Thursday, June 21, 2007
Improvements have been made in making diagnoses

By Dr. Anthony Policastro

As I celebrate my 35th anniversary as a pediatrician, I also plan to move back into doing pediatrics again. I will be retiring from Nanticoke Memorial Hospital on July 1. Sometime this summer I will move to expand my developmental practice in the local community. I have spent the last two articles going over the changes that have occurred in both infectious diseases and pediatric treatments over the last 35 years. There have been changes in the way we make diagnoses as well. X-ray techniques that we now take for granted were not always there. I saw my first movie on CT scans when I was an intern. Now pretty much everybody knows what a CT scan is. There were no such things as MRI machines. There were certainly not differences between open and closed MRI machines. PET scans were not even thought of. Ultrasound equipment was not available for looking at pregnancies. It was not of much value for other things as well. The result of this was that it was much more difficult to diagnose things. Even more importantly, it was more difficult to prove that things were not present. For example, we could not do a CT scan after someone had head trauma. It was hard to judge which patients had serious injuries and which did not. Ultrasound of the heart is called an echocardiogram. Those did not exist. If we had a child with heart disease, we would have the stethoscope to listen with. We would have a Chest X-ray to tell us if the heart was large. We would have an EKG to tell us if there were electrical problems. However, the way to tell what the heart structure looked like was to do a heart catheterization. That had many more complications than an echocardiogram. Lab tests have changed as well. There are many new tests. There are many more complex tests. A good example of this is the measurement of chromosomes. At one time, we could check the total number of chromosomes that a patient had. That was of limited value. Now we can check the size. We can check the structure. We check how fragile the chromosomes are. This has led to finding the cause of some genetic disorders. It has led to the discovery of new genetic disorders. As a medical student, I used to do many lab tests by hand on my patients. These are all automated now. For example, when a blood stream infection is suspected, a blood culture needs to be done. In the past it had to be checked every 24 hours to see if there were bacteria growing. Now the checking is done automatically. There is an alarm that goes off when bacterial growth is present. We have learned how to control pain better. Sedation for painful procedures has become much more refined. We now use novocaine for circumcisions. It was not that way in the past. We also can sedate patients for more complex procedures. The sedatives that we use act rapidly. They wear off quickly. In the past, it would take time for them to work. They would last for hours. That increased the chance of complications just from the sedation. Making a diagnosis in pediatrics has become easier to do. It has become more accurate. It has caused less anxiety for the patients. We can expect continued advances in all these areas in the future.

Nanticoke Memorial Hospital offers Stroke Support group
Nanticoke Memorial Hospital announces the start of a Stroke Support Group. The support group is designed for individuals who have survived a stroke as well as their families and caregivers. Modeled from the American Stroke Association, the hospital is engaging with speakers to provide education, community resources and emotional support to those who have been affected by this life-altering event. The first meeting will be held on June 29 at Nanticoke Cancer Care Center, from 1:30 - 3:30 p.m. Monthly meetings will be held the third Thursday of each month. The two-hour support group meetings will consist of guest speakers and breakaway sessions, in which caregivers and stroke survivors will meet in two groups to discuss concerns, provide support and networking. Refreshments will be provided. Sheila Brant and Joan Burditt, Occupational Therapists at Nanticoke Memorial Hospital, will facilitate the support group meetings. Pre-registration is not required for this free support group. For additional information contact Nanticoke Memorial Hospital at 629-6611, ext. 5121.

Beebe to offer bone, balance tests
Beebe Medical Center will offer bone density screenings, as well as Berg Balance and Fall Risk Assessments, Tuesday, July 10, at the CHEER Center in Georgetown on Sand Hill Road. Bone density screening will be done from 9 a.m. to 11 a.m. and Berg Balance and Fall Risk Assessment will be done from 9 a.m. to 2 p.m. No appointments are necessary for the non-invasive bone density screenings, which take just a few minutes. A nurse will interpret the results. The screenings will help to identify osteoporosis, a serious health concern that can lead to bone fractures that can cause disability and even death. Appointments for the balance test are required. They can be made by telephoning Marie Berntsen, RN, at 645-3623. Physical therapist Roseanne Schneider will carry out the individual, 15-minute, balance tests. She also will be available to discuss findings. The balance and fall risk assessment can identify people who are statistically at risk of experiencing a fall. Patients who have a high risk for a fall will be provided with documentation of their score and will be strongly encouraged to discuss it with their primary care physician.

Safe Sitter classes to be at NMH
Safe Sitter classes for girls and boys aged 11 to 13 will be offered at Nanticoke Memorial Hospital, Seaford, from 9 a.m. to 3 p.m. on Monday and Wednesday, July 25 and 27. A second course will be held Aug. 7 and 9. Cost for the classes is $50. Participants are to bring a bag lunch. To register your son or daughter or your child's babysitter, call 629-6611 ext. 2540. The Safe Sitter program is a medically-accurate instructional series that teaches youngsters how to handle emergencies when caring for younger children. The goal of Safe Sitter is to reduce the number of accidental and preventable deaths among children being cared for by babysitters. Thousands of young adolescents across the country have been trained by Safe Sitter to handle life-threatening emergencies. All medical information will be taught by a certified professional. During the course, students get hands-on practice in basic life-saving techniques so they are prepared to act in a crisis. Instructors also provide tips to make sitters more confident caregivers. For more information about Safe Sitter, contact Nanticoke Memorial Hospital at 629-6611 extension 2540.

Leadership nominations open
Nanticoke Memorial Hospital is seeking nominations for its third annual Tributes For Healthcare Leadership Recognition Dinner, scheduled for Nov. 1, at Heritage Shores Clubhouse in Bridgeville. The Founders award will be presented to an individual who has made significant contributions in furthering the mission of the hospital to improve the health status of our communities. The Leadership in Philanthropy Award is presented to an individual or a group who has made support of Nanticoke Memorial Hospital and community health a philanthropic priority in their lives. The Physicians Hall of Fame will recognize physician(s) who have served Nanticoke Memorial and the community with distinction and selflessness. Please direct questions to Renee Morris, 629-6611, ext. 2404.