207 South Washington Box 433, Coldwater, Kansas 67029-0433

Phone: (620)582-2431 Fax: (620)582-2491

2009 H1N1 Flu (Swine Flu) and You

by Karen Oller, RN, CCHD

More than one million Americans are believed to have contracted the H1N1 (swine) flu since it emerged in March of this year. It is spreading from person-to-person worldwide and considered Pan-demic because it involves more than one continent. It is a new type of flu virus and is so widespread because no one has natural resistance against it.

The way this virus spreads is much the same way the seasonal flu spreads – through coughing or sneezing by people who have it. Sometimes folks have been infected by touching something with the virus on it and then touching their mouth or nose.

The symptoms of 2009 H1N1 flu virus in people include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people may also have vomiting and diarrhea. Note that this is a respiratory illness. There are other types of viruses out there like the “stomach flu” that should not be confused with H1N1. Also, we do not want to jump to the conclusion that every sneeze or cough is H1N1. There are a lot of allergies right now, as well as the common cold.

Fortunately, illness from this virus is usually mild and only lasts a few days; although in some cases severe disease and death can result. So far, most cases have occurred in children and young adults and some of those have needed hospitalization.

As with influenza virus, folks are encouraged to take the following steps to reduce spread:

*Wash your hands thoroughly with soap and warm water for 15-20 seconds or use an alcohol-based hand sanitizer to get rid of most germs and avoid touching your eyes, nose and mouth.

*Stay home when you are sick to avoid spreading illness to co-workers and friends.

*Cough or sneeze into a tissue, and properly dispose of used tissues. If you have no tissue, cover your face with your elbow.

*Stay healthy by eating a balanced diet, drinking plenty of water and getting adequate rest and exercise.

Who should get this new flu vaccine?

Eventually, everyone. Initially, however, the vaccine will be made available to folks in the following priority groups. These groups were identified based on who is most at risk for severe illness from the H1N1 virus:

*Pregnant women

*Household contacts and caregivers of infants younger than 6 months of age

*All children and young adults ages 6 month through 24 years

*Healthcare and emergency medical services (EMS) personnel

*People aged 25-64 years with certain high-risk medical conditions

I have had several people 65 and over that say “Oh, they don’t care about what happens to us – we’re old!”. No, it is just that the most affected people are the younger ones - actually 80% are under the age of 34.

Is the vaccine safe?

CDC (Centers of Disease Control) is taking vaccine safety very seriously and they reassure us that the it is safe. This vaccine is made by the same process and in the same facilities as the seasonal flu vaccine.

We have not received any H1N1 vaccine yet and when we do, it will be in small amounts for awhile.

When the health department does receive adequate vaccine , we will do mass immunizations at both the elementary and high school (grades 4-12). Consent forms will be sent out for each child to be signed by a parent/guardian and returned before shots are given. No one will be forced to be immunized; this will be the parent’s option. I am recommending an appointment be made at the Health Department for children in third grade and younger to get the shot; this group will be happier if a parent is with them.

In this Pandemic, we all must work together to help prevent the illness from spreading. It is important for you or your child stay home if you or they are not feeling well and have flu-like symptoms. We strongly recommend that no one returns to work or school for at least a full 24 hours after the fever is gone and without the use of a fever reducing medication.

The hospital, doctor’s offices, schools, daycares, pharmacy and health department are doing everything we can to stay on top of this. We all want to keep our county healthy.

Childhood Obesity

By Karen Oller, CCHD

Have you noticed not hearing or seeing many children outside playing like we use to, even on the nice days. Why? I do not think it is because they are quieter these days. Kids spend a lot more time in front of the TV, computer and video screens than they used to. As physical activity has decreased, body weight has increased in many cases.

Obesity in kids is now epidemic in the US. It’s true! Currently one in five children is overweight. Too many times we say “Oh, he is just carrying a little baby fat yet” or “she is just a little chunky” or “he is just husky”. So when is this extra weight considered a problem for the child? A child is obese if his weight is more than 20% higher than the ideal weight for a boy or girl of their age and height.

