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Infusion services


i n fusi o n report... vol 8, issue 1 • Summer 2013

PURPLE p o w e r The ARJ team is proud, honored and excited to be celebrating our 13th year anniversary in business, providing home infusion pharmacy, nursing and reimbursement services. ARJ Infusion Services continues to grow with purpose and commitment to the patients we are privileged to serve and deliver our unique and caring service. Summer has arrived! Spring has been a challenging array of weather extremes this season in many areas of the country. Our thoughts and prayers are with all the people suffering from catastrophic loss, due to severe weather conditions. The color purple has become popular and described as a color that makes the statement of adventure and intrigue. In 2000, companies were not advertising purple as the company color. At that time purple was not a standard color pantone for printing companies, it was a custom order. I believed purple was a color of strength, passion and royalty. “ARJ Purple” captures and defines our commitment to provide the best standard of care for each patient and family throughout their home infusion experience. The people of ARJ are passionate about the opportunity to provide healthcare services to the communities we serve. ARJ is still here, with the same Owner, and the passionate commitment to give each patient the Royal treatment. I want to recognize the staff of professionals I am privileged to work with at ARJ Infusion Services. We recently received our required 3 year reaccreditation from Community Health Accreditation Program (CHAP) and I am proud of the entire team for their past and present performance to achieve excellence in patient care and services. ARJ Infusion Services once again demonstrated our commitment to patient care and met nationally recognized standards of care. Thank you all for choosing our TEAM to provide care and service. One last note, my mom, Mary Frances Martin, retired from ARJ in February. It is difficult to describe what a blessing it is to have such an extraordinary, beautiful and caring mother. I thank her for working with me and helping build ARJ from the very beginning. I thank her for her 13 years of service, half of which she never took a paycheck. She volunteered (and still does) hundreds of hours for the patient disease state organizations, so close to our hearts. Thank you Mom! Wishing all a Safe and Fun Summer,


inside... FEATURED ARTICLES preventing overheating this summer free at last brand name vs generic prescriptions healthy viens FOR YOUR INFORMATION employee spotlight bulletin board since you asked kids corner captain clot beckers books and much more...

If you would like to receive THE I n fus io n report... by email, please contact or call toll free 866.451.8804 please look for us on facebook for up to date information and events


Employee Spotli g ht...

i n fusi o n report...


How long have you been with ARJ? 3 years. What are your Hobbies and Interests? I love watching sports (any and all) and I play lots of tennis throughout the year. I really enjoy hunting and fishing, and spend much of my time outdoors. I also love to travel – both in the US and internationally. What was your first job? I mowed lawns, and also worked selling power tools and hardware for an eBay business when I was in high school. My first “real job” was at Cerner Corporation in Kansas City after my college graduation. I worked on a technical support team for an EMR application. Who or what inspires you? My parents have always been a big inspiration for me. I hope that I am as successful as they have been in raising a family.

What are your favorites? Movie: Grand Torino Book: The Kite Runner Color: Burnt Orange Food/Foods: Mom’s Cooking: homemade chicken and dumplings Restaurant: the original Z-Man from Oklahoma Joe’s Ice Cream Flavor: Vanilla            What School did you graduate from (High School and/or College)? Lee’s Summit North High School The University of Texas at Austin, Hook ‘em Horns!


PHARMACIST IN ST. LOUIS, MO Keri Henry, PharmD PHARMACIST IN LENEXA Mallory Hoy, PharmD FULL TIME INFUSION NURSES Sarah Meier, RN Laurie Rupe, RN Cordie Conley, RN Sue Sevedge, RN PRN INFUSION NURSE Sheri Bosch, RN Anna Ewbank, RN Lori Wilkerson, RN Abbi Chapman, RN HUMAN RESOURCES GENERALIST Jennifer Cary

since you asked... QUESTION: I have Common Variable Immune Deficiency (CVID) and would like to join a public swim club. Will this put me at a higher risk for bacterial infections? ANSWER: Not only is swimming a great form of exercise, but it’s also a refreshing escape from the heat. There really is not a definitive answer to this question as it all depends on the details. Each patient with a primary immunodeficiency disease is unique. How the disease affects the body’s various systems and the patient’s

