I Hereby Resolve

It’s getting close to the New Year, and you know what that means. Yes, it’s time to come up with our New Year’s resolutions, those polite fictions in which we swear that this will be the year we’ll lose those five pounds (which have become ten since we first resolved to lose them), eat right, drink less, make new friends, and stop wasting time playing Candy Crush. And read more. All those things that will make us better human beings. I told you they were fiction.

This year I’m going to take a different approach. All those good-for-me things should be on my to-do list anyway. Instead, I’m going to try some good-for-someone-else resolutions.

First, I resolve to help get the word out about the Mercy Health Clinic. I’ve been on the board of directors for about a year now, and have learned a lot about the people who come to Mercy for health care, folks who can’t afford or don’t qualify for insurance. Many patients’ lives literally depend on Mercy Health Clinic. I’ve also learned a lot about the people who provide the care, busy professionals who could step back and leave it to others but instead step up. There are heart wrenching and uplifting stories here, and if you heard more of them I think you’d want to help, too.

Next, I resolve to reach out more often to people who are important to me, and not just on Facebook. I was reminded rudely this month that we don’t get to keep our dear ones forever or even as long as we think we will. An old friend from a long-ago workplace, with whom I’d once been very close but hadn’t seen in years, now lies in a coma on life support after an accident. Her prognosis is not good. She and I had moved to different cities and saw each other in person rarely but when we did, it was as if no time had passed. We laughed and cried together as easily as we did back then. And now I’ve very likely run out of chances to see her again, to tell her how much her friendship meant to me during a most turbulent period in my life. So in B’s honor, I’ll try to not take the length of life’s highway for granted.

Finally, I resolve to be kinder and look for the best in people. This could be hard, I admit. I’m a cynic and voracious news junkie, and it could be tough to stay upbeat while breathing in that miasma of toxic rhetoric every day. My strategy (besides cutting down on my miasma consumption) will be to surround myself with good, decent people doing good, decent things for people who need help. Come to think of it, I think I have this one covered.

Best wishes to you all for a happy and safe holiday season and New Year. See you in 2016!

— Pam Saussy, Board Member

Voir, Dear

Back in the winter of 2001, I was summoned for jury duty. Now, I’m one of the few people I know who actually enjoys jury duty. Not only do I think it’s our civic duty and privilege to serve on a jury of someone’s peers, it’s interesting to experience first-hand what it means to live in a nation of laws, without actually getting arrested.

Anyway, I was in the generously named “Jury Lounge” at the courthouse when an announcement came that they needed to seat a jury for a long trial, possibly going 25 days or even longer. Folks who wanted to be excused from that particular trial were invited to approach the desk to make their case. Talk about a stampede. I was left sitting in the dust among only a few of us who apparently had thought to ourselves, “sign me up!” envisioning Atticus Finch arguing some high-profile case.

Long story short, I made it through voir dire and onto that jury. The case was not as inspiring as it was sad: a woman with diabetes had died and her family was suing the manufacturer of one of the drugs she’d taken (which soon after was taken off the market). Jurors were given thick notebooks and for the next 28 days we learned all about diabetes. We listened to hours of testimony from experts and viewed gruesome photos of damaged organs. The lawyers had charts of statistics and “boxes and boxes of documents” as one of them kept boasting. I’ll spare you the unhappy details of this case but the bottom line for me was learning how absolutely destructive diabetes can be. (See what I did there, after teasing you with the Atticus Finch thing? But it’s November and that means National Diabetes Month. Stay with me – this is important.)

The American Diabetes Association reports that

  • Nearly 30 million children and adults in the United States have diabetes – nearly 10% of the population.
  • Another 86 million Americans have prediabetes and are at risk for developing type 2 diabetes.
  • African Americans and Hispanics are almost twice as likely to have diabetes as non-Hispanic whites.
  • Someone is diagnosed with diabetes in the U.S. every 19 seconds. ADA estimates suggest that by the year 2050, as many as 1 in 3 Americans could have diabetes.
  • The total national cost of diagnosed diabetes in the United States is $245 billion.

The health impact of diabetes goes way beyond simply needing to take a pill or inject insulin. Did you know that diabetes nearly doubles the risk for heart attack and of death from heart disease? It’s the leading cause of kidney failure and of new cases of blindness among working-age adults. One in 10 health care dollars is spent treating diabetes and its complications, and one in 5 health care dollars is spent caring for people with diabetes.

