Healthy U — April 2018 by Times Record

VO L U M E 2 , E D I T I O N 3

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APRIL 2018

BEST NURSES IN THE RIVER VALLEY National Nurses Week May 6-12

ALSO INSIDE:

Fort Smith woman overcomes sleep apnea

Hypertension and young people

Concerns about coffee and cancer

HEALTHYU Contents VOLUME 2, EDITION 3 | April 2018

THE FORT SMITH AREA’S TOP NURSES

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Nominations result in recognition for the best nurses in our area.

MERCY INTRODUCES VALET SERVICE

Attendants help support patients, visitors to hospital

TAKING ON SLEEP DISORDERS

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Fort Smith woman discusses how she overcame sleep apnea

SELFIE MEDICINE

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Phone apps push people to take their pills

MEDICAL DIRECTORY

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Access to the area’s leading medical providers by category so readers can easily ﬁnd contacts for their areas of need.

about HEALTHYU

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Healthy U is a monthly publication of the Times Record, focusing on issues of health and wellness for the River Valley area. It publishes the third Saturday of every month. For more information: ccosta@swtimes.com

Publisher Crystal Costa Editor Mardi Taylor Staff Writer John Lovett Contributor Carole Medlock Photographers Brian Sanderford, Jamie Mitchell Production Manager Christy Morrison

ADVERTISING Sales Manager Julie Newman

TOP NURSES

Sparks nurse plans for his future Dobbs pursuing career in primary care

recommendations for lifestyle changes. We’re able to, as a specialized unit, provide speBy Carole Medlock cialized care,” Dobbs said. Special to the Times Record Joseph Kennon, RN, emergency room director at As one local nurse plans a Sparks, said Dobbs is the kind transition from one area of of person you want taking nursing to another, he is looking care of your loved ones. He forward to a new opportunity said Dobbs is one of the most that will provide him new ways compassionate and caring to help people. nurses he has ever met. Paul Dobbs, currently a Tracing the progression of registered nurse working Dobbs’ career in nursing is not at Sparks Regional Medical necessarily easy. He started Center, said as three years as a nursing assistant and of full-time school nears an worked in that capacity until end, he is excited about future 9/11. In the aftermath of the opportunities. Dobbs is curattacks on the World Trade rently completing his master’s Center, Dobbs wanted to use degree in nursing, which will the skills he had, but serve his qualify him as a nurse practicountry at the same time so tioner upon graduation. he enlisted in the Air National He plans to pursue a career Guard as a medic. with a primary care area of His military work earned focus. him enough credit to be Dobbs said family medicine awarded an associate’s degree will allow him to see patients in nursing but Dobbs did not of all ages, and to be a problem stop there. He worked in solver. intensive care, the emergency “Someone comes to you room, and finally the chest with a problem … you sit pain observation unit, and down with them and try to fix earned a bachelor’s degree in it. They go home and try (what nursing in 2016. Immediately you’ve suggested) and if it upon the completion of that doesn’t work they come back degree, Dobbs began work and see you,” Dobbs said. toward his becoming a nurse Exactly what his next step practitioner. will look like, Dobbs is not sure He currently serves in the yet. But he is confident about Arkansas Air National Guard, the opportunities locally. 189th Airlift Wing in Little “There are so many opporRock. He works one weektunities; so much of a need end a month, two weeks per for primary care. I would year, and other times as he is be happy to work anywhere needed as a part of his Guard around here,” Dobbs said. duties. Dobbs currently works in Dobbs said no matter the chest pain observation what the capacity, nursing is unit at Sparks, and said he about making a difference for enjoys the work he does there. patients. “The fact that I have a “The job is the reward. specialized population, nearly You get to do something few all of my patients have similar people get to do … make a difcomplaints. That lets me ference every time you walk dial in knowledge and make into a room,” Dobbs said.

Registered nurse Paul Dobbs, BSN, RSN, TNCC, moves a cart used for medical emergencies down a hall at Sparks Medical Center. Dobbs is in the process of completing his master’s degree in nursing. [BRIAN D. SANDERFORD/TIMES RECORD]

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TOP NURSES

Mercy nurse enjoys serving others By Thomas Saccente Times Record tsaccente@swtimes.com

For Amber Bellcock, working at Mercy Hospital Fort Smith allows her to help others on a regular basis. Bellcock, 28, is a staff nurse and a relief charge nurse in the Intensive Care Unit at Mercy. Born and raised in Maumelle, Bellcock graduated with a bachelor of science in nursing degree from Harding University in 2011. She said there were a few factors that made her decide to pursue nursing as a career, which included her always liking the medical field. Bellcock loves that it is a very serviceoriented profession. "I think initially, I always thought I was going to be a pediatric nurse," Bellcock said. "I wanted to spend time with, you know, kids and take care of them, and then that has certainly changed, and as I was in nursing school, my views kind of changed on what I wanted to do, and it shifted towards this kind of ICU type career, but I think a lot of it still came down to ultimately ... it's very empowering, and there's a lot that you can do for your patients, and there is a whole lot of knowledge base, and you can ... dive very deep into it, and it's one of those things that you can really advocate for your patients, work with the doctors as a team." 4

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As a charge nurse, Amber Bellcock is constantly on the go caring for patients and handling calls from ICU staff. [COURTESY PHOTO/MERCY]

Bellcock said she enjoys taking care of very sick people as well. Bellcock moved to Fort Smith about a month after graduation. She said she had trouble finding a job when she graduated because not many places were hiring new graduates at the time. "My dad ... he works for the state, and he came back from a trip up here, and told me that there was this hospital in Fort Smith that I should look into, which at the time was St. Edward Mercy Medical Center," Bellcock said. "And so I looked at the jobs there, and I looked about the

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hospital, and I started reading into the Mercy values, and what Mercy's mission was, and it was something that really aligned with my own personal feelings, my own personal vision and mission, and so it was something that made me want to come here." Bellcock has been at Mercy for seven years and in the ICU for slightly over six years. She said the hospital has been a wonderful place to work. Bellcock's responsibilities as staff nurse in the ICU include coordinating care for typically one to two patients. "You draw a lot of

things in as far as we need to have this done here, we need to have this test done, we need to get them up, we need to do whatever it is that they need to get done that day," Bellcock said. "You help carry out the physician's orders, but you're also being proactive in making sure that we're going the right direction. I'm watching to see that things are headed the right way, and I'm letting the doc know. I'm that constant base of communication for them." As charge nurse in the ICU, Bellcock said one is responsible for assigning the patients of one's shift and assigning

patients as they need to be admitted to the ICU. All of the communication for where patients are going comes through the charge nurse, with a large part of the job being to serve as a resource for the nurses, among other responsibilities. Bellcock said she works some days as a staff nurse during the week and other days as a relief charge nurse. She does not do them both at the same time. Bellcock was nominated as one of the area's best nurses by Todd Nighswonger, senior media relations and communications specialist for Mercy.

Nighswonger said at Bellcock's age, he was very impressed at how quickly she has embraced not only nursing, but nursing leadership as well. "She also mentors nurses with, you know, different programs that may be introduced, or ... she's a very good leader in helping others get better in addition to herself," Nighswonger said. "So she's very good at balancing between making the patients better and making her coworkers better." A Mercy news release states Bellcock was also named one of the Great 100 Nurses of Arkansas for 2018. She was honored April 10 at the Great 100 Nurses Celebration of Arkansas in Little Rock. "The Great 100 Nurses Foundation was founded more than 30 years ago by registered nurse PK Scheerle in New Orleans," the release states. "Great 100 Celebrations have honored thousands of nurses across Arkansas, Oklahoma, Louisiana, North Carolina and Texas. These exemplary nurses are selected based on their concern for humanity, contributions to the nursing profession and mentoring." Bellcock has several certifications, including critical care registered nurse, and is finishing a master’s degree in nursing from the University of Texas at Arlington, the release states.

