Thursday, April 19, 2012
Testing may not be necessary

By Dr. Anthony Policastro

There is an old saying in medicine related to testing on patients. The saying goes: Think what you will do if the test is positive. Think what you will do if the test is negative. If the answer is the same, then don't do the test. This saying means that doing tests does not always add anything to the treatment plan even if the test is positive. A classic example involves head trauma. In the days before CT scans, the only thing we could do to look at a patient after they had head trauma was an X-ray of the skull. We were concerned whether the trauma might have caused a hemorrhage in their head. The only thing a skull X-ray could tell us was if they broke a bone. The X-ray couldn't tell us anything about brain hemorrhage. Even if there was a skull fracture, there was nothing to do to treat the fracture. You could not put a cast on the head. As a result skull X-rays provided little value. Since we could not see any signs of a hemorrhage, we had to watch the patient carefully. If we saw a fracture on a skull series, we still had to watch the patient carefully. For that reason, we ultimately reached a point where skull X-rays were considered to be of little value and were no longer recommended. However, parents did not understand that. They still wanted X-rays of their child's head. The radiation would not do the child any good. A negative X-ray did not mean anything. We still needed to watch the child carefully. However, the parents felt everything was fine with their child if they had a negative X-ray. We see similar things when children come in with fever. Sometimes we find the cause of the fever. There might be an ear or throat infection. However, many fevers are caused by viruses so the physical exam is normal. In those instances, some parents will ask if we can do a blood test. Yes, we can indeed do a blood test but it is not going to tell us anything. Most viral infections have a low total white blood cell count. However, some of them have a high white blood cell count. Some bacterial infections have a high white blood cell count. However, many of them do not. Therefore, looking at a blood test just tells us which is more likely to be present. It does not really give us a definitive answer. What it does do is cause the child pain to get the blood drawn and increase the cost of medical care. This is often the case with testing - whether it is a laboratory test or an X-ray procedure. There are times when the test will not add anything at all just like doing skull X-rays with head trauma. There are times when the test will only change the probability of what we are dealing with. That is similar to doing blood tests in children with fever. Patients often go to the physician thinking that they need a test done. When that does not happen, they take the attitude that the physician is trying to deprive them of the test. What they really need to do is find out what the physician will do if the test is positive or negative. If the answer is the same, then they need to realize that they really do not need the test at all.

Spring allergy season has arrived The spring allergy season is in full swing. With a wide variety of allergens in the air, more than 40 million Americans are suffering the coughing, wheezing and sneezing of the season. "Spring is probably the worst time of the year for allergy sufferers since there are so many allergens that can irritate your upper respiratory tract," said Bayhealth Otolaryngologist William Wood. Common reactions from seasonal allergies include sneezing, itchy throat, and watery eyes. Chronic symptoms may cause fatigue, slowed thinking, and diminished concentration. If you have severe or chronic symptoms, you may be a candidate for sublingual immunotherapy, which are anti-allergy drops administered under the tongue. Sublingual immunotherapy helps you develop a tolerance to your specific allergy and will alleviate your symptoms as well as the need for future allergy medication. If you suffer from allergies, you may also try to limit your outdoor exposure on days when the pollen count is high. Keep track of the pollen count, limit your outdoor exposure and see your doctor if your symptoms persist.

Tanger supports mammography The Delaware Breast Cancer Coalition (DBCC) recognizes May as Mammography Awareness Month, and in honor of that Tanger Outlets is offering a free $10 Tanger gift card to any Delaware woman that shows proof of her recent mammogram to the Delaware Breast Cancer Coalition. Most cancer organizations agree that women of normal risk who have had no previous breast symptoms or problems should begin getting mammograms every 1-2 years starting at age 40, but Vicky Cooke, executive director of the Delaware Breast Cancer Coalition (DBCC) advises, "Talk to your doctor if you have any breast symptoms or a family history of breast cancer. You may need to get tested earlier or more frequently than other women." For more information, or to receive your free $10 Tanger gift card, visit the DBCC, or call toll free at 1-866-312-DBCC.

Medication take-back event DNREC's Division of Waste & Hazardous Substances and Office of Community Services have partnered with Nanticoke Health Services for a medication take-back event to be held in conjunction with the U.S. Drug Enforcement Administration's National Prescription Drug Take-Back Day. Medications including prescription drugs can be handed in for safe disposal from 10 a.m. to 2 p.m. on Saturday, April 28 at the Mears Health Campus, 200 Rawlins Drive (formerly Health Services Drive) in Seaford. The take-back event is open to all households who have unwanted, unused or expired medications they want to turn over for safe disposal. Aerosol sprays and syringes will not be accepted. Unused medications that are flushed down the toilet can enter our waterways and drinking water supply. If thrown into the trash or discarded haphazardly, these medications also can be retrieved by persons other than the prescription holder to be abused or illegally sold. Handing in unused medications for safe disposal is completely anonymous, with no identification required. For information, visit or call 1-800-882-9539.

