Fall Edition 2012
Winning the Fight
In the News Your World Daily Dose
Break the Chain of Nicotine Addiction
Pins & Needles The Healing Art of Acupuncture
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Ounce of Prevention 8
WINNING THE FIGHT
WINNING THE FIGHT
The Great American Smokeout provides a great opportunity to break the chains of nicotine addiction.
CONSIDER THE ALTERNATIVE
Explore the ancient art of acupuncture.
Carteret General Hospital moves forward with all-inclusive cancer center.
21 DAILY DOSE
The internet has brought a wealth of medical information into our homes. But when faced with symptoms, how safe is it to self- diagnose?
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IN THE NEWS
OUNCE OF PREVENTION
Creative Director Kim Moore AST CO
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Mail 201 N. 17th Street Morehead City, NC 28557
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Staff Writer Josh Lambert
NCCOAST Health & Wellness Magazine
Vol. 5, Issue #3 Fall 2012
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NCCOAST Health & Wellness is distributed in five counties and other high-traffic sites throughout North Carolina, and is also available by request at nccoasthealth.com. Entire contents, ad and graphic design and nccoast. com copyright 2012 by NCCOAST Communications. Reproduction of any portion of this publication or its website without the publisher’s written consent is strictly prohibited. Information found herein is as accurate as possible at presstime but should be solely used as a guide. For more specific advice, please consult your family physician.
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The Weight Is Over Announcing medical weight loss
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In the News CGH Licenses 1-800-DOCTORS
Carteret General Hospital announced that it has licensed the phone number 1-800-DOCTORS to make it easier than ever for patients to find the perfect doctor. By becoming a licensee of 1800-DOCTORS, the hospital has acquired access to a powerful physician referral program through the most memorable name and number in healthcare. The 1-800-DOCTORS telephone number assists consumers looking for physicians and hospital services – from primary care to specialty physicians. “We believe having this easy to remember name and number will benefit many residents in our community and strengthen our integration of services and physicians.” said Beth Beswick, vice president of human resources. “Our physicians are some of the best anywhere and this is why the service will also provide the professional background of physicians, board certifications and specialty training.” Carteret’s service area includes all of Carteret County, Havelock and Swansboro. This number will make it easy for area residents looking for a quality doctor to choose a physician affiliated with Carteret General based on their individual needs. Anyone calling outside of Carteret County, Havelock or Swansboro may call Carteret General Hospital directly at 252-8086336 or visit www.carteretgeneral.com/physicians to access physician services information. “1-800-DOCTORS is another way that we want to show our commitment to the health of our community. Now anyone can access valuable information about physician services quickly, easily and effectively.” Beswick continued. “They will even make the appointment for callers.”
No More Hiding At Medicine Time! When your child is sick, the last thing you need is for medicine to taste like medicine.
The NC Dept. of Health and Human Services is urging residents and visitors to protect themselves from mosquito-borne illnesses following the death of a Wayne County adult from West Nile Virus. A second death was announced during the last week of August, bringing the tally to two by press time and marking the first West Nile-related deaths in the state in recent history. West Nile virus is one of several mosquito-borne viruses common to North Carolina. The US Centers for Disease Control and Prevention reports more than 390 cases of West Nile virus disease nationwide this year, the highest number since 2004. There have been at least eight fatalities.
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N VA URGENT CARE â€œThis is a tragic reminder of the importance of prevention,â€? said NC Health and Human Services Secretary Al Delia. â€œMost cases of West Nile virus and other mosquito-borne illness happen in August and September, so protect yourself and your family from mosquito bites by using mosquito repellants and making your home or work environment less attractive to mosquitoes.â€? While cases peak at the end of the summer, the warning is especially pertinent in North Carolina, where the less humid days of fall often lure residents outside for extracurricular activities they avoided during the heat of summer. Mosquitoes, which are most active at 80Â°, can often linger well into November and beyond waiting for a good cold snap to knock down the population. Mosquitoes can develop from an egg to an adult in as little as a week. DHHS recommends the following precautions to eliminate potential breeding sites around your home and business: â€˘ Eliminate standing water in places like flower pots, discarded containers, gutters and kiddie pools. â€˘ Clean ornamental ponds and ensure that filtration systems are functioning properly. â€˘ Clean and change water in horse troughs at least once a week. It also is important to keep window screens and panes in good condition to prevent entry of insects into your home and wear long sleeves, pants and socks when weather permits. Health officials say mosquitoes are most active from dawn to dusk, so if you plan to be outdoors, always use repellent containing DEET, picaridin, IR3535 or oil of lemon eucalyptus on exposed skin as well as on clothing (mosquitoes will bite through thin cloth).