TOP NURSES

Mindy Blake’s ‘heart is in the ER’ By Carole Medlock Special to the Times Record

After first exploring other career options, a local nurse said she finally found her place in the emergency room helping people. “I do love taking care of people,” said Mindy Blake, a registered nurse who works in the emergency room at Sparks Regional Medical Center. “And, I fell in love with the ER.” Before becoming a nurse, Blake said she pursued an education in both business and information technology. And although ultimately she did not stay with either, she said both come in handy in nursing. “(The field) is so broad, you use business and IT both in nursing. It has been helpful to have both of those backgrounds ...,” Blake said. Blake has been nursing for four years. She started in the ER as a new graduate, saying it was her semester in nursing school that focused on critical care that made it clear where she wanted Registered nurse Mindy Blake, BN, RSN, TNCC, works in the emergency room at Sparks Medical Center. After Blake spent time in the ER during nursing to be. school, she knew where she wanted to work. [BRIAN D. SANDERFORD/TIMES RECORD] The diversity of the patients and care She said that an together. We get through means to be an ER nurse. Even with Blake’s with personnel from required is one of the incredibly close group it. Everybody knows how Blake said future career obvious passion for other parts of the things that Blake said of employees in the ER the other is feeling. We plans includes returning emergency medicine, she hospital. keeps her job interesting. makes her job easier on take care of each other." to school for a master’s said she also likes helpBut no matter where She also likes to care for the days a patient outJoseph Kennon, ER, program, although she ing other places in the she is working, Blake patients in trauma situcome might be less than emergency room direchasn’t decided whether hospital whenever and stressed that the best ations, although she said ideal. tor at Sparks, described she will pursue a degree wherever she is needed. part of nursing is helping there are not very many “I don’t know of any Blake as a nurse with a as a nurse practitioner She said learning about someone get well. of those cases in Fort other career that would “very caring soul” who or a degree in adminishospital operations as “Whenever you see Smith. have the support system wants to do what is best tration. Either way, she a whole helps her do a someone getting better “I love it that it is that we do. I love my for all of the patients plans to stay in the ER. better job in the ER. She … that’s awesome,” something different all co-workers,” Blake that she sees. He said “My heart is in the enjoys building connecBlake said. the time,” Blake said. said. "We're all strong she exemplifies what it ER,” Blake said. tions and relationships HEALTHYU

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TOP NURSES

Surgical tech enjoys being ‘familiar face’ By Carole Medlock Special to the Times Record

The opportunity to be a familiar face in an often scary situation is what one local healthcare professional says she loves about what she does. Gayla Patterson, certified surgical technologist, said her job in the operating room at Mercy Fort Smith allows her to form relationships with patients during what can be a scary time for them. “I am a familiar face in a sea of strangers. They have seen me before in the (doctor’s) office. I want patients to know there is someone (in the operating room) that they know,” Patterson said. As a surgical tech, Patterson said she gets to see a patient at every stage of a surgery: during their pre-operative appointment in the doctor’s office, in the operating room, and after the surgery during post-operative follow up appointments. It is during those encounters that she said a relationship with those patients forms. “I am very fortunate … very blessed that my position allows me to share my faith with my patients,” Patterson said. “I pray with them for peace and comfort, and encourage them to (pray) with someone else once they are through their tough time.” Patterson works 6

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Gayla Patterson, certiﬁed surgical technologist at Mercy Fort Smith, works with patients not only in the operating room, but in pre- and post-operative appointments, allowing her to build relationships with each patient. [BRIAN D. SANDERFORD/TIMES RECORD]

exclusively with Dr. Stephen Seffense, a general surgeon at Mercy Clinic, acting as an extra set of hands for the physician in the operating room. Her duties can range from preparing the operating room for surgery, holding a camera, suturing or suctioning blood — she said her duties allow her to be more hands-on during a surgery than a nurse. Being a surgical technician was not first on Patterson’s list of career choices. She said she

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wanted to be a veterinarian, but decided to pursue a career as a medical technician, drawing blood. When she was told that program was full, she switched gears and enrolled in the surgical technology program at then-Westark College. “I have never regretted it. The first time I stepped in the OR, I knew that’s where I wanted to be,” Patterson said. Patterson said she enjoys that no two days for her are ever the same. She deals with different

people and different surgeries each day which helps keep her job exciting. Surgeries can include gallbladder, colectomy, thyroid, appendix, melanoma, and breast cancer surgery among other surgical procedures. Patterson added that breast cancer patients often become like extended family to her. “You get to know them. You get involved in their lives,” she said. For those interested in pursuing a similar carer, Patterson said there

are many benefits. Not only is the job fulfilling, she said, but there will always be a need for someone in her position. “You see things others don’t see. You do things others don’t do,” Patterson said. “You get to meet some of the coolest, neatest people. It’s amazing the friends I’ve gotten to know.” The job does have its difficulties, both mentally and physically, Patterson said. Working with a patient you know is terminally ill is

mentally hard, while long days and long surgeries can by physically hard. But having the opportunity to get to know patients, form relationships, share her faith, and help people make it a job that Patterson would not trade. She’s been working with Seffense since 1995, just three years after beginning her career. “I’ve yet to have someone say they don’t want to pray with me. I love what I do,” Patterson said.

TOP NURSES — HONORABLE MENTION

The area’s other best nurses Times Record Staff

Where would we be without nurses? The Fort Smith area has some of the best around, and we are delighted to profile a few in this section. Nominations for the area's best nurses came in from friends, family members and co-workers. Each nurse has a different story to tell, but they all agreed that being a nurse is the best job in the world. Nurses work long hours and long days but do so to help keep us healthy. They help keep Fort Smith's state-of-the-art medical centers running around the clock. They often are asked to go above and beyond the call of duty and never fail to deliver. Nurses hold the world in their hands, and for that, we are grateful. Thank you to all our area nurses. Janice Austin, Sparks Maternal Child Department Janice was born in Fort Smith and studied at Westark Community College. She will mark 30 years as a nurse in December. Austin "I always dreamed of being a nurse," Janice says. "I loved being around babies and children. My entire nursing career has been maternal child nursing." Janice says the best part of her job is experiencing the joy of families bringing

new babies into the world. The most challenging part is losing a baby, child or new mother. Janice says her passion is neonatal intensive care nursing. Janice encourages anyone interested in nursing to pursue their dreams. "I would tell them, if you are feeling the call to become a nurse — GO FOR IT!" she says. "It is the most rewarding experience." Janice and her husband, Marty, have been married for 23 years and have two daughters, Olivia Austin, 20, who attends Arkansas Tech University, and Ella Austin, 15, who attends Greenwood High School. Kelsie Benavides, Sparks ICU Kelsie came to Arkansas in 2009 and moved to Fort Smith in 2010 after growing up in Kansas. She studied at the University of Arkansas at Benavides Fort Smith, where she graduated in 2014, after deciding "to conquer my fear of germs." "I used to play video games a lot, and I was always the healers for everyone," she says. "I have always been drawn to helping others and felt that my compassion would be a great fit with nursing. Helping others get better is very rewarding." Kelsie has been with Sparks ICU since 2014 and encourages anyone interested in nursing to go into it

