Healthy Living

With increased interest in “all-natural” and “organic” products, many consumers are looking for these labels, and who can blame them?

People are inundated with claims on television, radio, internet, and store advertisements that products labeled as “all natural” are safer alternatives to those which may have been chemically manufactured.

However, when it comes to medications and supplements, such as vitamins and herbs, is it really safe to say that what grows naturally is always safe?

Probably not. That’s why Backus Hospital is offering a free community education program, “Know Your Meds, Supplements, and Vitamins,” on Thursday, Feb. 16, from 6:30-8 p.m. at the Plainfield Recreation Center. To register, call 860-889-8331, ext. 6381. The presentation, part of the ongoing Enjoy LIFE (Lifelong Investment in Fitness and Exercise), will be made by Backus Hospital pharmacists Michael Smith and Kate Wheeler.

Prescription and over-the-counter medications, such as Advil or Tylenol, are manufactured by companies responsible for proving that their product is safe and effective at the labeled dose when taken according to the labeled instructions. These companies must also prove that each dose contains the labeled ingredients and will remain stable, safe, and effective until the labeled expiration date. All of this information must be submitted to the Food and Drug Administration for evaluation to ensure that what is being produced is appropriate for marketing and availability to the consumer.

Unfortunately, the same is not true for vitamins and herbal medications that can be bought over-the-counter. The manufacturers of these products are not required to follow quality and safety standards, and are not required to prove that the product is effective for the stated claim (i.e. relieve insomnia, improve memory).

As the consumer, it is impossible to evaluate consistency from tablet to tablet, and bottle to bottle. One cannot be sure exactly what is being taken with each dose.

This is not to say, however, that vitamins and herbal medications do not play an important role in overall health.

It is important to remember that vitamins and herbals should be treated just like other prescription and over-the-counter medications.

When thinking of starting a new product, it is vital to be informed as to the potential benefits, while also the risks.

Having a discussion with your physician or community pharmacist about the medications you are currently taking, as well as your medical conditions, can help narrow down which products are best for you.

Some vitamins and herbal medications, although “all natural," can and do interact with many prescription drugs and increased monitoring may be needed.

It is important to remember that all natural does not necessarily mean safe. The human body does not differentiate between an “all-natural” product and one that is man made, thus the body breaks down and processes both products in a similar fashion. A discussion with your physician and/or community pharmacist is the best way to determine which products, whether prescription or over-the-counter, are best for you, taking into account all medical conditions and current medications.

Jillian Asselin, PharmD, is a pharmacist at The William W. Backus Hospital. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, visit the Healthy Living blog at www.backushospital.org/backus-blogs or e-mail Ms. Asselin or any of the Healthy Living columnists at healthyliving@wwbh.org

Major Depressive Disorder is a common disorder affecting about 16 million to 18 million Americans in any one year at a cost of $82 billion. This is a leading cause of disability, and a crippling disease that leads to major disturbances in one’s life — affecting patients in their work, family, and social life.

“Having depression made me feel like I was an awful person. I did not want to leave my house or be with my family or friends. I would not go to work because I could not bring myself to get out of bed in the morning. Sometimes I would only sleep a few hours of the night and wake up repeatedly. When I was awake I could not focus on anything. I felt completely empty; I could not enjoy anything. Food was tasteless and I lost a lot of weight. I was continuously fighting to get through another day.”

This was a quote from a depressed, 55-year-old female patient. This married woman was treated by her primary care provider with Zoloft for months without any improvement. She was then referred to me. The antidepressant was switched to another antidepressant (Effexor XR), and she began psychotherapy.

Her mood improved to some degree but she still complained of lack of motivation, poor energy, inability to enjoy hobbies (crossword puzzles, cooking, and her three grandchildren who previously were her pride and joy).

After a year of treatment with minimal improvement, I suggested Transcranial Magnetic Stimulation (TMS). The patient agreed and within three weeks she was back doing crossword puzzles, and cooking. Within four weeks she was spending a lot more time with her grandchildren — she looked forward to going to work, her concentration was much better, she reconnected with her friends, enjoyed going out to dinner with her family, gained back the weight she had lost and felt her life was meaningful again.

TMS is the latest non-pharmaceutical treatment modality for major depressive disorder that does not respond to other treatments. In a large clinical trial done by the National Institute of Mental Health involving over 4,000 patients, it was found that only 30% of patients treated with antidepressants were totally free of any symptoms of depression.

