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2/14/2024

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Air Quality / COVID-19 / Social Anxiety
/ Heart Health / Medicaid and Medicare

Health Blog Topics

Cigarette Butts Everywhere - Theresa E (2/13/2024)
Medical Warning Signs - (11-7-2022)
Doctors' Office - How to be your own best advocate (11/1/2022)
Hearth Health (update 11/1/2021)
Air Quality (6/21/2022)
Caption Call Voice to Text (5/18/2022)
Heat Safety (5/7/2022)
Water Intake and Dehydration (3/9/21; 5/7/22; 7/24/22)
Social Anxiety (6/4/2021)
Regular Exercise (3/10/2021)
Women's Heart Health 101 (2/17/2021)
Insider Tips To Improve ER Visits (1/15/2019)
Learn Hands Only CPR- FREE March 2019 (1/9/2019)
Mental Health First Aid Dec-8-2018 (12/4/2018)
Mental Health First Aid Jan-19-2019 (11/28/2018)
Healthy Aging with Lis Swihart (9/10/2018)
Living with Memory Loss Video (6/22/2018)
Living Well Workshop 2018 (4/19/2018)
Bullying Among Older Adults (3/14/2018)
Vaccinations (12/8/2017)
Hepatitis A (12/7/2017)
Emergency Aid For Mental-Behavioral Health (10/16/2017)
Signs of Stroke (10/29/2017)

Other Health Resources

Health Care For All - Washington - Newsletter with Events, Resources
Signs and Symptoms of AFib
Risk factors for AFib can include:
advancing age; diabetes; high blood pressure; sleep apnea; heavy alcohol use; heart disease, such as congestive heart failure and coronary artery disease; prior heart attacks

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Cigarette Butts

2/13/2024

Toxic Cigarette Butts Everywhere
by Theresa E.

Photo by Theresa E.

"As I walk my dog around the complex, I see cigarette butts in front of the buildings, in the plant beds, and in other places where they shouldn't be. I have filled up sandwich bags with cigarette butts that accumulated on our grounds."

"Cigarette butts are the most abundant form of plastic waste polluting our environment. They are made of cellulose acetate, a man-made plastic containing toxic chemicals, arsenic, lead and nicotine. It takes up to 10 years to completely degrade. The chemicals released remain in the environment for many more years beyond the life of a cigarette butt itself."

"Cigarette butts improperly disposed of on the ground will leach the toxins which presents a serious threat to us and our environment. They cause significant harm to our water sources, to marine life and to land animals who eat the tiny butts. Cigarette butts need to be properly disposed of in an appropriate waste bin, not on the ground."

References

Cigarette Butts: Toxic Threat and Tobacco Control Opportunity
January 04, 2024 / GlobalHealthNow.org

Cigarette Butts: Toxic Plastic Pollution from Cradle to Grave
August 3, 2023 / OceanCare.org

Cigarette butts leak deadly toxins into the environment.
May 3, 2023 / University of Gothenburg

Cigarette butts are toxic waste.
Apr 6, 2022 / Undo.org

Tiny but deadly: Cigarette butts are the most commonly polluted plastic.
August 28, 2020 / Earthday.org

5 ways cigarette litter impacts the environment.
Apr. 21, 2017 / TruthInitiative.org

Tobacco and cigarette butt consumption in humans and animals
May 2011 / NIH

Toxicity of cigarette butts, and their chemical components, to marine and freshwater fish
May 2011 / NIH

Medical Warning Signs

11/8/2022

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Additional Resources

Medical Emergency Warning Signs

Recognizing Medical Emergencies

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Doctor's Office

11/1/2022

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How to be your own best advocate at the Doctor's Office

Additional Resources for Self-Advocacy

Community Health Advocate (CHA)
Mary Pope, RN, BCPA (Board Certified Patient Advocate)
Telephone or Facetime: 425-765-2757
Email: marytpope-at-hotmail.com (change -at- to @)
In-person by appointment.

Seven Healthcare Self-Advocacy Tips for Women

How to Advocate For Yourself at the Doctor During Virtual and Office Visits

Ten Ways to Advocate for Yourself at the Doctor's Office

Six Ways to Advocate for Yourself at the Doctor's Office

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Caption Call

5/18/2022

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CaptionCall provides hearing assistance
on telephone by transcribing caller's voice to text.

