The "Care" in Health Care

Safety First This Fourth of July

2011-06-30T13:59:00.000-07:00

This weekend, we will observe our 235th year as an independent nation. That is a LOT of candles to blow out! Happy Birthday USA!! Americans love a reason to celebrate. And the birth of such a grand nation is a great reason to do so! While we are a young country, we are strong in our history and heritage. Our traditions have shaped our past and at the same time they influence our future.
One tradition for many families is the 4th of July backyard barbecue. Burgers, hot dogs, baked beans, potato salad and apple pie are on many Texan’s plates. And remember the sparklers too. Of course, all of these involve some form of heat. Whether it is from the grill, fireworks, or just the outside ambient temperature, July can be a dangerous month.
With all the distractions, keeping an eye on the children can be a challenge. They are fearless and without boundaries. I just returned from a week at the beach with my grandson. I am exhausted. One minute he was under the umbrella, the next he was running after the seagulls, and yet a split second later, he was splashing in a tide pool with the fish. So the question is: How do you grill the perfect burger, flip the hot dogs, apply the sunscreen, refill the iced tea, and blow out the 235 candles on the nation’s birthday cake while tending a toddler? The grill is a tempting touch point for little fingers. As are candles and snuffed out sparklers. The answer to the question is: Take turns watching the tot so everyone can participate in the celebration and commemoration of our countries birth. Here are a few other tips to help you and your families celebrate and safe and happy 4th of July!

· Don’t walk away from a hot grill
· Pick the right location: never grill indoors, and have the grill in a well ventilated area
· Never add charcoal starter fluid once the fire has started
· Keep a fireproof pan under the grill to catch the grease drippings
· Always have water to put out fires/sparklers
· Never point fireworks at anyone
· Don’t wear loose clothing next to the grill
· Dispose of coals properly, soaking them in water until the fire is completely out
· A clean grill prevents fire flare-ups
· If friends and family are driving to your party, remember to have plenty of non-alcoholic beverages on hand

MaryAnn Contreras, RN

Trauma Nurse/Injury Prevention Coordinator

Preventing Swimmer’s Ear

2011-06-29T08:54:00.000-07:00

Spending a lot of time at the pool this summer? Otitis externa, sometimes known as swimmer’s ear is a common problem especially among young children and teenagers. It can turn into a painful reason to avoid the pool and end up ruining summer fun. The good news is there are ways to prevent it.

Swimmer’s ear is caused by moisture in the outer ear canal which allows bacteria and fungus to grow creating an infection. Otitis externa can also result from irritation to the ear canal. This can be caused by foreign bodies, cleaning the ears with sharp instruments, and chemical irritants.
Symptoms of swimmer’s ear include ear pain, redness, itching, tenderness, discharge, and possibly muffled hearing. These are not to be confused with symptoms of otitis media or an inner ear infection. The inner and outer ear are separated by the ear drum. Since swimmer’s ear is an infection of the outer ear, tugging and prodding the ear lobe causes pain unlike an inner ear infection. Inner ear infections can be accompanied by fever and may be treated with oral antibiotics depending on the cause and the patient’s age.

Your ears have natural defenses that help keep them free of infection. One of these mechanisms is the production of ear wax. Earwax helps remove debris such as dirt and dead skin cells by moving them out of the ear. The ear canal is also slanted downward to help water drain out. There are a few simple ways to help prevent swimmer’s ear and get the most out of going to the pool this summer. Earplugs are a simple way to keep water out of the ear canal thus preventing an environment for bacteria to grow. Also drying ears and allowing water to drain from each ear can help prevent swimmer’s ear. To help remove water after swimming, over the counter drying agents and home remedies containing alcohol and acetic acid (white vinegar) can be placed in each ear and then drained to get any excess water out. They should not be used if there is a current infection, injury to the ear drum, or the child has tubes in their ears.

Swimmer’s ear should be treated by a physician. Treatment for an existing swimmer’s ear infection may require antibiotics, steroids, acidic solutions, or antifungals. These are usually prescribed by the physician in the form of ear drops since they are targeting the outer ear canal. Oral medications can also be given.

To keep an earache from spoiling your summer fun, following these simple tips for preventing swimmer’s ear and enjoy your time at the pool.

Lacey Mullins, Pharm D.

Maintaining Roadway Safety

2011-06-07T13:41:00.000-07:00

As gas prices continue to increase, so does the need for some motorists to find other means of transportation. This need has given rise to one of the more dangerous hobbies: motorcycle riding. Whether or not the sun is shining and regardless of the temperature, motorcycle riders or “un-caged” drivers can be found out riding their prized possession. Unfortunately, the Emergency Department at Texas Health Fort Worth generally encounters a number of individuals who fall victim to injuries sustained while riding out on local streets and highways. Many of the injuries can be avoided by implementing a few preventative measures.
Most people can tell you, “I heard the bike”, and can mentally imagine the bike, usually due to the distinctive and discernable sound of these vehicles. Even with the audible noises, sadly, the rider and bike are never actually seen until after an accident has occurred, in a usually less than recognizable state. Statistics tell us that hearing simply isn’t enough. Some of the worst crashes have occurred because the opposing driver simply did not have sight of the motorcyclist.
The simplest and most cost efficient thing any rider can do to help prevent an accident is to add reflective devices and wear reflective clothing. They can help increase rider visibility. State law requires all motorcycle bikes to maintain an active, lit headlight while the ignition is on. This helps to increase motorcycle visibility by attracting additional attention.
Each driver, whether a two or four wheeled vehicle, has the same responsibility: ensuring roadway safety. Simple and inexpensive devices and gadgets can help improve visibility and audibility, which can help to decrease the occurrence of an incident. According to the Texas Department of Public Safety, nearly two-thirds of vehicle vs. motorcycle accidents are caused, not by the motorcyclist, but by the driver. The driver either does not see the oncoming motorcyclist at all or does not see the motorcyclist in time to avoid an accident.
One summer day in 2010, a motorcycle collision and lack of efficient safety and protective devices put my life at risk. As a motorcycle enthusiast, it is important that I do my part to help others understand the importance of driver safety.

Tim Farris
Nursing Student

The Truth about Potassium Iodide

2011-05-19T08:52:00.000-07:00

Due to recent nuclear events in Japan, there has been an increased interest in potassium iodide supplements. Iodine is an important nutrient in the body that aids in the production of thyroid hormones. Our body gets most of the iodine it needs from the food we eat. When a nuclear event occurs, our bodies are exposed to radioactive iodine either through the contaminated air we breathe or contamination in our food supply. Once our bodies are exposed to radioactive iodine, it is quickly absorbed by the thyroid gland, which can damage the gland and ultimately lead to thyroid cancer. Potassium iodide is the medicinal form of iodine and can be taken orally to protect the thyroid gland by blocking the radioactive iodine from being absorbed.

If a nuclear event occurs and radioactive iodine is released into the environment a public health official may advise you to take one dose of potassium iodide daily for a few days. Babies and children will likely be treated first because they are more sensitive to radioactive iodine than adults and may be more likely to develop thyroid cancer from radiation exposure. One dose of potassium iodide protects the thyroid gland for 24 hours. Taking potassium iodide for too long can lead to harmful side effects such as allergic reactions, skin rashes, and thyroid problems. People with an allergy to iodine should not take this medication. People with certain skin disorders or thyroid disease (e.g. Graves’ disease) should be treated under the supervision of a doctor.

There are three over the counter potassium iodide supplements available that are approved by the Food and Drug Administration (FDA): Iosat, ThyroSafe and ThyroShield. All other potassium iodide products have not been evaluated by the FDA for consumer safety. There is a common misconception that potassium iodide will protect a person from any and all radiation exposure. However, potassium iodide only protects a person from radioactive iodine and not other forms of radiation. Thus while the thyroid gland may be protected, potassium iodide does not protect the body’s other vital organs from the harmful effects of radiation.

For more information on Potassium Iodide please visit the Centers for Disease Control and Prevention website, http://www.bt.cdc.gov/radiation/ki.asp.

Nicole Day
PharmD

Patient’s Guide to the Proper Use of Antibiotics:

2011-04-21T11:53:00.000-07:00

Ever wonder why directions on your antibiotics say “Take until finished” or “Complete all doses as specified”?
Why is it so important to finish all antibiotics? You must not need antibiotics when you’re already feeling better and have been for days now, right?

Wrong. Let’s take a look at why…

Antibiotics are medicines that help fight bacterial infections. Remember, antibiotics do not fight infections caused by viruses, and most common colds are caused by viruses. Antibiotics are prescribed to last for a specified amount of time. This length of time varies, but is designed for the antibiotic to last until all (or most) of the disease-causing bacteria are killed. The body’s own immune system will help in this process too, but it’s very important to take the whole course of antibiotics, regardless of how you may feel.

There are a few reasons for taking the antibiotics that have been prescribed as directed. First, keep in mind that bacteria are “survivalists”; If there are enough harmful bacteria lingering around in the body, they will eventually “get smart” and start finding ways to change and avoid being killed by an antibiotic. This can happen through various means and is called “antibiotic resistance”. Also, bacteria will try and re-mount an attack on the body when antibiotic levels are low, or if antibiotic therapy has stopped prematurely. For these reason it is important to take every dose as scheduled to complete the entire therapy as directed.

Why is antibiotic resistance bad and how can it affect others too?
Antibiotic resistance can cause a drug to not be effective anymore. By allowing the bacteria to linger and mutate, it can now evade the antibiotic with which we are treating. In essence, you have bred a new strain of bacteria – one that is not killed by the antibiotic we might like to use. This will limit antibiotics that can be used in the future, both for you and others in the community, since bacteria can be transferred easily from person to person.

Always keep in mind that most drugs are prescribed for a specific length of time for a reason. Taking antibiotics based on how you feel is NEVER a good idea.

Lance Ray, Pharm.D.

Distracted Driving Effects Everyone

2011-04-19T07:17:00.000-07:00

I am always multitasking. I have been that way for a long time. Being the mother of four sort of predisposes one to this condition. I can answer the phone, go over homework, throw in a load of clothes and make a mean chicken parmesan all at the same time. I say that with pride. I like to know that I make the most of every minute. I love to cross things off my list, it gives me a since of accomplishment. So naturally when I hop in my car (to do list in hand) buckle my seatbelt, and put the car in gear, my cell phone is within reach. After all, I wouldn’t want to miss a call digging thru my purse while it rings incessantly. It could be an important message, or a photo of my grandbaby, or my son calling from Afghanistan, or my best friend to schedule lunch. It might even be a tweet from my techno-proficient seventy-something year-old mother. There are a lot of people who rely on me to answer my phone. Which is why I should not answer it while I am driving. That is the point.

My friends, my children, my parents, my co-workers and even the person who is driving in front of me rely on me to pay attention to the road. Sending a text or even talking on the phone raises the possibility of crashing by 400 percent. 400 percent is HUGE. If only my stock portfolio had such a percentage. Of course we always assume it won’t happen to us. Distracted driving injured 448,000 folks in one year alone. One in five drivers has admitted to surfing the web while driving. Distracted driving is quickly becoming an epidemic. The vaccine is prevention! The safest way to get from here to there is to just put down the phone and drive. I’m making that commitment, how about joining me? After all, there are people counting on you too.

MaryAnn Contreras, RN

Injury Prevention/Trauma Nurse Coordinator

MaryAnn Contreras

Injury Prevention Coordinator

Were You Born at Texas Health Fort Worth?

2011-03-29T08:43:00.000-07:00

Prior to joining Texas Health Resources (THR), I’d had the opportunity to work with the organization on a number of events and developed a positive impression. I began to feel like it was something I had to be a part of. I joined THR more than 11 years ago, but my connection to the organization goes back much farther.

I was born at Texas Health Harris Methodist Hospital Fort Worth where my mother also delivered my three sisters. I followed suit and delivered my two beautiful children at Texas Health Fort Worth as did my sisters. We even shared the same OB/GYN for four of our children’s births. For me, choosing to deliver at Texas Health Fort Worth wasn’t just about a family tradition. I remember growing up when someone asked, “Where were you born,” the response was always, “Harris Methodist”! It became almost “club” like. As I got older and more educated, I had a better understanding why that was the answer.

My mother chose Texas Health Fort Worth because of the level of care she knew she would receive, the tenured staff and the advanced technology. My sisters and I chose to deliver there for the same reasons. I think as the community grows, people need to feel that sense of family in knowing who their neighbors are and who they can trust.

Texas Health Fort Worth has built their reputation based on providing care for patients at their most vulnerable times and treating them as if they are family. The hospital embodies the philosophy of “treat others the way you want to be treated.” That’s something that my mother instilled in me and my siblings and something that we work to instill in our children as well. So, I am very fortunate and proud to represent an organization that places individualized care at the forefront of everything they do.

Jeanine Andersen

Marketing Manager

The Only Thing Constant

2011-03-02T06:19:00.000-08:00

Most likely you have heard the maxim that the only thing constant in life is change. Change is always with us. Like it or not a great many things that we have, know, and even hold near and dear will be transformed, modified, and morphed into something completely different. That fact is usually proclaimed as a lament, a sad truth we just have to live with. I hope you will allow me to offer a different, and hopefully refreshing, approach to this poser we call change.

It is true that we live in a world of transformation. But is that really so bad? I want to be brazen enough to suggest that we consider welcoming change into our lives. Constant sunshine, just like constant rain and dreary skies, does become lackluster. I have lived in the land of blue skies and an ever-present sun. Trust me when I tell you that we longed for the crack of thunder and a good downpour. It most likely will not surprise you then when I declare that it is likewise good and healthy for our emotions to change. Constant happiness, smiles, and pure glee will become nothing special, indeed trite after a while. Sadness is not my first choice, but it sure helps me appreciate the joy in my life.

Change is an ever-present companion in our hospital. Our patients and families arrive because something has changed, shifted in their world. As a team of healthcare professionals our goal then becomes to bring about yet another alteration, albeit for the better this time. It is in this change journey, this process focused on healing and fueled by hope that we ourselves change. Striving together as agents of change our goal becomes the restoration of peace in what is often perceived as a storm of chaos by our patients and families. And when the skies clear, when everyone involved breathes deeply once again, we realize we have survived this tempest of change. Dare I suggest that we perhaps might even be better as a result of what we have been through?

Allow me to offer a reminder, therefore, that change will always be with us. It waits just around the corner. The ebb and flow of life will not evaporate, will not cease, but is indeed a constant on which we can depend. Life bristles with a flux all its own. But, within this maelstrom of modification we can, and in fact are challenged, to find good. Change often does feel like bedlam run amuck. But good things frequently are birthed in the cauldron of chaos.

And finally permit me to challenge you to have something in your life that is beyond change. For me it is tending to my spiritual yearnings and needs. My Creator has simply and significantly declared I AM. That is enough. Bring on the change, transformation, modification, and the whirlwind of chaos. When the dust settles, the battlefield of adjustments is surveyed, and the wounded tended to, my Comforter is there ready to encourage and convince me that perhaps whatever is new is not so bad after all.

So, let the change begin—we will not have to linger very long l assure you. But do not fear. It is standard equipment with this thing called life. And, we will endure.

Carey Reynolds

Staff Chaplain

Use over the counter products to really quit smoking in 2011

2011-02-15T10:37:00.000-08:00

According to the World Health Organization, tobacco kills more than five million people a year. The CDC reports that smoking is the leading preventable cause of death in the United States today. Of the smokers in the United States, 70% desire to quit. Smoking cessation success rates double when tobacco use treatment is utilized.

Fortunately for smokers, there is a wide variety of OTC (over-the-counter) nicotine replacement products to assist them in their quest to quit. Nicotine replacement therapy dosage forms include patches, gum, and lozenges. As soon at these OTC nicotine replacement therapies are started, the smoker must completely quit using all tobacco products.

Nicotine Patches
Nicotine replacement patches are the only OTC product to provide a constant release of nicotine throughout the day. The downside of this constant release of nicotine is that the patches do not allow the smoker to respond to acute cravings throughout the day. Therapy with nicotine patches is available in three steps that included the dosages of 21 mg, 14 mg, and 7 mg patches. Smokers that use fewer than 10 cigarettes per day should start on the 14 mg patch for 5 weeks and then decrease to the 7mg patch for 2 weeks.

It is important to never cut nicotine patches or wear more than one patch at a time. Nicotine patches should be applied to clean; dry skin area and the application site should be rotated on a daily basis to help decrease skin irritation, which is the most commonly reported side effect. Some nicotine patch wearers have complained of insomnia and vivid or abnormal dreams . To prevent these side effects, the nicotine patch can be removed at bedtime and a new patch can then be applied every morning.

Nicotine Gum

Nicotine gum is available in 2 mg and 4 mg strengths. For smokers who smoke fewer than 25 cigarettes per day, the 2 mg strength should be used. Those smokers who smoke more than 25 cigarettes per day should use the 4 mg strength.
During weeks 1-6 of nicotine gum therapy, one piece of gum should be chewed every 1-2 hours with at least 9 pieces of gum used per day. During weeks 7-9, one piece of gum should be chewed every 2-4 hours. Finally in weeks 10-12, one piece of gum should be chewed every 4-8 hours. The most common side effects of nicotine gum include upset stomach, unpleasant taste, hiccups, and jaw soreness.

Nicotine Lozenges

Nicotine lozenges are available in 2 mg and 4 mg strengths. It is recommended that patients who smoke their first cigarette within 30 minutes of waking up should start with the 4 mg strength lozenge. For all other smokers, it is recommended to start with the 2 mg strength lozenge. It is important to dissolve the lozenge slowly in the mouth and never to chew or swallow the lozenge whole. Food or drink should be avoided for 15 minutes prior to, during, or after using the lozenge. Two lozenges should never be used at one time.

Never use two nicotine replacement therapies at the same time unless directed to do so by your primary care provider. It is generally not recommended to use the nicotine patches, gum, or lozenges longer than 2-3 months, but talk to your primary care provider to assess if a longer amount of therapy is needed.

Alisia Baker, PharmD

Texas Health Fort Worth

2011 Shouldn’t Hurt

2011-02-08T07:52:00.000-08:00

Now is a time for resolutions and new beginnings and I want to challenge you all with a goal that you don’t have to take on alone.

The goal is to initiate a change in the rapidly increasing numbers of domestic violence crimes that are occurring in our community. Domestic violence, as defined by Webster's dictionary, is the inflicting of physical injury by one family or household member onto another. Violence takes many forms and usually leaves the victim traumatized for life if they survive.

At Texas Health Fort Worth we are dedicated to caring for patients mind, body and spirit, but the number one weapon against domestic violence is education. The Domestic Violence Task Force seeks to improve how we provide compassionate and caring service to the victims of domestic violence who come through our doors. Through the assistance of the continuous improvement department, the task force has developed a threefold strategy:

Research the latest trends in domestic violence

Educate Texas Health Fort Worth staff, physicians and volunteers on how to sensitively approach a potential victim

Provide a resource manual for victims to find long-term support

If you suspect a loved one is a victim of domestic violence, please contact a health care professional.

Angelo Betancourt

Staff Chaplain

2011-02-02T12:21:00.000-08:00

Well, it is nearly here. Everyone is gearing up, parties are being organized and I’m sure there are a few wagers out there regarding who the next Super Bowl champs will be. Cowboy Stadium is ready, all 73 acres. Did you know the entire Statue of Liberty and its base can fit into the stadium with the roof closed? And if that isn’t big enough, the stadium holds the world’s largest high-definition video display. The parking lots open at 10AM while the kick off is scheduled to begin at 5:30PM, so you know that local traffic will be hectic to say the least.

Much preparation has taken place to keep all 110,000 fans safe at the stadium. While we are all aware of the times we live in, not all the risks are at the game. Young males, ages 21-34 who are the core audience for major sporting events, are most likely to be involved in car crashes, to drive impaired and not wear seatbelts according to the National Highway Traffic Safety Administration. You have heard me say before that a seatbelt is your best defense against an impaired driver, so buckle up!

Personally, I am enjoying the game (and the innovative commercials) at home with friends. I can’t boast of having the largest high-definition TV, but I have a primo parking spot and reserved seating. If you are having friends and family over, remember to designate your driver early. Serve lots of food, including non-alcoholic beverages. In the third quarter, put the adult beverages up and bring out the coffee and desserts. It’s also a great idea to have the numbers for local cab companies handy. Enjoy this event without penalties, fouls or calls of unsportsmanlike conduct, because in real life there aren’t instant replays.

Mary Ann Contreras, RN

Injury Prevention Coordinator

Bariatric Diary: Happy New Year!

2011-01-10T09:02:00.000-08:00

I for one have never been happier to start a new year. This past year has brought on lots of changes in my life. I come into 2011 with a renewed spirit and a new body to go with it.

The holidays are one of the many challenges you will come across as a bariatric patient. You have the fears of what you will eat, when you will eat it, and how your body will be affected. I am a big believer that the whole process of recovery is a mental game. I told myself going into the holidays that it was just going to be business as usual and that it wouldn’t be a big deal to watch everyone around me eating the normal foods and enjoying what might have been my favorite dishes from the past. I have to admit that those things didn’t bother me so much. The thing that did get under my skin a little was everyone being so darn concerned with my diet. I quit counting how many times people would ask what I could eat, if it was hard for me to pass up certain foods, or if there was anything special I needed for food options. I would have never thought my eating habits would affect so many people!!

So as I start this New Year, I have for the most part overcome any difficulties I once had from my surgery. If you remember, a few months ago I had to have a couple endoscopies to dilate my stomach due to a stricture. It’s a miracle, it worked!! My food options have expanded greatly and I am maintaining my weight without any major fluctuations. There are still foods that I cannot eat and others that I have psyched myself out from eating.

One thing I will mention that I have found to be the most challenging part of the surgery is shopping for clothes. One thing you take for granted many times when you are bigger is the options your smaller counterparts have when clothes shopping. Before, I would head straight to the big and tall section and pick from a limited supply of clothes in one of a handful of colors. Now, I actually have to shop through the entire store. Don’t get me wrong, I like having more options and more trendy clothing but who would have known shopping was such hard work. This probably isn’t an issue for all bariatric patients, but I have never been a big shopper. This is slowly changing with my new body and my shrinking closet.

Now the information you all want to know. I started off in January 2010 at 354 lbs. Based on being 6 foot tall I had a BMI of 48. I was wearing a size 50 waist in pants and 4x in shirts. As of today, I weigh in at 198 lbs with a BMI of 26.9. I am now wearing a 38 waist in pants and XL in shirts. So as you can see I have made a big transition in less than 8 months since surgery.

The journey continues…..

Rev Up Your Metabolism in 2011

2011-01-06T08:26:00.000-08:00

Are you sick of being 10, 20 or more pounds overweight and ready for a change? Let’s rev up your metabolism in 2011 so you can look and more importantly, feel great! Many people want a quick fix and get caught up in all of the fad diets and temporary weight-loss eating programs, but the problem is they cannot maintain it and end up gaining weight back. One goal of starting a new eating program should be to get your metabolism burning and make lifestyle eating changes. It’s often not the easy way, but is a healthier form of weight loss that tends to outlast the fad diet results. It’s not rocket science! There are 3 easy ways to get the metabolism burning:

Eat Small Frequent Meals

Many people think skipping meals is the way to lose weight. Not true!!! Your metabolism actually raises each time you eat to digest the food you are eating. Thus, eating 6 times per day versus 3 times per day keeps the metabolizing up and running. Your goal should be to eat 3 small meals and 2-3 snacks per day. Each meal should contain nutrient rich foods to help you stay full and satiated throughout the day.

Eating frequently does take some time and effort. Just remember, if it was easy everybody would be doing it! So, in order to be successful, consider making your meals and snacks on the weekends so it does not cause extra work during the week. Grab some snack baggies and bag up nuts, whole grain crackers, turkey, raw veggies, etc so they are ready to grab. Make it a habit and it will get easier!

Pay Attention to What You Are Eating

Each meal should contain a serving of whole grain carbohydrate (granola bar, whole wheat crackers, 1 slice whole wheat bread) or fruit. Carbohydrate will give your body energy over the course of the day. However, eating carbohydrates along will spike your blood sugar and cause it to drop more drastically. So, pair your carbohydrate with a lean protein (2% cheese, yogurt, cottage cheese, deli meat) or healthy fat (peanut butter, nuts, avocado, egg). Protein and fat slow down digestion, help prevent blood sugar from spiking and keep you feeling full longer.

Be sure to include non-starchy vegetables (starchy = corn, peas, potatoes, winter squash) in as many meals as possible. Veggies are full of vitamins, minerals, antioxidants and fiber! They will help you feel full for little calories.