CarolinaEast Earns Recognition
CarolinaEast Medical Center, New Bern, has received the American Heart Associationâ€™s Mission: Lifeline Bronze Achievement Award. Each year in the United States, nearly 300,000 people have an ST-segment elevation myocardial infarction, often called a STEMI, the most severe form of heart attack. A STEMI occurs when a blood clot completely blocks an artery to the heart. To prevent death, itâ€™s critical to immediately restore blood flow, either by surgically opening the blocked vessel or by giving clotbusting medication. Hospitals involved in Mission: Lifeline are part of a system that makes sure STEMI patients get the right care they need, as quickly as possible. Mission: Lifeline focuses on improving the system of care for these patients and at the same time improving care for all heart attack patients. As a â€œSTEMI Receiving Hospital,â€? CarolinaEast meets high standards of performance in quick and appropriate treatment of STEMI patients to open the blocked artery. Before they are discharged, patients are started on aggressive risk reduction therapies such as cholesterol-lowering drugs, aspirin, ACE inhibitors and beta-blockers, and they receive smoking cessation counseling if needed. Hospitals must adhere to these guideline-based measures at a set level for a designated period of time to be eligible for the achievement awards. ď Ž
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Winning The Fight
Kicking Butt The Great American Smokeout Helps Break the Chain of Addiction The glamorous image of a 1940s starlet lounged back on a chaise with a long cigarette holder poised high in the air has long been replaced by the realism that smoking simply isn’t good for us. There are few who will argue for the benefits of tobacco use. Yet, despite the fact that we know the health risks involved, Americans continue to smoke. In 2010, 43.5 million adults, 19.3 percent of the US population were current smokers, according to the Centers for Disease Control, 21.5 percent of which were men and 17.3 percent were women. That same year, 52.4 percent of adult smokers quit for at least a day. Lung cancer is the most preventable form of cancer death in our society, according to the American Cancer Society (ACS). An estimated 226,160 cases will be diagnosed in 2012 and an estimated 160,340 deaths will be attributed to lung cancer. In addition, smokers are at risk for myriad additional forms of cancer,
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including mouth, lips, esophagus, ovary, colon/ rectum, uterus, bladder, kidney, stomach and more. The habit also contributes to a variety of other chronic diseases, including heart disease and respiratory diseases, and takes a toll on other areas of overall health, including eye diseases, peptic ulcers, dental diseases and fractures. According to an ACS report, smokers who quit can expect to live as many as 10 years longer than those who continue to smoke; and smokers who quit, regardless of age, live longer than people who continue to smoke. Research shows that much of the risk of premature death from smoking could be prevented by quitting. “Quitting smoking is a very important step in reducing cancer risk, as tobacco use remains the single largest preventable cause of disease and death in the US,” said Dr. Edward Partridge, national volunteer president for the American Cancer Society. “The American Cancer Society Great American Smokeout is a great first step for smokers to take charge of their health by quitting or making a plan to quit, and the Society can help smokers through a variety of resources including personalized telephone coaching by trained specialists.” The American Cancer Society (ACS) marks the 37th Great American Smokeout on Thursday, Nov. 15, its annual attempt at encouraging smokers to plan their break from nicotine addiction. And that may be just the nudge North Carolinians need. According to the NC Dept. of Health and Human Services (DHHS), the state leads the nation in smoking cessation hotline calls (1-800-QUIT-NOW). More than 36,900 people have reached out for free telephone coaching so far this year, the largest volume of calls since the service began in 2005. “The call volume is clear evidence that tobacco users in our state want help in quitting,” said DHHS Secretary Al Delia. “The Quitline has provided a valuable tool for support and encouragement.” According to numbers released in July by the CDC, North Carolina consistently led the nation in Quitline call attempts between January and May. Studies have shown that telephone counseling, like that provided by QuitlineNC, is a proven way to increase the odds of tobacco users quitting for good. Tobacco use is costly to North Carolina with health care costs alone for tobacco-related diseases topping $2.46 billion annually, including $769 million in Medicaid costs. Across the country, cigarette smoking costs more than $193 billion annually.
Not only does it cost the state and the nation, but it’s a costly habit on the home front as well. Visit www.cancer/healthy/toolsandcalculators/calculators/app/smoking-cost-calculator.aspx for a more personalized look at the cost of smoking. A person spending $3.75 per pack who smokes a pack a day, for example, goes through about $114 a month or $1,370 a year. Been smoking since Jan. 1, 1995? You’ve already spent $24,000. Quitting is hard, but the odds of winning the battle are increased for those who reach out for help in their quest. Phone support, a buddy to share the process with, nicotine replacement tools and hypnosis – there are a variety of methods available today to help patients ready to quit.
