health
defendernetwork.com
SEPTEMBER 17 | 2015 | DEFENDER
Defender Special Edition
JOINT PAIN: ABOUT ARTHRITIS By AMBER VERNON Defender
system attacks one’s own joints by mistake. It is characterized by stiff and possibly swollen joints, usually worse in the morning and relieved by f you have arthritis, you are one of 53 million Americans movement. Symptoms also include with the joint disease. According to the Arthritis numbness and swollen feet. Foundation, it is the number one cause of disability in the “There are some genetic risk factors country. involved, but the biggest risk is an Arthritis is the painful inflammation and stiffness of the environmental one derived from smoking joints, and there are more than 100 different types of arthritis which increases the risk of getting arthritis and related conditions. Though minorities have lower rates of by 20 times,” Johnston said. arthritis compared to whites, they experience greater severity of “Untreated, RA can cause major disability pain and more activity limitations than whites. as well as significantly increased risk of heart Rheumatologist Dr. Kirkwood Johnston of Kelseyattack and stroke. Fortunately there are effective Seybold Clinic said the cause of severity of arthritis and safe medications available these days such that among Blacks and Hispanics is unknown. severe complications are quite rare. Rheumatologists “It may be related to background genetics, are experts in using these medications, which would health care access, use of health care services, almost never be prescribed by a family doctor.” and willingness to report limitation and pain,” Fibromyalgia can cause fatigue, insomnia, muscle Johnston said. pain, and tenderness in places on the neck, shoulders, “The prevalence of risk factors for back, hips, arms and legs that hurt when touched. arthritis, such as obesity and physically “Fibromyalgia is better classified as a pain disorder demanding jobs, could also be a with whole-body sensitivity to pain, or a feeling of muscle/ factor. More research is needed.” bone pain without any actual painful stimulus,” Johnston Studies support the link to said. obesity and certain diseases. The “The main causes are lack of restorative sleep, due Arthritis Foundation says arthritis to sleep apnea, psychological disorders, other underlying can be found in 57 percent of diseases, thyroid disorders, and low vitamin D. Treatment is adults with heart disease, 52 percent geared toward the underlying causes and can include various of adults with diabetes, 44 percent medications, sleep therapy, and exercises/physical therapy.” of adults with high blood pressure and 36 Gout is caused by uric acid that builds up to form hard percent of adults who are obese. needle-shaped crystals that go to the joints. “The crystals The risk of arthritis increases with age. Almost half cause an intense inflammatory reaction involving severe of adults 65 years old or older have arthritis. pain, redness, and swelling of affected joint,” Johnston said. Johnston offered insight on the four most common types of “Family history, kidney dysfunction, and excess beer arthritis. consumption are big risk factors. Gout typically presents Osteoarthritis is the most common type of arthritis, and as incredibly painful and swollen big toe joint occurring becomes more likely as people age. This disease occurs when all of a sudden, often in the early morning hours. cartilage breaks down and wears away, leaving bones to rub “Treatments involve joint injections and against each other. medications to control inflammation and decrease uric Symptoms include pain, stiffness or swelling in joints, and a acid in the body. Untreated, gout can cause bone and crunch feeling that sounds like bone rubbing against bone. joint destruction in addition to the repeated painful “It can be aggravated by family history and previous attacks,” he said. injuries,” Johnston said. “Treatments In order to maintain control over include various types of medication from arthritis, research shows exercise acetaminophen and ibuprofen to other pain “Treatments include various types of medication from and maintaining a healthy weight is pills, exercises and physical therapy, braces, needed to improve the function of acetaminophen and ibuprofen to other pain pills, medicated ointments, and joint replacement joints and decrease pain. At least two surgery.” exercises and physical therapy, braces, medicated and a half hours of physical activity Rheumatoid arthritis is an ointments, and joint replacement surgery.” each week is recommended to help inflammatory arthritis where the immune Dr. Kirkwood Johnston manage the disease.
I
defendernetwork.com • Serving the Houston area for over 80 years
1B
2B
DEFENDER | SEPTEMBER 17 | 2015
health Caring for kids with
arthritis
Inside Lupus more prevalent in Black women 3B MD Anderson Cancer Center
Looking back on a life-changing year 4B Joint pain: Know causes, symptoms & treatment 6B Know the facts about bone cancer 6B Memorial Hermann
Keeping students healthy, ready to learn 8B Texas Children’s Hospital
Supporting children after accidental injury 10B Kelsey-Seybold Clinic
Cholesterol: The good, bad & ugly 12B
defendernetwork.com
J
By AMBER VERNON Defender
uvenile arthritis, also known as childhood arthritis, mostly affects children 16 and under and can begin as early as six months. Among the different types of childhood arthritis, juvenile idiopathic arthritis (JIA) is the most common. Dr. Marietta DeGuzman, clinic chief of the Pediatric Rheumatology Center at Texas Children’s Hospital, said JIA is a different disease from the one seen in adults. “JIA is an autoimmune disease,” DeGuzman said. “Like other autoimmune diseases, there is a malfunctioning of the body’s immune system, which in JIA causes inflammation of the joints.” DeGuzman said more research is still being conducted on JIA as the causes are not known. “It is not considered hereditary and rarely involves more than one family member,” she said. “Because the causes of JIA are unknown, no one knows how to prevent these conditions.” Diagnosis of JIA depends on physical findings, medical history and the exclusion of other diagnoses. Other conditions that can look like JIA, including infections, childhood cancer, bone disorders and lupus must be ruled out before a diagnosis of JIA can be confirmed. “JIA may be difficult to diagnose because some children may not complain of pain at first, and joint swelling may not be obvious,” she said. “There is no blood test that can be used to diagnose the condition in children.”
