Thursday, December 11, 2008
A few useful pearls of wisdom to consider
By Anthony Policastro, M.D

Many people have heard the term "pearls of wisdom." In medicine we use a similar term. They are called "clinical pearls.' They refer to things that provide an unexpected approach to a clinical problem. For example, we have heard about children who push their heads through two bars and get stuck. Most people try to figure out a way to pull them back through the bars. However, children's heads are the largest part of their body. If you turn them sideways so their shoulders are parallel to the bars, you can usually easily push them through to the other side. It is almost like delivering a baby. Another example relates to zippers. There are times when someone will accidentally pull a zipper up and get their skin caught in it. The logical approach is to think about unzipping it. The problem is that you cannot do that without causing more pain. A better approach is to cut the zipper at the bottom. It can then be separated from the skin just like when your zipper comes apart at the bottom of a jacket. A third example relates to injuries to finger nails and toe nails. Such injuries are often associated with bleeding under the nail. These are known as subungual hemorrhages. They are quite painful. Some people may think that you just need to put up with the pain until it goes away. However, most emergency rooms have a tool. It puts a hole in the nail. the blood pours out through the hole. The pain is quickly relieved. In the office, I frequently see children who "W-sit." This means that they sit with their legs out to the side of them. The appearance is that of the letter "W." The lower part of the legs form the outside portions of the "W" and the upper part of the legs form the inside portion. If you look at a child sitting in this position, you will notice that their knees point inward. If they keep their knees in the same position when they stand, their feet will point inward. Over a period of time, they will feel so comfortable that way that they will start tripping over their own feet. The corrective action is to have them sit with their legs crossed. The trick to this is to recognize "W-sitting" in the first place. There are many other clinical pearls that we use. The problem is that there are so many that there is never enough room to list them all. However, there is always time to ask if one exists.

Children's Tree supports the Pediatric Fund at Nanticoke The community is invited to visit Grotto's Grand Slam in Seaford to view the parade of trees that decorate the restaurant in support of local charities. One of the trees is the "Children's Tree" decorated by the students of St. John's Preschool. All proceeds from the collection box placed under the preschool tree will support "The Pegeen and Samantha Brown Pediatric Fund" at Nanticoke Memorial Hospital. The fund was established in memory of Samantha Brown, 17-year-old daughter of Tom and Pegeen Brown, who was tragically killed in a car crash in Jan. 2007, and Pegeen Brown who passed away suddenly just one month later. Pegeen was a kindergarten teacher at Woodbridge Elementary School and Samantha was an active volunteer at Nanticoke Memorial Hospital. The new pediatric area in the emergency room at Nanticoke Hospital is designed to make children feel comfortable during a visit to the hospital. The treatment rooms are decorated in a beach theme with underwater paintings. There is a wagon to transport children to the Radiology Department. An art cart and supplies allow children to stay busy while waiting for tests and other procedures. A play area is available with soft furniture and cushioned flooring. Televisions have been installed in all rooms. Sippy cups are available to pediatric patients and Pastoral Care Prayer Bears are given to all children. "We encourage the community to participate by dropping in a few dollars this holiday season when you visit Grotto's," says St. John's member, Connie Halter. The tree that collects the most charitable contributions will win an additional $250 for their charity donated by Grotto Pizza.

Information sessions at Del Tech Become a member of the rapidly expanding health care field by taking the evening nurses' assistant training program, offered through Delaware Technical & Community College, Owens Campus, Georgetown. A free information session about this program will be held on Dec. 15 from 6 to 8 p.m. at Delaware Tech. This 150-hour course teaches students to safely perform basic nursing skills under the supervision of a licensed nurse. Course begins on Feb. 2 at LifeCare at Lofland Park in Seaford; or April 6 at Atlantic Shores in Millsboro. Classes meet Monday through Thursday from 5 to 10:30 p.m. Free training is available to qualified applicants. For complete information or to register, contact Delaware Tech's Corporate and Community Programs at 302-854-6966.

New Program for Dietary Assistants The Sussex Tech Adult Division is offering a new Dietary Assistants program to help prepare workers for the institutional food service profession. Specific emphasis will be on hospital and long-term care facilities. Classes in this certification program will start Jan. 5, and be offered two nights each week at the Georgetown campus. Students will learn about the medical profession, nutrition, food service and gain computer skills. The industry-recognized ServeSafe certification is included in the program. Students will learn the skills necessary to get a job in institutional food service (primarily health care) to help dietary staff provide healthy, safe, and nutritious food. Duties of a Dietary Assistant usually include interacting with clients and/or patients and performing various food production and service tasks. The demand for dietary assistants is increasing. Individuals currently working in a related field may choose to schedule the 60-hour portion of the class to earn ServeSafe certification. To register for the program, contact the Sussex Tech Adult Division at 302-856-9035, or visit the website at

Ready to be "The Biggest Loser?" Healthy U of Delmarva at Salisbury University, the Wicomico County Health Department and the YMCA Activate America sponsor this 12-week guided exercise and nutrition program starting January 9. Individuals or teams of 4-6 may participate. The program features seminars, classes and events about nutrition, body image, stress eating, nutritional labels, recipe tips and fun physical activities. It is designed to promote positive lifestyle changes and improved habits. Participants will receive Biggest Loser T-shirts, prizes, nutrition and fitness tips, YMCA or University Fitness Club access, confidential monthly weigh-ins, body measurements, exclusive classes and a session with the Fitness by Design team. Registration is $35; $20 for members of Healthy U or the mid-shore Family YMCA, and SU students or staff. Deadline is Thursday, Jan. 8. For more information contact Deanna Harrell, YMCA community projects director at 410-749-0101 x16 or, or visit the and click the Activate Delmarva link.

Nanticoke raffles game system The Look-In Glass Shoppe at Nanticoke Memorial Hospital will raffle a Wii gaming system console that includes a CD with five sports games, two nunchucks and two remotes (retail value $350). Tickets are on sale at The Look-In Glass Shoppe (located within Nanticoke Memorial Hospital) from now until Dec. 15 at noon. Tickets cost $5 each or five for $20. The drawing will be held at noon on Dec. 15. All proceeds from The Look-In Glass Shoppe benefit Nanticoke Health Services. For more information about the raffle, call 302-629-6611, ext. 4955.

Delaware Hospice CEO elected Susan Lloyd, president and CEO of Delaware Hospice, was elected as the Northeast Geographic Area Representative to the National Hospice and Palliative Care Organization's board for a three year term, beginning in January 2009. Lloyd has directed Delaware Hospice for 21 years, overseeing its significant growth in terms of services offered to the community and the number of patients and families served in the state of Delaware and neighboring counties in Pennsylvania. As a regional representative to NHPCO, she will provide input on the national level on issues affecting the delivery of hospice services in the northeastern United States.