The US Food and Drug Administration (FDA) has approved five types of nicotine replacement therapy: patch, gum, nasal spray, inhalers and lozenges, several of which are available without a prescription. Each of the nicotine delivery systems comes with its own set of possible side effects and costs. Because people’s smoking habits differ, the required dose will differ as well. Nausea and headaches, the most common side effects with each of the therapies, can often be eliminated by adjusting the dose. Patches: Purchased with or without a prescription, patches are applied to clean, dry skin each morning. They come in a variety of doses, allowing smokers to reduce the amount taken over the course of several weeks. There are several brands and strengths available in both a 16-hour or 24-hour delivery system. The FDA has approved using the patch for a total of 3 to 5 months. Gum: Available in 2 or 4 mg strengths, gum provides the immediate dose of nicotine that smokers often come to expect. Based on packaging instructions, gum is to be chewed until a peppery flavor is emitted and then held between the check and gum. Users can repeat the process as the flavor fades for up to 30 minutes. Gum use is recommended for 6-12 weeks, but no more than six months. (cont. on page 10)
Robert Metts, M.D.
Sean Scully, M.D., PhD
WeÕll Þx it. Your best option for orthopaedic care is right here in Jacksonville, at EC Ortho. Here, you’ll receive personal attention and excellent care from our Board Certified physicians and, thanks to our affiliation with Onslow Memorial, you’ll benefit from the resources of our area’s top medical center. But maybe the most important thing that sets us apart is our local familiarity. We understand military families’ needs, accept TriCare, and we’re efficient, typically seeing you within 24 hours. So when you need care, don’t even give driving out of town a thought. Come see us at EC Ortho.
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Winning The Fight (cont. from page 9)
Nasal Spray: A prescription is required for this fast delivery of nicotine into the bloodstream, however, users say it quickly relieves withdrawal symptoms and allows the user to control their cravings. Use is recommended for no more than six months. Inhalers: These thin plastic tubes with a cartridge inside allow the user to puff on the device and receive a nicotine vapor. While inhalers deliver the nicotine into the lungs, inhalers release the nicotine into the mouth. A prescription is required. Recommended usage should not exceed six months. Lozenges: Available without a prescription, lozenges come in 2 and 4 mg strengths which take about 20-30 minutes to fully dissolve. Lozenges are recommended as part of a 12-week program, slowly decreasing the number used per day. While not approved by the FDA, some quitters have had success with less traditional alternative therapies, including hypnosis and acupuncture. Finding the ideal fit for your lifestyle is the most important thing of all. According to the ACS, only about 4-7 percent of people are able to quit smoking on any given attempt without medicines or other help. Journal studies have reported that the success rate for those who do use medicine is about 25 percent.
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Carteret General Hospital offers smoking cessation support at no cost to anyone who has been a patient within the last 30 days. The program uses nicotine patches or prescription medication Chantix. The initial cost of the program is $50 and covers eight weeks of medication. If a person remains tobacco-free for six months following the program, the money is refunded. Support groups and counseling are also shown to have a marked impact on success rates. The key, experts agree, is to be dedicated to the goal at hand. If one method isnâ€™t right for you, regroup and try another. If at first you donâ€™t succeed â€Ś well, you know how to finish that story. ď Ž
When You Quit
Benefits from kicking the habit include a lower risk of diabetes and better heart and lung health. But exactly how fast does the repair occur? While the younger we quit, the better, based on reports by the US Surgeon General, quitting smoking at any age can put years back on your life. 12 hours after quitting The carbon monoxide level in your blood drops to normal. 2 weeks to 3 months after quitting Your circulation improves and your lung function increases. 1 to 9 months after quitting Coughing and shortness of breath decrease; lungs begin to regain normal function, including the ability to handle mucus, clean the lungs and reduce the risk of infection. 1 year after quitting The excess risk of coronary heart disease is half that of a smokerâ€™s. 5 years after quitting Risk of cancer of the mouth, throat, esophagus and bladder is cut in half. Cervical cancer risk falls to that of a nonsmoker. Stroke risk can fall to that of a non-smoker after 2-5 years.
