Christmas through the eyes of those who care for your loved ones...

This is the time of the year where people worldwide pause to celebrate and share with their families and their friends. Regardless of anyone's personal faith, the seasonal message is one of peace, love, and thanksgiving. It would be hard to argue the notion that those kindly and worthy sentiments can get lost amid all the technology and demands in the health delivery world. After all, what does an MRI have to do with peace? Or an angiogram with sharing? How does the blaring siren of an ambulance jive with Christmas carols? If you've ever needed health care during the Christmas season, you could answer these questions. You see, the meaning of Christmas isn't about the parties, the gifts, the lights, the glitz...think about the sick, the damaged, the dying. Think about all the people - from security guards to nurses to techs to food handlers - who gave up their parties and their family time to tend to the needs of those people less fortunate. Think about how they spend their holidays - ministering to the sick and the dying. These caregivers embody the very meaning of the holidays - "good will towards men." So next time you're in a hospital, say "hello" or "thanks" to all the workers that stand ready to meet your/our health needs. Their giving and commitment makes every day of the year a special holiday.

- Dr. Joe Prosser
Chief Quality Officer

Winter Weather and Christmas Safety

“It’s the most wonderful time of the year” … and so the familiar song goes. It is true that December brings lots of people together for parties, reunions, and festivities. There are memorable smells, tastes, sounds and sights. I especially love the tastes! There is just something about beautifully decorated sugar cookies with sprinkles that makes my mouth water. Never mind what they do to my hips.
Something else wonderful happens during this season. People smile at each other and wish one another a” Merry Christmas”. Even strangers in crowded malls exchange greetings. The lines to see Santa are always long, but the folks don’t seem to mind.
All of this holiday cheer brings me to my point in this month’s blog. While we are busy preparing, cooking, eating, singing, shopping or however you mark this season, here are a few tips on making it even more meaningful.
• Consider an elderly neighbor. Pay a visit and make sure their heat is on. Sit and listen to their stories about Christmas‘s past. If it is cold outside, bring in their newspaper and mail.
• Living in Texas in the winter often brings the experience of sleet and ice. Keep your (and that elderly neighbor’s) walkway salted. Think about staying home instead of being out on the roads during inclement weather.
• Be mindful of young guests in your home. Poinsettias are poisonous, and Christmas trees can easily topple. Small toys can find their way to toddler’s mouths.
• Dogs and chocolate don’t mix. I discovered this several years ago. Thank goodness for veterinarians who take emergency call! Be aware of all the goodies that Santa brings.
• Shiny new bikes, scooters, skateboards and roller blades should all come with flashy helmets. And make sure they use the helmets!!
When you are out and about, looking at the radiant holiday lights and lovely displays, remember that a seat belt is always your best defense against an impaired driver.
Have a blessed Christmas,

Mary Ann

Aromatherapy for a sleepless night

Are you thinking about getting a bit more sleep next year? Well, eating an entire holiday turkey for the tryptophan effect may not be the best idea. The use of essential oils may just do the trick. Something called Lavandula angustifolia (True Lavender) may be a nice addition to your bedtime ritual. Many studies have shown L.angustifolia has calming and relaxing effects on the mind and body. Two chemical properties in this oil, linalol and terpineol, have been linked to relaxing the central nervous system (CNS).

Most patients could benefit from using this oil if they are suffering from insomnia or just having a sleepless night. Just adding a few drops on a cotton ball placed on a bedside table or pinned to their gown for direct or indirect inhalation. You can also mix True Lavender with a carrier oil. Add 1-2 drops of the essential oil into a teaspoon of "cold" pressed grapeseed or sweet almond oil, then apply the mixture by using the M® technique. This light touch technique, mentioned in a previous blog, is very relaxing and can send you into dreamland. We have also blended other oils, like Sandalwood, Mandarin, and Ylang Ylang with the True Lavander for a more restful sleep. You only need to add 1 drop to increase the relaxation effect of the blend.

Now you have to be sure you use the correct "Lavender". The chemical properties in Lavandula angustifolia (True Lavender) are completely different from Lavandula latifolia (Spike Lavender). As, I had stated, True Lavender is more calming and relaxing, but Spike Lavender is a stimulant and expectorant. So, you need to make sure you have the right one or it may add to your insomnia.

Make sure and keep aromatherapy in mind if you, a friend, or a patient are experiencing a sleepless night.

- Erin Munoz, RN

Want a FREE stocking stuffer that may save a loved one's life?

On December 17th, Texas Health Harris Methodist Hospital Fort Worth is having a Vial of LIFE drive thru. What better gift to give a loved on than an item that could potentially save their life?

What is it?

The Vial of LIFE is a project designed to place vital, medical information in the hands of first responders in the event of a medical emergency. Originally started in California more than 25 years ago, the Vial of LIFE is now available to Tarrant and surrounding counties!

