__MAIN_TEXT__

Page 1

12

2018

October 2018

HEALTH GUIDE

www.havredailynews.com


2

2018

October 2018

HEALTH GUIDE

2018

www.havredailynews.com

NMHC takes its patient portal into the mobile app world Pam Burke community@havredailynews.com Northern Montana Health Care’s patient portal that allows patients to interact with their health care remotely, including access some of their medical records, check appointment schedules and read lab results online, has upgraded to allow access with a new app for smart phones. “The app is new this year and that is a big plus for all of us that use smart phones,” Thora Beck, clinical analyst in information systems for the hospital, said. The patient portal allows enrolled patients, among other things, to see and print image reports as soon as they are filed and most lab results w i t h i n 3 6 h o u r s a f t e r t h ey c o m e through; discharge instructions and health summaries; allergies and conditions; immunization records; and medications and instructions, as well as view upcoming visits and send nonemergency messages to providers. Not all patient information is accessible through the patient portal, Beck said, because the committee overseeing the project has determined that some health issues are better handled

The app is new this year and that is a big plus for all of us that use smart phones. Thora Beck Clinical analyst in information systems Northern Montana Health Care

in person with a provider, such as lab results on STDs or cancer tests. “We are looking into making it so that there’s more out there,” Beck said, adding that they also are looking a t f u t u re c h a n ge s t h a t w i l l a l l ow patients to make appointments or pay their bill through the portal. The patient portal, which is a customizable feature of the hospital’s MediTech electronic medical records system, has been expanding in operation for about four years, said Beck, who has worked on the system from

■ See Patient portal Page 7

Havre Daily News/Gen Yamaguchi The MHealth smartphone app, with the online access page in the background, display two ways to access Northern Montana Health Care’s patient portal. The patient portal has been available for four years, but recently added the smartphone app option.

www.havredailynews.com Banner study leaders. “Most of them have been touched by the disease personally,” either by having a family member or close friend with it, she said. Langbaum’s 67-year-old mother, Ivy Segal, gave a DNA sample through a cheek swab and joined the registry in August. Her father was a patient at Banner and died of Alzheimer’s in 2011 at age 87. Watching him go from a mildmannered man whose smile could light up a room to what he was like when he died was devastating, she said. Being in GeneMatch doesn’t necessarily mean you’ll find out if you have the gene — folks with and without it may be contacted about various studies. But to be in one of the two prevention studies, people must agree to learn their APOE4 status and have at least one copy of the gene. Participants get periodic brain scans and memory and thinking tests every six months. They are given experimental drugs or placebo versions of them for several years. One study is enrolling people with two copies of the gene. They are given either shots every few months of a drug intended to help the immune system clear plaque from the brain or daily pills of a drug intended to prevent first steps of plaque formation, or placebo versions of these experimental treatments. The other study is in people who either have two copies of APOE4 or one copy of the gene plus evidence on brain scans of plaque starting to build. They will get one of two doses of the drug to prevent plaque formation or placebo pills. Larry Rebenack, 71, of the Phoenix suburb of Surpri se, A ri zona, j oi ned GeneMatch in August. “I have a lot of friends and acquaintances I’ve seen deteriorate,” including one who started blowing through stop signs on a route to a golf course they had safely traveled for years, and another who forgot not only where he had parked his car but even what kind of car it was, Rebenack said. “It’s a disease that takes a little part of you away each day.” Rebenack has decided to learn whether he has the gene if researchers give him the chance to find out. “It’s like any other piece of information. It helps you plan your life and you

HEALTH GUIDE

AP Photo/Matt York Principal Scientist Jessica Langbaum, right, and her mother, Ivy Segal, 67, go over procedures for Segal's gene testing Aug. 14 at Banner Alzheimers Institute in Phoenix. Banner is conducting two studies that target the very earliest brain changes while memory and thinking skills are still intact in hope of preventing the disease. owe it to all your loved ones, too.” —— Marilynn Marchione can be followed at @MMarchioneAP . —— The Associated Press Health & Science Department receives support from the H owa rd H u g h e s M e d i c a l I n s t i t u t e ’s Department of Science Education. The AP is solely responsible for all content.

October 2018

11


10

2018

October 2018

HEALTH GUIDE

2018

www.havredailynews.com

www.havredailynews.com

HEALTH GUIDE

October 2018

3

Studies in healthy older people aim to prevent Alzheimer’s Fencing with the flu: how to guard yourself this flu season By MARILYNN MARCHIONE AP Chief Medical Writer PHOENIX — It may be too late to stop Alzheimer’s in people who already have some mental decline. But what if a treatment could target the very earliest brain changes while memory and thinking skills are still intact, in hope of preventing the disease? Two big studies are going all out to try. Clinics throughout the United States and some other countries are signing up participants — the only studies of this type enrolling healthy older people. “The excitement in the Alzheimer’s field right now is prevention,” said Dr.

Eric Reiman, executive director of the Banner Alzheimer’s Institute in Phoenix, which is leading the work. Science so far has failed to find a drug that can alter the progression of Alzheimer’s, the most common form of dementia; 146 attempts have failed over the last decade, a recent industry report found. Even drugs that help remove the sticky plaques that clog the brains of people with the disease have not yet proved able to stave off mental decline. It may be that they were tried too late, like lowering cholesterol after someone has suffered a heart attack whose damage can’t be undone, Reiman said.

“What we have been learning, painfully, is that if we really want to come up with therapies that will modify the disease, we need to start very, very, very early,” said Dr. Eliezer Masliah, neuroscience chief at the National Institute on Aging. His agency is funding the prevention studies with the Alzheimer’s Association, several foundations, and Novartis and Amgen, makers of two experimental drugs being tested. The goal is to try to block the earliest steps of plaque formation in healthy people who show no symptoms of dementia but are at higher risk for it because of

age and a gene that makes it more likely. To participate, people must first join GeneMatch, a confidential registry of folks interested in volunteering for various Alzheimer’s studies who are ages 55 to 75 and have not been diagnosed with any mental decline. They are checked for the APOE4 gene, which doesn’t destine someone to develop Alzheimer’s but raises that risk. About one in four people have one copy of the gene and about 2 percent have two copies, one from each parent. More than 70,000 people have signed up since the registry began three years ago, said Jessica Langbaum, one of the

Stephen Real sbreal@havredailynews.com It’s that time of the year again — flu season — and here’s how people can protect themselves this season. The Center for Disease Control defines influenza as a respiratory illness that infects the nose, throat and sometimes the lungs. This is not to be confused with nausea or vomiting symptoms. “I think a lot of people, when they hear ‘I have the flu,’ the first thing we think about is nausea, vomiting and diarrhea,” said Desiree Norden, medical manager of Bullhook Community Health Center. “That’s actually not influenza. Influenza is a respiratory illness.” Who is at risk for contracting the flu? People with chronic diseases such as diabetes, heart and lung problems, asthma or kidney failure should get vaccinated said Ginny Heberly, a registered nurse and director of Infection Preve n t i o n fo r N o r t h e r n M o n ta n a Hospital. Heberly also recommends that children, pregnant women and people 65 years and older get vaccinated because they are among the high-risk category for influenza. Health-care workers or anyone who works with or cares for infants should also be vaccinated.