TMS works by stimulating key neurons in the brain that are believed to be involved in the pathophysiology of depression. Unlike antidepressants that are swallowed and circulate in the body, TMS delivers high intensity focused magnetic pulses that lead to the formation of electrical currents, which are transmitted to deeper structures in the that are also associated with symptoms of depression.

The electric impulses stimulate the neurons to increase neurotransmitters (much like antidepressants) that are lacking in depressed individuals. Unlike medication, TMS does not lead to side effects (weight gain, sexual dysfunction, sedation, gastrointestinal problems) and unlike Electro Convulsive Therapy it does not require anesthesia or muscle relaxants and does not lead to any memory problems. It is an effective treatment that is safe and non-invasive.

Typically the patient will drive to the office, will receive the treatment while lying in a comfortable reclining chair (similar to a dentist chair) will be awake and alert during the session (40 minutes) and can drive back to work or home. The course of treatment is approximately 20-30 sessions and is given five days a week, Monday through Friday. Some patients may require “booster” session after six months and some may need to continue on an antidepressants, but will definitely require less pharmacological intervention than prior to TMS treatment.

Mahmoud Okasha, MD, is a physician with Comprehensive Psychiatric Care of Norwich. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, visit the Healthy Living blog at www.backushospital.org/backus-blogs or e-mail Dr. Okasha or any of the Healthy Living columnists at healthyliving@wwbh.org

It might sound odd at first, but hospitals are actually working to keep patients out of the hospital.

Gone are the days when hospitals only took care of you when you are sick. To improve the community health, prevention is the best medicine.

At a time when many people don’t have medical insurance and only seek care when they absolutely have to, many people are seeking their care in hospital emergency departments. This is not healthy, and very costly.

That’s why the concept of “medical homes” is so important.

Think of it as “one-stop shopping” for your healthcare needs. In a patient-centered medical home, your care is coordinated through a real partnership with your doctor — your “personal physician.” Because the doctor knows you and your medical history, you can trust him or her to be responsible for all your healthcare needs. This includes arranging care and sharing health information with other qualified providers — specialists, hospitals, home health agencies, rehab specialists, nursing homes, or hospice.

In the medical home model, your care can be more effective, more efficient — and therefore safer. We have all had experiences where a test needed to be re-done, or a doctor didn’t know the results. Technology — backed by caring personal physicians — can create smoother transitions between the hospital, physicians and specialists. This is naturally linked to better overall health, disease prevention and greater patient satisfaction.

You can learn more about medical homes at our next Enjoy LIFE (Lifelong Investment in Fitness & Exercise program on Jan. 19 at 6:30-8 p.m. in the Plainfield Recreation Center. To register, call 860-889-8331, ext. 6381.

When people wait to seek healthcare until it is an emergency because they are without insurance or don’t want to pay a deductible, many times it is too late and their illness has progressed to the point where it is serious and possibly untreatable. Having a medical home can help patients lead healthier lifestyles, and prevent more serious illnesses.

Some of the most important healthcare now occurs before you ever get sick. Having a medical home provides a foundation for this.

Alice Facente is a registered nurse and clinical educator at the The William W. Backus Hospital Education Department. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, visit the Healthy Living blog at www.backushospital.org/backus-blogs or e-mail Ms. Facente or any of the Healthy Living columnists at healthyliving@wwbh.org

Good communication with your primary care doctor or nurse practitioner may be the most important factor in getting good health care.

You want a doctor who will listen carefully to your concerns, answer your questions, and explain things clearly and fully.

Asking questions is key to good communication with your doctor. If you don’t ask questions, he or she may assume you already know the answers or just aren’t interested in getting more information.

But communication goes two ways; It’s very important to feel comfortable discussing your concerns, especially sensitive issues. It is critical not to keep secrets – your primary care provider needs to know your health habits like alcohol or tobacco use, signs of anxiety or depression, incontinence, memory problems, sexual risk factors and behaviors. It’s also in your best interest to be honest if you are adhering to your prescribed medication regimen or treatment.

Our next program in the Enjoy LIFE (Lifelong Investment in Fitness and Exercise) series is “Getting the Most Out of Your Doctor Visit” on Thursday, Jan. 19, from 6:30-8 p.m., at the Plainfield Recreation Center.

Dr. Ramindra Walia, Medical Director of United Community & Family Services (UCFS) based in Norwich and a member of the Backus Medical Staff, will discuss how to choose a primary care provider, why it’s important to have a “medical home” and how to talk to your doctor.

This program is free, but registration is required by calling 860-889-8331, ext. 6381.