PHYSICAL SIGNS/SYMPTOMS
Signs include stiffness when awakening (in the morning or after
a nap), limping, reluctance to use the joint involved, reduced activity level, joint swelling, persistent fever, and redness around joint
TYPES OF JIA
DeGuzman said it is important for parents to understand the characteristics of each type of JIA and the best treatment. • Systemic JIA includes fevers, rash, and joint pain; usually affects the whole body. • Oligoarthritis affects four or fewer joints. • Polyarticular arthritis, rheumatoid factor negative, causes swelling or pain in five or more joints, usually affects the hands, knees, hips, ankles, feet, and neck • Polyarticular arthritis, rheumatoid factor positive, is similar to adult rheumatoid arthritis and puts kids at higher risk for joint damage. • Psoriatic arthritis is a rash that forms red, bumpy patches on infected areas. • Enthesitis-related arthritis affects the spine and lower body from the hip to the toes, inflammation may also occur where tendons join bone.
TREATMENT/SOLUTIONS
DeGuzman shared tips to help ease the symptoms of JIA. • Children should maintain an active, productive lifestyle with a nutritious, well-balanced diet. • A warm bath or shower can help with pain and stiffness. • Activities and exercises in the water help the soreness and stiffness of the arthritis joints. • Physical and occupational therapy can increase joint motion, reduce pain, improve function and increase strength and endurance.
Message from the Publisher
A
Sonceria Messiah-Jiles
nyone who has ever experienced joint pain knows how agonizing it can be, from arthritis to gout to carpal tunnel syndrome. In this health edition, we provide you with information that addresses your pain from head to toe. We begin with an in-depth look at arthritis, the severity of which disproportionately impacts African-Americans. Next, we explore juvenile arthritis, because joint problems can strike at any age. Our story on lupus sheds light on an ailment that can impact joints and other parts of the body. We also take an overall look at joint pain, and give you
important facts about bone cancer. In addition to reading about joint pain, we urge you to take steps to lessen it. Regular exercise, a healthy weight and a balanced, bone-healthy diet can help in many instances. Because your overall health is important, this special edition includes vital information from our partners – Kelsey-Seybold Clinic, MD Anderson Cancer Center, Memorial Hermann Health System and Texas Children’s Hospital. The Defender is proud to be Houston’s Leading Black Information Source, and we are dedicated to providing news you can use.
defendernetwork.com • Serving the Houston area for over 80 years
defendernetwork.com
SEPTEMBER 17 | 2015 | DEFENDER
health Lupus more prevalent in Black women
F
3B
By JASEMINE KNOWLES Defender
requently known as the “invisible disease,” lupus is an unpredictable and often misunderstood chronic autoimmune disease that can damage many different parts of the body, including the joints, skin, kidneys, heart, lungs, blood vessels and brain. According to the Lupus Foundation of America, Lupus can strike both men and women, but 90 percent of those diagnosed with the disease are women between the ages of 15 and 44. African-American women are three times more likely to get lupus than white women. They also develop lupus at a much younger age, and are more prone to suffer from the complications of the disease. “For unknown reasons, lupus causes the immune system to attack the body’s own tissue and organs,” said Dr. Gary Sheppard, an internist affiliated with Memorial Hermann Southwest Hospital. A healthy immune system protects the body against bacteria, germs, viruses, and other foreign materials. With an autoimmune disease like lupus, “the immune system loses its ability to tell the difference between those foreign substances and its own cells and tissue,” Sheppard said. The immune system then makes antibodies directed against “self” and begins attacking the body’s healthy tissue. There are three main types of lupus, and systemic lupus erythematosus (SLE) is the most common form. Discoid-induced lupus erythematosus mainly affects the skin, causing red rashes to appear on the skin of the face, scalp, or elsewhere, and could change color. Drug-induced lupus is triggered by certain medicines and is more common in men. It’s much like SLE, but symptoms are usually milder. Lupus is an incurable disease, and it is not to be confused with cancer, even though having lupus could increase your risk of developing cancer. “lupus is closer to something like rheumatoid arthritis,” Sheppard said. He said lupus is difficult to diagnose because there is no single test. It may take months before an individual finds out they have it and even more months or years for a doctor to diagnose the disease. Doctors use various tools to make a diagnosis, such as medical history, blood tests or biopsies. One person with lupus may have swollen toes and mouth sores. Another person may be tired all the time and lose hair. Someone else may experience chest pain and rashes. If you have lupus, it may affect two or three parts of your body.