AP Photo/Matt York Larry Rebenack, 71, finishes his gene testing procedure Aug. 14 at Banner Alzheimers Institute in Phoenix. "I have a lot of friends and acquaintances I've seen deteriorate," including one who started blowing through stop signs on a route to a golf course they had safely traveled for years, and another who forgot not only where he had parked his car but even what kind of car it was, Rebenack said. "It's a disease that takes a little part of you away each day."

What makes the flu so deadly? “It’s the complications of the flu that are what’s so dangerous,” Hill County Health Department Director Kim Larson said. “If you already have asthma, and you get influenza and then it goes to pneumonia, you already have compromised lungs so that can lead to a serious situation.” Receiving the influenza vaccination can significantly reduce the risk of getting influenza, said Heberly. There are other ways people can help prevent themselves from getting influenza this season. Heberly said that people should avoid contact with people who are sick. If people are sick, the “CDC recommends staying home for at least 24 hours after your fever is gone without use of fever-reducing medicine.” People need to keep their hands away from their face, Heberly said, because flu germs enter the body through the eyes, nose and mouth. People should stay home when they’re sick and not go to work, Larson said. The health department has been educating employers on the importance of emphasizing the use of sick time for their employees his flu season.

■ See Flu Page 9

Havre Daily News/File photo A registered nuse administers a flu shot in the Hill County Health Department in 2014. Flu season is here and the Centers for Disease Control and Prevention says that receiving an influenza vaccination can significantly reduce the risk of getting the respiratory disease.


4

2018

October 2018

HEALTH GUIDE

2018

www.havredailynews.com

‘Living donor’ uses his medical history to teach students By KATHERINE HAFNER The Virginian-Pilot NORFOLK, Va. (AP) — Russ Clark’s favorite part of the ultrasound is when the medical students go for his gallbladder. His heart might not be in precisely the

right spot, but it’s there. Same with his liver. But his gallbladder? It was removed years ago, and the students can get confused searching for it. So “from a humorous point of view,”

that’s his favorite. It teaches them that as you age, organs can shrink, grow or move around a bit. “Most of them are just young people, and all their body parts are in the right place, and they look wonderful, just like

what the text(book) pictures show,” Clark said. “But when they get my age, then they’ve had things happen.” Clark, 73, has had plenty: a spine injury from jumping out of a plane during the Vietnam War, liver scarring, surgeries on

www.havredailynews.com phonates — deterioration of the jawbone and unusual leg fractures. No cases of either occurred, but the study wasn’t big enough to rule out this risk. Other results stood out: Fewer women in the drug group were found to have cancer — 84 versus 121 in the placebo group. However, the study was not designed to test for this, so other factors such as a family history of cancer may have influenced those numbers. Deaths and heart attacks also were fewer in the drug group, but the difference was so small it could have occurred by chance alone.

HEALTH GUIDE Still, doctors said these were encouraging signs also seen in some earlier research. “It now raises the question, should we be doing additional studies” to look for cancer and heart benefits from these drugs, said Dr. Michael Econs, an Indiana University professor who is president of the bone society. THE BOTTOM LINE Novartis supplied the drug but had no role in the study; a New Zealand government health agency sponsored it. Reid con-

sults for the company and other drugmakers. An IV infusion of generic Reclast costs $200 to $500, depending on insurance and other factors, several doctors said. Other bisphosphonates may give similar benefits “but we can’t be certain of that,” Reid said. The benefits also can’t be assumed to extend to women under 65 or to men, said Dr. Clifford J. Rosen of Maine Medical Center Research Institute and an editor at the medical journal. Gauging a patient’s risk and need for treatment should focus on age and previous

October 2018

9

broken bones, not just the bone mineral density score, Rosen said. But “if you’re at high risk and you’re going to be treated, this is the kind of therapy you probably should get,” he said. —— Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP —— The Associated Press Health & Science Department receives support from the H ow a r d H u g h e s M e d i c a l I n s t i t u t e ’s Department of Science Education. The AP is solely responsible for all content.

Flu: Larson: ‘Getting your flu shot doesn’t just protect you, it protects our community’ ■ Continued from page 3 Some people have the misconception that getting an influenza vaccination will give them the virus. Norden said that is not the case. “You might receive some symptoms,” Norden said. “You might get a slight fever, joint pain, body aches or even pain at the injection site, but these are just your body’s natural defense to something foreign being introduced to the body.” An alternative to the influenza shot is the nasal spray, which is being brought back this year after being removed from use last year. Larson said that last year’s research showed that the nasal spray

wasn’t as effective as doctors had hoped, but modifications have been made to the nasal spray this year to improve efficiency. Community members will want to check with their health clinic of choice to see if the nasal spray is being administered at that specific location, Larson said. Flu vaccinations are not limited at this time and each clinic places its own orders once supply has run out. People who contract the flu can receive an anti-viral medication that can help to reduce symptoms, Norden said, but anyone who suspected they have the

flu should wear a mask when going to their provider’s office. This simple action can help prevent spread of the flu virus. Flu season can start as early as October and go as late as May, but the usual decline is in March. Influenza A strain is more common in the fall and Influenza B is more common in February and March, Larson said. Larson said that last year for the state of Montana, 10,400 cases of influenza were reported last year and that number was “more severe than usual.” It is hard to make predictions, however, because the actual number is not known each

year — some people don’t go to the hospital and remain at home for the duration of the flu. “I think it’s important for people to understand that you getting your flu shot doesn’t just protect you, it protects our community,” Larson said, “and it protects those people within our community who can’t get it. People who are going through cancer treatments probably can’t get shots right now because of how low their immune system is. Children younger than six months of age can’t get a flu shot, so if you’re around them, you’re protecting them, too.”

Radiation: Beyea: EPA proposal represents voices generally dismissed by scientists ■ Continued from page 6

L. Todd Spencer/The Virginian-Pilot via AP Russ Clark has a ultrasound performed Sept. 20 by Felicia Toreno, associate professor and director of Ultrasound Education, and first-year medical students Chris Serle, center, and Chris Stocki, right, at Eastern Virginia Medical School in Norfolk, Va. Clark is available during some of the medical students’ classes at Eastern Virginia Medical School, so they can examine him, ask him about his medical history and work through problems.