for the right reasons. "Go into nursing because it's your passion to help others," she says. "It is a very hard career mentally and physically. Burnout is high in this profession, but if you are in it for the right reasons, it makes the stresses of nursing so very worth it." Kelsie says working to the point of exhaustion and being able to see the positive changes and improvements in her patients are the best parts of her job. The most challenging parts are knowing there is nothing more medically possible to improve a patient's outcome and guiding the patient through their final moments. Kelsie is married to Luis Benavides and has a stepdaughter, BreeAnna, who is a cheerleader. She says her stepdad, Rick, married to her mom, Paula, is retired from pharmaceutical sales and has helped guide her to pursue her nurse practitioner degree. Her mother is a court reporter who is "the best support system I could ask for," and her father lives in Oklahoma and travels doing produce management. Leona Cardenas, LPN, Mercy Clinic Orthopedics — River Valley Leona is from Little Rock but has lived in Fort Smith for many years and considers this her home. She studied at Sparks School of Nursing Cardenas and has been

a nurse for 40 years. She says her dad was a brittle diabetic, so she grew up wanting to make a difference for him. Seeing patients improve with their health care is her favorite part of the job, while dealing with non-compliant patients is the most challenging. Leona urges anyone going into nursing to pay close attention to their patients. "Be empathetic and sympathetic to your patients," she says. "Listen to your heart." Leona has one married son and one grandson. Debbie Hewett, clinical nurse manager II, Mercy Hospital Fort Smith ICU Debbie has been a nurse for 20 years. She is from Van Buren and studied at the University of Arkansas. She says the best part of the job is serving Hewett others. "Nursing was actually a second career choice for me (music being my first), but I have absolutely no doubt that this was the path I was meant to walk. Nursing fulfills my desire to help others," Debbie says. Nursing can also be challenging, and she says dealing with the emotional stress of being in critical care is the most difficult thing for her. "Funny thing, my son recently decided to go into nursing next fall," she says. "My advice to him is to understand that

nursing is a commitment to serve others, not just your patients, but their families and your fellow co-workers. Every opportunity you have to positively impact another person’s life is an opportunity that should not be missed." Debbie has two sons, Ryan and Zachary. Kim Huston, Sparks medical/surgical unit Kim is originally from Macomb, Ill., but moved to Fort Smith in 1986 and studied at Carl Albert State College in Sallisaw. She has been a Huston nurse for six years and says she was drawn to nursing after her youngest son, Jordan, was born with spina bifida. "We spent a lot of time at Arkansas Children's Hospital in Little Rock," Kim said. "We experienced some wonderful nurses. They made a big difference in our lives. So I decided to go into nursing to help others and to make a difference in someone's life." Kim says the most challenging parts of the job is multitasking and patient satisfaction. She encourages anyone interested in pursing nursing to "Go for it!" "It is a very rewarding job, and when you graduate, you can apply at the best hospital in town — SPARKS!" she says. Kim has two sons, Joshua and Jordan.

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Amanda Moore, Arkansas Family Supports Amanda is originally from Ohio but grew up in Lawton, Okla., and now lives in Van Buren. She studied at Cameron University in Lawton Moore before receiving her CNA and HHA certification from PRN Medical Services and an associate degree in science. She has obtained 17 certifications from OKDHS to work with people who have disabilities. "What drew me to nursing was when I worked as a habilitation specialist years ago, I learned so much from working with people who have disabilities, and that is where my passion grew and grew," Amanda says. "Their smiling faces despite their disabilities was a very humbling and motivating factor that forever changed my life." Amanda has been in some form of nursing for more than a decade, taking a few breaks in between for school and parenting. "The best part of my job is feeling like I make a difference in someone's life for the positive," she says. "If I can say I've made someone smile, provided a meal or medical assistance, a bath, etc., I am happy. It is a very rewarding job." The most challenging part of the job, she says, is losing someone she got close to. "That is extremely hard to internalize," she says. Amanda's advice to someone pursuing a nursing career is to never quit. "No matter how hard it gets, these people need us, and you will be glad that you

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did!" she says. Amanda's family includes two sons, Darion Moore, 23, of Edmond, Okla., and Cameron Moore, 6, of Van Buren; mother and stepfather, Beverly and Samuel Britton of Van Buren; father, Alan Moore of Fort Smith; two brothers, Cee-Jay Johnson of Van Buren and Phillip Moore of Lawton; sister, Brittany Moore of Duncan, Okla.; and former stepdaughter, Adrianna Moore, 10, of Vorhees, N.J. MOTHER AND DAUGHTER:

• Sherri Rogers, Sparks medical/surgical unit • Ashley Brasher, Sparks ER

Sherri Rogers and Ashley Brasher are a mother-anddaughter duo who both work for Sparks. Sherri is from Rudy and studied nursing Rogers at Westark Community College. She has been a nurse for more than 35 years. She says she wanted to Brasher become a nurse from the time she was 3 years old. She says the best part of her job is "the wonderful patients who I have had the pleasure in taking care of, making new friends, meeting great people and learning new things." Sherri encourages anyone who wants to be a nurse to go for it. "It is a great job to help people, learn every day and make a difference," she says. "You are always learning new things." Sherri's family includes

husband Billy Rogers, sons Joshua Sharp and Jeremy Sharp, daughter Ashley Rogers Brasher, who works in the Sparks ER, and two grandchildren, Magen Sharp and Braxton Sharp. Ashley is also from Rudy and currently lives in Alma. She is an Alma High School graduate who studied at the University of Arkansas at Fort Smith and Carl Albert State College. She is currently enrolled in the LPN program at Indian Capital Technology Center in Sallisaw with a graduation date of June 14. She has accepted a position at Sparks Medical Center observation unit. "From an early age, I experienced the nursing field by volunteering at Sparks Regional Medical Center and completing 360+ hours," Ashley says. "By the age of 18, I was hired on as a full-time unit assistant and fell in love with patient care." Ashley has been a nurse assistant/ER technician since July 2011. She calls her mother a "wonderful influence and positive role model." "My mother is my inspiration to become a nurse," she says. "I admire her compassion, caring and willingness to help others, as well as the platform she has built over her 30-plus years' experience as a nurse and manager." The most challenging part of her job is accepting the loss of patients, Ashley says. "I bond with my patients over time, and it never gets easier with any loss for myself," she says. "But knowing that I was able to be there even if it was to hold their hand for their last few hours does make that lasting difference in the patient's and family's lives."

Ashley encourages anyone interested in nursing to give it a shot. "I'm not saying it is going to be easy, but I do believe anyone can do it," she says. "I was very fortunate to work at Sparks once I graduated, because they have helped me pay for my education. I will graduate in June with no debt! I would love to talk to anyone who would be interested in going to school to help give you that extra push." Shannon Smith, Sparks house supervisor Shannon is from Corinth, Miss., and studied at Northeast Mississippi Community College and the University of North Alabama. Smith She says she originally wanted to be an actress and started college as a theater major. "My dad suggested I try following in my mother's footsteps and switch to nursing," she says. "To help pay for school, I started working as a nurse's aid on the night shift. Seeing the impact I could have on people's lives as a nurse up close and in person made me realize he was right and nursing was the career for me (Don't tell him I said that). I realized that I had really found a career I could love and I developed a passion for patient care. I am really lucky to have found a job I love thanks to some help and inspiration from both of my parents." Shannon has been a nurse for almost 11 years and says the best part of her job is being a member

of a winning team that can produce positive results for patients and their families. "Working together as a unified team to create an atmosphere where each and every patient feels their welfare is paramount is our goal in nursing," she says. "Nurses face different challenges every shift. Over the years, a recurring challenge has been finding creative ways to execute excellent patient care despite running short on time, energy and resources. I can say for sure, that the hardest jobs I have worked as nurse have taught me the most about my own strengths and weaknesses." Her advice to anyone interested in nursing is: "1. Wake up early, iron your scrubs and eat breakfast before you get to work. 2. If you’re not sure, ask! Keep learning! 3. If you drop food on the ground at work, do not eat it. No matter how hungry you are. Trust me." Kristin Swanson, Sparks Labor & Delivery Kristin is from Fort Smith and studied at the University of Arkansas at Fayetteville. She has been a nurse for almost 13 years. Swanson "My mom was a nurse, and I really enjoyed the medical field," Kristin says. "I love learning new things and being challenged." Kristin says being a part of the best moment in a patients' lives is the best part of her job, while the most challenging is helping people emotionally deal with negative outcomes. Kristin is married and has three children.