WE ALSO WOULD LIKE TO CELEBRATE THE PROMOTIONS OF ARJ TEAM MEMBERS. Andy Copeland has been promoted to VICE-PRESIDENT/GENERAL MANAGER Debralee Mick has been promoted to ARJ’s BUSINESS OFFICE MANAGER. Vanessa Sidwell is ARJ’s new PATIENT SERVICES TEAM LEADER. Congratulations to Kathy Logan for completing her certification as a CERTIFIED REGISTERED NURSE INFUSION, CRNI!

general health will determine whether someone is at greater risk for bacterial infections. Patients should ask their treating physicians if they have a recommendation regarding this. Another important factor to consider is whether your public swim club has adequate pool sanitation. Proper sanitation not only keeps the water clear, but is imperative in preventing the transmission of infectious diseases. Filtering pool water, adding chlorine, salt, and other disinfectants will usually control harmful germs. You can always inquire about the sanitation process and details. This, along with your physician’s recommendation should help you make an informed decision about whether joining is right for you.

vol 8, issue 1 • Summer 2013

PREVENTING o v e r h e a t i n g this summer By Katie Grigg When temperatures climb into the 90s we begin to think and feel HOT! Dangers of overheating include heat cramps, heat syncope, heat exhaustion and heatstroke. These conditions can become serious and even lifethreatening. Research shows that as we get older our bodies have a much harder time handling extreme heat. Symptoms of overheating may include: • • • • • • • • • •

Sudden dizziness Thirst Headache Nausea Muscle spasms Cramps in the abdomen, arms, or legs Fatigue Swelling in the ankles Lack of coordination Cold, clammy skin

If the following symptoms occur, seek emergency medical care: • • • • • • • • • •

High body temperature (over 104°) Confusion Changes in behavior Fainting or feeling of fainting Staggering Strong, rapid pulse; or slow, weak pulse Dry skin Flushed skin Lack of sweating despite the heat Coma

To protect your health, when the thermometer rises, remember to use your head and keep cool. The best defense against heat-related illnesses is prevention. LISTED BELOW ARE SOME KEY RULES FOR COPING WITH THE HEAT: LISTEN TO THE WEATHER FORECAST. Know when it’s too hot to go out. STAY IN TO STAY COOL. Air conditioning is best for beating the heat. Fans do not prevent heat-related illness. Cover windows in direct heat by pulling the curtains or closing the blinds. COOL OFF WITH WATER. Take a cool shower or bath as an effective way to cool down. When on an outing take along a hand-held spray bottle filled with water. WEAR APPROPRIATE CLOTHING. Choose lightweight, light-colored, loose fitting clothing and grab a widebrimmed hat or umbrella when going outside. Also helpful are commercial cooling garments such as vests, headbands and neck bands.

USE SUNSCREEN. Select SPF 15 or higher when outdoors, and don’t forget to reapply according to package directions. SCHEDULE OUTDOOR ACTIVITIES WISELY. Pick the cooler times of the day, usually early morning or evening. Rest frequently in a shady area. DRINK PLENTY OF FLUIDS. Increase your water intake. People 65 years of age and older have a decreased ability of responding to external temperature changes. Avoid caffeinated drinks as they are diuretics and cause you to lose fluid. If exercising, drink fruit juice or sports beverages to replace salt and minerals in your body. However, stay away from very cold drinks as they can cause stomach cramps. CHECK MEDICATIONS FOR SUN SENSITIVITY. Some medications require avoiding the sun as they can cause skin inflammation. Be aware that certain medical conditions, including autoimmune diseases can aggravate a multitude of symptoms. Increased fatigue, weakness and visual disturbances are just a few. Make simple changes by staying out of the heat, wear appropriate clothing, increase your intake of water and check medications for sun sensitivity. Help your body be stress-free in the heat. Stay safe and have a cool summer! Resources:


i n fusi o n report...

ki d s corner... reci p es BREAKFAST BANANA


Peel banana and cover in peanut butter, roll banana in rice krispies. Slice into bite size pieces or eat on a popsicle stick!