Exercise

If you want your metabolism to rev up, you gotta get moving!!! Exercise not only speeds up metabolism, but also burns calories. Cardiovascular and strength training togetherburns calories and builds lean muscle mass. Lean muscle mass is more dense than fat and thus takes up less space. So the more muscle you have, the smaller and leaner you look! In addition, exercise has a variety of cardiovascular benefits from helping lower blood pressure and bad cholesterol to increasing good cholesterol and decreasing triglycerides.

The American College of Sports Medicine recommends 60-90 minutes a day of moderate exercise, most days of the week, for weight loss. So if you are not moving at all, let’s get started! Aim for at least 30 minutes of activity most days of the week to get your metabolism up and burning!

Amy Goodson, MS, RD, CSSD, LD
Registered Dietitian

If you have a question for the dietitian, visit www.texashealth.org/askamy

Heartburn Hurting You?

2010-12-22T09:35:00.000-08:00

Many people suffer from gastric esophageal reflux disease or GERD. GERD results from a combination of excess gastric juices and impaired esophageal clearance of acid leading to a burning discomfort referred to as heartburn.

There are different degrees of GERD ranging from mild symptoms which can be managed by over the counter products and lifestyle changes, to severe or recurrent problems requiring medical treatment.

There are several ways to help with GERD symptoms other than taking medications. Lifestyle modifications such as elevating the head of the bed 4-6 inches can help prevent symptoms of GERD.

Avoiding tight fitting clothes, eating 2-3 hours before bed, and sitting up right after meals can decrease the risk of having heartburn. In addition to lifestyle changes dietary modifications can also decrease the occurrence of heartburn. Avoid acidic beverages such as orange juice, red wine, and sodas as well as fatty foods and foods which exacerbate symptoms. Eating smaller more frequent meals and maintaining a healthy weight can decrease the risk of GERD.

There are several different products available over-the-counter that decrease heartburn. Antacids such as Tums, Rolaids, Maalox, and Mylanta neutralize acid. These can be taken for mild, infrequent heart burn and for relief of current symptoms. Other over the counter medications lower the amount of acid secreted. H2 blockers such as Pepcid®, Zantac®, and Tagamet® are effective and relatively inexpensive. Prevacid® and Prilosec® are the only proton pump inhibitors available OTC, others require a prescription. Over the counter medications are relatively safe but they can interact with other medications. Ask your pharmacist or physician which medication is most appropriate for you.Even though heartburn is common it could be a sign of more serious problems. Patients should see a doctor if they have symptoms two or more times a week, don’t get relief from medications, have difficulty swallowing, acid causes choking, wheezing, or hoarseness, or unexplained weight loss.

Lacey Mullins, Pharm.D.

“Med/Surg Gives”

2010-12-17T07:22:00.000-08:00

In the spirit of the season, the Medical-Surgical Division at THFW recently spent 3 hours at the Tarrant Area Food Bank moving food. It’s astonishing what can be done with a bit of time and effort…In the grocery area for boxing food, we packaged 13,960 lbs. of canned and boxed food items. In the back sorting area, we moved another 11,700 lbs. of food. In total, we boxed and sorted 25,660 lbs. of food which will be used to feed the hungry in our community this holiday season.

The teamwork during this project was amazing. We showed up with a job to do and we exceeded expectations. Those that participated came with full knowledge of the work that needed to be done and demonstrated the spirit of the season—GIVING! Our goal was to gather supplies and food for about 8 pallets and we finished 11! We rolled up our sleeves and hustled. Nine units participated and we all worked together to get the most done in the time allotted. Texas Health Resource’s Mission is, “To improve the health of the people in the communities we serve”. We would like to believe that this project allowed us to serve our community on a grand scale outside of our traditional roles in the hospital.

I hope that during this time of year, we all look for ways to give back to our families, friends, and community. The reward in giving to others is seeing their great joy return. It is easy to get caught up in the hustle and bustle of the season. This year let’s take a moment to reflect on our blessings and the blessings we have given others.

Advent: "A Song for all Seasons"

2010-12-13T07:05:00.000-08:00

“The Word became human and made his home among us."

~ John 1:14

There once lived a king with dominion over all nations. His courts were of richest splendor. Music and laughter floated from his castle. Clouds wrapped it in ethereal majesty. The peasants, in their valley of violence and hunger, looked longingly at the castle, wishing they might know the king. But none could reach it.

One day in the cold of winter, the king’s tailor entered the king’s chambers with new additions to the royal wardrobe. He had chosen the finest materials and woven them into the most beautiful garments ever seen.

But the king was not pleased. He ordered the tailor out and said, “I will make my own clothes.” The door to the throne room was shut and locked. Weeks passed. All waited in keen anticipation to see what the king would make for himself. Surely they would be blinded by his glory! Finally, the day arrived, the door opened, and the king appeared.

Everyone, especially the tailor, gasped in shock. For the king was dressed in the simplest, cheapest, most “unkingly” garments imaginable! He had the choice of the world’s finest materials, but he had chosen to wear the clothes of a beggar. He spoke softly to everyone and said simplyh: “I am going down into the valley.”

“Behold, I bring you good news of a great joy…
for today…there has been born for you a
Savior, who is Christ the Lord.”

The stage was set. The day had finally come. Prophets had anticipated it for generations. God had hinted at it for millenia. Now was the beginning of that “into which angels longed to look.” The “fullness of time” had finally come.

The world had long been imprisoned, groaning and trapped in a web of sin and death, heartbreak and sorrow.

“Long lay the world in sin and error pining,
till HE appeared and the soul felt its worth.”

Now, God Almighty – King of the universe, Lord of history, rightful ruler of the Earth – is about to invade this rebel-ruled world.

You would think His invasion would come with mighty signs and wonders! You would think the skies would be lit as far as one could see! You would think the shouts of the heavenly host would be ear-splitting! You would think that the whole earth would shake mightily from the impact of His landing – that in some sense all of mankind would know that God had landed!

But, here comes GOD!!! – Almighty Creator, Sustainer of the universe -- by whom, and through whom, and for whom are all things! And the only sound heard is the gentle breathing of a tiny baby sleeping in his mother’s arms.

History’s turning point, the greatest event in all of history – and the only sign we have of it is a baby lying in a manger, a group of shepherds scared silly … and a single, bright star.

“What child is this, who laid to rest, on Mary’s lap is sleeping –
Whom angels greet with anthems sweet, while shepherds watch are keeping?
THIS, THIS is CHRIST the KING!”

Emmanuel! God with US! It is the most outlandish, mind-boggling story in all the Bible, in a million galaxies, in all of eternity. The heavens were stunned into silence and unbridled praise all at the same time.

Even the angels could not have anticipated this one! Gabriel had to be scratching his head! God coming to the valley! God coming to earth … in the body of a human being! “The Word became human and made his home among US!”

And for 33 years, Jesus would feel everything that you and I have ever felt. He blew his nose, he hit his thumb, he cut his hands, and his back hurt. He felt weak. He grew weary. He was afraid of failure. His feelings got hurt. His feet were tired. His head ached. And he felt lost and alone … without his Father.

The Christmas season has always been special to me – trees, lights, decorations, wrapping, giving. My heart is filled to overflowing. Despite all the “What do I get her?” – and, “How much can we afford this year?” – I try with all my being to focus on Jesus.

I grew up in Dallas, where Christmas meant repeated trips to the corner toy extravaganza display at the Sears store on W. Jefferson … wearing out the Sears and J.C. Penney Christmas catalogs…and avoiding sitting in Santa’s lap! But since my childhood, it has been the songs that awaken so much inside me.

As much as I enjoy “Jingle Bells”, and “White Christmas” (ever wonder how those play out for folks in Hawaii?), and the kids’ favorite song -- “Grandma Got Run Over By a Reindeer!” -- it’s the other songs that stir something deep within me:
O Holy Night …
What Child is This? …
Silent Night, Holy Night …
Joy to the World …
Hark, the Herald Angels Sing!

Nothing stirs our heart like song. Nothing expresses the heart like song. And Jesus is the focus of more songs than anyone to ever walk the face of the earth. How fitting that His coming was announced by a heavenly chorus? But “Christmas” is truly only the beginning of the story...

Jesus sent word to John: “The blind can see, the lame can walk, the lepers are made clean, the deaf can hear, the dead are raised to life, and the Good News is preached to the poor.” Good News! Great Joy! For ALL people!

And ever since -- even in the midst of heartbreak, struggle and pain -- the story of Jesus has given hope and new life to the human heart. “A thrill of hope, a weary world rejoices!”

Together with the songs, the most conspicuous, consistent symbol of the season has to be all the lights. Lights are everywhere! Lights cover houses, office buildings, department stores, town squares, hospitals … even a few semis rumbling down the highways!

There has always been a connection between “light” and “glory.” Can you imagine what it was like that night, out on the hillside?! The “glory of the Lord” was a light of such incredible magnitude that the angel had to quickly calm the shepherds, telling them not to be afraid. The Good News not only begins with Jesus the infant, it begins with Jesus the Light: “In Him was life, and the life was the light of men” (John 1:4).

I’ve seen that Light. In fact, it amazes me the number of times every day that I see Jesus in our hospital:
• In the faces of little children…
• In the eyes of patients whose bodies are ravaged by deadly disease and broken by trauma…
• In the tears of those whose loved one has died, or is dying…
• In waiting rooms where families spend sleepless, restless nights in prayer on hard floors, as a loved one clings to this life…
• As doctors lovingly and compassionately share the news that so many don’t want to hear…
• As everyone -- from Nurses, to PCT’s, to Secretaries, to Transportation, to Dieticians, to PA’s, to PT’s, to RT’s, to Social Workers and Case Managers (and all those whose job titles I just left out!), and yes, Chaplains – rushes to the side of those in pain … lifting them up, sharing their pain, holding them up…arms wrapped securely around them, drying their tears, and often in tears with them…
• And as hospital administrators discuss how to more effectively, compassionately, and lovingly meet the needs of the growing numbers of God’s children in need of our care.

Yes, Jesus is in YOU. When those we serve in life go looking for Jesus, needing Jesus … guess where they find Him?! In you. Through you, the light shines even in the darkness. For those of us whose lives have been transformed by the power and presence that was wrapped up in those swaddling clothes 2,000 years ago… “Christmas” means new birth and a living hope – a hope that we share with one another – hope for a time when all of our pains and sorrows will be swept away by endless joy… and in endless SONG.

So why let Jesus be the reason for only one season? Why sing certain songs only one month out of the year? Corrie Ten Boom wrote: “If Jesus were born 10,000 times in Bethlehem, and not in me, I would be lost.”

Let’s keep the message of Jesus alive in our hearts throughout the year. Let’s make the story of Jesus “A Song for ALL Seasons.”

One starry night, our world was changed forever.......

Jim Tenery
Staff Chaplain
Board Certified Chaplain, APC

2010-12-07T11:40:00.000-08:00

My name is David Swearingen and this is my story. I am the youngest of three boys in my family and my dad is retired from the United States Air Force. My life was pretty much like many other high school students all across America until the spring of 1979. That spring, I decided to try out for the Stephenville High School baseball team. A pre-requisite to trying out was a routine physical. This routine physical determined there was too much protein in my urine – not routine at all.

I was 16 years old at this time. I was sent to Carswell Air Force Base in Ft. Worth, Texas for testing and it was later determined that a kidney biopsy would be necessary. The biopsy showed that I had a kidney disease known as glomerulonephritis. Eventually I would need a kidney transplant.

All of my family members were tested and it was concluded that my brother, Weldon, would be the best match for a kidney transplant when the time came. Having this reassurance, I was able to live a normal life until January 1981.

I was in my second semester at Tarleton State University in Stephenville, Texas. Just a few weeks into the semester, my kidney function took a drastic turn for the worse. I was in kidney failure and it was necessary for me to go on dialysis for six weeks.

In March of that year, Weldon and I were both admitted into Wilford Hall Medical Center in Lackland Air Force Base in San Antonio, Texas. I was 18 years old and my brother was 21 years old. I was apprehensive about what the future would hold; my brother, on the other hand, didn’t display any fear. At the young age of only 21, he voluntarily would donate a kidney – a heroic and loving gesture.

I will remember the day of my transplant forever. It was like an additional birthday to me – it was the day my brother gave me a second chance at a happy, normal and productive life. At the hospital, Weldon and I were in two different rooms. After the surgery, I asked my parents to roll me into Weldon’s room. When I saw him for the first time after surgery, he was in a lot of pain. His surgery scar is about twice the size of mine. I could not help but cry when I was able to see what he had gone through for me.

He healed well and has never had any problems related to having only one kidney. I, too, healed well and have never gone through any rejection episodes at all. Despite the fact that my brother is three years my elder, the surgeon told me that we were matched almost as well as twins might be. I think this is why I have done so well with this transplant.

Since the transplant, I have lived a normal life. I still have to take anti-rejection medication for as long as I have this kidney. That will be for the rest of my life. I have experienced a “few bumps in the road” along my journey. Now, more than 29 years later, my brother Weldon is still doing well and so am I. I have a wonderful 18-year-old son and I am able to work full time.

I am thankful to God for blessing me with a loving and supportive family and such a giving and unselfish brother. I also feel grateful to God for giving the surgeons and medical staff the skill and knowledge to perform this successful transplant. I now try to “give a little back” for the blessings that God has given me. I work full-time at FMC Technologies in Stephenville. I am an active member and past-president of the Stephenville Kiwanis Club. I participate in National Kidney Foundation walks, I volunteer for LifeGift, I participate on a Relay for Life team and I am the photographer for the Stephenville High School Band. I am also an elder at the First Christian Church of Stephenville and occasionally help with the high school youth group. Additionally, I remain active with the Team North Texas U.S. Transplant Games team, a team of athletes who have all been touched by organ donation.

Please consider being an organ donor. It takes less than five minutes, is free and could save a life.

May God bless you as he has blessed me.

David Swearingen (kidney transplant, March 10, 1981)

I Didn't Know... Did You?

2010-11-30T07:17:00.000-08:00

Did you know that for three decades November has served as National Hospice and Palliative Care Month? I didn’t know, and I work in Palliative Care. So now I am here to spread the word…NOVEMBER IS NATIONAL HOSPICE AND PALLIATIVE CARE MONTH.

Why is this significant?

In 1978, President Jimmy Carter signed the first proclamation designating November as hospice month. At that time, hospices served several thousand patients and their families. Current data from the National Hospice and Palliative Care Organization (NHPCO) shows that a record 1.56 million people with life-limiting illness and disease (41.5 percent of those who died in the US in 2009) were served by hospice and palliative care organizations.

What is palliative care?

According to http://www.getpalliativecare.org/, “Palliative care is the medical specialty focused on improving overall quality of life for patients and families facing serious illness. Emphasis is placed on intensive communication, pain and symptom management, and coordination of care.”

In July 2009, Texas Health Harris Methodist Hospital Fort Worth opened North Texas’ first Palliative Care Unit. We are a 16-bed unit that focuses on providing quality care to patients and their families. We see patients at many points during their disease process and should, ideally, become involved as part of the care team when a patient first receives a chronic disease diagnosis.

Why palliative care?

Palliative care at Texas Health Fort Worth provides a holistic approach to treatment. Our interdisciplinary team works together to coordinate a plan of care that best meets the patients’ and families’ wants and needs. Our goal is to relieve the symptoms that may come along with a disease and to improve quality of life.

Many of you may have a personal experience with palliative care or hospice. I know that my family benefitted greatly when we had a loved one in need. I hope that you will take a moment this month to remember those you have lost and thank those that may have cared for them along the way.

References:
http://www.getpalliativecare.org/
http://www.nhpco.org/

Ashley Hodo, RN

Palliative Care Unit Manager

Thanksgiving…Indulge without guilt!

2010-11-24T06:22:00.000-08:00

Does your Thanksgiving meal leave you stuffed and on the couch watching football all afternoon? If so, you might just need to “fine-tune” your indulging. There are a variety of Thanksgiving dishes that are scrumptious, but lower in calories. Take a look at how you can treat yourself without killing your waistline!

Before the Meal

Many people make the mistake of “saving up their calories” for the big meal. The problem is that when you skip meals you end up feeling starving and thus overeat. So to prevent overeating:

- Eat breakfast!
- Do NOT skip meals all day. Eat small meals and snacks all day so you are not starving upon arriving at Thanksgiving dinner!
- Drink water throughout the day as dehydration can make you believe you are hungrier than you actually are!

The Table Setting

The best way to prevent over eating is make it “difficult” to get food…if the food is within arm’s distance, typically people eat more because it is convenient! So what can you do?

- Leave the food in the kitchen instead of placing it family style on the dinner table
- Use the “small” plate at the meal and if you are hungry, you can go back for more
- Only put one serving of each item on your plate; don’t create a mountain of food

Drink This, Not That!

Wine, martinis and champagne…oh how the calories can add up! Alcohol is full of empty calories, which means it has a good amount of calories with no nutrients. The real problem, however, is that alcohol does not make you full like food does so you keep drinking those extra calories. Make your first goal to drink water then have a drink or two throughout the day and alternate water in between.

- Drink red wine INSTEAD of a red fruity cocktail
- Drink light beer INSTEAD of regular beer
- Drink hot chocolate or coffee INSTEAD of eggnog

Eat This, Not That!

Thanksgiving dishes are known for their calories, but there are many healthy choices you can make at the meal and even with dessert. Check out the TOP 10 healthiest decisions you can make at dinner:

- Choose a green salad or raw veggie appetizer INSTEAD of chips and dip
- Choose skinless, white meat turkey INSTEAD of fried or dark meat turkey
- Choose fresh green beans INSTEAD of green bean casserole loaded with creamy sauces
- Choose brown gravy INSTEAD of creamy gravy on your mashed potatoes
- Choose a sweet potato INSTEAD of a sweet potato casserole loaded with marshmallow & sugar
- Choose bright colorful veggies INSTEAD of a plate loaded with white starches
- Choose a whole wheat roll INSTEAD of a croissant or flaky biscuit
- Choose water as your beverage INSTEAD of an alcoholic beverage, sweet tea or soda
- Choose desserts that are fruit based INSTEAD of chocolate or cheesecake based
- Choose pumpkin pie INSTEAD of pecan pie

Amy Goodson, MS, RD, CSSD, LD
Registered Dietitian

Words of Holiday Wisdom

2010-11-23T06:40:00.000-08:00

Well, it’s almost Thanksgiving already. With the changing color of the leaves comes heightened expectations of holidays, parties, gifts and more. A couple of thoughts on fall and winter holidays:

1. Be patient. Don’t let crowds get you blood pressure up. Plan to give yourself more time, whether at the airport or in the mall.

2. Be active. Even though its dark early, and temperatures have dropped, don’t stop exercising. Walking, jogging, biking…whatever you want. Push yourself to burn a few more calories to keep up with the eating extravaganzas…oh, and have you ever wondered why so few people take the stairs – even for a single flight? Fifteen steps up to the next floor isn’t too many. Get going!

3. Get plenty of rest. All the hype and excitement will upset your sleep patterns. There is plenty of evidence that a good night sleep reduces cardiac risks, as well as other conditions. Don’t forget to take care of yourself even as you enjoy the many social occasions.

4. Eat right. Enough said.

5. Don’t go to gatherings if you are feeling sick. Why offer your bug to everyone else? That’s not the kind of present most people want…

6. Get your flu vaccination. It’s not too late, and it protects you…should you be on the receiving end of someone else’s sneeze…

7. Be thankful. There will always be those who have more than we do, and that will never change. But we have much. And giving thanks is good for the spirit, the heart, the soul.

Joseph Prosser, MD

VP, Chief Quality Officer

Ode to breastfeeding mothers!

2010-11-12T08:40:00.000-08:00

My hat goes off to all the women who are reading this blog. As a childbirth educator and lactation consultant for the hospital, we are confronted with moms at many stages of the breastfeeding process. Some have a very positive experience and seem to transition into breastfeeding smoothly while for others, well... I'll let you read for yourself.

"I truly believe breastfeeding is the best for your baby and that is why I continue to stick with it. But let me tell you, it has not been an easy road.

Breastfeeding was a choice and the best choice I feel I have made as a mother yet. Studies show, and I have to agree, that breastfeeding gives your child the healthiest start of life possible. I always knew I wanted to breastfeed my children for as long as I could, but never knew of the dedication and mental toughness this part of motherhood would require. Here is a snippet of my journey...

Breastfeeding is one of the most special bonds a mother and baby can share. You carry this baby for 10 months and bond with it during that time and when he or she is born, breastfeeding is an extension of that bond that you have in utero.

What I was not prepared for is how painful breastfeeding can be and how time consuming it is. The lactation experts at the hospital do a great job of educating you and showing you technique, which is important. The wild card in breastfeeding is how your child will respond and how they will latch.

My baby latched just fine, but has always had poor technique while nursing.
Poor technique=sore nipples!

I was very consistent with my visits with the lactation nurses. You never know the importance or value of the lactation nurses until you have a screaming baby and sore nipples.
After many consultations and working on his technique, I got on the right track. Or so I thought...

This is the part where mental toughness comes into play. After 2.5 months of nursing, I still struggle at times with sore nipples. That is no fault of any ones. I have anatomy that has not complied and a baby who continues to battle poor technique.

I decided long before my baby entered the world that I was going to be successful with breastfeeding. That determination, coupled with a breast shield and lots of nipple cream, has lead to a mental toughness to get through the sore nipples and the occasional discomfort associated with breastfeeding.

On to the issue of time. I am an active person who hates to sit still. Breastfeeding forces you to sit still, enjoy your baby and let them eat - ON THEIR TIME TABLE. This has been a challenge for the "do it" mentality I have. Good news - we live in a world of technology and AWESOME breast pumps. When you need to give your breasts a break and you need to feed your child more efficiently - just pump.

Lactation nurses will tell you that only pumping can lead to a decrease in your milk supply. So, I don't recommend solely pumping. However, I have used pumping as a tool to alternate between breastfeeding and pumping to give my breasts a break and feed more efficiently at times. Just an option!

Bottom line - the benefits of breastfeeding far outweigh the negatives. I have always heard that you lose a lot of weight while breastfeeding. That fact is very true. I also heard that it was more cost-effective to breastfeed. That is also true.

When you go to the grocery store next, price formula. $23 a can for formula that might last a week gets expensive very quickly.

The satisfaction that I know I am giving my baby the very best is mostly what continues to remind me that I CAN do this breastfeeding thing - it is simply a choice.

Must run - baby is screaming and ready to eat."

- Breastfeeding mom

Becky Law, RN, IBCLC, LCCE

Childbirth educator/Lactation consultant

If you have any tips or stories to share, please comment.

Holiday Eating:Cook With This and Not With That

2010-11-09T06:30:00.000-08:00

When thinking about the holidays, most people imagine their grandma’s homemade pie, their mom’s scrumptious casserole and their aunt’s candied sweet potatoes. Umm mm! However, all of these foods have one common denominator: lots of calories! And lots of calories can lead to unwanted weight gain. The average person gains 7 pounds over the holidays because typically people eat higher calorie foods and exercise less.

It is not that you have to cut these foods totally out of your holidays, but making some key substitutions can lower the fat and calories in recipes while keeping the same great taste! Remember, it is not just baked goods that are full of calories, some of your favorite dishes are also loaded with them!

When cooking, substitute:

Cook with this - 1 cup oats or crushed whole wheat crackers
Not with that - 1 cup bread crumbs

Cook with this – 1 cup 2% mozzarella cheese
Not with that –1 cup cheddar cheese

Cook with this – ¼ egg substitute or half banana mashed with half teaspoon baking powder
Not with that - 1 egg

Cook with this – 1 cup low-fat sour cream or plain yogurt
Not with that – 1 cup mayonnaise

Cook with this – 1 cup cooked barley, bulgar or brown rice
Not with that – 1 cup cooked white rice

When baking, substitute:

Bake with this – 1 cup yogurt
Not with that - 1 cup buttermilk

Bake with this – 1 cup natural honey
Not with that – 1 cup corn syrup

Bake with this – 1 cup frozen light whipped topping (thawed)
Not with that – 1 cup cream (whipped)

Bake with this – 1 cup low-fat cottage cheese (pureed)
Not with that – 1 cup cream cheese

Bake with this – 1 cup apple sauce or fruit puree
Not with that – 1 cup oil

Note: Don’t substitute every single ingredient because you might alter the taste and integrity of the end result. However, making a few substitutions will help lower the fat and calorie intake of your product!