How does it work?

The Vial of LIFE is a simple idea that can have lifesaving results. Medical information such as allergies, chronic conditions, medications, and contact information is stored is a medicine vial that is marked with a special sticker and placed on the top, right shelf of the refrigerator. The same sticker is placed on the entry door and refrigerator door.

In the event of an emergency, the first responders know to bring the vial of LIFE along with the patient to the emergency room.

How can you get one?

Texas Health Fort Worth employees will be outside of the main entrance of the hospital (the corner of Henderson St. & W. Cannon Avenue in Fort Worth). We are extending an invitation to the community to drive by and allow us to give you this FREE gift just in time for the Holidays. If you need a larger quantity, you can call ahead (1-877-THR-WELL) and the employees will have the Vials ready for you. The drive thru will be open from 10am-1pm and then again from 4-7 pm.

Even Santa is planning on coming by.

Special thanks to the Texas Health Harris Methodist Foundation who is funding this project so that the community can receive the vials free of charge. This is one way the hospital continues it's mission to improve the health of our community.

- Juanita Hernandez, RN
Medical/Surgical Nurse
Texas Health Fort Worth

Is your hospital "Baby Friendly?"

It seems like a silly question to ask when you are trying to decide where to deliver your baby. Isn't any hospital that delivers babies "Baby Friendly" by definition? Surprisingly, the answer is no.

The Baby Friendly Hospital Initiative is a worldwide effort by the World Health Organization and Unicef to support and promote breastfeeding. Hospitals must apply for accreditation as Baby Friendly, a lengthy and involved process.

In order to be considered for Baby Friendly Accreditation, hospitals must:

1. Have a written breastfeeding policy that is routinely communicated to all health care staff

2.Train all health care staff in skills necessary to implement this policy

3. Inform all pregnant women about the benefits and management of breastfeeding

4. Help mothers initiate breastfeeding within 30min of birth

5. Show mothers how to breastfeed and maintain lactation even if they are separated from their infants

6. Give the newborn no food or drink other than breast milk (no sugar water, no formula) unless medically indicated

7.Allow mothers and infants to "room-in" together 24 hours per day

8. Encourage breastfeeding on demand (whenever the baby shows signs of hunger like rooting, sucking on hands)

9. Give no pacifiers to breastfeeding infants

10. Foster the establishment of breastfeeding support groups and refer moms to them upon discharge from the hospital.

Many of these requirements sound like common sense, but most maternity hospitals in the United States were not designed with breastfeeding as a primary focus. Historically, in many hospitals, infants were separated from their moms for the first 4-6 hours of life to be observed in the nursery for problems with breathing or staying warm. In addition, sugar water was often given as the first feed to "make sure it was tolerated" before infants were given breast milk or formula. An unintended consequence of these practices was that moms were not able to breastfeed in the first hour---often the most alert time for a newborn in the first 24 hours. In addition, these practices sent mom the message that supplements were an acceptable alternative and possibly even better than breast milk for their infants.

Texas Health Harris Methodist Fort Worth is currently working toward accreditation as a Baby Friendly Hospital. As of September 2009, their were only 89 Hospitals and Birthing Centers with the Baby Friendly designation in the United States, and only THREE in the entire state of Texas.

I am proud to be a part of a facility that has put so much time and effort into such a worthy endeavor that will ensure a better tomorrow for our most precious gifts---our babies.

- Fran Lynch MD, Neonatologist
Associate Medical Director of NICU
Texas Health Harris Methodist Fort Worth

Healthy Holiday Baking…Recipe Substitutions

Do you love to bake, but hate the calories that come along with holiday goodies? I would encourage you to branch out when you grocery shop and find some healthy substitutions that will cut some of the calories, fat and sugar from your recipes. Now, it is important to note that you should not substitute EVERY single ingredient, but make some substitutions will improve the healthfulness of your baked goodie.

There are a couple of things you can do to reduce total fat in recipes. One option is to replace half the butter or shortening in a recipe with applesauce or prune puree. You can also use cooking spray or non-stick pans instead of butter or margarine to grease your pans. Next, two egg whites or ¼ cup egg substitute can take the place of one whole egg. The yolk is where the fat and cholesterol is so removing the yolk takes that out. Finally, other ways to reduce fat are to use low-fat milk instead of whole milk, evaporated skim milk instead of evaporated milk, low-fat sour cream or cream cheese instead of their full-fat alternatives and even using fat-free creamy soups or half broth/half creamy soups will help reduce calories.

Many baked goods are loaded with sugar! To reduce the sugar content of your recipe you can substitute half the sugar for baking Splenda® or Equal®, two artificial sweeteners that are calorie-free. You can even add fiber to recipes! Try using whole wheat flour for ½ the All-Purpose flour or substitute rolled oats/crushed bran cereal for bread crumbs.