online guidelines for radiation effects advised: “Current science suggests there is some cancer risk from any exposure to radiation.” “Even exposures below 100 millisieverts” — an amount roughly equivalent to 25 chest X-rays or about 14 CT chest scans — “slightly increase the risk of getting cancer in the future,” the agency’s guidance said. But that online guidance — separate from the rule-change proposal — was edited in July to add a section emphasizing the low individual odds of cancer: “According to radiation safety experts, radiation exposures of ... 100 millisieverts usually result in no harmful health effects because radiation below these levels is a minor contributor to our overall cancer risk,” the revised policy says. Calabrese and his supporters argue that smaller exposures of cell-damaging radiation and other carcinogens can serve as stressors that activate the body’s repair mechanisms and can make people healthier. They compare it to physical exercise or sunlight. Mainstream scientific consensus on radiation is based on deceptive science, says Calabrese, who argued in a 2014 essay for “righting the past deceptions and correcting the ongoing errors in environmental regulation.” EPA spokesman Konkus said in an email that the proposed rule change is about “increasing transparency on assumptions”

about how the body responds to different doses of dangerous substances and that the agency “acknowledges uncertainty regarding health effects at low doses” and supports more research on that. The radiation regulation is supported by Steven Milloy, a Trump transition team member for the EPA who is known for challenging widely accepted ideas about manmade climate change and the health risks of tobacco. He has been promoting Calabrese’s theory of healthy radiation on his blog. But Jan Beyea, a physicist whose work includes research with the National Academies of Science on the 2011 Fukushima nuclear power plant accident, said the EPA science proposal represents voices “generally dismissed by the great bulk of scientists.” The EPA proposal would lead to “increases in chemical and radiation exposures in the workplace, home and outdoor environment, including the vicinity of Superfund sites,” Beyea wrote. At the level the EPA website talks about, any one person’s risk of cancer from radiation exposure is perhaps 1 percent, Beyea said. “The individual risk will likely be low, but not the cumulative social risk,” Beyea said. “If they even look at that — no, no, no,” said Terrie Barrie, a resident of Craig, Colorado, and an advocate for her husband and other workers at the now-closed Rocky Flats nuclear-weapons plant, where the U.S.

government is compensating certain cancer victims regardless of their history of exposure. “There’s no reason not to protect people as much as possible,” said Barrie. U.S. agencies for decades have followed a policy that there is no threshold of radiation exposure that is risk-free. The National Council on Radiation Protection and Measurements reaffirmed that principle this year after a review of 29 public health studies on cancer rates among people exposed to low-dose radiation, via the U.S. atomic bombing of Japan in World War II, leak-prone Soviet nuclear installations, medical treatments and other sources. Twenty of the 29 studies directly support the principle that even low-dose exposures cause a significant increase in cancer rates, said Roy Shore, chief of research at the Radiation Effects Research Foundation, a joint project of the United States and Japan. Scientists found most of the other studies were inconclusive and decided one was flawed.

None supported the theory there is some safe threshold for radiation, said Shore, who chaired the review. If there were a threshold that it’s safe to go below, “those who profess that would have to come up with some data,” Shore said in an interview. “Certainly the evidence did not point that way,” he said. The U.S. Food and Drug Administration, which regulates electronic devices that emit radiation, advises, broadly, that a single CT scan with a dose of 10 millisieverts may increase risks of a fatal cancer by about 1 chance in 2,000. Supporters of the proposal say it’s time to rethink radiation regulation. “Right now we spend an enormous effort trying to minimize low doses” at nuclear power plants, for example, said Brant Ulsh, a physicist with the California-based consulting firm M.H. Chew and Associates. “Instead, let’s spend the resources on minimizing the effect of a really big event.”


8

2018

October 2018

HEALTH GUIDE

2018

www.havredailynews.com

Study suggests more older women may benefit from bone drugs By MARILYNN MARCHIONE AP Chief Medical Writer A bone-strengthening drug given by IV every 18 months greatly lowered the risk of fracture in certain older women, a large study found. The results suggest these medicines might help more people than those who get them now and can be used less often, too. Broken bones are a scourge of aging. A hip fracture can start a long decline that lands someone in a nursing home. The risk is most common in women after menopause. But who should use drugs called bisphosphonates is debatable. They’re recommended for people with severely brittle bones, called osteoporosis, but their value is less

clear for millions of others with moderate bone loss. Yet “that’s the group in whom 80 percent of fractures occur,” and the new results suggest they also may benefit from treatment, said Dr. Ian Reid of the University of Auckland in New Zealand. He led the study, reported Oct. 1 at an American Society for Bone and Mineral Research meeting in Montreal and published by the New England Journal of Medicine. ABOUT BONE LOSS Estrogen keeps bones strong; they weaken after menopause when levels of that hormone drop. It often gets worse after 65, and women of that age are advised to have a

bone mineral density scan — a low-dose X-ray to estimate bone strength. If osteoporosis is found, treatment usually is Fosamax, Boniva or generic versions of these drugs, which help prevent bone from being lost faster than the body is able to renew it. Some people don’t stick with the pills or endure digestive side effects, so the medicines also can be given by IV, usually once a year. However, concern about some rare side effects have limited their use, along with a lack of evidence that they might help before bone loss becomes severe.

THE NEW RESEARCH The study involved 2,000 women, average

age 71, with moderate bone loss. One quarter had previously had a fracture. They were assigned to get a Novartis drug, sold as Reclast in the United States and Aclasta elsewhere, or a placebo IV solution every 18 months. After six years, 122 women in the drug group had broken a bone versus 190 of those on placebo — a 37 percent lowered risk. The drug also cut in half the risk of a vertebral fracture, when bone compression causes part of the spine to collapse. For every 15 women like this treated for six years, one fracture was prevented — a ratio that some experts said makes treatment worth considering. Two rare problems are tied to bisphos-

AP Photo/Nam Y. Huh An elderly couple walks inside an assisted living facility in Illinois. According to a study released, Oct. 1, a bone-strengthening drug given intravenously every 18 months greatly lowered the risk of fracture in certain older women. The results suggest these drugs may benefit more people than those who get them now and that they remain effective when used less often.

www.havredailynews.com his eyes, heart, lungs and foot. More than a dozen cases, in all. At first glance, he could be mistaken for a professor at Eastern Virginia Medical School, roaming the halls in a white lab coat and wire-rimmed glasses, greeting students and faculty. But the coat he commissioned himself bears unofficial titles: LC/LD, Living Cadaver/Living Donor. Clark, a U.S. Navy veteran and retired educator, is a full-time volunteer who donates something unconventional: his life story, told through his medical history. He lets students ask him anything about his past — to get a real patient’s perspective — and use him as a test subject in the ultrasound room. “I love interacting with them and they like having me around,” he said. Clark was raised on a farm in Maine and moved to Norfolk during his 23 years in the Navy. He married, had four sons — he now has a dozen grandchildren — and spent another many years as a school administration consultant before retiring in the late ’90s due in part to health issues. Over the course of his many medical ordeals, Clark said he had mostly “excellent care” and started thinking about giving back. He couldn’t be an organ donor “because my organs aren’t good enough for that.” He was drawn instead to the idea of being a whole-body donor, allowing his body to go to scientific research after death. That brought him three years ago to the office of Craig Goodmurphy, vice chair and professor of anatomy and pathology at EVMS and director of its human anatomy and ultrasound programs. But Clark didn’t want to wait until he was dead, when he wouldn’t get to experience being a part of the medical education. His “natural question from that was, what else can I do before the time at which I’m going to lay across this table?” Goodmurphy said. The idea for a living donor was born, for medical students “to meet a real patient and ask somebody who is not necessarily medically educated himself to answer in a way that a patient would naturally answer.” Now, Clark’s medical cases are built into the first-year students’ curriculum. They read about each, hear Clark give a short presentation about himself and ask questions they wouldn’t be able to of a cadaver. “Your donors are revealing a lot to you, but what they can’t do is answer questions,” Clark told students at a recent lecture. It’s the subtle, personal stuff that he really brings to the table. For instance, Clark talks about the fear he had as a young Navy aircrewman after he had to bail out of a plane in Vietnam and his parachute didn’t fully open, leading to a spine fracture. “I was bruised up pretty good. I hit the

