Thursday, December 05, 2013
Dr. Anthony Policastro

Anemia treatment takes months
People frequently use the term Anemia. However, it is often apparent that the word means different things to different people. From a medical standpoint, anemia means that a person's red blood cell count is low. There are two ways that we measure the red blood cell count. The first is something called Hemoglobin or Hb. The normal Hb level is usually between 12 and 15. A result below 12 means that a person can be considered to have anemia. The second measurement is called a Hematocrit or hct. The normal hct is usually between 36 and 45. A result below 36 means that a person can be considered to have anemia. The hct is usually about three times the Hb. There are a few things about anemia that people do not understand. The first is that the actual Hb or hct number covers 95% of the normal population. Five percent of the population will normally run a Hb of less than 12 or a hct of less than 36. Therefore, a result just below expected levels is nothing to get excited about. A second area of misunderstanding is about how quickly changes in blood counts can occur. It is true that if you lose a lot of blood quickly, your counts will drop rapidly. In addition, if you get a blood transfusion, your counts will rise quickly. However, for all other situations, changes in the Hb and hct occur very slowly. The reason for that is related to the fact that red blood cells live for 120 days. Thus, every day we replace 1/120 of our total red blood cells. With that being the case, it takes days to see a change in the counts. For example, if you stopped making blood today, it would take about 12 days (10% of the 120 days) for you to see a 10% change in the counts. Thus, the Hb would only drop 1.2 to 1.5 during that period. The hct would drop 3% to 6%. If the person started with a Hb of 14 and a hct of 42, after 10 days the Hb would drop 1.4 points to 12.8. The hct would drop 4.2% to 37.8%. Both results would still be normal. After 20 days the Hb would fall to 11.6. The hct would be at 33.6%. Both values would be close to enough to normal to ignore. Thus, you could stop producing blood for almost three weeks without a noticeable effect. On the other hand, it would take as long to see a change in the opposite direction. Thus, a person who gives a pint of blood would take about three weeks to replace the blood if the number of new blood cells doubled over that time. If the increase was less than double it would take even longer. A person who is iron deficient would also not see a change occur very quickly. If all of your blood cells do not have enough iron, you would need to replace them all with blood cells that had more iron. That would take 120 days to do. If you start taking iron because of iron deficiency, you need to take it for 120 days to have cells that are no longer iron deficient. Many people stop taking iron before that time and then wonder why they did not get better. The bottom line is that anemia is a complex problem with many causes. While iron deficiency is the most common cause, it is not the only one. In addition, adults who are not losing blood for obvious reasons do not get iron deficient. A cause needs to be found and, once treated, recovery will take weeks to months not days.

DNREC issues penalty order DNREC Secretary Collin O'Mara has issued a Notice of Administrative Penalty Assessment and Secretary's Order to The H&K Group and River Asphalt, LLC, for violations of federal and state air quality regulations and its air permit. The order calls for a cash penalty of $13,680 and an additional $2,052 as cost recovery reimbursement to DNREC for expenses associated with the investigation. The Secretary's Order addresses air quality violations that occurred at the Delmar facility during stack testing conducted on Nov. 7 and 8, 2011. River Asphalt II, LLC has since performed maintenance activities and conducted stack tests again on March 27 and 28, 2012, and was able to demonstrate compliance. The company has 30 days to request a public hearing.

School of Nursing groundbreaking The Margaret H. Rollins School of Nursing at Beebe Healthcare in Lewes will break ground on its $10 million building expansion at 1 p.m., Saturday, Dec. 14.

School officials invite residents, visitors and local dignitaries to attend this special groundbreaking ceremony, which will be held in front of the school's Market Street entrance. Beebe Healthcare is poised to address the local shortage of nurses by expanding its 90-year-old nursing school. When the project is complete, 60 new nurses will be eligible each year to take the licensure exam. The grand opening of the new building is planned for 2015. A reception will follow the event at the Inn at Canal Square in Lewes. For more information, call the Beebe Medical Foundation at 302-644-2900.

Event helps feed 250 families Trinity Logistics hosted its first annual "Hustle for Hunger" 5k run/walk in November at their corporate headquarters in Seaford. The event was held to raise money to help feed 250 local families in need this Thanksgiving. After the event, a month long food drive was held to collect non-perishable food items for inclusion in the Thanksgiving meals. The event saw 50 participants. Awards were given for overall male, female and master's winners, as well as the top 3 male and female runners in each 10-year age bracket, starting with 14 and under, up through 70 and over. Team members from Trinity Logistics and Perdue Farms came together to prepare food bags that were given to the families on Nov. 22. With the donation of 250 roasters by Perdue Farms and the proceeds from the 5k and food drive, Trinity Logistics was able to meet their goal of feeding 250 families. To learn more about the event, visit

Early renewals offered for insurance As a result of President Obama's federal waiver, Commissioner Karen Weldin Stewart has reached an agreement with health insurance carriers to offer early renewals for current policies whose term of coverage was to end on or before March 31, 2014. Consumers that are affected by this agreement and take advantage of this option must renew their policy on or before Dec. 31, 2013. All policies with an effective date after Jan. 1, 2014, must be in compliance with Delaware law. Contact your insurance agent or broker if you have questions regarding your health insurance policy.

Dr. Fan elected president Nancy Fan, M.D., an obstetrician/gynecologist who practices at Women to Women OB/GYN in Wilmington and is on the staff of Saint Francis Healthcare, was elected to lead the Medical Society of Delaware for the 2013-2014. Other officers who will serve for the coming year include: Dorothy Moore, M.D., president-elect; Thomas P. Barnett, M.D., vice president; Harry A Lehman III, M.D., secretary; Randeep S. Kahlon, M.D., treasurer; and Janice E. Tildon-Burton, M.D., speaker of the council. The Medical Society of Delaware was founded in 1789 to further the ideals of the medical profession, thereby enhancing the health and well being of the citizens of Delaware.

'Wrap it Up & Unwind Party' The stress of the holidays is here! Come to our Wrap it Up & Unwind Party at Heritage at Milford from 4 to 7 p.m. on Tuesday, Dec. 10. Let us wrap your gifts (limit 10 gifts per person) while you unwind with some special holiday refreshments, aromatherapy and soothing chair massages. RSVP by calling 302-422-8700.

Key Club Blood Drive Woodbridge High School's Key Club Blood Drive will be held from 8 a.m. to 1 p.m. on Monday, Dec. 16, at the high school auditorium. If you cannot participate that day, you can go to any local blood bank at your convenience and fill out a hero card when donating which will still give Woodbridge High School credit for your donation. Also, please spread the word among your families, friends and in the community. To register to donate, contact Evelyne Adams at 337-8289, ext. 402 or