Thursday, July 25, 2013
Avoid habits that contribute to poor quality of life

By Dr. Anthony Policastro
Possum Point Players in Georgetown will present "Les Miserables" this fall. I auditioned for a role and was lucky enough to be chosen for the cast. I appear in the opening scene as a convict. My line goes, "How long, O Lord, before you let me die?" It was likely very tough being a criminal in 19th century France. That is when the action of "Les Miserables" takes place. It was so tough that the convict that I play would rather be dead. It got me thinking. There are some people who have such poor quality of life that they might be asking the same question. In many cases, that poor quality of life is of their own doing. I will give three examples to support that. One of them is related to COPD (chronic obstructive pulmonary disease), formerly known as emphysema. This is usually related to cigarette smoking. It also has a genetic basis. If you have family members with emphysema, you are at high risk for developing it. If you already smoke, you need to stop. If you do not yet smoke, you need to avoid it. Many of these individuals belong to what we term the 50/50 club. What that means is that their oxygen levels are about 50. That compares to the high 90s for the normal person. Thus they are always short of breath. Some get to the point where they have to carry oxygen around with them all the time. They also have carbon dioxide levels that are higher than normal. These levels are also in the 50s. That means that they are always sluggish. Thus they cannot breathe and have no energy. They might ask, "How long, O Lord, before you let me die?" A second example is congestive heart failure (CHF). There are a variety of causes. They include cigarette smoking, obesity and untreated high blood pressure. Once someone goes into CHF, they are in a precarious state. Too much salt or too much fluid will make their heart failure worse. They are often not able to walk a few steps without getting out of breath. They need to monitor their weight every day. When they see themselves gaining weight, that usually means their CHF is worsening. It will result in a visit to the doctor which might result in being put into the hospital for a few days. They might ask, "How long, O Lord, before you let me die?" A third one is diabetes. Diabetes often produces few symptoms in the early years. However, damage occurs to multiple areas of the body over time. The more carefully you control the diabetes, the longer it takes for the damage to occur. Some diabetics will suffer several of the long-term effects. They might go blind, develop dementia, be put on dialysis and suffer amputations that make their quality of life poor. They too might ask, "How long, O Lord, before you let me die?" One might wonder how common these things are. The Dartmouth Medical Atlas says the following: "Among the Medicare population, the toll is even greater: about nine out of 10 deaths are associated with just nine chronic illnesses, including congestive heart failure, chronic lung disease, cancer, coronary artery disease, renal failure, peripheral vascular disease, diabetes, chronic liver disease and dementia. Patients with chronic illness in their last two years of life account for about 32% of total Medicare spending, much of it going toward physician and hospital fees associated with repeated hospitalizations." We often take quality of life for granted. We should not do so. There are some chronic diseases that are not preventable (certain forms of cancers). There are many others that are preventable. We need to think about preventing them early. Otherwise, you can be like the convict that I play. You can ask, "How long, O Lord, before you let me die?"

Skin cancer prevention campaign The Delaware Division of Public Health has announced its skin cancer prevention campaign: "SPF is your BFF." Every two weeks a Delawarean dies of skin cancer and Delaware's melanoma rate is increasing three times as fast as the nation. Long-term sun exposure, sunbathing, having sunburns, or using tanning beds increases the chance of developing skin cancer. Protection from damaging and dangerous ultraviolet (UV) radiation is important year round. To prevent skin cancer, DPH recommends the following measures:

  • Stay indoors or seek shade when the ultraviolet (UV) rays are most dangerous, between 10 a.m. to 4 p.m.
  • Regularly use a water-resistant sunscreen with UVA and UVB and a broad spectrum SPF of 15 or higher. Apply sunscreen liberally and reapply it every two hours, or more if swimming or perspiring. Wear sunscreen and cosmetics with a high SPF year-round.
  • Wear wide-brimmed hats to cover the head, face, neck and ears; and sunglasses to protect your eyes from the sun's UVA and UVB rays. Also wear protective clothing such as long-sleeve shirts and pants.
  • Diligently protect children from the sun. Encourage them to play in shaded areas, and apply sunscreen regularly. Don't let them get sunburned.
  • Avoid tanning beds, which have been linked to the deadliest form of skin cancer called melanoma. Tanning beds produce UV rays just like the sun.
The risk of skin cancer is greatest for persons who are fair-skinned or who have blue or green eyes; has skin that burns, freckles, reddens easily, or becomes painful in the sun; has many large and irregularly shaped moles; and who are exposed to the sun through work and play. Persons at high risk of developing skin cancer have a history of excessive sun exposure, blistering sunburns, or indoor tanning; and have a personal or family history of skin cancer.