HEALTH GUIDE ground rather hard,” he told the class. “I did not want to see a doctor because I was scared of them telling me I was out of the Navy. ... I lived with that and I still live with it today.” His philosophy is no holds barred. In fact, it’s a rule for the students: Don’t be scared or embarrassed to ask anything. Clark certainly won’t be. He told about 150 students at a recent lecture that his spine injury still affects certain sexual positions with his wife. On a recent Thursday, Clark walked around the school’s anatomy lab as students worked on dissecting cadavers. He moved from table to table, answering questions. “I think it just makes it much more real,” said 23-year-old Jasmyn Brown, a first-year medical student, “instead of just (studying) a patient that doesn’t have a name.” They learn “things you wouldn’t have heard before but really do matter to people in their lives.” Students also practice ultrasound techniques on Clark. “Hold your breath for a couple seconds, please,” 24-year-old Chris Stocki instructed as he held a linear probe to Clark’s neck, looking to a grainy black and white image on the screen above. “That’s the jugular.” Carrie Elzie, associate professor of anatomy and pathology, said she’s seen the very nature of students’ questions shift as Clark gets more involved in the curriculum. “The questions are more centered around feelings — what could your doctors have done differently,” she said. “That’s a huge shift. I was astounded.” Anatomy is often thought of or portrayed as “being a place where we close off our humanity and we distance ourselves from emotion,” Goodmurphy said. He hopes to change that, starting with Clark. A couple other people from the

October 2018

5

L. Todd Spencer/The Virginian-Pilot via AP Russ Clark watches medical students Sept. 20 at Eastern Virginia Medical School in Norfolk, Va. Clark wanted to donate his body to science but he's still alive, so he decided to help by being a living donor. Clark is available during some of the medical student’s classes at Eastern Virginia Medical School, so they can examine him, ask him about his medical history and work through problems. community have since expressed interest as well. Patient stories are “hard for us to get. They’re contrived because of anonymity issues and HIPAA violation issues of sharing that,” Goodmurphy said. “But he’s opened that box up to us. ... Clearly he’s getting something from it, but I always feel like we’re just getting so much more.” Virginia has a centralized system that sends donor bodies to Richmond to be distributed, but Clark has a special setup and knows he’ll go to EVMS when he dies. Though he’s “not anxious to go too fast.” Students ask him if spending time in the anatomy lab around cadavers has made him think twice about donating his body, he said. He tells them, “No, it encourages me

more. The alternative is being put in the ground. Here, you’re allowing yourself to be the object of learning. I think that’s a marvelous thing.” —— Information from: The Virginian-Pilot, http://pilotonline.com/.


6

2018

October 2018

HEALTH GUIDE

2018

www.havredailynews.com

Experts say Trump’s EPA is moving to loosen radiation limits By ELLEN KNICKMEYER Associated Press WASHINGTON — The EPA is pursuing rule changes that experts say would weaken the way radiation exposure is regulated, turning to scientific outliers who argue that a bit of radiation damage is actually good for you — like a little bit of sunlight. The government’s current, decades-old guidance says that any exposure to harmful radiation is a cancer risk. And critics say the proposed change could lead to higher levels of exposure for workers at nuclear installations and oil and gas drilling sites, medical workers doing X-rays and CT scans, people living next to Superfund sites and any members of the public who one day might find themselves exposed to a radiation release. The Trump administration already has targeted a range of other regulations on toxins and pollutants, including coal power plant emissions and car exhaust, that it sees as costly and burdensome for businesses. Supporters of the EPA’s proposal argue the government’s current model that there is no safe level of radiation — the so-called linear no-threshold model — forces unnecessary spending for handling exposure in accidents, at nuclear plants, in medical centers and at other sites. At issue is Environmental Protection Agency’s proposed rule on transparency in science. EPA spokesman John Konkus said Tuesday: “The proposed regulation doesn’t talk about radiation or any particular chemicals. And as we indicated in our response, EPA’s policy is to continue to use the linear-

no-threshold model for population-level radiation protection purposes which would not, under the proposed regulation that has not been finalized, trigger any change in that policy.” But in an April news release announcing the proposed rule the agency quoted Edward Calabrese, a toxicologist at the University of Massachusetts who has said weakening limits on radiation exposure would save billions of dollars and have a positive impact on human health. The proposed rule would require regulators to consider “various threshold models across the exposure range” when it comes to dangerous substances. While it doesn’t specify radiation, the release quotes Calabrese calling the proposal “a major scientific step forward” in assessing the risk of “chemicals and radiation.” Konkus said the release was written during the tenure of former EPA Administrator Scott Pruitt. He could not explain why Calabrese was quoted citing the impact on radiation levels if the agency does not believe there would be any. Calabrese was to be the lead witness at a congressional hearing Wednesday on the EPA proposal. Radiation is everywhere, from potassium in bananas to the microwaves popping our popcorn. Most of it is benign. But what’s of concern is the higher-energy, shorter-wave radiation, like X-rays, that can penetrate and disrupt living cells, sometimes causing cancer. As recently as this March, the EPA’s

■ See Radiation Page 9

AP Photo/David Goldman, File A radiology technician looks Feb. 9 at a chest X-ray of a child suffering from flu symptoms at Upson Regional Medical Center in Thomaston, Ga. The Trump administration is quietly trying to weaken radiation rules, relying on scientific outliers who argue that a little radiation damage is actually good for you — like a little bit of sunlight.

www.havredailynews.com

HEALTH GUIDE

Patient portal: Patients encouraged to use portal ■ Continued from page 2 the start. it in to their provider. I t ’s b e e n n i c e fo r They can also self-enroll patients, she added, to for the patient portal by be able to get online on f i r s t p r ov i d i n g t h e i r a computer and print email address at their medications lists and p rov i d e r ’s a d m i s s i o n s labs when seeing anothdesk then going online er provider outside to http://www.nmhcare. Northern Montana org and accessing the Hospital’s provider netpatient portal page and work, and now the app follow instructions. The has expanded that p a t i e n t p o r ta l w i l l b e access and made it even accessed through their easier. smartphone or other “(The app) does the devices using the app whole state of Montana MediTech MHealth. Thora Beck — the places that use A portal inquiry line Clinical analyst in information systems MediTech — so it’s not and email also connects Northern Montana Health Care only our facility,” Beck sys t e m u s e rs to t h e said. “If you happen to i n fo r m a t i o n sys t e m s be at Benefis, you can people to get help using use that app for Benefis. You can use the portal, Beck said. People can send that app for Kalispell; they use the inquiries to portal@nmhcare.org, call same kind of EMR system as we do. 262-1450 or fax 262-1664. But that MHealth app is very nice “We highly encourage patients use because you can just click on it and go the portal because it gets all patients in and see everything very easily.” involved in their own health care,” N o r t h e r n M o n t a n a H e a l t h C a r e Beck said. “The more you know the patients can enroll by downloading the more you can take care of yourself forms off http://www.nmhcare.org, and-or better communicate with your filling out the paperwork and turning provider.”

We highly encourage patients use the portal because it gets all patients involved in their own health care.