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10 years after quitting The risk of dying from lung cancer is about half that of a person who is still smoking. The risk of cancer of the larynx (voice box) and pancreas decreases. Smokers who reach out for help, have better success, according to the American Cancer Society. Here are some great places to find the support: www.quitlinenc.com â€˘ Smokefree.gov www.ucanquit2.org â€˘ www.cdc.gov/tobacco www.cancer.org
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Consider the Alternative
Acupuncture Offers an Ancient Treatment Option By Josh Lambert Needles are reminders of painful shots as a child, pricking oneself on a pin or tack and the daunting task of getting blood drawn. Needles intimidate many people, which is one of the main reasons folks are afraid to try an alternative medical technique that requires several needles to be strategically placed into the skin at certain points of the body – acupuncture. Acupuncture is the alternative form of medicine originating roughly 5,000 years ago in China, based on the ancient teachings that deal with the flow of energy through the body. This energy, known as Chi (pronounced “chee”), travels along channels and paths known as meridians. The Chinese and modern practitioners of acupuncture believe that illness occurs when this flow of energy is disturbed or interrupted. This form of medicine treats patients by using extremely thin needles, which are inserted into acupuncture points along the skin. According to traditional Chinese medicine, using the needles in the correct points along the body stimulates the areas, releasing a better flow of energy, or Chi. According to the Chinese, the Chi is in a constant state of flux, flowing through the meridians of the body. Each of these channels, or meridians, is connected to specific organs and glands throughout the body. The pathways are symbolic of a river, because when a river flows freely and unobstructed, it provides life-giving nourishment to the land, plants and animals. The same goes with a person’s Chi – if the pathways in 12
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the body allow Chi to flow freely, it nourishes every cell, piece of tissue, muscle, organ and gland in the body. However, illness results if the flow of Chi is disturbed or blocked in any way. If no Chi is flowing, there is death, according to the Chinese. A person’s health is influenced by the quality, quantity and balance of Chi in their bodies. Treatment with acupuncture aims to re-establish the normal flow of Chi, thus restoring the body’s health. Scientists of modern medicine are beginning to identify some of the physiological mechanisms at work in the body, and there is evidence to support the insertion of needles into designated acupuncture points speeds the conduction of electromagnetic signals within the body. This process may increase the flow of endorphins, a pain-relieving chemical naturally found in the brain, as well as blood circulation and immune system cells, which aid healing and health preservation. Acupuncture appears to best treat the problems and symptoms that Western medicine struggles to treat. Things such as hot flashes, recurrent infections, muscle pain and other chronic conditions that don’t register on x-rays or blood tests have been treated effectively with acupuncture. Proponents of acupuncture therapy also emphasize the lack of side effects from the treatment. A well-trained acupuncturist will use sterilized, disposable needles, eliminating the chance of infection. The worst that patients can expect is some bruising around needle sites or a brief feeling of faintness. This is why many practitioners call on acupuncture when other treatments have failed — or when Western medicine has no answers. The treatment was approved by the National Institute of Health in 1997 for certain types of nausea and pain, listing other conditions like addiction, asthma, carpal tunnel syndrome and menstrual cramps. New studies are being published each year evaluating acupuncture’s effectiveness in treating everything from depression to Parkinson’s disease. “Most people come in for muscular and skeletal problems, but acupuncture is really made for systemic problems, so it’s really great for digestive concerns, respiratory problems and immune system boosting. I even us acupuncture for fertility. I’m treating a woman right now to help her conceive,” said Stephanie Kaplan, senior acupuncturist at Acupuncture Point, Morehead City. “What I’m doing is putting the body in balance, so it doesn’t matter too much what the symptom is, because if I restore the body’s balance, the symptoms will start to go away,” she said. “It really just puts the body in balance and you don’t know what type of benefits will occur.” She noted a patient who came to treatment for back pain and inadvertently quit smoking cigarettes. Since the acceptance of acupuncture by the NIH, more health insurance providers have started to cover the treatment.