The next demonstration at Arrowhead Gardens will be in July 2022.
If you would like a one-on-one consultation, call Rick Burns.
Or, click Frequently Asked Questions for information.

Rick Burns
Account Manager
Western Washington
425-789-8074
[email protected]
Customer Support 877-557-2227
Promotion code: 1615783

Click an image below for a full-size PDF copy.

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Water Intake and Dehydration

5/7/2022

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This is a companion article to Heat Safety and Air Quality

Water Intake and Dehydration  (3/9/2021; 5/7/2022; 7/24/2022)
Download 3-Page Version: PDF / 2-Page Version: DOCX & PDF
Submitted by Emily Lord from Community Life Foundation

Dehydration is extremely common among adults aged 65 and older.

How much water do I actually need?

Experts generally recommend that adults drink about 8 cups or 64 ounces a day.
Recent research has suggested that water intake should correlate to weight, height, age, and activity output.
Check with your doctor to confirm how much water you should be drinking

What are the signs of dehydration?

Little or no urination
Dark or amber-colored or strong-smelling urine
Extreme thirst
Dry skin that stays folded when pinched
Irritability, dizziness, or confusion
Low blood pressure
Rapid breathing and heartbeat
Weak pulse
Cold hands and feet

5 Ideas for Seniors to Drink More Water

Having trouble meeting your daily goal for water intake? It’s easy to get caught up in the momentum of daily life and forget to stay hydrated. Below are some tips to help older adults stay hydrated and incorporate more water into their daily routine:

Keep water easily accessible: Keep a pitcher of water nearby on a table or carry a water bottle when going out. The more convenient it is to drink water, the more likely you will be to do it.
Incorporate other beverages: While water is always the best choice, you can switch things up with juices, coffee, sparkling water or even soup broth.
Eat your water: Many foods are a great source of water. Popsicles, watermelon, celery, strawberries, and tomatoes are water-rich foods that are also healthy!
Download an app: If you are tech-savvy consider downloading one of the many apps available to help track your water intake as well as provide you with helpful reminders to stay hydrated throughout the day.
Experiment with fruit: Adding different fruits to your pitcher of water can help change the flavor in a subtle way that makes it more satisfying. Experiment with different flavors and find what works for you.

(data from Saint Joseph’s Senior Living Community)

RESOURCES

Caregiver Training Video with Slides
Hydration/Dehydration - To drink or NOT to drink? That is NOT the question!
Fluid intake is important for people of all ages and dehydration in the elderly is especially crucial issue. When older adults become dehydrated, they may experience muscle cramps, disorientation, confusion and many other threatening healthcare conditions. If they are severely dehydrated, they may go into shock, which can be life threatening. In this video training, you will learn more about the importance of hydration and strategies to increase fluid intake for yourself and the people you care for.
Presented by Maria L. Wellisch, R.N., LNFA
https://training.mmlearn.org/caregiver-training-videos/dehydration-in-the-elderly

Chronic illnesses caused by heat stress and dehydration
Medical researchers are starting to find links between sustained heat exposure and chronic health conditions ranging from diabetes to kidney stones, cardiovascular disease and even obesity.
Fat production is the body’s reaction to—and anticipation of—dehydration.
https://time.com/6196564/climate-change-obesity-long-term-health-impacts/

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Regular Exercise

3/10/2021

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Submitted 3-9-2021 by Emily Lord from Community Life Foundation

Did you know that regular exercise can:

Lower chance of diseases such as heart disease and diabetes
Improve mental health
Decrease risk of falling
Improve cognitive function

How much exercise do I need?
The CDC recommends at least 150 minutes of exercise a week. Be sure and check with your doctor for their recommendation.

Struggling to exercise with the covid-19 pandemic?