Amy Goodson, MS, RD, CSSD, LD

Registered Dietitian

If you have a question for the dietitian, visit www.texashealth.org/askamy

Breast cancer awareness all year long

2010-11-05T07:03:00.000-07:00

Breast Cancer Awareness Month is officially over, but as the manager of the Kupferle Comprehensive Breast Center at Texas Health Harris Methodist Hospital Fort Worth, it’s ongoing. For those of us who work in the breast center, spreading awareness is an everyday priority.

Regular screening mammograms are an important weapon in the fight against breast cancer. At the Kupferle Comprehensive Breast Center we follow the American Cancer Society’s (ACS) Guidelines for the Early Detection of Breast Cancer which are:

· Yearly mammograms for women starting at age 40 and continuing as long as a woman is in good health.
· Clinical breast exam every 3 years for women in their 20s and 30s and every year for women 40 and over.
· Women should know how their breasts normally look and feel and report any breast change promptly to their health care provider. Breast self-exam (BSE) is an option for women starting in their 20s.
· ACS recommends that some women -- because of their family history, a genetic tendency and other factors -- be screened with MRI in addition to mammograms. Talk with your doctor about your history and whether you should have additional tests at an earlier age.

It is also important to have your screening mammogram at a healthcare facility you trust with your life, because mammograms save lives. When choosing a mammogram facility, take a moment to ask yourself “what if?”

“What if they find something during my mammogram?”

“What if I have breast cancer?”

At the Kupferle Comprehensive Breast Center, if something is found during your screening mammogram, you are not alone. If it turns out to be breast cancer, you are not alone. If you have questions or need guidance from people who have been through breast cancer, you are not alone. We are here with the support through your journey from beginning to end.

Lesley Kibel, RN

Manager Kupferle Comprehensive Breast Center

Bariatric Diary # 8: Things are looking up

2010-11-03T08:03:00.000-07:00

Good day, kind readers!!

Last time I wrote I was about to have an endoscopy due to some internal issues. I had the procedure and thankfully, we found the problem. I had at some point developed a stricture at the bottom of my stomach where the new pouch connects to the intestine. My body essentially overcompensated during the healing process and almost closed off the stomach pouch at the bottom opening. Unfortunately it could not all be repaired in the one procedure. On Tuesday of this week, I had a second procedure and I am glad to report that things are back to where they should be with one small exception. During the 2nd endocscopy they found a small stomach ulcer so I will be taking medicine for awhile until that can be taken care of. No fun, but hey its better than the alternatives.

I did find it very funny my experience with the endoscopy. It really is painless and no big deal. However, both times I had weird experiences in the recovery room. Apparently both times, everybody wanted to tell me very important information while I was more or less in a comatose state of mind. Thankfully, I had my dad with me the first time and my sister the second time. If not I very well might have given away everything I own. The nurses were great, the doctor was great, and I am much better off now.

So other than the medical side of things, life has been good. The job is good, the family is good, the Rangers made it to the World Series (Antlers Up!!), hunting season start next weekend, and life seems to be going in the right direction. As of today, I am proud to say that I have lost approximately 141 lbs and glad that my weight is staying fairly consistent now.

I encourage everyone to come out to the Bariatric Support Group tomorrow, Thursday, November 4. It should be a good time and much knowledge to be shared by all.

The journey continues…..

Casey Armstrong

Be Safe for Halloween!

2010-10-26T07:49:00.000-07:00

Halloween is just a few days away. Which reminds me that I need to buy more candy. Why is it that I can remember where I hide the candy, (yum) but I can’t remember where I put the car keys? And speaking of car keys, did you know twice as many children are struck by cars on Halloween than on any other day in the year? So as you venture out on this spooky night, remind your children when crossing the street to look left, and then right, and then left again. Streets should only be crossed at the corner. Try to stay on sidewalks, but if there are none in your neighborhood, walk on the left side of the street, facing oncoming traffic. It is much easier for a driver to see your goblin with reflective gear such as glow in the dark bracelets, necklaces and reflective tape.

Turn on your full headlights between 5:30 and 9:30, which is the most popular hours for trick-or-treaters. Of course you should obey all traffic signs. In residential areas, drive slower than usual where children will be out. Pay special attention when going in and out of driveways. Be mindful of any distractions such as talking on cell phones, or eating to better concentrate on driving. If driving trick-or-treaters through the neighborhood, remember to use seat belts and exit the vehicle on the passenger side.

Halloween is an exciting time for children. They look forward to dressing up and getting heaps of candy! As parents we are responsible for checking out the candy (especially the chocolate ones), and keeping our little ghouls safe and sound. This includes reminding your teens (the scariest ones of all) about attentive driving, no matter how many times they roll their eyes.

MaryAnn Contreras, RN
Injury Prevention Coordinator

Who needs a flu vaccine?

2010-10-22T07:29:00.000-07:00

Influenza, commonly referred to as the flu, is a highly contagious viral infection. Symptoms often include a quick onset of fever, muscle ache, sore throat, cough and headache. Influenza symptoms are usually mild to moderate in severity and last for 2 to 3 days. In more serious cases however, the flu can lead to further complications such as pneumonia or even death. Each year more than 200,000 hospitalizations are flu-related. Flu season usually peaks in December and continues through March. The flu vaccine provides protection against contracting the flu. There are two types of influenza vaccines available for the 2010 season, the traditional “flu shot” and a nasal vaccine.

The flu shot is a yearly vaccine that can be given to adults and children as young as six months of age. This vaccine contains three different inactivated strains of the flu virus. One of the strains in the 2010 influenza vaccine will be the 2009 H1N1 virus. Because the peak flu season begins in December, the optimal time to receive the influenza shot should be during October or November. The flu shot is usually recommended for all persons that are high risk for complications such as those 50 years of age and older, healthy children 6 months through 18 years of age, residents of long term care facilities, pregnant women, and those 6 months of age and older with chronic illnesses (such as pulmonary or cardiovascular illnesses). Common side effects are redness and soreness at the injection site that usually lasts for 1 to 2 days. Less than one percent of people experience fever, muscle ache or tiredness. Some individuals have not been able to receive the influenza vaccine in the past because of an allergy to eggs. However, in 2011 a non-egg based vaccine will become available.

Another option for protection against the flu is the nasal vaccine also known as FluMist. FluMist is approved for healthy persons age 2 through 49 and it is given as a nasal spray. Unlike the influenza shot, the nasal vaccine may be given as soon as it is available in the late summer or fall. FluMist contains a live attenuated virus, which is a weakened form of the flu virus. The most common side effects of the nasal vaccine are runny nose, cough, nasal congestion, chills, sore throat and headache.

Visit http://www.flu.gov/ for further information on the vaccines.

~Nicole Day, PharmD

Grateful for Small Miracles

2010-10-21T06:33:00.000-07:00

After learning that we were pregnant with twin girls our excitement was beyond measure. We were so excited to share our lives with not one, but two precious babies. Unfortunately, God had other plans for our family. Pre-term labor reared its ugly head in the 19th week of my pregnancy, and I was rushed to Texas Health Harris Methodist Hospital Fort Worth where I would remain for three days.

After my third night at the hospital, my water broke, and our first sweet baby, Lily Grace, was delivered…too soon for any chance of survival. Miraculously, my labor stopped after Lily was born, and Dr. Bradford and her nurses did everything they possibly could to keep our second twin safe for another 25 days. Isabelle “Izzy” Eden was born at 23 weeks and 6 days gestation, weighing 1 pound 9 ounces and measuring 11.75 inches long.

She was immediately rushed to the Neonatal ICU after her birth, and she ended up spending the first four months of her life there. She was released to come home the day after her original due date. Izzy was under the care of Dr. Miao and Dr. Brann, and they both took excellent care of her. And we just can’t say enough about the NICU nurses. They were wonderful! They went out of their way to make us feel at ease while we were visiting Izzy, and they were so patient with all of our questions. It was hard to walk away from our baby every night, but we knew we were leaving her in very capable hands, and most importantly, that she was loved. We are forever grateful to our doctors and nurses at Texas Health Fort Worth for taking such excellent care of our little girl. She wouldn’t be the picture of health she is today without them.

~The Babb Family

Brandon’s Story

2010-10-18T08:47:00.000-07:00

My name is Brandon and I would like to share my story with you on how being a tissue recipient has impacted my life. In 2003, I started working at Community Tissue Services – Fort Worth as a customer service representative. My job was to help surgeons and patients get the tissue they needed for surgeries such as ACL repairs, hip surgeries, burn grafting, and many other types of surgeries that helped people walk, work, and live a full life. Seeing the impact that donation made every day for recipients and donor families, I became an avid supporter of donation.
Like most boys in Texas, football is a way of life. I played football my entire life and was given the opportunity to play college football for the University of Pennsylvania. During four years of playing Division I football, I never sustained any injuries.

While playing soccer in 2005, I came down on an opponent’s cleat and completely tore my Anterior Cruciate Ligament (ACL), one of the most important of four strong ligaments connecting the bones of the knee joint, damaged my lateral meniscus, a cartilage-like band that covers the lateral side of the interior of the knee, and tore a ton of cartilage. Needless to say, my knee was in disrepair. When I met with my surgeon, Dr. William Coleman, I told him without any hesitation that I wanted to use a donated ligament. As an employee of CTS, I knew of all the advantages using a donated ligament would bring me. When Dr. Coleman performed my surgery, I was given a “new” ligament.

One of the most important decisions I have ever made was to use a donated graft to repair my knee. Because of the tissue transplant, my knee is as “good as new”. Today, I am a football coach at North Side High School, and my coaching style revolves around being able to show my athletes how to play the game, getting on the sled and bags and being a “hands on” coach. I also have a three –year old son that loves to play, run, and do all the things a wild three-year old does. Without question, receiving my tissue transplant has allowed me to live my life the way I want!

I owe this all to the person that decided to donate the tissue of someone they loved. Soldiers, firemen, police officers, and so many others that come into harms way benefit from the tissue, skin, and bone donated by the families of those that have passed. The decision to “give” can be life saving to some, and can allow others to continue their way of life. This also keeps the memory and spirit of the donor alive.

I am a supporter of donation and plan to become a donor. My family is aware of my decision to “give”. We can’t all be heroes, but we can all help each other by giving the gift of life, the gift of giving someone’s life a second chance, and the gift of helping a family that has lost a loved one carry on their memory.

Too Much of a Good Thing

2010-10-15T08:02:00.000-07:00

Acetaminophen is the generic name for the commonly used over-the-counter (OTC) product Tylenol®. Since acetaminophen is most often used to reduce pain and fever, it is found in many combination OTC and prescription medications. Many consumers have the misconception that acetaminophen is extremely safe because it is so easily available and unlike ibuprofen, aspirin, or naproxen, it does not cause stomach pain or bleeding.

Acetaminophen can be most dangerous when the daily recommended total dose of 4 grams is exceeded. An overdose of acetaminophen can lead to liver damage. Patients with liver disease should probably receive less than 4 grams of acetaminophen per day, but should consult their physician for the recommended daily maximum dose.

A study in 2005 showed that acetaminophen poisoning accounted for 42 percent of acute liver failure cases. Many of these cases were caused by unintentional acetaminophen overdose. The FDA held a meeting in June 2009 to help decrease the number of consumers who experience liver toxicity through acetaminophen use. A public education campaign has been started to educate consumers.

Consumers can do their part by reading all of the ingredients in combination products. On OTC medications, check the “Drug Facts” label under the “Active Ingredients” section. On prescription combination products, it can be listed as acetaminophen or APAP, a well known abbreviation for acetaminophen.

Common prescription medications that contain acetaminophen:

Acetaminophen and Hydrocodone (Vicodin®, Lortab®, Norco®)
Acetaminophen and Oxycodone (Percocet®, Roxicet®, Endocet®)
Acetaminophen and Propoxyphene (Darvocet-N®)
Acetaminophen and Tramadol (Ultracet®)
Acetaminophen and Isometheptene and Dichloralphenazone (Midrin®)
Acetaminophen and Butalbital and Caffeine (Fioricet®)
Acetaminophen and Codeine (Tylenol #3®, Tylenol #4®, Tylenol Elixir with Codeine)

Common OTC medications that contain acetaminophen:

Acetaminophen and Diphenhydramine (Tylenol PM®, Excedrin PM®, Tylenol Severe Allergy®)
Acetaminophen and Aspirin and Caffeine (Excedrin® Extra Strength, Excedrin® Migraine)
Acetaminophen and Pamabrom (Midol®)
Acetaminophen and Phenylephrine (Alka-Seltzer Plus® Sinus Formula, Sudafed PE® Sinus Headache, Vicks® DayQuil® Sinus, Excedrin® Sinus Headache)
Acetaminophen and Dextromethorphan and Doxyalamine (Vicks® NyQuil® Cold and Flu Multi-Symptom)
Acetaminophen with Chlorpheniramine (Coricidin HBP® Cold and Flu)

Make sure you are checking your medication lists twice so that you aren't doubling up on your medications. And as always, speak to your family doctor regarding any medication changes.

Alisia Baker, Pharm.D.

Tips for Halloween Safety

2010-10-12T08:10:00.000-07:00

Just a little over two weeks to go before the big night of “trick or treat” commences. Personally, I have bought two bags prototype candy. Of course the treats must be tasted and tested before I hand it out to my neighborhood goblins. I am a responsible neighbor after all. I have also checked and made sure my front porch and driveway are clearly lit and there are no tripping hazards (such as garden hoses) for the galloping ghosts. I have a plan for my alarmingly energetic Jack Russell that includes being secured in the house to avoid any potential escapes she might attempt with the overactive ringing of the doorbell.

Now that the basic arrangements are made, I have started talking with my teenage daughter. It is an ongoing dialogue about being aware of her surroundings while driving. Certainly this conversation is frequented often, but as Halloween nears it is even more important. Remember how excited these little ghouls get questing for candy—they run right out into the streets and don’t even think to look both ways. Many costumes are dark and scary, and difficult to see from a driver’s point of view. Extra caution is the answer for everyone, especially the teen drivers.

Remind the witches and warlocks to be wary of parked cars. Crossing the street with an adult or in a group is always a safer approach. And speaking of groups, trick or treating in packs is a sure way to have a more enjoyable evening. Remind the kids to get their goodies from the front door and never go inside the house. Lastly, before they gobble those goodies, they should be inspected by an adult, making sure the candy is securely wrapped and not tampered with. It’s often tough being a parent, but during this time of year, how sweet it is.

Mary Ann Contreras, RN

Injury Prevention Coordinator

Breakfast tips: feed your kids and YOU

2010-10-11T08:57:00.000-07:00

Alarm rings, kids won’t get out of bed, you forgot to iron your clothes for work, dog is barking…eat breakfast? Yeah right!

This is a typical morning for many families in the United States. They run out the door without fueling for their day. So what is the problem? A nutrient-rich breakfast is key to helping people feel energized, stay focused and feel less hungry later in the day. Research shows that people who eat a complete breakfast typically manage their weight better and children think better, problem solve more efficiently and stay focused on their school work.

I would like to encourage all MOMS to feed themselves while feeding their kids! So many moms make breakfast and pack lunches for their kids and husband, but forget to fuel their own body. As women age, their metabolism slows down and skipping meals makes it worse! So no, the thought that “less is better” is not always the case, especially not with nutrition. In order to get your metabolism up and running, you have to eat breakfast, more than a yogurt or piece of fruit! Think of it like this…eat breakfast like a king, lunch like a prince and dinner like a pauper!

5 Quick Breakfasts for YOU and your KIDS:

2 slices 100% whole wheat toast each with 1 Tbs. natural peanut butter and top with slices banana
1 scrambled egg, 2 oz turkey sausage, 1 whole 100% wheat mini bagel with 2 Tbs. 100% fruit jelly and 8 oz low-fat milk
1 cup cooked oatmeal topped with ½ cup fresh blueberries and 2 Tbs. chopped pecans, 8 oz low-fat milk
Yogurt Parfait: 6 oz low-fat Greek yogurt, 1 Tbs. honey, ¾ cup whole grain cereal and 2 Tbs. chopped nuts (or flaxseed)
Non-traditional breakfast: 1 – 100% whole wheat tortilla rolled with 2 oz turkey and 1 slice 2% cheese in addition to a pre-made yogurt smoothie

Breakfast Check List:
Make sure your breakfast consists of complex carbohydrates (ex: whole grain cereal, wheat bread, fruit, low-fat milk), protein (ex: eggs/egg whites, lean meat, nuts), and some healthy fat (peanut butter, nuts, light cream cheese)

Look for whole wheat bread and grain products instead of white/refined products
Choose low-fat (skim, 1% or 2%) milk and dairy products
Limit your intake of fried foods, grease, and extra gravies & sauces
Aim to get fruit into your breakfast either as a juice or as a whole fruit

What is your go-to breakfast for yourself and your kids?

Amy Goodson, MS, RD, CSSD, LD

Registered Dietitian

For more tips and stories about moms in the Dallas/Fort Worth area, visit www.texashealthmoms.blogspot.com.

The Road Less Traveled

2010-10-08T06:47:00.000-07:00

“Two roads diverged in a yellow wood,
And sorry I could not travel both…” -Robert Frost

Life is unpredictable. Just ask anyone in the medical field. As we travel down the road of life we have to make decisions as to which way to go when we come to a crossroad. But what if you couldn’t tell us that decision? Does your family know what you want? What if you could no longer care for yourself? What if you could no longer feed yourself? Sooner or later this is a crossroad we all must face. In many cases, we as medical professionals can’t always provide our patients and families with immediately clear answers regarding a prognosis on a disease or injury, so knowing which direction your loved one would want to go helps ease the decision-making process during difficult times.

As healthcare providers we often have to help families through these troubled times of “guessing” and “assuming” what a loved one would want because they simply had never had this difficult dialogue. You are never too young or to healthy to have this vital conversation. Questions to consider and discuss with your family could include (but are not limited to):

1) Who you want to make health care decisions for you when you can no longer make them yourself? We should all choose someone to make difficult choices for us. It is vital that this person be able to agree to respect your wishes.

2) What kind of medical treatment do you want or not want? Life is precious. We all want to be treated with dignity, especially during difficult times. Dignity also means that your loved ones know your wishes and respect them when you are unable to communicate them yourself.

3) How comfortable do you wish to be if you have a chronic or life limiting disease? Most people wish to spell out for physicians and care givers that they want to be kept free from pain, nausea, and shortness of breath. Clearly identifying what you want treated and don’t want treated will make these choices that much easier.

4) How you want people to treat you? Do you want to be surrounded by your loved ones as the hours of your life draw to an end? Do you enjoy music and want your family to play music for you? Do you want to have pictures for special memories and share stories of the past? Do you want spiritual support from a church or chaplain? What customs and rituals would you like to have honored?

5) What do you want your loved ones to know as they care for you? It is also important to discuss feelings with loved ones during this time so that the ones you care about know how you feel about them in case you are unable to communicate those feelings at a later date. Leaving a letter with your last will and testament is a very moving way to let your loved ones know how important they were to you if you are unable to voice this in the end.

As an individual it is your right to make these decisions for yourself. Most of us have considered this at some point in our lives, but have we communicated it to those who care about us? If you come to a fork in the road about making life decisions do you and your family know which way to go?

Kenneth Ellis, RN; Ashley Hodges, RN; Jennifer Nelson, RN

Palliative Care

Healthy Harvest Bites…

2010-10-07T06:55:00.000-07:00

A healthy cookie twist!

More than just a decorative Halloween candleholder or a pie filling to be eaten only once a year, pumpkin is one of the most nutritional foods available year round. Rich in antioxidants, vitamins, minerals, and low in fat, both the flesh and seeds of the pumpkin provide many health-boosting nutrients. Check out some of the nutrients in pumpkin:

Alpha-carotene
Beta-carotene
Fiber
Vitamins C and E
Potassium
Magnesium
Pantothenic acid

Pumpkin is an excellent source of fiber; one-half cup serving contains 5 grams of fiber. Fiber helps reduce bad cholesterol levels, protect the body against heart disease, control blood sugar levels, promote healthy digestion, and plays a role in weight loss. In addition, alpha-carotene and beta-carotene are potent antioxidants found in pumpkin and are pro-vitamin A carotenoids which converts to vitamin A in the body. Vitamin A promotes healthy vision and ensures proper immune function. Not to mention, the Vitamin C in pumpkin also boosts immunity! Pumpkin also contains Vitamin E which promotes healthy skin by protecting the body from sun damage. So, stock up on pumpkin this fall and start by making the Pumpkin Protein Cookies!

“Pumpkin Protein Cookies” Recipe

3/4 cup SPLENDA® Granular
1 cup rolled oats
1 cup whole wheat flour
1/2 cup soy flour
1 3/4 teaspoons baking soda
1/2 teaspoon baking powder
1/2 teaspoon salt
2 teaspoons ground cinnamon
1 teaspoon ground nutmeg
1/2 cup pumpkin puree
1 tablespoon canola oil
2 teaspoons water
2 egg whites
1 teaspoon molasses
1 tablespoon flax seeds (optional)

Directions:
Preheat oven to 350 degrees F (175 degrees C). In a large bowl, whisk together Splenda®, oats, wheat flour, soy flour, baking soda, baking powder, salt, cinnamon, and nutmeg. Stir in pumpkin, canola oil, water, egg whites, and molasses. Stir in flax seeds, if desired. Roll into 14 large balls, and flatten on a baking sheet. Bake for 5 minutes in preheated oven. Cookies will turn out dry if overbaked.

Nutrition Facts per Serving:
Calories: 89, Carbohydrate: 15 gm, Fiber: 2.5 gm, Protein: 4 gm, Fat: 2 gm, Cholesterol: 0 mg

Amy Goodson, MS, RD, CSSD, LD
Registered Dietitian
Ben Hogan Sports Medicine
Executive Health Program

If you have a question for the dietitian,visit www.texashealth.org/askamy

Halloween: Part One

2010-10-05T06:30:00.000-07:00

What are you going to be for Halloween? My children used to pull out the box of costumes to see what would work for that year. There was always lots of princess attire as well as witches and a few odds and ends that could be transformed into aliens, ninja turtles and pirates. This year’s top costumes revolve around pop-culture icons such as Lady Gaga and movies like Avatar and Toy Story 3.

As you prepare for the big night out, remember to keep those costumes safe. Not too long as to cause a tripping hazard. Be careful with candles inside of pumpkins. Masks and head gear should not obstruct the gremlin’s vision. And speaking of vision, remember to take a flashlight, especially when crossing streets. Until next week, happy costume hunting!

Mary Ann Contreras, RN

Injury Prevention

Mother and Babies Need Skin to Skin

2010-10-04T07:09:00.000-07:00

Recent studies support what mother’s have known instinctively for generations. Mothers and babies belong together from the moment of birth. Skin to skin contact between mothers and babies immediately after delivery has many benefits for the new family.

Skin to skin contact involves drying the infant and placing him/her immediately from the womb to the bare skin of the mother’s abdomen, then placing a warmed blanket over the two of them. According to mammalian neuroscience, the intimate stimuli inherent in this kind of contact evokes neuro-behaviors ensuring fulfillment of basic biological needs and may program future behavior. Thirty studies involving 1925 participants found the following positive effects to keeping mothers and babies skin to skin immediately after birth.

Benefits to Baby:

· Stabilization of the baby’s heart rate with a decrease in bradycardia episodes
· Improved regular breathing patterns and a decrease in apnea episodes
· Improved oxygen saturation rates
· Improved temperature regulation
· Increased restful and deeper sleep
· Increase in weight gain
· Shorter hospital stays

Benefits to Parents:

· Improved bonding supports closeness to baby
· Increase in breast milk supply
· More successful breastfeeding episodes
· Increased confidence in the ability to care for the baby

Gloria Glidewell, CNM, MS

Nutrition Support in Critical Care

2010-09-28T08:46:00.000-07:00

When patients cannot help themselves in any capacity, there are professionals that step in and take the necessary steps to ensure that they receive the type of care that will sustain and nourish them back to the point where they can do it on their own. In the clinical nutrition field, professionals like Debbie Foster do just that.
Debbie’s career as a licensed and certified nutrition support dietitian began with Texas Health HEB and Texas Health Fort Worth.
“When I was a student working part-time, day after day I observed a culture of compassion, care and professionalism at both hospitals. It had a strong impact on me and I knew this is where I wanted to be.”
When asked about her daily motivators, she said “My satisfaction comes from having a direct impact on improving my patient’s overall outcomes”.
“I enjoy being able to use nutrition as part of the healing process that helps to get patients back to a productive and healthy life.”
Family members find it comforting to know that when their loved ones may be unable to eat on their own, there is someone ensuring that they are receiving the best source of nutrition.
Healthcare and science have always been a passion for Debbie. The profession allows her to use her passion to help others. She enjoys being part of a multidisciplinary healthcare team dedicated to the improving the health of the community mind, body and spirit.