COASTAL FOOT CENTER DR. VALENTINE HAMILTON
Some clinics accept the insurance on-site, while others require patients to pre-pay but provide assistance in filling out the proper claim forms for re-imbursement from their insurance provider. “In general, only some federal insurance will recognize acupuncture. Mail Handlers and Blue Cross Blue Shield Federal Standard Option cover acupuncture treatments in North Carolina,” said Kaplan. There are some common misconceptions regarding acupuncture, as Kaplan noted. She explained that many folks believe the success of acupuncture is psychological. “They think it might all be in your head or that it’s something we make up. But we treat animals like dogs and horses, and they get better. I don’t think those animals are wondering if their results are part of the placebo effect,” she said. Lynn Raeburn has been an acupuncture patient since 1997 and has used the treatment for a host of ailments. “I started getting pneumonia and bronchitis every winter and I would be out of work for weeks. I didn’t realize acupuncture could work for your immune system, but Stephanie started doing acupuncture treatments for my immune system and I didn’t get bronchitis or pneumonia for over ten years. That is until I forgot to get treatment for two years,” said Raeburn with a laugh. “There is no pain to it at all. It puts you in such a deep state of relaxation.” Research involving brain scans has revealed some of the most interesting information about the inner workings of acupuncture. In one study, published in 1998 in the medical journal Proceedings of the National Academy of Sciences, researchers put needles on the sides of subjects’ feet in points that were thought to affect the eyes while scanning their brains with a magnetic resonance imaging (MRI) machine. The part of the brain associated with vision lit up on the scan and showed activity, just as it did when a bright light was shone into the subjects’ eyes. Placing needles in any other part of the foot did not cause any such response from that part of the brain. If the practitioner is competent and certified, the risks of the process are minimal, however, anyone considering acupuncture should understand the risks of possible negative complications. These complications are very rare in the hands of a licensed and experienced practitioner. Some people are not good candidates for acupuncture. Someone with a bleeding disorder or taking blood thinners has increased chances of bleeding and bruising from the needles. Be wary of heart conditions and pacemakers, as some types of acupuncture involve applying mild electrical pulses to the needles, which can interfere with a pacemaker’s operation. When choosing an acupuncture specialist, one should go (cont. on page 14)
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Consider the Alternative (cont. from page 13)
about it in the same way as choosing a family physician: • Ask trusted friends and family for recommendations • Check the credentials and training of the practitioner. If an acupuncturist is not a licensed physician, most states require they pass an exam conducted by the National Certification Commission for Acupuncture and Oriental Medicine. • Talk with the practitioner and ask questions. Ask what is involved with treatment, how likely it is to help your personal condition, the number of sessions required and the cost. • Talk with your health insurance provider and see if the treatment expense is covered by your insurance. • One can also inform their doctor they are considering acupuncture
and he or she could possibly provide success rates of using acupuncture to treat the problem in question. Doctors may also recommend an acupuncture practitioner to try. Once a practitioner is chosen, they will ask questions about their patient’s symptoms, lifestyle and behaviors. The practitioner might also do some examinations of the parts of the body exhibiting pain, the shape, coating and color of the tongue, the color of the face and the strength and rhythm quality of the pulse in the wrist. Initial evaluations may take an hour and subsequent appointments last around 30 minutes. Treatment plans vary depending on the patient, but a common plan for most involve between six and 12 treatments, scheduled once or twice a week.
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Your World Carteret General Looks Forward to Cancer Center By Josh Lambert
Big plans are in store for cancer patient treatment and care with the newly formed partnership between Carteret General Hospital and the UNC Lineberger Comprehensive Cancer Center and UNC Cancer Care. The goal is to have a comprehensive cancer treatment and support services under one roof, making it easier for patients already living in the area or those who may want to seek a second opinion from UCH-Chapel Hill’s Cancer Care. “We approached [UNC Lineberger Comprehensive Cancer Center] because some of our oncology clinical leaders, both in radiation oncology and medical oncology, had interests for their patients to have opportunities to participate in certain clinical trials, so really to get some of the most current treatment methodologies that might become available locally,” said Carteret General’s President and CEO Richard Brvenik. This new affiliation brings great advantages to our area when it comes to cancer treatment and care, allowing the proposed center to use the UNCChapel Hill’s Institutional Review Board. This provides the most important elements of an experienced research staff, state-of-the-art technology and offers several potential clinical research studies based on Carteret County’s patient population and various types of cancer. In past years, patients interested in participating in treatment options through certain clinical trials had to travel out of town to find such alternatives. With the new treatment center and partnership, patients will have access to Phases I, II and III clinical trials for medical and radiation oncology, and they can be treated at Carteret General. Each clinical trial is conducted in four phases and the Food and Drug Administration must approve each phase before the study can continue. Phase I consists of testing a new drug on a small group of healthy people to identify side effects, how long it stays in the body and safe dosages. Phase II means the drug or treatment can then be 16