Fact: African-American women are three times more likely to get lupus than white women. Usually, one person doesn’t have all the possible symptoms such as extreme fatigue, kidney issues, unexplained fever, hair and weight loss, painful and swollen joints, mouth sores, sensitivity to the sun, chest pain, skin rash, abdominal pain, seizures, strokes, and in some cases, depression. The aforementioned symptoms are often associated with other illnesses besides lupus, which also makes it difficult to diagnose. In fact, lupus is sometimes also called “the great imitator” because its symptoms are often like the symptoms of rheumatoid arthritis, blood disorders, fibromyalgia, diabetes, thyroid problems, Lyme disease, and a number of heart, lung, muscle, brain, and bone diseases. Sheppard said researchers are still studying why
African-American women are more inclined to develop lupus, what causes it to start, and why it is mild in some and more severe in others. “There are many factors that lead doctors to believe why African-American women are more prone to lupus. It’s not one thing that causes it,” he said. “Possible reasons could be late diagnosis, less access to health care, and poor compliance to recommended treatments,” Sheppard said. “Researchers also believe the environment, along with genetics, socioeconomic, and demographic factors,” play a tremendous role in who gets lupus. Another factor could be lack of knowledge about lupus. There is currently no way to prevent lupus, “but people who smoke may be more likely to develop lupus,” Sheppard said. Avoiding smoking and other tobacco products may decrease your risk of developing lupus. Though there is no way to prevent lupus, it is treatable. Treatment is tailored to the patient’s conditions, such as age, symptoms, general health, and lifestyle. Treatment could be anything from taking certain medications to undergoing chemotherapy in some severe cases. With the correct medication and taking care of themselves, most lupus patients can hold a job, have children, and lead a fulfilling life.
defendernetwork.com • Serving the Houston area for over 80 years
4B
DEFENDER | SEPTEMBER 17 | 2015
defendernetwork.com
health
Looking back on a year fighting breast cancer
“
By MD ANDERSON CANCER CENTER
If you keep waking me up, I will do whatever you need me to do.” That’s the pact that Jamie Bernard made with God when she was diagnosed with cancer in 2013 at age 32. She knew she was going to do whatever it took in order to be around to watch her daughter, Caydin, grow up. “My biggest thing was I needed to be alive,” she says.
An unexpected breast cancer diagnosis
Before her diagnosis, Jamie was a healthy, active mom, running 5Ks and reveling in a 45-pound weight loss. She never thought that she’d be diagnosed with breast cancer. When Jamie went for her annual well woman exam in January 2013, her doctor asked if she’d been checking for changes in her breasts. “I lied and said yes,” she admits. But the guilt of lying led her to start looking for changes that November. And on December 3, she discovered a lump in her left breast. A few weeks later, Jamie made an appointment to have the lump checked. That’s when she got her breast cancer diagnosis, which led her to MD Anderson Cancer Center, where she already worked in organizational development.
Jamie’s breast cancer treatment
At MD Anderson, Jamie’s doctors discovered her cancer was growing as a result of the estrogen produced by her body, making her chances of cancer recurrence higher.
Jamie worked with her doctors to customize a treatment plan. Her treatment plan included a mastectomy and 16 rounds of chemotherapy. Once her treatment was complete, she began a prescription for tamoxifen, a drug that is used to prevent breast cancer recurrence.
A difficult choice made simple
Jamie did her best to prepare for the rapid changes and confront her cancer head on. “I didn’t have time to process. I got diagnosed and in less than 30 days I had a mastectomy,” she says. Because scans revealed the cancer was isolated to her left breast and she has no family history, Jamie opted not to have a double mastectomy. At times, the thought of cancer returning lurks in her mind, but she’s confident she made the right choice. She also doesn’t harp on her age. “Yeah, I’m young, but it happens,” she says with a shrug and a smile. “I got over the ‘you’re young’ comments really quickly.” After waiting the required 30 days after her final chemotherapy session, she underwent breast reconstruction surgery in October 2014. But the process didn’t end there. She still has additional decisions to make before her transformation is complete. Jamie is putting a lot of thought into her new appearance to ensure she’s satisfied with the end result. “You can never be too picky,” she tells others. “This is
your life, and this is how you’re going to view yourself.”