Debbie Foster

Registered Dietitian

Get Your Metabolism Fire Burning!

2010-09-21T10:32:00.000-07:00

Alarm rings, kids won’t get out of bed, you forgot to iron your clothes for work, dog is barking…eat breakfast? Ya right! This is a typical morning for many families in the United States. They run out the door without fueling for their day. So what is the problem? A nutrient-rich breakfast is key to helping people feel energized, stay focused and feel less hungry later in the day. Research shows that people who eat a complete breakfast typically manage their weight better and children think better, problem solve more efficiently and stay focused on their school work.

September is National Breakfast Month and we would like to encourage you to get your metabolism burning with breakfast! Think of your metabolism like a fire…in order to get a fire going you have to use a sufficient amount of wood. Same with your metabolism fire…you need to fuel your body with a sufficient amount of nutrition to get the fire burning. Try to wake up five to ten minutes earlier and make time for breakfast whether you are a mom, dad, single adult or teenager…everyone needs breakfast!!! Here are some examples to get you started…

5 Quick Breakfasts for YOU and your KIDS:

Make sure your breakfast consists of complex carbohydrates (ex: whole grain cereal, wheat bread, fruit, low-fat milk), protein (ex: eggs/egg whites, lean meat, nuts), and some healthy fat (peanut butter, nuts, light cream cheese)
Look for whole wheat bread and grain products
Choose low-fat (skim, 1% or 2%) milk and dairy products
Limit your intake of fried foods, grease, and extra gravies & sauces
Aim to get fruit into your breakfast either as a juice or as a whole fruit

Amy Goodson, MS, RD, CSSD, LD

Registered Dietitian

If you have a question for the dietitian, visit www.texashealth.org/askamy

The journey has speed bumps…

2010-09-14T07:17:00.000-07:00

Well I have been pretty busy over the last couple weeks. My stress level reached an all time high, but finally settled down a little bit last Friday. I changed careers with little to no notice, went out of town a couple times, posed for a photo shoot, got sick and scared myself senseless, and the list just keeps on going.

So I am a big believer now that stress and bariatric surgery do not mix well. I went to the Bariatrics support group a couple weeks ago and was not feeling all that well. I talked with our dietician Jaime Bass about what was going on and she suggested that I give Dr. Lorimer a call the next morning. Little did I know that before I could make it home that all hell would break loose and I would start panicking enough to make me call the doctor. For those who don’t know me very well, I avoid calling doctors at all cost and very rarely will even take aspirin if I can help it.

On the way home, I started feeling worse than when I was at the hospital so I pulled over on the side of the road to give myself a moment. Next thing I know I was vomiting uncontrollably on I-30 and feeling like I was about to die right there next to my truck. After calling my dad (who is also a bariatric patient) to get his thoughts, I got back in the car thinking the worst was over. This was probably a very bad idea, as it got worse the longer I drove. I got home and called Dr. Lorimer and talked things through. I took it easy all weekend eating mostly soup until I got a chance to go see Dr. Lorimer this last week. Last Wednesday, I got in to see the good doc and we talked everything through further and then I went over to see a gastro doc. The appointment was short and sweet and I am now scheduled for Friday September 16 to have another procedure to get to the bottom of some of these recent issues. I am a little nervous about it just because I am a little worried about knowing what is really going on inside. I will admit though that I am excited about potentially being able to expand my diet further than soup menu!! I will update everyone after I find out more on Friday.

Another exciting thing I did last week was I became a model (Fashion Week, here I come). Only temporarily, but I drove to downtown Dallas to pose for photos for an upcoming article the Dallas Morning News and Fort Worth Star Telegram are doing in a special section for Texas Health Resources. There are going to be some amazing articles in the section. I brought in a bunch of my old clothes from before surgery and diligently stood between them, laid on top of them, and manipulated myself through them for about an hour. It really made me take a look back at how big I had really gorwn just over a year ago. One of the biggest eye openers during this experience was holding a photo of my son and I this past spring from our t-ball team. I don’t think I really ever realized how big I looked until last Friday. I am proud to say that I can now see a huge difference from before.

-Casey Armstrong

Bariatrics Patient

Giving the Gift of Life

2010-09-13T06:40:00.000-07:00

My name is Claudia and three years ago I was diagnosed with Good Pastures Syndrome, an autoimmune disease that attacks the kidney and lungs. As I was told by one of the doctors, it was simply my “bad luck” that I contracted this disease because the odds of getting it are very rare. The disease took both of my kidneys, but thanks to the wonderful team of doctors at Texas Health Fort Worth, its progression was stopped before any further damage could be done.
As a single mom it impacted not just me, but my son as well because I am the only family he has. Through everything he was so scared that he would lose me. But I knew the Lord would get us through this. I do often think and say a special prayer for my donor and their family. I sent them a thank you letter for being so thoughtful. While my family and I rejoiced over receiving the gift of life, they were grieving the loss of a loved one. I only wish they knew how much I value them and am so grateful for everything because if it wasn't for them, my son wouldn't have his Mommy.
On June 30, I will celebrate the one-year anniversary of my transplant. This whole experience has changed my life completely. It gave me back my life; my independence and most important, more time to cherish with those I love the most, my family and friends.
I have always lived a good, healthy Christian life, but now I go to the extreme! I exercise regularly and pay more attention to my diet. And most importantly, I enjoy every day. If you are a donor or the family of a donor THANK YOU and if you are not, please consider becoming one. This decision can many lives!

Fall into Nutrition with Winter Squash

2010-09-10T09:34:00.000-07:00

Shop seasonal this fall! Winter squash is available from August through March; however, they are at their best from October to November when they are in season. Winter squash, members of the Cucurbitaceae family and relatives of both the melon and the cucumber, come in many different varieties. While each type varies in shape, color, size and flavor, they all share some common characteristics. Their shells are hard and difficult to pierce, enabling them to have long storage periods between one and six months. Their flesh is mildly sweet in flavor and finely grained in texture. Additionally, all have seed-containing hollow inner cavities.

Winter squash are also rich in a variety of vitamins and minerals. It is a great source of Vitamin A in the form of beta-carotene which has powerful antioxidant and anti-inflammatory properties. Beta-carotene is able to prevent the oxidation of cholesterol in the body. Since oxidized cholesterol is the type that builds up in blood vessel walls and contributes to the risk of heart attack and stroke, getting extra beta-carotene in the diet may help to prevent the progression of atherosclerosis. Winter squash is also an excellent source of Vitamin C, potassium, dietary fiber and manganese. Potassium may help lower blood pressure and Vitamin C is known for its ability to strengthen the immune system. In addition, dietary fiber is significant in helping lower bad (LDL) and total cholesterol.

Get to know your 5 winter squashes:
Butternut Squash: Shaped like a large pear, this squash has cream-colored skin, deep orange-colored flesh and a sweet flavor
Acorn Squash: With harvest green skin speckled with orange patches and pale yellow-orange flesh, this squash has a unique flavor that is a combination of sweet, nutty and peppery
Hubbard Squash: A larger-sized squash that can be dark green, grey-blue or orange-red in color, the Hubbard's flavor is less sweet than many other varieties
Turban Squash: Green in color and either speckled or striped, this winter squash has an orange-yellow flesh whose taste is reminiscent of hazelnuts
Pumpkins: The pumpkin with the most flesh and sweetest taste is the small sized one known as sugar or pie pumpkin, the latter referring to its most notable culinary usage

Amy Goodson, MS, RD, CSSD, LD

EHP Registered Dietitian
Ben Hogan Sports Medicine Dietitian

If you have a question for the dietitian, visit www.texashealth.org/askamy

The Role of Palliative Care to Improve Quality of Life

2010-09-09T07:04:00.000-07:00

Why do only cancer patients get Palliative care? This is often the question posed by many patients and family members with other terminal illnesses such as Congestive Heart Failure (CHF), Chronic Obstructive Pulmonary Disease (COPD), or neurological diseases with difficult to manage symptoms. The fact is, end-stage COPD typically results in debilitating dyspnea, poor quality of life, and increased morbidity and mortality. Patients frequently require several hospital admissions a year for relief of acute exacerbation of COPD symptoms. This negatively impacts patient’s quality of life as they enter the final chapters of their life. Additionally, COPD sufferers become increasingly homebound with limited mobility and ever reliant upon family members to assist with everyday care and ADLs.

Palliative care has been proven to improve perceptions of quality of life and decrease health care costs to patients with terminal cancer. The same positive influence can be utilized in those with end stage COPD, CHF, or any terminal illness. Unfortunately, patients suffering from these conditions typically are not as prepared to face end-of-life decisions, discuss dying, or prepare for death with family members in comparison to those same patients entering the end stages of cancer. This has as much to do with the unwillingness of patient’s to engage in end-of-life care planning, as it does the uncertainty of general practitioners to relay poor prognostic features of the disease or shrinking survival rates.

Palliative Care can be of great assistance in this setting by providing holistic care, active listening to fears, anxiety, and concerns of the patient and family members alike, improve perceptions of quality of life, and assist in end-of-life preparation. Palliative care’s role in symptom management for the end stage COPD patient is crucial in regaining modest amounts of self care, facilitate energy conservation, and maximize function.

Amy Lunsford, RN, MSN, ACNP
Palliative Care Nurse Practitioner

The Special Grief that Follows a Miscarriage

2010-09-07T06:56:00.000-07:00

Typically, when a pregnancy is realized, the mother and father begin to dream of this new one to be added to their lives, to their family. The mind allows us to imagine what it will be like to first hold this baby, to bring this little boy or girl home from the hospital. We wonder what this little one will look like; will this child have mama’s hair, or daddy’s toes? Sometimes we even project out, dreaming about the first holiday with a baby, considering what it might be like when this child goes to school. All of this is a normal part of pregnancy.

But not every pregnancy develops normally. And not every dream becomes a reality. During my year of residency as a chaplain with Texas Health Fort Worth,I was assigned to the Women and Infants unit. With my anxiety about providing pastoral care to those who experience loss through a miscarriage, I wrote to family and friends and asked them to share with me stories, feelings, and grief associated with the loss of an infant. To my surprise I received many responses, some from family members who for years had silently been carrying this hidden grief . I soon learned that many women and men remain silent about the pain of a miscarriage. And, I learned how the pain of grief does not go away, even when it is ignored.

Through my ministry with grieving mothers and fathers, children, grandparents, and staff, I am learning the importance of recognizing the significance loss that occurs through a miscarriage. I encourage folk to mourn and to expect a variety of emotions. There may be numbness and shock initially. Seeing and holding the baby is an important option to give each person who experiences a miscarriage. For some, naming and blessing the baby are sacred rituals that help to recognize the child’s worth and spirit. In addition having a funeral or memorial service is an important option. If it is determined to have a funeral, then waiting until the mother is able to attend is important.

Rev. Denise Hill

Supervisor Candidate/Chaplain in Pastoral Care Department

Planning to Have A Baby?

2010-09-02T09:21:00.001-07:00

Taking care of your baby doesn’t start the day they are born. It starts long before.

WHAT YOU NEED TO KNOW WHEN YOU ARE TRYING TO GET PREGNANT:

Most women don’t know they are pregnant until they miss their period. The baby is often 4-5 weeks gestation at that time and many of the vital organs are already in critical stages of development. Alcohol and other drugs (even over-the-counter remedies) can cause problems for your unborn child. It is wise to avoid alcohol and other unnecessary medications if you are trying to become pregnant. One thing that you should NOT avoid is folic acid. Folic acid is a vitamin that plays an important role in the development of baby’s brain and spinal cord. Deficiencies in folic acid are known to cause neural tube defects (also known as spina bifida). Spina bifida is a birth defect in which the backbone and spinal canal do not close before birth. The spinal cord is exposed at birth and these children do not have normal function of their bladder, bowels, or legs. Many are confined to wheelchairs. This birth defect is largely preventable by taking 400mcg of folic acid per day. All women of child-bearing age are encouraged to take 400mcg of folic acid daily, either as part of a multivitamin or by eating cereals or grains with added folic acid.

I’M PREGNANT-WHAT NOW?

Once you find out you are pregnant, you need contact your obstetrician to start prenatal care. Prenatal care is EXTREMELY important for the health of you and your baby. Your doctor will prescribe prenatal vitamins to be taken throughout your pregnancy, and will send screening tests for infections that may compromise the health of your baby if untreated. In addition, your doctor will perform at least one complete ultrasound of your baby to screen for birth defects or problems with the baby’s growth. All expectant moms are screened routinely for the development of diabetes and the development of high blood pressure during pregnancy. Both of these disorders are often asymptomatic and can be very dangerous for the health of mom and baby if untreated. Last, your obstetrician can help you to prepare for the birth of your baby. They will have recommendations about prenatal classes, can discuss options for pain control during labor, and can give you important information about the benefits of breastfeeding your baby. Prenatal Care is the most important gift you can give your unborn child.

Fran Lynch, MD FAAP

Neonatatologist

Teen Talk: Underage Drinking

2010-08-27T11:13:00.001-07:00

We are now in the middle of another sizzling Texas summer. Yard work and grilling on the back porch are weekly events in my neighborhood. There are children outside in the evenings chasing dogs and soccer balls. Students that graduated from high school have already headed off to college. A recent study from the University of Rhode Island has shown that this is a time when teens tend to increase their alcohol consumption. In fact, many American teenagers begin to drink at the age of 15. By the time they leave for college, most have considerable drinking experience. Parents should take the opportunity to have conversations about alcohol throughout high school, but it is never too late to begin a dialogue concerning drinking. More than 1800 college students die each year in alcohol related crashes. 750,000 are involved in alcohol related physical or sexual assaults. It is important for parents to make known their beliefs and guidelines as well as to provide clear and fair consequences associated with crossing the line. Research shows this combination of factors decreases alcohol use and problems all through adolescence and into college. Parents have so many tools available to communicate with their students now. I proudly admit to texting 748 times last month. Of course that is nothing compared to my 17 year olds 2332 rambling banters. Adolescents tend to increase their alcohol use the summer before entering college and during their first semester at college. Research has proven that parental involvement influences the decisions students make. This internalization of values, attitudes and expectations continue to exert a positive effect. These students are less likely to transition to heavy drinking or experience alcohol-related problems. This same research also shows students overestimate how much their peers are drinking, and correcting this false impression results in lower levels of alcohol use and alcohol problems. So go ahead and be bossy but informative. Set the standard and then hold firm. Let your teens know you care by communicating in a way that they will listen. Who knows, I may just twitter or update my Facebook status to get their attention…

MaryAnn Contreras, RN
Injury Prevention Coordinator

Bariatric Diary # 7: Frustration sinks in

2010-08-24T09:16:00.001-07:00

You remember that time when your parents told you not to stick your finger in the hole because it might get cut off? As a child we always did it anyways, just to find out. Well now I am faced with same dilemma after having weight loss surgery. I really want to be on the full foods diet like I should be at this point post surgery. Well everyone keeps telling me to take it easy and take it slow. Everyone has some tidbit of advice on what I should or shouldn’t eat. Do I listen? Kinda sorta, but not really.

This month has been extremely busy. By the end of the month, I will have gotten so frustrated that I actually called Tiffany in bariatric services, traveled for almost two weeks throughout Texas and Oklahoma for work, been sick, been to the hospital, be banished to a week of liquids, do an interview for the newspaper, and turned another year older. Sounds like fun but this has been one of the most frustrating months I have had since I had my surgery in May.

So let’s break this all down.
Frustration- Yes, I admit it. I sometimes want to scream I get so frustrated. See 2, 3, 4, 5, 6, and 7 below. Then I realize I got myself into this situation and I have to grab the ole boot straps and keep trucking. One of the nice perks of having surgery at Texas Health Fort Worth is that you get to call and voice questions and concerns with Tiffany Norris and Jaime Bass in bariatric services. I sometimes wonder why they have not reached sainthood for dealing with everyone’s whining… Oops I meant answering everybody’s questions and addressing concerns. I am kidding of course; every question is a good question!!!
Work- Aren’t we glad we are all grown up and get to be responsible? HAHA. It was actually kind of nice to get out and meet some of my new clients and make new ones.
Sick- Had a few rough weeks with food not agreeing with me. I talked with Dr. Lorimer and we game planned, which lead to both the liquid diet for a week and the trip to the hospital. The last week has proven that the plan is working fairly well. I guess that is why they call him a doctor.
Liquid Diets- At least it wasn’t clear liquids. Seven days of full liquids to give my stomach some time to try and recalibrate its thingy-ma-bob so it would quit rejecting anything solid that entered it. Not too horrible actually.
Hospital- Well shortly after the liquids wore off; I found a couple things that still made me sick, so I went to have an Upper GI performed at Texas Health Fort Worth. Barium breakfast is something that I highly recommend passing off if ever given the opportunity. The good news is that it came back normal and now I just need to stick to what my body will allow until I can advance things.
Interview- While on my way back from my first work trip, I did an interview with the Fort Worth Star -Telegram about minimally invasive bariatric surgery and my experience. I should probably apologize for all the dropped calls that almost resulted in my phone becoming a casualty on the highways of Paducah, TX. Maybe if one person reads about my experience and is able to make a life changing decision, I will earn some brownie points with the big guy upstairs
Birthday- I turned 31 this week. I am starting to get old. I still remember kindergarten when I was not willing to let 0+0=0.

So in summary, when the staff at the hospital tells you take it easy, don’t charge forward full steam. I have learned my lesson several times now. This is a huge adjustment for every patient who goes through the procedure and just because something works for one person doesn’t mean it will work for everyone. You have to listen to your body when it says stop and not your eyes and taste buds. Nobody said this was supposed to be all fun and games!!

Overall things are going well. I have slimmed down to a much more aerodynamic 238 lbs. I feel relatively strong and my energy to do different things in the yard and around the house seems to be better than ever. Since I started this journey in January I have now lost 116 lbs. Keep in mind about 20 lbs of that was before I started the liquid preoperative diet in May. Nonetheless, I am happy as a clam in the sand.
The journey continues……

Casey Armstrong- bariatric patient

Eating to Live Healthy

2010-08-23T07:33:00.000-07:00

Recently, I read an article suggesting that fast food restaurants provide statins (a class of cholesterol-lowering medications) to their customers. The idea is that taking a statin with a fatty meal would help prevent some of the harmful effects of that meal. Statins are essential in the fight against heart disease, diabetes, and stroke. They prolong survival and improve quality of life for many.
Has our society’s health conscience waned so much that we now dress our burger with extra cheese, the special sauce, and an extra shot of Simvastatin? The authors appear to equate taking a statin before a fatty meal to safety measures like wearing your safety belt when driving or wearing a helmet prior to riding a bike. These medications are intended to treat high cholesterol when lifestyle changes like exercise and diet have failed. Statins, nor any other medication, should be taken so that the patient can make poor health choices and “get away with it”. The truth is no one can “get away with it”. Poor food choices cause so many other health problems that are unrelated to cholesterol. If you really wanted to premedicate prior to a massive fast food binge, the condiment tray needs to include a statin for cholesterol, a blood pressure pill, a diuretic to get rid of all of the added salt, and don’t forget to top it all off with a shot of insulin to help digest all of the extra sugar and simple carbohydrates. If this sounds ridiculous, that’s because it is!
If your doctor has prescribed you medication to treat cholesterol, diabetes or other health problems, it is in your best interest to keep taking such medication as prescribed. Remember that good health requires us to make good lifestyle choices. Medication to treat cholesterol, diabetes and high blood pressure is not an excuse to reject a healthy lifestyle – Instead it’s a second chance for many to start making new ones. Ask your doctor or pharmacist about lifestyle changes you can make to improve your overall health.

Randy Martin, Pharm.D.
Pharmacy Department

A Lesson in Celebration

2010-08-20T12:11:00.000-07:00

With the palliative care unit having been opened a little over a year, this is a time to celebrate and reminisce. What a year! The palliative care unit is a special unit with very special patients and families. One thing we have all learned is that “Life doesn’t stand still, even when you are ill.” We have witnessed weddings, baptisms, deaths, and many other memorable events on our unit.
One of the most special events that come to mind was the birthday of an “elderly” gentleman turning 103 years old. Minus him being hard of hearing, he was relatively healthy!!!! The Palliative Care (PC) Team of Harris 2nd floor worked above and beyond the demands of their daily jobs to ensure this would not be an ordinary day for this beloved man. The staff purchased streamers, banners to decorate his room as well as birthday hats, party blowers, plates, napkins, and birthday cake. They even made arrangements for his son to retrieve his wife so that she, too, could participate. To make this occasion even more memorable, the patient’s wife of 64 years arrived to our unit walking with the use of her walker (she was just 97 years old, herself). The party was complete with decorations, singing, laughter, and cake and the whole Palliative Care team! I do not think this 103 year old birthday party is one that the patient, family, or staff will ever forget.
Although there is quite a bit of sorrow within our specialty, we also see a lot of joy. We learn to celebrate each day that we are fortunate to have and share with others. We have learned from our patients and families to embrace life with death and refocus our priorities daily. What a wonderful blessing it has been to share in these life lessons and experiences on this unit and with this INCREDIBLE staff of friends!!!

Hayley Brown, RN,MSN,ACNP-BC

Palliative Care Nurse Practitioner

Medical snippets

2010-08-09T13:55:00.000-07:00

There is even more evidence from recent medical publications that nearly all patients hospitalized are at increased risk for blood clots. Fortunately, there’s also ever-growing evidence that current pharmacological approaches to prevention have reduced the risk of blood clots in hospitalized patients. Unfortunately, the evidence of protection is not as strong for non-pharmacologic approaches, but when used in combination with medications to prevent blood clots, the overall results are quite satisfactory. One of the more exciting developments is the growing awareness that the use of medications to prevent blood clots in patients who have undergone surgery rarely results in bleeding from the operative site. Earlier applications of medicines to reduce blood clots will improve outcomes in our patients.

More good news: evidence now exists that suggests hospitals that use automated processes for early detection of infections have better outcomes when compared to hospitals that use manual processes. Texas Health Resources hospitals use automated electronic processes for infection surveillance. Early detection leads to quicker treatment and better outcomes.

There’s mounting evidence that many women who have had children by C-section may still be able to have natural vaginal deliveries if they subsequently become pregnant. These results offer a choice to mothers who want to experience natural childbirth.

Remember that each patient we touch is someone special. If we treat each patient as if they were our mom, we will advance exceptional outcomes.

-Dr. Joseph Prosser
Chief Quality Officer

Healing Through Artwork

2010-08-06T07:51:00.000-07:00

The hallways that lead up to the Texas Health Harris Fort Worth surgery area can be an anxious place at times. Before major surgeries, it’s common to see loved ones kiss the patient in the hallway before they go into surgery. In order to create the most peaceful environment possible, these high traffic hallways recently got a “therapeutic upgrade” with the addition of many beautiful pictures and original paintings. Perioperative Services Director Megi Ball and her department coordinated this initiative with a number of physicians.

One of the many art work contributors is E.L. Young. E.L. works in the Surgery Department and is also a brilliant painter who was kind enough to loan some of his original works of art to the surgery area. E.L. is known by many for his quick smile and kind words and it’s my privilege to offer this short interview question and answer (Q and A) with him:

Q: How long have you worked at Texas Health Harris?
A: October 1990, so around 20 years.

Q: When did you start painting?
A: Since 1960. My elementary teacher saw that I stayed in the lines better than the other kids and helped me get started out. I’ve enjoyed honing the craft since then and my passion is drawing pastels. I also love to draw realistic paintings of people that end up looking like real photographs.

Q: What would you like for patients and families to get out of your pictures?
A: A sense of peace so people can focus on what’s important in life and not get carried away by their circumstance. For instance, in one picture there’s a storm cloud overhead but the pond’s waters are still and confident that things will be ok.

Q: Do your paintings have any common theme?
A: Yes, all my pictures tell different stories but the underlying theme is that I like to show the celebration of life even through adversities.

Q: Any other comments?
A: I just hope people stop for a minute and look at the paintings and are grateful for ourselves and one another. I hope that people feel this during their challenging time with the surgery.

Thank you E.L. for giving this personal part of yourself and touching the lives of many people during their time of need. I also wish to thank the many other Perioperative staff and physicians who donated other works of art as just one of many initiatives Texas Health Harris Fort Worth uses to make sure patients and their families have a very satisfied experience.

- Craig Pomykol
Patient Advocate

A 3-year-old embarks on a space ship journey to recovery!

2010-07-30T06:23:00.000-07:00

Most people would give up when faced with insurmountable odds, but then again, Bella isn’t like most people. Bella Counts is a three-year-old leukemia patient who developed necrotizing fasciitis, otherwise known as flesh-eating bacteria, as a result of her weakened immune system. She was sent to Texas Health Fort Worth for hyperbaric wound treatment to heal skin grafts that were unsuccessfully healing.