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tested on a larger group of people to see its effectiveness and further study its safety. If the drug or treatment makes it to Phase III, it is ready to be tested on even larger numbers of people, looking at its effectiveness, side effects, overall safety and how it could improve a patient’s quality of life. Many of the drugs that reach this phase are considered for approval by the FDA. “Given certain diagnoses, sometimes the ability to participate in some research trials can give a patient a treatment that may offer them the greatest hope and prospects for long-term success,” explained Brevenik. During a public hearing on Monday, Aug. 13, the proposed cancer center accumulated support from multiple perspectives. Cancer patients, caregivers, hospital leaders and others from the medical community were among the speakers who attended the public hearing on Carteret General Hospital’s application for a Certificate of Need Section from the NC Division of Health Service Regulation to develop the cancer center. North Carolina law does not allow healthcare providers to acquire, replace or add to facilities or equipment without the prior approval of the NC Dept. of Health and Human Services, except in specified instances. This law is intended to prevent unnecessary increases in healthcare costs and limit redundant health services and facilities based on geographic, demographic and economic considerations. Because the proposed project exceeds $2 million, the hospital must obtain a certificate of need before developing or pursuing the project. According to Brvenik, the hospital expects to hear the results of their certificate of need proposal sometime toward the beginning of calendar year 2013. The proposal is for a 33,225-square-foot cancer facility that costs approximately $20 million and would bring all of the hospital’s cancer and support services together in the same building. The new facility will have medical oncology, presently located off of the main campus in the Raab Oncology Clinic, radiation oncology, located in the Coleman Radiation Oncology Center within the hospital, and all other support and cancer-related services. These other services include case management, cancer patient navigation, diagnostic services and complementary services that support cancer patients and their families. To fund the cancer center project, the hospital turns to the money it has generated itself and to philanthropy and fundraising through the hospital’s foundation. “The largest source of dollars will be the money left when the hospital has earned an excess operating margin. Those dollars can be redirected back into this [project],” said Brvenik as he explained the funding for the new center. This project will not only put the treatment and support services local patients require in one location, but also provides a state-
of-the-art facility in their home community. Area patients have had the daunting task of driving long distances if treatment is needed elsewhere, like New Bern, Greenville or Raleigh. Many patients incur thousands upon thousands of dollars in hospital bills when being treated for cancer. These financial instabilities, along with physical problems, are compounded when patients have to drive long distances for care, treatment or support services. “We can take advantage of information and the transfer of knowledge that we could have available here so people can get their care locally, because most of us would prefer not to have to travel great distances,” said Brvenik. “The biggest benefit of the relationship is for our patients. When people get a diagnosis of cancer, it is probably one of the most devastating things anyone can confront. Immediately people start to think ‘what is the best course of action’ or ‘what do I do,’ and what I think is wonderful here is that we have the ability to have these other resources, like second opinion consultations. When there’s a determination of what the best treatment course is, much of that can be done here at Carteret General locally, without having to drive multiple hours.” The only think lacking with the recent partnership, according to Brvenik, is the physical space for the cancer center. He notes the skills and expertise of the hospital’s clinical team, but illustrates the limited space for support services, especially for the medical oncology patients. He said there was not enough capacity for multidisciplinary cancer clinics, interdisciplinary case conferences or tumor boards, along with patient, community and professional education. The proposed center would address the space shortages and help provide coordinated and comprehensive treatment and care for cancer patients. “We have an opportunity for both our patients who are presented at tumor boards or case conferences here, when we try to plan where some of their oncology, subspecialists will be able to participate through teleconferencing, bringing in some of those experts as well. And conversely, when they have their specialty tumor boards that they will have for all kinds of different cancer sites – our individuals can likewise, through video conferencing technology, tie into those.” Currently, Carteret General serves more than 209 radiation therapy patients and 378 chemotherapy patients each year. Due to cancer incidence statistics and the aging population, an increase to 224 radiation patients and 426 chemotherapy patients is expected by 2015. This predicted increase is considered conservative and does not account for an increase in market share. Although three separate locations are being considered for the cancer center, the hospital boards are spending the majority of their present time focusing on an on-campus site that would have the cancer center be developed adjoining to the main hospital building, according to Brvenik. “The reasons for that are; we want to make sure we can create a very attractive, comforting and soothing environment, but we also want to make sure that by having it co-located near other diagnostic services it can make things as easy and simple (cont. on page 19)
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Your World (cont. from page 17) for the patients and their families,” he said. As far as job creation, it is unknown the amount of jobs this project will create. However, with any major construction project, there are several jobs for individuals in the construction and subcontracting fields. Dr. Luis Cuervo joins the staff at Carteret General as the new medical oncologist who will work with James Loynes, the senior medical oncologist at the hospital. These two individuals will work side by side, enabling the hospital to care for the volume of patients that continues to grow. New jobs will arise
from the cancer center, but according to Brvenik, it is too early to tell just how many medical professionals, cancer support specialists and other specialty employees will be needed. “Right now, what we are designing is largely an outpatient area for the cancer center, but obviously some of the cancer patients become hospital inpatients. This is where the on-campus location becomes important. For example, it will make it easier for Dr. Loynes, and save time, if he is able to round on patients and coordinate care for those patients, as opposed to him strictly being at an off-campus location site.” Dr. Thomas C. Shea, associate director of clinical outreach at UNC Lineberger said they “are pleased to extend the UNC Cancer Network to Carteret County. Enhancing cancer screening rates, using telemedicine for consultation and continuing education and providing clinical trials to patients in their own communities is at the heart of our mission – to improve cancer care for all North Carolina citizens.” “We want our patients to have the highest quality cancer services that we can possibly offer to our community. And we want them to have a really comfortable and tranquil environment where they receive care. It really is such a positive relationship, and I really am very excited,” said Brvenik.