Remember that any movement is better than no movement
Try to do exercise in chairs, use household objects as weights
Look for online workouts such as Shag Workout classes-Contact Judi at [email protected] to sign up or look for flyers in the lobbies

Need ideas of stretches to do at home?
Click image to open PDF

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Insider Tips To Improve ER Visits

1/14/2019

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Source: Dailykos 2019/01/13

The scenario: it’s 2 AM, and you feel awful
You suddenly have chest pain, or worsened difficulty breathing, or severe vomiting — and you just can’t avoid the frightening truth that you need to go to the local ER. Maybe you’ve never been to the ER before, or have only been there a few times and have found it to be a slow and unpleasant place. But here you are, it’s 2 AM, and you are scared that something serious is happening, something that needs medical care…. NOW. You hastily grab your wallet, keys and phone and head for the car, or you call 911 for an ambulance — but either way, you grimace and head to the hospital.

What an ER does well, and what is does not do well
The first and most important thing to understand is that ERs are designed to care for potentially life-threatening or serious acute conditions. Heart attacks, bowel obstructions, kidney stones, allergic reactions and the like — these conditions are what ER staff are trained for, what they generally diagnose and manage quite well. So if you have a relatively new, or a newly worsened symptom such as chest discomfort, difficulty breathing, vomiting, severe abdominal pain, or a new itchy rash all over your body, the ER is the right place for you. What ERs tend to do a lousy job with are conditions that are more chronic in nature — one month of abdominal pain, several weeks of back pain for which you have seen a specialist already, or intermittent headaches for 6 months. We just don’t have the resources, time, or ability to do a great job with such conditions, and your visit to an ER is likely to be frustrating, and result in an expensive co-pay without many answers. Sometimes you just don’t have a choice (maybe you don’t have health insurance or don’t have a regular primary care provider) — but your ER visit often won’t get you the care that you need.

The discussion above may sound obvious to you — but you’d perhaps be surprised to know that easily half of the patients that I see in my ER have conditions that are chronic or mild in nature, and would have been more efficient and more pleasant for the patients to manage in a clinic setting.

Orientation to the ER: who are these medical people and what crazy language are they using?

There are a bewildering array of staff who work in the ER setting. Knowing who they are, and the roles they play, can be a useful bit of knowledge when you visit the place. The ER also has a whole set of bizarro jargon terms, often used by staff to patients without remembering that “civilians” don’t use these words — thus adding to confusion and miscommunication.

Who are these guys?The ER is generally led by a supervising physician (known as the “attending physician” or simply the “attending”, a word I dislike because no one outside an ER actually knows what this means. I always introduce myself as the “supervising physician” to patients and families, everyone gets the meaning of that). The supervising physician makes the final decisions about “disposition”, meaning whether you stay in the hospital or go home, and what treatments you will receive. At many hospital ERs, there is a junior group of physicians who may care for you, physicians-in-training known as “residents”(much more familiar term, thanks to all the medical TV shows out there). If you are in the ER, and a physician walks in and says “Hi, I’m Dr. Jenkins” , it’s important to know if they are resident or supervising doc. It’s totally fair to pleasantly ask them, “Hi Dr. Jenkins, nice to meet you, are you the resident or attending physician?” That way, you will know if they are really calling the shots. It is absolutely your right to speak to the attending; if the resident physician says “you’re going home, everything checked out just fine” but you haven’t actually spoken to the attending (believe it or not, this happens not infrequently, but is not OK) — ask to speak to them. Ditto if the resident is telling you things that are totally confusing, it’s always fair to nicely ask “I appreciate what you are trying to say, doctor, but I’d like to ask some questions of the attending when they get a moment”.
The other crucial person on your ER team is the “primary nurse” — that means the nurse assigned to you during your stay. ER nurses are some of my favorite people in the world — generally strong-willed, sometimes blunt but deeply caring under that gruff exterior, smart and dedicated to their vocation. They can be your best ally during the ER stay — so make sure you are as courteous to them as your condition allows. Like flight attendants, they have a really tough customer service job, with most people complaining or being rude. A few kind words of appreciation towards a primary ER nurse can make a huge difference in their day, and often in the attention paid to you in the ER. You may also meet an “ER tech”, often a paramedic. These techs do a range of activities to support your care, including placing intravenous lines, preparing splints for sprains and fractures, and sometimes serving as a transporter to get you to x-rays or CT scans. Another member of the cast of characters is the “registration clerk” who will collect your information (insurance, drivers license) during your stay. “Consultants” are other physicians you may meet during your stay, called upon for specific expertise, such as surgeons or dermatologists or neurologists. They will help the ER team make decisions, but often are not ultimately responsible for your care.
ER physicians and nurses tend to work fast, and they often forget to drop their ER-speak. Here’s some common terms you may hear: “dispo” means disposition, or whether you are going to be admitted to hospital or sent home — if you hear a nurse say “let me find Dr. Jones and find out your dispo” that’s what they mean. Often abbreviations are used with patients (inappropriately) to explain test results. If a resident says “good news, your CBC was normal” — they mean your “complete