Stewards of Children presentation Nanticoke Memorial Hospital is hosting a Stewards of Children Presentation on "How to Protect Your Children from Sexual Abuse." This training session will take place on Tuesday, April 24 from 5:30 to 8:30 p.m., at Nanticoke Memorial Hospital. The cost of the session is $10 per person to cover the cost of course materials. Stewards of Children is a primary prevention, sexual abuse prevention training program that educates adults to prevent, recognize and react responsibly to child sexual abuse. Provided is a three hour training, the program is presented by an authorized facilitator. An interactive workbook and accompanying video are utilized to share the message that adults are accountable for the safety of children. To register or for more information, contact Kathy at 629-6611, ext. 3910.

Stroke and osteoporosis screenings Residents living in and around the Bridgeville community can be screened to reduce their risk of having a stroke or bone fracture. Union United Methodist Church will host Life Line Screening on Friday, May 4. The site is located at 2 N. Laws St., Bridgeville. Screenings identify potential cardiovascular conditions such as blocked arteries and irregular heart rhythm, abdominal aortic aneurysms, and hardening of the arteries in the legs, which is a strong predictor of heart disease. A bone density screening to assess osteoporosis risk is also offered and is appropriate for both men and women. Packages start at $149. All five screenings take 60 to 90 minutes to complete. For more information regarding the screenings or to schedule an appointment, call 1-877-237-1287 or visit Pre-registration is required.

Girl's Night Out benefit Don't miss Milford's first ever Girls Night Out, benefitting the DE Breast Cancer Coalition and the Chamber of Commerce for Greater Milford (CCGM). Enjoy a night of shopping complete with dancing, door prizes and fashion displays on Friday, May 4 from 4 to 8 p.m. at the Carlisle Fire Hall. Tickets can be purchased to win an all-inclusive Girls Weekend Getaway and Spa Package at the Atlantic Sands Hotel, on the boardwalk in Rehoboth. For your chance to win the getaway or to purchase admission tickets ($20 before May 3 or $25 at the door) contact the CCGM at 302-422-3344 or visit

NMH offers CPR classes Nanticoke Memorial Hospital will offer community CPR classes to anyone interested in learning CPR at the Nanticoke Training Center located on Water Street in Seaford. Participants will learn how to perform the basic skills of CPR on adults, children, and infants and how to help an adult, child, or infant who is choking and use of the AED. This classroom-based, video, and instructor-led CPR course offers families, friends, and community members the opportunity to learn CPR and need a course completion card. Classes are open to participants ages 12 and up. This program is specifically designed for those who prefer to learn in a group environment with feedback from an instructor. The target audience is those who have a duty to respond to a cardiac emergency because of job responsibilities or regulatory requirements. Cost is $40. Payment and registration is required by no later than five business days prior to the class. Late registrations may be accepted if seating is available. To register and to obtain a listing of class dates/times, contact the Nanticoke Memorial Hospital's Training Center office at 629-6611, ext. 8919. Pre-registration is required.

Brain injury awareness competition The Brain Injury Association of Delaware (BIAD) is hosting a competition for Delaware's high school seniors. The organization will be accepting short video submissions spreading awareness about brain injury with a deadline of April 30. After submission to BIAD, videos will be posted to BIAD's YouTube channel - and the senior who receives the most "Likes" by May 31, will win a $150 college book voucher, donated by members of BIAD's Board of Directors. Any Delaware high school senior may enter the competition, and BIAD encourages competitors to get creative with the video - students may document their own awareness activities or tell a story with their video. BIAD reserves the right to reject inappropriate submissions. Competition guidelines are available on BIAD's website at

Mosquito Control begins season With the early arrival of warm weather, DNREC's Mosquito Control Section has begun its annual spring woodland-pool spraying, treating wooded wetlands near populated areas in New Castle, Kent and Sussex counties. Approximately 7,000 to 10,000 acres with woodland pools where early season mosquitoes breed in quantity will be strategically larvicided by helicopter and possibly airplanes. As in the past, advance public notice of when and where spraying will occur this year will be given daily via radio announcements, by calling 800-338-8181 toll-free, or by visiting the Mosquito Control website. To request local relief, call Mosquito Control's Milford office at 302-422-1512. For more information about Delaware's Mosquito Control program, call the Dover office at 302-739-9917.