Celebrating new beginnings after breast cancer
Jamie recently celebrated her one-year anniversary of being declared cancer-free with a trip to New Orleans with her girlfriends. But that’s not all she had to celebrate. In December, she received a promotion to a new role as a human resources recruiter. “Last year started off with a bang and ended with a bang,” Jamie says of the full-circle feeling of receiving a cancer diagnosis and a promotion within the same year. “Life is really precious -- you realize what is really important.” What matters most is her support system comprised of her immediate and extended family, close friends and coworkers who have helped her adjust to the physical and emotional changes of the past year. And while the full impact of Jamie’s cancer battle may not be realized for quite some time, it has already influenced 5-year-old Caydin, despite her limited understanding of her mom’s illness. “My daughter used to say she wanted to be a veterinarian. Now she says she wants to be a doctor like the ones who helped me get better,” Jamie says, misty-eyed. “That’s the best thing I’ve heard this year.”
defendernetwork.com • Serving the Houston area for over 80 years
defendernetwork.com
SEPTEMBER 17 | 2015 | DEFENDER
“My team will get you, cancer� Dr. Sapna Patel | Cancer Physician & Researcher Every day, we at MD Anderson are making new discoveries in immunotherapy to end cancer. For good. To help fight, call 1-855-894-0145 or visit MakingCancerHistory.com.
Ranked number one in the nation for cancer care by U.S. News & World Report.
5B
6B
DEFENDER | SEPTEMBER 17 | 2015
cente
K
JOINT
PAIN TOP TO BOTTOM
J
oints for inside of to help y or injury pain, aff Dr. William ated with Memo having joint pain can be treated. H body.
SHOULDER
The shoulde man body and is grees. This wide to deterioration Causes of sh ry to the rotator that help you mo tions. Tendinitis tendon that occu Symptoms i stiffness. Treatm physical therapy
BACK
Back pain c quickly if not tre strains or injurie Symptoms i tingly feeling. T the seriousness. physical therapy stretch exercises
ELBOW
r e c n a c e n o b t u o b a s t c a f e Fiv
erou s a (typ e of ca nc ncer is a sa rcom ncers ca ca e er on B e bo ne. O th e th in ts ar st Accordi ng to th ntu m or ) th at g se co nd ar y ca ce r bo ne s, in cl ud in e A m er ic an Can . th dy ct bo fe e af th ay m rt s of from ot he r pa So ci ety, ca ncer ad re ’s sp in at gk th od rs H ce d er in cl ud e no nof th e bo ne s an er ty pe s of ca nc th O up e ak ti pl e mye lo m a. jo ints m a is ph om a an d m ul m ly l al of og en ic sa rcom t .2 pe rcen rcom a or oste sa rs eo cu st O oc ca ncer. It ca ncers in th e n ty pe of bo ne d it ai m an e s, th nt ol es ce U.S . H ere are ch ild re n an d ad in er n nc te ca of t ne os m of bo ou t on e- fo ur th so m e fa ct s from ab e r th fo in ts un lly co ua ac lls , us so n gi ns in bo ne ce th e M D A nd er be nd It ou . ar ts ul ea ad ar in th e Can ce r Cente r. le gs , es pe ci al ly pe lv is , ar m s or
1
2
at io n vi si t m .m Fo r m ore info rm
th e kn ee. ca rt ila ge ce lls , a is ca ncer of om rc sa ro nd ncer in C ho eval ent bo ne ca pr t os m e th is an d e in pati ents ent of ca se s ar rc pe y nt ve Se m ors are ad ul ts . dros arco m a tu on ch y an M . over 40 be ni gn . an d m ay m ptom s va ry, B on e ca ncer sy ne ss in or nd el lin g or te er sw , in pa e ud in cl m ovem ent, ty w it h no rm al ul ic ff di t, in jo or fractu re s. ne ar a t lo ss , an em ia gh ei w r, ve fe eatm ent fo r fati gu e, th e pr im ar y tr n te of is y er Su rg sa rcom a.
3
4
5
er-typ es /b fo rm at io n/ca nc -in er nc ca g/ or da nd er so n.
on e- ca ncer/.
Elbow pain elbow is used in definitely have a fractured elbow the elbow, or a t osteoarthritis or may come and g Symptoms i ness, and tender Treating ten pain/inflammato requires surgery treated through p
WRIST, HAND
Whether it i suddenly stoppin ground, the hand and injury at all Causes of pa drome, which is and arm caused
defendernetwork.com • Servin
erfold
defender network.com
7B
Know the causes, symptoms, treatment in some cases, surgery as well.