Mercy introduces valet service for patients, visitors Austin Lovell with Med Valet Corp. of Oklahoma City holds the door open for Kathy Richmond as she helps Eula Elmore of Huntington into her car at the valet station at the entrance of the Mercy Medical Building. A ribbon cutting and blessing ofﬁcially kicked off the valet service for patients and visitors at the Medical Building as well as the Labor & Delivery/ Oncology Building.

QA &

IS THERE A CURE FOR TINNITUS? As a hearing healthcare provider, I regularly get asked about a cure for tinnitus. Trust me, if there was one, I would be using it! I have had tinnitus NWZ UWZM \PIV Å N\MMV aMIZ[ 1\ UISM[ Q\ PIZL \W [TMMX \W KWVKMV\ZI\M \W read a book. Basically, anything that is normally done in quiet became a struggle for me. Let’s talk about what tinnitus is, and what you can do to help manage it.

WHAT IS TINNITUS? Tinnitus is the perception of sound when no actual external noise or sound is present. It is often referred to as “ringing” in the ears. I have even heard some people call it “head noises.” While ringing sounds are very common, many people will describe the sound they hear as buzzing, hissing, whistling, swooshing, and clicking. In some rare cases, tinnitus patients report hearing music.

[JAMIE MITCHELL/TIMES RECORD]

Free service available weekdays at two entrances on Fort Smith hospital campus Mercy Media Relations

Mercy’s goal of providing great service and care now begins before patients walk through the door. Visitors and patients seeking care in the Mercy Hospital Forth Smith now have the option of complimentary valet service from 7:30 a.m. to 5:30 p.m. weekdays at entrances to the Medical Building and Labor & Delivery/Oncology Building. Valet attendants will be available to support patients and visitors in various ways, including parking vehicles, getting a walker out of the back seat, obtaining a wheelchair and providing directions.

“The addition of this service is in direct response to safety and accessibility concerns received from patients and visitors due to the rapid growth we have experienced over the past few years,” said Juli Stec, the hospital’s chief operating officer. “This service also will help with patient flow by allowing people to get to their appointments and treatments on time without having to look for parking.” While Mercy always has offered help to patients once inside, their only option previously was to park and make their way to the clinic entrance. Now, care begins curbside with valets, with tipping optional. To provide this new service, Mercy has partnered with Med Valet Corp. an Oklahoma Citybased company that also

serves Mercy locations in Rogers, Oklahoma City and Joplin, Mo. “We pride ourselves on providing a service for people who truly need it,” said Joshua Rydberg, general manager of Med Valet. “We’re the first and last person they’ll see when they visit the clinic, so we look for people to hire who have empathy and sympathy.” While the added service comes at a cost, Mercy believes the investment is an appropriate use of the ministry’s resources to help ensure safety, improve accessibility and enhance the overall patient experience. “As always, we will remain relentless in assuring our patients’ and visitors’ experiences reflect the Mercy Charism of hospitality and Mercy values of service and excellence,” Stec said.

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SO, IS THERE A TINNITUS CURE? Tinnitus, by itself, is not a disease. It is a symptom of something else. There are many things that can trigger tinnitus. Tinnitus can be associated with exposure to loud sounds and acoustic trauma, hearing loss, or certain drugs and medicines. In addition, roughly 200 health disorders can be associated with tinnitus. ABOUT THE AUTHOR: Jerry Richards, ACA, BC-HIS Graham Hearing 1005 Lexington Ave. Fort Smith 479-783-5250 2708 N. Broadway Poteau, OK 918-649-0223

Because tinnitus can be triggered by so many things, no cure for tinnitus has been found. I know, there are a lot of websites that promote “cures” — drops, supplements, oils and lotions — but be cautious as most of these PI^M VW\ JMMV [KQMV\QÅ KITTa XZW^MV 5IVa PI^M VW\ M^MV JMMV \M[\ML

WHAT CAN YOU DO IF YOU HAVE TINNITUS? Luckily, hope is not lost there are things you can do! There are tools and treatments that have been tested and established over time. You can manage your tinnitus! ,]ZQVO \PM LIa 1 _MIZ ;\IZSMa¼[ 5][M Q9 PMIZQVO IQL[ _Q\P 5]T\QÆ M` Tinnitus Technology. This proven technology helps minimize how much \PW[M ¹KZQKSM\[º I‫ ٺ‬MK\ UM )\ VQOP\ 1 ][M I NIV WV \PM JML[QLM \IJTM \W create a “masking” sound which helps me fall asleep. As someone with tinnitus, I recommend both. There are other tools, treatments and devices available, as well. Depending ]XWV PW_ U]KP IVL _PMV aW]Z \QVVQ\][ QUXIK\[ aW] LQ‫ ٺ‬MZMV\ \WWT[ UQOP\ JM JM\\MZ I\ LQ‫ ٺ‬MZMV\ \QUM[ Good advice is to consult with a hearing healthcare professional who can help customize a tinnitus relief program just for you. There may not be a K]ZM NWZ \QVVQ\][ J]\ \PMZM IZM _Ia[ \W TM[[MV \PM I‫ ٺ‬MK\ IVL MVRWa TQNM HEALTHYU

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BIGSTOCK.COM

Stay home when sick — even if you’re a nurse “Recovery happens more quickly when sick people get the rest, nutritional support and medication they ne ed. d …N ursiing need. Nursing can be a physically demanding job — involving long hours on the feet; turning, lifting and transferring patients; and the mental work of assessment and care — so being well before returning to work is always a benefit to the nurse.” Vicki G. Allen

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By M Melissa elis el iissa sa E Erickson rick ri ickso son n More Content Now

eeling under the weather and possibly contagious? The best bet is to call in sick to work and make a doctor’s appointment. But But what what happens hap appe pens ns when whe hen n you you work work in the doctor’s office or hospital? If you’ve got a hacking cough, a sore throat, throat flu-like flu like symptoms or other illill ness that’s making you feel lousy, experts agree: Just stay home. “Some nurses may feel both guilty and heroic in terms of their desire to not abandon their team, so they may take the risk and go to work anyway,” said Keith Carlson, RN, a career coach for nurses with a podcast and blog at nursekeith.com. “This is not the best strategy since going to work sick could infect both colleagues and vulnerable patients. Overall, I believe a great many nurses likely bite the bullet and go to work when it would probably be more prudent and wise to stay home.” Not only are sick nurses less productive, they also put others at risk, said Vicki G. Allen, infection prevention director at CaroMont Regional Medical Center in Gastonia, North