October 2018

7


6

2018

October 2018

HEALTH GUIDE

2018

www.havredailynews.com

Experts say Trump’s EPA is moving to loosen radiation limits By ELLEN KNICKMEYER Associated Press WASHINGTON — The EPA is pursuing rule changes that experts say would weaken the way radiation exposure is regulated, turning to scientific outliers who argue that a bit of radiation damage is actually good for you — like a little bit of sunlight. The government’s current, decades-old guidance says that any exposure to harmful radiation is a cancer risk. And critics say the proposed change could lead to higher levels of exposure for workers at nuclear installations and oil and gas drilling sites, medical workers doing X-rays and CT scans, people living next to Superfund sites and any members of the public who one day might find themselves exposed to a radiation release. The Trump administration already has targeted a range of other regulations on toxins and pollutants, including coal power plant emissions and car exhaust, that it sees as costly and burdensome for businesses. Supporters of the EPA’s proposal argue the government’s current model that there is no safe level of radiation — the so-called linear no-threshold model — forces unnecessary spending for handling exposure in accidents, at nuclear plants, in medical centers and at other sites. At issue is Environmental Protection Agency’s proposed rule on transparency in science. EPA spokesman John Konkus said Tuesday: “The proposed regulation doesn’t talk about radiation or any particular chemicals. And as we indicated in our response, EPA’s policy is to continue to use the linear-

no-threshold model for population-level radiation protection purposes which would not, under the proposed regulation that has not been finalized, trigger any change in that policy.” But in an April news release announcing the proposed rule the agency quoted Edward Calabrese, a toxicologist at the University of Massachusetts who has said weakening limits on radiation exposure would save billions of dollars and have a positive impact on human health. The proposed rule would require regulators to consider “various threshold models across the exposure range” when it comes to dangerous substances. While it doesn’t specify radiation, the release quotes Calabrese calling the proposal “a major scientific step forward” in assessing the risk of “chemicals and radiation.” Konkus said the release was written during the tenure of former EPA Administrator Scott Pruitt. He could not explain why Calabrese was quoted citing the impact on radiation levels if the agency does not believe there would be any. Calabrese was to be the lead witness at a congressional hearing Wednesday on the EPA proposal. Radiation is everywhere, from potassium in bananas to the microwaves popping our popcorn. Most of it is benign. But what’s of concern is the higher-energy, shorter-wave radiation, like X-rays, that can penetrate and disrupt living cells, sometimes causing cancer. As recently as this March, the EPA’s

■ See Radiation Page 9

AP Photo/David Goldman, File A radiology technician looks Feb. 9 at a chest X-ray of a child suffering from flu symptoms at Upson Regional Medical Center in Thomaston, Ga. The Trump administration is quietly trying to weaken radiation rules, relying on scientific outliers who argue that a little radiation damage is actually good for you — like a little bit of sunlight.

www.havredailynews.com

HEALTH GUIDE

Patient portal: Patients encouraged to use portal ■ Continued from page 2 the start. it in to their provider. I t ’s b e e n n i c e fo r They can also self-enroll patients, she added, to for the patient portal by be able to get online on f i r s t p r ov i d i n g t h e i r a computer and print email address at their medications lists and p rov i d e r ’s a d m i s s i o n s labs when seeing anothdesk then going online er provider outside to http://www.nmhcare. Northern Montana org and accessing the Hospital’s provider netpatient portal page and work, and now the app follow instructions. The has expanded that p a t i e n t p o r ta l w i l l b e access and made it even accessed through their easier. smartphone or other “(The app) does the devices using the app whole state of Montana MediTech MHealth. Thora Beck — the places that use A portal inquiry line Clinical analyst in information systems MediTech — so it’s not and email also connects Northern Montana Health Care only our facility,” Beck sys t e m u s e rs to t h e said. “If you happen to i n fo r m a t i o n sys t e m s be at Benefis, you can people to get help using use that app for Benefis. You can use the portal, Beck said. People can send that app for Kalispell; they use the inquiries to portal@nmhcare.org, call same kind of EMR system as we do. 262-1450 or fax 262-1664. But that MHealth app is very nice “We highly encourage patients use because you can just click on it and go the portal because it gets all patients in and see everything very easily.” involved in their own health care,” N o r t h e r n M o n t a n a H e a l t h C a r e Beck said. “The more you know the patients can enroll by downloading the more you can take care of yourself forms off http://www.nmhcare.org, and-or better communicate with your filling out the paperwork and turning provider.”

We highly encourage patients use the portal because it gets all patients involved in their own health care.

October 2018

7


8

2018

October 2018

HEALTH GUIDE

2018

www.havredailynews.com

Study suggests more older women may benefit from bone drugs By MARILYNN MARCHIONE AP Chief Medical Writer A bone-strengthening drug given by IV every 18 months greatly lowered the risk of fracture in certain older women, a large study found. The results suggest these medicines might help more people than those who get them now and can be used less often, too. Broken bones are a scourge of aging. A hip fracture can start a long decline that lands someone in a nursing home. The risk is most common in women after menopause. But who should use drugs called bisphosphonates is debatable. They’re recommended for people with severely brittle bones, called osteoporosis, but their value is less

clear for millions of others with moderate bone loss. Yet “that’s the group in whom 80 percent of fractures occur,” and the new results suggest they also may benefit from treatment, said Dr. Ian Reid of the University of Auckland in New Zealand. He led the study, reported Oct. 1 at an American Society for Bone and Mineral Research meeting in Montreal and published by the New England Journal of Medicine. ABOUT BONE LOSS Estrogen keeps bones strong; they weaken after menopause when levels of that hormone drop. It often gets worse after 65, and women of that age are advised to have a

bone mineral density scan — a low-dose X-ray to estimate bone strength. If osteoporosis is found, treatment usually is Fosamax, Boniva or generic versions of these drugs, which help prevent bone from being lost faster than the body is able to renew it. Some people don’t stick with the pills or endure digestive side effects, so the medicines also can be given by IV, usually once a year. However, concern about some rare side effects have limited their use, along with a lack of evidence that they might help before bone loss becomes severe.

THE NEW RESEARCH The study involved 2,000 women, average

age 71, with moderate bone loss. One quarter had previously had a fracture. They were assigned to get a Novartis drug, sold as Reclast in the United States and Aclasta elsewhere, or a placebo IV solution every 18 months. After six years, 122 women in the drug group had broken a bone versus 190 of those on placebo — a 37 percent lowered risk. The drug also cut in half the risk of a vertebral fracture, when bone compression causes part of the spine to collapse. For every 15 women like this treated for six years, one fracture was prevented — a ratio that some experts said makes treatment worth considering. Two rare problems are tied to bisphos-

AP Photo/Nam Y. Huh An elderly couple walks inside an assisted living facility in Illinois. According to a study released, Oct. 1, a bone-strengthening drug given intravenously every 18 months greatly lowered the risk of fracture in certain older women. The results suggest these drugs may benefit more people than those who get them now and that they remain effective when used less often.