By JASEMINE KNOWLES Defender
HIP
Your hips allow you to walk, run, and jump; support the body’s weight and propel the motion of the legs. The causes of hip pain vary but include osteoarthritis and bursitis/tendinitis from wear and tear of key muscles to running, cycling and other sports. A fractured hip bone is a serious injury and can be life-threatening. Older people are more prone to a broken hip bone because bones tend to weaken as they get older. It could also occur from falling or a car accident. Hip dislocation is a result of a large trauma like an athletic sport accident or a motor vehicle accident. Symptoms include inability to move, severe pain in the groin area, swelling, stiffness, inability to put weight on the leg of the affected side and tenderness. For treatment, physical therapy helps hip pain, as does anti-inflammatory medication. A fractured or dislocated hip would require surgery or total hip replacement depending on the seriousness of the affected area.
rm the connection between your bones f your body. They also provide support you move. Any damage from disease y could alter your movement and cause ecting your quality of life. Hadnott, an orthopedic surgeon affiliorial Hermann Southwest Hospital, said n “is not the end of the world,” and it Here’s a look at different parts of the
er is the most complex joint in the hus designed to rotate at a full 360 dee range of mobility also makes it prone or injury. houlder pain include arthritis or an injucuff, which is a group of four muscles ove your shoulder in all different direcs is a result of the wearing down of the urs slowly over time. include pain, tenderness, swelling, and ment includes medication, surgery or y.
KNEES
an range from mild to severe very eated. Causes include arthritis, muscle es, or degenerative disc disease. include pain weakness, numbness and Treating back pain varies depending on For the most part, one must undergo y, take medication, and practice gentle s.
usually isn’t serious, but because the n many different ways, the pain can an effect. Causes include tendinitis, a resulting from a fall, a direct impact to twisting injury to the arm. A bad case of rheumatoid arthritis can also be a cause and go. include discoloration, bruising, pain, stiffness ndinitis in the elbow includes ice, rest, and ory medication. Repairing a fractured elbow y or the wearing of a cast. Arthritis can be physical therapy and medication.
D, FINGERS
is from performing minor repetitive tasks, to ng the force of the body during a fall to the d, wrist, and fingers are vulnerable to pain stages of life. ain include: arthritis; carpal tunnel syna numbness and tingling feeling in the hand by a pinched nerve in the wrist; sprains and
Back pain can range from mild to severe very quickly if not treated. Causes include arthritis, muscle strains or injuries, or degenerative disc disease. strains which are common in athletes; and a fracture within the wrist, hand, and finger caused by a break in one or more bones due to an injury. Symptoms include pain, swelling, tenderness, bruising, loss of function, weakness and numbness. Treatment includes anti-inflammatory medicine, splinting the wrist, or in some severe cases, surgery for carpal tunnel syndrome. Treatment for a sprained, strained, or fractured bone, would require a cast, pain medication, and
ng the Houston area for over 80 years
There are a lot of different things that could cause knee pain, including osteoarthritis, a dislocated knee cap, a torn meniscus caused by the twisting of the knee in an accident or from playing sports, or an ACL injury, which is the tearing of the anterior cruciate ligament and is common in basketball players. Symptoms include popping or crunching noises, swelling, tenderness, severe pain, weakness, and inability to walk. In the area of treatment, an ACL, dislocated kneecap or a torn meniscus are treated through surgery or total knee replacement depending on how serious the affected area is. Anti-inflammatory medication and physical therapy also helps.
ANKLE
The ankle is composed of bones, muscles, and tendons that support the weight of your body and allows your foot to move. Causes of ankle pain include arthritis, strains and sprains. Symptoms include pain, swelling, tenderness, and redness. Treatment includes ice, rest, physical therapy, and the wearing of a cast .
HEEL, TOE, FOOT
One cause of pain is gout, which occurs when toxins within the body develop tiny crystals that release into the big toe. Plantar fasciitis and heel spurs occur through the tightness in the tissue of your foot from being overweight. Symptoms include pain, swelling, tightness, tenderness, redness, and the feeling that the arch in the foot is tearing apart. Treatment includes medications, therapy and exercises.
8B
DEFENDER | SEPTEMBER 17 | 2015
defendernetwork.com
health
Memorial Hermann’s Health Centers for Schools
Keeping students healthy, ready to learn
A
By MEMORIAL HERMANN
