Thursday, May 17, 2007
Rx cards can save you

By Anthony Policastro, M.D

I take three prescription medicines on a regular basis. I also take three over the counter medications on a regular basis. I know the dose of all these medications. However, if I were involved in an accident or had something happened that impaired my ability to remember them, it would do me no good to know them. Therefore, I have them written on a card. It is in my wallet. It allows health care workers to find it. It allows me to give it to them so they can read it. This kind of thing prevents medication errors. It helps prevent errors of not getting the drug. Every drug is listed. That way one will not be forgotten. It prevents errors of the wrong dose. If the dose is written down, it serves to help check the correct dose that I tell them. It helps prevent drug interactions. Many drugs interact with each other. In order to avoid that, it is necessary for the prescriber to know exactly what drugs you already take. Another place to think about keeping the drug lists for all family members is on the refrigerator. You can list everyone's medication. You can put it in a zip lock bag. You can hold it in place with a magnet. Ambulance personnel are trained to look in this location for the lists. You need to make sure they are clearly labeled with the name of the individual. A good idea is to also record the chronic medical problems that you have. You should have allergies recorded as well. You should list recent surgical procedures as well. In emergencies, the time that is saved can be very important. My medication card lists the fact that I react to wheat and exercise the way some people react to bee stings. Having that information could get me the injection that I need much more quickly.

Hospitals announce tobacco-free decision

By Ann Wilmer

Hospital officials at Nanticoke Health Services and two other local medical centers are taking steps to improve your health by making all three campuses tobacco-free starting July 1. Hospital officials acknowledge that the transition will be difficult for smokers but doctors, volunteers and many visitors to the hospital have greeted the decision enthusiastically. Most people recognize that smoking is an unhealthy life choice and many who smoke, want to quit. "We hope to persuade not just our employees but also patients and their families [not to smoke]," said Doug Connell, president and CEO of Nanticoke Health Services. Already they are helping in-patients by using nicotine patches to curb the urge to light up. Nanticoke's in-patient program has been in effect for a while through the respiratory department. Attending physicians can write an order for nicotine replacement patches for their patients who smoke to help them stay away from tobacco while hospitalized. Annette Hall-Barnes, MSN, APRN-BC, director of occupational health, is directing the effort to help employees to kick the habit. "Tobacco use is the largest cause of preventable death in the U.S.," she said. Older Americans are among those who are disproportionately affected by tobacco-related deaths because many of them started smoking as teenagers and may have smoked for 50 years or more before the overwhelming evidence of the dangers of smoking prompted them to quit. Second-hand smoke has done damage to many elderly individuals who never smoked but were exposed to it at work or at home. And older Americans are much more likely to die or suffer serious injury in tobacco-related fires. The Center for Social Gerontology, says that the primary victims of the disease and death caused by smoking and secondhand smoke in the U.S. are older adults. Over 94 percent of the annual tobacco-related deaths involve persons aged 50 and over, and 70 percent involve persons aged 65 and over. But most state tobacco-settlement funding initiatives have been targeted a keeping young people from starting. The American Lung Association of Delaware has advocated raising the excise tax on tobacco products because studies show a direct correlation between the price of cigarettes and the number of youth who buy them. Increasing the price, by increasing the excise tax, can decrease use. But since we know that even heavy smokers see health benefits if they stop smoking, it makes sense to mount a broader effort to reduce the number of smokers with programs aimed directly at workplace populations. By making the ban include the entire campus, particularly at a hospital, the message reaches all age groups. Hospital officials from Peninsula Regional Medical Center and Beebe Medical Center who also unveiled plans to rid their campuses of tobacco at a press conference in Salisbury recently said that tobacco use is the cause of many illnesses that they treat but, as Tom Brown, public relations director at Nanticoke Health Systems said, "We don't want your business."