Like any parent, you want your child to grow up to be both healthy and happy. However, if that child has an unhealthy weight it can lead to some serious medical problems such as:

1. Type 2 Diabetes (this use to only occur in adults).

2. High blood pressure and cholesterol (this can put them at risk for heart disease).

3. Sleep apnea and breathing problems (in some cases this can lead to problems with learning and memory).

4. Bone conditions (such as hip problems).

5. Gastro-intestinal disease.

6. Early puberty.

7. Poor self esteem and depression.

Over weight adolescents have a 70% chance of becoming overweight or obese adults.

What causes childhood obesity? There are several causes and no doubt genetics does play a part. However, genes alone cannot account for the increase in rates over the past two decades. The main culprits are the same as those for adult obesity:

1. Not getting enough physical activity. Watching TV, playing video games and internet surfing can keep children from getting the exercise they need.

There are numerous things you can do with your child or encourage them to do such as walking, going for a hike and exploring, swimming, bike riding, dancing, sports, jumping rope, playing in the park etc. Playing is not only helpful, they can have lots of fun and fellowship!

2. Making unhealthy food choices. We need to stop the soda monster! Sodas and juice drinks are real monsters when it comes to weight gain. A soda every now and then is okay but it is not a substitute for healthier drinks. Water and low fat milk are best for your child. Juice and sports drinks should be limited. A small glass of 100% fruit juice each day is fine but that is all your child needs.

3. Eating giant-sized meals. Serving adult-sized meals, even of healthy foods provide more calories than kids need. It is easy to forget that they do not need to eat that much. Do not make them clean their plates. If they are still hungry following a meal, offer more fruits or vegetables.

Dieting is not the answer. Growing children need healthy food for strong bodies. They should not be put on a calorie-restricted diet. Instead, kids should be encouraged to play each day and eat healthy foods instead of junk foods. Taking them with you grocery shopping and letting them choose healthy foods that they could assist in preparing would be very helpful. Food should never be used as a reward or punishment.

Concerning milk, if a child is over the age of two, then it is a good idea to switch from whole milk to low fat milk. An easy way to make the switch is to do it gradually. You can start by using 2% reduced fat milk, then change to 1% low fat and finally try fat free (skim) milk. One percent and fat free milk have the same great taste and the same calcium and vitamins as whole milk, just less fat and fewer calories.

Some parents wonder if medications could help. None of the new medicines to treat obesity are approved for children or adolescents to use. They could affect their

growth and development or put them at risk of dangerous complications which could be far greater than any benefit they might have.

We live in a “quick fix” world. Weight comes on gradually and it takes time and patience for it to come off.

If your child is overweight, it is not just your child’s problem, but a problem the whole family must be involved in. Your child lives within your family environment. The most important role model your child will ever have is YOU. You cannot expect your child to change his or her habits if you do not set a good example. Be sure to involve grandparents and others in your child’s life, too.

Not all problems in our lives or our children’s lives can be solved, but this is one that can be. Little changes add up. Be consistent. Hang in there. Don’t give up.

Every Second Counts

By Karen Oller, RN

A stroke is serious business, every 53 seconds someone in the US has a stroke. Every 3.3 minutes someone dies from stroke. Stroke is the third leading cause of death and the number one cause of disabilities in adults.

There are other terms for a stroke such as CVA or “brain attack” but no matter what word you use, it means that an artery in the brain or leading to it (the carotids) becomes blocked or ruptures. When this happens, the flow of blood to a part of the brain abruptly stops or slows down. This can kill brain cells in the area within minutes to a few hours after the stroke starts. It is easily preventable if risk factors are addressed early. The “lets wait and see” attitude will not work in this case. Every second counts!

Risk Factors

There are some risks for stroke that no one can control:

Age is the greatest risk factor – it doubles with each decade of life.

Gender – men have more strokes, but women’s strokes are more likely to be fatal.

Family history.

Since these are out of our control we need to focus on the risks that are “controllable” – the ones we can change, treat, or at least modify.

1. High Blood Pressure (Hypertension)

A person is particularly at risk if they have an elevated blood pressure of over 140/90 persistently. This may increase the risk by six times because it damages the blood vessels and contributes to hardening of the arteries. So monitoring your blood pressure, maintaining a healthful weight, exercising regularly, taking prescription medicines as needed, and not smoking are very helpful practices. Smokers face eight times the risk.