2 BANANAS GREEK YOGURT CRUSHED ALMONDS CINNAMON • Line a tray with parchment paper. • Mix the Greek yogurt and cinnamon together. • Peel the bananas. • Cut off an end off from each banana, then insert the popsicle sticks. • Coat the bananas in Greek yogurt and almonds. • Lay the bananas on the parchment paper and freeze for 45-55 minutes. The bananas will be creamy, yet firm, but not completely frozen.


INSTRUCTIONS: Flatten the bag and cut off the handle and the bottom part. Basically this makes a rectangle. Cut along both sides to split into 2 plastic sheets – only use one side of the plastic. From the center of the plastic sheet, fold it like a tiny balloon to make the head-part of the jelly- fish and tie it with the thread – not too tight. You must leave a little hole in order to pour some water in the head part. Now you’ll have the head balloon part and the remaining will be its tentacles. Cut from the edge up to the head part roughly. You’ll get about 8-10 tentacles. For each of them, cut again into 3-4 small strings – and cut off the remaining part. Trim to make random long and short tentacles.


Under the faucet, add water into the head-part to allow it to sink, but you must leave some air inside to make the jellyfish able to float.


Fill up your plastic bottle with water. Put your jellyfish in the bottle with a few drops of blue food coloring. Screw on the cap tightly. Turn the bottle upside down and watch the jellyfish move! For picture illustrations go to Search for ‘jellyfish’ and click on the caption on how to make your own jellyfish.

Captain lotin:&squirrelly! arjie in: squirrelly! Captain Clot & aC rjie AA














vol 8, issue 1 • Summer 2013

b i c y c le Safety 1. Always wear a properly fitted bicycle helmet to protect your head – every time you ride. 2. Use a bicycle that is the appropriate size for you, not one that is too big. 3. Before you ride make sure you don’t have any loose clothing, drawstrings, or shoelaces; they can get caught in your chain and make you fall. 4. Have an adult check the air in your tires and that your brakes are working before you ride. 5. Wear bright clothes so others can see you at all times of the day. 6. Stay alert at all times; never listen to music when riding. Pay attention and watch for cars, people and other bicyclists around you. 7. Don’t bicycle at night. If you must ride, make sure your bike has reflectors and lights, and wear retro-reflective materials on your ankles, wrists, back and helmet. 8. Before you enter any street or intersection check for traffic by looking left-right-left to make sure no cars or trucks are there. 9. Learn and follow the rules of the road.

Free At Last! by John Carleton

I still remember sitting in emergency rooms for hours waiting on doctors and nurses to treat one of my many injuries. In their defense, my persona in our comic strips of Captain Clot being an accident prone and unthinking daredevil is not far from the truth. I was almost always a victim of my own doing. Those stories are numerous and best left for another day. On one of my visits to the ER, a male nurse came up to me and point blank asked why I was not infusing at home. I recall sitting in stunned silence, not the norm for me, at the idea that I could! I don’t remember what connection the nurse had to hemophilia, but he informed me that any bleeder worth his salt was taking care of most bleeds at home. With the help of my HTC I immediately began the training for self infusion. I have not been in an emergency room since! I still look back on that experience as a gift from God. There are many reasons to learn self infusion. Probably the first in my mind is the fact that my accidents, yes… I still do stupid things, are treated immediately. The damage to joints and tissue is minimized by the rapid response. The hours involved in getting to the ER, waiting for factor to arrive, educating the staff, getting infused, and


RULES OF THE ROAD 1. When riding in the road, always ride on the right hand side (same direction as traffic). 2. Obey traffic laws, including all the traffic signs and signals. 3. Ride predictably—ride in a straight line, don’t weave in and out of traffic. 4. When riding on a sidewalk—show respect for the people walking on the sidewalk. Always pass pedestrians on the left. 5. Look for debris on your route that could cause you to fall off your bicycle, like trash, stones, or toys.