Free vascular screenings offered The Guerrieri Heart & Vascular Institute at Peninsula Regional Medical Center will sponsor free vascular screenings for people 55 or older on Thursday, May 10. Screenings will be performed by Peninsula Regional medical professionals in the medical center's Vascular Lab between 8 a.m. and 3 p.m. Fourteen, 30 minute screenings sessions are available on a first come basis. Appointments are required. The free screenings will include testing for carotid artery blockage, peripheral artery disease and also abdominal aortic aneurysm. The screening will be offered to individuals who exhibit at least three prominent risk factors or one symptom. Risk factors for vascular disease include smoking, high blood pressure, high cholesterol, diabetes, sedentary lifestyle, obesity, heart disease and a family history of vascular disease. Symptoms include leg pain when walking, numbness in the leg or foot, stroke-like symptoms (numbness, weakness, dizziness and difficulties with speech or vision), a family history of aneurysm and unexplained abdominal or back pain. Those currently under a physician's care for vascular or arterial health issues and those who have participated in this screening in the past are not eligible to participate. If you are 55 or older, call the Guerrieri Heart & Vascular Institute at 410-543-7123 to find out if you qualify for the free vascular screenings and to reserve a date and time.

Breast cancer support group Delaware Breast Cancer Coalition, Inc. (DBCC) has expanded its Beginning Your Pink Ribbon Journey, a program for women newly-diagnosed with breast cancer, by partnering with Nanticoke Memorial Hospital Cancer Center in Seaford. The free, monthly program is offered at the Cancer Center located at 801 Middleford Road, Seaford, the third Thursday of each month from 3 to 4 p.m. To learn more, call Lois Wilkinson at 672-6435. Registration is required and light refreshments and small gifts are provided.

Bereavement luncheons Delaware Hospice's "New Beginnings" bereavement luncheons are an informal way to meet and talk with others, who have had similar loss experiences. Lunch begins at noon and is followed by a brief program. The location rotates each week of the month throughout Sussex County. "New Beginnings" luncheons are open to the public. Registration is not required. There is no fee except the cost of your lunch. For more information, call Midge Dinatale or Paul Ganster at 856-7717.

Stop child abuse awareness month Child advocates and legislators have launched a statewide, month-long awareness campaign to stop child abuse in Delaware. Coinciding with April as National Child Abuse Prevention Awareness Month, the efforts focus on encouraging citizens to recognize the signs of abuse and promoting the 24-hour child abuse and neglect report line number people should call to report suspected cases of abuse or neglect. Last year in Delaware, over 14,000 reports of child abuse, neglect, and dependency were received by the Division of Family Services. Sadly, research shows that as much as 75% of incidents of child abuse go unreported. To report suspected child abuse or neglect, call the 24-hour Report Line at 1-800-292-9582. For more information, visit or

'Heart & Sole' Run/Walk April 28 How can a business owner or manager get fresh air, exercise, camaraderie, valuable brand name exposure, feelings of personal reward for less money than a family outing to a pro sports event and a tax deduction to boot? Sponsorship of the April 28th 5K "HEART & SOLE" Run/Walk (starting at West Seaford Elementary School) provides your business with all of these benefits and the potential for long-term name exposure. Sponsor logo shirts and banners are about to be printed, and sponsorships are limited, so download the sponsorship form online now at Participants may also download entry forms online. Participants get shirts, free food and beverages, and chances to win dozens of unique awards. Run/walk awards will be given out for overall female and master's winners, as well as for the top three male and female runners in ten-year category age groups - from 14 and under to 70 and over. 5K walk awards will be presented to the top three male and female finishers. Medals will be given to all "Healthy Kids" race finishers. Results/photos will be posted at Run/walk participants will follow a five kilometer path around the Hoopers Landing Golf Course, beginning at 10 a.m. (rain or shine). A special "Healthy Kids Run" for children, ages 8 and under, is scheduled to start 10 minutes earlier at 9:50 a.m. Entry registration is $20 until April 23; $25 after April 23, and on event day. Registration on race day starts at 9 a.m. The Healthy Kids registration is free. Registration forms are available by calling Ray at 674-3213 or by email You can also register directly online at The "Heart & Sole" 5K Run/Walk is a TriSports Events Ultimate Challenger Series Event.