2. Diabetes

About 20% of people who have had strokes have diabetes. The risk of this is far lower if blood sugars are closely monitored and kept below 130 with diet and/or medication.

3. TIA’s

People who have had TIA’s (light stroke or mini-stokes) are at very high risk for subsequent major strokes. There are medications for this and a surgical procedure (carotid endarectomy) in some cases. Usually a simple remedy is to take 1 aspirin daily, which lessens the occurrence by interfering with the blood’s ability to clot.

4. Heart Disease

About 15% of strokes occur in folks with a condition called atrial fibrillization (AF). This is an irregular beating of the upper chamber of the heart. This leads to uneven blood flow, which can sometimes cause blood clots. These clots may leave the heart and travel to the brain, and triggers a stroke. Aspirin and Coumadin (Warfarin) helps.

5. High Cholesterol

Too much cholesterol in the blood can cause atherosclerosis (a build up of fatty plaque in the artery wall). An artery with atherosclerosis may become blocked and result in a stroke. Diet, exercise and possible cholesterol lowering meds will help with this.

Warning signs:

A stroke or brain attack is a medical emergency. Know the warning signs and if you or a loved one experiencing any of these – call 911.

*Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body

* Sudden confusion, trouble speaking or understanding

* Sudden trouble seeing in one or both eyes

* Sudden trouble walking, dizziness, loss of balance or coordination

* Sudden severe headache with no known cause

Some people have only one or two signs: others have more.

There are new break throughs in the treatment of stroke – the earlier it is recognized, the earlier intervention can occur – the better prognosis.

A highly effective therapy is called TPA. It is available for treatment of strokes caused by a blockage. A CAT scan would be done prior to find the cause. TPA can reduce damage to the brain and increase the odds to a full recovery. Not everyone is a candidate for this method of treatment but many are. If this is done, it must be given within 3 hours after stroke symptoms start.

I know that experiencing a stroke or being with someone who is showing signs of one would be scary but the outcome really does not have to be devastating. The important thing is to recognize it for what it is and don’t delay getting proper and immediate help. Life depends on it. Truly, every second counts!

If you have any questions, feel free to call the Health Department at 582-2431. We care.

MRSA

Karen Oller RN, Admin.

Oh Mercy, it’s MRSA! If you have been listening to the news lately you’ve heard a lot about MRSA (Methicillin Resistant Staphylococcus Aureous). There has been a lot of expressed concern about this in our community and within the school so I thought I would try to clarify a few things.

Staphylococcus aureous is usually referred to as “staph”. It is a bacteria commonly carried on the skin and in the nose of healthy people, actually in about 25% to 30% of the population. Staph bacteria are one of the most common causes of skin infection in the U.S. Most skin infections are minor (such as pimples or boils) and can be treated without the use of antibiotics. However, some staph infections can cause serious infections. The problem arises if these serious staph infections are resistant to antibiotics. MRSA is a type of staph that is resistant to antibiotics.

The most serious staph infections, including MRSA, occur most frequently among persons in hospitals and healthcare facilities (such as nursing homes and dialysis centers) who have weakened immune systems. These healthcare-associated staph infections include surgical wound infections, urinary tract infections, bloodstream infections, and pneumonia.

Staph and MRSA can cause illness in folks outside of hospital and healthcare facilities. This is usually manifested as skin infections. These may look like a pimple or boil and can be red, swollen, painful, or have pus or other drainage. (Some MRSA lesions have been mistaken for brown spider bites)
These skin infections can spread by close skin to skin contact, openings in the skin such as cuts or abrasions, crowded living conditions and poor hygiene.

If you have MRSA, you can prevent spreading staph or MRSA skin infections to others by following these steps:

1. Cover you wound. Keep wounds that are draining or have pus covered with clean, dry bandages. Follow your healthcare provider’s instructions on proper care of the wound. Pus from infected wounds can contain staph and MRSA, so keeping the infection covered will help prevent the spread to others. Bandages or tape can be discarded with the regular trash.

2. Clean your hands. You, your family and others in close contact should wash their hands frequently with soap and warm water or use an alcohol-based hand sanitizer, especially after changing the bandage or touching the infected wound.