Hyperbaric wound treatment exposes patients to 100 percent oxygen at below sea-level pressure. The oxygen is forced into the bloodstream at a quicker rate to promote quicker cell growth. It is a therapy typically used to treat elderly diabetic and carbon monoxide poisoned patients. Bella is the first child to undergo treatment for these types of wounds at the hospital. For her parents, the forty treatments have meant a chance to save her tiny legs from amputation.

For 40 treatments, Bella climbed into her “space suit” and “space ship” to begin the healing process. Without any complaints, she embarks on the two-hour treatment with a smile on her face and brightening the staff and other patients around her. Her bravery has been an inspiration to others and has been a big part of her healing process.

If you know a child or individual who you believe might also benefit from wound care and hyperbaric treatment, leave us a comment and we will be happy to get into contact with you!

Tissue Donation

2010-07-27T08:26:00.000-07:00

Every year thousands of lives are saved or enhanced from the gift of tissue donation. Whether it’s a burn patient who has received countless skin grafts to heal or a athlete receiving a donor tendon so they can play their favorite sport again, tissue donation is the ultimate gift of life to those in need.

One full tissue donor can save and enhance the lives of more than 50 people with the various grafts that can be made. In 2009 alone, nearly 1,000 tissue grafts were recovered from 57 donors at Texas Health Harris Methodist Hospital Fort Worth. These grafts included skin, bone and tendons, heart valves and veins.

Skin grafts save the lives of thousands of burn patients every year. Grafts recovered are about the same thickness of a sunburn peel. They are processed and meshed to provide greater surface area. These grafts aid burn victims by preventing fluid loss and infection. The average donor yields nearly 3.5 to 4 square feet of skin, while the average severely burned patient requires nearly 40 square feet of skin. Skin is recovered from the back and front and back of the thighs. Burn victims require so much skin because the body will continuously reject skin grafts, so they have to be replaced every few days.

Bones from the upper and lower extremities are used in many different ways. They can be cut into small rings to alleviate severe back pain in spinal fusions. These bones also can be cut into cubes or crushed for orthopedic or dental surgeries. Tendons recovered from the lower extremities are used most commonly in ACL repairs. Bone and tendon grafts from one donor can enhance the lives of up to 50 people with the various grafts that can be made.

If the heart cannot be transplanted, it can be recovered for valves. These valves are used in children with congenital heart defects. Saphenous veins from the leg can be used for dialysis access in dialysis patients.

One of the most common myths about organ and tissue donation is that one cannot have an open casket viewing. However, the donor is treated with the utmost respect and reconstructed so there is no difference in appearance so an open casket is possible.
There is also no cost to the donor family for any cost related to donation.

“You have the power to donate life. Be an organ, eye, & tissue donor.” You can register your decision at www.donatelifetexas.org and to hear stories of hope from tissue donation go to www.communitytissue.org/miracles/recipients

- Amanda Williams, transplant coordinator

Bariatric Diaries 6: The dog days of summer!

2010-07-26T10:53:00.000-07:00

The last few weeks have been HOT!! July has brought things into perspective for me on the whole recovery process from my surgery that I had in May. Over the July 4th weekend, things were business as usual with a few minor changes being made for my recovery. We went to lovely Junction, TX for some good times on the Llano River and relaxing at the ranch for the weekend. Unfortunately, there were no hot dogs and adult beverages for me this year but I was ok with that. I made due with the things I could eat and had just as good of a time. On Monday, we were headed back home and all the sudden something just wasn’t right. I was starting to feel sick and had not interest in even drinking water. By the time I got home, things were really not going to well. I tried food, and that didn’t work out. I tried water and Gatorade, and that did not work out either. The thing that scared the heck out of me was that when I got sick, I was vomiting black coffee grind type material. Just for the record, I have not eaten anything black since my surgery so you can imagine what was running through my head. I called Dr. Lorimer in a state of panic and he instructed me to not eat or drink anything the rest of the day and that I was throwing up dried blood. The real question is where the heck it came from. The next morning, I was not feeling well so I called back and moved my appointment up a day. We came to the conclusion that this sometimes happens and I needed to take it easy on food for a few days and see what happens. He also gave me a medication for stomach ulcers in hopes of being able to coat my stomach before eating. Let me be the first to admit that I hate taking pills, but it is a part of the recovery. This pill he gave me is approximately the size of a small baby so I was even less thrilled. In all seriousness, it is big but I was able to break it in half and get it down the ole windpipe. Blood work and a little but of chaos later, I am all good. Dr. Lorimer did tell me during the appointment that he felt like I was losing weight a little too fast. I am glad to report that it has now slowed down.

I also thought I would share with you the top things that I am convinced I will never be able to eat/drink again:

1. Potatoes of any kind. Complete mental block on them right now.
2. Cream of Wheat. This was my dining choice immediately after surgery. Just can’t do it.
3. Chicken Nuggets. This is my son’s favorite meal, he is sad that I don’t get to share it with him anymore.
4. Beans. I have tried several times in many different consistencies and they just don’t agree with me anymore
5. Grand Prairie Water. I am officially a water snob now. I keep a case of cold bottled water handy at all times.

I feel so much better after a little over 2 months since surgery. I get constant reminders from my wife and 6 year old about things I should and shouldn’t be eating. That gets a little old after some time, but I know they are doing it for my own good. My son thinks it is funny to remind me before we go anywhere to eat that I can’t have one thing or another and tries to make his food choices based on what I can have. Speaking of food, I think I am becoming a pregnant woman. I have these cravings that are so odd sometimes, but I am a little hesitant to try them out. For example, I really want lemonade one minute and then I think I just have to have a pickle. I have tried the lemonade and it has become a drink of choice this summer, I bought pickles at the store yesterday but I will try those slowly in the near future.

Other than some really bad decisions on my part a couple times, surgery has been a huge success so far. I have learned from my mistakes and try my best to not repeat them. I am stubborn and I admit that, but most of the mistakes I made have taught me that I don’t necessarily get my way when it comes to food anymore. Drink your water and lots of it. The dehydration factor is in full effect on these 100 plus degree days. As of today, I have lost a grand total of 101 pounds.

The journey continues…..

- Casey Armstrong, bariatric patient

Proper Drug Disposal: An Environmental Concern

2010-07-15T08:10:00.000-07:00

In recent Associated Press report, over just a five-month period of time, twenty-four metropolitan areas across the U.S. were found to have detectable levels of drugs in their drinking water. Philadelphia reported fifty-six different pharmaceuticals, including pain medications, hormones, and antidepressants. The report also included data on the feminization of fish in waterways, presumably from estrogen-containing drugs, and various pharmaceuticals found in earth worms.

A common misconception is that the body absorbs all drugs introduced to it with no waste byproduct, when in fact, many of the drugs we take are excreted unchanged where they then make themselves in the wastewater system.

While much of this problem is a result of natural elimination by humans and animals, the issue of pharmaceuticals found in the environment is due to improper disposal as well. This happens most commonly by pouring or flushing unused drugs down household drains.

Most know not to throw car batteries in the trash, or motor oil down the drain, but when it comes to proper drug disposal most are unaware of the proper procedure. However, there is also little literature on how to properly dispose of medications. The Environmental Protection Agency is currently working on recommendations for patients and institutions on how to properly dispose of drugs.

Currently, there are occasional “drug take-back” programs in the community. Some are provided through participating pharmacies. Many states across the U.S. are utilizing law-enforcement in this process through organized drug “take-back” events. These programs will continue to arise as more attention is placed on drug disposal and the environment.

If no drug take-back programs are available in your area, there are recommended disposal procedures found on the Federal administration’s website:

http://www.whitehousedrugpolicy.gov/publications/pdf/prescrip_disposal.pdf

Drugs flushed down the toilet can damage the environment and eventually end up in drinking water. In order to minimize our impact on the environment, encourage those needing to dispose of medications to utilize these resources and stay aware of community events involving drug take-back programs.

Lance Ray, Pharm.D.

Reading and Interpreting Food Labels

2010-07-12T09:11:00.000-07:00

As part of nutrition education for the Bariatric Program, I often include how to read and interpret food labels. Most of us are familiar with the Nutrition Facts Panel; however, there are two areas that bear review.
1. Serving Size: My son bought a $5.00 candy bar from a little girl who was selling candy for a fund raiser. Five dollars seems high for a candy bar, even for a fund raiser, but it was a really big candy bar. I casually looked to see how many kcalories it contained. The label said 220 kcalories. Not really that bad, then, I looked at the number of serving sizes: 2 ½ servings in this bar meaning that the entire bar contained 550 kcalories. I did notice this morning that my son, not a big sweet eater, had saved most of the bar in a zip-lock bag (not the sandwich size bag but a quart size bag.)
Lesson learned: remember to look at the serving size and the number of servings on the label.
2. Trans fat: The FDA has required food manufacturers to list trans fat on the Nutrition Facts Panel since January 1, 2006. A food can be labeled as having zero trans fat but still contain .5 grams of trans fat per serving. Therefore, it is possible to eat more that the AHA recommends (2 grams a day) by eating several servings of these foods without realizing it.
Even if you are able to decipher the information on the Nutrition Facts Panel, sometimes the “front of the package” labels can be misleading. In fact, a commentary in a recent issue of JAMA reported that the front of package labels may so thoroughly mislead the public that eliminating “all nutrition and health claims from the front of processed food packages” should be considered. This action may seem drastic but I agree that something needs to be done to protect the public from these misleading claims.
The FDA is aware of this problem. Indeed, FDA commissioner, Margaret Hamburg announced last fall that her agency would be taking nutrition and health claims on packaging seriously. She stated, “some nutritionists have questioned whether information is more marketing-oriented than health-oriented”.

- Jamie Bass
Dietitian, Bariatric Services

Sunscreen 101

2010-07-09T08:33:00.000-07:00

Sun exposure and sunburns have been linked to the development of melanoma, a deadly form of skin cancer. All skin types, from those that are fair and burn easily to those that never burn are at risk for developing skin cancer if not properly protected. The best way to protect sun-exposed skin is with sunscreen.

There are numerous sunscreens available, so how do you know what to look for? When choosing a sunscreen make sure it protects against UVA and UVB rays. UVB rays are primarily responsible for sunburns. UVA rays can cause wrinkles, leathering, and photo aging. Many people assume they are protected from the sun’s harmful effects when indoors but UVA rays can penetrate windows.

Another important factor when selecting a sunscreen is the SPF or Sun Protection Factor. SPF is the ability of the sunscreen to prevent UVB damage. The American Academy of Dermatology recommends wearing at least an SPF of 30, which blocks about 97% of UVB rays. There is currently no measure for protection against UVA rays, but this is currently being evaluated by the FDA and may lead to changes in the future.

For maximum protection sunscreen should be applied one half hour prior to sun exposure and should be reapplied every 2 hours. Water proof and sweat proof formulations are available but should also be reapplied frequently. Most people do not apply enough sunscreen. It must be applied generously to exposed skin, then rubbed in completely.

Some medications such as diuretics, certain antibiotics, and chemotherapy drugs can make the skin more sensitive to the sun. Commonly used antibiotics including Levaquin, Cipro, Bactrim, and doxycycline and diuretics like furosemide and hydrochlorothiazide are known to increase photosensitivity. While taking medications such as those, people should protect their skin by covering up, wearing sunscreen, and limiting sun exposure.

Wearing sunscreen is an easy way to decrease the risk of skin cancer. According to the American Academy of Dermatology, everyone regardless of skin type should wear sunscreen of at least SPF 30 year-round. All of this information and more can be found on the American Academy of Dermatology website: http://www.aad.org/media/background/factsheets/fact_sunscreen.htm.

Lacey Mullins, Pharm. D.

From a physician's perspective...

2010-07-08T13:44:00.000-07:00

When Ashley asked me to write a blog, my first thought was, “Holy Cow! What in the world do I talk about?” I could talk about my fellowship or the Palliative Care Unit or something random. What I eventually decided to do was highlight a group of individuals that have impressed me to no end. I recently graduated from residency last June from a rival hospital, and through my rotations have worked at hospitals around the country, so I have seen a wide variety of teamwork.
The first thing I noticed after spending a few days here at THFW is the nursing staff at our Palliative Care Unit. Wow! What an amazing and dedicated group of people. As a fellow in Palliative Care, I am learning to relate with patients and their families in ways that never really were an option during residency. The nurses and nurse practitioners on the Palliative Care Unit are among the best I have ever seen. Every day I learn more about being compassionate and caring, and they are my number one example. We frequently have patients transferred out of the PCU for a variety of reasons, and many times patients ask to be transferred back because they miss that compassionate care.
I have never seen such a giving and loving group of nurses, and they deserve all the accolades that can be given them, but it’s not just the emotional aspect of these men and women that impress me, it’s also the technical aspect. The Palliative Care unit is also an acute med-surg. unit, and these nurses excel in that respect also. They provide quality, accurate care that rivals any other med-surg. unit in any hospital I’ve worked with. If you see any of these amazing nurses about the hospital, please pat them on the back and tell them, “Good job!” The work they do is not only physically draining, but emotionally draining, and they do it with style and grace.

- Dr. Stephanie Sun
Internal Medicine Physician

Have a Safe 4th of July !!

2010-07-02T14:50:00.000-07:00

Independence Day honors the birthday of the United States of America and the adoption of the Declaration of Independence on July 4, 1776. It's a day of picnics and patriotic parades, a night of concerts and fireworks, and a reason to fly the American flag.
Typically this weekend is a time filled with family reunions, backyard cookouts and road trips. I have great memories of piling the kids into the car, playing car bingo and answering a myriad of questions, with the most popular being “are we there yet?” Keep in mind this was all before personal DVD’s were invented. With all these trips, I never realized that summer is the most dangerous time of the year to be on the road. In fact, according to the National Highway Traffic Safety Administration, and the Fourth of July weekend is historically the deadliest for road travel in the US. Interestingly enough, an overwhelming percentage of Americans consider winter to be the most perilous driving season. Rural roads are particularly hazardous. Fifty seven percent of highway deaths occur on these back roads.
Alcohol is a factor in almost half of these holiday crashes. Emergency room visits for underage alcohol use will nearly double this weekend. Texans lead the nation in alcohol-related fatalities. This weekend, local police will be out in force helping to keep us safe. The best defense against a drunk driver is your seatbelt. Put it on. Even in the back seat. Do it for your family so you can spend even more holidays together answering those questions like “are we there yet?” Happy Fourth!

Mary Ann Contreras RN
Injury Prevention

The Circle of Life

2010-07-01T09:28:00.000-07:00

The circle of life begins and ends everyday for many within the walls of this hospital. Tears of joy and tears of sorrow are shed as people experience a wide range of events from the birth of a new child to the loss of a loved one.

But for some, the circle of life does not stop with the end of one’s life; rather it continues through the life of another through organ and tissue donation.

Texas Health Harris Methodist Hospital Fort Worth, together with LifeGift, has created the “Wall of Life” to recognize and honor the many mothers, fathers, sons, daughters, grandparents and many others who gave the ultimate gift – the gift of life. This precious gift completes the circle of life and further extends the legacy of each individual.

In addition to recognizing those who gave life, the wall also recognizes those who received it through the precious gift of kidney transplants. These recipients are here today because a family – deep in sorrow and grief – had a heart big enough to say “yes” to organ and tissue donation, passing on the gift of life. At the same time, we also honor a different type of donor – a living donor.

Living donors are people who are healthy enough to donate a single kidney so that someone else might be freed from the confines of dialysis and resume normal life. Living donors do not always donate their kidneys to family members. They may also donate to a perfect stranger simply because they can.

If the world had more people and more families like the ones we are honoring with the “Wall of Life,” the national waiting list for lifesaving organs would not exceed 108,000. Nor would there be a shortage of life-enhancing tissue.

Created by Rebecca Low, a local Fort Worth artist, the wall depicts a man, a woman and a child. In essence, these figures represent everyone – mothers, fathers, brothers, sisters, you and me. The figures are linked together by a ribbon and surrounded by doves representing peace, love and the miracle of life. Most importantly, the wall carries the names of those who have given the gift of life and those who received that precious gift.

I hope that you will take some time out of your busy schedule and stop by the “Wall of Life” located in the main lobby in the alcove just past the gift shop. I hope that the “Wall of Life” will inspire you to say “yes” to organ and tissue donation, continuing the circle of life.

Amanda Williams
Donation Clinical Specialist
LifeGift

Delivering Hope

2010-06-29T07:56:00.000-07:00

Hope. This very short word is a powerful one when you are struggling with infertility. Believe me, I know. Throughout my battle with infertility, all I wanted a doctor to do was to tell me it was going to be ok and there was hope. Guess what? There was hope for us and there is hope for many couples.

Many people do not know that 10 percent of couples experience infertility problems. That is the other amazing thing about this journey. When you are in the throws of trying to start a family, the people who you never knew struggled with infertility become some of your greatest supporters and resources.

Finding a physician you believe in and you trust is also extremely important. If you are like many couples, you do not know what is involved with infertility treatment, if you are a candidate or even how much it is going to cost and if your insurance will cover it. These are normal questions!
If you find yourself reading this and feel like you can relate, I want to invite you to join us for a free advances in medicine seminar with Dr. Laura Lawrence.

Details:
Infertility Advances in Medicine
July 14, 5:30 - 6:30 p.m.
Texas Health Harris Methodist Hospital Fort Worth
Call 1-877-THR-WELL or click here to reserve your spot

An opportunity like this is a very non-threatening way to get many of yours and your spouse's or significant other's questions answered. Hopefully, for many of you, it will offer some hope! Hope to see you there!

- Whitney

Bariatric Diaries 5: Is the room spinning?

2010-06-28T08:59:00.000-07:00

First of all, I apologize for taking longer than normal to get my next blog entry done. The last few weeks have been very, very hectic to say the least.

I went back to see Dr. Douglas Lorimer a couple weeks ago for my 3 week checkup after surgery. It was pretty routine office visit. He checked out all the incisions to make sure everything was healing up well and asked some questions about how the diet was working out for me. After I got done, he sent me over to the lab to have some blood work done and to see if there were any changes since pre-op. I got a call later in the week that everything was looking good and all the results within normal range. I am fortunate to have not had a lot of medical issues before surgery with the exception of normal day-to-day stress and something called fatty liver syndrome. From my understanding there are lots of bariatric patients who have fatty liver syndrome. I assume that since all the results came back normal, that maybe that is gone now. I will need to confirm with Dr. Lorimer next office visit. I have my next follow up on July 7th.

Then last week, I received some very unfortunate news. My lovely mother passed away at the young age of 59. My poor mother has been through the ringer with medical issues in her life but had been doing well recently so this came as a huge shock. So instantly life go a little crazier as my family starting making plans and trying to deal with all the stress that comes with it. I didn’t do very well with my diet last week. I was so busy that I found myself on what amounted to a very poor clear liquid diet again. I wasn’t keeping much of anything down and was starting to think that I had fallen off the deep end and maybe mentally I was making myself sick. I talked with our dietician Jaime Bass at the hospital and she reminded me to do my best to stay hydrated and eat when I needed to eat. She put my mind at ease that I was not going crazy and that a lot of this was probably my body’s way of dealing with stress. After all in just a month, I have had major surgery and now this. My body probably didn’t know what to think. Things are better now and one of my biggest supporters is my guardian angel who can be with me all the time. She will be missed, but I have found peace in knowing she is in a much better place and all her health problems are gone.

I experienced my first holiday since surgery, Father’s Day. We spent some time with my dad on Saturday and then had dinner with my father n law on Sunday afternoon. My son and wife plotted together to make a custom made card for me. I opened the card and couldn’t help but laugh a little when it said I love you dad. I am glad you had your surgery. At first I thought this was my wife’s way of making a joke but apparently when they ordered online, that is what he asked her to put into the card. Obviously with the holiday and the meals that came with it, I was put to a major test. I did well. I had my little portion of food and sat back and enjoyed the company of my family. I think it is funny that people realize the position I am in and apologize for eating in front of me. I make it a point to explain to them that it is not a problem and as much as I would love to partake in the bbq or steak, I would much rather not be sick from eating it.

So after yet another week off work, I am back in the saddle and working to play catch up here at the office. Things are going well in my mind though. It is nice to be back at work and talking with my clients again. It has been a very productive week which always makes it better and next month is already looking up as well.

These little life occurrences make the journey a little more interesting but really tests my ability to stay strong and continue down the right path. If it is ok, I would prefer to not have many more big surprises like I have had over the last couple weeks for awhile. So far I have lost 80 lbs since I started this journey and I feel like I am beginning to gain some of my strength back. I encourage everyone to come to the support group for Bariatric surgery patients Thursday, July 1 at 6:00 pm at the hospital. Jaime Bass from bariatric services will be discussing Bartiatric diet which I know I can definitely use.

The journey continues….

- Casey Armstrong

It's Snake Season

2010-06-25T07:33:00.000-07:00

Snakes are remarkable animals successfully living on land, sea, forests, grasslands, lakes, deserts and as of last week my backyard. Although the one my back porch wasn’t successful for long. I don’t know how you feel, but I HATE snakes. I coexist with all the geckos, spiders, frogs and other various forms of wildlife that make it to my backyard from the open field behind my house. I don’t even mind listening to the coyotes that “yip-yip” alongside my fence at night after a big rain. But I do draw the line at snakes. They are simply sinister. I realize that most snakes are harmless and even beneficial. I have read these cold blooded creatures are almost always more afraid of humans than we are of them. Whoever wrote that hasn’t met me.
With that being said, I am focusing this month’s blog on snakebite prevention. We are now officially in “snake bite season”. These legless reptiles are more active in the summer months. Recently several patients have been admitted for snake bite treatment. Most of those bites have been from copperheads and rattlesnakes. All snakes are meat eaters. They don’t see humans as their next “value meal” but rather as a threat and will strike out when they are startled, provoked or have no means of escape if cornered. There are about 45,000 snakebites per year in the US. Only a small percentage of those are poisonous. If you are bitten you should seek immediate medical attention. Effects from a bite can be instant or gradual. Puncture wounds can easily become infected from non-poisonous varieties. A tetanus shot is required if the victim hasn’t had one within 5 years. Keep the injured area below the level of the heart, and DON’T apply a tourniquet or ice. Remove any constricting items near the bite, such as rings or other jewelry which could cut off blood flow if the bite area swells. Being calm also helps slow the absorption of the venom. Although I don’t believe remaining calm after a snakebite is even possible. Do not risk further bites or delay treatment by attempting to capture or kill the snake.
Obviously snakebite prevention is far superior to treatment. If you see a snake, give him the opportunity to escape. Step away slowly and cautiously. Use a flashlight when camping. Never reach into firewood or under rocks or crevices without examining them first. I even wear my cowboy boots when trimming bushes (we do live in Texas after all). Be aware that snakes may be swimming in the water. Avoid snakes that appear to be dead, as some species will actually roll over on their backs and stick out their tongue to fool potential threats. Which means those species are essentially smarter than my Jack Russell. If you do kill a snake, know that the detached head can immediately act by reflex and potentially bite.
Have a healthy respect for them (or at least a rational fear) and enjoy your summer.

Mary Ann Contreras RN
Injury Prevention

Doctor Talk

2010-06-14T13:20:00.000-07:00

I’ll set the scene: You have been admitted to the hospital and this time your Primary Care Physician (PCP) won’t be coming to see you as an inpatient, so you’re assigned a hospitalist. A hospitalist is a physician who specializes in inpatient care. The hospitalist just read your medical record when they approach your bed to discuss your care…
Communicating with this new physician can seem intimidating since you’re in a new environment and sick enough to be admitted. It’s important that you tell the hospitalist and nursing staff all the important details of your medical history and current symptoms so the best plan of care can be created. There’s a natural hesitancy not to tell a stranger everything about your private medical conditions, but the physician and staff are here for you and you’re protected by federal privacy laws. The time to open up is now.
It’s no secret that hospitalists and PCP’s have a lot of patients to see in the hospital and don’t always ask if you have any questions before they leave your hospital room. Please don’t let that stop you from asking. It’s best to be prepared. Write down the question(s) beforehand so that you’ll be organized, then ask the physician if they “have a minute” to answer your most important question(s) and fire away. Think of it as a “grocery list” for your acute health problems. If possible, it’s best to limit questions to the appropriate specialist. For example, the neurologist will not be able to answer your question about an ankle rash. Your nurse is your guide about which physician to ask which question on your list.
If you listen to the physician’s answers and are not sure if you understand, it’s ok to repeat back what you think he/she said and let them correct you if need be so you’re both on the same page. Misunderstandings left uncorrected are worse than not understanding at all.
It’s important to be proactive and involved in your own care. As Texas Health Harris Methodist’s “Patient Rights and Responsibilities” states, “You have the right to take part in developing and carrying out your plan of care.” Communication is the key and whether you’re at our hospital or a routine physician’s appointment, it’s best to make the most of that limited time by being prepared.