www.havredailynews.com his eyes, heart, lungs and foot. More than a dozen cases, in all. At first glance, he could be mistaken for a professor at Eastern Virginia Medical School, roaming the halls in a white lab coat and wire-rimmed glasses, greeting students and faculty. But the coat he commissioned himself bears unofficial titles: LC/LD, Living Cadaver/Living Donor. Clark, a U.S. Navy veteran and retired educator, is a full-time volunteer who donates something unconventional: his life story, told through his medical history. He lets students ask him anything about his past — to get a real patient’s perspective — and use him as a test subject in the ultrasound room. “I love interacting with them and they like having me around,” he said. Clark was raised on a farm in Maine and moved to Norfolk during his 23 years in the Navy. He married, had four sons — he now has a dozen grandchildren — and spent another many years as a school administration consultant before retiring in the late ’90s due in part to health issues. Over the course of his many medical ordeals, Clark said he had mostly “excellent care” and started thinking about giving back. He couldn’t be an organ donor “because my organs aren’t good enough for that.” He was drawn instead to the idea of being a whole-body donor, allowing his body to go to scientific research after death. That brought him three years ago to the office of Craig Goodmurphy, vice chair and professor of anatomy and pathology at EVMS and director of its human anatomy and ultrasound programs. But Clark didn’t want to wait until he was dead, when he wouldn’t get to experience being a part of the medical education. His “natural question from that was, what else can I do before the time at which I’m going to lay across this table?” Goodmurphy said. The idea for a living donor was born, for medical students “to meet a real patient and ask somebody who is not necessarily medically educated himself to answer in a way that a patient would naturally answer.” Now, Clark’s medical cases are built into the first-year students’ curriculum. They read about each, hear Clark give a short presentation about himself and ask questions they wouldn’t be able to of a cadaver. “Your donors are revealing a lot to you, but what they can’t do is answer questions,” Clark told students at a recent lecture. It’s the subtle, personal stuff that he really brings to the table. For instance, Clark talks about the fear he had as a young Navy aircrewman after he had to bail out of a plane in Vietnam and his parachute didn’t fully open, leading to a spine fracture. “I was bruised up pretty good. I hit the

HEALTH GUIDE ground rather hard,” he told the class. “I did not want to see a doctor because I was scared of them telling me I was out of the Navy. ... I lived with that and I still live with it today.” His philosophy is no holds barred. In fact, it’s a rule for the students: Don’t be scared or embarrassed to ask anything. Clark certainly won’t be. He told about 150 students at a recent lecture that his spine injury still affects certain sexual positions with his wife. On a recent Thursday, Clark walked around the school’s anatomy lab as students worked on dissecting cadavers. He moved from table to table, answering questions. “I think it just makes it much more real,” said 23-year-old Jasmyn Brown, a first-year medical student, “instead of just (studying) a patient that doesn’t have a name.” They learn “things you wouldn’t have heard before but really do matter to people in their lives.” Students also practice ultrasound techniques on Clark. “Hold your breath for a couple seconds, please,” 24-year-old Chris Stocki instructed as he held a linear probe to Clark’s neck, looking to a grainy black and white image on the screen above. “That’s the jugular.” Carrie Elzie, associate professor of anatomy and pathology, said she’s seen the very nature of students’ questions shift as Clark gets more involved in the curriculum. “The questions are more centered around feelings — what could your doctors have done differently,” she said. “That’s a huge shift. I was astounded.” Anatomy is often thought of or portrayed as “being a place where we close off our humanity and we distance ourselves from emotion,” Goodmurphy said. He hopes to change that, starting with Clark. A couple other people from the

October 2018

5

L. Todd Spencer/The Virginian-Pilot via AP Russ Clark watches medical students Sept. 20 at Eastern Virginia Medical School in Norfolk, Va. Clark wanted to donate his body to science but he's still alive, so he decided to help by being a living donor. Clark is available during some of the medical student’s classes at Eastern Virginia Medical School, so they can examine him, ask him about his medical history and work through problems. community have since expressed interest as well. Patient stories are “hard for us to get. They’re contrived because of anonymity issues and HIPAA violation issues of sharing that,” Goodmurphy said. “But he’s opened that box up to us. ... Clearly he’s getting something from it, but I always feel like we’re just getting so much more.” Virginia has a centralized system that sends donor bodies to Richmond to be distributed, but Clark has a special setup and knows he’ll go to EVMS when he dies. Though he’s “not anxious to go too fast.” Students ask him if spending time in the anatomy lab around cadavers has made him think twice about donating his body, he said. He tells them, “No, it encourages me

more. The alternative is being put in the ground. Here, you’re allowing yourself to be the object of learning. I think that’s a marvelous thing.” —— Information from: The Virginian-Pilot, http://pilotonline.com/.


4

2018

October 2018

HEALTH GUIDE

2018

www.havredailynews.com

‘Living donor’ uses his medical history to teach students By KATHERINE HAFNER The Virginian-Pilot NORFOLK, Va. (AP) — Russ Clark’s favorite part of the ultrasound is when the medical students go for his gallbladder. His heart might not be in precisely the

right spot, but it’s there. Same with his liver. But his gallbladder? It was removed years ago, and the students can get confused searching for it. So “from a humorous point of view,”

that’s his favorite. It teaches them that as you age, organs can shrink, grow or move around a bit. “Most of them are just young people, and all their body parts are in the right place, and they look wonderful, just like

what the text(book) pictures show,” Clark said. “But when they get my age, then they’ve had things happen.” Clark, 73, has had plenty: a spine injury from jumping out of a plane during the Vietnam War, liver scarring, surgeries on

www.havredailynews.com phonates — deterioration of the jawbone and unusual leg fractures. No cases of either occurred, but the study wasn’t big enough to rule out this risk. Other results stood out: Fewer women in the drug group were found to have cancer — 84 versus 121 in the placebo group. However, the study was not designed to test for this, so other factors such as a family history of cancer may have influenced those numbers. Deaths and heart attacks also were fewer in the drug group, but the difference was so small it could have occurred by chance alone.

HEALTH GUIDE Still, doctors said these were encouraging signs also seen in some earlier research. “It now raises the question, should we be doing additional studies” to look for cancer and heart benefits from these drugs, said Dr. Michael Econs, an Indiana University professor who is president of the bone society. THE BOTTOM LINE Novartis supplied the drug but had no role in the study; a New Zealand government health agency sponsored it. Reid con-

sults for the company and other drugmakers. An IV infusion of generic Reclast costs $200 to $500, depending on insurance and other factors, several doctors said. Other bisphosphonates may give similar benefits “but we can’t be certain of that,” Reid said. The benefits also can’t be assumed to extend to women under 65 or to men, said Dr. Clifford J. Rosen of Maine Medical Center Research Institute and an editor at the medical journal. Gauging a patient’s risk and need for treatment should focus on age and previous

October 2018

9

broken bones, not just the bone mineral density score, Rosen said. But “if you’re at high risk and you’re going to be treated, this is the kind of therapy you probably should get,” he said. —— Marilynn Marchione can be followed at http://twitter.com/MMarchioneAP —— The Associated Press Health & Science Department receives support from the H ow a r d H u g h e s M e d i c a l I n s t i t u t e ’s Department of Science Education. The AP is solely responsible for all content.