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Caro Ca roli lina na, and and spokeswoman spok sp okes e wo woma man n for for the the Carolina, Association for Professionals in Infection Control and Epidemiology. “Just like anyone who is ill, a nurse should stay home until symptoms subside. Viruses that cause flu and colds can spread from an infected person to othe ot hers rs through thr hrou ough gh the the air, air ir, as well wel elll as during dur urin ing g others contact. Considering the fact that nursing involves significant care, contact and patients staying home interaction with patients, when you are ill protects the patient from further exposure and illness,” Allen said. Especially vulnerable are immunocompromised patients, which includes people receiving chemotherapy and immunotherapy, and individuals with HIV, AIDS and other diseases that severely curtail the body’s immune response, Carlson said. “The elderly and the very young are also quite vulnerable. For an elder with fragile health, one viral infection can trigger a cascade of events leading to pneumonia and other complications,” he said. Just like other workplaces, hospitals, nursing homes and health-care facilities have policies in place advising employees on when to stay home from work, Allen said. While written policies may be in place, they don’t always translate to

enfo en forc rcem emen entt or adherence, adh dher eren ence ce, Carlson Carl Ca rlso son n said. said sa id. enforcement Because they’re aware of the risks, “it is probably less common for health-care professionals to go to work ill than it is for other types of personnel,” Allen said. Smart nurses will recognize the signs and symptoms of illness as well as as the the importance impo im port rtan ance ce of of staystay st aywell ing home when ill, Allen said. “Recovery happens more quickly rest nutrinutri when sick people get the rest, tional support and medication they need. … Nursing can be a physically demanding job — involving long hours on the feet; turning, lifting and transferring patients; and the mental work of assessment and care — so being well before returning to work is always a benefit to the nurse,” Allen said. “Health-care professionals are subject to the same laws of nature and illness as anyone else. Heroic gestures — like going to work sick — on the part of nurses or doctors may seem laudable, but sick health-care workers need to stay home and rest just like the rest of us. Health-care institutions need to enforce policies in terms of sick days, and flexible staffing needs to be in place so that teams and units don’t needlessly suffer when someone calls out,” Carlson said.

Study: More young adults need hypertension treatment More Content Now

Hypertension is commonly treated in elderly patients, but a new study found that young adults would benefit from more aggressive treatment to significantly reduce the risk of stroke, and kidney and brain damage. High systolic blood pressure is often thought to not be a problem and is left untreated in young adults. Called isolated systolic hypertension, it occurs when blood pressure exceeds 140, while diastolic blood pressure remains normal, under 80. Systolic pressure is the top number in a blood pressure reading, and diastolic is the bottom number. This study — the largest ever conducted in the U.S. looking at whether young, otherwise healthy isolated-systolic-hypertension patients actually have a cardiovascular problem — suggests the common approach of ignoring the higher levels in younger adults may be wrong, said study author Dr. Wanpen Vongpatanasin, director of University of Texas Southwestern Medical Center’s hypertension program. “Our study suggests that the presence of high systolic blood pressure with normal diastolic blood pressure in young adults — a condition which was thought not to be dangerous — should be taken more seriously as it may cause damage to the aortic artery, and this damage may occur even early in life. ... I think we should consider

treating these patients sooner rather than later,” Vongpatanasin said. Some physicians have avoided prescribing drugs to treat hypertension in younger patients, thinking the higher systolic reading was an anomaly related to youth that would self-correct, or perhaps even a sign of a stronger heart since it sometimes showed up in high school athletes. Although young people

rarely have heart attacks or strokes, the incidence of isolated systolic hypertension in Americans ages 18 to 39 more than doubled over about a decade, in the late 1980s and 1990s, and is now estimated to be around 5 percent in that population, according to Vongpatanasin and data from the Centers for Disease Control and Prevention. Researchers suspect the growing numbers may be related to increasing rates of obesity.

This new study, published in the journal Hypertension, found that the threat of aortic stiffness is not only real, but visible. Researchers examined 2,001 participants in the Dallas Heart Study, a populationbased study of more than 6,000 adults. The researchers took cardiovascular magnetic resonance pictures of participants’ hearts to assess the condition of the aorta — the

major artery that carries oxygenated blood from the heart to the body. A section of the aorta that leads directly from the heart, called the proximal aorta, was the part found to be stiffened. Aortic stiffness “may cause damage to blood vessels or a tear in the wall of the aorta — or even damage to the brain and kidneys. The heart also has to pump against a higher workload when the aortic artery is stiff,”

Vongpatanasin said. Helping patients gain better control of their blood pressure greatly improves their quality of life as well as their longterm health outlook, Vongpatanasin said. “Physicians should monitor patients more closely and start treatment sooner rather than later to prevent further damage to the aortic artery in young adults with isolated systolic hypertension,” he said.

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APRIL 2018

WHEN SLEEP ISN'T EASY Mercy Sleep Center helps patients get diagnosis, treatment for disorders By Mardi Taylor Times Record

When Sue Mitchell of Fort Smith began feeling excessively tired during the day, she knew something was wrong. She says a recent diagnosis of sleep apnea by the staff at Mercy Sleep Center changed her life.

APRIL 2018

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"For at least the last 10 years, I had been tired. Really tired," Mitchell said recently. "And I would sleep every time I sat down. I started feeling drowsy during the day, and it just progressed to ... I didn't do anything, really. People called and would want me to do something, and I just wasn't up to it. I didn't even feel like going to

play cards. When you're retired, you're supposed to really enjoy retirement. And it just kind of took the fun out of being retired." When Mitchell described her condition to her doctor, he recommended a sleep study. Dr. Stephen Snell and staff members at Mercy Sleep Center conducted the study, which involves spending the night

Doreen Wallace, RPSGT, RST, left, talks with Sue Mitchell in the sleep lab about her diagnosis of severe obstructive sleep apnea after being tested at the Mercy Sleep Center. [JAMIE MITCHELL/TIMES RECORD]

at the center while sleep patterns are monitored. "When you do a sleep study, what we're looking at is to document what stages of sleep you're in,” Dr. Snell said. The diagnostic stage of the sleep study involves using a variety of machines, including an EEG that shows brainwaves and shows which stages of sleep a patient is getting in. Flow meters show how much air a patient is getting each night. Electrodes show other scenarios like jaw clenching and teeth grinding, and EKG electrodes can measure things like leg movement during sleep. Specialists can figure out percentages of each stage a patient is getting to each night. "They do a good job," Mitchell said of the sleep study. "I was very pleased. I didn't know what to expect. ... It wasn't invasive, it was just restrictive, and elaborate. I didn't think you could have that many wires attached to you. I'm kind of fascinated ... because she would tell me what each wire was going to tell her. And I was fascinated at all the information (that you can get). That was amazing to me. They're not even in the room with you." Mitchell filled out a survey before the study, which indicated she might have sleep apnea. After her diagnosis, she began using a Continuous Positive Airway Pressure (CPAP) machine each night with positive results. She said the machine took about a week to get used to. "Let me just say that it changed my life," Mitchell said. "When I started on the CPAP machine, my husband could not believe it. He thought it was kind of quackery. But, he was stunned that I didn't make noise, and I didn't get up and walk around in the night because I was awake." Mitchell said she, her husband and their dog are all

sleeping better these days. "I don't sleep during the day (anymore)," she said. "I still like to take a nap now and then, but I am retired, so I can if I want to. But it's lovely to decide, you know, and just not be exhausted all the time." Dr. Snell explained that the "hibernated" sleep state is the stage when the body, including the heart, lungs and kidneys, repairs itself. When a sleep disorder disrupts this stage, the body suffers because of it. "People with sleep apnea, as they're trying to get in those deep, reparative, restful stages of sleep, where the tongue's falling back, the palate's falling back, chest falling in, or a combination of all, they can't get that relaxed because the airway narrows and oxygen level starts dropping to the brain, and it kicks in, saying, 'Don't be so asleep, don't be so asleep,'" Dr. Snell said. "So that's where you have this fragmented sleep that you had, because you're trying to get into the deeper, restful, reparative stages of sleep, to have the obstruction brain that would kick in, that's why (someone) is up and down all night, because (they're) in more of the twilight, lesser stage of sleep than the very relaxed, reparative stages of sleep." Dr. Snell says the second half of sleep, the REM stage, is different. "I just equate it to trying to jump-start a car," he said. "That's where the dream sleep comes in. The heart rate's variabled, blood pressure is going up and down, the dreams are popping in and out. To me, it's sort of trying to jump-start the car for the next day. But, so you don't act out your dreams, you still have to remain that relaxed, so that's a very relaxed state." Mitchell says now that she is using a CPAP machine each night, both her nights and her