hey, wait, that’s MY blood. Here’s a tube for a CBC.blood count”, a lab test that measures the number of white blood cells, red blood cells and platelets in a given volume of blood. If they say “we’re going to draw a BMP” — sometimes called a “Chem-7”, that means they are going to measure blood electrolytes (such as sodium and potassium). Another common ER blood testing term is “belly labs” — this means blood tests for the liver, gallbladder and pancreas. Another term that is often thrown out there to patients: “acute abdomen” — if a resident says “Mr. Adams, we are worried you have an acute abdomen”, that means they are worried you may have a sudden process in the abdomen often requiring surgery (conditions such as appendicitis or bowel obstruction are often considered “acute abdomens”). If a nurse says “I need to stick you again, Ms. Ramirez”, that means he or she needs to draw blood for another test. They may grab a “butterfly” to “stick you”; a butterfly is a form of needle to draw blood. If you are a family member, and someone tells you that your confused loved one (the patient) is “only A and O x 2” that means alert and oriented to only two criteria (the three criteria often used are person, (“tell me your name”), place (“where are we right now?”) and time (“what is the date today? what day of the week?”). Unfortunately, there are many more jargon terms, enough to fill a book, but hopefully this list of common ones may be useful as you interact with the ER team.

PRO TIP #1: when possible, go to the ER linked to your prior care

There is no universal electronic medical record in the US, unlike many other countries (a sad consequence of not having single-payer healthcare, although I suppose the two don’t have to go hand-in-hand). That means your ER team may not know about your prior heart attack, or your high blood pressure, or your usual asthma medications. Sometimes, such information is critical to your care. If you go to an ER at an unlinked health system, the staff may have no access to your medical records, and may end up duplicating many expensive (and possibly unnecessary) tests. So, if your primary care doctor is affiliated with a specific hospital, or you have recently hospitalized at a specific hospital, it is ideal to go to the ER at that hospital.
No matter where you end up going for emergency care, it’s best to assume that some records may not be in the computer system, and you can help yourself by bringing a few items along. A specific example where you can be a rock-star patient: if you ever get a routine ECG (electrocardiogram, electrical recording of your heart, often called a “12-lead ECG” or simply a “12-lead”), take a photo of your ECG with your phone and put it in your “favorites” — or if you’re old-fashioned like me, just make photocopies and bring one along to the ER). When you go to the ER with chest pain or difficulty breathing, showing the team your old ECG is a hugely helpful thing. Another example — if possible, keep handy any recent blood testing you may have had and similarly put your recent blood tests in your phone or on a folded sheet of paper in your purse or wallet. It could save loads of testing time in the ER, and possibly save you a hospitalization, if the abnormalities they find are actually your usual state. Always be ready to answer the question “are you allergic to any medications?” — putting your allergies on a card in your wallet can be lifesaving.

PRO TIP #2: make sure you have an exit strategy

ER visits tend to be long — expect to stay for hours. This means that sometimes a friend drives you there at 8 PM, but suddenly it’s 2 AM and you’re being sent home. Be sure to plan for a way home. Uber and Lyft have really changed the game for many patients going home from the ER; but if you don’t have the funds or the app, be sure to have a plan. A dear friend who would be sure to answer the phone at all hours and pick you up? A clear knowledge of bus or light rail routes? An emergency $20 for getting a taxi? Whatever your plan, realize you need one — ERs generally don’t provide services to get you home (in the ideal world, they should, in my opinion), so you need to be ready. In a real pinch (no funds, no ride, and it’s freezing cold outside), many ERs will take pity and allow you to stay in the waiting room until daytime or a ride can be found — ask them nicely, explain your predicament, and this might be a last-resort option for you.