So how do we stem this rising tide of diabetes? The fact is that diabetes can be prevented with proper diet, exercise, and weight control, even for patients whose genetics and family history might indicate otherwise. I’m sorry to have to bring this up the week before Thanksgiving. If it’s any consolation, I am in this boat myself as diabetes runs in my family, so I exercise, eat right (more or less), and work with my doctors to keep an eye on my numbers.

It’s hard enough for me, but for the most vulnerable among us, these outwardly simple steps can be overwhelming. The Mercy Health Clinic cares for many patients struggling with diabetes and other chronic health conditions. Mercy provides lab tests, insulin and medications, and health education free of charge to uninsured and low-income patients, along with massive doses of compassion and support to keep patients on track. This is the Mercy difference in providing health care from the heart.

My 28 days of jury service may not have resulted in a triumph of justice, but they did leave a lasting impression on me about the devastating effects of diabetes. You can learn more about diabetes while avoiding all the courtroom drama by checking out the facts at:

http://www.diabetes.org/in-my-community/american-diabetes-month.html?referrer=https://www.google.com/#sthash.MZZ8G0X2.dpuf

— Pam Saussy, Board Member

 

On a More Humerus Note…

It’s October, and Halloween is soon upon us. Since we’re on the subject of skeletons (and we are, it turns out), I’d like to note that October 12 – 20 is Bone and Joint Health National Awareness Week. Not so scary at first glance, but the facts about bone and joint health are downright frightening:

  • More than half the American population over the age of 18 – 54 percent – are affected by musculoskeletal (bone and joint) conditions, according to The Burden of Musculoskeletal Conditions in the United States.1
  • One in three (33%) people over the age of 18 required medical care for a musculoskeletal condition in each of the years 2009 to 2011, a 19% increase over the last decade.2
  • Musculoskeletal conditions can lead to significant disability plus diminished productivity and quality of life. Treatment and lost wagecosts associated with musculoskeletal diseases in the U.S. alone was estimated at $874 billion in 2009 to 2011 – equal to 5.73 percent of gross domestic product (GDP).3
  • Bone and joint conditions are the most common cause of severe long-term pain and physical disability worldwide affecting hundreds of millions of people. 4
  • 1 in 2 women and 1 in 4 men over age 50 will have an osteoporosis-related fracture, with 20% mortality rate within 12 months of a hip fracture.5

I don’t know about you, but that last one kind of freaks me out. Bone and joint conditions include common things like arthritis, fibromyalgia, back pain, osteoporosis, and trauma. “Trauma” includes very serious things like those hip fractures mentioned above, but also stupid things like trying to do something with a skateboard that seemed perfectly reasonable when you were twenty, but which turns out to be decidedly unreasonable when you’re 50. We’ve all been there, or likely will be at some point.

If you find all this a bit frightening — and you should — now imagine being one of the 65,000 uninsured adults in Montgomery County without health insurance and facing a serious musculoskeletal condition. Now that’s scary, given that such conditions can not only impact one’s ability to work and support one’s family, but can be truly life-threatening.

The good boos — er, news – is that the Mercy Health Clinic provides uninsured adults in Montgomery County with specialty care including rheumatology and orthopedics, in a warm and compassionate environment that is decidedly NOT scary. Your support of the Mercy Health Clinic helps ensure that our uninsured neighbors in the County get the care they need to keep their bones and joints healthy.

Bone up on joint and bone conditions and what to do about them by checking out the US Bone and Joint Initiative at http://www.usbji.org/. And have a happy and safe Halloween!

— Pam Saussy, Board Member

 

1,2,3 http://www.boneandjointburden.org/2014-report/ib0/prevalence-select-medical-conditions

4 Woolf AD, Pfleger B. Burden of major musculoskeletal conditions. Bulletin of the World Health Organization 2003;81:646-656.

5 http://www.boneandjointburden.org/docs/By%20The%20Numbers%20-%20Musculoskeletal%20Conditions%20%28Big%20Picture%29.pdf

No Bran Muffins Required

Like many people, I have high cholesterol. Unlike some of those people, however, I have my cholesterol under control through a combination of diet, exercise, and medication. Hyperlipidemia (the medical term for high cholesterol) runs in my family; my parents had it, my siblings have it, I have it. Mine was diagnosed back in the 1990’s when I was in my 30’s. I had never smoked and wasn’t overweight. But there I was, baking bran muffins to beat the band. I’m not much of a baker but as it turned out, no degree of culinary skill was going to enable me to eat sufficient bran muffins to make a difference in my body chemistry. So I’m one of the over 30 million adults in the U.S. who take a cholesterol-lowering medication. More on that later.