"Based on national statistics, we know that most tobacco users want to quit and that work site policies can help them to accomplish this goal. If it were easy, everyone would quit. That's why we wanted to put some things in place for those who want to stop smoking," Hall-Barnes said. Since the tobacco settlement in 1999, state health officials, alarmed at cancer rates in the First State, began a program to encourage smoke-free workplace initiatives to help the 35 percent of Delawareans who smoked to kick the habit. About one-quarter of state residents still smoke. Still, the reduction represents significant progress. Nanticoke Health Services are providing options to those who want to quit - either one-on-one counseling or group support programs. Nanticoke's employee health insurance offers tobacco-cessation benefits. The campaign has been in the planning for some time. Smoking cessation classes - American Cancer Society's (ASC) "Fresh Start" program involve four one-hour sessions. Several members of the Nanticoke staff have completed the ACS training and will start offering the program to employees in June. "We would like to extend some of these programs to the community," said Hall-Barnes. Both the Delaware and Maryland Quit Line programs offer one-on-one counseling to smokers who want to stop smoking. Telephone counselors with the Delaware Quit line are also ACS-trained. Some members of the community who don't work for the hospital will also have to make adjustments to accommodate the new policy. Tina Reaser, composition manager at Morning Star Publications, which rents office space from Nanticoke Health Systems, is one of them. Reaser is one of the five out of 14 employees at the firm who smokes. Reaser started smoking when she was 12. "Mom told me it didn't look ladylike," she said. But her Mom smoked, so the admonition not to start was ineffective. "I thought she was the epitome of womanhood," she said. "When I get stressed, I run out the door and grab a cigarette," said Reaser." She and her mother, who also works for Morning Star, go outside and walk to the end of the office complex. "I guess I'm going to cross the street now. I really would like to quit," she admitted. Reaser also has a home-based business that teaches people weight management. "I'm trying to teach people how to get healthy, and here I am smoking," she said. Like many smokers Reaser admits trying unsuccessfully to quit. That only adds to her stress "because I've tried to quit and cannot. Obviously, stopping smoking is a goal for my future but I've not set a date." She talked to her doctor about it and he has urged her to take one step at a time. He prescribed something to help her reduce her body's response to stress. He told her that when she noticed reduced stress levels, they would talk about getting rid of her cigarettes. She has learned that nicotine is a common form of self-medication for people whose work (or life) is stressful. This is a factor that often defeats a smoker's efforts to kick the habit. At her fast-paced job, she said she feels disorganized as she tries to juggle many different assignments. She joked, "I'm still not organized but now I don't care," revealing another coping method she employs: humor! In the next breath she claims she doesn't know how long it's been since she's seen the top of her desk, something many people whose jobs involve multiple projects know all about. Restrictions on smoking at work are not new. Delaware Gov. Ruth Ann Miner signed the most stringent statewide smoking ban in the country into effect November 27, 2002, which banned smoking in restaurants, bars and casinos as well as offices when legislators responded to the state's tobacco-related cancer death rate, the third highest in the country. Smoking is also banned in all places of business in Maryland. Other illnesses that are caused or exacerbated by tobacco use include emphysema and coronary heart disease. According to the Tobacco-Related Disease Research Program, at the University of California at Santa Barbara, the effects of smoking on the cardiovascular system include an acute increase in blood pressure and decrease in oxygen delivery. Smoking is a strong risk factor in cardiovascular diseases that include arrhythmia, hypertension, myocardial infarction, stroke and ischemic heart disease. Both smokers as well as non-smokers who are exposed to secondhand smoke are at increased risk of cardiac disease.
Tips on quitting
  • Don't try to go it alone. Tell your friends and ask for support.
  • Destroy all your cigarettes.
  • Substitute positive behaviors, such as nibbling on carrot or celery sticks or even chewing sugar-free gum when trying to quit smoking.
  • Avoid coffee, sugar and alcohol as these stimulate the desire to smoke.
  • Drink lots of water to flush the nicotine and other poisons out of your system.
  • When the urge strikes, do deep-breathing exercises to reduce stress.
  • For more tips on quitting go to