executive Order establishing the Infant Mortality Task Force (IMTF), which she charged with developing recommendations to reduce the rate of infant deaths in the state. The 2005 IMTF report presented the Governor with a set of twenty recommendations which would achieve the sort of systemic change needed to not only reduce infant deaths but also sustain that decrease over time. The Governor also established the DHMIC, a group of health specialists, legislators, community health advocates and other stakeholders, led by neonatologist Dr. David Paul, and Dr. Jaki Gorum, retired dean of the College of Health and Public Policy at Delaware State. To date, over 5,000 women have been enrolled in preconception programs. The majority of these women are uninsured or underinsured, are part of an ethnic minority group, live in geographic areas with the highest number of infant deaths, have had previous problems delivering healthy newborns, or suffer from chronic diseases. To view the report, visit Click Here

    Keeps kids safe in the pool

    As pools open their doors around the state this Memorial Day, SAFE KIDS wants to remind you that drowning deaths among children ages 14 and under increase 89 percent in the summer over the average annual monthly rate, with 64 percent of all children's drowning deaths occurring in the summer months. To help keep kids safe this pool season, The Delaware SAFE KIDS Coalition recommends these precautions:
  • If you have a pool or spa, it should be surrounded on all four sides by a fence at least five feet high with gates that close and latch automatically. Studies estimate that this type of isolation fencing could prevent 50 to 90 percent of child drownings in residential pools.
  • A pool or spa should be equipped with an anti-entrapment drain cover and a safety vacuum release system to prevent children from being caught in the suction of the drain.
  • Don't leave toys in or near the pool, where they could attract unsupervised kids.
  • Enroll your kids in swimming lessons around age four, but don't assume swimming lessons make your child "drownproof."
  • Remember: inflatable swimming toys such as "water wings" and noodles are not flotation devices and do not prevent drowning.
  • Learn infant and child CPR. In less than two hours, you can learn effective interventions that can give a fighting chance to a child whose breathing and heartbeat have stopped. Contact your local hospital or Red Cross affiliate for information about local CPR classes.
  • Keep rescue equipment, a phone and emergency numbers by the pool.
  • These guidelines apply to inflatable and portable pools, not just in-ground pools. A child can drown in just an inch of water. Kiddie pools should be emptied and stored out of reach when not in use.
  • Stroke support group Nanticoke Memorial Hospital will offer free monthly Stroke Support Group meetings designed for individuals who have survived a stroke and their families and caregivers. Meetings are held the third Thursday of each month at Nanticoke Cancer Care Center, from 1:30 - 3:30 p.m. The meetings will consist of guest speakers and breakaway sessions, in which caregivers and survivors will meet in two groups to discuss concerns, provide support and networking. Refreshments will be provided. Sheila Brant and Joan Burditt, occupational therapists at Nanticoke Memorial Hospital, will facilitate the support group meetings. Pre-registration not required. For more information, call 629-6611, ext. 5121.

    Oncology symposium planned The Sixth Annual Seaside Oncology Symposium will take place Saturday, Oct. 11, at the Boardwalk Plaza Hotel in Rehoboth Beach. The Tunnell Cancer Center and the Medical Society of Delaware sponsor this annual, half-day symposium to update participants on the diagnosis and management of cancer. It is designed for physicians, nurses and other healthcare professionals. The conference, which begins at 7:30 a.m. and ends with lunch at 1 p.m., is planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint-sponsorship of the Medical Society of Delaware and Beebe Medical Center. The Seaside Oncology Symposium is supported by unrestricted educational grants from various pharmaceutical companies and programs. Details regarding this year's topics and speakers will be available soon. Hotel reservations may be made directly with the Boardwalk Plaza at 800-332-3224.

    Nursing assistant program begins Become a member of the rapidly expanding health care field by taking the evening nurses' assistant course, offered through Delaware Technical & Community College, Owens Campus. Instruction will be given at Lifecare at Lofland Park in Seaford from June 9 to Aug. 27. Classes will meet on Monday, Tuesday, and Wednesday from 5 to 10 p.m. This 150-hour course teaches students to safely perform basic nursing skills under the supervision of a licensed nurse. Graduates will be prepared to take the Nurse Aid Competency Exam for certification. All nurses' assistants must take this exam to be certified to work in Delaware. For complete information, contact Delaware Tech's Corporate and Community Programs at 302-854-6966.

    State earns high score Delaware's Division of Public Health (DPH) received the high score of 96 percent average on its annual Strategic National Stockpile (SNS) preparedness assessment released by the Centers for Disease Control and Prevention (CDC). The Federal Strategic National Stockpile is a supply of essential medications and health equipment available to states during a disaster. The SNS contains more than 100 specialized containers of bulk oral antibiotics, bandages, intravenous medications, and antidotes that states would repackage into individual doses. DPH also received a 97% average on its Dover Cities Readiness Initiative (CRI) jurisdiction preparedness assessment, which evaluates the states capabilities in distributing and dispensing SNS assets within the City of Dover and surrounding localities. DPH partnerships with the State's pharmacists, Delaware State Police, Delaware National Guard, City of Wilmington, City of Dover, Department of Safety and Homeland Security, and Delaware Emergency Management Agency are crucial in managing the transportation, security, storage, and dispensing of this national asset. The CDC team met with DPH program managers and partners in determining Delaware's scores.

    Depression support group The Mental health Association in Delaware will be sponsoring a Depression Support Group in Laurel on the second and fourth Thursdays of each month. The meetings begin at 7 p.m. The MHA encourages anyone dealing with a depressive disorder to attend. Register in advance by calling 1-800-287-6423. Peer support groups sponsored by Mental Health Association of Delaware are not intended to replace professional mental health treatment. MHA does not publish support group locations; locations are provided with registration.