Flu: Larson: ‘Getting your flu shot doesn’t just protect you, it protects our community’ ■ Continued from page 3 Some people have the misconception that getting an influenza vaccination will give them the virus. Norden said that is not the case. “You might receive some symptoms,” Norden said. “You might get a slight fever, joint pain, body aches or even pain at the injection site, but these are just your body’s natural defense to something foreign being introduced to the body.” An alternative to the influenza shot is the nasal spray, which is being brought back this year after being removed from use last year. Larson said that last year’s research showed that the nasal spray

wasn’t as effective as doctors had hoped, but modifications have been made to the nasal spray this year to improve efficiency. Community members will want to check with their health clinic of choice to see if the nasal spray is being administered at that specific location, Larson said. Flu vaccinations are not limited at this time and each clinic places its own orders once supply has run out. People who contract the flu can receive an anti-viral medication that can help to reduce symptoms, Norden said, but anyone who suspected they have the

flu should wear a mask when going to their provider’s office. This simple action can help prevent spread of the flu virus. Flu season can start as early as October and go as late as May, but the usual decline is in March. Influenza A strain is more common in the fall and Influenza B is more common in February and March, Larson said. Larson said that last year for the state of Montana, 10,400 cases of influenza were reported last year and that number was “more severe than usual.” It is hard to make predictions, however, because the actual number is not known each

year — some people don’t go to the hospital and remain at home for the duration of the flu. “I think it’s important for people to understand that you getting your flu shot doesn’t just protect you, it protects our community,” Larson said, “and it protects those people within our community who can’t get it. People who are going through cancer treatments probably can’t get shots right now because of how low their immune system is. Children younger than six months of age can’t get a flu shot, so if you’re around them, you’re protecting them, too.”

Radiation: Beyea: EPA proposal represents voices generally dismissed by scientists ■ Continued from page 6

L. Todd Spencer/The Virginian-Pilot via AP Russ Clark has a ultrasound performed Sept. 20 by Felicia Toreno, associate professor and director of Ultrasound Education, and first-year medical students Chris Serle, center, and Chris Stocki, right, at Eastern Virginia Medical School in Norfolk, Va. Clark is available during some of the medical students’ classes at Eastern Virginia Medical School, so they can examine him, ask him about his medical history and work through problems.

online guidelines for radiation effects advised: “Current science suggests there is some cancer risk from any exposure to radiation.” “Even exposures below 100 millisieverts” — an amount roughly equivalent to 25 chest X-rays or about 14 CT chest scans — “slightly increase the risk of getting cancer in the future,” the agency’s guidance said. But that online guidance — separate from the rule-change proposal — was edited in July to add a section emphasizing the low individual odds of cancer: “According to radiation safety experts, radiation exposures of ... 100 millisieverts usually result in no harmful health effects because radiation below these levels is a minor contributor to our overall cancer risk,” the revised policy says. Calabrese and his supporters argue that smaller exposures of cell-damaging radiation and other carcinogens can serve as stressors that activate the body’s repair mechanisms and can make people healthier. They compare it to physical exercise or sunlight. Mainstream scientific consensus on radiation is based on deceptive science, says Calabrese, who argued in a 2014 essay for “righting the past deceptions and correcting the ongoing errors in environmental regulation.” EPA spokesman Konkus said in an email that the proposed rule change is about “increasing transparency on assumptions”

about how the body responds to different doses of dangerous substances and that the agency “acknowledges uncertainty regarding health effects at low doses” and supports more research on that. The radiation regulation is supported by Steven Milloy, a Trump transition team member for the EPA who is known for challenging widely accepted ideas about manmade climate change and the health risks of tobacco. He has been promoting Calabrese’s theory of healthy radiation on his blog. But Jan Beyea, a physicist whose work includes research with the National Academies of Science on the 2011 Fukushima nuclear power plant accident, said the EPA science proposal represents voices “generally dismissed by the great bulk of scientists.” The EPA proposal would lead to “increases in chemical and radiation exposures in the workplace, home and outdoor environment, including the vicinity of Superfund sites,” Beyea wrote. At the level the EPA website talks about, any one person’s risk of cancer from radiation exposure is perhaps 1 percent, Beyea said. “The individual risk will likely be low, but not the cumulative social risk,” Beyea said. “If they even look at that — no, no, no,” said Terrie Barrie, a resident of Craig, Colorado, and an advocate for her husband and other workers at the now-closed Rocky Flats nuclear-weapons plant, where the U.S.

government is compensating certain cancer victims regardless of their history of exposure. “There’s no reason not to protect people as much as possible,” said Barrie. U.S. agencies for decades have followed a policy that there is no threshold of radiation exposure that is risk-free. The National Council on Radiation Protection and Measurements reaffirmed that principle this year after a review of 29 public health studies on cancer rates among people exposed to low-dose radiation, via the U.S. atomic bombing of Japan in World War II, leak-prone Soviet nuclear installations, medical treatments and other sources. Twenty of the 29 studies directly support the principle that even low-dose exposures cause a significant increase in cancer rates, said Roy Shore, chief of research at the Radiation Effects Research Foundation, a joint project of the United States and Japan. Scientists found most of the other studies were inconclusive and decided one was flawed.

None supported the theory there is some safe threshold for radiation, said Shore, who chaired the review. If there were a threshold that it’s safe to go below, “those who profess that would have to come up with some data,” Shore said in an interview. “Certainly the evidence did not point that way,” he said. The U.S. Food and Drug Administration, which regulates electronic devices that emit radiation, advises, broadly, that a single CT scan with a dose of 10 millisieverts may increase risks of a fatal cancer by about 1 chance in 2,000. Supporters of the proposal say it’s time to rethink radiation regulation. “Right now we spend an enormous effort trying to minimize low doses” at nuclear power plants, for example, said Brant Ulsh, a physicist with the California-based consulting firm M.H. Chew and Associates. “Instead, let’s spend the resources on minimizing the effect of a really big event.”


10

2018

October 2018

HEALTH GUIDE

2018

www.havredailynews.com

www.havredailynews.com

HEALTH GUIDE

October 2018

3

Studies in healthy older people aim to prevent Alzheimer’s Fencing with the flu: how to guard yourself this flu season By MARILYNN MARCHIONE AP Chief Medical Writer PHOENIX — It may be too late to stop Alzheimer’s in people who already have some mental decline. But what if a treatment could target the very earliest brain changes while memory and thinking skills are still intact, in hope of preventing the disease? Two big studies are going all out to try. Clinics throughout the United States and some other countries are signing up participants — the only studies of this type enrolling healthy older people. “The excitement in the Alzheimer’s field right now is prevention,” said Dr.

Eric Reiman, executive director of the Banner Alzheimer’s Institute in Phoenix, which is leading the work. Science so far has failed to find a drug that can alter the progression of Alzheimer’s, the most common form of dementia; 146 attempts have failed over the last decade, a recent industry report found. Even drugs that help remove the sticky plaques that clog the brains of people with the disease have not yet proved able to stave off mental decline. It may be that they were tried too late, like lowering cholesterol after someone has suffered a heart attack whose damage can’t be undone, Reiman said.