Top your desserts off with a bang! Try using low-fat whipped topping instead of cream cheese icing or add fresh fruit instead of a high-sugar fruit drizzle. You will get the same great taste for a lot fewer calories!

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

Making Sense of Mammography Recommendations

Now that the U.S. Preventive Services Tasks Force has reversed its position on screening mammography for women in their 40’s: the group no longer recommends routine screening for average risk women in this age group and the ACS has stated that it will continue to recommend annual mammograms starting at the age of 40, this controversy has a big number of women very confused.

How are you supposed to respond to this? With calmness and communication with your physician. Ask your physician, what are the risks and benefits? What is the right decision for you? Each woman needs to consider the individual benefits and risks and discuss them with her healthcare provider before making a decision about when to start screening mammography and how often to get one.

It is important to emphasize that the new guidelines are for women considered at “average” risk at developing breast cancer. Women with a family history or other factors (a positive BRCA gene mutation, for example) are considered to be at a “higher” risk of developing breast cancer and are likely to receive a recommendation for more frequent mammography screening or beginning screening at an earlier age than the average woman.

We know this issue raises concerns, especially for young women. Regardless of your age or history of breast cancer, if you notice unusual changes in your breasts, you should consult a health care provider and discuss whether or not a mammogram or other testing is necessary.

- Dana McGuirk, RN
Breast Nurse Navigator

The Proactive Patient

Being a hospital patient is not on anyone’s “Top 10 List” of places to visit, (unless you’re having your beautiful baby, that is), but it’s a part of life, so we might as well make the most of the opportunity to improve our health. While the Patient Advocate Department at Texas Health Harris is ready to help if you have any concerns during the hospital stay, the #1 patient advocate will always be …YOU, the patient.

There are many understandable reasons for you to hesitate before speaking up to correct an issue while staying in any hospital. For example, you are: in a new place and out of your routine; surrounded by unfamiliar nursing staff and physicians; nervous about initiating verbal conflicts; coping with fatigue, pain, and fears about your future. All these reasons and many more could add up to not speaking up about your preferences, questions, and concerns.

Conversely, what is the main reason why it is important to speak up as a patient? Proactively speaking up will give hospital staff the knowledge needed to offer you a personalized hospital stay, which will then increase your satisfaction so you may then feel better faster. As described in this previous blog nursing staff play a key role in helping the patient feel safe enough to speak up by using “proactive communication techniques.”

Sometimes I hear concerns from patients whose hospital stay was seen as a negative experience due to something that happened a week before, and now they’re being discharged home. The patient may say something similar to “I want to tell you about this issue so the next person won’t have the same experience.” While it’s important to improve our services for future patients, our #1 focus is in the present tense - to hear and take action on all your comments when they occur. Nursing staff and Patient Advocates are on your side as we work together to reach your optimal health goals.

While it’s established that no hospital stay is on your “Top 10 List” of get-away destinations, speaking up for your health’s sake can be the most important thing you can do for yourself this side of Hawaii.

- Craig Pomykal
Patient Advocate

Talking about abstinence?

Between AP Biology and the last home football game of her senior year my daughter and her friends dash off to the hospital to visit their teen friend who is about to give birth. Texas teens rank number one in the nation in having babies. Although the U.S. teen birth rate has dropped by one-third, Texas has only dropped by 19%. Other states have seen a decrease in teen births by 47%. What is the difference? Is it the fact that Texas teaches an abstinence only curriculum? In Texas public schools sex education does not have to be offered and if it is offered the focus must be on abstinence. There are many great programs out there discussing abstinence as the preferred choice for unmarried young people. The state spends about $5 million a year just on education grants to contractors to come in to the schools to teach abstinence programs. While I am extremely pleased that my daughter and many other teens have chosen abstinence, what about the girls and boys that are not making that choice? During my six years on the health advisory committee for the school district, I learned that no one wants to talk about teens having sex. Is this why we are number one in the nation? We assume that teaching teens about contraception encourages them to have sex. That is not what the research shows. Many teens plan on not having sex, however we are talking about real life and sometimes, real life fails. Do teens need to be educated about how to avoid risky sexual behavior and how to use contraceptives correctly? Do they need to develop skills in communication and sexual decision-making so that sex does not just "happen?" Do they need information on disease prevention? Texas’ policy is to deny contraceptives without parental consent wherever possible. Low-income teens are protected by the federal government and can get birth control without parents consent under Medicaid, however many of them do not know this.
Yes we can help reduce the teen pregnancy rate by educating young people about the consequences of premarital sex and promoting abstinence. Could we reduce the teen pregnancy rate further by educating teens on contraception? As I talked with teens many say by the last couple of years of high school they have tuned out the abstinence talks because that is all they hear. In the time it took you to read this, a teen in Texas gave birth. Talk to your teens about sex, yes it is a difficult topic but one that needs to be discussed.

- Becky Law, RN
Childbirth Educator