nother school year is off and running with thousands of students returning to greater Houston region schools to learn reading, writing and math. Many returned to school happy, healthy and fed, but many others have a different and unfortunate reality. For those students, Memorial Hermann’s Health Centers for Schools program is a beacon of light. The good news for students in need of access to health care is that Memorial Hermann added three new health centers and a third mobile dental van to its list of clinics where uninsured and underserved students can access medical, mental health, nutritional and dental care. New clinics were opened on the shared campuses of Hastings and Elsik High Schools in Alief ISD, at Kruse Elementary in Pasadena ISD and at Dunn Elementary in Aldine ISD. Launched in 1996, the program now has 10 school clinics in five districts, including Houston and Lamar Memorial Hermann Health Centers for Schools nurse practitioner examines student. Consolidated ISDs. With school feeder patterns served, the clinics are available to more than 65,000 barriers to health care,” explained Deborah Ganelin, underserved children at 68 schools. Associate Vice President, Community Benefit Corporation The program’s recent expansion was due largely for Memorial Hermann Health System. to funds received through the Center for Medicaid and “Barriers to health care for many of the students who Medicare Services (CMS) 1115-Waiver program. The access our clinics include low income, lack of knowledge 1115-Waiver has been a great benefit as it has helped about available health care, lack of transportation and Memorial Hermann expand medical, mental health, parents’ inability to take time away from low-paying hourly nutritional and dental care to 22 additional schools in three jobs.” school districts and opened access to nearly 15,000 more The services offered at the Health Centers for Schools students and close to 9,500 more visits. clinics have made a difference to students’ health as well The Memorial Hermann Health Centers for Schools as their academic lives, Ganelin said. The general profile program has a primary goal: Keep students healthy and in of children being served by Memorial Hermann’s Health school so they can learn and impact their chance of success. Centers for Schools program is: The program accomplishes that by providing a medical n 93% are on the free/reduced lunch program, a home for uninsured students from prekindergarten through nationally accepted indicator of poverty 12th grade. n 34% of students have limited English proficiency The 10 clinics in the greater Houston region are staffed n 44% of the students served are without any kind of by a nurse practitioner, social worker, licensed vocational health insurance coverage nurse (LVN) and receptionist with physician oversight n 27% have some form of Medicaid provided. Certified Community Health Workers (CHW) The outcomes for students who have accessed the or navigators rotate among centers and assists parents with school health clinics have been exceptional. For instance: applications and social service, medical and dental referrals. n Grade point averages increased Two dietitians provide nutritional counseling. n Absenteeism decreased Open five days a week, year round, the program serves n Suspensions/detentions decreased students in the schools’ designated school feeder patterns. n 92% of students served returned to class on the same Services includes sick and injury care, general and sports day (after a clinic visit) physicals, immunizations, chronic care (asthma, obesity and n Asthma exacerbations, ER visits and cholesterol), mental health therapy, social service referrals, hospitalizations have been reduced by 92% nutritional guidance and other care to meet students’ needs. “The clinics are making a difference because these Dental services offered include periodic oral children are lacking in the most basic of primary care and examinations, diagnostic x-rays, prophylaxis, fluoride illnesses and chronic conditions left untreated can grow treatments, oral hygiene instructions, sealants, composite increasingly serious,” Ganelin said. fillings, extractions, stainless steel crowns and pulpotomies. “Memorial Hermann is committed to exploring “The idea behind the program is to break down innovative ways to address the healthcare access
issues experienced by the medically disadvantaged. We see school-based healthcare as an avenue to address these issues for children and, collaboratively with the school districts prepare them for a healthier, brighter future.” For more information on Memorial Hermann’s Health Centers for Schools program, visit http://communitybenefit.memorialhermann. org/locations/school-based-health-centers/
Memorial Hermann School-Based Health Centers locations: n Burbank Health Center (HISD) 315 Berry Rd. Houston, TX 77022 (713) 742-8151 n Elrod Health Center (HISD) 6230 Dumfries Dr. Houston, TX 77096 (713) 771-1805 n Hogg Health Center (HISD) 1100 Merrill St. Houston, TX 77009 (713) 864-7614 n Sharpstown Health Center (HISD) 7504 Bissonet St. Houston, TX 77074 (832) 658-5260 n Lamar Health Center (Lamar Consolidated ISD) 1002 E. Stadium Dr. Rosenberg, TX 77471 (281) 762-8383 n Terry Health Center (Lamar Consolidated ISD) 5500 Avenue N. Rosenberg, TX 77471 (281) 238-0852 n WAVE Health Center (Pasadena ISD) 1500 Main St. South Houston, TX 77587 (713) 946-7461 n Alief Health Center (Alief ISD) 12360 Bear Ram Rd. # T-1 Houston, TX 77072 n Kruse Health Center (Pasadena ISD) 400 Park Ln. Pasadena, TX 77506 n Nimitz Health Center (Aldine ISD) 2003 W. W. Thorne Blvd., # TM-01 Houston, TX 77073
defendernetwork.com • Serving the Houston area for over 80 years
defendernetwork.com
SEPTEMBER 17 | 2015 | DEFENDER
FEELING SICK BUT NOT SURE WHAT TO DO? SPEAK WITH A REGISTERED NURSE FOR ANSWERS TO YOUR HEALTH QUESTIONS. When you or a family member is feeling sick, but you’re not sure if you need to see your doctor or go to the hospital, call the free Nurse Health Line. Experienced nurses will help you decide when and where to go for medical care. These trained nurses are available around the clock, seven days a week to answer your health questions by phone. Anyone living in Harris or the surrounding counties can use this free service. Funded through the Centers for Medicare & Medicaid Services and the Texas Health and Human Services Commission.