- Craig Pomykal
Patient Advocate

Beyond the walls of the hospital!

2010-06-11T08:09:00.000-07:00

If you take time to think about it, how often do you hear comments such as, “People just aren’t like they used to be?” Or “Well in the good old days, people would treat you better.” Or “Nobody cares for anyone but themselves.” We’ve all heard it and probably even said it a time or two. So, if you or a loved one has ever felt dismayed about your fellow human beings, then this story might just change your mind.
Not too long ago on the Palliative Care Unit, a decision was made that a patient would be going home on hospice. A hospital bed would need to replace the bed in the bedroom...but there was a problem. Both husband and wife were elderly, and the husband was not able to dismantle the bed and did not know anyone that could help him. Always willing to help, one of the unit nurses contacted a co-worker who was on vacation. He went over and helped the patient’s husband take down the bed. In the meantime, the hospice decision was altered, and it was determined that the patient actually needed inpatient hospice facility care. The nurse again took time from his vacation to go back over and help the husband put the bed back together. Not only did he stop what he was doing while enjoying his time off, but he heard someone needed help and gave his time, strength, and aid.
While something like this may not happen every time we deal with our fellow human beings, it does serve as a reminder that most people are kind and compassionate. So, today, if you feel a bit disgruntled because you dealt with someone who was insensitive and unsupportive, try thinking of all the people you know who are just the opposite. It’s guaranteed to lift your spirits and put a smile on your face! This story and nurse exemplify that amazing care and compassion are not limited to your hospital stay at Texas Health Fort Worth, but can be experienced outside of our doors!

- Ashley Hodo

Palliative Care Nurse Manager

Bariatric Diaries 4: Back to work and BIG NEWS!!

2010-06-02T08:04:00.001-07:00

Well summer is finally here and man is it hot outside. Drink your water because you get dehydrated very quickly, and the last thing you want is to end up in the ER because of dehydration.

I went back to see Dr. Lorimer last Wednesday (1 week and a day after surgery) for my first check up. If your surgery is done laproscopically, you will have six small incisions across your stomach area and each one will have a clear band-aid type covering over it. Each incision was glued shut but I did have 4 stitches on one of mine that had to be taken out. Let me just say OUCH!! The covering material is a lot stickier than a band-aid and ripped my skin in a couple places. Those small little spots are a very small price to pay for the end results. So my stitches are out and I am moving on to recovery. I am still a bit sore from surgery but stopped taking pain meds a couple days after I was home from the hospital. I figure that there is no need to take them unless I am in serious pain. Full liquids for two more weeks, I am really excited, ok not really. I left Dr. Lorimer’s office with an appointment for 2 weeks out and his blessing to return to work, so all in all I was a happy camper.

I went back to work June 1 and to be honest, it was nice to get out of the house and be back around a large group of people. I did find that working all day tired me out a lot quicker than before surgery. I am sure it will get easier every day and the sooner the better. It was nice to see everybody again and definitely helped that they were all telling me how good I look now that I have lost more weight.

For the most part, I have just been taking it easy when I get home and try to walk as much as I can when my wife and I go places. You will get tired a lot quicker that you expect and especially if you are out in the heat of the day. Fortunately for me, my wife is there to keep an eye on me and make sure I don’t overdo things. I feel like I am recovering well and hope to be able to start working out later this month to help burn off some extra pounds. With all the heat we are experiencing I make sure to keep a bottle of water with me at all times and it seems to help with hunger as well as keep me cool.

Oh yeah, I forgot to mention some very big news. I have officially reached my first milestone in this journey. As of this morning, I am officially less than 300lbs. There is no turning back now. Goodbye 300s I am done with you forever!! My total weight loss since the start of the year is 55 lbs. I am fitting into clothes I thought I would never get to wear again and feeling great.

The journey continues…

Bariatric Diaries 3: First Weekend Home

2010-05-25T08:02:00.000-07:00

What a rollercoaster.

I got released on Thursday afternoon from the hospital and left pretty sore but looking forward to recuperating in my own bed. Friday I was home alone so that my wife could go back to work. I relied on the pain medication to help me make it through the day and slept most of the day between HBO movies. Saturday, I got to see my son for the first time since the surgery. In the most innocent 6 year old voice he immediately said ”Wow you look like you lost some weight already Dad.” Even though I knew he was trying to make me feel better, I played along. I also got out and did some walking with my wife while she ran some errands. She must be a saint, because she has been so supportive and waited on me hand and foot this week.

The pain has not been too bad so far. My surgery was laparoscopic, so I have 6 small incisions forming a rectangle on my stomach. I would offer to show a picture, but trust me when I say you don’t want to see that. The incision on the upper left side is by far the most painful. Dr. Douglas Lorimer, who did the surgery, explained that is the “port” where they insert the stapler and so it will generally be the worst pain wise. So as of Sunday evening, I am for the most part pain meds free (5 days post op). I have made it to the evening without taking any pain meds, which depending on how much I am moving around, makes me question myself. Overall the pain is about a 1 or 2 on the infamous pain scale you will experience at the hospital.

Ok, so I know you are probably telling yourself that there has to be something that isn’t going so well. A couple things!! I am having issues with nothing tasting good to me anymore. Things I fell in love with preparing for the surgery taste like awful. Even my fall back plan of fat free pudding that I have eaten most of life tastes bad. I unfortunately had to pay another trip to Vitamin Shop today because the one protein I really liked before surgery tasted and smelled so bad that I started to gag from drinking it. Oh yeah, the vitamins aren’t so bad, but I have found myself brushing my teeth more because they make my breath smell horrible. Not sure what is causing this problem; I have to figure something out QUICKLY!!

Overall, I give 2 thumbs up with my surgery experience. I will make it through the couple bad things and I will be a better human because of it. Life is too short to let small issues like those get in my way. I go back to my follow up appointment with Dr. Lorimer next Wednesday morning. I am sure he will have some answers to my issues and more importantly he is planning on taking out the stitches. I forgot how much they can start to itch after a few days. Be very careful with your wounds, the last thing you want is an infection or something to happen to those stitches.
Also, I want to take a quick moment to thank some very special people at Texas Health Fort Worth. Dr. Lorimer and Dr. Castaneda, you guys did a great job and I really appreciated the kind words from both of you after I got to my room. I could not have asked for a better team of surgeons to work on me. The nurses and patient care techs on the 3rd floor are amazing. They can be tough on you when it matters most, but they are always there. I can now confirm that in any state of medication I will forever be able to provide my full name and date of birth. J I have worked with nurses for several years through my job and I have never seen such a professional and caring group of nurses in one place at any given time. The “Lovely Ladies of Bariatrics”, Tiffany Norris and Jaime Bass, are again awesome. They both came and checked on me daily and helped make the stay just a little easier. Carey in the chaplain’s office also came by to see me every day. He prayed with me and my wife pre surgery and really made me feel so much calmer and always had some kind words to share when I was stuck in the hospital bed. Finally, thank you to Whitney Jodry in marketing who braved the early morning hours to tweet about my surgery to promote obesity awareness. It is a huge problem (no pun intended) and people should know their options. My family is extremely appreciative of the work that the entire team of Texas Health Fort Worth put forward to make our experience that much better.
Since surgery, I have lost about 10 lbs. bringing my total loss since January to approximately 46 lbs.

The journey continues…..

Full coverage of the Casey James Visit!

2010-05-17T08:10:00.000-07:00

Casey James' visit to Texas Health Fort Worth was nothing short of amazing! I have documented his entire visits with the highlights pictured below. I also want to mention that his visit has been well documented on People.com, MTV.com as well as on Fox 4 last Friday. We also have been told that the segment from his visit will air on Wednesday night on American Idol. Please tune in...

Texas Health Fort Worth surgery nurses made their own posters and came to catch a glimpse of Casey!
Hundreds of fans waited in anticipation of his arrival!
The police motorcade that escorted Casey all over the metroplex!
He finally arrived! And in style...
Fans first glimpse of Casey!

Casey took time to stop, sign autographs and take pictures with his fans! He was so gracious!
This precious boy brought his guitar for Casey to sign!
Casey and his mama seeing Dr. Cory Collinge, orthopedic surgeon at Texas Health Fort Worth, for the first time.
Casey presented Dr. Collinge with one of his guitars that said "To the good people that saved my life, I love you!" This was a very touching moment!
From left to right: Lillie Biggins, senior vice president of operations at Texas Health Fort Worth, Dr. Cory Collinge, orthopedic surgeon, Casey James and his mama!
Dr. Collinge and Casey James with two of our excellent clinical staff in Trauma ICU!
Dr. Collinge and Casey!
Casey doing an interview with the local Fox affiliate about his accident and what the staff at Texas Health Fort Worth mean to him!
Casey even made time to stop and visit with a patient, Dalton Williams, who recently was in a motor vehicle accident and was thrilled to have the opportunity to meet Casey!

Casey gave one last hug and picture to the PR girls at Texas Health Fort Worth!

I have to say after working at this wonderful hospital for six years, this media event goes down in the books as one of the most memorable and most touching! I am proud every day to work with such incredible physicians, nurses, administrators, volunteers and professional staff who make it their goal to improve the health of the community!

Thank you, Casey, and American Idol for stopping to pay it forward to our clinical staff! This day was truly one we will all remember for the rest of our lives!

- Whitney Jodry

Texas Health Fort Worth spokeswoman

Bariatric Diaries 2: Getting closer

2010-05-17T07:47:00.000-07:00

I woke up early today to visit Texas Health Harris Methodist Fort Worth to have my pre op testing done for surgery day. You can schedule your pre op tests up to 5 days out from the date of the surgery. The tests were pretty straight forward. They did blood work, an EKG, a couple chest x- rays, and of course a weigh in. Also, be prepared to give your life history. I am almost positive they asked me over 1000 questions. Ok, maybe it was more like 40 or 50. Before all the testing I paid a visit to a friendly admissions counselor who verified all my information and collected my deposit for the surgery. I was in and out in less than an hour.
So now I am preparing for my last weekend before surgery. A friend asked me earlier today what I had planned for the weekend, and I could hear in their voice they were waiting for this great lineup of events. No, I am not going to go slay a dragon, or go bungee jumping, or anything crazy. It’s just another weekend like all the others. I am going to relax with my wife and son while trying to get some things done around the house since I will be out of commission for a week or two. If it doesn’t rain too much, I will be coaching t-ball on Saturday morning. I will probably slip away to do a little shopping for chewable vitamins, protein, and all the other supplements that I will begin taking once I am home from the hospital. Other than that, I plan on spending most of the weekend at home.
Oh yeah, I almost forgot to mention how the weigh in went this morning. Drum Roll Please………. I have lost 23 lbs since my last weigh in a month ago. Great way to start the morning!
Have a good weekend everybody!! The journey continues….

- Casey Armstrong

All about Casey James today!

2010-05-14T11:46:00.000-07:00

What a day we have had at Texas Health Fort Worth! So glad to have former patient Casey James and top 3 American Idol contestant in the house! Here are a few pics from his visit...

Casey exiting the limo to hundreds of fans!

Casey was so generous and signed this little boys guitar! He probably made his year! He also took pictures and signed autographs with hundreds of fans!
From Left to Right: Lillie Biggins, senior vice president of operations at Texas Health Fort Worth; Dr. Cory Collinge, orthopedic surgeon at Texas Health Fort Worth and Casey's doctor; Casey James and his mama!
Casey presented the hospital and Dr. Collinge with one of his guitars signed "To the good people who saved my life. I love you." Signed Casey James.

What a priceless gift!

Dr. Collinge is quite the miracle worker. I love the beaming look on his face after receiving one of Casey's very own guitars - signed!!!
Casey also went and visited one of our trauma patients, who is also a musician and loves to play the guitar! Glad we could have you participate today, Dalton!

These fans made today even more special! Thanks to the community for coming and showing your support!

I will be posting more pictures as I get them, so make sure you check back! What an incredible day we have had and can't wait to share more photos and video with you!

- Whitney Jodry

Texas Health Fort Worth Spokeswoman

Guess who is coming to Texas Health Fort Worth Today??? Casey James!!!

2010-05-14T07:19:00.000-07:00

If you want to catch a glimpse of Casey today, be here at 11:45 a.m.

Texas Health Harris Methodist Hospital Fort Worth
1301 Pennsylvania Avenue
Fort Worth, TX

Fans will be welcome to line the streets of W. Cannon Street!

Hope to see you there!

Bariatric Diaries 1: A Perspective from Casey Armstrong

2010-05-13T08:45:00.000-07:00

My name is Casey Armstrong. I am a fat guy.
I have been an obese person since the day I was born. It all began August 18, 1979 when my parents gave birth to a strapping 10 lb baby boy whom the doctor proclaimed needed to be playing for the Cowboys. Growing up I was always active in sports and other activities and I always made a mental note of the fact that I was always the biggest kid in the group. That might have bothered some people, but I was lucky to have been taught that I shouldn’t let people’s words bother me. By junior high I was already hovering around the 200lb range and by high school I was nearing 275. After high school I went on to college at SMU in Dallas and after tearing my ACL and becoming less active, I was quickly over 300 lbs. I am now 30 years old and at the beginning of the year I was close to 350 lbs. All these years I would make excuses as to why I didn’t need to diet, I was in denial.

This year has brought lots of twists and turns to my already jammed packed life. Back in January I got some bad news, my mom was very sick from complications of congestive heart failure. Not long after that, I found out that an old friend had passed away at just 37 years of age. My mind raced with the idea of death, illness, and my family. Life is short, and the fact that I have a family history of medical issues a mile long and the fact that I was overweight didn’t help my cause much. Later that night, I stood in the kitchen with my wife and we talked about death, our family, and the fact that I needed to do something to change my life because I didn’t want to die. We decided that I should call to get more information on weight loss surgery. At that moment, I knew my life was about to change.
I contacted Dr. Lorimer at Texas Health Harris Methodist Hospital in Fort Worth and scheduled an appointment. My wife went with me to find out what my options were. I was nervous to the point that I was sweating and almost couldn’t think straight. After talking to Dr. Lorimer, I knew what I had started down a path of no return and now I had to finish it. I began all of the prerequisites set out for me by my insurance company so that they would help pay for the procedure. A pulmonologist visit, then a psychiatry visit (I now have proof I am not crazy), a monthly trip to see the “Lovely Ladies of Bariatrics” at the hospital, and finally attending a monthly support group (yes men go to support groups too) for weight loss surgery patients. After 5 months of appointments and mentally and physically preparing myself I am scheduled to have gastric bypass surgery on May 18, 2010.

I get asked a lot of questions lately, so I thought I would get those answered one more time for anybody out there reading this. Here we go…

Why am I doing this?
That’s easy. Although I don’t have any major health problems, my family does. I am married and have a 6 year old son, and I want to watch my marriage grow and be there for my son as he moves on in his life. Most importantly, I am doing this for ME!! I am smart enough to know that if I don’t change the way I live, I will most likely miss out on things in life. I am not one to miss the party, and I plan on being here for many more years.

What do I look forward to the most with losing the excess weight?
I can finally walk into any store and buy clothes off the shelf rather than paying more money to buy big and tall clothes. My wife always reminds me how good it will feel to lose the weight when I get discouraged or try to venture off my plan.
What is the worst part of getting to surgery day?
Two words, CHICKEN BROTH!! You will have to go to a liquid diet 2 weeks before surgery and Chicken broth cannot be altered enough ways to make it appetizing. Also note that once you put no sugar into your body for a few days and then you accidentally eat something sweet, WOW you will get a rush. I experienced this at the hands of a cherry Popsicle. I bounced off the walls for hours. It sounds horrible to go to a liquid diet, but it becomes easier the further you go. On top of that I have lost over 20 lbs after my first 8 days on the diet.

What is my goal?
My goal is to lose approximately 120 lbs. That would put me close to 200lbs for the first time since junior high. Also I have made it a mission to compete in some type of endurance race with a few of my friends within a year of my surgery.

How long will I be away from work?
I have been told 2 weeks. I am stubborn and want to go back sooner, but I am playing it safe and doing as I am told. I hope to be fully recovered within a month.

What does everyone think about this?
I have some of the most supportive people on the planet in my corner. My family and friends are rooting for me the whole way and have already told me that I will be under watchful eye. Your support group is probably one of the most important elements in this process. This is not a quick fix, it is a lifestyle change.
I go in tomorrow morning for my preop testing; I am nervous and excited all at the same time.

I am having surgery in 6 days. Now more than ever, my life is changing. The journey has just begun! Keep you posted!

- Casey Armstrong

Nutritional Facts - Coming to a Restaurant Near You

2010-05-10T12:08:00.000-07:00

There’s a lot of talk about menu-labeling laws requiring restaurants to post exactly how many calories, fat grams, sodium, etc. are in that quick lunch you eat on your way to your next meeting or your daughter’s soccer practice. Americans are spending almost half of their food dollars on food outside of the home, specifically at fast food restaurant and food-service vendors. And most don’t know exactly what they are eating.

The nutritional facts are available for most of these restaurants and have been for years, but research from the American Journal of Public Health show that most don’t look. Researchers observed 4,311 patrons of several very popular fast food restaurants to see if they accessed in-store nutrition data. The info was not on the menu board but in a pamphlet, on a wall poster or an on-site computer. Only six, or 0.1%, of the patrons looked at the numbers.

Some will argue that consumers don’t care or won’t change their selections based on nutritional information, but does that mean we shouldn’t have this information readily available. Would you choose to super size your order, knowing it adds 220 calories and 6 grams of fat? Maybe, but it would be an informed choice.

We cannot argue that obesity, heart disease and diabetes are growing rapidly. If laws require us to know what our clothes are made of and how to properly launder them, shouldn’t the same be said of our food?

- Tiffany Norris
Bariatric Nurse Coordinator

Knowing Your Rights

2010-05-06T11:11:00.000-07:00

If you are admitted to our hospital or come to our Emergency Department, you’re given a small stack of papers to sign. While it’s tempting to quickly sign the forms and feel that you’re done, these forms are provided for your protection to empower you while you’re in the hospital. It’s more than okay to read the forms and ask questions before you sign them.

One form you or your loved one will receive is titled “Patient Rights and Responsibilities.” It lists numerous patient rights which are based on the inherent values of dignity, respect, and consideration. Some of the patient rights on this form involve important topics such as privacy, freedom of choice, and obtaining information from the medical record.

I think many people underestimate their influence over their own health care decisions. For example, you could be going into a state of the art operating room with the best physician in the country with our amazing nurses ready to help …but it still comes down to you consenting to have the surgery done. The surgery starts with you and ends with you.

Just as looking at your favorite restaurant’s menu is the best way to see what to order and what to expect, reading the “Patient Rights and Responsibilities” form at the start of your hospital stay is the best way to prepare for a very satisfied experience.

Craig Pomykal
Patient Advocate

Boat Safety and Summer...

2010-05-04T08:18:00.000-07:00

It looks like spring has officially arrived here in North Texas. The skies are clear, school is nearly out and the bluebonnets are everywhere, making even traffic jams tolerable with their incredible beauty. There is just something about spring that brings a new found energy and beginning.
Folks spend more time outside this time of year. In Texas, that also means on the lake. We have more square miles of inland water than any other state. I have lots of memories being pulled behind a boat trying to get up on water skis. Thank goodness that was before personal video cameras. Remember those big orange life-jackets?
Speaking of life jackets, it is a law that anyone younger the age of 13 must be wearing one. Nearly 85% of all boating fatalities were not wearing a life jacket. Of course they don’t have to be the orange ones, just one that are coast guard approved, and they have come a long way baby. In fact, life jackets are a requirement for personal water crafts.
Be the “designated driver “and avoid alcoholic beverages while boating. Alcohol plays a role in 50% of all boating accidents. Boating while intoxicated carries penalties similar to driving while intoxicated.
It’s also a great idea to take a boater education class. They will tell you to maintain a 50 foot distance from other boats, personal water crafts and swimmers unless operating at an idle speed. They will also let you know that weekends between noon and 7PM are the busiest times on the lake, so operate your vessel at safe speeds, especially in crowded areas. Information can be found at the Texas Parks and Wildlife web pages.
Both of my sons love the lake. They spend hours perfecting their wake boarding flips including “front roll, back roll and half-cabs”. They post their pictures on various social networks. It’s an enormous workout. I know my heart rate increases when I see the photos! But most of all they have a great time with friends and family. That’s what spring and outdoors is about.
Until next time keep it safe and shipshape!

--Mary Ann
Injury Prevention Coordinator

Buying medications online

2010-05-03T09:14:00.000-07:00

Internet pharmacies have increased in popularity over the last few years. Although pharmacies provide customers with a convenient, private, and affordable way to buy prescription medications, the use of online pharmacies can be a safety concern, particularly when unapproved drugs are dispensed.

The National Association of Boards of Pharmacy (NABP) conducted a review of over 5,000 internet pharmacies and found that 96% of online pharmacies are not in compliance with the laws and regulations set forth by the Food and Drug Administration (FDA). Medications dispensed by these non-compliant pharmacies may be unapproved by the FDA and contain the wrong ingredients, too much or too little of an active ingredient, or even dangerous substances. For example, recently the FDA purchased and analyzed several products claiming to be Tamiflu, a medication commonly used to treat flu. When analyzed, some of the products did not even contain the active ingredient found in Tamiflu, but instead contained a common over-the-counter pain reliever, acetaminophen (Tylenol).

In order to protect the public from the dangers of illegal online pharmacies, the NABP has set forth guidelines to help identify websites from which prescription drugs may be safely ordered. Signs of a trustworthy website include a valid physical address in the United States, a license by the State Board of Pharmacy where the website is in service, and a licensed pharmacist available to answer your questions. Prior to dispensing the medication, internet pharmacies should require a valid prescription from a physician who has physically examined the patient and determined the prescribed medication to be an appropriate treatment. Some illegal online pharmacies issue a prescription without a physical medical examination, which may result in an incorrect diagnosis and/or treatment.

The NABP has also developed a program, Verified Internet Pharmacy Practice Sites (VIPPS), to help reduce confusion and ensure customer safety. This program places a hyperlink seal on a pharmacy website (image shown below). When a customer clicks on this seal, they should be linked to the VIPPS website which contains information about the particular pharmacy website they are visiting. The VIPPS seal verifies that the pharmacy has met state licensure requirements as well as the NABP criteria for a valid pharmacy practice. An additional tool for consumers to use when considering an online pharmacy is a list of approved online sites provided by the NABP. (www.nabp.net/vipps/consumer/listall.asp).

Online pharmacies can provide benefits for patients and their healthcare as long as precautions are taken to ensure their privacy and safety. The NABP is continuing to research internet pharmacies in order to help educate the public on the dangers of buying prescriptions online. With a little research and the use of the VIPPS seal, consumers can help ensure the safety of their health and privacy information.

Nicole Day, PharmD

Cultures of Flavor

2010-04-27T08:10:00.000-07:00

The Texas Health Fort Worth family is a melting pot of the world’s culture. I have been blessed with the opportunity to travel to many of the places from where Texas Health Fort Worth employees originate. Before I pack my bags I research the culture, which includes the food; it’s actually the impetus for my chosen destination.

For five days the Cramer Café will feature dishes inspired by street foods and world comfort food, from a host of Mediterranean, Asian and Latin food cultures, and across the Caribbean. Highlighted regions and food cultures include Korea, India, England, Jamaica, Cuba, Mexico, and the Caribbean.

The phenomena of world street food and world comfort food each imply a broad range of food traditions—some of which overlap—but together represent flavors, dishes and culinary ideas that often fall outside of the realm of fine dining menus. In recent years though, American chefs, even those with the most upscale menus and operations, have found new inspiration from these “fast casual” and slow cooking world traditions.

Well-traveled chefs and their savvy, foodie customers have long known that in many cultures, “street food” and other non-restaurant foods (including bar foods, snacks, and the prepared foods of open-air and wet markets) represent the best, most delicious cooking in a given country. From Singapore’s famed hawker chefs and the street food vendors of Delhi, Luck now and Mexico City to the market stalls of Saigon, Bangkok, Penang and Marrakech (a personal favorite) to the tapas bars of Spain and meze hot spots of Greece and Turkey, these are food experiences packed with vibrant flavors; hand-held, in a bowl, or otherwise easy to eat; and inexpensive. A world-class bowl of noodle soup can still be savored “on the go” in much of Asia for a couple of dollars—or less! Street food is especially ubiquitous in tropical cultures where much of life is lived outside, and the perfect evening meal is a string of small bites from street vendors who are typically famous for one or two dishes, having perfected them for 20 or 30 years.