Wallace talks with Sue Mitchell about the mask she’ll wear when she goes to bed after her diagnosis of severe obstructive sleep apnea. Mercy Sleep Centers in Fort Smith, Ozark and Waldron recently received a three-year national accreditation that demonstrates a commitment to providing the highest level of performance and patient care. [JAMIE MITCHELL/TIMES RECORD]

Mercy Sleep Center Staff • Dr. Stephen Snell, ENT, DABSM • Paula Brosnan, APRN, NC-P • Sheila Overstreet, LPN • Chellie Smith, RPSGT, RST, CRT, director of sleep services There are eight registered polysomnographic technologists, four of whom are certified respiratory therapists, and one certified polysomnographic technician. Staff members have a combined 200 years of medical experience. Mercy Sleep Centers in Fort Smith, Ozark and Waldron recently received three-year national accreditation from the Accreditation Commission for Health Care, which focuses on clinical care when patients are tested for a variety of sleep disorders such as insomnia, restless leg syndrome and sleep apnea. Anyone who thinks they could benefit from a sleep study should ask their primary care doctor for a referral to one of the three sleep centers or make an appointment at Mercy Clinic Sleep Medicine, 7001 Rogers Ave., 479-314-8917.

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Some links to possible sleep apnea include: • Severe snoring. • Irregular snoring. • Excessive tiredness during the day. • High blood pressure. • Diabetes. • Atrial ﬁbrillation. Sleep apnea can put patients at risk for other things, including stroke or death.

APRIL 2018

days have improved. "I had not been able to walk, really walk, any distance, half a block even, for the last three or four years," she said. "Well now, I walk 15 minutes twice a day on my treadmill. Now, that is a miracle, I'm telling you. I will live longer; I know this. My blood pressure's lower, I'm able to be active, and enjoy things." She and her husband are even planning a trip to Canada, something she said she never would have considered doing before. And she's taking her CPAP machine with her. After diagnosis, a patient receives a CPAP machine to use at home during sleep. Mitchell said the CPAP machine makes a light hum that acts more like white noise. She described the machine as like having a "sleep blanket." Dr. Snell explained that there isn't a onesize-fits-all type of CPAP mask. There are nasal pillows and slings and a multitude of masks that weren't always available, which makes treatment more individualized. Many of the masks are much less invasive than they used to be, and different masks and levels of air pressure are used depending on a patient's sleep apnea severity. A person's sleep apnea level can change as he or she ages or gains weight, Dr. Snell said. "What those machines are, basically, is they blow various pressures of air to help the airway stay open, and they'll

APRIL 2018

probably get those deeper, relaxed stages of sleep," Dr. Snell said. "And doing that, they're able to breathe without collapsing down and are more and more relaxed, and that's when they can get the deeper sleep over time." Whether a patient would need to stay on a CPAP machine forever depends on the patient. Dr. Snell say he uses a CPAP mask himself and has for about 10 years, even after losing 50 pounds. "I may or may not need it (now), but I don't care, because I like sleeping with it," he said. "So the idea is, I don't think it should be thought of as a finalistic type thing. It is something that you benefit from, so it doesn't matter to me whether I necessarily need it, because I sleep so much better with it." The CPAP masks send messages to the sleep center electronically, and the staff can monitor a patient's progress and answer questions should problems arise. "An interesting note is, when I put my mask on, it's almost like taking a sleeping pill," Mitchell said. "I get in bed, I put that on, and (I'm asleep) almost before my head hits the pillow. The flow of the air is comforting to me. "The first week, it took getting used to every night. But all my friends who have it said, 'Stay with it. Do it every night.' But when you're watching TV in bed, put it on so you get used to it. And once you're used to it, you can't sleep

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without it. It's amazing — I'm telling you, it is." There's a huge correlation between the development of sleep apnea and high blood pressure, Dr. Snell said, and what's you're trying to do is make sure you oxygenate the system while you sleep, because you're supposed to repair yourself. "You're creating a toxic environment for your body if you're unable to do that," he said. The vast majority of patients at the sleep center are there for sleep apnea, but the staff also treats other disorders such as narcolepsy, restless leg syndrome and periodic nighttime leg movements, REM behavior disorders and Post-Traumatic Stress Disorder, Dr. Snell said. "You'll find that a reasonable percentage that do have (sleep) problems that you wouldn't think just by looking at them," Dr. Snell said. Chellie Smith, RPSGT, RST, CRT, director of sleep services, says patients have no reason to be anxious or nervous about the diagnostic procedures. She encourages anyone who thinks they may have a sleep problem to come in for testing, because getting a diagnosis is too important. Mitchell is one of the sleep center's success stories. "I'm not even used to it yet," Mitchell said of the improvements she's seen since coming to the sleep center. "I'm not used to having a life again."

Can statins help prevent brain aneurysms from rupturing? By American Heart Association News

People who learn they have an unruptured brain aneurysm typically have two options: surgery or watch and wait. Researchers hope to add a third alternative — drugs to lower the odds of the aneurysm rupturing. Statins — drugs that reduce the risk of heart attack and stroke by reducing cholesterol levels — are one treatment that has been investigated. Initial studies conducted in animals were promising, but research on people with brain aneurysms has had conflicting results. In a new study published this month in the American Heart Association/American Stroke Association’s journal Stroke, researchers looked at cholesterol levels and statin use in about 4,700 patients who had been diagnosed with one or more brain aneurysms — ruptured or unruptured — between 1990 and 2016 at Brigham and Women’s Hospital and Massachusetts General Hospital in Boston. The analysis showed that people with higher levels of HDL — the good cholesterol — or who were taking a cholesterol-lowering statin were less likely to have their brain aneurysms rupture. “This study shows an association, but it doesn’t necessarily show causality,” said the study’s senior author Dr. Rose Du, director of cerebrovascular surgery

at Brigham and Women’s Hospital. “We don’t know what the actual link is between lipids and aneurysm ruptures.” About 6 million — or one in 50 — people in the United States have a brain aneurysm — a weak spot on the wall of a brain artery. The aneurysm typically bulges out like a berry at the point where an artery divides. Most people will never know they have a brain aneurysm. There is no recommended screening test, and in most people it will cause no symptoms. But for the

30,000 people each year in whom an aneurysm ruptures, causing blood to leak into the space around the brain, the results can be devastating. About 12,000 will die, and about two-thirds of those who survive will have long-term neurological problems. People typically learn they have a brain aneurysm by chance, when having an MRI for another medical problem, or because they are being screened due to a family history of aneurysms. If an aneurysm expands quickly or

ruptures, it can cause symptoms such as a sudden severe headache, stiff neck, dizziness, nausea and vomiting, blurred vision and weakness. When possible, surgery is performed to stop the bleeding. Dr. Kimon Bekelis, director of the Stroke and Brain Aneurysm Center of Excellence at Good Samaritan Hospital Medical Center in West Islip, New York, and his colleagues have also studied the relationship between statins and brain aneurysms. Their study of 28,930 Medicare patients, published

in 2015, did not find an association between current or recent statin use and the risk of a brain aneurysm rupture. “We knew if they were taking statins and how much they had taken,” said Bekelis. “We also knew how long before they had the aneurysm that they had taken the statin or if they were still on it when the rupture happened.” The new study didn’t include this data. For Bekelis, that raises questions about the findings. “I’m passionate about finding a drug to prevent aneurysms from

rupturing,” he said. “But at this point I think we have evidence that statins are not that drug.” Du disagrees. Her team’s next steps, she said, include trying to identify a mechanism of action for why statins might work to lower aneurysm risk. Du emphasized, however, that her study doesn’t support statin use to prevent a rupture. “We are not there,” she said. “Before jumping to that step, we would need stronger data.”