September is National Cholesterol Education Month, so in the spirit of education here are a few facts courtesy of the Centers for Disease Control (CDC):

  • Cholesterol is a waxy, fat-like substance that your body needs. But when you have too much in your blood, it can build up on the walls of your arteries and form blockages. This can lead to heart disease, heart attack, and stroke.
  • There are two kinds of cholesterol: high-density lipoprotein (HDL) and low-density lipoprotein (LDL). HDL is also called “good” cholesterol. LDL is called “bad” cholesterol. When we talk about high cholesterol, we are talking about “bad” LDL cholesterol. Anyone can have high cholesterol, including children.
  • Seventy-one million American adults have high cholesterol, but less than half are getting treatment to lower it, and less than one-third have the condition under control. 1

What does it mean to have one’s cholesterol “under control”? According to the CDC, it means having a total cholesterol level under 200 mg/dl (milligrams per deciliter of blood), high-density lipoprotein level (HDL or “good” cholesterol) over 60 mg/dl, and a low-density lipoprotein level (LDL) or “bad” cholesterol) level under 100 mg/dl.  Simply put, you want more of the good and less of the bad.

A tricky aspect of having high cholesterol, and likely one of the reasons why so many people don’t have it under better control, is that it has no symptoms. You need to be screened with a simple blood test to find out if you have high cholesterol and then consult with your doctor on how best to treat it. For some folks, changes in diet and exercise will be sufficient. For others like me, genetics (that family history thing) make controlling high cholesterol difficult without medication.

Speaking of which, there are literally dozens of medications targeting high cholesterol, not to mention supplements and diets.  I’m not advocating any particular therapy or medication here, as that’s best worked out with your doctor.

By the way, low-income people without health insurance are at higher risk of having undiagnosed high cholesterol, which places them at higher risk for heart disease, heart attack, and stroke.3  These health crises are much more expensive to treat than to prevent in the first place, and supporting Mercy Health Clinic in tackling high cholesterol is a great place to start. No bran muffins required.

— Pam Saussy, Board Member

 

1 Source: http://www.cdc.gov/features/cholesterolawareness

2 Source: http://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_cholesterol.htm

3 Source: Health Affairs, 2009.

 

Just a Little Pinch

August is National Immunization Awareness Month. “But I got all my shots when I was a kid!” you say. Not so fast. Childhood shots don’t necessarily last forever (that is, confer lifelong immunity) and sometimes you need to get boosters. For instance, if you’ve got a chronic illness, work with children, will be living in a dorm with lots of people, or are traveling to another country, you might need to give your immune system a jump-start. The Centers for Disease Control (CDC) advises people to protect their health by getting vaccinated against infectious disease.

I’m traveling to China next month, and was advised to get Hepatitis A and B series, as well as a typhoid vaccine and a tetanus/diphtheria/pertussis (Tdap) booster. It’s a bit unnerving to consider that water quality and public sanitation issues over there might put me at risk, but I was surprised to learn that (perhaps typhoid aside) these shots are recommended for most adults even if they’ll be staying stateside. Yeah, food service workers are required by law to wash their hands after using the restroom, but do they? What about these E.Coli infections that people can get from salad bars? Sometimes it seems like a miracle that we don’t get sick more often than we do, but it wasn’t all that long ago that people died from diseases which, today, are routinely prevented with a simple shot in the arm.

Who should get vaccinated? Adults with chronic diseases such as asthma, Chronic Obstructive Pulmonary Disease (COPD), diabetes, or heart disease should get vaccinated. Adults who will be in close contact with the very young, the very old, people with weakened immune systems, or people who can’t get vaccinated themselves should get vaccinated.

Everyone should get a flu shot each year (and no, you can’t get the flu from a flu shot). Other vaccinations, such as for Hepatitis, shingles, pneumococcal disease, or Human Papilloma Virus (HPV) might be required at different points in an adult’s lifespan as well.

Of course, there are always exceptions; depending on your personal health profile, particular vaccinations may not be right for you, or you may need a particular form of vaccine.  Don’t disregard vaccinations out of hand, though — get the facts and protect yourself. The CDC has more information at http://www.cdc.gov/vaccines/ about who should get vaccinated, for which diseases, and when.