completing the paperwork is painful to say the least. Most hospitals don’t stock or even know about factor or bleeding disorders. By the time the infusion takes place, the bleed has continued and the situation has worsened by the minute. Second, I take care of my infusion in the comfort of my home. If I need assistance, my wife is trained to help. Although she doesn’t like needles and sticking me, she can do the job when needed. The longer we have been married it does seem the more eager she is to stick me. It appears revenge can be a strong motivator! Third, for me there is a real confidence factor in knowing that I am truly free of dependence on others. I can travel and participate in most activities of my choice. As I have grown older I have become more selective and minimized the number of accident-related infusions also. If something happens, I have my infusion equipment at home and carry my travel bag when on the road. If you’re reading this, you have another good reason to home infuse. Our specialized and highly capable team of nurses can train you at home. All of them are trained to deal with patients of every age. And, if you run into a problem, our nursing team is always available to take your phone call. In closing, there is no time like the present to learn self infusion. Whether you are infusing yourself or a loved one, it is the right thing to do for all of the above reasons. Give your nurse a call and commit to becoming FREE!


i n fusi o n report...

bulletin board... CONGRATULATIONS Outstanding Swimming Instructor Award for the Kansas Recreation and Park Association Sharon C. of Derby, KS. Judy and Joel F. of Ness City, KS on the arrival of your new baby boy, Silas. Jessie and Tracie T. of Andover, KS on the arrival of your new baby girl. Carmen M. of Dodge City, KS on your new baby boy. Summer M. of Lincoln, NE on your new baby boy. Saul and Mayra E. of Wichita, KS on your new baby girl. Heather and Jeremy of Derby, KS on new baby boy. Dakota R. of Belton, MO on Graduation from High School. Joseph G. of Edwardsville, IL for being awarded one of two certificates in the CSL “Getting In the Game” golf competition in TX.

ready, set, read ...

Congrats Alex H. of El Dorado, KS on graduating high school. Congrats Austin H. of St. Louis, MO on graduating high school.

DADDY ROCKS AWARD Mark S. of North Newton, KS Nathan M. of Springfield, MO MOMMY ROCKS AWARD Melissa P. of Moline, IL Linda W. of Eldorado Springs, MO Emily S. of North Newton, KS Dawn M. of Springfield, MO Cornisha H. of Coralville, IA

MIXING FACTOR AWARD Jared L. of Blue Springs, MO BRAVERY AWARD McAger T. of Derby, KS FIRST STICK AWARD Joseph C. of Independence, MO Terrance W. of East St. Louis, IL Hannah S. of Wichita, KS Zachary R. of Rayville, MO Adam R. of Viola, KS

At ARJ Infusion, we feel the Becker’s Book program provided for our patients is a vital resource. We encourage reading by sending birthday books and books in shipments to patients ages twelve and younger. If you would like more information about this program or would like to donate books, please contact Patient Services at 1.866.451.8804.

HOW TO PROOF READ A PRESCRIPT ION and PRESCRIPT ION ABBREV IAT ION CHART All of us at one time or another had prescription medications to manage. Important aspects of your medication are necessary for you to verify and question every time your medicine is filled by the pharmacy.

• Is your name correct on both the prescription and the medicine bottle? • Is the name of the medication correct? • When refilling a prescription, do the tablets/liquid look the same as those you previously had? • Are the instructions clear?