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Ounce of Prevention Whooping Cough on the Rise
After issuing a press release in June urging residents to be vaccinated in light of the recent rise in cases of pertussis, commonly known as whooping cough, the NC Dept. of Health and Human Services announced the state’s first death from the disease in mid-August – a 2-month-old in Forsyth County. “We really cannot stress enough what a serious health problem this is, especially for infants and young children who are not fully immunized,” said Mary Fournier, communications specialist with the Carteret County Health Dept. Between December and the first week of June, state public health officials tracked some 179 cases of whooping cough covering 23 counties – a marked increase compared to the 126 confirmed during the entire 2011 year. Around the country more than 18,000 cases have been confirmed. Fournier notes that there have been three suspected cases thus far in Carteret County. Pertussis, which is characterized by a loud whooping sound as the body sucks in air during coughing fits, is a highly contagious illness that is spread from person to person, usually by coughing or sneezing while in close contact. It can be serious at any age, but is life threatening in newborns and infants who are too young to be fully vaccinated. The Centers for Disease Control estimate that mothers are responsible for about 30-40 percent of infant infections. Often, they don’t even realize they have the disease. Like the common cold, pertussis begins with congestion, sneezing, a runny nose and perhaps a fever. But within 1-2 weeks severe coughing can begin. “Babies and young children are not fully immunized until they have finished a series of vaccinations, so their only protection against whooping cough is the people around them,” said State Health Director Dr. Laura Gerald. “Anyone who lives with or will be around a baby should be vaccinated.” The state is recommended that residents: 20
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1. Make sure children are current on their vaccinations. The DTap vaccination series is recommended for children starting at 2 months of age, and continuing at 4 months, 6 months, 15-18 months and 4-6 years of age. 2. Insist that the adults in your children’s lives are vaccinated also. Whooping cough spreads easily from person to person, and young babies especially are not fully protected until they receive the full series of shots. 3. Ask about your children’s caregivers. Babysitters, child care providers, family members and others who come in close contact with your children should be vaccinated. 4. Don’t forget booster shots. By age 11, children should receive the Tdap booster. It’s never too late for teenagers or adults to receive the booster if they haven’t already. “State law requires pertussis vaccinations for preschool and schoolage children, but we know that immunity wanes over the years,” Dr. Gerald said. “A booster shot is a safe and effective way for adolescents and adults to protect themselves and those they love.” Fournier said the Tdap vaccination is required for all rising sixth graders and many colleges and universities are now calling for incoming freshmen to be immunized. “It is highly recommended for all teens and adults, especially those who have close contact with infants and children,” said Fournier. The state announced in March that the Tdap vaccine, which protects against pertussis, would be available at no cost to anyone age 7 and older for a limited time. The vaccine is still readily available through the NC Immunization Network, which includes private health care providers and local health departments. Fournier said the booster is available at the Carteret County Health Dept. on a walk-in basis from 8am-4pm, Monday through Friday. To hear a pertussis cough, visit www.soundsofpertussis.com. To learn more about the disease, call the health department at 252-728-8550 or get in touch with your family physician.