— Pam Saussy, Board Member

Between a Walk and a Hard Pace

I’m a big fan of Scandinavian crime fiction. I’d love to visit Norway or Sweden some day, although I’m a bit concerned about the apparent proliferation of serial killers over there. Aside from dysfunctional detective chief inspectors, though, my favorite export from that part of the world would have to be Nordic walking, also known as pole walking or urban poling.

I first learned about walking poles in a magazine for people living with multiple sclerosis. The article described how folks with uneven gaits, stability problems, and balance issues could continue to enjoy walking for recreation and exercise through the use of walking poles. Many of us with MS or Parkinson’s fear tripping and falling; for instance, my left foot doesn’t always lift quite as high as it needs to, and I’ve endured a couple of scary and embarrassing face plants. So far I haven’t seriously injured myself, although one of those falls tore a hole in the knee of my favorite skinny jeans as well as bloodied the knee of my actual skinny leg. But that fear means I tend to walk slowly and keep my eyes focused on the ground, rather than enjoying the sights and sounds around me. What’s worse, I start to lurch after about a half mile as my muscles weaken, and don’t relish my neighbors thinking that I’ve been at the sauce quite that early in the day. A cane is fine for trips to the mall or shopping, but it doesn’t allow me to walk at a fitness pace, get my heart rate up, or work my core (more on that below).

Although the article discussed the specific technique of “Nordic walking”, the poles I ended up buying after some web research were of a type sold under the brand name of “Exerstrider”. The Exerstrider poles have a special handgrip design and arm-extension technique that promised to work my arm and core torso muscles more intensively during the walk. That sounded great to me, as I’m in a constant battle against the dreaded muffin top (and mostly losing). The upper-body motion is similar to that used in cross-country skiing. (Note to the wit in my neighborhood who invariably shouts “Hey, where’s the snow?” when I chug past your house: That was amusing the first five times you tossed it my way, buddy. Get some new material.)

The poles cost about $100 for the pair, which is pretty cheap for exercise equipment. (Unlike a treadmill or exercise bike, though, the poles can’t do double-duty as a convenient place to drape your dirty clothes. Alas.) I have an exercise room at home, so I normally just wear ratty yoga pants and holey t-shirts when I work out, but going out in public with the poles was an opportunity to invest in some cooler duds like Spandex running pants, colorful Dri-Fit shirts, and neon-laced running shoes. Along the way I’ve added a ball cap with a brim to keep the sun out of my eyes and a waist pack for my house key, energy gels, ID, and phone. My phone, by the way, is not just for calling home for a ride if I decide I can’t make that second mile (which, for the record, has never happened). I use an app called MapMyWalk, which uses the GPS in my phone to track and record my route, miles walked, steps taken, and calories burned; it also plays music from my iTunes. (Mostly the Boss and the Talking Heads, in case you were curious.)

Walking poles not only improve my stability by providing essentially two more “legs”, but also engage my upper body and arms to help move me along, dramatically improving how far I can walk. I routinely walk over two miles around my neighborhood in about 40 minutes. No one who sees me hustling along with my poles can tell I’ve got a neuromuscular disorder and would be in a gelatinous heap on the ground without them. I look like anyone else out there walking, running, or biking to stay in shape. Pole walking isn’t for everyone, but for many of us, it’s a terrific way to get outside and keep moving.

You can find out more about Nordic walking on the web. Some sites I’ve found helpful:

https://www.youtube.com/watch?v=ZKTufkzpo8E

http://www.walkingpoles.com/shop/how-it-works

I’m not endorsing any particular kind of pole or program, but if you’d like to learn more about my experiences with pole walking for fitness, feel free to send me email at pam.saussy@gmail.com. I’d love to hear from you! In the meantime, I’ll be getting back to my Scandinavian police procedurals. Skoal!

Important: As with any new exercise program, if you decide to give Nordic pole walking a try, check with your doctor first.

— Pam Saussy, Board Member

I Only Have Eyes For You

June is National Cataract Awareness month. Were you aware? I was not, but I should be better informed, as I’m no stranger to vision problems. I have worn glasses since the fourth grade and can’t see worth a darn without them. When I headed off to college I got contacts so I could (theoretically) meet cute guys, since glasses hadn’t yet become associated with fashionable hipsters and gazillionaire tech wizards.