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APRIL 2018

Selfie medicine: Phone apps push people to take their pills By Carla K. Johnson The Associated Press

SEATTLE â&#x20AC;&#x201D; Take two tablets and a selfie? Your doctor's orders may one day include a smartphone video to make sure you took your medicine. Smartphone apps that monitor pill-taking are now available, and researchers are testing how well they work when medication matters. Experts praise the efficiency, but some say the technology raises privacy and data security concerns.

APRIL 2018

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Selfie medicine works like this: Open an app on your phone, show your pills, put them in your mouth and swallow. Don't forget to show your empty mouth to the camera to prove today's dose is on its way. Then upload the video proof to the clinic. Fans say the technology addresses a big problem: About half of drugs for chronic conditions aren't taken as prescribed because of cost, side effects or patient forgetfulness. With treatment for opioid

addiction, a skipped dose can mean a dangerous relapse. The National Institute on Drug Abuse is funding research to tailor a smartphone app for those patients and see if they'll use it. "If we can keep patients engaged, we can keep them in treatment longer," said lead researcher Dr. Judith Tsui of the University of Washington School of Medicine in Seattle. The next phase of her research will compare a group of patients who use the monitoring app called emocha

ABOVE: Public health nurse Peggy Cooley of the TacomaPierce County Health Department, seen on the phone screen, uses Skype video to remotely monitor a patient taking antibiotics for tuberculosis at home in Lakewood, Wash. [MANUEL VALDES/THE ASSOCIATED PRESS]

with those who don't to see if there's a difference. At one Tennessee treatment center, some patients with opioid addiction are already using the app to upload selfies of their daily dose and answer questions about how they're doing. "Every time they sign on, it allows us to capture data. Are they having cravings? Suicidal tendencies?" said Scott Olson, CEO of Dallas-based Pathway Healthcare, which is trying the app at its Jackson, Tennessee, site. "Maybe a phone call from a counselor might make the difference between staying clean and a relapse." Olson thinks insurers will pay for the service with more evidence. For monitoring tuberculosis patients, health departments pay roughly $35 to $50 per patient each month for systems that include encrypted data storage. A small health department might pay as little as $500 a month.

The idea of watching someone take their medicine — called directly observed therapy or DOT — has roots in tuberculosis where one person's forgetfulness can be serious for everyone. If patients don't take all their antibiotics, their infectious TB germs can get stronger, developing drug resistance and endangering the broader community. But taking a handful of pills daily for up to a year is difficult, so public health departments traditionally sent workers to people's homes and workplaces to watch them take their doses. Today, many TB patients prefer remote monitoring. Nurses like it too. Nurse Peggy Cooley has used Skype for years to chat live with patients taking TB medicine. "We can accomplish in a twominute phone call something that might have taken an hour to do and most of that hour was

in the car," said Cooley, who works for the Tacoma-Pierce County Health Department in Washington state. The new uploaded selfies don't need an appointment. They are a daily routine for many tuberculosis patients in Seattle, San Francisco, Los Angeles and Houston, where savings on mileage and worker time amounted to $100,000 in a recent year. In Boston, Albuquerque and five other cities, researchers are studying whether the technology works for hepatitis C, a blood-borne virus that's surging among a new generation of injection drug users. New drugs for hepatitis C can cure, but they're expensive — $75,000 for a 12-week course of treatment — so insurers want to make sure patients take them. "I think it holds a lot of promise," said researcher Dr. Alain Litwin of University of South Carolina School of Medicine, who's testing

Welcome Laura Pace, APRN | Erica Quitoriano, APRN | Whitney Scantling, APRN Get appointments sooner. Mercy’s talented nurse practitioners are taking new patients and can help you get medical care when you need it. Nurse practitioners prescribe medicine, diagnose illness and provide treatment much like doctors do. Call today to schedule an appointment.

Find care within a ﬁve-mile radius of your location at mercy.net/nearby

whether patients do better when someone watches them take their pills. What's next? An insurer in Maryland plans to use the technology in diabetes and high blood pressure to make sure Medicare and Medicaid patients take their medicine. Startups selling the apps say they could be used by faraway adult children monitoring an elderly parent's daily pill-taking. Experts worry about privacy, data security and penalties for poor pill-taking. "That's the biggest ick factor," said Carolyn Neuhaus, a medical ethicist at the Hastings Center in New York. "You can imagine a program where benefits are tied to compliance and the insurer says, 'We won't pay for medication anymore unless you're taking it correctly.'" Globally, the rapid spread of smartphones creates an opportunity to eradicate TB, say the app developers.

But eliminating TB may take simpler, cheaper technologies that can be scaled for millions of cases, said Dr. Daniel Chin, who leads TB efforts for the Bill and Melinda Gates Foundation. The group supports research in China and India on two homegrown technologies. China's tool, about the size of a child's shoebox, reminds patients to take their pills and saves data for review. In India, the government favors a blister pill pack printed with phone numbers; a patient punches out a daily pill, then calls the revealed number. Worldwide, TB kills more than 1.6 million people annually, even though most deaths are preventable with treatment. "If we are going to eliminate the disease, we need technology," said Dr. Richard Garfein of the University of California, San Diego School of Medicine, who helped develop one of the smartphone apps, SureAdhere.

Laura Pace, APRN Mercy Clinic Primary Care – Chaffee Crossing 7003 Chad Colley Blvd. Barling, AR 72923 479.314.3500 Erica Quitoriano, APRN Mercy Clinic Pediatrics 3224 S. 70th Street Fort Smith, AR 72903 479.314.4810 Whitney Scantling, APRN Mercy Clinic McAuley Family Medicine 3420 S. 74th Street Fort Smith, AR 72903 479.573.3740

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APRIL 2018

Poll: Most Americans see drug addiction as a disease

Spenser Flowers is seen as homecoming king at Hampton Township High School in 2014 is surrounded by other photos from his life in a collage at his parents’ home in Hampton Township, Pa. After Flowers died of an opioid overdose in January 2017, Hampton schools launched a drug prevention crusade and his mother, Tina Flowers, launched the nonproﬁt Spencer’s Voice to combat drug abuse in young people. [STEPHANIE STRASBURG/PITTSBURGH POST-GAZETTE VIA AP]

By Matthew Perrone The Associated Press

WASHINGTON — A slim majority of Americans see prescription drug addiction as a disease that requires medical treatment, but most would not welcome those suffering from the problem into their neighborhoods, workplaces or families. 18

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New survey results reveal Americans' complex view of addiction as the deadliest drug epidemic in U.S. history ripples through communities nationwide. More than 1 in 10 Americans say they have had a relative or close friend die from an opioid overdose, according a recent survey by The Associated Press-NORC Center for Public Affairs Research.