Daily Dose The Trend of Self-Diagnosis
By Josh Lambert
In today’s society, at the first sign of health trouble, the majority of people do the same thing – run to the closest computer and type in their symptoms to see what could possibly be wrong. While many folks still seek out professional doctors for their medical woes, more and more people are looking to the Internet for diagnoses. With sites like Webmd.com, symptomchecker.com and Dr. Google, people have begun to take their medical queries to the web. While this may be fine for someone looking for research on a pre-existing illness, there are problems that arise when relying on websites for a full health diagnosis. It is easy to understand why so many choose to seek advice and try to self-diagnose, with some doctors possessing little to no communication skills or simply trying to have a quick turnaround time in order to fit more patients in to their busy days. The other obvious reason self-diagnosis is the cost – free. With our healthcare system on the fence and a struggling economy, simply visiting the doctor can cost a fortune. This is especially true for those who are out of work and don’t have any form of healthcare or insurance. To save money, these folks will try their best to determine what is wrong with themselves or their children to save a visit to the doctor and the costs incurred. The Pew Internet & American Life Project, part of a nonprofit group that provides information on issues, attitudes and trends in America, shows that 80 percent of internet users looked online for health information. Although this survey was taken in September of 2010, The Pew Project illustrates this percentage to be a very stable trend dating back to 2002. This means that in 2010, roughly 59 percent of US adults sought medical advice online according to The Pew Center. Also, according to a study done by Scarborough Research, more than half of American teens turn to the internet for answers to their health-related quandaries. The most commonly researched health topics are specific diseases or conditions, treatments or procedures and doctors or other health professionals. And according to the Pew survey, 15 percent of adults have used their cell phones to look up health advice or medical information. With the plethora of diagnostic services that allow anyone to enter symptoms and find probable causes, there are concerns with people, especially young folks, taking their health into their own hands. Although those visits to the doctor’s office for the common cold or headache may not feel worthwhile, self-diagnosing droves of symptoms could cause more harm than good. Many
doctors speak out about the dangers of self-diagnosis as opposed to a consultation with an actual health care provider. “It’s dangerous. I think all medical personnel will give you the same answer,” said Barbara Yates, a registered nurse and the director of clinical services for Maxim Healthcare Services. “If you are sick, you need to see a physician and have a complete physical; they can do the tests to determine what is wrong.” When people seek out their own diagnosis, it can often lead (cont. on page 22) w w w . N C C O A S T. c o m
Daily Dose (cont. from page 21)
to an over-diagnosis, misdiagnosis or even late diagnosis. The reason this form of healthcare is so disposed to error is simple – ignorance. Medical school is long, tedious and difficult for a reason. Many different health problems can cause the same symptoms, meaning a search for “upset stomach” can lead to a diagnosis of anything from food poisoning to colon cancer. Although Webmd.com uses many health experts that are certified medical doctors or have doctoral degrees, most health diagnosis and information sites aren’t regulated. It would be impractical to have every disease and disorder known to man catalogued on the internet. If someone does find some health information online, they must verify the source or author as a qualified professional and check the date of publication for the site or article as it could be years out of date. This information should then be provided to a physician for their opinion, and not just taken as the solution. A person’s health can be placed in jeopardy due to a wrong or missed diagnosis. This risk is two-fold, leading either to the failure to diagnose a serious illness due to the dismissal of symptoms thought to be benign, or linking symptoms to an acute illness and using treatments that aren’t suited for a person’s actual condition, making their health worsen. When someone gets the results of an internet symptom diagnostic tool, several possible illnesses are indicated.
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This causes some people to immediately panic over a small pain until a trip to the doctor causes their stress, anxiety and worries to subside because the pain was a confirmed stomach virus. The opposite case is also true, as a patient might perform a search for “chest pains” and the results could lead them to believe there is nothing to worry about, when the symptom could actually be something as serious as a precursor to a heart attack. When patients diagnose themselves, they usually try and treat themselves as well, searching for over-the-counter medications or natural remedies used to treat whatever is self-diagnosed. While this may work in some cases, it could easily compound the situation by causing further harm with incorrect medications. “I’ve known people who tried to treat themselves with all the herbs and vitamins they had read about online, and they didn’t get any better. You must also be very careful with overthe-counter medications. Mixing them can be dangerous,” said Yates. There are other issues with online medical diagnostic tools and information, such as the level of detail on each site and how the information is presented. An online self-diagnosis procedure usually happens one of two ways – a person looks up a disease or illness and searches its key symptoms for comparison, or they input their symptoms to see what ailments present the same symptoms. One important problem with this process is that medical websites do not usually show which symptoms are considered the most significant. It is impossible to know if all ailments that display the same symptoms are shown, and a patient may not know what, or where, to look for the important signs, signals and symptoms that physicians train for years to identify. And, when self-diagnosing, there are usually several options or possible outcomes to medical symptom queries, making it even harder for the average person to identify medical problems correctly. The bottom line is there is no substitute for a face-to-face consultation with a well-educated doctor and the advancements in medical technology when it comes to diagnosing illnesses or ailments. Only a trained, licensed physician has the experience and knowledge to properly perform the sequential process of diagnosis, ask the right questions and run the correct series of tests. Another reason to speak with a doctor is that someone may not even see, or be aware of, every symptom they exhibit. Many of the things a doctor looks for may not be immediately obvious to the everyday, untrained eye.
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