Hand-Held & Full of Flavor
These foods utilize all methods of preparation and cooking, from the steaming of tamales in Cuba and Mexico to the very hot, wood-fired oven baking of pizzas in Naples, and from the olive oil-frying of Andalusia and deep-frying of Indian pakoras and Brazilian salt cod and potato fritters to the charcoal grilling of skewered meats in Istanbul, Jakarta, Kuala Lumpur, and Tokyo. In many cultures, bread creates the wraps for handheld street foods. Consider the tortas in Mexico City, the pressed Cuban sandwiches of Havana and Miami, the delicious harissa-spiked, grilled pepper and tuna sandwiches of Tunis, the porchetta sandwiches of Italy, and the falafels of the Middle East. In Southeast Asia, rice paper (think salad rolls) and greens (think Vietnamese sizzling crepes) are the wraps of choice, with a singular starring role for baguettes in Vietnamese banh mi. In Peru, crispy dough encases the savory fillings of empanadas.
And at Japanese train stations, nori wraps up inexpensive grab-and-go sushi

Join us as we plunge into a five-day, sauce-slopping, noodle-slurping, tandori-sampling, jerk-nibbling, tortas-savoring, bulgogi-grazing epic tour of the best of world street food and world comfort food!

- Chef Hugh Gittens

The Gift of Life

2010-04-23T13:27:00.000-07:00

As we enter spring, we enjoy all the new life sprouting up, the beautiful spring flowers, the blossoming trees and the baby animals. We are surrounded by the gift of life in many shapes and forms. One of the most meaningful ways to share the gift of life and leave behind a true living legacy is through organ, tissue and eye donation.

Currently 107,015 men, women and children are in need of a lifesaving organ transplant and numerous others need tissue and eye grafts. Every 12 minutes, a name is added to this national list. Sadly, an average of 17 people die every day waiting for a lifesaving transplant.

As the sister of one of the 107,015 potential recipients, I understand the day-to-day waiting, as well as the ups and downs of living life on “the list.” We prayed not for the death of someone, but for a family to have a heart big enough to say yes to organ, tissue and eye donation in their time of grief and let their loved one’s legacy live on by giving the gift of life. We prayed for peace for the families that consented to donation and that their loved ones would be blessed and honored. Sadly, my sister died last month – one of the 17 – still waiting for that precious gift.

The topic of organ, tissue and eye donation is not a typical conversation that one has around the dinner table. But, I challenge everyone to change that. We need to create a culture where everyone says yes to organ, tissue and eye donation.

The first step to achieving this culture is to talk to your family about your wishes in regards to donation. Second, sign up as a donor on Texas’s state registry at www.donatelifetexas.org. Finally, be an advocate for donation. Slowly we will change the culture and see the waiting list getting smaller. One day in the future, we may even eliminate the list altogether. What a day that would be!

So as we close out National Donate Life Month in April and we continue to enjoy all the new life that we are blessed with, think of the ultimate gift that you may one day pass on through organ, tissue and eye donation.

- Amanda Williams
Donation Clinical Specialist
LifeGift

The Serving Size Dilemma

2010-04-20T14:00:00.000-07:00

Have you checked the serving size?

The Serving Size Dilemma

In February 2010 the New York Post published an article discussing the challenges with the serving size on food labels. Many “individual” food items have more than one serving per container such as a can of soup, a pint of ice cream and even a bag of animal crackers. You think you are eating 120 calories, but wait! If you look closer there are actually three servings in the container so you just ate 360 calories! The question becomes, “Do you really know how much you are eating?” Unless you are examining the food label and using a calculator, you may not!

A New Trend in Food Labeling

The Food and Drug Administration (FDA) wants to simplify grocery shopping and label reading for the consumer. They are considering two things that might help you grocery shop smarter. First, the FDA is considering putting food labels on the front of the package. This way the calorie and serving size information will be starring at you on the shelf. Second, they are re-evaluating serving size and making the serving match how much is in the actual package for applicable items. For example, a muffin’s food label would provide the nutrition information of the whole muffin, not just half of it.

With 64 percent of America overweight, we have to wonder if making the food label more visible will help people be aware of calories and thus eat less. After all, that is the goal. So many Americans snack mindlessly. It is not uncommon for people to come home from work, grab a bag of chips and munch until dinner. They likely have no idea that every 6 chips they eat can be 150 calories.

Putting the food label on the front of the package might jolt reality and hopefully help them think twice about grabbing another handful.

Eating Wisely

The key to eating wisely is paying attention. In order to know how many calories you are consuming, you have to flip the package over and scan the food label, specifically the serving size. Then you can evaluate if you are getting the best caloric bang for your grocery buck!

If you are a person who does not like to think about nutrition or calculate calories, it is likely best for you to buy foods that have one serving per container. This should keep you from over-eating this particular item. It is impossible to avoid foods that have multiple servings per package, but buying less of them should help you on your nutrition journey. However, if you don’t mind a little calculating, there are some creative things you can do to avoid eating an extra serving at a snack or meal:
 When you get home empty the package and divide it into individual servings. Then put those in snack baggies.
 Separate loaves of bread, packs of bagels and containers of tortillas in half and put half in your refrigerator to freeze for next week.
 Write a list of what snacks you will have for the week, gather those foods and group them together in the appropriate serving sizes.
 When you cook a bag of rice or pasta, immediately refrigerate half of it.
 Locate your measuring cups and spoons and have them handy for measuring things like cereal, grains and peanut butter.

If you have a question for the dietitian, visit www.texashealth.org/askamy

Amy Goodson, MS, RD, CSSD, LD
Registered Dietitian
Ben Hogan Sports Therapy Institute
Executive Health Program

Working for a pay check or following your passion?

2010-04-15T16:05:00.000-07:00

Vincent Van Gogh said, "Your profession is not what brings home your paycheck. Your profession is what you were put on earth to do with such passion and such intensity that it becomes spiritual in calling."
This passion, intensity, and spirituality are what we experience each day in the Palliative Care Unit. We opened our unit for patients July 15, 2009, and as we approach the end of our first year, I gain a new respect for the people that work on this unit. If you were to visit us on any given day, you would see the staff busy caring for their patients. They are eager to meet the needs of each patient and their family members. Additionally, the nurses and techs work to educate their peers throughout the hospital on the amazing service we can provide patients with progressive diseases. During the past 9 months, we have transitioned from what Van Gogh calls individuals coming to work for a paycheck, to a team; you might even say a family.
Our staff family works hard to ease the pain and burden of their patients. During this year, we have helped a patient achieve his last wish by working with the ICU in allowing him to spend his last few moments outside in the Meditation Garden. We have seen patients come and go that were not expected to live. We have helped a couple renew their wedding vows. We have watched wives curl up in bed beside their husbands, for one last hug. And we have held each other during difficult times.
Our family is not unlike your family. We have our struggles, our hopes for the Palliative Care Unit and each other, and we come to work each day hoping to provide the best possible care for our patients and their families.

- Ashley Hodo
Palliative Care Nurse Manager

From the heart of one of our patients...

2010-04-13T07:17:00.000-07:00

I was completely devastated when I first received the news, on June 25, 2009, that I had an aggressive cancer. It was as if I had been punched in the gut by a two ton gorilla. I felt complete despair. To my surprise, the entire staff at Texas Health Fort Worth came to my rescue. Not only did they restore my sense of hope, but my sense of humor as well. Each day I was lifted up by their enthusiastic spirit, their absolute professionalism and their deep concern for my well being. They took what could have been a hellish experience and made it a heavenly one. They restored my sense of self worth and my hope for the future. This was done as a matter of course. Not rehearsed, not falsely, but truly from their hearts. I don't have the words to adequately express my sense of gratitude to this organization during my time of trouble. The doctors, the nurses, the technicians, even the clean up crew, were there to help me every step of the way on my journey with cancer. I will forever sing their praises. May God richly bless each and every one of you. May you continue to be a beacon of light in the darkness that is the despair of cancer. Thank you all.

With deep gratitude,

Perry William Allen III

The profusion of newness...

2010-04-06T08:11:00.000-07:00

April! Newness bursting forth everywhere. The new leaves on the tree at “my” parking spot in Klabzuba now block the view of JPS. I went to the Botanic Gardens one morning recently and the profusion of daffodils and some small wild lilies that grow close the ground and azaleas, etc., etc. was impressive. As I drive between here and Granbury, the plum and red bud trees are marvelous, as are the large clumps of bluebonnets and verbena. I’m looking forward to the progression of black-eyed susans, Indian paintbrushes, fiery pokers, Queen Anne’s lace, wine cups and many other wildflowers whose names my grandparents taught me and I have now forgotten. All of this natural beauty brings me great joy.
Reflecting on this beauty and joy, I’m reminded of some lessons from childhood. Every summer my family went to a cabin in the mountains. My brother and sister and I liked to play on what remained of a huge fallen pine tree. We dubbed it “Tree-mendous”. We clambered over the rough bark, which as years went by crumbled at our touch. We explored the crevices where the standing tree trunk had been invaded by the beaks of red-headed woodpeckers, squirrels needing nesting places, and branches too heavy with ice or over-growth had broken off and exposed the tender, bright wood (softer than the protective bark. In these crevices now, soft mosses grew and doodle bugs and beetles found nourishment and made homes (We often took the doodlebugs from these metropolises and raced them on tracks we made of sticks and rocks. I hope that we returned them to these former abodes, but I don’t really remember.). Other places where the original tree was deteriorating we found lovely flowers—some of which, I confess, went home in our hot little hands to be presented with great love and admiration to our mother or grandmother. These flowers were put on the kitchen table where we ate and reminded us of the bounty and gifts of nature that almost matched the profusion of love shared in that home in the woods. In still other spots weakened by time and the elements, shoots of new trees were taking root: natural reforestation.
I could go on and on, but I think I’ve said enough for you to notice what all the present newness of spring has reminded me: new life and growth springs from disaster if we allow it to do so. Often human nature wants to bulldoze away the great falls, the results of the lightning bolts, the tremendous tragedies that befall us in life. Modernity wants to clear out all the deadwood of difficult or broken relationships, flawed or shattered dreams, overgrown or unrealistic expectations, losses from separation and death. Yet, even if what has befallen us is moved out of the way, for healthy new growth to occur, compost and fertilizer (manure) must be applied and allowed to nourish and strengthen.
As you enjoy the beauty of spring and the profusion of newness this April, I urge you to be reminded of the bleakness, rain and darkness that has made this newness possible and I encourage you to engage in prayer about them and to find friends, family, a support group, a chaplain or some other individual or group with whom you can share the tragedies of your life so that with time they can nourish newness of your life in all its profusion. And when the new growth begins to sprout, celebrate it and share it also. Life is good, and when you think life might be over, know that new life can be even better!

- Candace Stroup, chaplain

Thoughts and Observations on Health Care and Preventative Medicine

2010-03-22T13:48:00.001-07:00

While traveling in Florida during spring break, I stopped at a 7-11 store to put gas in my car. What was surprising to me was that each gasoline pump had a bright blue sticker with a message to perform proper hand hygiene…you see, the Florida Department of Health is trying to get the message about H1N1 flu prevention to everyone, using every available opportunity. Maybe their example should be food for thought.

Last night the House of Representatives finally cleared the health care reform bill. I’m in the majority of those who desire health care reform. I’m not certain, however, that the bill that was passed is, in any way, “reform.” It seems to be a way to add insurance coverage without actually “reforming” our delivery model. If we continue to focus on acute care and episodic medicine, then we will simply drive costs higher. At some point, we need to realize that the best approach is prevention. Anything that keeps a patient out of the hospital, or supports a patient who has been discharged, so that patient is not readmitted, should be our ultimate goal. While some pundits suggest that prevention efforts do not reduce costs, I would argue that we haven’t really made a effort expansive enough to even measure the benefits. Labels on cigarette packages, labels on alcoholic beverages, labels on cereal boxes…is that prevention? Exercise? Weight control? Stress management? Are these initiatives getting enough attention? Sadly, the reimbursement model currently applied to health care values high tech procedures, and minimizes non-procedural components. Maybe our model at least partly explains why the United States ranks so poorly when compared to other countries in the arena of health care outcomes. We need true reform. Not just some version of expansion, but truly a sea change that impacts us on all levels. Health reform must include components that touch and affect society at all levels, including education, family life. habits, activity, and personal responsibility.

A final thought:
Where is the willpower to confront the reality in our society which super sizes everything, makes being a couch potato an art, requires elevators to go even one floor, and considers exercise nothing more than bending a elbow as food is moved from plate to mouth? Failure to actively address these and other issues will keep any hope for improved health in our country stalled.

- Dr. Joe Prosser, MD
Chief Quality Officer

Let’s Talk about Prostate Cancer

2010-03-19T11:43:00.001-07:00

Prostate cancer has been in the news again this month with the American Cancer Society releasing some new guidelines about screening using the PSA blood test, and whether mass screening opportunities should be offered to the general public. This is a complex topic and much like the recommendations made last year to change the age women should start mammograms, the response from prostate cancer survivors has been filled with confusion and emotion. As the coordinator of the Prostate Cancer Resource Center, I have been asked several times to respond to the issue. The good news is I can proudly say that the program we have at Texas Health Harris Methodist Hospital Fort Worth addresses the concerns expressed in the publication by the American Cancer Society.
The Prostate Cancer Resource Center was opened in January of 2003 with the primary goal to educate and support prostate cancer survivors about their diagnosis. This support includes the STEPs to Surviving Prostate Cancer series and one-on-one counseling with the nurse navigator. Through this education and support process we are able to provide the information a man and his family needs to make an educated decision about treatment choices, potential side effects and potential complications down the road. I have found that most men that take the initiative to be screened are proactive in their health and want to explore some sort of treatment if diagnosed with cancer. At our major screening event in the Fall (during the Cowtown Cruisin for a Cure car show) we provide several opportunities for men to ask questions and understand what is involved in a screening and what the results potentially mean. That information prior to screening and the resources provided through the Prostate Cancer Resource Center meet the standards recommended in the guidelines article.
We’ve recently expanded our resources for survivors to include a chat day on Tuesdays – “Lets talk on Tuesday.. about prostate cancer” is held every Tuesday from 10:00 am – 2:00 pm in the Cancer Resource Center in the Klabzuba Cancer Center. Specially trained THFW volunteers are available to chat with men about their personal journey with prostate cancer and answer any questions men might have about the disease, treatment options and coping with side effects. If you know someone that is newly diagnosed or dealing with prostate cancer issues, please encourage them to come and by.. let’s talk!

Gayle Wilkins, MSN,RN,OCN
Coordinator of Prostate Cancer Resource Center.

Brand Name Versus Generic Drugs: Is Price the Only Difference?

2010-03-17T11:36:00.000-07:00

Many Americans are frustrated and concerned with the high cost of prescription drugs. Generic forms of drugs offer consumers an alternative to the sticker shock of brand name drugs. The price of a generic drug is typically less than that of a brand name drug because the manufacturer does not have to complete the same research, development, and marketing process that the original drug manufacturer accomplished.

Before a generic drug is approved for use, the FDA requires that it has the same active ingredients, dosage form, administration route, strength, quality, purity, and stability as its brand name counterpart. Although they contain the same active ingredients, brand-name and generic drugs go by different names.

Mainly due to patent protection, not all medications have a generic equivalent commercially available. Drug manufacturers have to perform such extensive research and development that laws have been created to protect a brand name drug’s patent for a designated number of years. Once the patent expires, generic drugs may then enter the market. Brand name drug manufacturers actually often own generic drug companies.

Although brand name and generic drugs have the same active ingredients, their medication exteriors can vary due to inactive ingredients which can result in different colors, shapes, sizes, and flavors. It is always important to question your pharmacist if you feel uncomfortable about the medication that you picked up due to it having a different appearance from a previous prescription fill. The medication may look different because it is made by another manufacturer, or the generic form may now be commercially available.

In Texas, when a prescriber writes a prescription, it is generally filled with the generic drug if available unless the prescriber designates a brand name prescription as “dispense as written.” Most drug coverage plans require patients to utilize generic medications if available. If a patient chooses to fill a prescription with a brand name drug when a generic drug is available, many drug coverage plans will not cover the patient’s drug expense.

Although many brand name manufacturers try to show an advantage of using their brand name drug versus its generic rival, FDA regulations are in place to make sure the generic drug is providing the same quality of treatment to the patient. Generic drugs provide a safe alternative to brand name drugs and hopefully will have you smiling at your receipt the next time you visit your local pharmacy.

- Alisia Baker
Pharmacist at Texas Health Fort Worth

Source: U.S. Food and Drug Administration.

Nutrition for One Please…A Success Story

2010-03-09T08:39:00.000-08:00

The average person has an idea of general nutrition information. Most people recognize that grilled meat is better that fried and wheat bread is healthier than white bread. However, people get confused when trying to piece together what they should be eating at meals and snacks on a daily basis. Often times it takes a registered dietitian to help someone understand how many calories he/she needs, where those calories should come from and how to fit them into nutritious meals and snacks throughout the day.

In 2008, Gary Bishop decided to work with me to help himself lose weight and improve his health. Here is his story:

"I have always been consistent in working out, particularly cardiovascular exercise. However, I have never seemed to do very well on the diet part. I guess I was like many other people who felt like you could eat as much as you want as long as you exercised. This worked fairly well in my younger years but after passing age 40 it did not work as well. Like everyone else, I would try the latest ideas of "hunger curbing methods" such as drinking water before and after meals, but they would only work temporarily. Finally I read about Texas Health Fort Worth Executive Health Program’s registered dietitian Amy Goodson in my City Club newsletter and decided to set up an appointment. I thought I should finally find out what is truly the best way to eat by a professional. During our meeting she asked many questions such as what I ate currently, where did I eat out, what did I eat for each meal, how often did I exercised, etc.

Next, Amy explained to me about nutrition including protein, carbohydrates, fiber - soluble and insoluble, portion size, number of meals per day, proper calorie intake, good fats and bad fats, what to eat at different kinds of restaurants (Mexican, Italian, Chinese, etc) and the correct combinations of food for each meal. Finally after all the years of conflicting information , I felt I had finally heard the correct answers.

Within a couple days, Amy sent me a personal meal plan that included all sorts of ideas for meals and snacks. The part I liked the most was the plan for eating at fast food restaurants for lunch. I consider this real information for the busy lifestyles all of us live today. There was also a list of different foods and brands to pick up at the grocery store that were healthy. I would take the information that Amy provided to grocery store to make sure I picked the proper brands and types of various food products.

I began to lose weight steadily and did not get hungry. I really felt good about eating healthy and of course, excited about the weight starting to come off. I lost 20 lbs easily within about 5 months but still needed to lose another 10 to reach my goal. I felt like I had reached a plateau. So I emailed Amy and told her my situation. Within hours, Amy emailed me back with 3 options that she would guarantee to take off the remaining weight. I picked the additional day of exercise. It worked quickly and the additional weight came off. A few weeks later it was time for annual physical. I was very anxious to see if the weight loss would improve my cholesterol readings. Well, my reading had dropped over 40 points since the previous year and my doctor allowed me to come off my cholesterol medicine. I was very excited! I admit that I have days when I don't eat like I should, but 90% of the time it is easy to stay on track. It has been 15 months since meeting with Amy and the weight continues to stay off.

If you have a question for the dietitian, visit www.texashealth.org/askamy

Amy Goodson, MS, RD, CSSD, LD
Registered Dietitian
Ben Hogan Sports Therapy Institute
Executive Health Program

Sad is not bad.

2010-03-08T07:08:00.000-08:00

Not long ago I listened as a grandfather, swollen with pride, brag to his young granddaughter. He explained to her that he had recently been injured but was now okay. The point he emphatically drove home with the child was that throughout the entire ordeal he never once shed a tear, not one. He simply forced himself to keep the tears inside. I was amazed.

As a chaplain I often share time with patients, times when very few words are uttered. Sometimes we sit in silence. On more than one occasion I have been present, in silence, as the patient, family, or staff member wept, sometimes uncontrollably so. With this in mind the well intentioned grandfather’s words caused me to ponder what lesson the young child would take away from this tutorial on the art of sucking it up. Would she hear, and be proud of the fact that her grandfather was one tough buckaroo, able to resist and hold back those dreaded telltale signs of weakness called tears? Or, would she sadly walk away and join the ranks of millions of others in our society who are convinced that crying, i.e. being sad, is bad a thing, a definite Achilles' heel in one’s persona?

Certainly it is not my place to judge the concerned grandfather. Not for one second do I doubt that he desires the absolute best for his granddaughter. And when I hear “there, there, don’t cry” around the hospital I have to remind myself that the comforter is most likely truly concerned for the one who weeps. But what has happened in our society, what has happened to us, and why have we succumbed to this notion that sadness is a bad thing to be avoided at all cost? How did tears become the icon for fragility?

In the midst of this magnificent journey called life it can be healthy if we come to grips with the fact that there will be times of sadness. Happy simply cannot happen on a twenty-four seven schedule. Someone once proclaimed that the brook could not make those soothing sounds if it were not for the rocks. I like that. Our hard times, our days of trudging through the dark valley, blinded by tears of anguish, serve well to multiply the intensity of our joy. Of all the things we seek in life, balance is a prized commodity. It might be hard for some to admit, but we really do not want a life that is nonstop hilarity and knee slapping merriment. Bliss and sorrow, laughter and tears -- all indispensable ingredients for a well-adjusted enjoyable life.

If we must embrace times of weeping, to whom or what can we turn to for solace? Just knowing that the sadness will pass can provide minuscule consolation in the midst of intense agony. Here is where I want to offer that there is One who has promised never to abandon us, never. When I read the Bible I find three letters, two short words that never fail to help me when I am sad. These two words, proclaimed by God, are concise and to the point yet brimming with theology and hope. God’s proclamation of “I AM” is in fact, a not too shabby summation of the divine message for all.
In this decree we find the promise of divine hope in the darkest of our times. In this declaration I hear an assurance, a promise from One who has always been with us, is with us now, and will always be with us. And let’s be honest, when we are sad nothing is more comforting than the presence of a fellow sojourner offering not judgment, nor half baked advice, but his or her nonjudgmental self. Please do not ask me how our Creator does it, but in some mystical and comforting way God shows up, on time, ready and willing to offer succor and hope. This may come as a visit from a friend, church member, chaplain, nurse, or other staff member. Somehow, time and again, God’s ambassador arrives when the stream of tears is about to become an overwhelming river of sorrow. I see this every day, and everyday it gives me hope.
I too have a granddaughter. And it just may be that someday I will speak with her about my being sick, hurt, and sad. And when that happens I know now that I will say “sweetie, Grandpa is going through a hard time. It is so hard in fact, that today I cried my eyes out. But you know what? It’s okay. In fact, it felt good to cry. For you see, sad is not bad.”

- Carey Reynolds, Chaplain

Nutrition from the Ground Up

2010-03-04T12:13:00.000-08:00

Do you know that March is National Nutrition Month (NNM)? Well it is!

NNM was developed by the American Dietetic Association (ADA) to promote nutrition education and information. The ADA, the world’s largest organization of food and nutrition professionals, started NNM in 1973.

This year’s theme is “Nutrition from the Ground Up” emphasizing the key to a healthful diet is improving your nutrition…from the ground up. Comparing good nutrition to a farmer planting and raising his crop is so appropriate! A good crop doesn’t happen in two weeks nor does a healthy diet claim to “drop two dress sizes in two weeks”.

Developing a healthy diet takes time. Just like farming, healthy eating requires a good foundation. It requires a plan, daily consistency, and follow-through with that plan. It takes work but the rewards are worth it. Don’t get discouraged, even making small changes can make a difference.

When I teach nutrition education, I always start with the basics:

• Eat at least 5 fruits and vegetables daily
• Consume healthy carbohydrates that are high in whole grains
• Eat more lean types of meat and poultry and try to eat more fish
• Decrease the amount of refined carbohydrates especially in beverages
• Consume low-fat or no-fat dairy products
• Decrease the amount of fat in your diet especially trans-fat and saturated fat

Start with one step to improve your eating habits. Don’t make drastic changes or completely overhaul your diet. Making small, reasonable changes increases the likelihood that you will make them a permanent part of your lifestyle.

For more ideas on building your healthful diet from the ground up and other topics, such as food safety, disease management and prevention, and the tip of the day, visit the ADA website: www.eatright.org. This site is a good resource for nutrition education all year long.

