Thursday, November 05, 2015
Doctor's Perspective
Toxic stress in children

By Dr. Anthony Policastro Stress is a fact of life. Like most things, stress in small quantities is good for us. Most of us are familiar with the stress that comes from being asked to speak in front of a group of people. This experience is healthy for our bodies. Other types of stress are more difficult to handle but they are usually overcome. A good example is dealing with the death of a pet. A new type of stress - Toxic Stress - has been identified in children. Toxic Stress is a frequent and prolonged stress that occurs in certain situations. It is brought on by what are called Adverse Childhood Experiences (ACE's). I attended a daylong session devoted to ACE's at the American Academy of Pediatrics meeting recently. Ten ACE's have been identified. Three are associated with child abuse - physical, emotional and sexual. Two are associated with child neglect - physical and emotional. The other five are household related. They include mental illness in a parent, substance abuse in a parent, incarceration of a parent, witnessed domestic abuse of a spouse and absence of a parent from the home. The presence of four of these 10 in any patient produces significant adverse physical and emotional effects. About 15% of children will have four ACE's which means it is fairly common. Some of the effects are seen during childhood and adolescence. About half of these children will have learning problems in school. Insomnia is common. Weight issues are often present. Many of these children will develop ADHD type symptoms. About one third of them will engage in sexual activity before the age of 15. About 40% of the girls will have a teen pregnancy. About one third of the boys will be teen fathers. Much of this is related to the fact that there are negative effects on the reward center of the brain. These effects lead to more risk taking. That type of risk taking leads to 16% of these individuals becoming alcoholics as adults. It also leads to high risk health behaviors. For that reason we see a higher death rate from many causes in this group of individuals. They are 12 times as likely to commit suicide. They are about three times as likely to die from COPD. They are about twice as likely to die from heart disease or diabetes. Other causes of death also increase. They are twice as likely to die from stroke. They are four times as likely to die from Alzheimer's disease. Some groups of children easily can add up to a total of four ACE's. For example, most children in foster home placement have a history of parental separation. In many cases this is due to abuse, neglect or parental mental illness. Thus, this group of children is at high risk. As with any medical issue, the first step is recognition of the problem. The data suggests that the time to recognize Toxic Stress is here. The next step will be to address it. We are likely to hear much more about that in the future. Stress can be helpful but that is not always the case. Prolonged and frequent stressful situations can take a heavy toll.

Bariatric Support Group Nanticoke Physician Network General & Bariatric Surgery will host bariatric support groups on the first Tuesday and third Thursday of each month from 5:30-6:30 p.m. at Nanticoke Memorial Hospital in the Medical Staff Conference Room. This free group is designed to provide education and support to patients before and after their bariatric weight loss surgery. Support group meetings will consist of guest speakers and presentations to provide useful information about nutrition, supplements, exercise and behavior modifications. Patients and their spouses, family members or friends are welcome to attend. Registration is not required. The next meeting will be held on Thursday, Nov. 19. For more information, contact Shelly Geis at 629-6611, ext. 8810.

Diabetes Education Program Nanticoke Memorial Hospital will hold a four-session diabetes educational program, The Diabetes Connection, on Nov. 4, 11, 18, and Dec. 2, from 5-7 p.m. The cost of the program may be reimbursable by insurance. This four-session diabetic program includes weekly education sessions in a group setting and individualized meal planning for diabetes self-management. One family member or significant other is welcome to attend. Pre-registration is required prior to attending classes. To register and for more information, contact Nanticoke Memorial Hospital's Diabetes Education Department at 629-6611, ext. 2446.

Nanticoke joins Veterans Choice Veterans needing to travel more than 40 miles for care may now have a choice. Nanticoke Memorial Hospital has been approved as a Veterans Choice Program Hospital, helping veterans receive more care closer to home.

The Veterans Choice Program was established in 2014 to help expand access to care to veterans. This program provides veterans access to care when the closest VA medical center has long wait times, is an extraordinary distance from the veteran's home, or when there is a lack of specialists at the VA facility. If you were enrolled in VA health care benefits on or before Aug. 1, 2014 and have to wait for specific care more than 30 days or live more than 40 miles from the closest VA medical center, you may be eligible to use an authorized non-VA facility, like Nanticoke Memorial Hospital. Eligible veterans must contact Health Net Federal Services, LLC (Health Net). Health Net coordinates all care under this program, scheduling appointments and sending the authorization to the participating VCP providers. The Veterans Choice Program only covers medical needs approved by your VA physician. Health Net will assign eligible veterans a Veterans Choice Program card. For more information, to enroll in the Veterans Choice Program or to schedule non-VA appointments through this program, call 866-606-8198. You can also find more information about the program at (click on "Veterans Choice" under the Veterans Affairs box).

Breastfeeding support group Breastfeeding is natural, but it doesn't always come naturally. During the early weeks after birth, moms and babies experience challenges as they both learn how to breastfeed. At times, even the most dedicated nursing moms want to give up. On Monday, Nov. 23 at 10 a.m., Nanticoke Memorial Hospital will hold The Mom's Circle, a free breastfeeding support group, in the Nursing Conference Room. The Mom's Circle is a safe place for moms to come for support, advice and friendship from both experienced nursing moms and new moms and a lactation consultant. Registration is not required. For more information, contact Jacalyn Bradley, lactation consultant, at 629-6611, ext. 2234.

Better Breathers Club meeting Nanticoke Memorial Hospital will host a Better Breathers Club on the third Monday of each month from 2-3 p.m. This month's meeting will be held on Monday, Nov. 16, in the Medical Staff Conference Room. This free support group is open to anyone affected by a chronic lung disease including relatives and caregivers. Backed by the American Lung Association, the Better Breathers Club offers a venue for participants to learn from featured speakers and educational materials, socialize with others affected by a chronic lung disease, and practice skills that will help them better manage their condition and improve their quality of life. Refreshments will be provided and registration is required. For more information or to register, call 629-6611, ext. 1010.

'Coping with the Holidays' workshop Delaware Hospice will hold a one night grief support workshop on Thursday, Nov. 19 from 5:30-7 p.m. at the Milton Library for individuals who have lost a loved one and are dreading the upcoming holidays. This presentation offers coping strategies for the challenges the holidays offer and suggestions for self-care. To register or to learn about other support groups at Delaware Hospice, contact Bereavement Counselor, Midge DiNatale, BA, GC-C at 856-7717, ext. 4120 or email

Safe Sitter Class Nanticoke Memorial Hospital will host a Safe Sitter class from 9 a.m. to 4 p.m. on Saturday, Nov. 14, for children ages 11 to 13 who are interested in learning child care essentials and safety. The course is designed to train teenagers how to be safe baby/child sitters. Components include infant/child development and care, safety, injury prevention, first aid, accident management, rescue breathing and choking management. Cost is $35 per student, which includes the class and all materials. Advance registration is required. To register or for more information, call 629-6611, ext. 2540.

Nanticoke Senior Center Volunteer Banquet Nanticoke Senior Center held a banquet recently to honor the volunteers and staff who assist with the center's homebound meal program. The center serves over 38,000 meals a year to clients in the Seaford area. If you or someone you know needs meals or if you would like to volunteer, call 629-4939 for more information.