Although there are some people who are at greater risk for developing skin cancer, skin cancer can affect anyone. The earlier that skin cancers are detected, the less likely that they will metastasize (spread) to other body parts. See a dermatologist immediately if you have moles that are different from others, sores that do not heal, new skin growths, and moles with one or more of the ABCDE characteristics:
  • Asymmetry - If an imaginary line is drawn through the mole, the halves do not match.
  • Border - Irregular, uneven borders.
  • Color - Moles that have several colors, or moles which become lighter or darker.
  • Diameter - Moles larger than the size of a pencil eraser (greater than 6 mm in diameter).
  • Evolving - Moles that itch or bleed, shrink or grow, change color, or have portions that are elevated; or a new growth on the skin.
For more information, contact the Delaware Division of Public Health's Comprehensive Cancer Control Program at 302-744-1020; or visit or

Hospice offers Camp New Hope Delaware Hospice has spaces available at its Camp New Hope, which will be held from Aug. 6-9, at Killens Pond State Park, for children and teens who have suffered the recent loss of a loved one. Since 1990, Delaware Hospice's New Hope program has offered individual and family grief counseling to more than 1,500 children and adolescents aged 6-17. The New Hope program, including Camp New Hope, is a free, community outreach program. Camp New Hope is the annual highlight of the New Hope Program. This inspirational day camp takes place over four days, connecting children in similar age groups in order to help them process their feelings of loss and grief. Many of the children in New Hope have lost a parent, sibling, or grandparent due to illness or sudden death. Learn more about Camp New Hope by contacting New Hope Coordinator for Kent and Sussex Counties, Robin Murphy at 302-678-4444 or

Free to Breathe Delmarva 5K Champion the lung cancer cause by registering for the fourth annual Free to Breathe Delmarva 5K run/walk and 1-mile walk on Sunday, Aug. 11, at Cape Henlopen High School in Lewes. The inspirational event will bring the community together to raise funds that will fuel groundbreaking research necessary for making the dramatic breakthroughs in early detection and treatment that can save lives. All proceeds support the National Lung Cancer Partnership, a non-profit organization dedicated to doubling lung cancer survival by 2022. For more information, to register or donate, visit

Hendricks earns FACHE designation Nanticoke Health Services congratulates Barbara Hendricks, vice president of human resources and support services, for receiving her FACHE designation. Hendricks recently became a Fellow of the American College of Healthcare Executives, the nation's leading professional society for healthcare leaders. To obtain Fellow status, candidates must fulfill multiple requirements, including passing a comprehensive examination, meeting academic and experiential criteria, earning continuing education credits and demonstrating professional and community involvement. Fellows are also committed to ongoing professional development and undergo recertification every three years.

Outing to benefit Hospice Center The 3rd Annual Eleanor Soltner Memorial Golf Outing to benefit the Delaware Hospice Center will be held at The Rookery North at Shawnee in Milford on Wednesday, Aug. 14. Registration and a light breakfast will begin at 7:30 a.m., and the shotgun start is at 9. Contests will include the team putting, longest drive ladies & men, and closest to the pin ladies & men, along with team prizes. Registration is $100 per person, which includes greens fees, cart, light breakfast, refreshment cart, range balls, and an awards reception with lunch. Silent auction items will be available. Proceeds benefit the Delaware Hospice Center. Sponsorship opportunities are available. For $25 you can attend the luncheon, awards and silent auction. For more information, call Bob Burd at 302-422-3501.

Clean water loan workshop DNREC's Financial Assistance Branch (FAB) and the Department of Health and Social Services' Division of Public Health (DPH) will host workshops in each county, in preparation for the development of Clean Water State Revolving Fund (CWSRF) and Drinking Water State Revolving Fund (DWSRF) Revised FY 2013 Project Priority Lists (PPLs). In Sussex County, a workshop will be held on Wednesday, July 31 from 9 a.m. to noon at Delaware Technical and Community College, Owens Campus, William Carter Partnership Center-Room 540 A & B, Georgetown. The purpose of the workshops is to inform and provide municipal government representatives, privately-owned wastewater and drinking water utilities, consultant engineers, and other interested parties with detailed overviews of the CWSRF and DWSRF programs. RSVP by contacting Jessica Velazquez at 302-739-9941 or