For more information or to get trim in 2010, register for our advances in medicine seminar on Tuesday, March 30th from Noon - 1 p.m. at the Heart Center on the campus of Texas Health Fort Worth. To register, click here.

Jamie Bass, MS, RD/LD
Bariatric Services

What is the value of a strong trauma center...in your opinion?

2010-03-03T08:40:00.000-08:00

I love Texas. We have so much to be proud of. The people are friendly, the skies are blue and where else can you wear cowboy boots with a suit? I have lived in several other states, and even in a few other countries. But as Dorothy said, (and I know I’m not in Kansas) “there is no place like home”.

I also love being a nurse and working in a hospital. There is so much hope and energy. I have seen families come and celebrate a birth as well as express tremendous relief when their loved one was spared in a car crash. Because of fantastic medical care given, so many folks have a second chance at living a life and making a difference in their community.

Working in a Trauma Center can be challenging. There are times when my heart is so moved as I see the physical damage that didn’t have to happen. Sometimes the choices are made by the patients we care for, and with others, well, they were just innocent products of someone else’s decision. Working in a Trauma Center has certainly shown me a different perception on life. My own dramas are so minuscule compared to what others are going through. Kind of puts life into perspective. Don’t get me wrong… remember I still have a 16 year old GIRL in my house, and that alone brings drama that can compete with the latest TV sitcoms.

Trauma Centers are a unique place. Studies have proved that if you are involved in a trauma such as a motor vehicle crash, your chances of survival and return to a normal life are much higher if you are treated in a trauma center. There are many specific requirements that have to be met in order to be a designated “trauma center”. Having specialized care physicians, specially trained nurses, and specific equipment are only the beginning. These resources are costly. But what price is life? And what if someone can’t afford medical care? Do we turn them away? Of course not.

At Texas Health Fort Worth all trauma patients are treated with the same high quality of care. One way to offset the cost of trauma is through fines levied at those who choose to drive irresponsibly. These fines are hefty, aimed at discouraging drinking and driving, speeding, and red light running. They supply a resource of revenue for those who are treated in trauma centers. Millions of dollars have been distributed to help designated trauma centers and EMS agencies that care for trauma patients. These fines are currently under attack by Texans who feel they are unjust. This funding is a lifeline for the whole trauma system. Most Texans are not even aware of the stringent laws that are in place to discourage dangerous driving.

We all want superior health care. We need Trauma Centers to deliver. That requires financial support. Health care isn’t economical, it’s quite costly. But when it comes to family and friends, we know that we will do whatever it takes. And when it comes to our patients, we know we will do the right thing. We take care of our community and its families. It’s something we take pride in. And it’s something we do quite well. Thank you all for the job you do.

- Mary Ann Contreras, RN
Trauma Injury Prevention Coordinator

OH BABY!

2010-03-01T12:44:00.000-08:00

Are you a new or expecting mom? If so, listen up....

Texas Health is offering a free weekly parenting e-mail for expectant and new parents.

A personalized E-mail comes straight to your inbox each week with information specific for you. You will receive information on your baby’s developmental milestones every week of your pregnancy. There will also be great research findings to give you the most up to date information. Included in the email is a section for resources to better support and guide you. We will offer you weekly tips and advice as well as information about classes and events that are available. Best yet is you will continue to receive emails until your baby’s first birthday. You will also have the ability to email questions that will be answered by a registered nurse.

Since babies do not come with an instruction manual this is a great way to have information at your fingertips. If you have an email address, it is as simple as that. We welcome parents, grandparents, childcare providers and anyone wanting to share in the milestones of your baby. Therefore, do not delay and visit this site or visit www.TexasHealth.org/OhBaby.

- Becky Law
Manager, Childbirth Education

Innovative thinking and the future of health care!

2010-02-23T07:41:00.000-08:00

In a world where it sometimes feels better to “stay the course,” it’s both exciting and refreshing to watch a new process unfold.

Led by Winjie Miao, President of Texas Health Harris Methodist Hospital Azle, and supported by a strong cast from the Center for Learning at Texas Health Resources, a small group of intrepid explorers are about to embark on a virtual journey to the future.

This dozen or so employees, representing a wide spectrum of experiences and skills are charged with “future thinking” their way to a new vision of health care delivery by Texas Health. To what model will health care morph, five, ten, twenty years from now? What should it look like? These employees hope to create a vision that will help us get to that reality.

Make no mistake. The future of health care will look much different that it does today, regardless of what is accomplished in the US Congress. As the demographics evolve, we will need to look ahead and be ready for an aging population. Bricks and mortar alone will not get the job done. New structures in health care delivery will need to be created to meet the growing needs of our communities. New ways to enhance disease prevention and disease management will be mandated – failure to do so will result in health care drowning in a sea of acute care needs with no lifeboat in sight.

Starting at the end of this month, this group will begin working on what the next generation of health care delivery will look like. Congratulations to all the members of the team for their willingness to think outside the box. Congratulations to Texas Health for its willingness to support and nurture such innovation.

Now, we would like to hear from you. What do you think the next generation of health care delivery looks like? Leave us a comment!

- Dr. Joe Prosser, chief quality officer
Texas Health Fort Worth
Texas Health Azle

What more can we do to ease our patient's anxiety??

2010-02-17T10:54:00.000-08:00

As health care workers, we see many patients that become anxious in the hospital. Whether it be related to a new diagnosis, a disease process, or prior to any procedure, patients may not be able to cope. Essential oils can be very effective in promoting relaxation in patients with anxiety. These highly concentrated oils have chemical properties that can help sooth and relax the body. In the ICU's, we have used single oils or a blend of oils including Sandalwood, Mandarin, Frankincense, Bergamot, and True Lavender. Oils higher in esters, such as Frankincense and True Lavender are known to have calming properties. Studies on True Lavendar have shown to produce sedating effects similar to diazepam, whereas Sandalwood had shown to have an action similar to chlorpromazine.

Patients are given two to three different oils to choose from. Not everyone may enjoy a floral smell like True Lavender. We try to involve the patient in picking out the most suitable oil for them. Essential oils for anxiety have been administered through direct/indirect inhalation and the M® technique. The use of touch by using the M® technique adds an extra calming effect to the oil during application. Again, (as mentioned in previous posts) this can be taught to family to aid in care of their loved ones. What is more calming then light touch by a family member?

Our patients who used aromatherapy in the ICU responded with a decrease in anxiety on a numeric rating scale, expressed a feeling of relaxation, and overall enjoyed the experience. Medications like Ativan and Xanax are commonly used for anxiety, but may have unwanted side effects. Essential oils are a safer way to reduce patient anxiety and also reduce the amount of medication needed to calm a patient. Also, the use of essential oils can be a complimentary option to consider adding to your routine treatment/procedure.

- Erin Munoz, RN, Med-Surg ICU nurse

Red Wine: To Drink or Not to Drink

2010-02-16T11:36:00.000-08:00

February is National Heart Health Month…Can red wine help your heart?

The Thought

Many years of research has touted the pros and cons of consuming alcohol, especially regarding heart health. New research has given insight into what the link between red wine and a healthy heart might be, but the real question is, “To drink or not to drink.”

The Research

Antioxidants, such as flavonoids, are generally thought to be one of the main components in red wine that promote heart health. Resveratrol has gotten the most fame for its suspected role, but studies have yet to confirm a heart-protective effect. Resveratrol is thought to help decrease inflammation and prevent blood platelets from sticking together, thus reducing blood clot formation. This, in theory, would decrease the risk for stroke. Resveratrol, among many other antioxidants, is also found in whole plant foods and juices, like cranberries and red grape juice. The jury is still out, however, regarding whether these foods or juices may be equally as helpful in protecting the heart as red wine or other alcohol.

Studies have also shown that alcohol consumption, in moderate amounts, may help slightly raise HDL (“good”) cholesterol, prevent artery damage from high LDL (“bad”) cholesterol and reduce blood clot formation. Studies have not concluded, however, that red wine is the only form of alcohol that can provide such benefits.

The Recommendation

The bottom line with alcohol consumption is moderation. Just because red wine is potentially helpful to heart health, more is not better! In fact, too much alcohol can cause triglyceride levels and weight to increase. Increased risk for high blood pressure, heart failure, stroke and breast cancer are just a few other problems related to excessive alcohol consumption. Moderate alcohol consumption is no more than one drink per day for women and two drinks per day for men. Remember, one drink is not equal to whatever will fit in your glass! One drink is: 12 ounces beer, 4 ounces wine, 1.5 ounces 80-proof spirits or 1 ounce 100-proof spirits.

It is also important to note that the American Heart Association does not recommend that you start drinking alcohol for heart-protective reasons if you do not generally consume alcohol. Remember, nothing is a cure-all or substitute for healthy lifestyle choices such as eating a balanced diet, exercising regularly, not smoking and maintaining a healthy weight! Certain health conditions and medications may contraindicate alcohol consumption. Check with your doctor about whether it is safe for you to drink alcohol.

If you have a question for the dietitian, visit www.texashealth.org/askamy

References

American Heart Association. Alcohol, wine and cardiovascular disease. Available at:
http://www.americanheart.org/presenter.jhtml?identifier=4422. Accessed December 9, 2009.
Ferreira M & Weems M. Alcohol Consumption by Aging Adults in the United States:
Health Benefits and Detriments. Jour Amer Diet Assoc. October 2008; 108: 1668-1676.
Mayo Clinic Staff. Red wine and reseveratrol: Good for your heart? Available at:
http://www.mayoclinic.com/health/red-wine/HB00089/NSECTIONGROUP=2. Accessed,
December 9, 2009.
Peregrin T. Wine- A Drink to Your Health?. Jour Amer Diet Assoc. July 2005; 105: 1053-1054.

Amy Goodson, MS, RD, CSSD, LD
Registered Dietitian
Ben Hogan Sports Therapy Institute
Executive Health Program

Is Obesity a National Security Threat?

2010-02-10T11:23:00.000-08:00

According to the Pentagon, 75% of young Americans are unable to serve in the U.S. military due to being physically unfit, not having a high school diploma or having a criminal record. 27% of prospective applicants cannot join because they are overweight; making weight factors the single biggest factor in limiting potential recruits.

Child obesity rates have tripled in the last 30 years. 1 in 3 American children ages 10-17 are overweight or obese. The White House has taken notice and so have many retired admirals and generals who have formed Mission: Readiness. (www.missionreadiness.org)

To add to this impending crisis, our current troops are gaining weight at an alarming rate. The number of troops diagnosed with being overweight or obese has more than doubled since the start of the war in Iraq.

According to a Defense Department study, from 1998 to 2002, 1 to 2 out of every 100 servicemen was diagnosed as overweight or obese. By 2003, nearly 1 in every 20 servicemen was diagnosed as overweight or obese. Stress and readiness for deployment are the most frequent cited reasons for gaining weight.

Obesity issues that affect the general public, such as fast-food restaurants and popular sedentary activities such as video games, are also affecting military personnel.

"Overweight/obesity is a significant military medical concern because it is associated with decreased military operational effectiveness," according to the January edition of the Defense Department's Medical Surveillance Monthly Report.
If the chronic illnesses increase in health care dollars, decreased life expectancy and the other myriad of maladies that affect us with each increasing percentage of obesity don’t get our attention, decreased military effectiveness and increased national security risks should.

What are you going to do to fight this epidemic in our country?

- Tiffany Norris, MSN, RN, BC, PMHNP
Bariatric Nurse Coordinator

Sources: Washington Post, Mission: Readiness.

An experience through the med-surg residency program.

2010-02-10T09:07:00.000-08:00

Being a part of the Med-Surg Residency was a really interesting experience for me. I got to see all of the med-surg floors at Texas Health Fort Worth and as I rotated through the floors I got to bring my experiences from the previous units with me.

Through the residency program, I was exposed to a lot of different opportunities that I might not necessarily have received if I had just hired on to one specific unit. I was able to see an actual kidney transplant from before the surgery, through the surgery and even the monitoring that occurs after the surgery on the unit. I was able to take care of patients receiving chemotherapy, patients with chest tubes, ones that had recently had strokes and patients before and after all different types of surgeries.

As much as I enjoyed working in all of the different units by the end of the year of rotating I was more than ready to have a home on a specific unit. Even though there were a lot of really great units none of them really felt like home for me and I was a having a difficult time trying to decide which unit to apply for.

Palliative Care was suggested to me as a unit that I should apply for. I was skeptical at first because I wasn’t too sure what palliative care was and the 7-70 schedule was something that was completely new to me. However, I thought that it was an interesting concept and thought that I would apply for the unit. Once the unit opened I realized that I had truly found my home. I love the Palliative Care Unit and know couldn’t imagine working anywhere else. We really strive for excellent patient care and with the overlap we have more opportunities then most units to concentrate not only on our patients physical needs, but also on our patients’ and their families emotional and spiritual needs, as well.

All the staff really work together to try to give our patients the best possible experience at a really difficult time in their life. Another great bonus is the fact that we work really closely with Dr. Mathe and the Nurse Practitioners and are able to easily communicate with them when we need something.

- Ashley Hodges, RN
Palliative Care Nurse

End-of-Life Care - a Learning Opportunity

2010-02-08T08:28:00.000-08:00

“I must have missed that course in school.”

Whether we are referencing seminary, social work school, nursing school, or medical school, there are some career experiences that leave us feeling like we must have missed something. Staring into the faces of a family that is struggling with decisions about end-of-life care is one of those situations. As human beings who are nurtured by families and communities, we have developed some basic skills that help us respond when a neighbor or a stranger is grieving. We know we should be kind to them, express sympathy, and offer to help. Our extensive advances in medical technology, however, have left some patients and their families trapped in difficult “in between” territory. A human being who in days past would have died in the natural course of a disease process can now be kept alive by machines, medicine, and around-the-clock nursing interventions. That person can be kept alive far beyond his or her ability to appreciate or enjoy life.

You and I are often the people these patents’ family members look to for guidance amid these emotional and moral quagmires. Responding to their searching stares with inspiring clichés or just more technical information proves unhelpful. This is true because the ethical and religious mazes of these dilemmas are mixed in with longstanding family dynamics and the messy landscape of anticipatory grief with all its sadness, guilt, and anger.

“Was I sick the day we had this lecture?”

If that’s how you sometimes feel when you care for people in these predicaments, this year’s Faith Community Leadership Summit is one you cannot afford to skip. You will hear from clinicians who courageously lead patients and families through the humbling and holy encounter with dying. They will teach from both their personal experiences and state-of-the art research. If you feel like you missed out on a piece of training when confronted with these situations, this is make-up day. Don’t miss it.

Register today here! . For more information, please call 817-703-8432.

- Timothy Madison, PhD, BCC
Chaplain Manager
timothymadison@texashealth.org

Red, Red, Red!

2010-02-03T11:40:00.000-08:00

What are you doing to beat heart disease? Check out this fun video about beating heart disease and "Going Red." Hope it inspires you!

http://www.youtube.com/watch?v=UjHz-ErKqlg

Please share this video with others!

Happy Heart Month and don't forget to wear red on Friday (National Wear Red Day).

Saving lives in the church congregation!

2010-01-29T09:51:00.000-08:00

I would like to share with you an amazing story from a faith community nurse that really emphasizes the difference a faith community nurse can make in a congregation.

Here is her account:

“Several Sundays ago I was sitting in my official parish nurse pew, when a congregant came rushing into the service, up the aisle and grabbed me by the shoulder. She whispered in my ear.. 'Quick, I need help in the parking lot!' As we left the sanctuary I realized I had nothing with me... No watch, no phone, no blood pressure equipment and I was not sure what I was walking into. Because I had worked with this woman and her husband I knew he had a cardiac history. So, as we rushed passed a minister I said 'please call 911 and have an ambulance sent. I want no sirens.' I figured I could always call and cancel the ambulance but I had a gut feeling that we were walking into a bad situation. I made it to the car in the lot to find a disoriented man babbling on about double vision. I could counted a rapid thready pulse and observed that he was more pale than usual. I assessed for signs and symptoms of a stroke. He was not outwardly demonstrating any signs other than double vision and flat affect. Our other nurse and a paramedic met me in the parking lot. They brought all the necessary equipment AED, blood pressure cuff and phone. The firemen arrived and assessed the man and we agreed he needed to get to a hospital. Final diagnosis.. brain stem stroke! He was in church this Sunday to tell the story! He does remember me talking to him and having trouble with his vision but nothing else. He has a slight hitch in his gait but NO other residual. The doctor says this was amazing and credited his recovery to rapid medical response. Because the other nurse and myself see him in our blood pressure clinic each month, we had the knowledge to project forward and anticipate what could possibly be his problem, even without overt symptoms. The faith community nurse program is a valuable asset to the community.”

Not every faith community nurse will have an experience like this but every one is making a difference in the lives of the people in their congregations and the community. They do this by taking blood pressures, visiting with home bound members, those recently discharged from the hospital, holding the hands of those who are grieving over the loss of a loved one or a member who has just received a diagnosis of a terminal illness. Faith Community nurses are there for all the stages of life.

Faith Community nurses are knowledgeable, caring and able to advice and direct individuals to appropriate health care facilities. They also offer spiritual, emotional, and physical support, if they don’t have the answer, they will pursue the question until they get answers.

If every faith community had a faith community nurse we would indeed see health care reform , because we would be tending body, mind and spirit.

For more information on faith community nursing, please click here

- Paulette Golden, RN, community health manager and faith community nurse coordinator

Emotional Eating and How to Gain Control Over It

2010-01-28T07:45:00.000-08:00

First of all, what is it emotional eating?
Emotional eating can be defined as eating in response to feelings rather than to true hunger.

Emotional eating is common in our society. We eat to celebrate, we eat to mourn, we eat when we are tired, happy, sad, anxious and often, when we are bored.

So, what is the solution?

The first step is to determine what causes the triggers of your emotional eating.

Stress is a frequent trigger for out of control eating. If you know you tend to overeat when you are stressed then you can plan for it. Learn from your past experiences. Plan to have healthy snacks available during these stressful times.

Maintaining a balanced diet and healthy life style is a great defense against emotional eating. If you always eat breakfast then you will have the energy and reserves to tackle your job demands. Munching on your favorite comfort food can make you feel better physically and relieve the stress that you are feeling temporarily. If you skip breakfast, then become too hungry during the day, your body will go into survival mode and your food choices may not be as wise as when you have planned ahead.

Another great defense against emotional eating is physical activity. Taking a walk (outside if the weather allows) will help to relieve some stress and get you out of the environment of eating. Exercise can also improve your mood and give you more energy. (This is what emotional eating may be trying to do).

Maybe a specific food or situation is the trigger for your eating. If you identify a certain food that gives you problems, then don’t have that food around. If possible, avoid places where that food is available. Unfortunately you can’t always do this.

One of my favorite solutions (to many different types of nutrition related questions, not just emotional eating) is to keep a food diary. (Yes, I can hear you moaning). Food journals may seem tedious but with just a little work and planning they can provide insight and solutions that, normally, are not obvious. Food journals are great tools. They can be very simple. Keep a record of what you eat, when you eat it, and how you are feeling at that time.

After a few days, your answer may be obvious.

- Jaime Bass, RD, dietitian for the Bariatric Program at Texas Health Fort Worth

What do the airline industry and health care have in common?

2010-01-21T14:21:00.000-08:00

There’s a short video making the rounds that compares health care to the airline industry, looking at data and information sharing. Click here to watch this short video:

It’s humorous, and worth watching. Sadly, it’s also very true. In this time of extreme high-tech capabilities, the ability of health care workers to access or share information about a patient continues to be sorely lacking. Does it matter? Yes it does and it is something our hospitals are working on fixing for you the patient. A few short examples below are scenarios that can be resolved through a meaningful use of the electronic health record and hospitals who are focused on improving coordination of care:

1. A female patient enters your emergency department with abdominal pain. She notes that the symptoms are similar to a spell she had six weeks ago, while she was visiting her mom out of town. At that time, she went to the urgi-center and underwent numerous xrays and blood tests, and was told that she could go home. You, the doctor, cannot access those records, since the urgi-center only uses paper charts. As a result, you will need to perform studies that are potentially unnecessary.

2. A man enters your emergency room after a motor vehicle accident that had occurred the prior day. He had gone to another hospital and underwent numerous CT scans. Now, due to persistent discomfort, he has come to your hospital for a “second opinion.” Your electronic record does not “talk” to the electronic record at the other hospital, so you cannot access the results of the CT scans. Your next step, after your physical exam of the patient, is to duplicate the studies.

3. An elderly patient is admitted with pneumonia. You order a pneumococcal vaccination. Since you cannot access the patient’s office records, you don’t realize that he received the vaccination only four weeks ago.

Cost, excess radiation exposure, pain and suffering, wasted time, delayed diagnoses…yep, it matters. That is one reason our hospital is working to make health care more human again and reducing the pain, waiting and improving coordination of care for our patients.

Hopefully, the national focus on the meaningful use of electronic medical records will reduce the likelihood that the scenarios suggested above will perpetuate into the distant future. It’s about time we got serious over this issue. I hope we have the willpower and the backbone, as a society, to seize the electronic data sharing opportunity and use it to improve the lives in the communities we serve.

- Dr. Joe Prosser, chief quality officer

Welcome to Harrisville!

2010-01-21T09:45:00.000-08:00

Some people call Texas Health Fort Worth Harris Hospital a small town since its grown so much. Along with this hospital growth, so do the opportunities for you to explore while you’re here. Click HERE for a map to “Harrisville,” population 4,023 (number of employees) who are here to serve you. Listed below are some places to consider the next time you’re “passing through” our town.

As a town, our picturesque park would be the Morris Meditation Garden. It’s a beautiful place to get away without having to. The park entrance is by the Heart Center entrance. Open every day during daytime hours.

As a town, our family diner is the brand new Cramer Café which offers something for everyone and it’s no “greasy spoon.” Fresh sandwiches, salad bar, Italian, hamburgers, taco bar, soups, and more. The café is located by the Bloxom Tower with the main serving hours between 7:00 AM – 8:00 PM.

Our local place of worship is highlighted by the Castleberry Memorial Chapel. From the Richardson Tower elevator go to the Plaza Level and behind the elevator is the chapel’s entrance.

Our newly renovated library is here to help with medical research and offers internet access. Go up the escalator from the ground floor of the Harris Tower. Keep veering right past the elevator. Open daily Monday – Friday, 817-250-3191.

No town is complete without a general store. The 5th Avenue Gift Shop offers flowers, magazines, gifts, and snacks and is located on the Ground Level of the Richardson Tower. Open daily with a smile, 817-250-3024.

Our “town square” is in the Klabzuba tower, the separate building just a few steps south of our Emergency Department which offers numerous opportunities to improve your health on the ground floor:
• The Cancer Resource Library & Consumer Health Information Center has a large selection of books to consider along with internet access.
• The Healing Arts Center offers 4 types of massages, clinical aromatherapy, and reflexology. 817-820-4839
• Cancer Boutique and Resource Center helps cancer survivors with many specific needs. 817-820-4861

Parking can be an issue for any town so if you’re planning on staying a few days, Standard Parking Company located on the ground floor of the Harris Professional Center offers discounted parking tickets for the visitor’s garages, 5 tickets for $10.00, 817-250-7885.

Our “bank” (which means ATM machines) are located in the Jones Tower lobby by the west entrance doors and also in the Emergency Department lobby.

These are just a few things to see in our “town.” Like any town, what makes it special are the people who are here to welcome you during your stay.

- Craig Pomykal, patient advocate

Meet Mr. Nichols

2010-01-18T11:26:00.000-08:00

Mr. Michael Nichols, senior vice president of Freese and Nichols, was making one of many bi-monthly trips to the company’s corporate office in Fort Worth, Texas. Since he’d been trying to get back in shape, he thought it would be a good idea to visit the Executive Health Program at Texas Harris Methodist Hospital Fort Worth while in town.

He knew he needed to make some changes in his diet, so he decided to end his habit of drinking Mountain Dew two months before his appointment. Boy, did that decision change his life!! After going through the first screening, Mr. Nichols returned for a second appointment and doctors discovered he had a very low heart rate. The caffeine he had been drinking made it appear that he had a normal heart rate.

After learning of his naturally low heart rate, Mr. Nichols was immediately referred to a cardiologist and within 30 minutes had made the decision to have a pacemaker implanted. He had this done only three days later!!! Thanks to Texas Health Fort Worth’s Executive Health Program, he has returned to his home in Austin, Texas and has returned to his normal life (now a healthier life) with his family and friends!

- Nikki Hall-Branch and the staff at the Executive Health Program