Looking at the slip of paper the doctor hands you as a prescription often appears as if it is written in a foreign language. It is! Doctors and pharmacists communicate in Latin. With the help of this mini-dictionary, you can decipher their dialogue and feel comfortable that you and the doctor communicated correctly.

vol 8, issue 1 • Summer 2013


v s generic prescriptions By Keri Henry, BSP Pharm D

Have you ever wondered why when you pick up your order at the pharmacy one medication costs $50 and the other costs $10? More than likely, you get a brand name drug and a generic drug. A brand name medication is a new drug developed by a pharmaceutical company and approved by the FDA to be on the market. The “brand name” of a new medication is a name given to it by the company to catch people’s attention and is easy to remember. However, even “brand name” medications have a scientific name that will eventually be referred to as it “generic name”. For example, Benadryl is a brand name over-thecounter medication. Its scientific name or generic name is diphenhydramine. Once a drug is approved, the FDA issues the pharmaceutical company a patent on the new medication. Patents may last up to 20 years for certain medications. There are several factors that influence the lapsing of a patent, however, and so not all patents last the full 20 years. Once a brand name medications patent has expired, generic equivalents can now enter the market. Either the same pharmaceutical company can manufacture a generic or any another pharmaceutical company now has the opportunity to develop a generic equivalent and also put it on the market. A generic drug has to have the same active ingredient of the brand name medication that was on the market. It also has to be the same dosage form (tablet, capsule, liquid) and the same strength (10 mg, 20 mg). However, other ingredients in the medication, such as fillers and dyes, may be different from company to company. The difference in inactive ingredients is why some people can take LATIN


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ac before meals bid twice a day gt drop hs at bedtime od right eye os left eye po by mouth pc after meals prn needed q3h every 3 hours qd every day qid 4 times a day tid 3 times a day

one generic and may have another generic of the same medication not agree with them. So, as we all know, brand name drugs cost quite a bit more than generic drugs. This is because brand name drugs require a lot of research, time and expense to be developed. For generic drugs, a lot less time and money are needed since the background work has already been done for the brand name medication. Your insurance company determines what you pay for your medications. Your plan usually has different tiers based on the cost of the medication. Generics are usually in the bottom tier and will cost you the least amount of money. Some insurance companies are now requiring their participants to use generic medications first, and if that doesn’t work, then your doctor can request that you need a brand-name medication. Pharmacies have contracts with wholesalers and will stock products from different manufacturers of a generic medication from pharmacy to pharmacy, and may even get different manufactures from order to order. This is why some months your medication may be orange and the next month it is blue. Check with your pharmacist if you notice any difference in your medication. If you have a preference of brand versus generic medications, let your pharmacist know and they can make a note in your profile. Generic equivalents of a brand name medication work just as well for most people and are worth trying first and saving several dollars. However, your doctor knows your complete medical history and will make the best decision for you. For more information about brand-name versus generic medications, and to see if your brand-name drug has a generic, you can go to References: QuestionsAnswers/ucm100100.htm Generic and Brand Name Drugs: Understanding the Basics. 2007.



i n fusi o n report...

veins By Edie Williamson, MSN, RN

Healthy veins are pliable and elastic. They usually have plenty of leeway to move within the surrounding tissue allowing body movement and injury avoidance. As we grow older, these defenses falter. The vein walls become more friable and skin bruising is common. With aging, venipuncture is more likely to result in vein rupture and bruising because the tissues are now too lax to contain the spread of blood adequately. While poor vein care while we are younger does not speed up these natural changes, it does make life more difficult by causing vein walls to harden or veins to thrombose as they clog up with old clots.

PROMOTING VEIN HEALTH There are several factors that can contribute to promoting healthy veins. Veni-puncture technique is important; a controlled, smooth and continuous movement should be used when withdrawing a needle from the vein. No pressure should be placed over the puncture site during withdrawal. This is because pressure over the moving needle within the vein may damage its wall or even strip the lining, making early repeat veni-puncture impossible. Gentle pressure should be applied immediately once the needle is clear of the skin and maintained for at least five minutes to prevent bruising. The development of healthy veins is further aided by the development of good supporting muscles. That is why it is important to exercise regularly to tone your muscles and improve vein strength and your circulation. The repeated squeezing of a rubber ball or the regular use of a gripper exerciser are simple ways of achieving this. Cardiovascular exercises such as walking, running and cycling are also especially effective. As with any exercise, it is important