Free 24/7 Nurse Health Line 713.338.7979 (Toll-Free) 1.855.577.7979 Individuals with life-threatening conditions and emergencies should call 9-1-1.
sponsored by Memorial Hermann Community Benefits Corporation
9B
10B
DEFENDER | SEPTEMBER 17 | 2015
defendernetwork.com
health
healthnotes
Supporting your child after accidental injury
Identifying post-traumatic stress symptoms after accidents
By DR. GINGER CLINE Psychologist at Texas Children’s Hospital
Unfortunately, accidental injuries happen more often than we like. Did you know as many as 25 percent of all children require emergency room visits each year? It’s not uncommon that an injury will require some sort of hospital treatment, especially amongst children and adolescents. Parents and family members play an important role in supporting children through these situations. Whether they are visiting the hospital for a minor injury or a more traumatic injury, many children may respond with anxiety, sadness and irritability as they interact with unfamiliar providers or are separated from their family at times during their care. While most children adjust well, here are some general recommendations for supporting your child/adolescent following an injury that requires hospital treatment: • Be an active listener! Hear your child’s concerns. Talking about the accident/injury may actually be helpful for processing what has happened. Should significant concerns occur, children/adolescents may benefit from having a consultation with a psychologist and/or social worker. At times, inpatient or outpatient therapeutic intervention can be helpful for supporting positive adjustment. • Acknowledge and normalize symptoms. Let your child/ adolescent know what they are experiencing and feeling is normal. Provide them with hope for improvement and reinforce the fact that the child is now safe. • Provide explanations of procedures to allow for expectations. By doing so you can help reduce the anxiety your child may feel as they are in an unfamiliar situation. Use of multisensory considerations is encouraged (i.e., what will the procedure feel like, what will he or she hear, what will he or she smell, how long the procedure will last). Frequently, many children’s hospitals have child life specialists who are skilled in these explanations. • Provide active distraction before, during and after any procedures. Parents are encouraged to direct the child/adolescent’s attention away from the procedure and to actively lead in the distraction. Examples could include talking about prior family stories, playing an interactive game (technology examples included), and asking questions about the child/adolescent’s favorite topics. Parents
are encouraged to provide specific praise for instances of bravery and engagement with positive coping techniques (i.e., deep breathing, distraction). As noted above, child life departments can also play a role in this. • Normalize your schedule. Families are encouraged to attempt to get back to their typical routines or activities as soon as possible to return to a sense of normalcy. This may include maintaining prior expectations for behavior, continuing typical routines (i.e., brushing teeth, bedtime story) and remaining connected with family members and friends. • Remember individuals may respond very differently. Providing siblings with developmentally appropriate updates regarding his or her sibling will be helpful for reducing worry and helping the sibling to remain integrated in the family system. Having a trusted family member/friend who can assist with maintaining a sibling’s typical schedule/activities is also important and will support positive adjustment. • Engage in self-care. To optimally care for your child, parents also need opportunities to express their own distress, emotions and/or concerns with other adults and to engage in positive coping strategies to ultimately be able to provide optimal support for their child/siblings. Parents are encouraged to take breaks, rely on social support to assist with caring for your injured child and his/her siblings. Social workers can be instrumental in assisting with any needed community resources and to provide parental support.
Most children/adolescents adjust well after an accidental injury, however, one in five children have been found to experience post-traumatic stress symptoms. These may include: • Avoidance of stimuli that remind him or her of the accident • Repetitive thinking about the accident (dreams, flashbacks, memories, play) • Having an altered sense of safety in the world (i.e., feeling the world is now a scary place) • Physiological symptoms (i.e., hyperarousal, exaggerated startle response, difficulty with concentration, sleep difficulties, irritability) • Having persistent negative emotions and a lack of interest in typically enjoyed activities • For the younger child, there may be regression related to adaptive skills (i.e., sleep, toileting), increased separation anxiety, or increased irritability/anger If you are concerned your child may be experiencing traumatic stress following an accidental injury, the experts at Texas Children’s Hospital can assist in the assessment of symptoms and in making appropriate referrals for support. One potential level of support for children/adolescents who have experienced a traumatic injury resulting in persistent symptoms of traumatic stress could be TraumaFocused Cognitive-Behavioral Therapy (TF-CBT). This short-term therapeutic intervention (12 to 20 sessions) is widely considered to be effective in reducing symptoms of traumatic stress and can be effective for children/adolescents ages 3 to18 years of age.
What parents need to know about dog bites complications can occur. For many children, petting and playing with For minor scrapes and abrasions, parents dogs can be fun and exciting! Even though many dogs appear friendly and harmless, it is important should thoroughly clean their child’s wound with warm water and soap and keep it covered for parents to be aware of the risk for dog bites with an antibiotic ointment and bandage. and other injuries! Immediate medical care should be sought Approximately 1 percent of for more serious wounds and injuries, such emergency department visits are as bites that: prompted by bite wounds, and dog • Have broken through the skin bites account for the overwhelming majority of these injuries. Most dog • Do not stop bleeding after applying bites are caused by animals known to direct pressure for 15 minutes the child, and in 15 to 30 percent of all • May have injured bones, joints or cases, the dog belongs to the patient’s tendons Dr. Katherine family. Fortunately, many dog bites • Are located on the head, face, neck, Leaming-Van Zandt are minor, but more severe injuries and hands or feet
• Appear infected • Occur in children with a weakened immune system Remember, although dogs can be great companions, they are still animals and can bite! Keep your children safe by remembering these important tips: • Never leave infants or children alone with a dog • Never allow children to pet or play with a dog while he or she is eating or sleeping • Teach children to be careful around pets • Teach children not to approach strange dogs or try to pet dogs by reaching through fences • Educate children to ask permission from a dog’s owner before petting a dog
defendernetwork.com • Serving the Houston area for over 80 years
defendernetwork.com
SEPTEMBER 17 | 2015 | DEFENDER
Quality health care for $50 or less a year. What a relief.