PRO TIP #3: bring food or money for vending machines

Trust me. Because ER visits are long, you will get hungry and thirsty. If the ER staff thinks it’s safe for you to eat (corollary pro tip — always ask your ER team if you can eat before you chow down, there may be some snacks available for free in the ER itself (often apple juice, crackers, and sometimes lousy turkey sandwiches are available as ER fare) — but if you can, bring a preferred snack in your purse or backpack, or bring a bunch of quarters for the frequently overpriced vending machines endemic in ER waiting rooms (many don’t take bills, so bring coins). If you’re like me, a 2 AM snickers bar goes a long way towards keeping my despair levels down and my mental alertness up.

PRO TIP #4: bring something to pass the time

Not only will the long ER visit (sometimes 6-8 hours in the ER is common!) make you hungry, it will drive you bananas with boredom. So bring a book, or iPad, or stack of work, or a newspaper — bring something so that you’re not hostage to the crappy TV in the patient room which only picks up Three’s Company re-runs or informercials.

PRO TIP #5: most ERs have phone chargers

If you have an iPhone or common Galaxy model smart phone, and it’s dying in the ER with 2% charge, don’t despair. Most ERs have chargers for staff, and if you ask nicely, your primary nurse can either bring your phone to a charger and bring it back later, or bring a charger to you. This is often a well-kept secret for obvious reasons, but in a pinch, and again if you ask super nicely, they are likely to help you with this. Nothing worse with a dead phone at 2 AM when trying to get a ride home!

PRO TIP #6: get your test results before you go home

Similar to TIP#1, you need to make sure you have your records handy for follow-up visits. It is absolutely your right to the results from any lab or imaging tests. Before you are “dispo’d home” (discharged from the ER), be sure to ask for a print out of all of your lab tests, x-ray reports, etc. Don’t assume this will get to your other health care providers. When you see that specialist in follow-up, bringing the CT report or lab tests will be hugely helpful to expedite your care.

PRO TIP #7: it’s your right to be transferred to your hospital, when possible

Let’s say the ER diagnoses you with a minor stroke, and you’ve had strokes before with all of your care at another hospital that is in the same city as the ER in which you are receiving care. Or you have a bowel obstruction, and you had prior abdominal surgery at another hospital. Let’s also say they want to admit you to the hospital for this condition. You can always ask to be transferred to Hospital X (the place where you have received most of your care). This is common, and often leads to better medical care, but many patients or families don’t realize this is an option. The ER can arrange for an ambulance to take you to the other hospital where you can be admitted. The process is somewhat slow and paperwork-heavy, but it absolutely can be done.

CONCLUSIONS

The ER is a challenging place to receive medical care. There are many more pro tips I could share, but I should stop since this is quite a long diary already — I want to avoid “TL;DR” comments as much as possible. Please let me know if you found this helpful, or what you would like to hear about in future posts, or how I can improve my communication for next time. I’m thinking of doing the next blog on blood clots (pulmonary embolism and deep venous thrombosis). My goal is to serve as the “friendly neighborhood” ER doc to this wonderful community, and keep all of us as safe and healthy as possible so that we can work together to make a better and more progressive world.

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Mental Health First Aid Dec-8-2018

12/4/2018

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Mental Health First Aid
FREE 8-hour Course
Saturday, December 8, 2018
– 8:30am to 5:00pm
Merrill Gardens at Burien
15020 5th Ave SW
Burien, WA 98166
Gmap
CONTACT EMAIL
[email protected]
CONTACT PHONE (preferred)
206-999-5934

Use the Registration Form Below to Attend

Three courses are offered in December 2018

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Mental Health First Aid Jan-19-2019

11/28/2018

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Back by popular demand.

What:
Mental Health First Aid Training

When:
Saturday January 19th 2019, 8am-5pm

Where:
Southwest Precinct
Seattle Police Department
2300 SW Webster St, Seattle, WA 98106

Register:
Sue Wyder- (253) 426-5957 or [email protected]

Training provided by King County at no charge.

A person you know could be experiencing a mental health or substance abuse problem. Learn an action plan to help! You are more likely to encounter someone in an emotional or mental crisis than someone having a heart attack. Learn how to help a friend, family member, coworker or neighbor in need. Get trained in Mental Health First Aid.