to consult your physician before starting a new regimen. Another way to promote vein health is by maintaining a diet that is low in salt and rich in fiber foods. Too much salt can lead to water retention and swelling causing pressure on veins. Constipation can also contribute to poor vein health. Include fiber in your diet to help promote regularity. Include foods like whole grains containing bio-flavonoids, such as dark fruits and berries, leafy greens, onions and garlic – these nutrients help keep veins healthy. The final note on promoting healthy veins is the importance of hydration. It has been noted that 50-75 percent of Americans are chronically dehydrated. While some water is available in the food we eat, the majority of water we need on a regular basis must be provided by drinking water. The consumption of tea, coffee, or soft drinks should never be considered water intake. Many of these drinks are so acidic that they end up pulling more water from the cells in order to help neutralize the acidity-making dehydration even worse. Water is necessary to take nutrients into the cells and to flush wastes from the cells, promoting healthy veins. So remember…Good veni-puncture technique, strengthening exercises, a healthy diet and adequate hydration are all important in maintaining healthy veins. Resources Jones, P. (2003). Vein Care, World Federation of Hemophilia. Carson, C., Dychter, S., Gold, D., and Haller, M. (2012). Infusion Nursing: Venipuncture Technique. Journal of Infusion Nursing.35 (2), 84-91. Lavizzo, R. (2007) Dehydration: A short review. Journal of the National Medical Association. 79 (10) 1033-1038.

getting connected with socal media... By Stephanie Smith For many years now, the internet has provided a way for those dealing with a chronic illness to find information about their disorder; medications being used; current research; insights on navigating health insurance and other valuable resources. With the recent popularity of social media sites like Facebook and Twitter, people are able to connect and share practical tips about living with a chronic disorder. They provide support, encouragement and help to develop feelings of being a part of a community. For someone who is homebound, these sites can be an invaluable way for their world to expand and stay connected. Additionally, for caregivers, these sites offer the same opportunities to share their experiences with others.

There are support groups and blogs for even the rarest of illnesses. Many more individuals are able to access the internet with the use of free Wi-Fi at multiple locations combined with the use of mobile devices such as smartphones and tablets. People that otherwise might not have been able to afford a computer and internet access can now participate and benefit from these invaluable personal connections. ARJ Infusion Services and Captain Clot are now on Facebook. ARJ’s Facebook page has almost daily posts sharing information, resources and encouragement to patients and families living with chronic illnesses. Captain Clot’s posts provide information as well as crafts and games for the whole family. So next time you are online, take a moment, LIKE us and keep checking back for more facts and fun!

vol 8, issue 1 • Summer 2013


i n fusi o n report... Editor: Katie Grigg

Look for me... Captain Clot, on Facebook!

Like ARJ Infusion Services on Facebook too!

Toll Free: 866-451-8804 If you have a submission that you would like to see in an upcoming newsletter, feel free to send it to: ARJ Infusion Services - Newsletter 10049 Lakeview Avenue Lenexa, KS 66219


The articles contained in this newsletter are for entertainment and informational purposes only. © 2013 ARJ Infusion Services, Inc. All Rights Reserved.

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HEMOPHILIA INFUSION EDUCATION FOR PATIENTS AND FAMILIES At ARJ Infusion Services we know the most effective way to manage and treat your disorder is to ensure you are educated and in control of your treatment. Our team of award winning, highly skilled nurses provide self infusion training in the home setting or at one of our many Infusion Clinics we offer throughout the year. They also help teach proper management of drugs and supplies. Our Patient Services staff makes sure you receive the educational information you need to manage your disorder. These and other components combine to provide you with comprehensive care and peace of mind. ACCOUNTABLE To the patients we serve and their healthcare providers RELIABLE Delivery of services to exceed your expectations JOINT PARTNERSHIP With our patients and families to attain treatment goals OUR MISSION To provide caring, comprehensive, cost conscious infusion therapy to people affected by chronic disorders. OUR PHILOSOPHY We are a large enough company to handle your needs, but small enough to understand them. That is what makes us unique and sets us apart.


10049 Lakeview Avenue Lenexa, Kansas 66219

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