“What we have been learning, painfully, is that if we really want to come up with therapies that will modify the disease, we need to start very, very, very early,” said Dr. Eliezer Masliah, neuroscience chief at the National Institute on Aging. His agency is funding the prevention studies with the Alzheimer’s Association, several foundations, and Novartis and Amgen, makers of two experimental drugs being tested. The goal is to try to block the earliest steps of plaque formation in healthy people who show no symptoms of dementia but are at higher risk for it because of

age and a gene that makes it more likely. To participate, people must first join GeneMatch, a confidential registry of folks interested in volunteering for various Alzheimer’s studies who are ages 55 to 75 and have not been diagnosed with any mental decline. They are checked for the APOE4 gene, which doesn’t destine someone to develop Alzheimer’s but raises that risk. About one in four people have one copy of the gene and about 2 percent have two copies, one from each parent. More than 70,000 people have signed up since the registry began three years ago, said Jessica Langbaum, one of the

Stephen Real sbreal@havredailynews.com It’s that time of the year again — flu season — and here’s how people can protect themselves this season. The Center for Disease Control defines influenza as a respiratory illness that infects the nose, throat and sometimes the lungs. This is not to be confused with nausea or vomiting symptoms. “I think a lot of people, when they hear ‘I have the flu,’ the first thing we think about is nausea, vomiting and diarrhea,” said Desiree Norden, medical manager of Bullhook Community Health Center. “That’s actually not influenza. Influenza is a respiratory illness.” Who is at risk for contracting the flu? People with chronic diseases such as diabetes, heart and lung problems, asthma or kidney failure should get vaccinated said Ginny Heberly, a registered nurse and director of Infection Preve n t i o n fo r N o r t h e r n M o n ta n a Hospital. Heberly also recommends that children, pregnant women and people 65 years and older get vaccinated because they are among the high-risk category for influenza. Health-care workers or anyone who works with or cares for infants should also be vaccinated.

AP Photo/Matt York Larry Rebenack, 71, finishes his gene testing procedure Aug. 14 at Banner Alzheimers Institute in Phoenix. "I have a lot of friends and acquaintances I've seen deteriorate," including one who started blowing through stop signs on a route to a golf course they had safely traveled for years, and another who forgot not only where he had parked his car but even what kind of car it was, Rebenack said. "It's a disease that takes a little part of you away each day."

What makes the flu so deadly? “It’s the complications of the flu that are what’s so dangerous,” Hill County Health Department Director Kim Larson said. “If you already have asthma, and you get influenza and then it goes to pneumonia, you already have compromised lungs so that can lead to a serious situation.” Receiving the influenza vaccination can significantly reduce the risk of getting influenza, said Heberly. There are other ways people can help prevent themselves from getting influenza this season. Heberly said that people should avoid contact with people who are sick. If people are sick, the “CDC recommends staying home for at least 24 hours after your fever is gone without use of fever-reducing medicine.” People need to keep their hands away from their face, Heberly said, because flu germs enter the body through the eyes, nose and mouth. People should stay home when they’re sick and not go to work, Larson said. The health department has been educating employers on the importance of emphasizing the use of sick time for their employees his flu season.

■ See Flu Page 9

Havre Daily News/File photo A registered nuse administers a flu shot in the Hill County Health Department in 2014. Flu season is here and the Centers for Disease Control and Prevention says that receiving an influenza vaccination can significantly reduce the risk of getting the respiratory disease.


2

2018

October 2018

HEALTH GUIDE

2018

www.havredailynews.com

NMHC takes its patient portal into the mobile app world Pam Burke community@havredailynews.com Northern Montana Health Care’s patient portal that allows patients to interact with their health care remotely, including access some of their medical records, check appointment schedules and read lab results online, has upgraded to allow access with a new app for smart phones. “The app is new this year and that is a big plus for all of us that use smart phones,” Thora Beck, clinical analyst in information systems for the hospital, said. The patient portal allows enrolled patients, among other things, to see and print image reports as soon as they are filed and most lab results w i t h i n 3 6 h o u r s a f t e r t h ey c o m e through; discharge instructions and health summaries; allergies and conditions; immunization records; and medications and instructions, as well as view upcoming visits and send nonemergency messages to providers. Not all patient information is accessible through the patient portal, Beck said, because the committee overseeing the project has determined that some health issues are better handled

The app is new this year and that is a big plus for all of us that use smart phones. Thora Beck Clinical analyst in information systems Northern Montana Health Care

in person with a provider, such as lab results on STDs or cancer tests. “We are looking into making it so that there’s more out there,” Beck said, adding that they also are looking a t f u t u re c h a n ge s t h a t w i l l a l l ow patients to make appointments or pay their bill through the portal. The patient portal, which is a customizable feature of the hospital’s MediTech electronic medical records system, has been expanding in operation for about four years, said Beck, who has worked on the system from

■ See Patient portal Page 7

Havre Daily News/Gen Yamaguchi The MHealth smartphone app, with the online access page in the background, display two ways to access Northern Montana Health Care’s patient portal. The patient portal has been available for four years, but recently added the smartphone app option.

www.havredailynews.com Banner study leaders. “Most of them have been touched by the disease personally,” either by having a family member or close friend with it, she said. Langbaum’s 67-year-old mother, Ivy Segal, gave a DNA sample through a cheek swab and joined the registry in August. Her father was a patient at Banner and died of Alzheimer’s in 2011 at age 87. Watching him go from a mildmannered man whose smile could light up a room to what he was like when he died was devastating, she said. Being in GeneMatch doesn’t necessarily mean you’ll find out if you have the gene — folks with and without it may be contacted about various studies. But to be in one of the two prevention studies, people must agree to learn their APOE4 status and have at least one copy of the gene. Participants get periodic brain scans and memory and thinking tests every six months. They are given experimental drugs or placebo versions of them for several years. One study is enrolling people with two copies of the gene. They are given either shots every few months of a drug intended to help the immune system clear plaque from the brain or daily pills of a drug intended to prevent first steps of plaque formation, or placebo versions of these experimental treatments. The other study is in people who either have two copies of APOE4 or one copy of the gene plus evidence on brain scans of plaque starting to build. They will get one of two doses of the drug to prevent plaque formation or placebo pills. Larry Rebenack, 71, of the Phoenix suburb of Surpri se, A ri zona, j oi ned GeneMatch in August. “I have a lot of friends and acquaintances I’ve seen deteriorate,” including one who started blowing through stop signs on a route to a golf course they had safely traveled for years, and another who forgot not only where he had parked his car but even what kind of car it was, Rebenack said. “It’s a disease that takes a little part of you away each day.” Rebenack has decided to learn whether he has the gene if researchers give him the chance to find out. “It’s like any other piece of information. It helps you plan your life and you

HEALTH GUIDE

AP Photo/Matt York Principal Scientist Jessica Langbaum, right, and her mother, Ivy Segal, 67, go over procedures for Segal's gene testing Aug. 14 at Banner Alzheimers Institute in Phoenix. Banner is conducting two studies that target the very earliest brain changes while memory and thinking skills are still intact in hope of preventing the disease. owe it to all your loved ones, too.” —— Marilynn Marchione can be followed at @MMarchioneAP . —— The Associated Press Health & Science Department receives support from the H owa rd H u g h e s M e d i c a l I n s t i t u t e ’s Department of Science Education. The AP is solely responsible for all content.

October 2018

11


12

2018

October 2018

HEALTH GUIDE

www.havredailynews.com

Profile for Havre Daily News

Health Guide 2018  

Health Guide 2018  

Profile for havrenews
Advertisement