3. Do not share personal items. Avoid sharing personal items such as towels, washcloths, razors, clothing or uniforms that may have had contact with the infected wound or bandage. Wash sheets, towels, and clothes that become soiled with water and laundry detergent. Drying clothes in a hot dryer, rather than air-drying, also helps kill bacteria in clothes.

4. Any surfaces that may have come into contact with pus or drainage should be cleaned with a good disinfectant.

Locations where MRSA skin infections commonly occur are schools, dormitories, military barracks, correctional facilities and daycare centers.
Usually, it would not be necessary to close school or a daycare to “disinfect” when MRSA infections occur. A child with a MRSA infection would not have to be excluded from school or daycare as long as the infectious area is covered with a clean, dry bandage. However, a student would need to be excluded from sports activities where skin to skin contact is likely to occur and showering etc, until their infection is healed.
No one wants MRSA but being aware of it and knowing how it spreads can make us cautious and therefore more protected.

If you have questions about this or any other health matter, feel free to call us at the Comanche Co. Health Department, 582-2431. We care.

Nocturnal Leg Cramps

by Karen Oller, RN, CCHD

I have worked as a nurse in the health department for almost 13 years. During this course of time, many folks have asked me about leg cramps – particularly those that occur at night.

Nocturnal leg cramps (also referred to as “Charley Horses”) are involuntary muscle contractions that occur in the calves, soles of the feet, or other muscles in the body during the night. Sometimes they last only a few seconds and other times up to ten minutes. One thing for sure is that they are painful. Soreness in the muscle may remain for some time after the cramp ends. These cramps can affect folks in any age group, but mostly they occur in the middle-aged and older populations. As a matter of fact, studies show that about 70% of adults older than 50 experience leg cramps. The precise cause of these cramps is unclear. Contributing factors are believed to include dehydration or low levels of certain minerals (magnesium, potassium, calcium, and sodium). Less common causes include more serious conditions or certain drugs. Other contributing factors are thought to be related to overexertion of the muscles, structural disorders such as flat feet, standing on concrete, or prolonged sitting.

What can you do to prevent these cramps?

Drink six to eight glasses of water daily. This will help prevent dehydration, which may play a role in the cramping.
Stretch calves regularly throughout the day and at night (See below for more information.)

Ride a stationary bicycle for a few minutes before bedtime. This activity can help prevent cramps from developing during the night, especially if you do not get a lot of exercise during the day.

Keep blankets loose at the foot of the bed to prevent your toes and feet from pointing downward while you sleep.

Wear proper shoes.

Stretch your way to better sleep

Nocturnal muscle cramps can often be prevented by doing leg-stretching exercises, such as the one outlined below.
Stand 30 inches from the wall.
While keeping your heels on the floor, lean forward, put your hands on the wall, and slowly move your hands up the wall as far as you can reach comfortably.
Hold the stretched position for 30 seconds. Release.
Repeat steps 1 through 3 two more times.
For best results, practice this exercise in the morning, before supper, and before going to bed each night.

Calf cramps at night are considered to be “normal” during the early stages of pregnancy. These can be mild to incredibly painful. This is not fail-proof but a commonly accepted treatment is a starchy food stuff before bedtime such as oatmeal or rice. It could be helpful. One thing for sure, it wouldn’t hurt!

What can make leg cramps go away?

Stretch the affected leg straight out and point the toes upward. Folks report also that quickly standing up and walking a few steps is helpful and lessens the duration.

Take a hot shower or warm bath, or apply an ice massage to the cramped muscle.

Persistent or severe leg cramps are often treated with medication. Quinine used to be frequently prescribed and was found to be very effective, but it can have unpredictable adverse effects. In 1995, the US Food and Drug Administration banned the sale of all quinine-based over the counter preparations. However, there are other medications available that can be prescribed by your health care provider if really needed.

If you need more information on this or any other health matter, just call the Health Department at 582-2431.

We are here for you.