Contacts turned out to be tough since my eyes were too dry; I’d go through bottles of eye drops like a fiend. Once I got married and we acquired a house and a dog and a baby, I ditched the contacts in a defiant burst of trying to simplify my life. (Right. Did I mention the house and dog and baby?) Anyway, I went back to glasses and enjoyed being able to see without the red swollen eyes of the tear-impaired. As I’ve gotten older, I’ve had floaters and flashers, and a brief bout of optic neuritis at one point. And my near-sightedness means I’m at higher risk of a detached retina, just in case I didn’t have anything to ponder at 4 a.m. when I wake up and can’t get back to sleep.

And now I come to find that I could have even more to worry about in the future. The Prevent Blindness organization (www.PreventBlindness.org) recently published a study, “Future of Vision: Forecasting the Prevalence and Costs of Vision Problems”, which reports that nearly 25.7 million Americans ages 40 and older have cataract, a clouding of the eye’s lens which blocks or changes the passage of light into the eye. This number is expected to increase by 50% — up to 38.5 million people – by 2032 and up to 45.6 million by 2050. While most cataracts are due to aging, they can also be congenital or caused by eye trauma, exposure to radiation, even some medicines or diseases (including diabetes). Most cataract patients today are women. More cataract patients today are white although the study indicates that this trend will level off and actually decrease by 2040. According to the study, Hispanics will exhibit the fastest rate of growth in cataract cases.*

Whew. Those are some scary projections, but the good news is that, with proper eye care, vision loss due to cataract can be restored. Learn more at www.preventblindness.org and see your eye-care professional regularly.  Even if you don’t currently wear glasses, eye exams should be part of your health maintenance routine.

One more thing you should know.  Because eye care is an essential part of wellness and good health, ophthalmology is one of the many specialty on-site clinics provided at the Mercy Health Clinic.  Two volunteer ophthalmologists are part of the MHC volunteer provider team, and patients are examined using the same modern equipment you’d find at any ophthalmology office. What’s more, the Columbia Lighthouse for the Blind sends an optometrist twice a month to do diabetic retinopathy screenings. As a lifelong “four eyes”, I’m thankful for these generous volunteers and sponsors who help Mercy patients maintain their eye health and vision.

* http://www.preventblindness.org/cataract-cases-reach-38-million-2032

 

— Pam Saussy, Board Member

On Not Taking Health Care for Granted

I joined the Mercy Health Clinic board this year because I believe that everyone is entitled to high-quality health care and want to help them get it. All of us who support Mercy share that belief and desire, but to be honest, I only started giving that first notion truly serious thought over the past few years, when my own health concerns forced me to leave the workforce and a job I loved. At first, I spent more emotional energy mourning my lost work identity and trying to figure out how to stay relevant in the world; I was only just turning 50 at the time so I bristled at being wished a happy retirement. I jumped into various volunteering gigs to stay active and connected with people, and to avoid becoming defined in my own mind as a patient.

The condition I’m managing, multiple sclerosis, isn’t fatal in most cases. But the medication to attempt to keep it at bay is ferociously expensive, to the tune of over $5,000 a month. (Don’t ask me why any ingredient in a capsule justifies a price tag of $180 a day; that’s not what this post is about but it’s a great question for someone smarter than me.) I also have hypertension and high cholesterol, which are readily managed with daily medications and medical oversight. These meds aren’t nearly as pricey as my MS drug is, and nowhere near the cost of the complications they seek to prevent, but still not cheap.

Fortunately for me, I have health insurance. I pay a monthly premium for peace of mind, knowing that I’ll be able to stay on the medications and get the medical oversight I need to stay as healthy as possible. Despite the occasional headache in navigating the health care system (usually haggling over that expensive medication), I don’t lose any sleep over whether I’ll be able to do what I need to do to keep on keeping on.

As I have navigated my own health adventures, I’ve gained a fresh appreciation for those around us who do not have health insurance to achieve that peace of mind. In Montgomery County, about 65,000 people are in that boat, most because they lack sufficient income to pay for health insurance even with a subsidy or because of their immigration status. Many are one illness or injury away from financial catastrophe and its inevitable effects on employment and family security.

Fortunately for them, there is Mercy Health Clinic. Mercy is a lifeline for so many of our neighbors here in Montgomery County, providing health and wellness information and support, specialty medical care, lab services, and pharmaceutical services free of charge. I’m looking forward to helping spread the word about Mercy and continuing to contribute my time and financial support to help it stay ready to serve those in need.

–Pam Saussy, Board Member