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Opioids are an addictive class of drugs that includes both prescription medicines like Vicodin and OxyContin and illicit drugs like heroin and fentanyl. Overdose deaths linked to the drugs have quadrupled since 2000, reaching an all-time high of 42,000 in 2016. The wave of addiction has dragged down the national

life expectancy, strained local budgets and challenged officials at every level of government. A study by the Kaiser Family Foundation released Thursday found large employers spent a record $2.6 billion to treat opioid addiction and overdoses in 2016, an eightfold increase since 2004. Most medical authorities view drug addiction as a

disease. The National Institute on Drug Abuse describes it as a long-term, treatable brain disease. Although 53 percent of Americans view addiction as a medical problem, they remain wary of the afflicted. Fewer than 1 in 5 Americans are willing to closely associate with someone suffering from drug addiction as a friend,

co-worker or neighbor. Emily Fleischer, a 36-year-old librarian, says she has seen the effects of the opioid epidemic in her home state of Indiana, including a massive oneyear increase in children forced into the foster care system due to drug misuse at home. She understands people wanting to keep their distance from those who misuse drugs, given their association with high-risk behaviors. "I can see why people wouldn't want that to be up close and personal, even if they do feel it is a disease and not the person's fault," Fleischer said. Medical experts say overcoming the stigma of addiction is an essential part of expanding treatment. About 2.1 million Americans are addicted to opioids but only about 1 in 5 received specialized treatment, according to the latest federal figures. "When something is stigmatized nobody wants to bring it up, so therefore people who need the help are less willing to come forward," said Dr. Corey Waller, an addiction specialist in New Jersey. Many of those polled see drug misuse as a moral failing and favor stiffer penalties. Forty-four percent of those surveyed say opioid addiction indicates a lack of willpower or discipline, and a third say it is a character flaw. Fifty-five percent favor a "crackdown" on those who misuse drugs. Those figures worry Baltimore Health Commissioner Leana Wen, who says it's counterproductive to blame people for their medical conditions. "If somebody is afflicted with heart disease or cancer then everybody brings that person or their family a

When something is stigmatized nobody wants to bring it up, so therefore people who need the help are less willing to come forwardâ&#x20AC;? Dr. Corey Waller, an addiction specialist in New Jersey

casserole, but if someone is afflicted with addiction then they don't have the same community support," Wen said. Hurdles to treatment include gaps in health care coverage and social stigma against some forms of therapy, including methadone. A majority of those surveyed don't think their local community is doing enough to address the problem. Two-thirds said decisionmakers should make treatment programs more affordable and accessible. Ramiro Juarez, 48, said he

tried quitting heroin more than a dozen times before a doctor recommended the addiction drug Vivitrol, a monthly injection to control opioid addiction. "I was trying methadone clinics, I would check myself into the hospital, I would try detox," said Juarez, a Chicago security guard. The federal government is set to spend $4.6 billion on the opioid recovery effort signed by the president last month, about three times more than the government is currently spending on the epidemic. The funding will primarily go to

state and local governments to fund treatment, prevention and law enforcement efforts. But critics contend the sum isn't nearly enough to fund the kind of national response needed. Despite government efforts, more Americans are seeing the problem hit close to home. Forty-three percent of Americans say the use of prescription pain drugs is a serious problem in their community, up from 33 percent two years ago. About 37 percent of survey respondents see heroin as a serious

concern locally, up from 32 percent in 2016. The AP-NORC poll of 1,054 adults was conducted March 14-19 using a sample drawn from NORC's probability-based AmeriSpeak Panel, which is designed to be representative of the U.S. population. The margin of sampling error for all respondents is plus or minus 4.1 percentage points. Respondents were first selected randomly using address-based sampling methods, and later interviewed online or by phone.

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APRIL 2018

CDC: Drug-resistant ‘nightmare bacteria’ pose growing threat By Marilynn Marchione The Associated Press

"Nightmare bacteria" with unusual resistance to antibiotics of last resort were found more than 200 times in the United States last year in a first-of-a-kind hunt to see how much of a threat these rare cases are becoming, health officials said earlier this month. That's more than they had expected to find, and the true number is probably higher because the effort involved only certain labs in each state, officials say. The problem mostly strikes people in hospitals and nursing homes who need IVs and other tubes that can get infected. In many cases, others in close contact with these patients also harbored the superbugs even though they weren't sick — a risk for further spread. Some of the sick patients had traveled for surgery or other health care to another country where drug-resistant germs are more common, and the superbug infections were discovered after they returned to the U.S. "Essentially, we found nightmare bacteria in your backyard," said Dr. Anne Schuchat, principal deputy director of the U.S. Centers for Disease Control and Prevention. "These verge on untreatable infections" where the only option may be supportive care — fluids and sometimes machines to maintain 20

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life to give the patient a chance to recover, Schuchat said. The situation was described in a CDC report. Bugs and drugs are in a constant battle, as germs evolve to resist new and old antibiotics. About 2 million Americans get infections from antibiotic-resistant bacteria each year and 23,000 die, Schuchat said. Concern has been

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growing about a rise in bacteria resistant to all or most antibiotics. Last year, public health labs around the country were asked to watch for and quickly respond to cases of advanced antibiotic resistance, especially to some lastresort antibiotics called carbapenems. In the first nine months of the year, more than 5,770 samples were tested for these "nightmare bacteria,"

as CDC calls them, and one quarter were found to have genes that make them hard to treat and easy to share their resistance tricks with other types of bacteria. Of these, 221 had unusual genes that conferred resistance. The cases were scattered throughout 27 states. "Even in remote areas" this threat is real, because patients often transfer to and from other places for

care, said Dr. Jay Butler, chief medical officer for the state of Alaska and past president of the Association of State and Territorial Health Officials. Others in close contact with the infected patient then were tested, and 11 percent were found to be carrying the same superbugs even though they were not sick. This gives the bugs more of a chance to spread.

What to do? CDC suggests: • Tell your doctors if you recently had health care in another country. • Talk with them about preventing infections, taking care of chronic conditions to help avoid them, and getting vaccines to prevent them. • Wash your hands regularly and keep cuts clean until healed.

Yucky ducky? Study reveals bath-time toy's dirty secret Swiss researchers now say the cute, yellow bath-time friends harbor a dirty secret: Microbes swimming inside. The Swiss Federal Institute of Aquatic Science and Technology says researchers turned up “dense growths of bacteria and fungi” on the insides of toys like rubber ducks and crocodiles. [AP PHOTO/FERDINAND OSTROP]

By Frank Jordans and Jamey Keaten The Associated Press

BERN, Switzerland — Scientists have the dirt on the rubber ducky: Those cute yellow bath-time toys are — as some parents have long suspected — a haven for nasty bugs. Swiss and American researchers counted the microbes swimming inside the toys and say the murky liquid released when ducks were squeezed contained "potentially pathogenic bacteria" in four out of the five toys studied. The bacteria found included Legionella and Pseudomonas aeruginosa, a bacterium that is "often implicated in hospital-acquired infections," the authors said in a statement. The study by the Swiss Federal Institute of Aquatic Science and Technology, ETH Zurich and the University of Illinois was published in March in the journal Biofilms

and Microbiomes. It's billed as one of the first in-depth scientific examinations of its kind. They turned up a strikingly high volume — up to 75 million cells per 0.15 square inch — and variety of bacteria and fungus in the ducks. Tap water doesn't usually foster the growth of bacteria, the scientists said, but low-quality polymers in the plastic materials give them the nutrients they need. Bodily fluids — like urine and sweat — as well as contaminants and even soap in bathwater add microbes and nutrients like nitrogen and phosphorus and create balmy brine for bacteria. "We've found very big differences between different bath animals," said microbiologist and lead study author Lisa Neu, alluding to other types of bath toys — like rubber crocodiles — that also were examined. "One of the reasons was the material, because it releases carbon that can serve as food for the bacteria." While certain

amounts of bacteria can help strengthen children's immune systems, they can also lead to eye, ear and intestinal infections, the researchers said. Among the vulnerable users: Children "who may enjoy squirting water from bath toys into their faces," a statement from the institute said. The scientists, who received funding from the Swiss government as part of broader research into household objects, say using higher-quality polymers to make the ducks could prevent bacterial and fungal growth. The Swiss government isn't making any recommendations at this stage. Known for their squeaks and eulogized in a Sesame Street song on TV, rubber duckies have been a childhood bath-time staple for years. Online vendor Amazon.com lists one such offering — advertised as water-tight to prevent mildew — among the top 10 sellers in its "Baby Bath Toys" category.