An Access to Care specialist will be available to talk about obtaining health insurance. At a time when many people don’t have medical insurance and only seek care when they absolutely have to, Backus and UCFS have partnered to station these specialists in the hospital’s emergency department to reach to identify uninsured and under-insured patients and link them with government insurance programs and health centers like UCFS that will help them establish “medical homes.”

Full-fledged, patient-centered medical homes provide comprehensive primary care that encourages relationships between patients, physicians and families. This model has been endorsed by many of the nation’s largest primary care physician associations, including the American Academy of Physicians, American Academy of Pediatrics, American College of Physicians and American Osteopathic Association.

In a nutshell, medical homes promote access to coordinated, personal, high quality and less costly care. For example, how many times have you ever been in a situation where you have had a test, but your doctor or the hospital doesn’t have access to it because it was performed somewhere else? Medical homes allow for patient information to be easily shared by providers, many times electronically.

As care becomes more coordinated and information is streamlined, patients have smoother transitions between hospitals, physicians and specialists. Communication increase, preventative health develops and overall health improves.

As the healthcare landscape continues to evolve, this kind of preventative medicine will become increasingly important.

When people wait to seek healthcare until it is an emergency because they are without insurance or don’t want to pay a deductible, many times it is too late and their illness has progressed to the point where it is serious and possibly untreatable. Having a medical home can help patients lead healthier lifestyles, and prevent more serious illnesses.

It also lowers costs. We all lament how expensive healthcare is, and how insurance coverage is becoming increasingly cost prohibitive. One of the reasons is the fragmented nature of healthcare, and also the fact that people with insurance inevitably pay for those without it.

Those without insurance many times only seek emergency care, which hospitals must provide regardless of a person’s ability to pay. But emergency care is more expensive, and many times less effective. Clinicians in emergency room environments are great at what they do – treating emergent issues.

But some of the most important healthcare occurs before you ever get sick. This can only occur when there is a healthy, long-standing relationship between patients and their healthcare providers.

Alice Facente is a registered nurse and clinical educator at the The William W. Backus Hospital Education Department. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, visit the Healthy Living blog at www.backushospital.org/backus-blogs or e-mail Ms. Facente or any of the Healthy Living columnists at healthyliving@wwbh.org

The tragic house fire in Stamford on Christmas Day was a sobering reminder to us all of the fragility of life.

According to the National Fire Protection Association, 482,000 structure fires occurred in the United States in 2010, resulting in 3,120 deaths and more than 17,000 injuries. Here is essential fire safety advice we all should heed:

• Formulate and practice a home fire escape plan that everyone, even the children, understands. Pull together everyone in your household and make a plan showing two ways out of each room, including windows. Don't forget to mark the location of each smoke detector. Determine a place to meet outside to make sure everyone in the family is accounted for. Have a practice fire drill at least twice yearly.

• Have smoke detectors installed on every level of your house, including the basement. Test batteries by pushing the button on the alarm, ideally once a month. Change batteries twice a year, each fall and spring when we change the clocks for daylight savings time. A smoke detector is worth so much, possibly a loved one's life, yet is so inexpensive. More than 90 percent of fire deaths occur in residential dwellings between 11 p.m. and 6 a.m. when occupants are asleep. Smoke detectors alert occupants when a fire is still small and there is still time to escape.

• Take extra care when burning candles in the home. Never leave burning candles unattended. Make sure the flames are not near anything combustible, including curtains or lampshades.

• Space heaters can be hazardous. Again, never leave unattended or place them near anything that could burn, including shoes or furniture.

• Carbon monoxide detectors are potential life-saving devices. Install carbon monoxide detectors on all levels of your home, especially near sleeping areas, advises Fred Potter, Backus Hospital’s Coordinator of Emergency Medical Services.

• Norwich Deputy Fire Marshal Jake Manke advises every household to have a working fire extinguisher in a readily available and reachable location. Check the battery gauge and be familiar with how to use it. But he stresses the most important thing is to get everyone safely out of the house and call 911, allowing the professionals to fight the fire.

The National Fire Protection Association is the standard for accurate information in the fire safety field. Family fire safety plans and other vital information is offered at its website: www.NFPA.org.

Let’s all work to protect our families as we look forward to a healthy and safe New Year.

Alice Facente is a registered nurse and clinical educator at the The William W. Backus Hospital Education Department. This column should not replace advice or instruction from your personal physician. If you want to comment on this column or others, visit the Healthy Living blog at www.backushospital.org/backus-blogs or e-mail Ms. Facente or any of the Healthy Living columnists at healthyliving@wwbh.org