You Can Live With Heart Failure
By Karen Oller, RN, CCHD

Five million Americans live with “Heart Failure” (HF). You or someone you love may be in that number. The term “heart failure” sounds pretty scary – as if the heart has “failed” or has stopped beating. Basically, it means the heart isn’t pumping as well as it should; the heart’s muscle becomes weak. There are several things that may contribute to developing this condition:

Previous heart attack
High blood pressure
High cholesterol
Damage to heart valve
Diabetes
Obesity
Advanced age

HF symptoms are not always apparent. Some folks in the very early stages of Heart Failure may have no symptoms at all. Others dismiss feeling tired and getting winded with activities as signs of growing older.
Some heart disease symptoms are more obvious, including:

Shortness of breath
Swelling of the feet and legs
Lack of energy, feeling tired
Difficulty sleeping at night due to breathing problems
Cough with “frothy” sputum
Increased urination at night
Confusion, impaired memory

There is currently no known cure but there are available treatments which can help. The combination of medications can help you feel better, slow the progress of the disease, help keep you out of the hospital and help you live longer. The good news is that today doctors can do more than ever to manage Heart Failure. If you have this condition, you can play an active role in managing your condition yourself. Watch your diet, eating a low salt or low sodium diet helps keep your heart failure under control.

Weigh yourself every day. If you notice you have gained weight for 2 days in a row or if you gain 2 or more pounds in a one day, call your doctor.Exercise as you can tolerate. Be active but don’t overdo. If you have heart failure (also referred to as Congestive Heart Failure or CHF) – you are certainly not alone. This is a serious condition, however do not get discouraged – lots of folks can lead a full, enjoyable life when the condition is managed with the right medications and healthy lifestyles changes.

You can do it, too!

Early Detection Works!

By Karen Oller, RN, CCHD

October is National Breast Cancer Awareness Month. Therefore, this seems like the perfect time to remind every woman age 40 and up to get a clinical breast examination and mammogram if they have not had one in the last year. Breast cancer is very real. One out of every eight women will have breast cancer at some point in her life. Chances are you or someone you know will be touched by this. As a woman ages, so does her risk of developing breast cancer. Eighty percent of women who are diagnosed are 50 and older. Early detection saves lives and increases treatment options. When diagnosed in the earliest, localized stage, breast cancer patients have a survival rate of 98%. Isn’t that great!

The American Cancer Society recommends that women begin having annual mammograms at age 40. These simple breast x-rays are quite easy and safe. Often they can detect breast cancer as small as a grain of salt – up to two years before it could be felt.. Some cancers, however, are not easily detectable by mammogram and an annual clinical breast exam performed by a nurse, physician, or other health provider is recommended, also.

The Comanche County Health Department has funding that is available through a program called “Early Detection Works” to provide income-eligible women ages (40-64) free clinical breast exams and mammograms. The breast exams are done at the Health Department and the mammograms are done at the Comanche County Hospital or Pratt Regional Medical Center. We are fortunate for having Western Kansas mobile unit coming to the Comanche County Hospital almost every month to provide mammograms locally so women do not have to travel a distance to get the service they need.

Women age 40-64 with no health insurance and household incomes that don’t exceed the following guidelines are “eligible” for this program:

            Family Size                 Gross Annual Income             Gross Monthly Income

                    1                                 $23,925                                        $1,994

                    2                                 $32,075                                        $2,673

                    3                                 $40,225                                        $3,352

                    4                                $48,375                                        $4,031

                    5                                 $56,525                                        $4,710

                    6                                 $64,675                                        $5,390

                    7                                 $72,825                                        $6,069

                    8                                 $80,975                                        $6,748

Add $8,150 for each additional person within the household

As you can see, you do not need to be extremely low-income to qualify. Many women have already benefited from this service and we are hoping to reach more. Four women have been diagnosed with breast cancer thru this program right here in our county. If a woman is enrolled in the “Early Detection Works” and diagnosed with breast cancer then she can receive a Medicaid card which provides benefits for her health care needs as long as she is in treatment for cancer. Women across Kansas have received the care they need because of this Treatment Act which became effective in 2001. It is important to understand that treatment is available only to those women that have been enrolled and screened through EDW and have no insurance coverage. The reason this program does not include women 65 and over is because Medicare covers the cost of an annual mammogram for this age group.

Take care of yourself and take charge of your health. If you think you qualify, give us a call at 582-2431 and make an appointment. We want to help.

You may be a woman out there that has insurance and money but just neglected to get that breast exam or mammogram. If so, we urge you to contact your health provider and “get ‘er done”! Do not wait – your life may depend on it. Cancer waits for no one.