Texas Children’s Health Plan covers children from newborns to teenagers. We even cover adults and pregnant moms through STAR Medicaid. Families with children who qualify for CHIP pay $50 or less a year. Those who qualify for Medicaid pay nothing. CHIP and STAR Medicaid offer a wide range of benefits including checkups and shots, dental services, medications, and more. With Texas Children’s Health Plan you also get: ■ Over 2,100 doctors. ■ A 24-hour nurse hotline. ■ Transportation to doctor visits at no cost. ■ Pregnancy support program and classes. ■ Help losing weight through the Keep Fit Program. ■ Learn how to play soccer from the Houston Dynamo coaches. ■ Fun member events!
For more information, to receive an application, or to find an event in your area, visit us online or call today.
MK-1208-007
1-800-990-8247 | TexasChildrensHealthPlan.org
11B
12B
DEFENDER | SEPTEMBER 17 | 2015
defendernetwork.com
health
Cholesterol: The good, the bad, the ugly tion. However, low-density lipoproteins (LDL) can float around in your blood, build up on artery walls and harden into eart disease is the leading plaque that restricts blood flow. This can cause of death for Africanlead to peripheral artery disease, heart American men and women. attacks and strokes. There is hope, however. By The only way to know if your living a healthy lifestyle, you can help cholesterol is unhealthy is to see your reduce your likelihood of developing doctor and get screened. In the early heart disease. Monitoring (and reducstages, unhealthy cholesterol levels ing if necessary) your cholesterol is an may not cause any symptoms. Thereimportant part of “living healthy.” fore, all adults age 20 or older should A common cause of heart disease have a fasting lipoprotein profile once is a blockage of the coronary (heart) every five years. This test includes total arteries due to the accumulation of cho- Toicha Vincent, M.D. cholesterol, LDL cholesterol (the “bad” kind), HDL lesterol deposits. These cholesterol deposits narrow the cholesterol (the “good” kind) and triglycerides. The arteries and slow blood flow. risk factors related to cholesterol levels are related to Cholesterol is a waxy, fat-like substance that resides in the cell membranes of your body. It comes from the balance or ratios between these different kinds of cholesterol. foods such as meat, dairy products and eggs. Your body The problems begin when the bad cholesterol needs cholesterol to function properly. What you need builds up in your arteries. If this is not reversed, your to understand is there are two types: one good, one bad. arteries can start to “harden” or become less elastic. Two types of cholesterol High-density lipoproteins (HDL) help your body by This is a disease known as arteriosclerosis. Eventually, the diseased arteries become narrowed and the blood producing nutrients and hormones and aiding in digesBy TOICHA VINCENT, M.D.
H
M O R E
W A Y S
T O
C O N Q U E R
flow to the heart and other organs is either slowed down or blocked. Some people mistakenly think they can’t have unhealthy cholesterol levels if they are young, thin, active or leading a healthy lifestyle. The truth is you might have inherited a tendency to have unhealthy cholesterol. Your age and gender may also impact your cholesterol number. Cholesterol levels increase with age. Women’s cholesterol may also increase after menopause. High blood sugar also contributes to higher LDL cholesterol and lower HDL cholesterol.
The cholesterol challenge
Keeping cholesterol at healthy levels can be challenging. The preferred way is to commit to a healthy lifestyle. This usually entails: Eating foods that are low in saturated fat, staying active and having regular medical checkups. Lastly, don’t go it alone. A physician is your best source to advise you on what you need to do and, if necessary, prescribe medications. Dr. Toicha Vincent is board-certified in Internal Medicine. She cares for patients at Kelsey-Seybold’s Tanglewood Clinic. To schedule an appointment, call 713-442-0000.
C A N C E R
Exceptional Cancer Care Just Got Even Better In our beautiful new facility, everything is under one roof – from our connected team of experts to state-of-the-art technology for radiation therapy.
Kelsey-Seybold’s nationally accredited Cancer Center is focused on not only treating patients, but on providing personal, coordinated care that encourages healing. Now, with state-of-the-art technology for radiation therapy and our beautiful and spacious facilities, we’re better equipped than ever to help our patients be victorious over cancer. It’s just one more way our exceptional cancer care has gotten even better.
Kelsey-Seybold.com/CancerCenter | 713-442-1080
Defender-Cancer Center-June2015_SP.indd 1
8/6/15 8:47 AM